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![Global Health Informatics Education 3
E.J.S. Hovenga and J. Mantas (Eds.)
IOS Press, 2004
1.1. Virtual University Governance
Evelyn J.S. HOVENGA
Faculty of Informatics and Communication, Central Queensland University,
Rockhampton MC4702 Australia
Abstract. There is a need to establish collaboration alliances or partnerships if we
are to provide global Health Informatics educatics education. Agreements need to
make provision for the existing diversity between country educational systems as
well as variations in funding, legislation and political systems and a number of other
issues including intellectual property and copyright. Four virtual University govern-
ance models were identified, 1) evolution of existing universities, 2) newly created
organisations collectively delivering one type of program eg MBA, 3) a consortium
of partners using a common portal and 4) a commercial enterprise. Collectively
IMIA academic members need to be in a good position to respond to the global
changes in higher education and minimise the risk of failure when establishing a vir-
tual University to collectively deliver Health Informatics education. Others have un-
dertaken a similar path in the past, some successful others not so, we need to learn
from these experiences.
1. Introduction
The provision of global education requires collaboration, alliances or partnerships between
any number of organisations. Educational providers within formal consortia may all be not
for profit, or for profit or there may a mix of not for profit and commercial organisations.
Governance concerns intellectual ownership of educational content vs an open source
model, competition policies and formal agreements detailing individual organisational re-
sponsibility arrangements to meet agreed objectives of global strategic alliances between
health and informatics education providers and possibly industry partners. This arrange-
ments include statements regarding national copyright issues, adoption of technology stan-
dards, cost/funding and administrative structures. Educational provider partners must also
comply with national Government policies regarding overseas students. This may influence
delivery methods to be adopted, acceptable cost/funding arrangements and educational op-
portunities. Issues associated with the establishment of alliances adopting any one of many
governance options are summarised in table 1.
To date only the Massachusets Institute of Technology (MIT) has been in a position to
make all its courses available free as opensource courseware via the web [1]. Their ap-
proach differentiates between content availability and teaching and learning. The latter re-
quires student administration, provision of academic student support and the awarding of
degrees. Their arrangement facilitates academics from elsewhere to make use of the MIT
material in the knowledge that many students will continue to value being an on campus
MIT student resulting in an MIT degree.](https://image.slidesharecdn.com/44531-250718053615-9b210814/75/Global-Health-Informatics-Education-Studies-in-Health-Technology-and-Informatics-1st-Edition-E-Hovenga-20-2048.jpg)
![4 E.J.S. Hovenga / Virtual University Governance
2. Changes in Higher Education
We are currently witnessing significant changes in higher education around the world due
to globalisating, an increasing reliance on information and communication technologies in-
cluding the Internet, government funding decreases and an increasing need to provide life-
long learning. These changes are resulting in a large competitive international higher educa-
tion market with a high student mobility factor, changes in student demographics towards a
larger number of adult learners, an increasing demand for continuing professional educa-
tion, the need to improve and demonstrate quality whilst reducing costs, changing academic
roles and the need to develop e-learning competencies[2]. These changes are providing new
challenges and require adaptable and flexible leadership styles.
Mason [3] states that ‘the impact of technology on the whole institution is of such mag-
nitude that the leaders of the university cannot delegate decisions about technology strategy
to the information officer. For most universities the senior team needs to own the IT issues
and to integrate them into the strategic vision for the university’ (p.11). We are also wit-
nessing an increase in the establishment of virtual universities. This is expected to erode the
traditional student base of universities in both developing and developed countries’ al-
though this is likely to be off set by the changes in student demographics and the associated
lifelong/adult learning market. Virtual universities tend to be [4]:
evolutions of existing universities where virtual or on-line education is offered by
one or more departments,
newly created organisations operating as a virtual university to deliver one or spe-
cific programs such as an MBA or offering programs from many discipline areas
on a State or Country basis, or
a consortium of partners constituted to develop and/or offer virtual education via a
common portal, or
a commercial enterprise, including corporate universities, media and publishing en-
terprises, offering on line education.
Some of these are Government sponsored, others are not. Whatever model we choose to
adopt will depend on funds available, the level of commitment from all stakeholders and
their willingness to provide input, strong leadership, carefull attention to the initial estab-
Table 1. Governance Options and Issues.
Governance
Options
Issues
Global Strategic
Alliances be-
tween health
and informatics
education pro-
viders and pos-
sibly industry
partners.
o Organisational and program accreditation
o Intellectual ownership of educational content vs an open source model
o Competition policies
o National and organisational copyright issues
o Adoption of technology standards
o Variations in National educational standards, degree structures, definitions and
managing credit transfers
o Program/course accreditation
o Health Informatics competency requirements, credentialing
o Professional recognition of a health informatician
o Professional, corporate and/or vacational education
o Cost/funding, administrative and governance structures
o Compliance with national Government policies regarding overseas students](https://image.slidesharecdn.com/44531-250718053615-9b210814/75/Global-Health-Informatics-Education-Studies-in-Health-Technology-and-Informatics-1st-Edition-E-Hovenga-21-2048.jpg)
![E.J.S. Hovenga / Virtual University Governance 5
lishment arrangements and to mechanisms needed to maintain and continue the relation-
ships between all players. In addition there needs to be a willingness and ability to change
various existing in-house arrangements or patterns of behaviour or modes of educational
delivery as required.
