L'informatique: un outil remarquable pour l'enseignement de la médecine interne générale [The informatics: a remarkable tool for teaching general internal medicine].

INTERMED training implies a three week course, integrated in the "primary care module" for medical students in the first master year at the school of medicine in Lausanne. INTERMED uses an innovative teaching method based on repetitive sequences of e-learning-based individual learning followed by collaborative learning activities in teams, named Team-based learning (TBL). The e-learning takes place in a web-based virtual learning environment using a series of interactive multimedia virtual patients. By using INTERMED students go through a complete medical encounter applying clinical reasoning and choosing the diagnostic and therapeutic approach. INTERMED offers an authentic experience in an engaging and safe environment where errors are allowed and without consequences.

Search and Discovery : OER's Open Loop

Open educational resources (OER) promise increased access, participation, quality, and relevance, in addition to cost reduction. These seemingly fantastic promises are based on the supposition that educators and learners will discover existing resources, improve them, and share the results, resulting in a virtuous cycle of improvement and re-use. By anecdotal metrics, existing web scale search is not working for OER. This situation impairs the cycle underlying the promise of OER, endangering long term growth and sustainability. While the scope of the problem is vast, targeted improvements in areas of curation, indexing, and data exchange can improve the situation, and create opportunities for further scale. I explore the way the system is currently inadequate, discuss areas for targeted improvement, and describe a prototype system built to test these ideas. I conclude with suggestions for further exploration and development.

Use of open educational resources at the UOC

The Open University of Catalonia (UOC: Universitat Oberta de Catalunya) is currently implementing its 2009-2014 Strategic Plan, which devotes an entire section to open educational resources. The working group on this topic is drafting a report that establishes the objectives to be met, analyses the current lay of the land and sets out the actions required to meet the objectives. This paper examines each of these three points.

MultiCampus Open Educational Resources : the case of OER-HE

In this paper we address the implementation strategies regarding Open Educational Resources within a multicampus setting. A comparison is made between 3 institutions that are taking a very different approach: K.U.Leuven, which is a traditional university, the Open Universiteit (Netherlands) which is in the process of starting up the Network Open Polytechnics, and the Universitat Oberta de Catalunya. We are looking deeper into the pedagogical and organizational issues involved in implementing an OER strategy and show how OER holds the promise of flexible solutions for reaching at first sight very divergent goals.

Variation in Current Management of Term and Late-preterm Neonates at Risk for Early-onset Sepsis: An International Survey and Review of Guidelines.

BACKGROUND: Uncertainty about the presence of infection results in unnecessary and prolonged empiric antibiotic treatment of newborns at risk for early-onset sepsis (EOS). This study evaluates the impact of this uncertainty on the diversity in management. METHODS: A web-based survey with questions addressing management of infection risk-adjusted scenarios was performed in Europe, North America, and Australia. Published national guidelines (n = 5) were reviewed and compared with the results of the survey. RESULTS: 439 Clinicians (68% were neonatologists) from 16 countries completed the survey. In the low-risk scenario, 29% would start antibiotic therapy and 26% would not, both groups without laboratory investigations; 45% would start if laboratory markers were abnormal. In the high-risk scenario, 99% would start antibiotic therapy. In the low-risk scenario, 89% would discontinue antibiotic therapy before 72 hours. In the high-risk scenario, 35% would discontinue therapy before 72 hours, 56% would continue therapy for 5-7 days, and 9% for more than 7 days. Laboratory investigations were used in 31% of scenarios for the decision to start, and in 72% for the decision to discontinue antibiotic treatment. National guidelines differ considerably regarding the decision to start in low-risk and regarding the decision to continue therapy in higher risk situations. CONCLUSIONS: There is a broad diversity of clinical practice in management of EOS and a lack of agreement between current guidelines. The results of the survey reflect the diversity of national guidelines. Prospective studies regarding management of neonates at risk of EOS with safety endpoints are needed.

