Health OER intro to SPHMMC Ethiopia


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Presentation by Kathleen Ludewig Omollo on April 26, 2012 to St Paul Hospital Millennium Medical College in Addis Ababa.

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  • This is where open licenses address the gaps in our current system.   As content creators, you take more control over how you want others to use and share your materials and you help other people do this by giving them permission ahead of time.   Open sharing practices encourage the cycle of creativity, learning and ultimately innovation by allowing others to legally build upon each other’s work.   In this way, we allow others to take control over the way they learn and what they learn, curating their own collections of materials and adapting those materials to suit their needs. Licensing provides even more opportunities for sharing and for using these materials in a variety of settings outside of the protected 4 walls of closed education systems allows for teaching and learning to happen formally and informally. Creative Commons are the most used licenses for content but there are software licenses (GNU) that can be used. Share online legally, throughout the world Choose how you would like to share Many of the license allow for adaptation You can choose how you want to share and easily show others how they can use your work. You take an active step toward sharing and making your materials more useful to others. “ Realizing the full potential of the internet — universal access to research, education, full participation in culture, and driving a new era of development, growth, and productivity.” ~ Creative Commons mission
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  • Presenter: Kathleen The Network began in mid 2008 at a workshop that included 27 participants from across Africa, who gathered to discuss the relevance and potential of OER to advance health education on the continent. During that initial workshop, the participants identified existing challenges to health education in Africa. Those challenges vary by country but generally include: - Low government budget for health Low health worker to population ratio, with disproportionate concentration of health professionals in urban areas High disease burden, particularly among infectious diseases Scarce, aging, and emigrating lecturers for basic sciences Demand for higher education in Africa has increased substantially over the past several decades. There are not enough instructors or physical classroom spaces to meet demand. For example, in Ghana, the national government aims to triple the number of healthcare workers, but the Ghanaian medical schools can only admit one-third of qualified applicants due to limited faculty size. Additionally, the existing instructors often must balance heavy of workloads research, service, and administrative duties with repetitive instructional responsibilities across the expanding enrollment
  • Presenter: Kathleen Another challenge in some of the universities is crowded lab demonstrations and clinical demonstrations in teaching hospitals. These crowded and often noisy conditions limit student’s ability to see, hear, or ask questions.
  • Presenter: Kathleen Lastly, another barrier that we realized was often overlooked was a lack of contextually appropriate instructional materials. Many of the most widely used textbooks and medical videos used worldwide are from European or U.S. publishers. This means that the books may promote different processes, have different cultural influences and practices, neglect tropical diseases, and rely more heavily on expensive tests and equipment to guide diagnoses compared to how those same topics would be taught by in African countries. Additionally, those textbooks often use images of Caucasian patients, which may occasionally be problematic. For example, certain dermatological diseases may manifest themselves differently in dark compared to light skin.
  • The 2008 workshop included participants from ten African universities and institutes, three foundations, and one U.S. university. A subset of those institutions formed the partnership that would later become the African Health OER Network. Founding African health science schools include University of Cape Town, University of the Western Cape, Kwame Nkrumah University of Science and Technology (KNUST for short), and the University of Ghana. The Network is co-facilitated by the South African Institute for Distance Education and the University of Michigan. Other partners added since 2008 include University of Malawi, University of Botswana, EBW Healthcare in South Africa, the East Africa HEALTH Alliance of 7 schools of public health, and the Global Health Informatics Partnership. One of our goals is strategically draw in more African and, eventually, global participants, while developing models of collaboration and sustainability that can be replicated in other regions of the world.
  • The approach that we’ve taken is four-fold. First, we strive to gather relevant existing OER. Then we train individuals how to adapt those materials as well as to create new materials if there no existing suitable materials. Then we distribute the materials as widely as possible through a variety of websites as well as offline methods such as sampler DVDs or external hard drive. Lastly, and perhaps most importantly, we try to facilitate dialogue around health education, quality assurance and instructional design of materials, and institutional OER practices and policies. The dialogue is essential, as we view Open Licenses as a means to streamlining education, not an end in itself.
  • Challenge: Both universities had nascent e-learning activities prior to engaging with OER, but many lecturers still relied on low-tech delivery methods, such as, paper notes, dry-erase boards, and PowerPoint slides. Physicians have many strains on their time, and while doctors can provide content, they rarely possess acute technological skill. Training doctors to be experts in multimedia production would be an expensive and inefficient use of their time. Thus, both universities sought alternatives to relieve the health educators of doing technical production . At KNUST in Ghana, the health OER initiative found expertise within the university in the College of Art. In the Department of Communication Design, recent graduates or final-students working on their capstone projects assist lectures with photos, videos, sound, and packaging for the learning modules . The Department of sculpture has also been involved in shaping 3-D sculptures of the top and bottom of the brain in order to converted to electronic 3D representation to teach about the central nervous system. University of Ghana adopted a similar approach, but hired out the university. They hired a media specialist who worked in the commercial film and television industry in Accra, a database specialist, and a graphic artist specializing in 3D animation.
