OER Capacity Building in Midwifery, Kamuzu College of Nursing, Blantyre & Lilongwe
Perceived Needs & Project Design
The initial meeting with a representative from the Nursing College, Rebecca Ngalande, identified the following needs within the 5th year Midwifery programme. There was a need to develop a course that would move students from having a purely theoretical knowledge to being able to apply skills and knowledge clinically. At most any support material developed needed to be ⅓ theory and ⅔ practical skills. Also lecturers lacked the ability to assess practical skills or to determine proficiencies so they too would need to be supported in teaching in a different way.
It was therefore decided to provide capacity amongst the KCN staff to develop a set of materials to support both students and staff in the use of Problem Based Learning (PBL) using OER. Rebecca also showed interest in distributing the materials electronically and incorporating some multimedia components into the new materials.
It was agreed develop a CD ROM containing the materials with an accompanying Facilitator’s Guide section that helped staff assess student proficiencies and also access local case studies. The whole course was to be organised according to a ‘Problem Solving’ approach to Nursing education. The focus of the pilot materials was to be on ‘Labour and Delivery’ and ‘Postpartum’. It was also suggested that we should look into both sourcing and development of video material when searching OER repositories. KCN also wanted to create their own videos to supplement the materials. It was anticipated that two workshops a few months apart, one three days the other two, could achieve these objectives.
The manual and facilitator’s guide was to be uploaded, tagged, stored and distributed using the OER Africa platform and repository.
Pilot Implementation & Processes
Prior to supporting and training staff it was necessary to source quality OER. This project’s need for materials relating to birth, delivery and post-natal mother care benefited from the sourcing of OER from private institutions rather than the public online repositories. Initial investigations of the Internet archives had uncovered little of use. Michigan State University (MSU) was, however, contacted by IADP/OER Africa and they kindly provided a set of useful materials on which to start adaptation. These materials formed the core of an OER workshop that was held between 30th March & 1st April 2009 in Lilongwe for a selection of nurses and course designers.
During the 1st workshop the participants were introduced to the OER movement, Problem Based Learning (PBL) methodologies, and were also able to start a process of adaptation on the materials to make them better fit the PBL teaching methodology and the Malawian context.
Between the 1st and 2nd workshops the nurses reworked the materials. The next workshop, June 11th & 12th in Blantyre, was originally planned to assess progress and introduce quality assurance issues. However, it was ascertained that staff needed help developing the materials. It was also at this workshop that the concept of releasing the materials integrated as a PBL learning pathway on a CD ROM was finalised. The structure of the course and its various components was clearly identified and mapped. It was also agreed to expand the CD ROM’s scope so that it would cover the entire midwifery course. A new section, Antenatal, was added to the scope of the materials.
Work by the KCN team continued after the 2nd workshop and was supported by the IADP via e-mail. The IADP team developed the HTML interface for the CD ROM and collated the draft materials submitted by the Nursing team. However, it became evident that another meeting was required to finalise the course and finish the creation and adaptation of the resources. A two day working meeting took place on the 27th & 28th August 2009 at the Capital Hotel in Lilongwe. Here additional materials were developed, editing of materials took place and quality assurance processes employed. Also a final list of actions was developed.
The CD interface and multimedia objects were posted on the Internet so that revisions and edits could continue from both Johannesburg and Blantyre. A language editor was also employed to check the materials. The editing and quality assurance processes were completed in November 2009.
Pilot Products & Outcomes
The main outcome of the pilot was to provide staff with capacity to create PBL courses using OER. Workshops 1 and 2 were well attended by members from the Nursing College. It was noticeable, however, that as time progressed the team dwindled. What is clear, however, is that KCN has a champion in Rebecca Ngalande, the project coordinator, who is clearly excited by the opportunities PBL and OER can bring to the institution. She has already shown interest in extending the project to other courses. She does not see staff capacity in course design as a the problem but rather the lack of technical skills such as HTML to be a barrier to expansion.
The product, a full Midwifery course, including a PBL learning pathway, core resources (adapted from OER), facilitator materials, videos and photos of Malawi examples delivered via CD ROM is impressive. Its effectiveness, however, still needs to be tested and KCN intend to pilot it at the next opportunity early in 2010. The course’s interesting mix of PBL methodology, e-learning delivery and use of OER’s might prove a lot for new the students to master however. Feedback and adjustments might be necessary. The courseware is to be offered back to the OER Community from the OER Africa platform and will be licensed as, CC: BY-NC-SA.
Screen from the University Certificate in Midwifery CD ROM showing the PBL learning pathway
The KCN team was also integrated into the wider OER community. A representative was asked to attend the Health OER Conference in Cape Town organised by OER Africa and University of Michigan in July 2009. The project coordinator had an opportunity to present the KCN Midwifery pilot to OER practitioners from around Africa and the US and also to see what other initiatives are happening.