3. A Global Health Informatics University
There are a number of options for the IMIA health and medical informatics education
working group to consider. To date our discussions have tended to favour the formation of
a loose consortium consisting of IMIA institutional academic members and the provision of
a common web based portal. Academic membership is available to any academic and/or
research facility that include health and medical informatics and associated fields of interest
in their curriculum or research program. This provides one level of quality ensurance in that
only reputable and accredited organisations are accepted for membership. At this stage only
links to these member websites are provided via the IMIA homepage, we need to explore
how to progress. This book is one step towards achieving this goal. All stakeholders need to
be well informed of the issues so that we can move on and reach agreement about a com-
mon vision, objectives and values.
3.1. Examples of Possible Governance Models
We can learn from other past experiences so as not to repeat mistakes. Mason [3] noted that
many ‘early adopters’ have ceased to exist. Nevertheless it is predicted that the increasing
adoption of on-line learning will continue.
The United Kingdom’s electronic university (UKeU) was a company established in
2001 to deliver degrees and degree level learning accredited by UK universities online and
worldwide. It is backed and very substantially funded by the UK Government working in
partnership with respected UK academic institutions and leading technological companies.
UKeU was to seek out the best courses in subject areas with high customer demand and
then work with their academic partners to develop these courses specifically for online de-
livery. They have invested to create an interactive eLearning platform in partnership with
Sun Microsystems and adopted Fujitsu’s operational and service support. Central Queen-
sland University and no doubt many others have developed this type of infrastructure over
many years on a shoestring by comparison. However funding isn’t all we need, in 2004 it
was reported that [4] :
“The Higher Education Funding Council for England has decided to discontinue a vir-
tual university set up in 2001 due to low numbers of students enrolled. U.K. eUniversi-
ties Worldwide (UKeU) had hoped to draw 5,600 students in its first year, but three
years later, the program only has 900 students enrolled. The British government had al-
located $111 million for the program, of which about $63 million has been spent.
Other anticipated sources of funding, including partnerships with businesses, never
materialized at acceptable levels. According to members of the funding council, the
crash of the dot-com economy at about the same time as the founding of UKeU led to
the lack of interest from most corporations. Others believe that UKeU was flawed in its
design, relying on faculty without adequate experience in online education, and that
developers of the program spent their resources building an educational platform rather
than using tools available on the market”
Another model no longer in operation was the Fathom knowledge network consisting on 14
member institutions and course partners. It began in 1998 as a Columbia university initia-](https://image.slidesharecdn.com/44531-250718053615-9b210814/75/Global-Health-Informatics-Education-Studies-in-Health-Technology-and-Informatics-1st-Edition-E-Hovenga-22-2048.jpg)
![6 E.J.S. Hovenga / Virtual University Governance
tive and was established as a for profit company. Fathom offered on line education from top
research institutions by providing a focus and an infrastructure to faciliate its partners to
share production resources, technology platforms, and market intelligence. It provide free
sample lectures as a means of attracting students prepared to pay for the course. Fathom
simply provided the portal so could seen as a marketing partner to the members. None of
the members provided full degree programs online yet it was noted in hindsight that “peo-
ple will pay handsomely for Internet education, but only if it leads to degrees, or creden-
tials, or certificates that have professional standing” [5]. Kirschner observed that traditional
universities spend lots to create online learning programs yet almost nothing is spent to
market these. Fathom’s capital requirements, carried exclusively by Columbia university,
were serious and a new administration no longer supported this as a signature project result-
ing in members recapturing their content to pursue their own individual plans.
A number of Virtual Universities are listed at a UNESCO website [6], some of which
are listed as examples in table 2 below.
4. Conclusion
We are now witnessing a paradigm shift in higher education as a result of technological ad-
vances, adoption of on line learning and a greater participation in e-commerce by higher
education providers. Given the dearth of academics with high level expertise in health in-
formatics in many countries, we need to explore how best to use our scarce resources to
have the greatest possible impact regarding the preparation of health professionals such that
they can make the best possible use of available informatics technologies to support health
service delivery.
Academic IMIA members need to reach consensus about how best to establish a global
health informatics virtual university model to enable global educational delivery and con-
tribute to global capacity building. In addition to resolving the governance issue it is also
necessary to establish how best to deal with country educational system diversity, establish
and maintain academic standards, manage credit transfers, student and teacher exchanges,
and gain support from the health disciplines and other stakeholders. These topics are dis-
cussed in greater detail in the following chapters.
Table 2. A Few Examples of Virtual University Models.
