Learning from the innovative open practices of three international health projects outside academia

Leigh-Anne Perryman and Tony Coughlan

The Open University, UK

Note: This paper has been accepted to be published in the special issue of Open Praxis. You can see the full paper at ow.ly/LXdiw

The open education community has long taken a narrow, formal education-specific view of how and where open educational resources (OER) might be used and open educational practices (OEP) enacted. Research in the field tends to mirror this perspective and little attention is given to the wealth of OER and OEP from outside formal education. The 2013 report by the Hewlett Foundation (The Hewlett Foundation, 2013) touches upon the massive potential for OER use and production beyond higher (and formal) education when stating that ‘by enabling virtually anyone to tap into, translate and tailor educational materials previously reserved only for students at elite universities, OER has the potential to jump start careers and economic development in communities that lag behind’. Additionally, the the UK-based OER4Adults report (Falconer et al, 2013, p. 46) recommended that the OER movement should ‘encourage OER development by organisations and communities outside mainstream education’.

Since 2011, we have been developing and piloting a new role for open academics, which we have named ‘the public open scholar’ (Coughlan and Perryman, 2013). The role involves open academics working with online communities outside formal education who might benefit from OER, identifying members’ expressed needs and then sourcing OER to meet those needs (see Figure 1).

Figure 1: The public open scholar role: See https://opencollection.files.wordpress.com/2014/12/2worlds-figure6.png

We developed this role aiming to increase awareness of open educational resources and to share with academia information about the resource needs of people beyond the academy who could really benefit from OER. In the process of developing and performing the role we have learned about a wealth of open resources and collaborative open educational practices emanating from outside formal education, for example from voluntary sector organisations, government and professional bodies. This inspired us to evaluate such resources and practices in order to identify what the open education movement might learn from them. We have based our evaluation on three case studies that we encountered during our public open scholar research and which, on first glance, appear to feature innovative OEP.

The selected case studies are the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP), the Virtual Campus of Public Health (VCPH), and Physiopedia. They each share four characteristics:

1. They are embedded within a specific health profession, and have links with other professional bodies;
2. They use volunteers, are not-for-profit, and aim to collaboratively pool and share professional expertise;
3. They play an international role and are based outside higher education, although all have links with universities;
4. They use Creative Commons licences and social media.

The International Association for Child and Adolescent Psychiatry and Allied Professions (http://iacapap.org) was established in Europe 75 years ago, although its membership now comprises 63 Latin and North American, European, and Pacific Rim-based organisations. IACAPAP advocates for the promotion of mental health and development of children and adolescents through policy, practice and research. Campus Virtual de Salud Pública – The Virtual Campus of Public Health (http://www.campusvirtualsp.org) was launched in 2003 and is now a network of more than 140 partner institutions and organizations across Central and South America that share courses, resources, and other education services with the common purpose of improving Public Health practices and workforce skills. Physiopedia is a non-profit company established in the UK in 2009. Physiopedia is building an evidence-based knowledge resource (www.physio-pedia.com) for physiotherapy and physical therapy professionals throughout the world, and aims to be a place where all physiotherapists and physical therapists can participate by contributing, sharing and building knowledge to develop a united profession and a global understanding.

Our evaluation of IACAPAP, VCPH and Physiopedia draws on two frameworks. The comprehensive and influential OPAL (2011) ‘open educational practice maturity matrix’ is our starting point. The matrix can be used to assess institutions’ OEP in terms of OER use and reuse, open learning architectures, organisation-wide OEP strategies and the implementation and promotion of OEP (see Figure 1). However, the object-focused OPAL framework is not sufficiently comprehensive to cover the open collaboration featuring in our case studies. We therefore extended our evaluation to include the four dimensions identified in the OEP social configuration framework developed by Vrieling et al (in press; but see also Schreurs et al, 2014): practice, domain, collective identity and organization.

Applying the OPAL ‘open educational practice maturity matrix’ to the three case studies (see Figure 2) confirmed that they all use both OER (the horizontal axis on the OPAL grid) and open learning architecture (the OPAL framework’s vertical axis). We rated IACAPAP and Physiopedia as ‘medium’ users of OER and OEP, so they appear in the central box in the grid. We did not rate them higher as neither are entirely open; for example they both keep some business objectives private, and also use non-OER. We rated VCPH highly on both counts, for having open objectives embedded within its policies, and for its high use of OER: 14 OER courses plus 5800 OER library items.

Figure 2: IACAPAP, Physiopedia and VCPH mapped onto the OPAL matrix. See https://opencollection.files.wordpress.com/2014/12/screen-shot-2014-12-08-at-15-19-58.png

Looking at the case studies and their practices in more detail reveals areas of distinct innovation. The International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) is a traditional professional body that began adopting open practices in 2011 after a distinguished 70-year history. It is now well-known for its open access (CC-BY) online journal Child and Adolescent Psychiatry and Mental Health, and its open access (CC-BY-NC) online Textbook of Child and Adolescent Mental Health. The 49-chapter textbook is a remarkable collaborative achievement by over 100 contributors from 5 continents, with five chapters now being offered in the French language alongside English. The textbook has a Facebook page to enable readers to make comments and suggestions to the editor and contributors. IACAPAP are also developing more self-directed learning activities, self-assessment exercises, and teaching materials, including a MOOC (Massive Open Online Course) entitled ‘Essentials of child and adolescent mental health across the world’.

