Exploring the potential of the 3 ‘O’s learning model – An action research for Continuous Professional Distance Education (CPDE) Education Intervention Proposal 2010 -2014 Gurmit Singh, M.Ed

48 T utors 3-4 tutors per LC (team-teaching + P2P OM) 6 Collaborating Teacher-researchers 12 6+6 6 Pairs (team-teaching) 12 T utors + 108 members PHASES 1 2 3 4 July ’10- July ’11 July ’11- July ’ 12 July ’12- July ’13 July ‘13 -July ’14 The 3 ‘O’s A 4-year action research project 1 W + 1 LC 3 W + 3 LC 9 W + 9 LC TBD Course 1 3 courses 9 courses (2 new, 1 P1) (4 P1&P2, 5 new) PARTICIPANTS: Tutors + 12 Fellows + 1 (subject matter experts) Researcher From Partner Agencies 1 Tutor + 12 Fellows 3 Tutors + 36 members (+ p2p OM) KEY: W = Workshops LC = online learning community of practice P2P OM = peer to peer online mentoring

Proposal – implement sustainable scalable systemic interventions To develop health professionals research capacity to improve practice for improved patient outcomes & for more effective impact on the AIDS response by delivering Strategic Goals

My brief as an health professional education programmes designer: How might we improve professionals’ access to education, transfer of knowledge & skills to do programme research, and transform one-off injections such as conferences & workshops so that they reflect the shift toward continuous learning, improve professionals’ engagement, and organizational/NGOs effectiveness as learning providers to build research capacity across time & distance?

How might we improve professionals’ access to education, transfer of knowledge & skills to do programme research, and transform one-off injections such as conferences & workshops so that they reflect the shift toward continuous learning, improve professionals’ engagement, and organizational/NGOs effectiveness as learning providers to build research capacity across time & distance?

Challenge Statement Traditional education models have a limited effectiveness on health professionals’ continuous development because of the limited effectiveness of one-off injections such as workshops and conferences based on input with no resources for follow-up This is also a general tendency of the whole health professionals’ education system, especially in resource-limited settings with low research capacity & traditional paradigm  Challenge is to improve our organizational effectiveness as education providers that can meet professional learning needs sustainably & scalably

Traditional education models have a limited effectiveness on health professionals’ continuous development because of the limited effectiveness of one-off injections such as workshops and conferences based on input with no resources for follow-up

This is also a general tendency of the whole health professionals’ education system, especially in resource-limited settings with low research capacity & traditional paradigm

 Challenge is to improve our organizational effectiveness as education providers that can meet professional learning needs sustainably & scalably

Continuous Professional Education (as opposed to Training) What can we say about learning in the 21 st century?

Sustainable Knowledge & Skills Transfer ? Evidence-based medicine is contingent upon effective transfer of knowledge and skills to improve practice & health outcomes by practitioners doing research on their programmes. Issuing and disseminating toolkits, guidelines and best practices is ineffective because they are often not implemented or followed-up. The conceptions of knowledge and skills as situated, tacit, and practice-based also indicate one-off injections are no longer valid in the new net-world of learning stored in connected networks. Learning is now understood as actionable & applied knowledge, that is situated in rich learning ecologies, collaborative, contingent, apprenticed, reflective, socially constructed through dialogue for problem-solving in context.  How can one-off conferences & workshops possibly sustain the transfer of learning to improve practice without overcoming the constraints of time & distance?

Evidence-based medicine is contingent upon effective transfer of knowledge and skills to improve practice & health outcomes by practitioners doing research on their programmes.

Issuing and disseminating toolkits, guidelines and best practices is ineffective because they are often not implemented or followed-up.

The conceptions of knowledge and skills as situated, tacit, and practice-based also indicate one-off injections are no longer valid in the new net-world of learning stored in connected networks.

Learning is now understood as actionable & applied knowledge, that is situated in rich learning ecologies, collaborative, contingent, apprenticed, reflective, socially constructed through dialogue for problem-solving in context.

