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Learning About Neuroethics Through Health Sciences Online: A Model For Global Dissemination

Abstract and Keywords

Health personnel regularly confront new and sometimes critical situations that add to the already heavy burden of providing healthcare with inadequate resources. This article describes Health Sciences Online (HSO), an initiative to improve professional educational resources for those in the global health community interested in neuroethics and other health sciences disciplines. HSO is placed in the context of online health professional education and the technological advances that make such education possible, and the article presents the strategic components of HSO project development and implementation in neuroethics and neuroscience overall, and addresses some issues of future developments in distance learning. New models of training and innovative ways of delivering such training should be further explored and tested in order to make neuroethics content widely available, not only in countries with relatively high volume of neuroethics content development, but also to their eager colleagues globally.

Keywords: healthcare, Health Sciences Online, neuroethics, professional educational resources, distance learning, global health community

There is no prescription more valuable than knowledge.

C. Everett Koop, MD, Former US Surgeon General

Introduction

Despite the importance of information for both health and development, the world’s vast store of knowledge and high-quality education remains largely out of reach for health professionals in many countries. Health personnel regularly confront new and sometimes critical situations that add to the already heavy burden of providing healthcare with inadequate resources. At the same time, health sciences students may complete their training insufficiently prepared to cope with the health problems they will encounter in practice with their local communities (World Health Organization 2006a).

Here we describe Health Sciences Online (HSO; http://www.hso.info), an initiative to improve professional educational resources for those in the global health community interested in neuroethics and other health sciences disciplines. We place HSO in the context of online health professional education and the technological advances that make such education possible, present the strategic components of HSO project development and implementation in neuroethics and overall, and address some issues of future developments in distance learning.

(p. 880) Background

The World Health Organization (WHO) has identified a need for 4 million additional healthcare workers, recognizing the lack of a trained health workforce as a threat for global public health: “Pressing health needs across the globe cannot be met without a well-trained, adequate and available health workforce” (WHO 2006b). Many national education systems are unable to provide basic or continuing education, and many countries lack sufficient resources to ensure that current knowledge, methods and materials are used in teaching. As an urgent step toward solving the emerging public health problem, the WHO calls for more direct investment in the training and support of health workers (WHO 2006b).

Aging and growing populations, and a dramatic increase in chronic diseases worldwide including a high burden of neurological and psychiatric disorders, are placing new demands on a health workforce that is already inadequate. Not only are there insufficient numbers of health workers, they are also unequally distributed, as shown in Table 51.1.

In industrialized societies where neurotechnology rapidly advances the field of neuroscience and the understanding of brain functions, health providers and researchers in clinical and academic settings are facing new challenges. The need for proactively identifying and addressing those challenges and recognizing the ethical, legal, and social implications of neuroscience research has been emphasized repeatedly by many pioneers in neuroethics (Roskies 2002; Illes, et al. 2006; Illes and Atlas 2007). Academic centers and universities in Canada, US, Europe, and Japan have responded to the urgent need to align advances in neurosciences and societal values. The newly established neuroethics centers and programs are becoming hubs for mobilizing resources and addressing neuroethical dilemmas through empirical research and knowledge translation. The federal governments and private funds support many of those centers, and many of them have vital information to share.

Additionally, the media and public show ever-increasing interest around neuroethics issues. As predicted by Sahakian and Morein-Zamir (2009) in Science, “neuroethical issues are surely going to become ever more pertinent” with new developments in imaging analysis techniques, imaging modalities, and means to link genetics with functional brain maps (Tairyan and Illes 2009). In the new era of neuroscience development and neuroethical dilemmas, there is a growing need for applied neuroethics training to be integrated into neuroscience education (Sahakian and Morein-Zamir 2009; Lombera et al. 2010). This is (p. 881) critical for the responsible and appropriate use of emerging brain-related technologies and methods; neuromarketing and cognitive enhancement; management of incidental findings among healthy volunteers and other research participants; public perception; and the management of hyperbole around potential implications of neuroscience research results, especially for patients with persistent vegetative states (Greely et al. 2008; Murphy et al. 2008; Racine et al. 2008; Wolf et al. 2008). Although the importance and the timeliness of neuroethics content in existing neuroscience programs has been emphasized by many neuroscience researchers around the world, two independent reports from the UK (Sahakian and Morein-Zamir 2009) and Canada (Lombera et al. 2010) have shown that neuroethics training is not commonly a formal part of neuroscience programs in those countries, and the majority of neuroscience students do not receive formal education about ethics in neuroscience. However, the Canadian study revealed that there is a strong interest in including more ethics content in programs among both faculty and students. The vast majority—more than 90%—of participating faculty program directors endorsed the importance of including formal ethics training in neuroscience programs. Despite the interest in and perceived need for more formal ethics content in the neuroscience curricula, lack of time and expertise, as well as lack of relevant resources were identified as the main barriers to incorporating ethics into the neuroscience education. This led the authors to recommend the development of more tailored educational tools to promote neuroethics expertise, and to offer more appropriate educational media to reduce time constraints. Similarly, the UK-based investigators suggested that academic programs should also have mechanisms in place for offering neuroethics teaching, although they were less specific with ideas of how this can be achieved. Investigators in both groups also commented on the already heavily loaded neuroscience training agenda, posing challenges for effective scheduling and inclusion of any new topics. Therefore, new models of training and innovative ways of delivering such training should be further explored and tested in order to make neuroethics content widely available, not only in countries with relatively high volume of neuroethics content development, but also to their eager colleagues globally.