The Virtual Campus of Public Health (VCPH) is a collaboration between over 100 institutions and organizations. Since 2003 VCPH has assembled a multilingual online library of 190,000 items in total, with 5800 identified as OER. They have also developed 14 OER courses delivered free through a Moodle platform, again in three languages, whilst also providing links to nine courses hosted elsewhere. A noteworthy feature of VCPH is the way that content is localised for individual countries in Central and South America. VCPH runs a successful Facebook page in Spanish with 5200 likes (subscribers).

Physiopedia is the most recent project amongst our case studies and has used web 2.0 tools from the outset. Physiopedia is characterised by the wiki that is at the heart of the project, currently containing over 1400 articles and attracting more than 150,000 users from over 200 countries each month. The Physiopedia wiki is offered under a GNU Free Documentation License (GFDL) coupled with a Creative Commons CC-BY-NC-SA license (the same pairing as Wikipedia), and users are encouraged to discover new ways of using it. A second distinguishing characteristic of Physiopedia is its pioneering use of Mozilla Open Badges to reward volunteer contributors and course participants. Physiopedia currently offer a small number of open courses, including a MOOC: ‘Physiotherapy Management of Spinal Cord Injuries’ which runs annually and last attracted 3,500 registrants from over 120 countries.

Structured courses, teaching and publications fit in well with the OPAL framework and inform our placement of the three case studies in Figure 2. However, this does not give the full picture of the OEP taking place in the three case studies. For example, it tells us little about the behaviour (e.g. collaborative practices) of the participants. We therefore applied the OEP social configuration framework developed by Vrieling et al (in press) to address this. The Vrieling et al framework comprises four dimensions: practice, domain, collective identity and organisation, which we applied to the three case studies as follows:

1. Practice. All three rate equally highly, as would be expected from occupational bodies.
2. Domain. An online shared area for participants is not a big feature of IACAPAP, whose members would traditionally communicate through journals and face-to-face conferences, so IACAPAP rates low on this dimension. VCPH achieves a medium rating for its repository, and Physiopedia rates highly for its collaborative wiki.
3. Collective identity. Again, Physiopedia rates highly here for its collaborative wiki, but IACAPAP and VCPH rate low on this dimension for their individual users, with structures and practices that reflect the needs of their largely institutional membership.
4. Organisation. The pattern of dimension 3 (Collective identity) is repeated here, with Physiopedia rating highly for its wiki and open badging, while IACAPAP and VCPH rate low on this dimension for individuals but would rate more highly if applied to institutional members.

Applying Vrieling et al’s framework did not draw out many differences between the three case studies, so did not significantly add to our insight or evaluation. We did note that Vrieling et al’s category 2 – Domain – is similar to OPAL’s learning architecture axis.

Our evaluation of IACAPAP, VCPH and Physiopedia highlights both innovative practices and the fact that current OEP evaluation frameworks are not sufficiently comprehensive nor nuanced to capture all of these practices. For example, the collaborative development of the 49 chapter open IACAPAP textbook by over 100 contributors, from 5 continents is innovative, as is its impact around the globe and especially in the developing world. However, neither of the models would allow for identifying this aspect of the case study. Indeed, the models reduce the three case studies to appearing very similar. The VCPH collaboratively developed library of 190,000 items, including 5800 OER, in three languages and localised, is a similar achievement. VCPH scores highly in the OPAL model as it is the sort of organisation that OPAL was designed to be applied to. However, the localisation is not accommodated by the OPAL model, and the institutional collaboration that is such a feature of both IACAPAP and VCPH is captured by neither OPAL nor Vrieling, which both tend to focus on individual educators. Finally, Physiopedia is pioneering in successfully engaging professional practitioners in contributing to an open wiki. The Vrieling framework captures this type of activity particularly well and of the three case studies Physiopedia – due to its emphasis on Web 2.0 practices – is the best fit with both evaluation frameworks.

Our study indicates that the open education movement does not currently have suitably flexible evaluation frameworks for evaluating diverse OEP. For example, influential frameworks such as the OPAL matrix, with its language of teachers, courses and educational institutions, are overly narrow and do not map easily outside academia. Additionally, while the Vrieling framework works well for the activities of individuals it does not easily accommodate the practices of professional consortia, which are common in the vocational world. We argue that an extended framework is needed in order to: (1) better encompass vocational and lifelong learning; (2) better address the ultimate application of knowledge and OEP outside the formal classroom, for example in clinics or community centres; and (3) better integrate social learning, open collaboration, object use and re-use and open learning architecture in a single set of evaluation criteria.

Clearly, there is much to learn from studying OEP outside formal education, especially in terms of collaborative approaches to knowledge creation, resource sharing and the ways in which a sense of collective identity can traverse geographical borders. However, the open education community does not currently have sufficient mechanisms for capturing and learning from innovative open practices outside academia. Additionally, our own research is limited in that we have only looked at one sector – health – and we strongly encourage other open academics to identify, evaluate and share open practices outside academia in their specialist fields, especially those which unite globally dispersed participants.

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