Telemedicine and eLearning in eHealth: case of Norwegian lessons learned

Tromso workshop 2010 June
Currently I am following, speaking and participating a workshop on Telemedicine and eLearning for eHealth. A one week workshop in collaboration between ITM and NST (WHO centre).

Participants from Sudan, Ethiopia, Ghana, Trinidad Tobago, Norway, Italy, Peru, Brazil, Canada, Belgium.

notes taken Monday 7 June 2010, First content session Steinar Pedersen:
Lessons learned from telemedicine projects which can also be used for eLearning projects in the medical field

• TTT: things take time and be patient, build maturity before implementing technology in a field
• Move from the competence centre to the periphery
• Be aware of the National competition and join forces so the National strength can grow, build round tables. It is better economics and knowledge exchange.
• Anchor level should be as high as possible (top level stakeholders)
• Argue on quality not on cost saving (Inge take this into the m/eLearning overview
• Secure the infrastructure
• The hen and egg problem (interconnectivity problem)
• Link technological developments to health priorities
• Always try to put a medical doctor or nurse in a the middle of the good medical/technological news (much more convincing)
• Use radiologists (or other people that are used to follow things on screens)
• By introducing technology, discussions on medical hierarchy can take place, be aware of this potential dynamic
• Chance of success is better if you introduce it to existing part of the organization, ideally if this service is 24 hours good for organizing the receiving part of the service.
• Create solutions based on national and international standards (e.g. visa card logic, electric power sockets)
• People are ready to be very, very innovative when it comes to do what they already are doing very well even better
• The same doctors and nurses are not very interesting in doing what they were already doing in another way (no benefit, just different).
• Even if developments go very slow, it will be part of the future health care, in that case even the smallest steps count.
• Keep the doctors responsible

Questions from participants, answered by Stainer
Developing countries big challenge is developing policies, how did Norway do it?
They health minister was not that strong, so parallel pillars were build for decision making, but policies can also be taken from similar countries, so you can leapfrog into policies that work.
How to get commitment from all the stakeholders: that is really difficult
Metrics and triangulation, how do you do it? How many refers, how much money is saved in transportation, how satisfied are the health care workers and the patients (the patients seems to be more satisfied and the peripherals are more satisfied (in general) than in the centre.
Were there infrastructural challenges in Norway for setting up Telemedicine? We still need to fly over a CD-rom to exchange data between South and North Norway. When we started out with radiology, there was very low bandwidth, downloads were done overnight because it took so much time. But from a mobile side, there are more mobile subscribers than there are people in Norway. eHealth is also subscribed in the medical curriculum of medical students which is important for longterm implementation. Trust is very important to get successful projects.

Ethics, technology and learning

This last couple of days have drained my spirit, mainly because my ethics were challenged on different levels. I did not find the energy to write about it until today and it is with a sad heart that I reflect on why I have felt a bit in despair.

Why do governments politicize education? (Becta in the UK, long-term vision in Belgium)

Belgium and long/short term educational vision

In Belgium education was in the hands of a visionary politician for some years. During his reign long-term vision constructed results in getting young learners from other national backgrounds integrated in our school system (and society), and in restructuring education so it would no longer be discriminatory for youngsters who were not good in languages/maths but good in technical intelligence. He was a visionary politician because he cared about results and he crossed political boundaries while gathering his cabinet (people with lots of experience and who belief in durability, loose from political views). After yet another fall of the government a different politician became minister of education, a different one though from the same political party. He had a short term vision and wanted to profile himself, he immediately started cutting initiatives. Which one’s? the ones that got good results with young learners from vulnerable socio-economic groups and the restructuring theme that would rectify some of the big Belgian education problems (e.g. less respect for hands-on jobs).

But a society is only as strong as its weakest link: get everyone educated in something they feel comfortable with to build a strong society.

Becta in the United Kingdom

Becta is the government agency leading the national drive to ensure the effective and innovative use of technology throughout learning. It got great results and – in my opinion – Becta single handedly got Britain into the 21^st century teaching by taking all (well, many) of the teachers along the learning path into the knowledge era. They produced an amazing amount of publication, accessible to all and tackling technology/learning issues that matter to many of us.

