 Welcome everyone. My name is Sally Parsley. I'm the technical lead on the Open Education Program here at the International Centre for Eye Health and I'm our webinar host for today. So I'm delighted to introduce this webinar on using open education to support local training in capacity building. And our two speakers, Dr. Nia Wiromuwangi from Kenya and Professor Colin Cook from South Africa. Before we get started, I've got a very quick bit of housekeeping information and then a little bit of introduction to this term open education for those of us who haven't joined us before. So the format is we'll hear our two presentations of about 10 to 15 minutes each and then we'll have some time for a short question and answer session at the end. Okay, so this is the fourth in a series of five monthly webinars that we're hosting to explore how we as eye health educators can use digital technologies and this idea of open education to innovate and improve teaching practice and address some of the big challenges that we face in eye care training today. So for anyone who's not attended our webinars before, it's worth just briefly giving a quick definition of what we think open education is. And we think it's any activity that's aimed at reducing barriers to participation in education and learning. It can be by reducing the cost of education, by reaching learners at a distance, or by removing the need for prior qualifications or different coders. So for instance, you might educate the ophthalmologist and the nurses together. It's not a new idea, it's been around for a long time. This is a very interesting graph from a paper on the history of open education, which was published a couple of years ago. And you can see it goes, they think it goes all the way back to the very first universities and public lectures. And then one example I'd like to pick out is UNICEF in South Africa, which in 1946 began its pioneering distance education program for everyone who wished to further their studies and could not attend residential institutions because of personal circumstances or occupational obligations. And UNICEF teaches about 330 students, 330,000 students now. So I could talk about this graph for a while, but we want to get onto the meat of the webinar today, so I shall rush on. And I just want to highlight that with the internet and digital technologies that the focus of open education has really shifted towards open online education, and in particular open courses in the last few years. And these are courses which are free to anyone to register and participate in, although that is starting to change. And in particular, massive open online courses on platforms like Coursera and FutureLearn have been incredibly popular over the last few years, with millions of people signing up to do these free courses. LSHTM has been part of this movement and we've run, I think, five or six open courses on FutureLearn with about 80,000 learners over the last few years. So another aspect which is worth talking about is open education resources. Now these are the course materials that are used in open courses and elsewhere, and they are defined by having an open copyright license. And this means anyone can download, use them, change them, share them for free without asking for the original publisher for permission. So in 2014, here at the International Center for Eye Health, we developed our first open course using open educational resources. So all the materials in the course are OERs and can be downloaded and adapted for free. The course was called Global Blindness, Planning and Managing Eye Care Services. It's an introduction to public health eye care, a topic that's vital for delivering equitable and accessible eye care services. It's been a huge success. We've had more than 5,000 people take the course. But here at ICH, we felt that to really make a difference in eye care training, and for this training to become sustainable in the tourist sense of the word, this training needed to be delivered by local faculty who really knew what the education needs were around public health and eye care in their own settings. So to take this further, we developed partnerships with eye care leaders in three settings who agreed to adapt the Global Blindness course and use it to support training in Kenya, South Africa and Nigeria. And I'm really delighted today to welcome our two presenters from those partners, two of the partners to present on their experiences today. Dr. Mwangi from KCMC Kenya, who's sitting here with me and Professor Cook, who's joining from South Africa. So they're going to share their experiences of adapting this course, why they decided to do it, the approach they took, who it was for, what they changed and so on, what the challenges have been, and also what the change has, the impact and the change for them has been and for their learners. Okay, so I hope that wasn't too much of a rush, and you've kind of got a sense of what these presentations are going to be about. So first of all, our first presenter is Dr. Nia Wirimwangi, an eye health system specialist and an educator. She had her medical training, ophthalmology training and health systems training in Kenya, and she later took a master's in public health for eye care here at the London School and is currently a research fellow with us. She is the principal lecturer for ophthalmology programs at the Kenya Medical Training College, Nairobi. This