Canadian Virtual
University ®(CVU)
A partnership of universities across Canada, committed to delivering university-
level programs that can be completed from anywhere in the country or beyond.
http://www.cvu-uvc.ca/english.html
Cardean Univer-
sity®
An academic consortium with five elite institutions offering only a MBA degree to
corporate customers, given degree-granting authorization in Illinois.
http://www.cardean.edu/cgi-
bin/cardean1/view/about_storyCardean.jsp?visitor=guest
Finnish Virtual
University
Develops procedures and co-operative networks in virtual education, with the aim
to make them a natural element in the Finnish higher education system. The activi-
ties aim to identify and remove obstacles to co-operation, and to promote the edu-
cational use of information and communication technologies and electronic access
to services. www.virtuaaliyliopisto.fi/index.php?language=eng
Idaho Electronic
Campus
Links to more than 1600 courses from the State's seven publicly funded colleges
and universities. A growing number of entire programs can be completed online.
http://www.idahoe-campus.state.id.us/about/about.html](https://image.slidesharecdn.com/44531-250718053615-9b210814/75/Global-Health-Informatics-Education-Studies-in-Health-Technology-and-Informatics-1st-Edition-E-Hovenga-23-2048.jpg)
![E.J.S. Hovenga / Virtual University Governance 7
References
[1] Massachusetts Institute of Technology (MIT) Open Course Ware, http://ocw.mit.edu/index.html ac-
cessed 24 June 2004.
[2] Hovenga E 2004 Changing Academic Roles: New Approaches to Teaching and Learning, paper pre-
sented at EuroMISE 2004 conference in Prague accepted for publication in a special issue of Methods of
Information in Medicine.
[3] Mason R 2003 The university – current challenges and opportunities in: The Virtual University, D’An-
toni S Editor, International Institute for Educational Planning, UNESCO
http://www.unesco.org/iiep/virtualuniversity/files/chap2.pdf accessed 24 June 2004
[4] D’Antonio S 2003 The Virtual University Models and messages: Lessons from case studies, D’Antoni S
Editor, International Institute for Educational Planning, UNESCO
http://www.unesco.org/iiep/virtualuniversity/home.php# accessed 24 June 2004
[4] U.K. Officials End Virtual University, Chronicle of Higher Education, 6 May 2004 (sub. req'd)
http://chronicle.com/prm/daily/2004/05/2004050606n.htm accessed 9 May 2004
[5] Ann Kirschner on Marketing and Distribution of Online Learning, Ubiquity, Volume 5, Issue 17, June
23-29, 2004, http://www.acm.org/ubiquity/ accessed 24 June 2004.
[6] United Nations Educational, Scientific and Cutural Organisation (UNESCO), International Institute for
Educational Planning, http://www.unesco.org/iiep/virtualuniversity/links.php](https://image.slidesharecdn.com/44531-250718053615-9b210814/75/Global-Health-Informatics-Education-Studies-in-Health-Technology-and-Informatics-1st-Edition-E-Hovenga-24-2048.jpg)
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- 6. GLOBAL HEALTH INFORMATICSEDUCATION
- 7. Studies in HealthTechnology and Informatics This book series was started in 1990 to promote research conducted under the auspices of the EC programmes Advanced Informatics in Medicine (AIM) and Biomedical and Health Research (BHR), bioengineering branch. A driving aspect of international health informatics is that telecommunication technology, rehabilitative technology, intelligent home technology and many other components are moving together and form one integrated world of information and communication media. The complete series has been accepted in Medline. In the future, the SHTI series will be available online. Series Editors: Dr. J.P. Christensen, Prof. G. de Moor, Prof. A. Hasman, Prof. L. Hunter, Dr. I. Iakovidis, Dr. Z. Kolitsi, Dr. Olivier Le Dour, Dr. Andreas Lymberis, Dr. Peter Niederer, Prof. A. Pedotti, Prof. O. Rienhoff, Prof. F.H. Roger-France, Dr. N. Rossing, Prof. N. Saranummi, Dr. E.R. Siegel and Dr. Petra Wilson Volume 109 Recently published in this series Vol. 108. A. Lymberis and D. de Rossi (Eds.), Wearable eHealth Systems for Personalised Health Management – State of the Art and Future Challenges Vol. 107. M. Fieschi, E. Coiera and Y.-C.J. Li (Eds.), MEDINFO 2004 – Proceedings of the 11th World Congress on Medical Informatics Vol. 106. G. Demiris (Ed.), e-Health: Current Status and Future Trends Vol. 105. M. Duplaga, K. Zieliński and D. Ingram (Eds.), Transformation of Healthcare with Information Technologies Vol. 104. R. Latifi (Ed.), Establishing Telemedicine in Developing Countries: From Inception to Implementation Vol. 103. L. Bos, S. Laxminarayan and A. Marsh (Eds.), Medical and Care Compunetics 1 Vol. 102. D.M. Pisanelli (Ed.), Ontologies in Medicine Vol. 101. K. Kaiser, S. Miksch and S.W. Tu (Eds.), Computer-based Support for Clinical Guidelines and Protocols – Proceedings of the Symposium on Computerized Guidelines and Protocols (CGP 2004) Vol. 100. I. Iakovidis, P. Wilson and J.C. Healy (Eds.), E-Health – Current Situation and Examples of Implemented and Beneficial E-Health Applications Vol. 99. G. Riva, C. Botella, P. Légeron and G. Optale (Eds.), Cybertherapy – Internet and Virtual Reality as Assessment and Rehabilitation Tools for Clinical Psychology and Neuroscience Vol. 98. J.D. Westwood, R.S. Haluck, H.M. Hoffman, G.T. Mogel, R. Phillips and R.A. Robb (Eds.), Medicine Meets Virtual Reality 12 – Building a Better You: The Next Tools for Medical Education, Diagnosis, and Care Vol. 97. M. Nerlich and U. Schaechinger (Eds.), Integration of Health Telematics into Medical Practice Vol. 96. B. Blobel and P. Pharow (Eds.), Advanced Health Telematics and Telemedicine – The Magdeburg Expert Summit Textbook Vol. 95. R. Baud, M. Fieschi, P. Le Beux and P. Ruch (Eds.), The New Navigators: from Professionals to Patients – Proceedings of MIE2003 ISSN 0926-9630