  • Challenge: Each institution chose to focus its OER production on clinical videos and laboratory procedures since those are the most difficult to see up close in large classes. Many of the clinical videos require filming of patients. In those cases, obtaining informed consent and upholding patient privacy are essential. KNUST and UG each have affiliated teaching hospitals, and it is expected that large groups of students will be shadowing physicians on ward rounds. At the outset of the projects, though, neither hospital nor university had existing consent forms or even informal accepted standards that would permit patient recordings for any use other than internal viewing among hospital staff. Each university had to therefore develop new practices for informed consent and request explicit permission to record. At University of Ghana, physicians opted to create a formal, written consent form for patients to sign. At KNUST, they currently rely primarily on oral permission but are currently exploring adapting University of Ghana ’ s written patient consent form for their OER productions .
  • Presenter: Kathleen Here are some of our preliminary results, over 160 people trained, 115 authors spanning 12 institutions, 135 learning modules. The vast majority of our materials are in English, since that was the common language among the founding partners. We do, however, have one bilingual English-Portuguese gynecology guide from Mozambique and a resource from University of Cape Town was translated from English into Spanish for the Journal of Occupational Therapy of Galicia. Our demonstration videos and animations have been especially popular on YouTube, with over 860,000 views in approximately 15 months.
  • Speaking of YouTube, we have over 175 comments on our videos. This is a visualization of word frequency from our comments. You can see that among the most common words are thanks, thank you, and understand.
  • Example of module that built upon existing OER
  • Article that was translated from Eng
  • We offer a number of opportunities for health educators and support staff to interact. We have three communities, each consisting of an audio conference every 2-3 months with a complementary mailing list. There’s a community for senior leaders, such as heads of departments. There’s one for multimedia and technology specialists. Lastly, there’s a third called dScribe, named for a distributed OER publishing model developed by University of Michigan. During that call, we discuss copyright education and clearance, as well as methods to engage students as producers and advocates of OER. We also coordinate a quarterly newsletter, which is sent to approximately 1000 email subscribers worldwide.
  • When creating new learning materials… Start now by making a small change in how you create your own content.
  • We build upon the work of others and make use of content whose rights are held by individuals, corporations, and organizations around the world. Respecting the copyright of those who we borrow and build from is an essential component of strengthening the culture of sharing. Why don’t we include seeking permission? That is only advisable if you have a connection to the author, as you can spend months waiting on permission.
  • Here is my email address if you would like learn more about the project. We also brought some handouts with us as well as some sampler DVDs of the learning modules from African universities.
  • Health OER intro to SPHMMC Ethiopia

    1. 1. Introduction to Open Educational Resources for Health Training Kathleen Ludewig Omollo International Program ManagerUniversity of Michigan Medical School Office of Enabling Tech. April 26, 2012 – St. Paul Hospital Millennium Medical College Slides at: Except where otherwise noted, this work is available under a Creative Commons Attribution 3.0 License( Copyright 2012 The Regents of the University of Michigan. Cover image CC:BY-SA Jessica Duensing (Flickr) 1
    2. 2. 2PATH•Copyright Trivia•What is “Open”?•Example: African Health Open Educational Resources(OER) Network•How to Create Your Own OER•Discussion: OER for Ob/Gyn at SPHMMC Image CC:BY-NC-SA werkunz (Flickr)
    3. 3. Image CC:BY gmahender (Flickr) 3
    4. 4. What rights are included in copyright?(hint: there are 5) Image CC:BY Ute Hagen (Flickr) 4
    5. 5. Copyright holders have the exclusive right to do andto authorize others to do the following:3. Reproduce the work in whole or in part4. Prepare derivative works, such as translations,dramatizations, and musical arrangements5. Distribute copies of the work by sale, gift, rental, orloan6. Publicly display the work7. Publicly perform the work 5
