DIFFERENCES IN ATTITUDES TOWARDS COMPUTER BASED TRAINING AND COURSE RETENTION BASED ON PUSH AND PULL DELIVERY MODES Ananda Mitra, Suchi Joshi, Kathi Kemper Wake Forest University, Winston-Salem, NC 27106 USA This work was supported by NIH grant R01 LM007709 from the NIH National Library of Medicine and by the Fullerton Foundation of Gaffney, South Carolina. ABSTRACT This paper reports on the differences between attitudes towards technology and student retention in a Web-based healthcare continuing education course that was delivered using both the push and pull technologies. Including nearly 1500 participants the course lasted for about 4 months and the results indicate that overall retention rate was at 64% with no significant difference between retention based on the mode of delivery. There were differences in attitudes towards computers and self-reported computer proficiency between the completers and non-completers with the completers reporting a lower comfort level with computers as well as lower proficiency. KEYWORDS Push, Pull, Retention, Computer Attitude, Proficiency 1. TECHNOLOGY USE BY MEDICAL PROFESSIONALS This study focuses on the attitudes toward technology among healthcare professionals enrolled in an on-line curriculum about herbal medicine. Many of these medical professionals are not students in the traditional sense; they have completed their academic studies and no longer reside within an academic institution. Furthermore, recent graduates used technology in their education. For example, senior level students in a 1998 baccalaureate nursing program surveyed before and after being exposed to various learning activities that required interaction with computer technology demonstrated increased comfort after the implementation of computer-based learning activities throughout the semester (Draude & McKinney, 1998). Similarly, nursing students' and faculty perceptions about computer-based instruction (CBI) were identified and examined from the standpoint of adult continuing education and program planning. Key findings revealed that CBI was helpful in learning and applying theory, but it was not helpful in developing nursing skills because it lacked hands-on activities (Leski, 2000). A survey of distance technology use in American Association of Colleges of Nursing (AACN) member schools revealed that distance course offerings were more accelerated in public than private institutions. Budget, time, and staff training were the chief barriers to distance technology use (Potempa et. al., 2001). Students in medicine, such as those at McGill Medical School, have also participated in online, multimedia-enhanced, undergraduate medical curriculum. Pedagogical values included the ability to use media to implement adult learning principles such as learner-centered, self-directed, and guided learning; the inherent interactivity of the technology; and the potential of the technology to provide a powerful means for fostering forms of "termless" learning that students will need to practice medicine (Fleiszer & Posel, 2003). Medical students at the University of Missouri have also been involved in computer-based learning. Many students easily became independent users of MEDLINE, a computerized literature retrieval system, and previous computer use was not related to effective MEDLINE use (Mitchell, 1990). Residents