Open educational resources - using and creating sharable teaching materials in health care - findings of the PORSCHE OER project Suzanne Hardy Megan Quentin-Baxter Lindsay Wood Higher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine University of Newcastle
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Open educational resources - using and creating sharable teaching materials in health care -
findings of the PORSCHE OER project
Suzanne HardyMegan Quentin-Baxter
Lindsay WoodHigher Education Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine
Programme• Welcome to and purpose of the workshop - introduction to open
educational resources and the PORSCHE project• Breakout - personal experiences of current practice• Introduction to Creative Commons and open licensing and questions• Demonstration of finding openly licensed resources online• Using attribution tools and attributing creators• Recordings of people (especially patients and their families, healthcare
workers, actors, students, etc.) in learning materials with discussion• Understanding risk, using risk assessment toolkits and 'digital
professionalism’• Hands on use of copyright, attribution and risk assessment tools (in groups)• Sharing resources between academia and the NHS• Wrap up and close
• Guidance and toolkits for institutional policy, consent, copyright and IPR, quality and pedagogy. • 2000 resources uploaded to www.jorum.ac.uk • Recommendations included:
• Authors ‘hallmark’ all content (whether to be made open or not) with CC licences• Consent everything (even where ownership and patient/non-patient rights appear clear) and store
copies of consent with resource• Review institutional policies against good practice risk-assessment tools• UK HE enter into dialogue with publishers to increase potential for third party upstream rights
(especially images, music and video)• Establish staff reward system (for recognition of sharing & reusing resources, PDRs, promotion
criteria, etc.)
organising open educational resources
Pathways for Open Resource Sharing through Convergence in Healthcare Education (PORSCHE)
Seamless access to academic and clinical elearning
Accredited Clinical Teaching Open Resources (ACTOR)Partners: University of Bristol, University of Cambridge, Hull York Medical School, Newcastle University,Peninsula College of Medicine and Dentistry.
• Public money• Transparency and accountability• Equality of access• Increased utility• Increased applications & better retention
• Recent blog post: It turns out students do use OER and it does save time http://blogs.nottingham.ac.uk/learningtechnology/2011/02/08/it-turns-out-that-oer-does-save-time-and-students-do-use-them/
One of the benefits of being explicitly ‘open’ is that it removes the need for people to ask before re-using stuff. Without it, everything boils down to ‘am I allowed to do this?’ type question and many forms of re-use will stop at that hurdle because the costs of getting the answer are too great
• There are four main types of IP rights – Patents protect what makes things work (e.g. engine parts,
chemical formulas)– Trade marks are signs (like words and logos) that
distinguish goods and services in the marketplace– Designs protect the appearance of a product/logo,
from the shape of an aeroplane to a fashion item– Copyright is an automatic right which applies when
the work is expressed (fixed, written or recorded)• Copyright, Design and Patents Act, 1988 • Copyright arises automatically when an original idea (author uses some
judgment or skill) is expressed/created– www.ipo.gov.uk
• The owner of the copyright is the person (or persons, if jointly owned) who created/expressed it, i.e. the author (writer, composer, artist, producer, publisher, etc.)– Original literary works such as novels or poems– Original dramatic works such as dance– Original musical works, i.e. the musical notes – Original artistic works such as graphic works (paintings, drawings etc.),
photographs and sculptures, including sound recordings, films and broadcasts
– Typographical arrangements of published editions• An exception is an employee who creates a work in the course of
• A copyright owner has economic and moral rights• Economic rights cover copyright owner acts, including rights to
copy the work, distribute (e.g. making it available on-line), rent, lend, perform, show, or adapt it
• Owners can waive, assign, licence or sell the ownership of their economic rights
• Moral rights can be waived (but not licensed or assigned) and include the right to – Be identified as the author – Deny a work (that an author did not create) – Object to derogatory treatment of the work
• It is an infringement of copyright (in relation to a substantial part of a work) without the permission or authorisation of the copyright owner, to– Copy it and/or issue copies of it to the public– Rent or lend it to the public– Perform or show it in public– Communicate it to the public
• Secondary infringement may occur if someone, without permission, imports, possesses or deals with an infringing copy, or provides the means for making it
• Material found on the internet is subject to copyright• www.cla.co.uk
