Open online courses inhealth professions

educationA systematic review of the literature

Michael Rowe UWC, South AfricaStephen Maloney Monash U., AustraliaChristian Osadnick Monash U., Australia

Background

“Exploitation of the power of IT for learning through development of evidence, capacity for data collection and analysis, simulation and testing, distance learning, collaborative connectivity, and management of the increase in knowledge.” Frenk, et al. (2010)

“No longer will a limited number of medical schools or faculty constrain our ability to educate medical students. Learning communities will form naturally, and students will need to take ownership of their education” Mehta et al. (2013)

Background (cont.)

There is currently relatively little research that has been conducted in the MOOC-domain (Fournier et al. 2014)

MOOCs are falling short of “democratising” education & may be doing more to increase gaps in access to education(Hollands & Tirthali, 2014)

“Open and networked educational environments must not be merely repositories of content. They must be platforms for engaging students and teachers as full, empowered agents of their own learning.” (Mackness, 2014)

Study aim

This systematic review set out to:

1. Map the scope of literature related to open online courses in health professions education;

2. Describe the features of existing open online courses relevant to health professions education; and

3. Examine the effects of open online courses on health professions education.

Methods | Search strategy

Searches of electronic database included PubMed, Medline, Embase, PsychInfo and CINAHL to identify publications without any restrictions

Inclusions: Undergraduate and postgraduate.

Exclusions: Distance education or generic (“traditional”) online courses; Professional education; No exclusions based on study type

Grey literature: Google Scholar & hand searching of included studies and reference lists

Methods | PICO

Participants: medicine, physiotherapy, occupational therapy, nursing, radiology, speech and language therapy, dietetics, public health, dentistry and psychology

Intervention: Any open online course / variants (Massive Open Online Courses; Distributed Online Collaborative Courses; Small Private Online Courses; Open Online Courses)

Control: N/A

Outcomes: Effectiveness (primary), Feasibility and acceptability, Economic value and Pedagogical framework

Methods | Extraction & Analysis

Selection and data extraction: one member of the team; random accuracy checks by a second, independent of knowledge of the first; discrepancies addressed by a third

Extraction: standardised electronic template for study characteristics (year and location of publication), study type (methodology), participant characteristics, key outcomes, and quality appraisal

Narrative approach to data synthesis, incorporating descriptive statistics to synthesise data on the effects of open online courses on health professions education

Methods | Critical appraisal

We knew that there would be a wide variety of study methodologies included in the review:

● Commentaries● Narrative reviews● Pre/post designs● Controlled clinical trials

Therefore we did not anticipate comprehensive systematic appraisal of all included studies and as a result, no studies were excluded from the review on the basis of study quality.

Results | Overview

31 publications Profession

RCTMixed methodsCase studyDescriptive auditCase reportLiterature reviewCommentaryEditorialCorrespondencePoint/counterpointReport

132116103111

CombinationMedicineNursingPhysiotherapyDentistryPsychologyPharmacyPublic healthDieteticsUnspecified

9752221111

Results | Effectiveness

3 papers reported on effectiveness

1. No significant difference between groups (knowledge, satisfaction and perceived confidence)

2. Participant self-report (“93% believed the course had changed their lives”)

3. Participant self-report (distraction while watching videos)

“Effectiveness” was not defined in terms of participants actually achieving any learning outcomes

Results | Feasibility

2 papers reported on feasibility

1. High ratings of content quality (lectures, quizzes, handouts, music in video introductions, etc.)

2. Low ratings of technical problems experienced (internet connection, videos not playing, etc.)

In these two cases, “feasibility” was therefore defined in terms of content quality and technical problems experienced.

Results | Economic value

No papers reported on any economic analysis of the course that was offered. Therefore, there was no reporting on:

● Cost of course development● Return on investment● Cost-benefit analysis

Results | Outcomes

6 papers described study outcomes

4 of these were the authors’ opinions i.e. not supported with data in the paper

1. MOOCs are less expensive and more accessible than most traditional classes; 2. Provides an affordable opportunity for low income earners to access “higher education”

1. No financial barriers to participate for students; 2. MOOCs may undermine the existing business model of universities given universities are reliant on tuition revenue

Results | Pedagogical framework

3 papers reported on a pedagogical framework (xMOOC)

1. Scalability of provision: many participants2. Open access (free) but restricted license: not really open3. Individual learning in a single platform: not collaborative4. Emphasis on acquiring knowledge and skills

No papers reported any integration of learning theory into course design or data analysis.

Conclusion

There is a lot of excitement around open online courses in health professions education, with an increasing number of papers being published in support of open online courses

Very few of these papers include studies that are rigorous or well-designed, and the conclusions they reach are often not supported with data

Exercise caution when using the current literature in support of decision making around open online courses

There is an opportunity for health professions educators to conduct strong research in this area

Thank youmrowe@uwc.ac.zamrowe.co.za/blog@michael_rowe