 How can one-off conferences & workshops possibly sustain the transfer of learning to improve practice without overcoming the constraints of time & distance?

Who are the audience? Primarily clinicians & researchers Large % from the global South What is the vision for them? To build a worldwide force working together to fight HIV/AIDS and improve health for all What do health systems need ? More flexible, self-confident health professionals who are lifelong learners ‘ About 70% of professional learning is self-directed” (Cross, 1991)

Who are the audience?

Primarily clinicians & researchers

Large % from the global South

What is the vision for them?

To build a worldwide force working together to fight HIV/AIDS and improve health for all

What do health systems need ?

More flexible, self-confident health professionals who are lifelong learners

‘ About 70% of professional learning is self-directed” (Cross, 1991)

The NEED: Why focus on Health Professionals Education now? Lack of skilled Health Professionals is an obstacle to achieving Universal Access/MDGs Health Systems Strengthening – health workforce development is a key building block Current education systems are not transferring skills to improve performance Existing solutions to capacity building are obsolete economically & pedagogically Technology plays an increasing role – MIT OCW, WikiEducator OER, Virtual Global Health Conference, MSH Virtual Forums, Oncology CoP, World Bank & Rockeffeller Foundation virtual project teams for innovative global problem-solving The search is on for scalable solutions across health & education fields  Recommend move to more systemic and sustainable Interventions, not 1-off workshops

Lack of skilled Health Professionals is an obstacle to achieving Universal Access/MDGs

Health Systems Strengthening – health workforce development is a key building block

Current education systems are not transferring skills to improve performance

Existing solutions to capacity building are obsolete economically & pedagogically

Technology plays an increasing role – MIT OCW, WikiEducator OER, Virtual Global Health Conference, MSH Virtual Forums, Oncology CoP, World Bank & Rockeffeller Foundation virtual project teams for innovative global problem-solving

The search is on for scalable solutions across health & education fields

 Recommend move to more systemic and sustainable Interventions, not 1-off workshops

Other important factors to consider Workshops where only 26% of participants learn a skill are not a good return on investment due to lack of effectiveness of transfer (K, S, A) to improve practice & patient health outcomes President Obama wants PEPFAR to train 140,000 health workers to scale-up treatment access by 2012 Students say in surveys that they want more access to quicker, personalised, self-directed, flexible learning opportunities at their own pace Effective education programmes require participation of learners in design & thinking, rather than current subject matter experts alone doing the curriculum with little thought for transfer & application New initiatives are moving towards sustainable learning by doing to build research capacity– Lung Union, CDC, Wellcome Trust Pressures to respond to climate change movement & reduce the carbon footprint of conferences

Workshops where only 26% of participants learn a skill are not a good return on investment due to lack of effectiveness of transfer (K, S, A) to improve practice & patient health outcomes

President Obama wants PEPFAR to train 140,000 health workers to scale-up treatment access by 2012

Students say in surveys that they want more access to quicker, personalised, self-directed, flexible learning opportunities at their own pace

Effective education programmes require participation of learners in design & thinking, rather than current subject matter experts alone doing the curriculum with little thought for transfer & application

New initiatives are moving towards sustainable learning by doing to build research capacity– Lung Union, CDC, Wellcome Trust

Pressures to respond to climate change movement & reduce the carbon footprint of conferences

Changing Concept of Health Professional Education Old CME New CPDE Setting Hospital/University At Practice & at a distance Framework Diplomas E-Portfolios Delivery Lectures Discussion, case-studies, problem-based learning. IT, blend Strengths Wise man on stage Relevance to practice, facilitator/mentor Availability One-off, random, not customised Internet, journals, flexible, personalised Pedagogy Didactic expert Constructivist, social & informal

What about technology? Web-based distance & flexible learning means we can reach more participants to further continue education beyond one-off conference workshops E-learning, m-learning, e-health, m-health offer opportunities to reach hard-to-reach professionals who find it difficult to attend workshops or conferences Health professionals digital literacy needs & skills building are a priority in 21 st century Some have begun to move in this direction – e-mentoring, online communities, repositories, etc.

