Workshop given at Haramaya University College of Health Sciences and College of Medical Sciences on 29 April 2012. CC BY The Regents of the University of Michigan.

1. Introduction to Open Educational
Resources for Health Training
Kathleen Ludewig Omollo
International Program Manager
University of Michigan Medical School Office of Enabling Tech.
April 29, 2012 – Haramaya University – Health and Medical Sci.
Slides at: http://openmi.ch/haramaya-oer-intro
Except where otherwise noted, this work is available under a Creative Commons Attribution 3.0 License
(http://creativecommons.org/licenses/by/3.0). Copyright 2012 The Regents of the University of Michigan.
Cover image CC:BY-SA Jessica Duensing (Flickr)
1

2. Free
Public
Under some licenses to use, adapt, redistribute
Image CC:BY-SA Colleen Simon (Flickr)
2

3. 3
PATH
•Overview of the African Health Open Educational
Resources (OER) Network
•Existing Maternal and Child Health OER That You Can
Use and Adapt
•Copyright Trivia
•What is “Open”?
•How to Create Your Own OER
•Discussion: Using, Adapting, and Creating OER at Your
Institution
Image CC:BY-NC-SA werkunz (Flickr)

4. Case Study: African
Health OER Network
Image CC:BY-NC Jon Milet Baker (Flickr) 4

5. Motivations:
Challenges to Health Education in Africa
•low budget, small workforce, high disease
burden
•scarce, aging, and emigrating teaching staff
•not enough instructors or classroom spaces
•repetitive instructional responsibilities
•and….
Image CC:BY Phil Roeder (Flickr) 5

6. large lectures &
crowded clinical situations
6 Image CC:BY-NC University of Ghana

7. 7
When you look in
textbooks it’s difficult to
find African cases. The
cases may be pretty
similar but sometimes it
can be confusing when
you see something that
you see on white skin so
nicely and very easy to
pick up, but on the dark
skin it has a different
manifestation that may be
difficult to see.
-Richard Phillips, lecturer,
Department of Internal
Image CC:BY-NC-SA Kwame Nkrumah
Medicine, KNUST (Ghana) University of Science and Technology

8. The mission of the African
Health Open Educational
Resources (OER) Network (est.
2008) is to advance health
education in Africa by creating
and promoting free, public,
openly licensed teaching
materials created by Africans
to share knowledge, address
curriculum gaps, and support
health education communities. www.oerafrica.org/healthoer
8

9. Founding members (2008):
 Kwame Nkrumah University of
Science and Technology
(KNUST)
 University of Ghana (UG)
 University of Cape Town (UCT)
 University of the Western Cape
(UWC)
 South African Institute for
Distance Education (Saide)
 University of Michigan (U-M)
We aim to scale to continent-wide www.oerafrica.org/healthoer
and, eventually, a global Network. 9

10. Approach
Use simple, low-cost technology to create
multimedia-rich learning materials that are
lower-cost and more contextually relevant
than previously available educational
resources.
10

11. Approach
The materials created will be useful to not
only the other institutions, but others in the
Network as well as people at other
institutions worldwide.
So we make the materials public and include
a simple license (terms of use) that allows
anyone world to use, copy, adapt, and
redistribute.
11

12. Gather Existing Materials
Assist health professionals in finding materials that
are free, electronic, and openly licensed (i.e.
expressly allow the general public to use, adapt,
copy, and redistribute)
APPROACH
Facilitate
Discussion
Foster dialogue
Publicly between health Adapt and Create
Distribute professionals around New Materials
Materials pedagogy, policy, Provide tools and
Promote the materials peer review, and openness guides for educators
worldwide through via onsite consultation, and students to design,
multiple online and discussion lists, conference license, and share
offline methods calls, and newsletters learning materials
12

13. Demo
13
13

14. 14
Community Usage
• 160 people • 8500 views/mo
trained in open on website
licenses • Accessed in
• 115 authors 190+ countries
• 12 institutions • 861K views on
YouTube
Collection • 795 favorites
• 135 modules on YouTube
• 339 materials • 173 comments
• 144 videos on YouTube
(906 minutes)
Image CC:BY-NC-SA HeyThereSpaceman (flickr)

15. Visualization of greatest word frequency in Youtube comments – from wordle.com.
http://wiki.datawithoutborders.cc/index.php?title=Project:Current_events:A2_DD 15

16. 16
Remix Example
Image CC:BY-NC-SA Saide and University of Botswana

17. Remix Example:
From This
17

18. 18
Remix Example:
To This
http://blogs.uct.ac.za/blog/oer-uct/2010/11/12/from-uct-opencontent-to-a-journal-article

