Open learning: the state of the art in nursing and midwifery.

In this paper the authors examine the differences between open and distance learning and describe a framework based on the two dimensions of contiguity and openness to identify four 'ideal type' teaching situations. In the second part of the paper, recent developments in higher education are summarised and the shift towards increased flexibility of education provision is highlighted. Finally, it is argued that alongside the debate about definitions and educational philosophies, there is an urgent need to evaluate the effectiveness of open and distance learning systems. Personal beliefs and assertions about the benefits of open/distance learning need to be replaced by sound evidence.