institution runs various training programs for frontline ophthalmic workers, including ophthalmic clinical officers, cataract surgeons, ophthalmic nurses, optometrists and low vision specialists. Nia Wirimwangi, it's so great you can join us today. Thank you so much, and I'm really looking forward to hearing you talk about your experiences. Okay, thank you, Sally. I'm glad to have the opportunity to talk about our experience in using OER within the Coexa Region College of Ophthalmology of Eastern Central and South Africa, which includes Kenya. So this, the map shows the Coexa Region, what those countries have in common. You see is the Great Rift Vary runs somewhere along those countries, and we work together under this college. So we have been doing the adaptation with this picture in mind that we need to increase the opportunities for learning. And the access and participation are two important issues to consider when you're talking about opportunity for learning. If you want to create a more enabling environment for learners, we need to think about what factors affect access, what factors affect participation in their own learning, and remove barriers in those aspects of education. So the process of really adaptation is about removing those barriers. Four important questions need to be asked before you begin to adapt a NOE course. One, is there a need and what is it? Two, what options do you have to meet that need? Three, are there particular opportunities that you can leverage on at that particular time? And four, we need to anticipate potential challenges, potential barriers. So with those four things in mind, one can begin the process of planning for adaptation. For our case, we began with the need. We have our region, and we have this course that International Center for iHealth developed, and it was a good course. So as educators, as health workers, we identified this was good material that would benefit more people in our region, and what we needed to do was to contextualize it for the users in this region. So that's our need. When we think about our users, we were targeting a wide group of people. We have various cadres of ophthalmic workers. So we have nurses, we have clinical officers, optometrists. We have a wide range of them. We also have those who are in training for those particular cadres. We have program officers. This would be managers, but they may also be the same health workers working as program officers. We also have educators running these programs. They are also health workers, IKR workers, also giving clinical services. So in our situation, this is an overlap of roles, and we needed to target people who are carrying out all these different roles. So we have to be able to return and to make sure the material is accessible to them. Thinking about the options, there are many options. When you have a course to adapt, you have options to change lots of things, or to change just a few, or to take it as it is. So there are many options. For our case, we had a lot of things we did not change in the original course. We only changed a small part of the pie. So the bigger pie remained unchanged. We didn't change anything on the name. We didn't change the objectives. We didn't change the sequence of the modules. We didn't change the content, or the quizzes, or the time requirements. We still need four hours every week. We're still in English, and the users can access the materials from different parts, using different appliances at different times, and they can learn at their own pace. So we still maintain the ethos of this training. So what did we change then? A few things we changed. One, we changed the lead educator to have a local lead educator. We changed some photos. We have one additional video, actually, to change the narration. And we wanted to use local case studies. We have maintained some local ones, but we are also going to add some more. So a few things were changed, but the main purpose of changing was to contextualize the material. We wanted to reflect maybe the user circumstances, or the ethos, or the language of the users, so that they can identify with it, and be able to navigate with it. So this was the ethos of our adaptation. The other question was what are the opportunities? They are big opportunities for course adaptation. One of them being copyright. We need to understand copyright, and this material is published with open licensing, which allows us to use it, to share it, to remix it, and reuse it. This therefore set the ground for us to adapt it for our purposes, but still maintaining its integrity and its objectives. The second good thing that we had a chance to participate in the course, when it was first run, a number of people from the region did take the course, so we knew the benefit. We understood the material, and we saw how relevant it was for us. We can download the materials, and they are good quality materials. You can download transcripts, or the videos, and that is a good opportunity because you have a chance to go and use it, and share it, and even change it the way you would like. Institutional support has come in quite early. For example, we have the support of the Ministry of Health in the area of policy. We have the support of training institutions. We have support of professional institutions. We are able to accredit this course. We are able to give the CPD points. We are able to give certificates. So