19. Remix Example:
From This
19

20. Remix Example:
To This
20

21. So, what makes these
Open Educational
Resources (OER)?
21

22. 22

23. Existing Maternal and Child Health OER
23

24. There are hundreds (thousands?) of existing
materials (e.g. lecture slides, animations,
videos, quizzes, image collections) for health
education that are freely and publicly
available and that also give you explicit
permission to use, share, copy, and adapt the
content with no or minimal restrictions.
24

25. Obstetrics and Gynaecology OER from African Health OER
Network
http://www.oerafrica.org/healthoer or
http://openmi.ch/healthoernetwork
1. Caesarean Section
2. Episiotomy & Repair
3. Examination of the Pregnant Woman
4. Procedures in Obstetrics and Gynaecology
5. Sexually-Transmitted Diseases and Pelvic Infections
6. Total Abdominal Hysterectomy
7. University Certificate in Midwifery
8. Textbook of Urogynaecology
9. Surgical Repair of Vesico-Vaginal Fistulae (VVF)
10. Clinical Examinations in Gynaecology Collection, including:
1. Basic Guidelines and History Taking
2. General Physical Examination in Gynaecology
3. Examination of the Abdomen
4. Pelvic Examination
25

26. Pediatrics OER from African Health OER Network
http://www.oerafrica.org/healthoer or
http://openmi.ch/healthoernetwork
1. Clinical Examinations in Paediatrics Collection, including:
1. General Physical Examination
2. Examination of the Respiratory System
3. Examination of the Cardiovascular System
4. Examination of the Abdomen
5. Overview of the Central Nervous System (CNS)
6. CNS Examination of Smell and Sight
7. CNS Examination of Facial Nerve and Hearing
8. Examination of the Peripheral Nervous System (PNS)
9. CNS Examination of the Legs
10. Examination of the Musculoskeletal System
11. Examination of the New Born: Part 1
12. Examination of the New Born: Part 2
13. Examination of the Ear, Nose, and Throat Systems
2. Case Scenarios In Pediatric Practices
3. Gastric Lavage Procedure Animation
4. South African Child Gauge 2009/2010 26

27. Relevant Pharmacology OER from African Health OER Network
http://www.oerafrica.org/healthoer or
http://openmi.ch/healthoernetwork
1. One Step Pregnancy Dipstick Test
27

28. Community Healthcare Worker materials from Open University
UK Health Education and Training in Africa (HEAT)
http://www8.open.ac.uk/africa/heat/heat-resources
1. Adolescent and Youth Reproductive Health
2. Antenatal Care
3. Communicable Diseases
4. Family Planning
5. Health Education, Advocacy and Community Mobilisation
6. Health Management, Ethics and Research
7. Hygiene and Environmental Health
8. Immunization
9. Integrated Management of Newborn and Childhood Illness
10. Labour and Delivery Care
11. Non-Communicable Diseases, Emergency Care and Mental Health
12. Nutrition
13. Postnatal Care
28

29. M1 Endrochrinology and Reproduction from University of
Michigan Medical School
http://open.umich.edu/education/med/m1/endo-
repro/winter2008/
1. Syllabus
2. 01.26.09: Histology of the Endocrine System
3. 01.28.09(a): Nutrition Assessment
4. 01.28.09(b): Histology of the Male Reproductive System
29

30. M2 Reproduction from University of Michigan Medical School
http://open.umich.edu/education/med/m2/repro/2010
1.Breast Lab
2.Gestational Lab
3.Ovary Testes Lab
4.Uterine Lab
5.03.15.11: Your Patient Has Breast Cancer Until You Prove She Doesn’t
6.03.16.09: Clinical Aspects of the Menstrual Cycle
7.03.18.09: Clinical Aspects of Gynecologic Diseases
8.03.19.09: Benign and Malignant Diseases of the Testis and Scrotum
9.Ob/Gyn Learning Resources from the African Health OER Network
10.Surgical Excision of a Multi-Lobular, Recurrent, Bartholin Duct Cyst
11.Daily Schedule: M2 Reproduction
12.03.18.09(a): Gynecologic Diseases
13.03.18.09(b): Abortion
14.03.18.09(c): Ovary Pathology
15.03.19.09(a): Testicular Disease
16.03.19.09(b): Testicular Pathology
17.03.20.09: Androgens
30

31. Image CC:BY gmahender (Flickr) 31

32. What rights are
included in
copyright?
(hint: there are 5)
Image CC:BY Ute Hagen (Flickr) 32

33. Copyright holders have the exclusive right to
do and to authorize others to do the
following:
1. Reproduce the work in whole or in part
2. Prepare derivative works, such as
translations, dramatizations, and musical
arrangements
3. Distribute copies of the work by sale, gift,
rental, or loan
4. Publicly display the work
5. Publicly perform the work
Image CC:BY OpenCage (wikipedia) 33