- 8. Global Health Informatics Education Editedby E.J.S. Hovenga School of Information Systems, Faculty of Informatics and Communication, Central Queensland University, Rockhampton, Qld MC 4702, Australia and J. Mantas Health Informatics Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece Amsterdam • Berlin • Oxford • Tokyo • Washington, DC
- 9. © 2004, Theauthors mentioned in the table of contents All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without prior written permission from the publisher. ISBN 1 58603 454 5 Library of Congress Control Number: 2004111546 Publisher IOS Press Nieuwe Hemweg 6B 1013 BG Amsterdam The Netherlands fax: +31 20 620 3419 e-mail: order@iospress.nl Distributor in the UK and Ireland Distributor in the USA and Canada IOS Press/Lavis Marketing IOS Press, Inc. 73 Lime Walk 4502 Rachael Manor Drive Headington Fairfax, VA 22032 Oxford OX3 7AD USA England fax: +1 703 323 3668 fax: +44 1865 750079 e-mail: iosbooks@iospress.com LEGAL NOTICE The publisher is not responsible for the use which might be made of the following information. PRINTED IN THE NETHERLANDS
- 10. v Foreword “Throughout the world,health care professionals often lack knowledge of the possibilities and limitations of systematically processing data, information and knowledge and of the resulting impact on quality decision-making. They are often asked to use information technologies of which they have limited appreciation, in order to enhance their practices through better use of information resources. However, for systematically processing data, information and knowledge in medicine and in health care, health care professionals who are well-trained in medical informatics or health informatics are needed. It will only be through improved education of health care professionals and through an increase in the number of well-trained workers in health and medical informatics that this lack of knowledge and associated skills can begin to be reversed. Health and medical informatics education is of particular importance at the beginning of the 21st century for the following reasons …: 1 progress in information processing and information and communication technology is changing our societies; 2 the amount of health and medical knowledge is increasing at such a phenomenal rate that we cannot hope to keep up with it, or store, organise and retrieve existing and new knowledge in a timely fashion without using a new information processing methodology and information technologies; 3 there are significant economic benefits to be obtained from the use of information and communication technology to support medicine and health care; 4 similarly the quality of health care is enhanced by the systematic application of information processing and information and communication technology; 5 it is expected, that these developments will continue, probably at least at the same pace as can be observed today; 6 health care professionals who are well-educated in health or medical informatics are needed to systematically process information in medicine and in health care, and for the appropriate and responsible application of information and communication technology; 7 through an increase in scope and the provision of high quality education in the field of health and medical informatics, well-educated health care professionals world-wide are expected to raise the quality and efficiency of health care.” These were the first paragraphs of the recommendations of the International Medical Informatics Association (IMIA) on health and medical informatics education1. Although we can recognise further progress in educating health care professionals in this field and although a considerable number of educational programs for health informatics / medical informatics specialists have been set up, there is still a need to enhance these educational activities world wide, considering global developments as well as new curricular concepts and technological opportunities. IMIA and in particular its working group on health and medical informatics education (www.IMIA.org) is the leading international society stimulating such educational activities in various ways. As part of these activities, the past and the current chairperson of IMIA’s 1 Recommendations of the International Medical Informatics Association (IMIA) on Education in Health and Medical Informatics. Methods Inf Med 2000; 39: 267-77. See also http://www.imia.org.