    6. 6. Under © it is illegal to:•Translate works (derivative)•Copy someone else’s photo, slides, report, orother work (without permission)•Dramatize a work (performance)•Reproduce in whole or in part (withoutpermission)•Make copies of a work (distribution) Image CC:BY OpenCage (wikipedia) 6
    7. 7. 7What is the purpose of ©? Image CC:BY ewiemann (Flickr)
    8. 8. • 1710, Great Britain:“For the Encouragement of Learned Men to Compose and Write useful Books…” - Source: “An Act For the Encouragement of Learning” by Queen Anne • 1788, U.S.: “To promote the progress of Science and Useful Arts, by securing for limited times to authors and inventors the exclusive right to their respective writings and discoveries.” • 1952, Universal Copyright Convention: “ensure respect for the rights of the individual and encourage the development of literature, the sciences and the arts.”8 Image CC:BY-SA Loz Pycock (Flickr)
    9. 9. 9Notable International TreatiesRegarding Copyright:•1886: Berne Convention for theProtection of Literary and Artistic Works•1952: Universal Copyright Convention•1988: Berne ConventionImplementation Act•1995: Trade-Related Aspects ofIntellectual Property Rights Image CC:BY tuppus (Flickr)
    10. 10. Takeaway: •Goal: To advance knowledge •How: Exclusive rights on creative works for limited times10 Image CC:BY-NC Cayusa (Flickr)
    11. 11. “Limited times” = ?11 Image CC:BY TJ Morris (Flickr)
    12. 12. Which of these is necessary to copyright a work?A. Tangible form?B. Publication?C. Copyright symbol ©?D. Registration?E. Effort?F. Creative Expression?G. Uniqueness? 12
    13. 13. Which of these is necessary to copyright a work? 13
    14. 14. Copyright occurs automatically at the creation of a new work, when it is fixed in tangible form. This means that almostImage CC:BY Horia Varlan (flickr) everything is copyrighted-- not just published material but also your lecture slides, your speaker notes, your drafts, your whiteboard/blackboard drawings, your snapshots... 14
    15. 15. What is a license?Licenses let people know how they may use a copyrighted work. Image CC:BY-SA lumaxart (Flickr) 15
    16. 16. Free PublicUnder some licenses to use, adapt, redistributeImage CC:BY-SA Colleen Simon (Flickr) 16
    17. 17. All Rights Reserved (default) 17
    18. 18. Types of Open Licenses:Creative Commons is one example Some Rights Reserved ( 18
    19. 19. BY :: Attribution You let others copy, distribute, display, and perform your copyrighted work but only if they give you credit. 19
    20. 20. NC :: Noncommercial You let others copy, distribute, display, and perform your copyrighted work but for noncommercial purposes only. 20
    21. 21. SA :: Share Alike You let others copy, distribute, display, and perform your copyrighted work as long as any derivative work is licensed under the same license. 21
    22. 22. Learning Creativity Sharing Public All Rights Domain Reservedleast restrictive most restrictive Adaptability means… Translation Localization Bridge materials Innovation Collaboration 22
    23. 23. Case Study: African Health OER NetworkImage CC:BY-NC Jon Milet Baker (Flickr) 23
    24. 24. Motivations: Challenges to Health Education in Africa•low budget, small workforce, high diseaseburden•scarce, aging, and emigrating teaching staff•not enough instructors or classroom spaces•repetitive instructional responsibilities•and….Image CC:BY Phil Roeder (Flickr) 24
    25. 25. large lectures & crowded clinical situations25 Image CC:BY-NC University of Ghana
    26. 26. 26When you look intextbooks it’s difficult tofind African cases. Thecases may be prettysimilar but sometimes itcan be confusing whenyou see something thatyou see on white skin sonicely and very easy topick up, but on the darkskin it has a differentmanifestation that may bedifficult to see.-Richard Phillips, lecturer,Department of Internal Image CC:BY-NC-SA Kwame NkrumahMedicine, KNUST (Ghana) University of Science and Technology
    27. 27. The mission of the AfricanHealth Open EducationalResources (OER) Network (est.2008) is to advance healtheducation in Africa by creatingand promoting free, openlylicensed teaching materialscreated by Africans to shareknowledge, address curriculumgaps, and support healtheducation communities. 27
    28. 28. Gather Existing Materials Assist health professionals in finding materials that are free, electronic, and openly licensed (i.e. expressly allow the general public to use, adapt, copy, and redistribute)APPROACH Facilitate Discussion Foster dialogue between health professionals around pedagogy, policy, peer review, and openness via onsite consultation, discussion lists, conference calls, and newsletters 28