Evaluation Findings & Lesson Learned
Evaluation
The KCN team provided monitoring and evaluation input on two occasions. During the first workshop, they filled in a baseline study that gauged the extent of their use of computers and also their awareness of OER. A follow-up questionnaire was used during the third meeting that monitored changes in behaviours and perceptions. However, the number of completed questionnaires on this occasion was small. Additional information has been received from the facilitator.
The KCN team were unanimous in their support for the use of OER in tertiary education. Of interest from the results was the comment made by one respondent who said that while OERs have a considerable role to play there needs to be efforts to sensitize students and management to their significance.
In terms of suitability the team affirmed the quality of the resources they adapted. The facilitator points out, however, that these resources were, strictly speaking, not OER. An initial search by the facilitation team had found nothing of use in the public repositories and the materials used had been identified by MSU staff from materials not yet released as OER.
The team also believed the materials were cost effective because they could be accessed for free. This group did not identify hidden costs associated with searching or adapting OER.
On the issue of availability they pointed out that ‘internet failure’ often made access difficult.
When asked, ‘Do you believe technology and e-learning in particular can play a role in enhancing the courses you design for the students in the future?’, the KCN team responded, "Yes, because of the demand for and [increased] use of technology [by students] and also because we are faced with bigger groups with fewer resources." and "Yes as they can be used as learning materials which enhance learning of the students even when they graduate."
The group was less positive when asked if they were confident in implementing problem based learning. One typical response was, ‘Yes, but may still need assistance here and there.’ The facilitator comments that even at the 3rd meeting the team members were struggling to ‘let go’ of the old methodologies and fully embrace PBL principals in their design decisions.
When asked to identify ‘future challenges’ in acquiring and adapting OER the following issues were identified, time to source and adapt materials, capacity building of additional staff, general sensitization of faculty and staff to benefits of using and adapting OER, access to the internet.
Lesson Learned
The UNIMA coordinator and IADP facilitator reported the following additional issues:
1] As the university was implementing three new aspects to teaching, (e-Learning, PBL and OER), it initially proved difficult to give Faculty and even the larger team a sense of what was involved. For example in the area of OER we were sometimes unclear of what to include and what to leave. Logistics too proved problematic with half the team in Blantyre and the other half in Lilongwe while the facilitator was in Johannesburg. Now, however, that we better understand the complexities, it will be easier to mobilise support and offer guidance in the future.
2] The project proved to be time consuming, especially to search and identify appropriate resources which are OER. This was especially true when groups are involved who are not conversant with the significance of using OER resources. If one was not careful these individuals would use textbooks which are easily downloaded from internet but which are not OER materials. In future we will need to make sure this is clear right up front to save on wasted time accessing materials we latter rejected.
3] Time allocations for project work often had to be outside normal work periods. This was especially true when it came to modify the resources and was a serious challenge. In future such project work must be part of normal working hours if we are to move forward with this model.
4] The creation of the multimedia components was hampered by a lack of the right equipment (e.g. Digital Camera, Digital Video camera, software etc.). Also power interruptions and intermittent Internet connectivity did not help. In future we need to incorporate the capital items in the project budget. Besides the hardware and software there needs to be additional focus on providing human capacity for creating the multimedia objects. Our technician/cameraman needed help which admittedly was not really the focus of this project. During the 2nd workshop the IADP facilitator provided some guidance but this was not enough. In future this can be done by training trainers who will in turn assist the rest of Faculty members and technical staff.
5] Partly because of the challenges expressed above the team dwindled as the project progressed. In future it will be necessary to keep the team intact. The team must not be too large and everyone must have a specific responsibility.
Feedback
At the time of reporting the materials had not yet been piloted, but were generating much interest amongst University of Malawi faculty members some of whom have suggested that this model be used as a basis for other e-learning programs. Some departments within the College have asked for similar CD based materials for their courses. The Librarian has also commented that although he is not a midwife the next time his wife is pregnant he can use the video clips to conduct the palpations!
As a consequence of this type of feedback the UNIMA project coordinator has asked OSISA/IADP/OER Africa to consider new OER projects that include, an expansion of the existing Midwifery course so that is incorporates genuine Malawian case studies and scenarios including clinical skills for midwives, i.e. Complicated antenatal, labour and delivery and postnatal. (This was omitted from the existing course)
Production of a DVD of common competencies and procedures which include both video and audio lecture material so that students can learn without having to attend lectures. Students would supplement these materials with a shorter audience with the lecturer at a set time for clarifications. Included would be additional materials that would show common competencies, procedures and how these are done in both ideal situation and in areas where resources are not adequate but without compromising quality.