• For permission to copy, contact the copyright owner in writing and specify– The material you wish use (title, author name etc.)– The exact content to be duplicated (i.e. page numbers)– The number of copies you wish to make– How the copies will be used (i.e. for an event, course work)– Who the copies will be distributed to (i.e. students)
• For most published works this will be the publisher • Permission is needed for each and every purpose • Fees may be charged to copy the item, or for administering the
• Your use of the work (which must be acknowledged) is fair dealing as defined under the 1988 Copyright Designs and Patents Act (UK) – Research and private study– Instruction or examination– Criticism or review– News reporting– Incidental inclusion– Accessibility for someone with, e.g. a visual impairment
• There is no simple formula or % that can be applied –instead use licenced materials, or ask for permission
• A licence (a set of rules) describes how copyright items may be used by others
• Licensing schemes (such as Creative Commons) that both authors (owners) and users can access for free – If both sides observe the rules then both parties are instantly
protected – Owners licence others to use their content– Users obey the terms of the licence– Creative Commons provides different licences that can be
combined together– Policies can be developed to guide owners what licences to use
Consent Commons ameliorates uncertainty about the status of educational resources depicting people, and protects institutions from legal risk by developing robust and sophisticated policies and promoting best practice in managing information.
• Defined by the 8 principles in the Data Protection Act 1998 (and Human Rights Act 1998)
• Recognises the need for more sophisticated management of consent for recordings of people (stills, videos, audios, etc.)– Teachers (academics, clinicians, practice/work based learning tutors,
etc.)– Students and ‘product placement’ (branded items) – Role players/actors/performers/hired help (including recording crew)– Patients/patient families/care workers/support staff/members of
public in healthcare settings (sensitive personal data) – GMC guidelines for consent/patient recordings
• Schedule 2 states (paraphrased in [], emphasis added)• "Conditions relevant for purposes of the first principle: processing of any
personal data• 1 The data subject has given his consent to the processing.• 2 The processing is necessary - [for any of the above (schedule 2) plus the
purpose of performing any right or obligation which is conferred or imposed by law on the data controller in connection with employment; in order to protect the vital interests of the data subject including where consent has been unreasonably with held, or another person in a case where consent cannot be be given or the data controller cannot reasonably be expected to obtain the consent; processing is carried out by a body or association which is not established or conducted for profit and exists for political, philosophical, religious or trade-union purposes, safeguards the rights and freedoms of data subjects and is not disclosed to third parties without consent.]”
• Schedule 3 states (paraphrased in [], emphasis added)• "Conditions relevant for purposes of the first principle: processing of any
sensitive personal data• 1 The data subject has given his explicit consent to the processing.• 2 The processing is necessary - [for the purpose of entering a into contract;
compliance with some legal obligation; to protect the vital interests of the data subject; for the administration of justice; for the exercise of any function of: houses of parliament, conferred on any person or under any enactment, Crown, a Minister of the Crown or government department, exercised in the public interest of any person; for the purposes of legitimate interests by the data controller except where prejudice the legitimate interests of the data subject; the Secretary of State has specified particular circumstances.]”
GMC principlesWhen making or using recordings you must respect patients’ privacy and dignity, and their right to make or participate in decisions that affect them. This means that you must:• give patients the information they want, or need, about the purpose of the recording• make recordings only where you have appropriate consent or other valid authority for
doing so • ensure that patients are under no pressure to give their consent for the recording to be
made • where practicable, stop the recording if the patient asks you to, or if it is having an
adverse effect on the consultation or treatment• anonymise or code recordings before using or disclosing them for a secondary purpose,
if this is practicable and will serve the purpose• disclose or use recordings from which patients may be identifiable only with consent or
other valid authority for doing so• make appropriate secure arrangements for storing recordings• be familiar with, and follow, the law and local guidance and procedures that apply
• And you must not:– make, or participate in making, recordings against
a patient’s wishes, or where a recording may cause the patient harm
– disclose or use recordings for purposes outside the scope of the original consent without obtaining further consent (except in the circumstances set out in paragraphs 10 and 15-17).