- 11. vi working group onhealth and medical informatics education, Professor Evelyn Hovenga, Central Queensland University, Rockhampton, Australia, and Professor John Mantas, National and Kapodistrian University of Athens, Greece, have now edited this book on global health informatics education. Their know-how and experience as well as that of the numerous authors of this book will especially be helpful for educators in the field of health/medical informatics. With the knowledge contained in this book, let us try to further improve education and with it, finally, the quality and efficiency of care. Prof. Dr. Reinhold Haux Rector of UMIT - the University for Health Sciences, Medical Informatics and Technology, Innsbruck, Austria IMIA Vice-President for Services
- 12. vii Preface Health and medicalinformatics education has received attention since the 1970s when the education working group was established and led by Dr Roger Salamon and Dr Francois Gremy to address this important issue for the International Medical Informatics Association (IMIA). Seven IMIA sponsored working conferences have been held over the years in France (Lyon and another in Chamonix), Canada, Czechoslovakia, Germany, Australia and the USA (Portland). All proceedings have been published. These have raised awareness of the importance of introducing informatics into medical and health professional curricula and to prepare specialists in medical informatics. There is agreement that health and medi- cal informatics can be regarded as a separate discipline with the need for specialised curric- ula although the scientific underpinnings of the field are not well articulated in our text- books or by our professional societies. Establishing a virtual health informatics university to provide global collaborative health informatics education and research was first discussed by a number of IMIA Health and Medical Education Working Group members at the conference held in Newcastle, Aus- tralia in 1997. Since then this idea has been nurtured and various possible organisational models explored. The decision that only institutional academic IMIA members are able to be collaborators in this initiative has resulted in a steady increase in members over recent years. IMIA currently has 29 academic institutional members from 12 countries. In 2003 the IMIA working group held a meeting in Portland, USA exploring how we could teach globally, learn locally. A selection of papers presented at this meeting was published as a special issue of the International Journal of Medical Informatics in March 2004. This book is a continuation of our efforts to develop a suitable implementation plan that requires us to fully understand educational differences so that we can better plan for global collaboration. We are witnessing a paradigm shift in higher education as a result of technological ad- vances, adoption of on-line learning and a greater participation in e-commerce by higher education providers. Given the dearth of academics with high level expertise in health in- formatics in many countries, we need to explore how best to use our scarce resources to have the greatest possible impact regarding the preparation of health professionals such that they can make the best possible use of available informatics technologies to support health service delivery. Electronic or e-learning is being adopted by many. It may include the use of Intranet, email, CD-ROM, DVD, video and audio (tele-) conferencing or electronic discussion groups via the web. Many of these methods are used as delivery methods for distance edu- cation to supplement print based materials. Once e-learning is adopted on a large scale there is a need to focus on organisational infrastructure changes required to accommodate these new ways of providing educational services as the adoption of such technologies requires a greater investment of academic effort together with a variety of specialist support staff. Borderless education was examined from a business perspective during 2000 with an update in 2001 for Australia’s Government. In European Union under the initiatives of e- health and e-government similar approaches were commencing to be developed. This can- vassed the emergence of corporate, for-profit and virtual universities. Two versions of ‘vir- tual’ universities were identified, an organisation providing an advisory service but essen- tially acting as a clearing house and an online ‘total service’ provider. The ‘clearing house’ concept has essentially been adopted by the IMIA education group in the first instance.
- 13. viii We have yetto adopt international standards regarding educational terms and their defi- nitions. The current global educational diversity makes the identification, assessment, rank- ing, accreditation of courses and awards as well as the provision of credit transfers between educational providers difficult, time consuming and challenging. The IMIA education working group is exploring the potential to develop a coordinated educational framework to suit the health and medical informatics discipline. This book is another step in this direc- tion. The Editors, Professor E.J.S. Hovenga Professor J. Mantas
- 14. ix Acknowledgements The Editors wouldlike to thank the IMIA President, the Board, and the General Assembly for accepting the proposal to publish the book and for their generous support. We would like to thank the authors for their enthusiastic acceptance of our invitation to contribute and for their suggestions. We thank especially Professor Dr. Reinhold Haux and Professor Arie Hasman for their constructive insights towards the coverage of all aspects of the theme of the book. Finally, we would like to thank Dr. Joseph Liaskos and Miss Martha Charalambidou from the University of Athens for their work to compile and prepare the documents in ac- cordance to the publishers’ instructions. Last but not least we thank IOS Press for their ef- fort to publish the book on time for distribution at Medinfo 2004, San Francisco.