Web-based distance & flexible learning means we can reach more participants to further continue education beyond one-off conference workshops

E-learning, m-learning, e-health, m-health offer opportunities to reach hard-to-reach professionals who find it difficult to attend workshops or conferences

Health professionals digital literacy needs & skills building are a priority in 21 st century

Some have begun to move in this direction –

e-mentoring, online communities, repositories, etc.

What now? Educators can make a difference How? Paying attention to issues of pedagogical design Framing education around policy priorities, essential questions where research & capacity gap exists, strategic goals and objectives related to on-going and summative assessment of members learning Using e-learning to sustain transfer of Knowledge & Skills to improve performance across distance Leverage health conference workshops programme to scale

How?

Paying attention to issues of pedagogical design

Framing education around policy priorities, essential questions where research & capacity gap exists, strategic goals and objectives related to on-going and summative assessment of members learning

Using e-learning to sustain transfer of Knowledge & Skills to improve performance across distance

Leverage health conference workshops programme to scale

The Solution: A New Approach The 3 ‘O’s A Learning Model to Transform HIV/Health Conferences & Workshops into Continuous Professional Distance Education Onsite, Online, Ongoing

The 3 ‘O’s

A Learning Model to Transform

HIV/Health Conferences & Workshops into

Continuous Professional Distance Education

Onsite, Online, Ongoing

An Intervention Proposal We propose an educational intervention focused on developing health professionals’ research capacity & in CPDE based on the 3 ‘O’s learning model With change management action research around this pilot innovation to test Effectiveness of this model

We propose an educational intervention focused on developing health professionals’ research capacity & in CPDE

based on

the 3 ‘O’s learning model

With change management action research around this pilot innovation

to test

Effectiveness of this model

Project Design: Goals To build professionals’ capacity for CPDE To enrich health professionals & researchers culture as a global learning community To improve professional engagement through continuous learning communities beyond workshops To optimize knowledge & skills transfer To integrate IT strategically into education programmes & capacity building

To build professionals’ capacity for CPDE

To enrich health professionals & researchers culture as a global learning community

To improve professional engagement through continuous learning communities beyond workshops

To optimize knowledge & skills transfer

To integrate IT strategically into education programmes & capacity building

Project Design: Phases 4-year research project in 4 phases

4-year research project in 4 phases

48 T utors 3-4 tutors per LC (team-teaching + P2P OM) 6 Collaborating Teacher-researchers 12 6+6 6 Pairs (team-teaching) 12 T utors + 108 members PHASES 1 2 3 4 July ’10- July ’11 July ’11- July ’ 12 July ’12- July ’13 July ‘13 -July ’14 The 3 ‘O’s A 4-year action research project 1 W + 1 LC 3 W + 3 LC 9 W + 9 LC TBD Course 1 3 courses 9 courses (2 new, 1 P1) (4 P1&P2, 5 new) PARTICIPANTS: Tutors + 12 Fellows + 1 (subject matter experts) Researcher From Partner Agencies 1 Tutor + 12 Fellows 3 Tutors + 36 members (+ p2p OM) KEY: W = Workshops LC = online learning community of practice P2P OM = peer to peer online mentoring

Learn “Topic” in Workshop (1-2 days) Select 12 Health/research Professional Fellows (Needs Assessment) Collaborative planning with tutors/partners/pps for Phase 2. Collect data from ongoing practice & S hare, build online Learning Community Phase 1 Learn how to connect & learn online Try out Social Networking The 3 ‘O’s example at AIDS 2010 & beyond

How to manage risk? Do it as a change management action research pilot project Use a conceptual model from Leeds University School of Education called EMAR Gradual evolution & orderly progress to ensure stakeholder consultation & members ownership & buy-in over time Conduct communications & policy around this innovation to change HIV health professional education practice