But the government changed, and because of this Becta will be shutting down in November 2010, in spite of many good learning outcomes and products.

So why do governments politicize learning?

Why can the military achieve what civil society cannot

In the last weeks I had the pleasure of meeting people actively involved in training soldiers. I am against violence, and I do belief no one on earth, no country, should have a military, but e.g. civilian aid army. But I cannot deny that the military offers opportunities for some young adults that they would otherwise never have (but they also risk their lives). No matter what group of human society, it is always a group of humans with all their nice and less friendly characteristics.

While talking to the teachers and exchanging ideas I wondered how they managed to reach learners that society could not reach. For example: many young recruits do not master basic calculations and/or reading/writing skills. This means that society and its education missed the boat. It is true that this is a joint responsibility, schools, parents, government should work together to improve the overall state of human comprehension in our young people.

The strange thing is military does reach them, and some of these young adults actually learn content that they did not absorb before (although I assume they had the chance). So why is that? Is it because the military actually use learning techniques that attract these young adults? (e.g. some of them got a Nintendo DS to learn simple math skills. Why? All of the peers were using Nintendo DS to play games, so if anyone was using a Nintendo DS, the peers would think “ah, he or she is playing a game” – so not loosing face while actually learning to count.

Another thing was language: recruits got language training, okay basic, but still it worked and they were actually eager to learn more (at first only words were offered, but on demand of the recruits complete sentences were offered for learning).

With new technology they were also provided just-in-time first aid help lessons, with simulations they were trained for in-the-field situations….

Say results would show learning outcomes improve drastically with the use of simulations, games… (Which is proven for some digital learning activities), than why can’t the government invest more money in them to reach those hard to reach learners that the military actually reaches?

Why is it still about technology and not about learning?

All of us that depend on funding know that if you stick the latest technological hype into a funding proposal, linking it to learning in some way or another, you have a far bigger chance to get your proposal accepted. Currently European politicians linked to EU funding say: we should get more learning results from the learning projects that run/ran, what are the long-term results (if any)? And indeed learning results are what count, not the technology. But is learning today actually about learning, or is it just another economic reason to sell stuff to regions or people that sometimes simply do not have the budget to sustain these technical solutions once the funding stops?

What are we to do?

How can we all insure that no matter what, learning and human consideration will improve with any technology for learning we introduce? How can we put education on the foreground and not technology? How can we opt for long-term actions leaping across political boundaries instead of ‘look-at-what-I-did’ projects from short term leaders?

ADL workshop first day - rough notes

This ADL workshop focuses on the challenges that mLearning has to tackle in order to improve both the educational and technical issues. The notes taken are mine and rough, so mistakes are more than probable.

Judy Brown: Assessment of Military mLearning trends
Wonderful and intelligent woman who knows how to get people thinking.
always plan for success (people want more, so make sure you will be able to provide more)
20 to 30% higher outcomes from students that used mobile to the ones that do not use them (reference will be given by Judy Brown, Merrill Lynch project) I would think it is related to rechewing informatoin when wanted and needed.
the main thing will not be courses, but it will be memory, re-access, real time feedback or update, intentional learning, the device should know who you are to give you the correct feedback, enhancement to learning, in the first level go with innovators and early adopters but also add nay sayers to keep a critical mind ...
mLearning should be fitted in your eLearning environment.
sensitive informatoin requires data and device encryption.

Robert Sottilare: U.S. Army mobile initiatives overview
Man with military walk (rather alfa) with active, creative learning brain it seems.
Why does not mLearning start on the level YOU as a learner are situated. Boredom, stress... can define your learning capacity.
mLearning should tailor the content and the tempo to me, the learner.
showed Aid Haiti relief: with mapping data both information and meta data (street view, building, what type of building)
speech recognition for communication out in the field, linking it to a mobile translator and enable synonimes (now based on set scripts).
www.vcom3D.com
check out ed manzatti and neal finkelstein
human - device interaction
longterm performance analysis is needed to get results on what works, performance, retention...hitting the 'sweat spot'
from handcraft solutions to semantic generic solutions
a lot of research needed to come to the 'optimal set'

inge thoughts
Three complimentary fields that need to be researched
machine learning
cognitive analysis of learner + physiological data of the learner
human analysis of the surrounding people (sensors, analysis + cultural aware filters - different cultures, different facial features and expressions) for reaction from the one using the machine

