The Influence of Instructional Media on Achievement: A Timeless Debate

Since the now infamous 1983 publication entitled “Reconsidering Research on Learning From Media,” written by Richard Clark, there has been considerable debate regarding the use of media in instructional design within the field of educational technology. In this article, Clark likened the role of media in learning to a delivery system, stating that, “media are ‘mere vehicles’ that deliver instruction but do not influence student achievement any more than the truck that delivers our groceries causes changes in our nutrition.” These statements were based upon the decades of empirical studies which, according to Clark, failed to demonstrate objective support of one media versus another in learning outcome. Clark’s publication was quite controversial. It stood starkly against the positions of other leading experts within the field of educational technology and cast doubt upon their efforts to establish the superiority of individual media and to discover the holy grail of technological media. The purpose of this white paper is to present both sides of this argument and explore its relevance to the use of instructional media/ technology in contemporary physical therapy teaching.

According to Clark, educational media are the mere vehicles in which educational content is delivered. Media has inherent attributes , which are symbol systems and provide “operational vehicles for methods that reflect the cognitive processes necessary to successfully perform a given task.” Media are distinct from educational methods in that any singular medium could potentially deliver educational content via various methods. In other words, it is the method that is the important quality relating to learning outcome; multiple media can execute a particular method. Although studies report superiority of one teaching medium over another, Clark concludes that in all cases, there was some confounding factor that resulted in the evidence of superiority, rather than there being true superiority of the medium. These include the novelty of the medium, the teaching methodology, or content differences. In his opinion, those differences are responsible for the benefits authors have erroneously attributed to the medium. To establish the superiority of a medium, the subject matter and method of instruction must be identical to compare apples with apples.

Clark (1983) concluded that instructors gain no specific advantage of employing one medium versus another. There is no compelling published or unpublished evidence of the benefit of using instructional media in producing learning increases (Clark, 1994). Clark’s position is that the primary debate on the choice of instructional media should be linked to cost-effectiveness rather than effectiveness when utilizing media. There may be ways that information is delivered that might be less expensive, delivered in a more timely manner, or delivered in a manner more cognitively efficient to the student than others. The attributes of certain media may be “more efficient for certain learners, learning goals, and tasks” (Clark, 1994). Therefore, the selection of media should be based upon the economy of teaching alone, as all other things are essentially equal.

In his 1994 article, Clark outlined what he believed to be the counterarguments held by his colleagues:

• Usual Uses: Clark acknowledged the position of his colleagues regarding the relationship between medium and method. Scholars such as Robert Kozma thought that media and method of instruction are inseparable. Therefore, it is not a practical argument to state that the medium does not impact the method. According to Kozma, method and media are indistinguishable, and therefore, an investigation that aims to distinguish them from one another is futile and consumes resources that would be better directed elsewhere. Kozma stated that researchers should not focus on the impact of media on learning but rather should aim to understand the relationship between media and learning (Kozma, 1994). Clark countered this counterargument, contending that the medium does not determine the method, such that media often have varied (and potentially unlimited, if considering the future potential of technology) functionality. Clark cited examples of the varied uses of individual media, which can be employed for multiple purposes within teaching methodology.

• Meta-Analytic Evidence: Another source of disagreement regarding Clark’s position pertained to published meta-analyses that summarized the available evidence about educational media at that time. These meta-analyses initially reported a benefit of computer-based instruction compared to live instruction but were later re-evaluated and the results nullified. Secondary data analysis revealed several confounding factors, casting doubt on the learning benefits resulting from individual media and ultimately reducing the strength of the statistical difference in outcomes between groups. Clark contended that the main confounding factor related to the lack of control is regarding the teaching method (1994). But another opponent, Jack Koumi, justified the lack of statistically significant difference between groups in another way. He retorted that the main reason for the lack of empirical support for the superiority of specific media was related instead to high variability within the qualities of students and low production quality of the media. Echoing Kozma, Koumi (1994) stated that individual differences in learning styles or attitudes could interact with media to obscure or confound the learning benefits.

• Empiricism Envy: Clark highlights the view of Cunningham (1986), stating that although Cunningham did not refute his claim that media do not affect learning, he argued against Clark’s “empirically-based claims that instructional methods were responsible for achievement gains.” Clark acknowledged that his claim was hypothetical rather than a conclusion proven through empirical study, and therefore Cunningham’s argument was not valid (1994).

• Necessary Media Attributes: Clark highlighted another point of contention within the debate related to the use of instructional media related to media attributes. Kozma (1994) described that media possess certain qualities that make them more-or less suitable for delivering different educational content. Kozma followed the lead of Solomon, who described that media have unique attributes, which make unique cognitive representations available when using them. These relate to the technology, symbol system(s), and processing capabilities of the medium (Clair, 1979). Kozma (1994) accused Clark of creating an “unnecessary and undesirable schism” between method and medium. Clark (1994) countered this argument, contending that “no one media attribute has a unique cognitive effect” and provided examples to demonstrate that multiple media can be used to accomplish the same effect.Koumi (1994) and Kozma (1994) agreed that future studies should focus on interactions between content and the use of media to enhance the student’s learning and experience.

As technology continues to develop and evolve, the question remains regarding the most effective and efficient manner in which to educate developing physical therapists and patients alike. Within physical therapy curricula, instructors continue to search for ways to provide engaging and informative content for their students. The movement within physical therapy education away from undergraduate- and toward graduate-level programs has contributed to the demand for increased sophistication of educational experiences for students. Today’s student has grown up in a high-technology world and demands technologically advanced modalities for learning in a way that previous generations have not. The modern healthcare climate includes the use of high-tech resources (online exercise prescription, electronic medical recordkeeping, digital communication, for example) for which we must prepare students. Therefore, it is imperative to select educational interventions which meet the needs of all stakeholders.

Due to the COVID-19 pandemic, physical therapists have been challenged to utilize technology in novel ways to accomplish our physical therapy interventions for patients, and educational interventions for students, in ways they had not previously. Remote learning within physical therapy programs and the rise of the use of telemedicine as a method of delivering healthcare have created limitations and opportunities regarding how content is delivered. In the absence of inperson interaction, traditional teaching methods have had to be placed aside instead of novel methods. Out of necessity, therapists have been challenged to consider and include a more comprehensive array of resources to accomplish the same objectives differently.

With a seemingly limitless selection of media to include in educational interventions with students and patients, it is crucial to remain focused on both the content of our educational initiatives and the method in which the content is delivered. While there may be practical advantages of selecting one medium versus another, it is essential not to confuse those advantages as attributable to the medium itself. Conceptualizing learning in this way enables instructors to achieve the same goals in various ways, which opens the door to the creation of educational experiences that can be customized to the situation and the learner considering the available resources. Today’s healthcare consumers may favor telemedicine over traditional in-person healthcare (Nguyen et al., 2020). Students have been found to have a high level of satisfaction with digital, social, and mobile technologies within their healthcare educational program (Curran et al., 2017) In light of the favorable consumer (patient and student) satisfaction with these novel delivery methods, it behooves teachers to incorporate these novel media into their approach.

Susan Camillieri, Program Manager, Physical Therapy, RUSK Rehabilitation, NYU Langone Orthopedic Hospital, 301 East 17th Street, New York, NY 10003. Adjunct Assistant Professor, Program in Physical Therapy, The College of Staten Island, 2800 Victory Boulevard, Staten Island, NY 10309.