Care delivery value chains for ophthalmic clinics in Switzerland

Perceived patient value is often not aligned with the emerging expenses for health care services. In other words, the costs are often supposed as rising faster than the actual value for the patients. This fact is causing major concerns to governments, health plans, and individuals. Attempts to solve the problem have habitually been on the operational effectiveness side: increasing patient volume, minimizing costs, rationing, or closing hospitals, usually resulting in a zero-sum game. Only few approaches come from the strategic positioning side and "competition" among hospitals is still perceived rather as a danger than as a chance to create a positive-sum game and stimulate patient value. In their 2006 book, "Redefining Health Care", the renowned Harvard strategy professor Michael E. Porter and hospital management expert Professor Elizabeth Olmsted Teisberg approach the challenge from the positive-sum perspective: they propose to form Integrated Practice Units (IPUs) and manage hospitals in a modern, patient value oriented way. They argue that creating value-based competition on results should have the same effect on the health care sector like transparency and competition turned other industries with out-dated management models (like recently the inert telecommunication industry) into highly competitive and customer value creating businesses. The objective of this paper is to elaborate Care Delivery Value Chains for Integrated Practice Units in ophthalmic clinics and gather a first feedback from Swiss hospital managers, ophthalmologists, and patients, if such an approach could be a realistic way to improve health care management. First, Porter's definition of competitiveness (distinction between operational effectiveness and strategic positioning) is explained. Then, the Care Delivery Value Chain is introduced as a key element for understanding value-based management, followed by three practice examples for ophthalmic clinics. Finally, recommendations are given how the Care Delivery Value Chain can be managed efficiently and how the obstacles of becoming a patient-oriented organization can be overcome. The conclusion is that increased transparency and value-based competition on results has the potential to change the mindset of hospital managers-which will align patient value with the emerging health care expenses. Early adapters of this management approach will gain a competitive advantage. [Author, p. 6]

Análisis del entorno colaborativo creado para una experiencia de mobile learning

Se presentan los resultados de una investigación sobre las concepciones y usos de dispositivos móviles de un grupo de estudiantes que trabajaron en un entorno de aprendizaje colaborativo como parte un proceso de e-learning. Se emplearon dos métodos de investigación, en primer lugar el análisis del contenido de los mensajes de un foro de discusión enviados durante todo el curso, para recoger datos acerca del uso y la valoración que hacían del proceso de mobile learning. Posteriormente, mediante las entrevistas en profundidad, se analizó la percepción de mobile learning y los cambios producido durante el curso en el entorno colaborativo de aprendizaje. Los resultados indican que el entorno de intercambio creado amplifica la participación y colaboración entre los alumnos en el proceso de mobile learning, favoreciendo un mayor protagonismo de los estudiantes en una experiencia de aprendizaje online.

On-line life history calendar and sensitive topics : A pilot study

The use of the life history calendar (LHC) or the event history calendar as tools for collecting retrospective data has received increasing attention in many fields of social science and medicine. However, little research has examined the use of this method with web-based surveys. In this study, we adapted this method to an on-line setting to collect information about young adults' life histories, sexual behaviors, and substance use. We hypothesized that the LHC method would help respondents to date sensitive and non-sensitive events more precisely than when using a conventional questionnaire. We conducted an experimental design study comparing university students' responses to an on-line LHC and a conventional on-line question list. A test-retest design in which the respondents completed the survey again two weeks later was also applied to test the precision and reliability of the participants' dating of events. The results showed that whereas the numbers of sensitive and non-sensitive events were generally similar for the two on-line questionnaires, the responses obtained with the LHC were more consistent across the two administrations. Analyses of the respondents' on-line behavior while completing the LHC confirmed that respondents used the LHC's graphic interface to correct and reedit previous answers, thus decreasing data errors. (C) 2015 Elsevier Ltd. All rights reserved.