institutional support is a very good opportunity that you can leverage on. Technical expertise, a lot of it is required, and this has been available. You need expertise in terms of IT as you do course adaptation. You need expertise in terms of often more of the content. You need the expertise of educational risks. So different kinds of expertise are important as you adapt the course. A lot of stakeholders play a role. So for our case, we have had the government, that's the Ministry of Health playing a role. We have had professional bodies, the College of Ophthalmology coming in. We have had collaboration with the University of Cape Town, the London School of Hygiene and Tropical Medicine. So a number of people have come in. Collaboration is definitely a strength that makes things easier and better. Funding is required for various things. So source funding actually does help. There is need for finances for travel during the course of adaptation, getting a platform for running it. So funding helps and it should be available. It helps. But most important is to understand why you are adapting the material and how to adapt it. The user is central to the process of adaptation because we need them to be able to use the material. Therefore, for us, we wanted to do a survey, first an initial survey to see the needs of the users. We wanted to find out have they done, know they are close before and what lessons can be learned from it. So that was a good opportunity. It has really been of help. There are more opportunities but perhaps I'll just list those. There are also challenges that one needs to think about. The first one being that this is a time-intensive process. So one needs to commit enough time, enough time to add. It's also cost-intensive. So there is need for finances. Technology is very important. If you're going to shoot some videos, technology, you're going to run the course on a platform, you need that technology. And you also need RIGAs, so there is need for commitment, continued commitment to quality. There must be mechanisms for quality assurance of which one of them is having a pilot test and secondly, the technical expertise also contributes to quality assurance. So this is a great need. A great need and we have had a good opportunity to learn about quality assurance. We must be aware of the barriers that our users face. We may have maybe reduced access to Internet, so it is good when the materials are downloadable so that people can be able to access them at their own time. They should also be able to use the course on your phone. They may not have computers, but they can use their phone. So these are barriers that we need to be aware of, we need to understand, and we need to design the course for that. There are a number of assumptions that one may come in. You might think that we'll begin adaptation point A and progress till point Z. What we have found is that it's not really linear, so you would want to come back. It's cyclic at many intervals. It's cyclic, so one must be prepared to come back and say I need to get that video done again, or that case study I need to do a second one. So there are assumptions that we may come with, but what we have learned is that we need to be aware of the assumptions. We must reach the target users to create awareness of this course and its benefits, so we need to advertise the course. We need to ensure that we are reaching all the users. Having an appropriate software is good at the moment. We are using Google platform. We adapted the course from Futureland, so these are changed in the platform, and we must anticipate the needs for that. With that experience, what would be my key take-home points? Just a few points at a time. 1. You must plan. It's good to plan. So a lot of planning went to it, and we have not regretted. 2. You need technical expertise. So it's good to leverage on people with various types of expertise. 3. You need different stakeholders to come in. That might be different individuals, different institutions, different sources of funding important. With a pilot test for quality assurance, very, very important. We have found it's good to have champions who come out and run with this course. It could be one, it could be two. Very important. Sadly, there are surprises around the way, so it's good to anticipate them as you do the pilot test. You'll find out, oh, because of a charging software, this is not exactly how I planned it, so let's anticipate the surprises. It's a learning point. So with that, I want to thank those that have really helped us. These are collaborators that have really been of help, and I also want to thank the persons that have participated in this process. Thank you very much. Thank you so much. Thank you so much, Niawira. That was so interesting. I'm laughing because I'm looking at a picture of myself looking a little bit surprised on the screen. I was really interested. I think it's so great that you focused on the need in your setting and how to address the need. And also, your take-homes were, yeah, absolutely. It's very interesting your identification of champions. I might ask you about that in the Q&A if I get a chance. Okay. So thank you so much. It was so interesting. So, let me... So, native Zimbabwean ophthalmologist, Professor Colin Cook, is the professor and head of the Division of Ophthalmology at the University of Cape Town. And Chruta Shure Hospital, I hope that's not too