LINDA:  And then I was personally interested in a few other elements of training.  One is that we had in YKHC area, we have 100 -- at that time about 160, 180 health aides, and if we can only have 6 to 8 or 12 in a session, that isn't very efficient, and how could we -- and what we found is we could increase our class size, but there is a point which you can't, you still need that one-on-one.  So you can't grow the classes too large. 

But I thought, well, how can we start to do training a little differently, instead of sitting in class, could they learn this information by distance.  And then come to Bethel for clinic. 

So in the late '80s, through support from the corporation, we bought computers and we started -- it was -- the network, the system was called Optel, and it required two phone lines in the clinic, and we took computers out to six villages.  And in 1989, this was pretty revolutionary. 

And we taught -- we -- at that time, there were three sessions instead of four, the curriculum was expanding and it's four sessions, but we taught Session 3 by Optel, which was a system that allowed you to have a picture on the screen and it gave you where each student could then respond back, and there could be different color codes. 

It was really quite sophisticated at the time.  And we could teach the theory by distance and instead of being away from home for four weeks for training, they would be away from home for two weeks. 

And that -- we did that program through the campus very successfully for about three years, and then the program moved, as I said, moved to YKHC in 1993. 

Teaching by distance always sounds -- plusses and minuses.  It actually takes more time and energy to prepare materials and teach by distance than it is to stand up in class and present the same information.  You have to be very prepared for distance.  And everything has, you know, to be organized in sort of a different way.  So -- and you also have to believe in it as a method. 

And so the program lasted at the corporation only a few years, and the fun thing is that 10 years later, we're now recreating that.  And through the whole network of computers, we are now looking at distance education for the basic training as an element of expanding opportunity to be in a training session. 

And I think within a few years we will see a very active theoretical component by distance and then the hands-on clinical.  The difficulty is that you really do need to marry those together at the same time, and how do you choose what will be taught by distance and what really needs to be hands on. 

So it's going to be -- it's really an exciting time to watch the evolution of this now.  The buzz word on that, you know, the educational synonym is called blended education, where you have the computer element, the materials, the hands on, probably some clinic visits, and then into the training center. 

So it's going to be really interesting to watch that, but I think it really will increase efficiency.  And the difficulty with training now is it can take two, two and a half, three years to get through those four sessions.
 
And the element of attrition for this program has always concerned me.