• Consent to make the recordings listed below will be implicit in the consent given to the investigation or treatment, and does not need to be obtained separately.– Images of internal organs or structures– Images of pathology slides– Laparoscopic and endoscopic images– Recordings of organ functions– Ultrasound images– X-rays
NHS states• Patients are any person or people currently in receipt of healthcare
treatment, or who has/have been in receipt of healthcare treatment.• Children and vulnerable adults may or may not be in healthcare treatment
but should always be considered under the 'sensitive' part of the Data Protection Act 1998.
• The NHS guidelines recommend at least three or possibly four (Scotland) levels of consent, ranging from none to 'publication' NHS level III consent.
• "Many NHS Trusts have patient consent forms which specifically designate 'level III consent' (public access including the internet). If this applies, then Open Access in the sense of sharing materials publicly clearly would fall within this permission.– Level I consent is for use within the patient record only.– Level II consent is for teaching and learning but with restricted access only.– Level III consent is usually for open access and in the public domain."
Policies, disclaimers and risk• In order to safeguard yourself against litigation for
copyright or data protection (consent) violation– Have a policy/disclaimer– Clearly publish your policy and keep it up to date– Train your staff in the use of the policy– Follow your policy (do what you say you will do)
• You may also want a disclaimer ‘this resource has been provided… use it at your own risk. If you have any concerns about any material appearing in this resource please contact…’
• Actively manage your risks• Take out liability insurance
Good practice compliance table (managing risk)Explanation Risk of litigation from
infringement of IPR/copyright or patient consent rights
Action
3 Institutional policies are clearly in place to enable resources to be compared to the toolkits.
Low. Institution follows best practice and has effective take down strategies. Institution able to legally pursue those infringing the institution’s rights.
Periodically test resources against policies to keep policies under review. Keep abreast of media stories. Limited liability insurance required.
2 Compliance tested and policies are adequate in most but not all aspects to allow the compliance of a resource to be accurately estimated. A small number of areas where policies need to be further developed for complete clarity.
Medium. Ownership of resources is likely to be clear. Good practice is followed in relation to patients. Take down and other ‘complaint’ policies are in place and being followed.
Review those areas where developed is required, possibly in relation to e.g. staff not employed by the institution e.g. emeritus or visiting or NHS. It may be that a partner organisation requires improvement to their policies. Some liability insurance may be necessary.
1 Compliance tested but too few policies available or insufficiently specified to allow the compliance of any particular resource to good practice guidelines to be accurately estimated.
Medium. It is unlikely that the ownership and therefore licensing of resources is clear. Resources theoretically owned by the institution could be being ripped off.
Collate suite of examples of best practice and review against existing institutional policies. Follow due process to amend and implement those which are relevant to the institution. Take out liability insurance.
0 Compliance with the toolkits unknown/untested.
Compliance has been tested and materials failed to pass.
High/Unknown. Risk may be minimal if resource was developed based on best practice principles. Institutional policy status (ownership, consent) is unknown.
Establish a task force to test some resources against institutional policies; then follow 1-3 below. Take out liability insurance.
Policies, disclaimers and risk• In order to safeguard yourself against litigation for
copyright or data protection (consent) violation– Have a policy/disclaimer– Clearly publish your policy and keep it up to date– Train your staff in the use of the policy– Follow your policy (do what you say you will do)
• You may also want a disclaimer ‘this resource has been provided… use it at your own risk. If you have any concerns about any material appearing in this resource…’
• Actively manage your risks• Take out liability insurance
Good practice compliance table (managing risk)Explanation Risk of litigation from
infringement of IPR/copyright or patient consent rights
Action
3 Institutional policies are clearly in place to enable resources to be compared to the toolkits.
Low. Institution follows best practice and has effective take down strategies. Institution able to legally pursue those infringing the institution’s rights.
Periodically test resources against policies to keep policies under review. Keep abreast of media stories. Limited liability insurance required.
2 Compliance tested and policies are adequate in most but not all aspects to allow the compliance of a resource to be accurately estimated. A small number of areas where policies need to be further developed for complete clarity.
Medium. Ownership of resources is likely to be clear. Good practice is followed in relation to patients. Take down and other ‘complaint’ policies are in place and being followed.