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- 16. xi Contents Foreword v Preface vii Acknowledgementsix Section 1. Governance 1.1 Virtual University Governance 3 E.J.S. Hovenga 1.2 Comparative Educational Systems 8 J. Mantas 1.3 Academic Standards, Credit Transfers and Associated Issues 18 E.J.S. Hovenga 1.4 Student and Teacher Exchanges – Criteria for Access 28 J. Roberts 1.5 Gaining Support from Health Disciplines and Other Stakeholders 36 J. Murphy Section 2. Curricula and Degree Structures (Outcomes and Recognition) 2.1 A Health Informatics Educational Framework 55 E.J.S. Hovenga 2.2 Curricula in Medical Informatics 63 A. Hasman and R. Haux 2.3 Competencies and Credentialing: Nursing Informatics 75 V.K. Saba, D.J. Skiba and C. Bickford 2.4 Health Informatics Needs Regulation and Registration to Add Value Recognition 90 J. Roberts and G. Hayes 2.5 Educational Standards – Terminologies Used 95 R. Engelbrecht, J. Ingenerf and J. Reiner 2.6 Future Trends in Health Informatics 114 J. Mantas
- 17. xii Section 3. Deliveryand Evaluation Methods (Pedagogy and Andragogy) 3.1 Current and Future Trends in Teaching and Learning 131 E.J.S. Hovenga and L. Bricknell 3.2 Cognitive Theories and the Design of E-Learning Environments 143 B. Gillani and C. O’Guinn 3.3 Self Directed and Lifelong Learning 152 S. Alexander, G. Kernohan and P. McCullagh 3.4 Managing Large Online Classes Across Multiple Locations 167 K. Egea and A.C.L. Zelmer 3.5 Evolutionary Epistemology and Dynamical Virtual Learning Networks 182 U. Giani 3.6 The Role of Evaluation in Web-Based Education 203 K. Saranto, J. Lammintakanen and K. Häyrinen 3.7 Student Support Infrastructure 213 C. Nohr International Medical Informatics Association (IMIA) Working Group on Health and Medical Informatics Education WG1 224 Recommendations of the International Medical Informatics Association (IMIA) on Education in Health and Medical Informatics 226 Authors 244 Glossary 246 Subject Index 273 Author Index 275
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- 20. Global Health InformaticsEducation 3 E.J.S. Hovenga and J. Mantas (Eds.) IOS Press, 2004 1.1. Virtual University Governance Evelyn J.S. HOVENGA Faculty of Informatics and Communication, Central Queensland University, Rockhampton MC4702 Australia Abstract. There is a need to establish collaboration alliances or partnerships if we are to provide global Health Informatics educatics education. Agreements need to make provision for the existing diversity between country educational systems as well as variations in funding, legislation and political systems and a number of other issues including intellectual property and copyright. Four virtual University govern- ance models were identified, 1) evolution of existing universities, 2) newly created organisations collectively delivering one type of program eg MBA, 3) a consortium of partners using a common portal and 4) a commercial enterprise. Collectively IMIA academic members need to be in a good position to respond to the global changes in higher education and minimise the risk of failure when establishing a vir- tual University to collectively deliver Health Informatics education. Others have un- dertaken a similar path in the past, some successful others not so, we need to learn from these experiences. 1. Introduction The provision of global education requires collaboration, alliances or partnerships between any number of organisations. Educational providers within formal consortia may all be not for profit, or for profit or there may a mix of not for profit and commercial organisations. Governance concerns intellectual ownership of educational content vs an open source model, competition policies and formal agreements detailing individual organisational re- sponsibility arrangements to meet agreed objectives of global strategic alliances between health and informatics education providers and possibly industry partners. This arrange- ments include statements regarding national copyright issues, adoption of technology stan- dards, cost/funding and administrative structures. Educational provider partners must also comply with national Government policies regarding overseas students. This may influence delivery methods to be adopted, acceptable cost/funding arrangements and educational op- portunities. Issues associated with the establishment of alliances adopting any one of many governance options are summarised in table 1. To date only the Massachusets Institute of Technology (MIT) has been in a position to make all its courses available free as opensource courseware via the web [1]. Their ap- proach differentiates between content availability and teaching and learning. The latter re- quires student administration, provision of academic student support and the awarding of degrees. Their arrangement facilitates academics from elsewhere to make use of the MIT material in the knowledge that many students will continue to value being an on campus MIT student resulting in an MIT degree.
- 21. 4 E.J.S. Hovenga/ Virtual University Governance 2. Changes in Higher Education We are currently witnessing significant changes in higher education around the world due to globalisating, an increasing reliance on information and communication technologies in- cluding the Internet, government funding decreases and an increasing need to provide life- long learning. These changes are resulting in a large competitive international higher educa- tion market with a high student mobility factor, changes in student demographics towards a larger number of adult learners, an increasing demand for continuing professional educa- tion, the need to improve and demonstrate quality whilst reducing costs, changing academic roles and the need to develop e-learning competencies[2]. These changes are providing new challenges and require adaptable and flexible leadership styles. Mason [3] states that ‘the impact of technology on the whole institution is of such mag- nitude that the leaders of the university cannot delegate decisions about technology strategy to the information officer. For most universities the senior team needs to own the IT issues and to integrate them into the strategic vision for the university’ (p.11). We are also wit- nessing an increase in the establishment of virtual universities. This is expected to erode the traditional student base of universities in both developing and developed countries’ al- though this is likely to be off set by the changes in student demographics and the associated lifelong/adult learning market. Virtual universities tend to be [4]: evolutions of existing universities where virtual or on-line education is offered by one or more departments, newly