Asi Degani: European Union (EU) mLearning programs
What is the definition of learning? after the learning is done you (learner) behaves differently.
Using the phone to engage in learning, to create learning bits.
giunti labs look at the research
scorm standards makes content packages consistent, but also interchangeable
iphone is only 3rd mobile device producer, after blackberry and android. Nokia sold more cellphones than Apple in 2010, so
www.ericsson.com/contsens
linking content packages to different learning areas
outcomes from questionnaires 97,7 % wanted to continue with learning, 76% found mLearning enhanced their learning, 94% wanted more. Content: generic comments: very good, eyes tired by the end (maybe age), building confidence...
www.irmosprojects.com,
Attention span is said to be lower, but in my mind it could also be that humans always had a shorter attention span.
great pusher in learning is need
social learning: at the moment memory becomes external, it can be analyzed and it can become part of the organization (so easy to get all data if a person falls away)
inside buildings: location identification by triangulation the wifi station: enables feedback in buildings (see nokia: visual search also, Inge: cfr google goggles)

Geoff from Tribal group (Cambridge)
Interested both in innovation, and in generic useful mobile solutions
augmented learning, augmented thinking

Andy Black/Christine Lewis of Becta: what's the business benefit
it is all about skills training
social inclusion
equality of access
employability
business productivity
learning and skills
home access programme: creates family learning units by using computers in an impoverished region. The package can be bought in the high street, so accessible to all (not sure of price).
independent review of adult ICT skills
70% informal learning, 20% small learning, 10% formal learning, so why such huge budgets for formal learning?
dare to innovate, use social media
measure the savings - return on investment
use learners personal mobile technology

Jill Attewell: MoleNET the UK program that reached 20000 mobile learners
Engaging reluctant learners (NEETs)
easier to take technology enhanced learning outside for reluctant learnrs to try
learning more interesting, enjoyable, engaging, tailored to different learning preferences, more relevant/moders
recognition teenage and young audult learners and
improved not worse behaviour from the students
economic recovery and regeneration
adult workers current and forecast economic climate
www.molenet.org.uk (also check out MoLeTV and the pdf publications)

(Geoff knows about a medical mLearning solution in which 5 uni's were working alone at first and in the second year of the project they looked at possible combinations of what they researched to get skills evidence tools with medical students.

Geoff Stead and Geoff Martin: mobile Learning Shareable Content Object Reference Model (m-SCORM) limitations and challenges
micro-courses / content
refugees or foreign learners for improving language skills: go through them, listen to them, ... at that moment usable mobile application.
Bloom: for transport workers, taxi-drivers, truckers... different languages and learning skills.
literacy skills in South Africa: authoring so the learners are teaching each other (so: consuming and producing).
mLearning needs a broad range of solutions.
learning by doing

mLearning beyond content
m.oc.ac.uk: mobile oxford: accessible to all: lots of information about oxford, making the services of the institute available to the people to help them with their learning (bus tables, access to the library...)
www.acu.edu/technology/mobilelearning/index.html: Abilene Christian University. Every undergraduate receives an iPhone/iPod touch. Provides acess to university's custom-built online infrastructure
Normanby Primary School: digital technology integrated into teaching. Emphasis on digital learning.
Layar: location aware information stream. You can put up a trail for your students yourself and for free.
Mobile and immersive learning for literacy in emerging economies, the www.millee.org Putting games on mobile phones, games that kids recognize (copies of the local playground games) and using that familiarity to teach the children their language.


Emily Medina: SPAWAR demonstration
young applied scientist, it is like Johnny Mnemonic
eGloves Nice gloves with accelerometers so people or workers that need to work with protective attire, can access communication devices.
the haptic glove: = gestural twitter, this one also has vibration sensors.
gloves for communication
This could go further than gloves, using it on different parts of the body.