La prévention du tabagisme et les facteurs organisationnels en médecine générale: une étude pilote en Suisse romande

Context: Several studies have been carried out to describe how general practitioners (GPs) follow smoking cessation counseling's recommendations and to identify GP-related factors that influence their practice. But limited information exists about practice organization's elements influencing smoking counseling and more generally about prevention activities in primary care (PC) in Switzerland. Objectives: Explore the feasibility of this study. Investigate determinants of PC practices associated with smoking cessation counseling in Switzerland. Explore the GP's attitude towards prevention and the organizational characteristics of PC practices. Design: Pilot Web-based survey in a representative sample of Swiss French speaking GPs. Results : 44 GP's responded; 66% were men; mean age = 57.5 years; 59% were in group practices; 1 GP was currently smoking and 32% were ex-smokers; 57% of GPs found very important to perform health prevention activities. 57% of GPs were trained (>5 hours throughout the career) to provide smoking cessation counseling. 84% of GP's always inquire about smoking status during first consultations, compared to 69% during emergency consultations for respiratory symptoms and only 9% during non-respiratory emergency consultation. Factors positively associated with smoking status inquiring were: young age (<57.5) of GP's for first consultations, rural location and solo practice for emergency consultations. Smoking cessation counseling is systematically provided by 48% of GPs during emergency consultations for respiratory symptoms and by 20% of GPs during follow-up consultations. Factor positively associated with smoking cessation counseling was solo practice. Discussion: In Switzerland, there are missed opportunities to provide smoking cessation counseling, especially in emergency situations, possibly in people who have rarely contacts with the health care system. Despite a small sample, this study showed the potential associations between organizational and GP-related factors and smoking cessation counseling. These findings will be further explored in a national study among 200 GPs' practices.

Barriers and Motivators for Using Open Educational Resources in Schools

In an explorative study, we investigated on German schoolteachers how they use, reuse, produce and manage Open Educational Resources. The main questions in this research have been, what their motivators and barriers are in their use of Open Educational Resources, what others can learn from their Open Educational Practices, and what we can do to raise the dissemination level of OER in schools.

OERopoly : A Game to Generate Collective Intelligence around OER

Collective Intelligence (CI ) is a phenomenon that emerges at the crossroads of three worlds: Open Educational Resources (OER), Web 2.0 technologies and Online Learning Communities. Building CI for the OER movement means capturing the richness of information, experiences, knowledge and resources, that the movement is constantly generating, in a way that they can be shared and reused for the benefit of the movement itself. The organisation of CI starts from collecting the knowledge and experiences of OER's practitioners and scholars in new creative forms, and then situating this knowledge in a collective 'pot' from where it can be leveraged with new 'intelligent' meanings and toward new 'intelligent' goals. This workshop is an attempt to do so by engaging participants in a CI experience, in which they will contribute to, and at the same time take something from, the existing CI around OER, Web 2.0 technologies and Online Learning Communities.

The role of mentoring in facilitating the process of repurposing OER

This paper presents the initial data analysis of a research that is work in progress. It discusses the role of mentoring and peer support in facilitating the process of repurposing open educational resources (OER). It also reports on the lessons so far learned from the analysis of two distinct but related case studies on working with learners to use and disseminate OER.

Faculty and Student Perspectives Toward Open Courseware, and Open Access Publishing: Some Comparisons Between European and North American Populations

Instructor and student beliefs, attitudes and intentions toward contributing to local open courseware (OCW) sites have been investigated through campus-wide surveys at Universidad Politecnica de Valencia and the University of Michigan. In addition, at the University of Michigan, faculty have been queried about their participation in open access (OA) publishing. We compare the instructor and student data concerning OCW between the two institutions, and introduce the investigation of open access publishing in relation to open courseware publishing.

Exploring new criteria to design materials for online education

Peer-reviewed

Enriching e-learning metadata through digital library usage analysis

Peer-reviewed