Do it as a change management action research pilot project

Use a conceptual model from Leeds University School of Education called EMAR

Gradual evolution & orderly progress to ensure stakeholder consultation & members ownership & buy-in over time

Conduct communications & policy around this innovation to change HIV health professional education practice

The EMAR Model to Manage Organizational Change: Learning By Doing Philosophy Learning Model – 3 ‘O’s Pedagogical Tactics Pedagogical Strategy Task s Programme Learning Activities Learning Outcomes Course and Programme Evaluation Organisational Context – e.g. conferences Action Taking Action Planning Action Evaluation Pedagogic Model Educational Setting – Workshops & Learning Communities

Who? In Y1, In order to establish proof of concept, the 3 ‘O’s should be initially piloted with a group of 12 Research Professional fellows, through a competitive open application process, which is a great marketing opportunity, and will make people really excited about learning by doing. An Advisory Group of research experts to collaborate in programme design and implementation. Partner agencies & universities can be drawn in gradually

In Y1, In order to establish proof of concept, the

3 ‘O’s should be initially piloted with a group of 12 Research Professional fellows, through a competitive open application process, which is a great marketing opportunity, and will make people really excited about learning by doing.

An Advisory Group of research experts to collaborate in programme design and implementation.

Partner agencies & universities can be drawn in gradually

When? Timeline & Scope Over 3-4 years Year 1 – CPDE for for 1 topic (e.g. Operations Research) as proof of concept Year 2 – supervising 3 new tutors for 3 new focus areas Year 3 – those 3 plus 3 they train (4)- so we have 12 focus areas – imagine the scale of that!

Over 3-4 years

Year 1 – CPDE for for 1 topic (e.g. Operations Research) as proof of concept

Year 2 – supervising 3 new tutors for 3 new focus areas

Year 3 – those 3 plus 3 they train (4)- so we have 12 focus areas – imagine the scale of that!

Where? Follow 1 cohort over 3 years with Face-2-Face workshops Sustained with online learning community with mentors & social networking (blogs, wikis, mobile) as they learn to communicate, publish and influence policy change Action evaluation of ongoing improvements in practice

Follow 1 cohort over 3 years with Face-2-Face workshops

Sustained with online learning community with mentors & social networking (blogs, wikis, mobile) as they learn to communicate, publish and influence policy change

Action evaluation of ongoing improvements in practice

Key research question to investigate during the pilot: “ Could a CPDE Approach to Educational Practice, based around the International AIDS Conferences, with a 3‘O’s model - Onsite, Online and Ongoing – improve the effectiveness of health Professionals as programme operations researchers by strengthening the impact and delivery of research capacity building programmes?”

“ Could a CPDE Approach to Educational Practice, based around the International AIDS Conferences, with a 3‘O’s model - Onsite, Online and Ongoing – improve the effectiveness of health Professionals as programme operations researchers by strengthening the impact and delivery of research capacity building programmes?”

Specific research questions: Does the 3 ‘O’s model: 1. Lead to an increase in the knowledge, skills and awareness of medical, public health, and scientific research professionals who participate in these workshops? (Onsite) 2. Enable participants to realise the key objectives of NGOs by encouraging engagement in ongoing web-based professional development, thus increasing their capacity to connect, contribute and collaborate, as well as to expand individual knowledge and skills? (Online) 3. Assist participants to develop research projects and strategies for advocating, introducing and implementing effective, sustainable and scalable evidence-based health interventions in their home regions, countries, and communities? (Ongoing)

Does the 3 ‘O’s model:

1. Lead to an increase in the knowledge, skills and awareness of medical, public health, and scientific research professionals who participate in these workshops? (Onsite)

2. Enable participants to realise the key objectives of NGOs by encouraging engagement in ongoing web-based professional development, thus increasing their capacity to connect, contribute and collaborate, as well as to expand individual knowledge and skills? (Online)

3. Assist participants to develop research projects and strategies for advocating, introducing and implementing effective, sustainable and scalable evidence-based health interventions in their home regions, countries, and communities? (Ongoing)