34. Copyright Exceptions and Limitations
There are some exceptions and limitations to
the 5 rights. Some of these enable *limited*
use of copyrighted material without
permission within the confines of an
educational classroom. Once you make
materials public though, those exceptions
and limitations may not apply.
34

35. 35
Notable International Treaties Regarding
Copyright:
• 1886: Berne Convention for the
Protection of Literary and Artistic
Works
• 1952: Universal Copyright Convention
• 1988: Berne Convention
Implementation Act
• 1995: Trade-Related Aspects of
Intellectual Property Rights
Image CC:BY tuppus (Flickr)

36. 36
What is the purpose of ©?
Image CC:BY ewiemann (Flickr)

37. • Goal: To advance
knowledge
(“encouragement of
learning”)
• How: Exclusive rights
on creative works for
limited times
37 Image CC:BY-NC Cayusa (Flickr)

38. “Limited times” = ?
38 Image CC:BY TJ Morris (Flickr)

39. “Limited times” >= Life + 50 years
39 Image CC:BY TJ Morris (Flickr)

40. Which of these is necessary to
copyright a work? (hint there are 2)
A. Tangible form?
B. Publication?
C. Copyright symbol ©?
D. Registration?
E. Effort?
F. Creative Expression?
40

41. Which of these is necessary to
copyright a work?
A. Tangible form
B. Publication
C. Copyright symbol ©
D. Registration
E. Effort
F. Creative Expression
41

42. Copyright occurs automatically
at the creation of a new work,
when it is fixed in tangible form.
This means that almost
Image CC:BY Horia Varlan
(flickr)
everything is copyrighted--
not just published material but
also your lecture slides, your
speaker notes, your drafts, your
whiteboard/blackboard drawings,
your snapshots...
42

43. What is a license?
Licenses let people know
how they may use a
copyrighted work.
Image CC:BY-SA lumaxart (Flickr) 43

44. Free
Public
Under some licenses to use, adapt, redistribute
Image CC:BY-SA Colleen Simon (Flickr)
44

45. All Rights Reserved
(default)
45

46. Types of Open Licenses:
Creative Commons is one example
Some Rights Reserved
(www.creativecommons.org)
46

47. BY :: Attribution
You let others copy, distribute, display, and
perform your copyrighted work but only if
they give you credit.
47

48. NC :: Noncommercial
You let others copy, distribute, display, and
perform your copyrighted work but for
noncommercial purposes only.
48

49. SA :: Share Alike
You let others copy, distribute, display, and
perform your copyrighted work as long as
any derivative work is licensed under the
same license.
49

50. Learning
Creativity
Sharing
Public All Rights
Domain Reserved
least restrictive most restrictive
Adaptability means…
Translation
Localization
Bridge materials
Innovation
Collaboration 50

51. Why make public and add an
open license?
•Time (build on others’ effort)
•Money (free to access)
•Quality of content (more eyes to
review)
•Recognition & collaboration
(worldwide visibility of authors)
51

52. How to share your own content
52 Image CC:BY-NC-SA 10000spoons (Flickr)

53. It's easiest to create open
content from the start.
53

54. Start now by making a small
change in how you create your
own content.
54

55. What does this mean for you?
55

56. 1. License your own work
2. Use openly licensed works
3. Attribute authors of the works
from step 2.
4. Share your work publicly online
http://open.umich.edu/share
56

57. 1. LICENSE:
EXAMPLE DISCLAIMER & TITLE SLIDE
Author(s): John Doe, MD; Jane Doe, PhD, 2009
License: Unless otherwise noted, this material is made available under the terms of
the Creative Commons Attribution 3.0 License:
http://creativecommons.org/licenses/by/3.0/ license (name and link)
We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize
your ability to use, share, and adapt it.
Copyright holders of content included in this material should contact open.michigan@umich.edu with
any questions, corrections, or clarification regarding the use of content.
For more information about how to cite these materials visit http://open.umich.edu/privacy-and-terms-
use.
Any medical information in this material is intended to inform and educate and is not a tool for self-
diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare
professional. Please speak to your physician if you have questions about your medical condition.
Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
57

58. Learning about Orchids
2, 3: Use, Attribute
Lady Finger Phalaenopsis A Phalaenopsis hybrid
add some extra information in the
attribution: author, source (name and
link), license
Lady Finger Orchid CC:BY aussiegall (flickr)
phalaenopsis CC:BY audreyjm529 (flickr)
Phalaenopsis hybrid CC:BY-SA Zizonus (flickr) 58