    29. 29. Example: KNUST and UG (Ghana)ChallengeElectronic learning activities arenot widespread; healthinstructors do not have time tolearn multimedia skills.Approach•KNUST: Multidisciplinarycollaborations with the College of Image CC:BY-NC-SA Kwame NkrumahArt University of Science and Technology•University of Ghana (UG): Hire (KNUST)external multimedia specialists 29
    30. 30. Example: Ghana Challenge Would like to focus materials development on clinical exams and surgical procedures Approach Update informed consent procedures to allow for public use30 Image CC:BY Alan Cleaver (Flickr)
    31. 31. 31Community Usage•160 people •8500 views/motrained in open on websitelicenses •Accessed in 190+•115 authors countries•12 institutions •861K views on YouTubeCollection •795 favorites on•135 modules YouTube•339 materials •173 comments•144 videos (906 on YouTubeminutes) Image CC:BY-NC-SA HeyThereSpaceman (flickr)
    32. 32. Visualization of greatest word frequency in Youtube comments – from 32
    33. 33. 33Remix Example Image CC:BY-NC-SA Saide and University of Botswana
    34. 34. Remix Example: From This 34
    35. 35. 35 Remix Example: To This
    36. 36. Remix Example: From This 36
    37. 37. Remix Example: To This 37
    38. 38. 38 Opportunities to Collaborate communities: audio conference + email list•Partners Forum (senior leadership)•Tech (multimedia and tech support staff)•dScribe (students, ©)Newsletter( Image CC:BY-SA lumaxart (Flickr)
    39. 39. How to share your own content (or help someone else share theirs)39 Image CC:BY-NC-SA 10000spoons (Flickr)
    40. 40. Its easiest to create open content from the start. 40
    41. 41. Start now by making a smallchange in how you create your own content. 41
    42. 42. What does this mean for you? 42
    43. 43. Hmm…Image CC:BY-NC-SAbetsyjean79 (flickr) 43
    44. 44. EXAMPLE DISCLAIMER & TITLE SLIDEAuthor(s): John Doe, MD; Jane Doe, PhD, 2009License: Unless otherwise noted, this material is made available under the terms ofthe Creative Commons Attribution 3.0 License: have reviewed this material in accordance with U.S. Copyright Law and have tried to maximizeyour ability to use, share, and adapt it.Copyright holders of content included in this material should contact withany questions, corrections, or clarification regarding the use of content.For more information about how to cite these materials visit medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcareprofessional. Please speak to your physician if you have questions about your medical condition.Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
    45. 45. On Slide Learning about Orchids 45 Lady Finger Phalaenopsis A Phalaenopsis hybrid add some extra information in the attribution: author, source (name and link), license (name and link) Lady Finger Orchid CC:BY aussiegall (flickr) phalaenopsis CC:BY audreyjm529 (flickr) hybrid CC:BY-SA Zizonus (flickr)
    46. 46. Additional Source Information Slide 3: Janeway. Immunobiology : The Immune System in Health and Disease. Current Biology Ltd./Garland Publishing, Inc. 1997 Slide 4: Spinach is Good” Center for Disease Control; Life Magazine. January 17, 1938; rejon, Slide 5: Goody Two Shoes - McLoughlin Bros (New-York) 1888 Slide 6: Jot Powers, “Bounty Hunter”, Wikimedia Commons,, CC: BY- SA 2.0 at the end of the presentation 46
    47. 47. What if you want to make yourexisting work available under an open license? 47
    48. 48. What types of third-party(i.e. created by someone other than you) objects might you encounter? 48
    49. 49. What should you do with them? 49
    50. 50. main policy concerns to publicly sharing content :: copyright : copyright law grants limited exclusive rights to authors of creative works :: product endorsement : avoiding the appearance of endorsing a product or organization :: privacy : the protection of an individual’s (student, instructor, patient) privacy 50
    51. 51. possible actions :: retain : keep the content because it is licensed under an open license or is in the public domain :: replace : you may want to replace content that is not openly licensed (and thus not shareable) :: remove : you may need to remove content due to privacy, endorsement, or copyright concerns 51
    52. 52. Discussion: OER for Ob/Gyn Residents at SPHMMC 52
    53. 53. Content3.Which key elements in core curricula are amenableto self-learning?4.What are the relevant learning objectives for theOER modules used/created?5.Where may existing OER be used wholely oradapted for the curriculum?6.In what ways can you adapt OER from anotherinstitution to fit SPHMMC context? 53