What’s in it for participants? Get support in Distance learning with Web 2.0 technologies Clinical programme management Research skills Improving self-paced practical skills building through participation in learning communities Credits towards CPDE Grow to become health professional leaders in improving practice to cascade to their peers

Get support in

Distance learning with Web 2.0 technologies

Clinical programme management

Research skills

Improving self-paced practical skills building through participation in learning communities

Credits towards CPDE

Grow to become health professional leaders in improving practice to cascade to their peers

What’s in it for faculty? Get support in transition to e-learning Planning, design & delivery Online mentoring & tutoring skills Improving their learning and engagement as educators through action research Pride & satisfaction as 21 st century health educators Grow to become educational leaders in curriculum and pedagogical design for CPDE Increase loyalty to NGOs

Get support in transition to e-learning

Planning, design & delivery

Online mentoring & tutoring skills

Improving their learning and engagement as educators through action research

Pride & satisfaction as 21 st century health educators

Grow to become educational leaders in curriculum and pedagogical design for CPDE

Increase loyalty to NGOs

What’s in it for the NGO Deepen participants’ engagement in developing their own learning solutions through participatory collaboration framework Deliver strategic plan goals Harness technology & new media intelligently by building e-learning competence among participants/target audiences Innovate to take your research capacity building initiatives into the 21 st century Build partnerships with top-notch academic partners Play a leadership role in health professional education compared to your competitors Improve organization educational effectiveness for sustainable impact on professional practice Higher return from investment in education than one-off workshops Deepen staff & stakeholders ownership of organizational strategy Align & cohere research, programme & policy areas

Deepen participants’ engagement in developing their own learning solutions through participatory collaboration framework

Deliver strategic plan goals

Harness technology & new media intelligently by building

e-learning competence among participants/target audiences

Innovate to take your research capacity building initiatives into the 21 st century

Build partnerships with top-notch academic partners

Play a leadership role in health professional education compared to your competitors

Improve organization educational effectiveness for sustainable impact on professional practice

Higher return from investment in education than one-off workshops

Deepen staff & stakeholders ownership of organizational strategy

Align & cohere research, programme & policy areas

Other spin-off benefits Develop a new ICT in Health Education Module, get it accredited with UK/US university as a CPDE programme for clinicians & program managers Replicate in African universities (Ethiopia, S o uth Africa, Malawi, Uganda, etc.) through CPDE Partnerships Provide consultancy to build research capacity of regional partners as we improve the 3 ‘O’s model & share our lessons from pilot

Develop a new ICT in Health Education Module, get it accredited with UK/US university as a CPDE programme for clinicians & program managers

Replicate in African universities (Ethiopia, S o uth Africa, Malawi, Uganda, etc.) through CPDE Partnerships

Provide consultancy to build research capacity of regional partners as we improve the 3 ‘O’s model & share our lessons from pilot

Summary With the 3 ‘O’s, you can: Address the problem of transfer of knowledge & skills Improve conference & workshops learning experience for participants by enabling & equipping rapid knowledge sharing & skills development on-the-job, practice-relevant, at distance, continuously Develop economic viability of organization through better product design Solve health systems problem & create a world-changing innovation as a social enterprise Imagine an integrated global health professionals education system Initiate policy & advocacy activities to promote a new way of professional learning to realise Universal Access In times of change, the 3 ‘O’s is an innovation for new problems that transform how we currently educate ourselves

Address the problem of transfer of knowledge & skills

Improve conference & workshops learning experience for participants by enabling & equipping rapid knowledge sharing & skills development on-the-job, practice-relevant, at distance, continuously

Develop economic viability of organization through better product design

Solve health systems problem & create a world-changing innovation as a social enterprise

Imagine an integrated global health professionals education system

Initiate policy & advocacy activities to promote a new way of professional learning to realise Universal Access

In times of change, the 3 ‘O’s is an innovation for new problems that transform how we currently educate ourselves

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