awful pronunciation, Colin. He has oversight of the clinical service delivery, teaching and research undertaken by the division. Colin has a long-standing and special interest in community eye health. And he was previously the course convener for the postgraduate diploma in community eye health. And he's now the convener for the community eye health track of the Masters in Public Health at UCT. He's also care advisor to CBM for the Southern Africa region. Before taking up his current post, Chruta Shure Hospital vision 2020 project, Colin worked as an ophthalmologist at Edendale Hospital in KwaZulu, Natal in South Africa. Thank you so much, Colin, for agreeing to present on your experiences of adapting the global blindness course in your context at UCT in South Africa. Okay. Well, thank you for that. And thank you for the opportunity to share our experience with the open education resource at UCT. It was very interesting for me to hear and I will use a presentation from Coexa. What has been our experience here? I'll just go on to the next slide. So I have to say that when we first heard about this new initiative from Daksha and Sally and others at ICH, we were suitably sort of skeptical about it. I mean, they're all such nice people. Everyone at ICH's, but Daksha and Sally and everyone, and we thought, well, what is all this newfangled stuff that they're on about? But of course we will, you know, give any support that they request from us, just because they're nice people. But we weren't sort of convinced of the real value of it. But I have to say that having worked with the team at ICH over the last few years and using it now for the courses that we run here, we now are very firmly convinced of the benefit of this. We run a community eye health workshop for registrars or residents in South Africa, which we've run at UCT since 2005, basically involving registrars coming from other centers in the country to Cape Town, which has been all good. But from this year, it's been replaced by the ICH course, the planning and managing course. So we, for the first time, are not needing to actually bring everyone together here. We can run it as a, we'll make it available as the ICH OER course. And that's on the ICH or the London School platform. So it hasn't been adapted for local need. And we're not monitoring that at all. We've just publicized the availability of that to everyone. The registrars have to do this training as part, as for part of their exam preparation. So we're not monitoring it all, but the facility is available for them. The postgraduate diploma in community eye health, we've been running this course since 2010. Dion Minnes, who's one of my colleagues, who's the director of our Community Eye Health Institute, convenes the course. I'm just listening to a very noisy group of patients, and I'm going to close the door. Hold on one minute. Apologies for that. I'm back. Somewhat happy, noisy patients just outside the door. So the postgraduate diploma started in 2010. Basically, the structure of this diploma has been previously 10 weeks on campus, four weeks community eye health, two weeks health promotion, human resource development, and then four weeks of management, and then 32 weeks off campus, and then back again at the end of the year. What we've done from this year is that the first course, the first four weeks, the community eye health, has been replaced by the ICH-OER course, which is run on our University of Cape Town Vula platform, and has been customized with some local content. So my colleague, Dr. Corinne Lacona, has been the one that has been responsible for that. And what we have found basically looking at the content there, Duckshaws was encouraging us to change as much as we felt necessary to change, but in looking at it, we didn't feel the need to change an awful lot, perhaps even less than Coexa has done. So for example, we were very comfortable just keeping a lot of the case studies that London School had included. So we think that the content is sufficient, has been sufficiently customized for local use. A lot of the participants in the postgraduate diploma are from outside of the Southern Africa region anyway. So we'll see how it goes. This is the first year that we're doing it. The students will be with us in a few weeks' time at the end of this month, and we will hear from them firsthand what their experience has been using the OER course for this first course of their diploma. Interestingly, what the plan is, based on that experience next year, the contact time for course two and for course three will be replaced by a similar UCT course, and that will be developed by Dion with assistance from Greg here at UCT to replace it as a distance learning. And of course the obvious advantage there is that we think it will reduce the cost for the students and improve the accessibility for the course. The students won't actually need to come to Cape Town at all. It will all be then a distance learning course. And then the third thing, the third course that we run is the Masters in Public Health Community iHealth Track. The MPH UCT has been running since 1999. The Community iHealth Track was a new track started in 2012, so it's been going for about five years now. It's basically run over one and a half years if it's taken full-time, but up to four years if it's taken part-time. And it's very much geared to be taken that it can be run or taken as a part-time