    54. 54. Obstetrics and Gynaecology OER from African Health OERNetwork or Section5.Episiotomy & Repair6.Examination of the Pregnant Woman7.Procedures in Obstetrics and Gynaecology8.Sexually-Transmitted Diseases and Pelvic Infections9.Total Abdominal Hysterectomy10.University Certificate in Midwifery11.Textbook of Urogynaecology12.Surgical Repair of Vesico-Vaginal Fistulae (VVF)13.Clinical Examinations in Gynaecology Collection, including: 1. Basic Guidelines and History Taking 2. General Physical Examination in Gynaecology 3. Examination of the Abdomen 4. Pelvic Examination 54
    55. 55. Pediatrics OER from African Health OER Network or Examinations in Paediatrics Collection, including: 1. General Physical Examination 2. Examination of the Respiratory System 3. Examination of the Cardiovascular System 4. Examination of the Abdomen 5. Overview of the Central Nervous System (CNS) 6. CNS Examination of Smell and Sight 7. CNS Examination of Facial Nerve and Hearing 8. Examination of the Peripheral Nervous System (PNS) 9. CNS Examination of the Legs 10. Examination of the Musculoskeletal System 11. Examination of the New Born: Part 1 12. Examination of the New Born: Part 2 13. Examination of the Ear, Nose, and Throat Systems5.Case Scenarios In Pediatric Practices6.Gastric Lavage Procedure Animation7.South African Child Gauge 2009/2010 55
    56. 56. Relevant Pharmacology OER from African Health OER Network or One Step Pregnancy Dipstick Test 56
    57. 57. Community Healthcare Worker materials from Open UniversityUK Health Education and Training in Africa (HEAT) and Youth Reproductive Health5.Antenatal Care6.Communicable Diseases7.Family Planning8.Health Education, Advocacy and Community Mobilisation9.Health Management, Ethics and Research10.Hygiene and Environmental Health11.Immunization12.Integrated Management of Newborn and Childhood Illness13.Labour and Delivery Care14.Non-Communicable Diseases, Emergency Care and Mental Health15.Nutrition16.Postnatal Care 57
    58. 58. M1 Endrochrinology and Reproduction from University ofMichigan Medical School Histology of the Endocrine System6.01.28.09(a): Nutrition Assessment7.01.28.09(b): Histology of the Male Reproductive System 58
    59. 59. M2 Reproduction from University of Michigan Medical School Lab5.Gestational Lab6.Ovary Testes Lab7.Uterine Lab8.03.15.11: Your Patient Has Breast Cancer Until You Prove She Doesn’t9.03.16.09: Clinical Aspects of the Menstrual Cycle10.03.18.09: Clinical Aspects of Gynecologic Diseases11.03.19.09: Benign and Malignant Diseases of the Testis and Scrotum12.Ob/Gyn Learning Resources from the African Health OER Network13.Surgical Excision of a Multi-Lobular, Recurrent, Bartholin Duct Cyst14.Daily Schedule: M2 Reproduction15.03.18.09(a): Gynecologic Diseases16.03.18.09(b): Abortion17.03.18.09(c): Ovary Pathology18.03.19.09(a): Testicular Disease19.03.19.09(b): Testicular Pathology20.03.20.09: Androgens 59
    60. 60. Policy3.Who owns the copyright to the materials intendedto be shared as OER - the faculty or the institution?4.Under which Creative Commons license will theOER be shared?5.How will you ensure the quality of the OER?6.If you intend to include record video or audio for ademonstration (e.g. surgical procedure), how will youobtain permission from patients or students beingrecorded? 60
    61. 61. Professional Development3.Are teaching staff familiar with multimedia andinstructional design principles? teaching staff know where to find OER andother open content to adapt for their own OER? will be responsible for assisting and trainingfaculty with technology and instructional design forOER? (e.g. existing technology or library staff) 61
    62. 62. Technological Infrastructure3.What is the desired format of the OER (e.g. text-based, narrated lectures, video)?5.How will you use to distribute the OER (e.g. mediatypes, file formats, soft copy or hard copy)?7.What are the technological factors affecting OERproduction and dissemination? (e.g. student andfaculty access to & attitudes toward technology,classroom environment, network instrastructure,technology support staff) 62
    63. 63. Concluding RemarksOER and content development are not an end but onefacet of an approach to enhancing instruction. •Collection of 19 video interviews in Ghana about OER: list=PLF4EC45F2B54D6112 •Open Health at UMMS Video: http:// CC:BY Willi Heidelbach (Flickr) 63
    64. 64. Image CC:BY Karrie Nodalo (flickr)This presentation builds upon slides from otherOpen.Michigan team members, including:Emily Puckett Rodgers, Pieter Kleymeer, GarinFons, Greg Grossmeier, Susan Topol, DaveMalicke, Ted Hanss, and Erik Hofer 64
    65. 65. Questions? Kathleen Omollo: kludewig@umich.edu65 Image CC:BY-NC-SA Oberazzi (Flickr)