nextgenu.org: the world's first portal to free, accredited higher education (166230039)

7/29/2019 NextGenU.org: The World's First Portal to Free, Accredited Higher Education (166230039)

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Erica Frank, MD, MPH

Founder, President, and Executive Director, www.NextGenU.org

Professor and Canada Research Chair, UBC – Faculty of Medicine

NextGenU.org

the world’s first free university



A distributed, computer-assisted, competency-based

mentored, and free model:

computer-based knowledge transfer, coupled with

peer and local mentored experiences.



The first problem we’re helping fix:

democratizing health sciences learning

• In 2006 WHO identified a need for 4.3million more trained health workers globally

• WHO also said that this will require greater use of training innovation, especially throughinformation and communication technologies



Founding Collaborators and Funders

American College of Preventive Medicine

Annenberg Physician Training Program

Centers for Disease Control and Prevention

NATO – Science for Peace

University of British Columbia

World Bank

World Health Organization

World Medical Association



How are we free?

• Cost-free

• Barrier-free

• Ad-free• Carbon-free



eDATA K Computer-Based Drug and Alcohol Treatment

Assessment in Kenya

UBC

Africa Mental Health FoundationOthers



Main components

Training – NextGenU.org – KAP and training performance

Randomized control trial – Alcohol, tobacco, SUD:

Results of screening VS Brief Intervention

Independent assessment of consumption, Follow-upforms, quality of life, stigma

Developmental Evaluation

Including the learning as it goes – modifying the intervention andresearch methodology



Settings

2 districts

One intervention “as is”

Other with practice support training

for the management team and leaders, to facilitateimplementing and maintaining the intervention

Public health care centers (4)

Private clinics (4) under a capitation modelserving middle income Kenyans



TrainingOffered to all who want to take it - Specific targets

Screening using the Assistlay health workers

Dx, Tx, Referral – mhGAP

Nurses, Medical Officers, General Practionners, MD

Fellowship in Addiction Medicine – ASAM (Tobacco, Alcohol)

Mentors

Practice Change (NHS Leadership Academy, Canadian Health Leaders, AccreditationCouncil for Graduate Medical Education – Common Competencies)

Managers – Clinical Leaders



Activities So Far 1.1:Engage and mobilize stakeholders

Sub-grant, Hiring, MoU, Advisors, Ethics

1.2: Select and adapt the learning materials and

evaluation methods – in progress

1.3: Pilot test and refine the training with 20 traineesand 10 mentors- April

2.1: Evaluation study preparation



Activities to come

Finish building and adapting the trainings

Pilot test the trainings

Train all the targeted stakeholders

Put the research infrastructure in place

Conduct the RCT and developmental evaluation

Analyze and disseminate the results

Improve and scale the trainings

Improve and scale the provision of SUD services in primary care in Kenya



2012-2013 Clinical Public Health and Prevention Trainings

= All core public health areas [Epidemiology, Biostatistics, Health Policy/Mgmt, Environmental Health, HealEducation, co-sponsored by the American Association of Public Health Physicians and the Association fo

Prevention Teaching and Research]

= Adolescent Health [American College of Preventive Medicine, UBC]

= Adult and Pediatric Cardiovascular Disease Prevention [Emory University, Latin American PediatricAssociation, Universidad San Francisco de Quito]

= Climate Change and Health [350.org, David Suzuki Foundation, Health Care Without Harm, InternationalSociety of Doctors for the Environment, Physicians for Social Responsibility, UBC]

= Physical Activity and Health [American College of Sports Medicine, Fundacion Sante Fe, U.S. Centers forDisease Control and Prevention]

= Preventive Medicine [American Association of Public Health Physicians, Public Health Foundation of Indand the Association for Prevention Teaching and Research]

= Prevention/Treatment of Alcohol Use Disorders [Annenberg Physician Training Program, UBC, UF]

= Prevention and Treatment of Tobacco Use [International Federation of Medical Student Associations,International Primary Care Respiratory Group]

= Trade and Health [Center for Policy Analysis on Trade and Health]



2012-2013 Clinical Trainings

= Emergency Medicine [Emory University, Society for Academic Emergency Medicine, International Federationfor Emergency Medicine]

= Family Medicine [MoH Sudan, U of Gezira, WONCA]

= Gynecology/Obstetrics and Perinatal Care [International Federation of Gynecologists and Obstetricians, LatinAmerican Pediatric Association, Medical Women’s International Association]

= Occupational/ Physical Therapy [Rocky Mountain University of the Health Sciences, Kenyan Physical TherapyAssociation]

= Pathology [UBC Department of Pathology]

= Pediatrics [Latin American Pediatric Association]

= Preventive Medicine [American Association of Public Health Physicians, American College of PreventiveMedicine, Association for Prevention Teaching and Research, USF Quito]

=Psychiatry [AMHF, Annenberg Foundation, UBC, U of Florida] = Surgery (Orthopedic) [Presbyterian University of East Africa, College of Surgeons in East, Central and

Southern Africa]



2012-2013 Basic Science Trainings

= Anatomy: Dental

= Clinical/PH Genetics

= Immunology

= Physiology (cardiophysiology)

