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The creation of online teaching material as a crisis solution

The creation of online teaching material as a crisis solution

In an effort to complete the 2016 academic year, the University of Cape Town leadership have called upon the body of lecturers to make use of online and blended teaching material.  The University, as others in the country, are reopening their doors under difficult circumstances.  These relate to continued protest action and the absence of consensus amongst students and staff on the if-and-how of reopening the University.  With classroom attendance expected to be poor or even unwarranted, the problem of providing didactic learning had to be addressed.  The solution, online learning.  A simple call to put recordings of lectures online and to incorporate already existing web-based material.

I am well familiar with this concept.  With more than 1,000 lectures on YouTube, two courses on the massive open online course (MOOC) platform Coursera® (here & here), and an international award in open education from the Open Education Consortium, I am sold on the concept of freeing knowledge from its academic confines.  Knowledge through education is power.  The access to it is a fundamental right and it should not be a commodity.  There can be no better tool to uplift a population, than through proper education.

So now, UCT wants to embrace online education as an instant solution to save the academic year.  So why, after pouring so much energy into the creation of online educational resources, am I not elated, ecstatic, vindicated?  To be honest, I do experience these feelings.  It is, however, mixed with feelings of trepidation, anxiety, and even frustration.

Frustrated, because my plea for the large scale creation of online resources have fallen on deaf ears.  We need only look at the efforts of leading Universities such as the Massachusetts Institute of Technology, Stanford, Harvard and many others that have embraced the online space in their educational efforts.  Not only to the benefit of their local students, but the world at large.  UCT should have been creating these resources at scale a long time ago.

We have to take cognizance of the fact that the efforts of leading Universities took years to develop.  Built with the input of experienced staff and stakeholders.  Experts who know that simply transforming face-to-face teaching or printed material into video and electronic format does not constitute education.  The problem cannot be solved with a purely cognitivist approach and most certainly, not overnight.

There are many problems inherent in the call for the rapid production of online course material.   One glaring example is the lack of formative and summative assessment.  The face-to-face method of providing learning material (lectures), asking a few unstructured questions during lecturing and sitting back in judgement during tests and exams is already a suboptimal approach to education.  When replacing this flawed concept with unstructured online teaching, the outcome must certainly be viewed with concern.  To develop a proper educational resource takes time, effort, experience, research, and most importantly, engagement and consultation with students.  Watch this video from smaccDUB on how students can choreograph their own education.

The call to make online resources available must be supported.  We need to do so in a measured and structured manner, though.  To the University’s credit the Dean of the Health Sciences Faculty has called for the creation of a technology in education committee.  The Centre for Innovation in Learning and Teaching have published an excellent guide to the creation of online educational resources.  Furthermore, they provide individual consultations and hold regular workshops.  Hopefully we can use this opportunity to align our efforts with those of the leading Universities in the world.

My Coursera MOOC now live!

My Coursera MOOC now live!

After many months of preparation, my massive open online course (MOOC) on healthcare statistics has gone live on Coursera today, December 01, 2015.  To sign up follow this link: Coursera.

This course build an intuitive understanding of statistics, without the use of complicated mathematical equations.  Everything from descriptive statistics to hypothesis testing, confidence intervals, p-values, Student’s t-test, chi-square tests and many more are explained.

On completion of this course you should feel confident in properly evaluating the published literature or even embark on your own research.

Our road to patient-centred, competency-based education

Our road to patient-centred, competency-based education

So, how can an academic surgical unit benefit from the computer code development skills of people such as Wes McKinney of pandas fame or the educational skills of an engineering professor such as Lorena Barba of Numerical MOOC (numerical massive open online course) fame? Answer: A lot. This post is about our efforts to transition from antiquated to more modern forms of surgical training and assessment, all with the help of the one of the best software projects out there, Project Jupyter. This is Groote Schuur after all!

The teaching and assessment paradigm has stood for many, many decades. Do four years of surgical rotations, watch what your superiors do, present on ward rounds, go to the clinic, take calls, assist in theatre, do some cases, attend (most) academic meetings (read: watch yet another PowerPoint presentation), pass three exams. Presto. Specialist. That’s how its done now, that how is was done in the 00’s, the 1990’s, 80’s, 70’s, 60’s, 50’s, 40’s,… You get the point. Hey, depending on which source you read, it was in the the 40’s that the overhead projector was first used by the military in World War II. If you think about it, an overhead transparency projector is just PowerPoint without a computer. If you slipped in one transparency while the other is still showing, it;s just like a slide transition!

Depending on your working environment, you might be surrounded by people in full support of this form of education. It has always worked that way. Why change now? Well, as the argument goes, by that logic bloodletting should still be all the rage. You will note that in contrast to medical education, actual medicine has come on in leaps and bounds. We buy into the new paradigm that is evidence-based medicine. So why is it so difficult to accept and, even more difficult, to practice evidence based medical education?

Some of us are fortunate enough to work in countries where there are national efforts and frameworks in place to motivate for change. Have a look at the CanMEDS program in Canada. Two of the key concepts in their program are patient-centred care and competency-based assessment. Without going into the detail of their programs, I want to concentrate on these two aspects. Reason being, it gives us a practical starting point. For those unfortunate enough not to work in countries with national frameworks and support, small steps have to be taken.

So what solutions have we implemented in the Acute Care Surgery Unit at Groote Schuur Hospital? First and foremost, involve the patients. They are at the centre of what we do after all. Why should they have no say in the evaluation of their care? Fortunately, validated tools are available when you turn to the literature. At this time we use the Jefferson scale of patient’s perception of physician empathy. Moving on to competency assessment, there is the Ward Round Assessment tool amongst many others. Point being, we are moving away from the 20-second, mark either average or above average on the end-of-rotation subjective question scorecard. You know the one: (1) Knowledge, (2) Surgical skill, (3) Punctuality…

Now, the Acute Care Surgery Unit is brand new (you can learn more about us from my talk at this year’s Association of Surgeons of South Africa conference here). We certainly have no research assistants, money, or personnel to help us in our efforts towards patient-centred, competency-based education. This whole process has to be self-driven. Solutions to the problem? Well, that’s the easy bit. The World has changed over the last few years. No longer is knowledge locked away behind expensive paywalls. If you want to learn something, go online. For me, it all started with the Massachusetts Institute of Technology (MIT). Their open courseware opened a whole new world to me. MIT and the massive open online course platforms such as Coursera (to which I will shortly contribute), EdX and FutureLearn (to name but a few) are handing the keys of knowledge to all humankind.

This brings me to Project Jupyter and computer languages such as IPython and Julia. If you have no access to software development teams and big budget research units, do yourself a favor, search for tutorials on these projects. You will find so many wonderful men and women, going out of their way to empower you with these tools. Even a lowly surgeon such as myself have online tutorials. Have a look at these:
The Klopper Lectures on Julia
Mini project: Medical research using Julia

Back to what this post is all about.  Here, you will find a link to some of our results using Project Jupiter (Github). To protect patients and trainees, the data have been altered and are not a true reflection of anyone or any given period. What it does show, though, is how easy it is to use data to properly guide the training of our residents; and this is just our first small step.