Tuesday, October 8, 2019

Role of MOOCs in Healthcare Education

Seferina Kim, PharmD, BCPS
Clinical Pharmacy Specialist
University of Maryland School of Pharmacy | University of Maryland Medical Center

Massive Open Online Courses (MOOCs) are free online courses with potentially large enrollment on a wide variety of subjects including healthcare.  They typically incorporate various media such as video, bulletin boards, and live chats, sometimes in conjunction with the traditional requirements of classes such as assigned readings and quizzes.  This platform inherently celebrates the pedagogical learner. 

There are two main types of MOOCs: xMOOCs and cMOOCs.  cMOOCs emphasize a learning style developed by George Siemens and Stephen Downes called, “Connectivism.”  Connectivism explains that internet technology creates opportunities for people to learn and share information in learning communities [1,2].  Imagine cMOOCs akin to forums established around common interests where participants can be both learner and teacher.  xMOOCs however incorporate more of a traditional approach to learning but through the online medium.  There are several websites and schools associated with xMOOCs.  Two of the largest companies act as repositories of these classes: Coursera (https://www.coursera.org/) and EdX (https://www.edx.org/)[3,4].  These companies offer a large catalog of courses affiliated with established, recognizable academic institutions such as UCSF, Stanford, Harvard, UC Berkley, UC San Diego, MIT.  Additionally, MIT (https://ocw.mit.edu/index.htm) and Johns Hopkins Bloomberg School of Public Health (https://ocw.jhsph.edu/) offer OpenCourseWare (OCW) which essentially provides all the teaching materials for free[5,6].  Aquifer (https://www.aquifer.org/) appears to be the only non-profit website devoted exclusively to virtual patient cases and promoting medical education in congruence with national standards for testing, including AMA and CME credits[7]. 

The initial excitement around MOOCs peaked in 2012-2013 with many large institutions offering classes which are now since defunct.  The enrollment and completion of these courses never fulfilled industry expectation.

Where does this leave healthcare education?  As stated earlier, MOOCs require a pedagogical learner.  Undergraduate studies and the didactic years of any healthcare program requires structure with formal assessment to ensure a uniform, baseline minimum knowledge as a foundation and therefore makes self-directed learning difficult.  While the theory of connectivism may not be conducive to andragogical styles, there are certain elements that might be translated for effective learning.  The presence of learning communities provides opportunities for collaboration and as such, UCSF currently offers an xMOOC through Coursera entitled, “Collaboration and Communication in Healthcare: Interprofessional Practice” which helps to facilitate communication between all the healthcare disciplines at their campus[3]. 

There are two current problems for once students transition to adult-learning styles.  First, in the context of pharmacy practice, xMOOC selection appears to be sparse.  As stated above, Aquifer provides an array of virtual patient cases in a variety of medical specialties however the coursework is geared towards physicians, NPs, and PAs.  Coursera appears to offer the greatest pharmacy-specific selection with 71 xMOOCs whereas EdX however only revealed three [3,4].  Coursera course content favors topics that are offered at the, “Beginner” level that are not directly pharmacy-related topics such as, “Global Health: An Interdisciplinary Overview” or, “The Science of Health Care Delivery.[3]”  While not to be discredited, they may not address the needs of the pharmacist, resident, or APPE pharmacy student.  The second problem is that there is little research describing outcomes such as completion rates or its impact upon scoring upon accrediting tests.  A study by Pickering and Swinnerton in the United Kingdom attempted to characterize the demographics and self-perceived benefits of providers after taking an xMOOC in anatomy however they only note a completion rate of the survey and not the course at 3% [8].

It is probable that xMOOCs are similar to required CEs in maintain knowledge, regardless of discipline, however this based on supposition and extrapolation to online CEs.  There is little validated data proving this, especially in the context of pharmacy.  There is even less little information on the role of cMOOCs upon healthcare education.  With the globalization and standardization of education, online education will also likely to continue to grow and hopefully, education research provides insight in the most effective manner in utilizing this medium.  Regardless, some of the courses currently being offered may simply just be interesting – I plan on starting a course on Chinese herbal medicine next year.

1. Goldie JG. Connectivism: A knowledge learning theory for the digital age? Med Teach. 2016 Oct;38(10):1064-1069. Epub 2016 Apr 29.
2. Kop, R. and A. Hill, Connectivism: Learning theory of the future or vestige of the past? The International Review of Research in Open and Distance Learning, 2008. 9(3).
3. Coursera [Internet]. Coursera, Inc. [cited 2019 Oct 6]. Available from https://www.coursera.org/.
4. edX [Internet]. edX Inc. [cited 2019 Oct 6]. Available from https://www.edx.org/about-us.
5. MIT OpenCourseWare. MIT. [cited 2019 Oct 6]. Available from https://ocw.mit.edu/index.htm
6. JHSPH Open courseware. The Johns Hopkins University. [cited 2019 Oct 6]. Available from: https://ocw.jhsph.edu/
7. Aquifer [Internet]. [cited 2019 Oct 6]. Available from https://www.aquifer.org/.
8. Pickering, J.D. & Swinnerton, B.J. An Anatomy Massive Open Online Course as a Continuing Professional Development Tool for Healthcare Professionals. Med.Sci.Educ. (2017) 27: 243. https://doi.org/10.1007/s40670-017-0383-7

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