Review those areas where developed is required, possibly in relation to e.g. staff not employed by the institution e.g. emeritus or visiting or NHS. It may be that a partner organisation requires improvement to their policies. Some liability insurance may be necessary.
1 Compliance tested but too few policies available or insufficiently specified to allow the compliance of any particular resource to good practice guidelines to be accurately estimated.
Medium. It is unlikely that the ownership and therefore licensing of resources is clear. Resources theoretically owned by the institution could be being ripped off.
Collate suite of examples of best practice and review against existing institutional policies. Follow due process to amend and implement those which are relevant to the institution. Take out liability insurance.
0 Compliance with the toolkits unknown/untested.
Compliance has been tested and materials failed to pass.
High/Unknown. Risk may be minimal if resource was developed based on best practice principles. Institutional policy status (ownership, consent) is unknown.
Establish a task force to test some resources against institutional policies; then follow 1-3 below. Take out liability insurance.
1. Acknowledge that patients’ interests and rights are paramount.2. Respect the rights to privacy and dignity of other people who are included in recordings, such as family members and health care workers.3. Respect the rights of those who own the recordings and the intellectual property of those recordings, and check and comply with the licences for use.4. Take professional responsibility for your making and use of recordings and alert colleagues to their legal and ethical responsibilities where appropriate.
professional every member of staff who contributes to curriculum delivery, in both NHS and academic settings should be able to identify, model and understand professional behaviour in the digital environment.
CC-BY Official US Navy Imagerywww.flickr.com/photos/usnavy/5509486066/
• Information/resources increasingly easy to find• Blurring of personal and professional identities online• Increasing need to manage issues of disclosure• Changing public expectations• Misunderstandings of digital spaces• Consequence
• Digital professionalism: how we present and manage presence in the digital environment and how that presence relates to professionalism in the curriculum
• Professionalism in Tomorrow’s Doctors:www.gmc-uk.org/education/undergraduate/professional_behaviour.asp
• No reference to professionalism online: implicit? explicit in your curriculum? Hidden?
“most learners are still strongly led by tutors and course practices: tutor skills and confidence with technology are therefore critical to learners' development”
• This file is made available under a Creative Commons attribution share alike licence
• To attribute author/s please include the phrase “cc: by-sa Suzanne Hardy, Megan Quentin-Baxter and and Lindsay Wood June 2011, http://www.medev.ac.uk/ourwork/oer/ “
• Users are free to link to, reuse and remix this material under the terms of the licence which stipulates that any derivatives must bear the same terms. Anyone with any concerns about the way in which any material appearing here has been linked to, used or remixed from elsewhere, please contact the author who will make reasonable endeavour to take down the original files within 10 working days.
Accredited Clinical Teaching Open Resources (ACTOR)Partners: University of Bristol, University of Cambridge, Hull York Medical School, Newcastle University,Peninsula College of Medicine and Dentistry.
References• Beetham, H., L. McGill, et al. (2009). Thriving in the 21st century: Learning Literacies for the Digital Age.
Glasgow, Glasgow Caledonian University/JISC. Online at http://www.jisc.ac.uk/media/documents/projects/llidareportjune2009.pdf
• Chretien, K. C., S. R. Greysen, et al. (2009). "Online Posting of Unprofessional Content by Medical Students." JAMA 302(12): pp1309-1315.
• Ellaway, R. (2010). "eMedical Teacher # 38: Digital Professionalism." Medical Teacher 32(8): pp705–707.
• Farnan, J. M., J. A. M. Paro, et al. (2009). "The Relationship Status of Digital Media and Professionalism: It’s Complicated " Academic Medicine 84(11): pp1479-1481.
• Ferdig, R. E., K. Dawson, et al. (2008). "Medical students’ and residents’ use of online social networking tools: Implications for teaching professionalism in medical education." First Monday 13(9). Online at http://www.uic.edu/htbin/cgiwrap/bin/ojs/index.php/fm/article/viewArticle/2161/2026
• Thompson, L. A., K. Dawson, et al. (2008). "The Intersection of Online Social Networking with Medical Professionalism." J Gen Intern Med 23(7): p954-957.
• Mostaghimi,A., Crotty, B.H., “Professionalism in the digital age” Annals of Internal Medicine 19 Apr 2011;154(8):560-562.