= Pre-health professionals certificate (biology, math, medical humanities,organic chemistry, physical chemistry, physics)



1. Identify expert driven

competencies 2. Populate course curriculum using free,comprehensive, easily accessed, high

quality, authoritative resources

3. Specify learning objectives f

each resource

4. Develop evaluation and interactive activities

MCQPeer-to-peer

Mentored activities

Discussion forum

Instantly translated chat

room

5. Course-specificAdvisory Committee toreview course material

6. Integrate learner

feedback

NextGenU.org Course Development Process



Matching existing competencies with existing resour



64 Languages Available

• Afrikaans

• Albanian

• Arabic

• Azerbaijani

• Basque

• Belarussian

• Bulgarian

• Catalan

• Chinese (Tr)

• Chinese (Si)

• Croatian• Czech

• Danish

• Dutch

• Italian

• Japanese

• Korean

• Latin

• Latvian

•Lithuanian

• Macedonian

• Malay

• Maltese

• Norwegian

• Persian• Polish

• Portuguese

• Romanian

• English

• Estonian• Filipino• Finnish• French• Galician

• Georgian• German• Greek • Haitian Creole• Hebrew

• Hindi• Hungarian• Icelandic• Indonesian• Irish

• Russian

• Serbian• Slovak

• Slovenian

• Spanish

• Swahili

• Swedish

• Thai

• Turkish

• Ukrainian

• Urdu• Vietnamese

• Welsh

• Yiddish



Interactive Activities Feedback Opportunities

Peer MCQs / cases Feedback form for each resource

Mentored activities Peer feedback for posted assignments

Discussion forums Guided & free text feedback in forums

Instantly translated chat rooms Course evaluations

Word Games: Crossword, Cryptex,

NextGenU.org version of “hangman”

Live technical support



Mentored Activities



Mentored Activities

•Review with your supervisor how to take a focused history appropriate to ED complaints.

•Review all your management plans with your supervisor.

•Review with your supervisor the role of your ED in your community and access to care.

•Review with your supervisor the costs of tests in your hospital.

• Review with your supervisor normal and abnormal glucose levels for your institution.

•Perform IV insertions under supervision.

•Perform phlebotomies under supervision.

•Watch any central lines performed by your supervisor.

•Perform bag-mask ventilation under supervision until comfortable ventilating a patient.

•Learn how to operate the defibrillator available to your institution from your supervisor.

•Have your supervisor demonstrate NG tube insertion with you.

•Have your supervisor review and demonstrate catheterization with you.

•Have your supervisor review and demonstrate casting/splinting principles with you.

•Have your supervisor review and demonstrate technique for incision and drainage.

•Have your supervisor demonstrate proper C-spine immobilization.

•Review the procedure with your supervisor if ultrasound is available at your institution.

•Perform local anesthetic infiltration under supervision.

•Review suturing technique with your supervisor.



Competency 3 1 Effectively communicate with patients family members and other



Competency 3.1 - Effectively communicate with patients, family members, and other

members of the health care team.

Meet with a health care professional, other than a physician, who works in the emergency

department (such as a nurse, respiratory therapist, or social worker). Discuss with themwhat their role is in the emergency department, and gain a brief understanding of their

training. Write a short essay (250-500 words) on the role of this health care provider, and

how their role helps you in managing your patients.

Evaluation criteria:

1. 250-500 words

2. Clearly outline the role of another health care professional (other than physician) in the

ED

3. Describe how the role of this health care provider is important in the care of emergency

patients

4. Describe how the role of this health care provider helps you in managing your patients

Case #1



A 15 year old female presents to the ED with a ruptured ectopic pregnancy. The gynecologist

wants to take the patient to the operating room and requires consent for the procedure. The

patient’s mother is in the waiting room. You have deemed that the patient is competent, and

understands the risks and benefits of the procedure. The patient has asked that you do not tell h

mother about the pregnancy.

Is this patient eligible to give her own consent at age 15? Would you tell the patient’s mother a

her condition? Write a short essay (300-500 words) justifying your decision, using ethical and

legal principles. Briefly outline the laws for age of consent in your country.


1. 300-500 words

2. Outline the law regarding age of consent in your country

3. Attempt to justify your decision to either tell or not tell the patient’s mother about her conditi

4. Identify at least 2 ethical issues surrounding your decision-making process

Case #2



A 35 male presents to your ED with fever, malaise, and cough. He tells you that he

has recently been diagnosed with HIV. You suspect that he has pneumocystis

jiroveci pneumonia. His wife is in the waiting room, and the patient tells you that

she does not know of his HIV diagnosis, and asks that you do not tell her. They are

currently sexually active.

Would you tell his wife about her husband’s HIV status, despite the fact that he

asked you not to, in order to protect his wife? Are you obligated to report his

disease to the local health authorities? Write a short essay (300-500 words) about

your decision making process, and justify your decision using ethical and legal

principles.


