Open online courses in health professionals education – A scoping review

I’ve been working with Stephen Maloney and Christian Osadnik at Monash University on a scoping review of open online courses in health professionals education, which we submitted to ER-WCPT. We’ve since changed the protocol to a systematic review (the main difference being the lack of critical appraisal in the scoping review) but I’ve left the protocol as is for this post. Here’s the abstract that was accepted for presentation at the conference in Liverpool later this year.

Despite increasing calls to integrate technology into health professions education, evidence to guide its effective implementation is lacking. Open online courses (OOCs) have emerged in the higher education space and may offer promise for health professions education. However, the uncritical nature of current discourse around OOCs means informed choices regarding the pedagogical value of this approach are difficult to make. The aim of this scoping review was to identify the current landscape of OOCs in health professions education, placing emphasis on issues regarding implementation and evaluation.

The study protocol followed the framework proposed by Arksey & O’Malley (2005). Electronic database searches were conducted in Ebscohost, PubMed, PloS One, PloS Medicine and Embase to identify publications from years 2008 – 2015. A comprehensive list of keywords and synonyms associated with allied health disciplines and “open online course” was used for searching. Grey literature was identified via Google Scholar. Eligibility criteria were applied independently by two study authors to determine study inclusion. Data were extracted using standardised templates and synthesised according to a framework of: economic value, pedagogical value, feasibility and acceptability, and measures of effectiveness.

From 104 citations, 33 articles were included in the review and were analysed using the following themes: feasibility and acceptability, effectiveness, economic value, and pedagogy. Most of the articles reviewed simply accepted OOCs as an inherent good in HPE, with few adopting a critical stance. This was especially evident when looking for evidence of effectiveness and economic value of OOCs. In addition, health professions educators have varying interpretations of the meaning of ‘open’ in OOCs, with few mentioning issues of licensing. Few of the articles described course design, and none reported on the use of learning theory to inform the design. In addition, there was almost no attempt by any of the authors to determine if any actual learning took place in the courses. There is an emerging acceptance of OOC in HPE, as seen by the increase in publications in this area in recent years. In general, findings were most often presented in the form of analytics that were gathered during participant engagement in the online environment.

There is a wide variety of interpretations among health professions educators on the meanings of “open” in the context of OOCs, with very few articles making any reference to the licensing issues inherent in the method. In addition, the lack of theoretical framework underpinning the OOCs considered in this review highlights significant pedagogical weaknesses limiting their application to the evidence-based clinical education setting. Most authors in this area seem to regard OOCs as having economic and pedogogical value, but few provide evidence to support the claim.

Health professions educators who want to integrate OOCs in their curricula should be wary of informing their decisions with the current research in the domain. We suggest that there is a need for more rigorous research into the use of OOC in HPE and recommend that educators using this approach pay particular attention to the effectiveness and pedagogical impact of OOCs.