created organisations operating as a virtual university to deliver one or spe- cific programs such as an MBA or offering programs from many discipline areas on a State or Country basis, or a consortium of partners constituted to develop and/or offer virtual education via a common portal, or a commercial enterprise, including corporate universities, media and publishing en- terprises, offering on line education. Some of these are Government sponsored, others are not. Whatever model we choose to adopt will depend on funds available, the level of commitment from all stakeholders and their willingness to provide input, strong leadership, carefull attention to the initial estab- Table 1. Governance Options and Issues. Governance Options Issues Global Strategic Alliances be- tween health and informatics education pro- viders and pos- sibly industry partners. o Organisational and program accreditation o Intellectual ownership of educational content vs an open source model o Competition policies o National and organisational copyright issues o Adoption of technology standards o Variations in National educational standards, degree structures, definitions and managing credit transfers o Program/course accreditation o Health Informatics competency requirements, credentialing o Professional recognition of a health informatician o Professional, corporate and/or vacational education o Cost/funding, administrative and governance structures o Compliance with national Government policies regarding overseas students
- 22. E.J.S. Hovenga /Virtual University Governance 5 lishment arrangements and to mechanisms needed to maintain and continue the relation- ships between all players. In addition there needs to be a willingness and ability to change various existing in-house arrangements or patterns of behaviour or modes of educational delivery as required. 3. A Global Health Informatics University There are a number of options for the IMIA health and medical informatics education working group to consider. To date our discussions have tended to favour the formation of a loose consortium consisting of IMIA institutional academic members and the provision of a common web based portal. Academic membership is available to any academic and/or research facility that include health and medical informatics and associated fields of interest in their curriculum or research program. This provides one level of quality ensurance in that only reputable and accredited organisations are accepted for membership. At this stage only links to these member websites are provided via the IMIA homepage, we need to explore how to progress. This book is one step towards achieving this goal. All stakeholders need to be well informed of the issues so that we can move on and reach agreement about a com- mon vision, objectives and values. 3.1. Examples of Possible Governance Models We can learn from other past experiences so as not to repeat mistakes. Mason [3] noted that many ‘early adopters’ have ceased to exist. Nevertheless it is predicted that the increasing adoption of on-line learning will continue. The United Kingdom’s electronic university (UKeU) was a company established in 2001 to deliver degrees and degree level learning accredited by UK universities online and worldwide. It is backed and very substantially funded by the UK Government working in partnership with respected UK academic institutions and leading technological companies. UKeU was to seek out the best courses in subject areas with high customer demand and then work with their academic partners to develop these courses specifically for online de- livery. They have invested to create an interactive eLearning platform in partnership with Sun Microsystems and adopted Fujitsu’s operational and service support. Central Queen- sland University and no doubt many others have developed this type of infrastructure over many years on a shoestring by comparison. However funding isn’t all we need, in 2004 it was reported that [4] : “The Higher Education Funding Council for England has decided to discontinue a vir- tual university set up in 2001 due to low numbers of students enrolled. U.K. eUniversi- ties Worldwide (UKeU) had hoped to draw 5,600 students in its first year, but three years later, the program only has 900 students enrolled. The British government had al- located $111 million for the program, of which about $63 million has been spent. Other anticipated sources of funding, including partnerships with businesses, never materialized at acceptable levels. According to members of the funding council, the crash of the dot-com economy at about the same time as the founding of UKeU led to the lack of interest from most corporations. Others believe that UKeU was flawed in its design, relying on faculty without adequate experience in online education, and that developers of the program spent their resources building an educational platform rather than using tools available on the market” Another model no longer in operation was the Fathom knowledge network consisting on 14 member institutions and course partners. It began in 1998 as a Columbia university initia-
- 23. 6 E.J.S. Hovenga/ Virtual University Governance tive and was established as a for profit company. Fathom offered on line education from top research institutions by providing a focus and an infrastructure to faciliate its partners to share production resources, technology platforms, and market intelligence. It provide free sample lectures as a means of attracting students prepared to pay for the course. Fathom simply provided the portal so could seen as a marketing partner to the members. None of the members provided full degree programs online yet it was noted in hindsight that “peo- ple will pay handsomely for Internet education, but only if it leads to degrees, or creden- tials, or certificates that have professional standing” [5]. Kirschner observed that traditional universities spend lots to create online learning programs yet almost nothing is spent to market these. Fathom’s capital requirements, carried exclusively by Columbia university, were serious and a new administration no longer supported this as a signature project result- ing in members recapturing their content to pursue their own individual plans. A number of Virtual Universities are listed at a UNESCO website [6], some of which are listed as examples in table 2 below. 