Overview of the African Health OER Network OER Africa Convening Kathleen Ludewig Omollo May 16, 2011 Motivation The African Health OER Network project emerged out of the belief that OER could be leveraged to address the health care worker shortage faced by many sub-Saharan African countries. Student applications and enrollment in the health sciences is high, but there are too few faculty members to support them. Existing faculty are overtaxed in time and ability to teach, reducing time available for ongoing program and materials development. Faculty members may harness OER to enrich instruction, save time on materials development, and use that time for other activities such as clinical demonstrations, group discussions, and professionalism when interacting with patients. Increased availability of relevant, need-targeted learning materials can contribute to more productive learners and faculty members and consequently increased numbers of health science graduates. More productive learners and faculty members can lead to more and better-trained health care providers and ultimately improved patient health. Project History In November 2008, we launched the Health OER project as partnership among KNUST, UG, UWC, UCT, U-M & OER Africa. The objective was to identify and address gaps in the existing curricula such as topics that may be particularly difficult topics to deliver to students, for example how to use an automated blood cell counter. Additionally, the goal was to encourage use and adaptation of the completed OER across institutions to reduce duplicate efforts in content development. The following year, we began an effort to scale health OER to other institutions and initiate a continent-wide Network around health OER. We also continued to strengthen the OER activities at the 4 partner institutions in Africa. As this is the African Health OER Network, some may be curious about U-M’s involvement. UMMS has several decades of experience in global partnerships, most notably with Ghana in ob/gyn. In 2007, UMMS launched a large-scale institutional health OER to publish the first two years of the undergraduate medical curriculum as OER. Through the partnership and the resulting OER, UMMS students gain a window into healthcare in different regions of Africa. Considering that 1/3 of UMMS students do part of their clinical training abroad,1 this exposure could help them better prepare for their service. What has been accomplished? Launched Network Website: The website includes African-produced OER, an OER request facility, a declaration of support for members to sign, and a quarterly newsletter. To date, 77 individuals and 16 organizations have signed a Declaration of Support for the Network. 1 http://med.umich.edu/medschool/globalreach/students/m4.html, http://www.med.umich.edu/medschool/about/ Shared under a Creative Commons Attribution 3.0 License http://creativecommons.org/licenses/by/3.0/ Created and Published OER: Participants have created and shared 170 new OER representing diverse health disciplines and media types. Mentoring and Consulting: We provided ongoing mentorship on OER production and policy to participants through user guides, onsite consultation, email, and conference calls. Authored Case Studies & Assessments: We interviewed over 50 individuals at participating universities to identify strategic priorities, achievements, challenges, lessons learned, and future plans. Fostered relationships with existing networks: We have liaised with the Association of American Medical Colleges’ MedEdPORTAL, the American Medical Informatics Association, the HEALTH Alliance, African Medical Schools Association, PRIMAFAMED for Family Medicine, and U.S.-funded Medical Education Partnership Initiative for HIV/AIDS education. Many of the Health OER activities seem similar to other thematic areas of OERA’s work. The unique aspects include the declaration of support and the regular conference calls to connect individuals across institutions that perform similar tasks, such as multimedia specialists. Over the course of the meeting, you will hear more about several of the Health OER projects, including the nursing and midwifery project at University of Malawi and the institutional OER policy processes at University of Ghana and Kwame Nkrumah University of Technology. What have we learned? Over 2 ½ years of the project, we have had to re-examine our initial assumptions and expectations. Original thought #1: The primary selling point of an African Health OER project was the end goal of improved patient health. Realization: The interim step of developing and promoting a corpus of African- produced content seems to attract the most interest. In speaking with faculty, there is a lack of contextually appropriate learning materials. Many medical textbooks and publications originate in Western countries, and therefore use photographs and examples that are not always suitable for the African context. In an OER from the health sciences, for example, there may be differences in curriculum, clinical practices, cultural sensitivity in patient interactions, and the manifestations of certain diseases, particularly dermatological diseases, on light versus dark skin tones. Original Thought #2: Once OER is developed, it will be used within the authoring institution and by other institutions. Realization: In many cases, OER is developed from existing materials as optional learning resources that are not integrated into the curricula. Instructional staff seem to be more interested in producing their own materials and enhancing their global reputation than in using and adapting OER from others. Additionally, when looking for instructional material, many faculty report that reliability and reputation (e.g. peer review) of the resource are far more significant factors than considering licensing fees. It is possible for OER to compete with all-rights reserved content on reputation and quality alone? How vigorous does the peer-review process of OER have to be generate good quality? What are the incentives for subject specialists to do peer review of OER? Original Thought #3: OER Authors will accept a Creative Commons license as the maximum restriction on content usage. Realization: Some faculty agree to Creative Commons licenses, but strive to restrict content in other ways. Some have tried to control where resources may are hosted (e.g. branding on institutional servers) or how people may come across them (e.g. CC BY pediatric palliative care videos from U-M are posted as unlisted videos on YouTube and only linked to from the OM website). Others may be fine with making their content freely viewable, but attach a No Derivatives clause to preserve factual information at the expense of prohibiting adaptations. The idea of a public license rather an exclusive license for identified groups still intimidates many. This resistance seems to be particularly strong in health since it concerns graphical medical images, requires the utmost factual accuracy, and may involve filming of patients, albeit most often anonymously and unidentifiably for OER. Additionally, authors are naturally interested in who and how many people are accessing the content. Once a resource is copied and hosted in multiple places, tracking its usage becomes more difficult. Is the Creative Commons license suite appropriate for health materials? Original Thought #4: There will be co-authoring of OER between institutions. Realization: The only co-authoring of OER across institutions happened between a few visiting professors and their host institution while they were in country. This is due in part to logistical challenges and the difficulty in identifying potential collaborators within one’s field, as well as the restrictions imposed by the local curricula. Health sciences curricula is often so dense and specific to local accreditation and certification that they hinder the co-authoring or even adaptation of alternative methods or procedures. Do health curricula leave any room for adapting outside materials? Original Thought #5: New connections between institutions will organically develop. Realization: Very little inter-institutional collaboration has developed, except for that which was initiated because of historical associations between institutions. The bimonthly conference calls across OER support specialists have addressed that in part, but there’s still a large gap between collaboration among authors.