José Cartas Orozco: bi-lingual mobile learning methods: a use case
http://elab1.ilce.edu.mx/ilias
user usuarioadl
pass adl123456
check out the scorm with ilias and moodle medical application

#mLearncon 2010 in San Diego with Mobile Moodle

While it is still three weeks away, the premier mLearning conference in the US is getting closer (June 15 - 17 June 2010).

During this conference my esteemed colleague Carlos Kiyan and I will be presenting one of the concurrent sessions. The concurrent session 802 on Wednesday 16 June at 4 PM.

I am really looking forward to attending this conference, as I will be able to see some mLearning friends I have not seen in a while: Judy Brown (who I will see at the ADLworkshop in London this week), Clark Quinn (who is on the verge of publishing an enlightening mobile learning book and gives many presentations at mlearncon), and Silke Fleisher (who will lead one of the pre-conference sessions, I will attend hers it is on Android SDK - jippie!). These people are always coming up with great mobile learning ideas and enchanting mLearning solutions so I know I will learn soo much.

From the mLearning theory, yes, it will be a blast: a mLearning panel will be organized. And many, many mLearning thinkers will be present (the above of course and), amongst them the enlightened Mohamed Ally from Athabasca Uni and the pivotal mobile theory builder Mike Sharples.

Want to follow what is going on during mLearncon? Follow the mLearncon twitter line or search on #mlearncon.

If you are in the neighborhood, give me a sign, I will gladly meet up during the conference!

Mobile Moodle and mLearning project for mLearncon in San Diego

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eLearning Africa: creativity and a lot of innovative eLearning

eLearning Africa 2010 eLearning Africa is a highlight in my conference year. The conference brings together people with innovative ideas that make a difference in Africa, but also in the global eLearning world. Each year I am baffled for most of the eLearning which is developed in Africa is interlinked with human needs or social priorities. There are of course North/South initiatives, but a lot of the initiatives are South/South eLearning projects that are build and implemented in Africa.

It is also a moment to meet friends and researchers I admire, people that inspire my heart and tell me to go for critical research, to not take anything for granted.

During the conference I will be co-moderating (with Françoise Lequarré) the pre-conference workshop "Envisioning Our Global Learning Future" . The workshop will allow the participants to get to teh core of the education versus technology dilemma. The participants can exchange their knowledge and ideas with three top educationalists: Steve Vosloo (Shuttleworth Foundation, South Africa ), Jacqueline Batchelor (University Pretoria, South Africa) and John Traxler (Learning Lab, United Kingdom).

If you have concerns, questions, ideas on how we can improve global learning, and whether technology should push education, or education should push technology, come and join us on 26 May 2010 in the morning (= 9.30 - 13.00). Let us hear your voice!

A few of my colleagues and I will also be speaking during the parallel sessions:
Friday 28 May from 10.45 - 12.45 Carlos Kiyan and Luis Fucay on "mLearning for Continuing Medical Education in Resource-Limited Settings .

Friday 28 May from 13.45 - 15.15 Carlos Kiyan and myself on "Ubiquitous Learning: Moodle Adaptation to enable iPhone and iPod touch access" .

Some of the foci of the conference:

OPEN SOURCE
The Open Source movement is again a major theme at eLA 2010, with experts from Kenya, Tanzania, Nigeria and South Africa discussing their experiences with open tools and content and how these can be successfully adapted to suit a sustainable and open African learning environment. In a Special Focus Session on Open Source, experts will debate the best strategies to implement the use of open/free source ware in higher education institutions. Several large international organisations are showcasing their experiences with open source repositories and a parallel session illustrates the use of various open source learning management systems.

HEALTH
Renowned institutions from Zambia, Zimbabwe and Ghana, and the World Health Organization in Gambia will illustrate how health awareness and health education can be improved in resource-poor and remote communities.

MOBILITY
Mobile Learning is gaining momentum and speakers from the Shuttleworth Foundation, AMREF and the Stellenbosch University will explain how they battle illiteracy and support teachers and health workers. Another session will feature smart and low-cost solutions that have been implemented to improve mobile learning environments.

All through the conference I will take notes and depending on the Internet connection I will post what I pick up during the conference.

In 2015 augmented learning in a ubiquitous learning environment will be fact

In the Big Question launched by Tony Karrer this month, he wonders what workplace learning will look like in 2015?