degree for people living in Cape Town. The Community iHealth Track, most of the participants that we've had thus far have taken it as a full-time course. They would then do ten courses over one year, five courses a semester, one five courses a semester, two, and then complete their dissertation in the first semester of the second year. The Community iHealth Track has two Community iHealth courses, and then the other eight courses the students choose from a sort of bouquet of 25 different courses that they can choose from. And so this year, for the first time, the contact time for the Community iHealth One course has largely been replaced by the ICH course Planning and Managing iCare Services, which has been customized for local use and is available on the UCT ruler platform. The Community iHealth Two course has been replaced largely by the Epidemiology for iHealth, which is not available to us, hasn't been customized at all, it's not available on the UCT platform, but the students are accessing that on the London School platform. And so our students, we have a cohort of group of six students who are presently enrolled for the Community iHealth Track this year, and they are one-third of the way through that Community iHealth Two course at the moment. So again, we still have contact time with them once a week, but a lot of the contact time, most of the contact time has been replaced by the OER courses. So that basically summarizes our experience at UCT. It's work in progress, and we will see how we go over what our experience is, what the experience of our students are over the next few years. But it's obviously been a huge value add for us in running the Community iHealth training that we run at UCT. Thank you so much, Colin. Thank you, just on meeting myself there. That was so interesting. The thing I was so surprised by is the different directions where Kenya and Nigeria and South Africa have all taken this contact. Because your contacts are so different, and I think it's really shown the need for this kind of collaboration of working together. I'm very excited you're working with them. You're working to create more OER, Colin. That's a very exciting development with Greg. Yeah, so as I say, that's a sort of direct, I think lesson that we've learned from this, is sort of recognizing the value add. And therefore it will be this time next year we'll see what our experience with that is. But as I say, it means we hope that it will open up the availability of the diploma, the postgraduate diploma, to a lot of people who otherwise find it difficult to get away from their work and come to Cape Town and will improve the accessibility. Yes, and that's true for both of you, isn't it? We have had a question in from Dacia, which I think is really aimed at Niawira, which is practically with Kwexa. How do you go about accreditation at the local level? Okay, thank you. So this being a very important incentive we're looking at it from three portions. So you have three institutions that will give accreditation and the user has choice. So they have choice, there's a coexter, there is a UCT short course, and also there's a South African council. So what happens, the squads can give security and can give certificate. And UCT short courses can give certificate at a fee. And the South African council can also give security. So users have a choice, they can take one or the other. What's best for them. Yes, a choice. That's really interesting. I have a question for both of you, actually. Colin, if you could have a go first and then we'll come back to Niawira. And that is, as an educator, for both of you, this is the first time you were through this at you. What would be your one piece of advice for other eye care educators who have kind of maybe been attending our webinars and thinking this content looks like it could be useful. What would be your advice to them to get started? Niawira, do you want to go first? I'm going to think about that. Okay, thank you. Yes, my immediate thought is at first you need to know your target user. For example, one difference with our two programs is the kind of activities we're focusing on. For example, we guys focus on a middle level of workers as well as of homologists who may not be in a form of training program right now but who can come in and take out this course. I see like UCT is doing something with the existing courses so we need to take who is the user you're targeting for this particular time and then you can adapt depending on the needs of that user. I think if I would add to that it would basically from what Niawira is saying the sort of experience that we have with the three courses that we offer the community eye health training for registrars we basically want what they need to just get a broad brush stroke understanding of the principles of community eye health and the course that has been developed by ICH is entirely suitable for that. So we're very comfortable with the idea that that course on its own covers the need there. The postgraduate diploma and the MPH courses without trying to change the content of those courses too much just leaving it as it is because basically it's good as is and then we are able to complement that with local activity or local inputs to sort of make it suitable for the particular target and the particular level of the course that we are offering. I don't know if that helps but it's basically the OER material is