59. Additional Source Information
Slide 3: Janeway. Immunobiology : The Immune System in Health and
Disease. Current Biology Ltd./Garland Publishing, Inc. 1997
Slide 4: Spinach is Good” Center for Disease Control; Life Magazine.
January 17, 1938; rejon, http://openclipart.org/media/files/rejon/11221
Slide 5: Goody Two Shoes - McLoughlin Bro's (New-York) 1888
Slide 6: Jot Powers, “Bounty Hunter”, Wikimedia Commons,
http://commons.wikimedia.org/wiki/File:Bounty_hunter_2.JPG, CC: BY-
SA 2.0 http://creativecommons.org/licenses/by-sa/2.0/
Alternative Format:
Attributions at the end of the presentation
59

60. 4. Share
60

61. What if you want to make your
existing work available under
an open license?
61

62. What types of third-party
(i.e. created by someone other
than you) objects might you
encounter?
62

63. main policy concerns to publicly sharing content
:: copyright : copyright law grants limited
exclusive rights to authors of creative works
:: privacy : the protection of an individual’s
(student, instructor, patient) privacy
:: product endorsement : avoiding the
appearance of endorsing a product or
organization
63

64. What should you do with them?
64

65. possible actions
:: retain : keep the content because it is
licensed under an open license or is in the
public domain
:: replace : you may want to replace content
that is not openly licensed (and thus not
shareable)
:: remove : you may need to remove content
due to privacy, endorsement, or copyright
concerns
65

66. Discussion: OER for Your Institution
66

67. Content
1.Which key elements in core curricula are amenable
to self-learning?
2.What are the relevant learning objectives for the
OER modules used/created?
3.In what ways can you use or adapt OER from
another institution to fit your institution’s context?
67

68. Policy
1.Who owns the copyright to the materials intended to
be shared as OER – the lecturer(s) or the institution?
2.Under which Creative Commons license will the OER
be shared?
3.How will you ensure the quality of the OER?
4.If you intend to include record video or audio for a
demonstration (e.g. surgical procedure), how will you
obtain permission from patients or students?
http://open.umich.edu/education/med/oernetwork/g
uides/ethical-consent-guide/2010
68

69. Example: KNUST
and UG
Challenge
Would like to focus
materials development on
clinical exams and surgical
procedures
Approach
Update informed consent
procedures to allow for
public use
69 Image CC:BY Alan Cleaver (Flickr)

70. Professional Development
1. Are teaching staff familiar with multimedia and
instructional design principles to make effective
learning materials?
http://www.youtube.com/watch?v=-fGBoacMRxE
2. Do teaching staff know where to find OER and
other open content to adapt for their own OER?
http://open.umich.edu/share/use
3. Who will be responsible for assisting and training
faculty with technology and instructional design
for OER? (e.g. existing technology or library staff)
70

71. Example: KNUST and UG (Ghana)
Challenge
Electronic learning activities are
not widespread; health instructors
do not have time to learn
multimedia skills.
Approach
• KNUST: Multidisciplinary
collaborations with the College
Image CC:BY-NC-SA Kwame Nkrumah
of Art University of Science and Technology
• University of Ghana (UG): Hire (KNUST)
external multimedia specialists
71

72. Technological Infrastructure
1. What is the desired format of the OER (e.g. text-
based, narrated lectures, video)?
2. How will you use to distribute the OER (e.g. media
types, file formats, soft copy or hard copy)?
3. What are the technological factors affecting OER
production and dissemination? (e.g. student and
faculty access to & attitudes toward technology,
classroom environment, network instrastructure,
technology support staff)
72

73. Concluding Remarks
OER and content development are not an end but one
facet of an approach to enhancing instruction.
• Collection of 19 video interviews in Ghana about
OER:
http://www.youtube.com/playlist?list=PLF4EC45F
2B54D6112
• Open Health at UMMS Video:
http://www.youtube.com/watch?v=LGtevQ9xCkI
Image CC:BY Willi Heidelbach (Flickr) 73

74. By making a small change
in how you create your
own content…
74

75. …and licensing your
creations as OER…
75

76. …you can gain
recognition, publish and
promote your research and
teaching materials,
connect with collaborators,
and preserve and apply
knowledge.
76

77. 77
Opportunities to Collaborate
http://openmi.ch/healthoernetwork-connect
3 communities: audio conference + email list
•Partners Forum (senior leadership)
•Tech (multimedia and tech support staff)
•dScribe (students, ©)
Newsletter
(http://openmi.ch/healthoernetwork-newsletter)
Reference Service (www.oerafrica.org/healthoer > Request OER)
Image CC:BY-SA lumaxart (Flickr)

78. Image CC:BY Karrie Nodalo (flickr)
This presentation builds upon slides from other
Open.Michigan team members, including:
Emily Puckett Rodgers, Pieter Kleymeer, Garin
Fons, Greg Grossmeier, Susan Topol, Dave
Malicke, Ted Hanss, and Erik Hofer
78

79. Questions?
Kathleen Omollo: kludewig@umich.edu
79 Image CC:BY-NC-SA Oberazzi (Flickr)