1. 300-500 words

2. Outline the law in your country regarding HIV reporting3. Identify at least 2 ethical issues surrounding this case

4. Attempt to justify your decision using ethical principles



Assessment Security

Students can be video-recorded

Students’ computers’ cut and paste functions can be frozen

Sites accessed during exam-taking can be tracked

Examinations can be printed and administeredlocally under direct supervision



Research Metrics

• Name• Email

• Prior degrees

• Current training• Location

• Institution

• Job title• NextGenU metrics

Registered Emergency Medicine Students – 41 Countries



Afghanistan Ethiopia Pakistan

Argentina Georgia Peru

Australia Germany Singapore

Barbados Great Britain South Africa

Brazil Hong Kong Sri Lanka

Bulgaria India Sweden

Canada Indonesia Switzerland

Columbia Ireland Syria

Czech Republic Italy Thailand

Denmark Jordan Turkey

Ecuador Kenya Uganda

El Salvador Mexico United Arab Emirates

Netherlands United States

Nigeria Venezuela

Zimbabwe

g g y



Average for Quizzes 86%

Final Exam 1 72/75 96%

Cumulative 188/210 89.52%

Student 2: Sample data for Quizzes and Final Exam

Final Exam Sampling



Fullname # of Attempts Marks Percentage Last attempted on Student1 1 59/75 78.7% April 26, 2012, 6:17 am

Student2 1 75/75 100% April 26, 2012, 6:35 am Student3 1 72/75 96% April 26, 2012, 6:44 am

Student4 1 68/75 90.7% April 26, 2012, 7:25 am

Student5 1 72/75 96% April 26, 2012, 7:34 am

Student6 1 71/75 94.7% April 26, 2012, 7:39 am

Student7 1 69/75 92% April 26, 2012, 7:34 am

Student8 1 68/75 90.7% April 26, 2012, 7:42 am

Student9 1 66/75 88% April 26, 2012, 8:11 am

Student10 1 74/75 98.7% April 26, 2012, 8:07 am

Student11 1 69/75 92% May 4, 2012, 11:49 am

Cumulative 763/825 92.48%

Final Exam Sampling



Quiz: Competency 6.1. Understand the approach to the approach to abdominal pain 10

66.66% 1

100.00% 9

Quiz: Competency 6.2. Understand the approach to altered mental status 10

66.66% 5

100.00% 5

Quiz: Competency 6.3. Understand the approach to cardiac arrest 10

66.66% 2

100.00% 8

Quiz: Competency 6.4. Understand the approach to chest pain

10

100.00% 10

Quiz: Competency 6.5. Understand the approach to gastrointestinal bleeding 10

66.66% 2

100.00% 8

Quiz: Competency 6.6. Understand the approach to headache 10

66.66% 1

100.00% 9

Quiz: Competency 6.7. Understand the approach to poisoning 10

33.33% 1

66.66% 3

100.00% 6



A distributed, computer-assisted, competency-based,mentored, and free model:

computer-based knowledge transfer, coupled with pe

and local mentored experiences.

N tG U h ith th MOOC



NextGenU shares with other MOOCs…

The knowledge that we:

• aim to help democratize learning;

• are not a panacea and will not replace many universityfunctions;

• rely heavily on the largesse of traditional universities,standing on the shoulders of generous giants who have

provided the learning resources, platforms, time, funding,and on- and off-line teaching precedents and inspirations;

• need to nurture each other as we learn how best to usethese powerful tools for massive good;

• will continue to improve by open-mindedly incorporatingothers’ innovations and generously sharing our own;

• have a long way to go to achieve educational nirvana, buthave an unprecedented opportunity for locally-deliverededucation everywhere, all the way to post-graduateeducation, and therefore an unprecedented obligation.

H N tG U diff f th MOOC



How NextGenU differs from other MOOC

1. Credit

2. Free

3. Financial sustainability

4. Best available resources

5. Higher-level education

6. Competency-based foundation

7. Language

8. Extensive human interactions

9. Interactive computerized learning

10.Extensive computerized and human assessment

11.Completely open use

12.Active partnerships with multiple experts and with end users

13.Customizability



“NextGenU is a visionary undertaking.” – Jeffrey P. Koplan, MD, MPH, Former

Director, U.S. CDC

“ NextGenU.org will help globally democratize health science knowledge.” -

Carmen Carpio, Knowledge Management Officer, World Bank

“NextGenU is an incredible resource for health professionals all over the world.

Open access to health information should literally save millions of lives and

lead to important new discoveries.” -Anne Margulies, former Executive Director,

Open Course Ware, MIT

“NextGenU is expected to make a considerable contribution to the advancement

of e-learning worldwide.” -WHO, Building Foundations for E-Health, 2006

“The internet at its finest… a bonanza… a boon… an incredibly worthwhile

enterprise… a model of what Health 2.0 and Science 2.0 can be… one of the

most altruistic and honorable health service resources on the planet.” -Online

reviews



Ways to Engage

Advisors

Course creators

Organizational collaborators

End-product users



Erica Frank, MD, MPH

[email protected], [email protected]

Founder and Executive Director, NextGenU.org

Professor & Canada Research Chair, University of British Columbia

mailto:[email protected]




nextgenu.org: the world's first portal to free, accredited higher education (166230039)

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