sound and provides a very sound sort of base on which other material might perhaps be added to complement it. That's a great point so it's balancing your needs with what's available what you can make use of with your capacity. Yeah. Thank you both. I have another question for both of you maybe Nia we are first here. What are the perceived benefits of OER for capacity building for local faculty? Okay, thank you. There are benefits actually at many levels. There are individual benefits and also institutional level benefits. So as in the faculties for the individual trainers you get access to first of all your self-land and also to get to know what is available for your learners what is you can look at quality and look at material modes available and then assess the quality and determine what will meet the needs for your learners. Then you can actually determine how to use it to influence learning. So you can put it as a short course of advice and to go and have a look at it you can use the quizzes so you can utilize the materials in various ways. For the institution because we know in sub-Saharan Africa we have a low number of health workers so we have a big need. So if you have this avenue for training it might contribute to using the available health workers more efficiently and more effectively. Because we can do it at the learning and also the trainees can do the same. Suddenly then you get to develop your staff your capacity and your ability to run other trainees through this particular kind of training. So I would say there are multiple benefits. Thank you. Sally from our side I'd have to say the main benefit is that it lets us off the hook Our faculty the people that teach in our courses the local faculty are all busy, busy, busy clinicians and getting them to being available for teaching on the course is always a challenge and so it's fantastic at the click of a button for the students to be exposed to all these very bright, capable, interesting people at ICH, all the resource that is available there is just sort of beamed into their computers and so whereas previously we would be having to get faculty someone to come from London to teach on the course and getting local colleagues sort of available for days at a time to teach. It makes life much easier now knowing that there's very good quality teaching available online and it just makes life much easier so in a sense it's doing nothing to develop local capacity it's just giving us a bit of breathing space and saying well this is great we can continue to provide what we think is good quality training but with this expertise from London Yes and so I guess I'm hearing, thank you so much Colin I guess I'm hearing from you both it's kind of a mix of, it's an opportunity for personal sort of development and impairment as an educator it just gives you a chance to reflect and change your practice and it's a time saver and support when you're completely over stretched I'm trying to get your work done it just provides that efficiency and efficiency to give you time and then on the other hand this is for the reaching this is the opportunity to reach these students as people start to get online and start to get access I have lots of questions as you can possibly tell but unfortunately we're nearly out of time and I just want to thank you both so much it was really interesting it's so exciting to hear your thoughts and final question and I'm going to run over time because it's in from Daksha and she asks the question she's asked Colin is would you consider yourself as an open education practitioner no Colin are you somebody that it's a very, what a mean question Yes I need to turn the question around and ask Daksha would she think that we are we kind of into it now and we've got a lot to learn and a long way to go but we are very committed to it we really do appreciate and understand the value of it now it has been and is a huge value for us so we're certainly on the journey and I think it's definitely the right way to go Very interesting to see how because I know you're going to evaluate this this year but how it moves forward with your own content would be interesting to see thank you so much Colin are you an open practitioner I would say thinking about it that is the thing that it provokes my thinking what is my role in the competition and what extent by reticulating the Christmas so I would say so far I'm beginning to think about it I'm not yet sure but I'm going in my direction Thank you I'm going to wrap up incredibly quickly now because we're kind of out of time thank you again to our really interesting presentations really interesting questions and just to let you know that our final webinar will be in May on the 24th and this takes us to a practical level where we're looking joined by Dr. Glenda Cox and Mr. Gregory Doyle from University of Cape Town they're going to be talking about creating and sharing your own and education resources as an open practitioner so Dr. Cox is going to talk about some of the research findings that her PhD has found about the enablers and constraints that educated spaces they start to think about this approach and then Mr. Doyle Greg's going to talk about how you get started some practical tips and how to so I very much hope you can join us thank you to everyone our presenters and our audience members and take care and I hope to see you in May Thank you, goodbye Thank you Salih, goodbye