This is a very nice challenge, it is short and this question allows you to focus on the gut-feeling you get when looking at all the new emerging technologies.

With the mobile technology increasing and all of us eLearning providers grasping what benefits mobile learning has, I feel confident that the most innovative corporations and academic institutions will invest in their learning environments. These investments will embrace the new learning opportunities that result from adapting a new sense of learning: augmented learning, and a new way of learning: ubiquitous learning.

Augmented learning
Through augmented learning a completely new layer is added to the real and virtual learning that is happening right now. Augmented learning allows us to perceive the real world, and add an extra learning layer to it. This learning layer might be delivered above the existing real world we observe (e.g. the mobile browser layar ), or it can allow us to recognize the real world and get information on it (e.g. google Goggles), or an augmented reality can be brought to live via a barcode attached to a camera (e.g. ARToolKit).

These innovative learning techniques seem to be far off, but they are actually already being incorporated in some corporate learning environments (see this finish example where engineers get on-site information from which they learn what can improve, and which enables them to give immediate feedback to the site again: link to the plant )

Augmented reality allows you to get more information than you can see with the naked eye. And because it can be linked to mobile devices, you can have that information where you need it.


Ubiquitous learning
Our learning environments have evolved. Until only a couple of years ago learning was rather linked to a certain location: your desk or school. With mobile learning on the rise, learning can happen apart from location (and whenever you want it). But in order to do this, the learning environment must be adapted so this ubiquitous learning can occur.

In order to do this the learning environment must be able to cater to a variety of technologies (sometimes you connect with your computer, sometimes with your mobile, sometimes with someone else's device...) and it must be build so the learner can reach relevant information in a variety of ways (e.g. qrcodes, mobile internet, wifi, ...). It must also cater to the need of the learner (some of us learn through our network => social media access, some of us through a content management system => cms that allows multiple device access...).

At this point in time it still takes a lot of effort to really roll out a ubiquitous environment, but in about 5 years we should be ready to feel comfortable to live in a world from which we learn what we want, whenever we want, and with any device we can get our hands on.

Of course this does express the need for standardization both on the device side as on the connection side (oh, would not that be great!).

And to see what lies ahead, it is always a good thing to look back. So have a look at the Future of Education: best articles from 2009 according to Robin Good.

Kontax m4lit Steve Vosloo taking on South African youth literacy via low-cost mobiles

Some researchers seem to have a natural savoir vivre to get idealism and research out there for all to enjoy. Steve Vosloo is such a researcher, a mobile learning researcher into critical research.

If you have the time to read any of his papers, you will see that his research reports satisfy your scientific mind with his great theoretical drive. But what I love above all is that his work and initiatives add an incredible human surplus.
It is never only about mobile learning initiatives in theory, he makes a difference. He breaks down cultural barriers, he finds learning solutions with the most basic of communication devices (low cost cell-phones)… he is the type of researcher I would love to be (I try to be, but it is a far way to go). Let me describe his latest big project: Kontax, with which he helps massive amounts of youth learners to improve their literacy skills via low-cost phones.

Kontax is a project that uses mobile phones for literacy, which is supported by the Shuttleworth foundation.

On 30 September 2009 Kontax – an m-novel created for the Shuttleworth Foundation’s m4Lit project– launches in South Africa, making world history as the first of its kind to be offered in both English and isiXhosa. The m4Lit project, led by Steve Vosloo, 21st Century Learning Fellow for the Shuttleworth Foundation, aims to not only explore the potential for increased reading and writing for 21st century teens through mobile phones, but also to introduce a more interactive style of story writing and publishing that holds appeal to the participatory culture of youth. The hope behind the m4Lit project is that by researching the role of cellphones in teen reading and writing, educationalists and publishers can better understand the opportunities and risk for literacy practices presented by the most popular communication device used by any teen today.

The project ran in pilot phase from August – December 2009 and it is ongoing.
• From 30 September 2009 onwards a new chapter from Kontax was released every day.
• Each chapter is about 400 words long.

The project is accompanied by a blog.
You can also follow the project on:
• On Twitter or using #kontax.
• On Facebook join the group Kontax.