4. Conclusion We are now witnessing a paradigm shift in higher education as a result of technological ad- vances, adoption of on line learning and a greater participation in e-commerce by higher education providers. Given the dearth of academics with high level expertise in health in- formatics in many countries, we need to explore how best to use our scarce resources to have the greatest possible impact regarding the preparation of health professionals such that they can make the best possible use of available informatics technologies to support health service delivery. Academic IMIA members need to reach consensus about how best to establish a global health informatics virtual university model to enable global educational delivery and con- tribute to global capacity building. In addition to resolving the governance issue it is also necessary to establish how best to deal with country educational system diversity, establish and maintain academic standards, manage credit transfers, student and teacher exchanges, and gain support from the health disciplines and other stakeholders. These topics are dis- cussed in greater detail in the following chapters. Table 2. A Few Examples of Virtual University Models. Canadian Virtual University ®(CVU) A partnership of universities across Canada, committed to delivering university- level programs that can be completed from anywhere in the country or beyond. http://www.cvu-uvc.ca/english.html Cardean Univer- sity® An academic consortium with five elite institutions offering only a MBA degree to corporate customers, given degree-granting authorization in Illinois. http://www.cardean.edu/cgi- bin/cardean1/view/about_storyCardean.jsp?visitor=guest Finnish Virtual University Develops procedures and co-operative networks in virtual education, with the aim to make them a natural element in the Finnish higher education system. The activi- ties aim to identify and remove obstacles to co-operation, and to promote the edu- cational use of information and communication technologies and electronic access to services. www.virtuaaliyliopisto.fi/index.php?language=eng Idaho Electronic Campus Links to more than 1600 courses from the State's seven publicly funded colleges and universities. A growing number of entire programs can be completed online. http://www.idahoe-campus.state.id.us/about/about.html
- 24. E.J.S. Hovenga /Virtual University Governance 7 References [1] Massachusetts Institute of Technology (MIT) Open Course Ware, http://ocw.mit.edu/index.html ac- cessed 24 June 2004. [2] Hovenga E 2004 Changing Academic Roles: New Approaches to Teaching and Learning, paper pre- sented at EuroMISE 2004 conference in Prague accepted for publication in a special issue of Methods of Information in Medicine. [3] Mason R 2003 The university – current challenges and opportunities in: The Virtual University, D’An- toni S Editor, International Institute for Educational Planning, UNESCO http://www.unesco.org/iiep/virtualuniversity/files/chap2.pdf accessed 24 June 2004 [4] D’Antonio S 2003 The Virtual University Models and messages: Lessons from case studies, D’Antoni S Editor, International Institute for Educational Planning, UNESCO http://www.unesco.org/iiep/virtualuniversity/home.php# accessed 24 June 2004 [4] U.K. Officials End Virtual University, Chronicle of Higher Education, 6 May 2004 (sub. req'd) http://chronicle.com/prm/daily/2004/05/2004050606n.htm accessed 9 May 2004 [5] Ann Kirschner on Marketing and Distribution of Online Learning, Ubiquity, Volume 5, Issue 17, June 23-29, 2004, http://www.acm.org/ubiquity/ accessed 24 June 2004. [6] United Nations Educational, Scientific and Cutural Organisation (UNESCO), International Institute for Educational Planning, http://www.unesco.org/iiep/virtualuniversity/links.php
- 25. 8 Global HealthInformatics Education E.J.S. Hovenga and J. Mantas (Eds.) IOS Press, 2004 1.2. Comparative Educational Systems J. MANTAS Health Informatics Laboratory, Faculty of Nursing, University of Athens, 123 Papadiamantopoulou Street, 11527 Athens, Greece Abstract. During recent years Europe has been engaged in an educational reform that tends to change the whole educational system concerning higher education. The main issues of this reform are related to the free movement of labour and students across the member states. Hence, the need of comparative educational systems, lev- els, and degrees. The European Union and its executive bodies the European Coun- cil and European Commission have issued a series of declarations that are amalga- mated in this chapter. The ideas behind these declarations formulate the framework of comparative educational systems that can have a significant impact on the global health informatics education. 1. Introduction The European process, thanks to the extraordinary achievements of the last few years, has become an increasingly concrete and relevant reality for the Union and its citizens. Enlargement prospects together with deepening relations with other European countries provide even wider dimensions to that reality. Meanwhile, we are witnessing a growing awareness in large parts of the political and academic world and in public opinion of the need to establish a more complete and far-reaching Europe, in particular building upon and strengthening its intellectual, cultural, social and scientific and technological dimensions. A Europe of Knowledge is now widely recognised as an irreplaceable factor for social and human growth and as an indispensable component to consolidate and enrich the Euro- pean citizenship, capable of giving its citizens the necessary competences to face the chal- lenges of the new millennium, together with an awareness of shared values and belonging to a common social and cultural space. The course has been set in the right direction and with meaningful purpose. The achievement of greater compatibility and comparability of the systems of higher education nevertheless requires continual momentum in order to be fully accomplished. We need to support it through promoting concrete measures to achieve tangible forward steps. While affirming our support to the general principles laid down in the Sorbonne decla- ration, we engage in co-ordinating our policies to reach in the short term, and in any case within the first decade of the third millennium, the following objectives, which we consider to be of primary relevance in order to establish the European area of higher education and to promote the European system of higher education world-wide: 1. Adoption of a system of easily readable and comparable degrees, also through the implementation of the Diploma Supplement, in order to promote European citi- zens employability and the international competitiveness of the European higher education system 2. Adoption of a system essentially based on two main cycles, undergraduate and graduate. Access to the second cycle shall require successful completion of first cy-
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