The full press release on the project can be found here.

And for those willing to take a look at the reports on the m4lit (mobile for literature) or Kontax project check out these research reports here.

Steve is not only a great researcher, he is also a very kind person in real life. I met him in the past and he has charisma and vision. So, if you have the chance to meet him, do it, he inspires.

m-Novels for Africa

View more presentations from Steve Vosloo.

Mobile learning challenges presentation starting from one of ITM's mobile projects

The ADL workshop in London, UK that will investigate what mobile learning challenges need to be investigated further draws near.

This will be the presentation I will give, proceeding the group brainstorm on what can enhance mobile learning research. The presentation gives an overview of ITM's latest mobile project (in Peru) and distills possible topics to enhance mobile learning research.
The presentation also takes a look at the mid-term evaluation results of the Peruvian mobile project.

If you know of any urgent topics that need to be investigated, please let me know, I will take them with me and give you feedback on the answers afterwards.

ADL workshop on mobile learning challenges May 2010

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Call for young medical researchers that work or reside in the South: essay competition

At ITM we are organizing the Emerging Voices colloquium which will feature new innovative technologies for research and put young researchers in the driving seat of the colloquium.

If you know any medical researchers residing or working in emerging countries, please send them this initiative. There are all sorts of introductions for the winners of the accompanying essay competition: how to present workshops, introductions to using new media in science, and collaborative research work...

The Institute of Tropical Medicine promotes ‘Health care for all’ in its mission statement. However, achieving universal health coverage is easier said than done. Although progress has been made, innovative perspectives are certainly welcome.

The global health scene is still largely dominated by Northern stakeholders. We want to encourage “Emerging Voices” from developing countries to participate actively in international academic conferences and to raise their voice in the scientific debate.

That's why we are organizing our essay competition. We want to give junior or 'emerging' voices from the South the opportunity to present new ideas on how to progress towards universal health coverage.

The authors from the best essays will be invited to Antwerp to participate in an intensive training workshop (2-10 November 2010) before presenting their work at the ITM colloquium.

They will also be encouraged to participate in the First Global Symposium on Health Systems Research (Montreux, Switzerland, 16–19 November, 2010).

A certain number of travel grants will be awarded for those who need it. Take a look at the essay competition rules for more information on how to participate.

The competition is in French and in English, for download see below:

Call for Emerging Voices in Global Public Health

Appel aux talents émergents en santé publique mondiale

2010 Horizon Report on K12 education is out, and free for download

Education and technology leaders, policymakers and key stakeholders in educational institutions need forward thinking information addressing opportunities for teaching, learning and creative expression. The 2010 Horizon Report: K-12 Edition is a collaboration between the New Media Consortium (NMC) and the Consortium for School Networking (CoSN). This annual report provides a rich set of topics, examples and resources for use in considering new technologies that hold strong promise for K-12 institutions in the US and globally.

The nice thing is: you can add your own comments to the document, really nice!
http://wp.nmc.org/horizon-k12-2010/

Accompanying the Report is the 2010 Horizon Report: K-12 Edition Toolkit, developed by CoSN in partnership with NMC, which helps to facilitate conversations among education leaders around issues discussed in the Report. The Toolkit includes a Discussion Facilitator’s Guide with leading questions to stimulate thinking and discussion and a Presentation Template of PowerPoint slides with notes. A post-event feedback form is also provided. Use these free resources to help maximize the impact of the Report and help education stakeholders better understand new applications of technology and better plan for their successful implementation.

What is covered? The critical challenges for k12 education, the upcoming educational formats, the adoption curve that is envisioned to embed new innovative educational techniques in K12 education... so lots of nice and relevant topics.

• Read a copy of the 2010 Horizon Report: K-12 Edition.
• Arrange for a conversation around the Report using the Toolkit.
• Request the 2010 Horizon Report: K-12 Edition Toolkit, which consists of the Discussion Facilitator’s Guide and the Presentation Template/PowerPoint.
• Hold a conversation in a format that works best for your educational entity.
• Offer CoSN your feedback using an online form.
• To participate in the accompanying K-12 Wiki, find out more information about the Advisory Board, or other work products, visit the NMC website.