Table 51.1  The health workforce in the Americas versus sub-Saharan Africa

The Americas

Sub-Saharan Africa

14% of the world’s population

11% of the world’s population

10% of the global burden of disease

25% of the global burden of disease

42% of the world’s health workers

3% of the world’s health workers

>50% of global health expenditure

<1% of global health expenditure

Reproduced from the World Health Organization. The global shortage of health workers and its impact. Fact sheet No 302, April 2006. Available at: http://webcache.googleusercontent.com/search?q=cache:MWQ24Udr1l8J:www.who.int/mediacentre/factsheets/fs302/en/index.html+%22Americas+versus+sub-Saharan+Africa%22&cd=1&hl=en&ct=clnk&gl=ca&source=www.google.ca (accessed 14 December 2009) © 2009 WHO with permission.

Technological development and e-learning

The Internet offers a well-developed and cost-effective option for delivering and enhancing professional education in high-income countries. Increasingly, as both Internet access and user-capability improve, the same option is becoming available in developing countries. Computers are also becoming increasingly prevalent in medical practices, regardless of location or relative wealth of the local healthcare community (Richwine and McGowan 2001). Computer-assisted training programs delivered through the Internet now make education and training increasingly available at a relatively low per-unit cost. As a result, health sciences education provided through cost-effective, largely available and acceptable, innovative initiatives such as Web-based virtual educational centers are expanding globally (Harden and Hart 2002).

The emergence of the Internet has introduced new ways for users to access information resources and has shaped user behavior and expectations. Users now expect instant and constant access to information, often from distant locations (MacCall 2006). However, rapid (p. 882) change in information technologies also means that users need to adapt to the changing environment faster than ever before. Then, as users’ perspectives change, online resource providers also have to keep up by anticipating the needs of users and updating, organizing, and managing resources effectively and seamlessly (Blansit and Connor 1999).

The rapid development of digital technologies combined with the growth of the Internet in the past decade has revolutionized traditional methods of research and teaching and has led to a proliferation of digital material. The amount of health-related material generated in digital format has also increased tremendously over a short period of time (Blansit and Connor 1999). Digital materials come in the form of online courseware, lab image files, statistical files and databases, clinical and research publications, reports, electronic books, and many other formats.

Today, world-class universities are developing and promoting online courses and degree offerings, extending their programs to meet the needs of local students as well as working professionals (Smith 2002). Faculty and staff in the health sciences arena now use and create digital material for their research and teaching on a daily basis. While campus-based education may continue to be the first choice of many students and institutions, the benefits of distance learning have increased international demand for access to virtual universities and other electronic educational resources (Phipps and Merisotis 1999; McKimm et al. 2003).

Online access to open-source education portals is growing every year; the increase is documented not only in industrialized countries, but also outside of the developed world. For instance, the OpenCourseWare of the Massachusetts Institute of Technology (MIT) recorded a 56% increase in visits in 2005; 61% of visits were from non-US users (MIT 2006).

In order to make the educational experience relevant, information must be accessible from anywhere and anytime, directly delivered to the end-user. Changes in information technology have allowed the world’s biomedical information to be available on a physician’s computer desktop. Changes in the practice of medicine, and technological developments are creating unprecedented opportunities to select and organize electronic resources, using the Web to deliver content throughout the world, and enhance knowledge. Ronald Phipps and Jamie Merisotis, of the USA Institute for Higher Education Policy, noted in their 1999 report on distance education:

Technology is having, and will continue to have, a profound impact on colleges and universities in America and around the globe. Distance learning, which was once a poor and often unwelcome stepchild within the academic community is becoming increasingly more visible as a part of the higher education family. (Phipps and Merisotis 1999, p. 29)

Educators even warned that universities that failed to transform courses and degree programs for Internet delivery would not survive long into the next century (Harden and Hart 2002; Endler 2005).

E-learning and continuing medical education

Health professionals increasingly rely on the Internet not only to obtain information on clinical issues and research, but also to fulfill continuing medical education (CME) (p. 883) requirements. A 2001 study on physician preferences for CME reported that only 2.7% of North American physicians used the Internet for CME (Brown et al. 2001), whereas more recent figures show use of the Internet by physicians to be closer to 31% (Rossett and McDonald 2006). Access to CME is one of the most commonly reported Internet uses by physicians. These data are consistent with reports by the US Accreditation Council for Continuing Medical Education (ACCME) of an upward trend in online CME offerings, with Internet CME activities increasing by 121% from 2003 to 2004. In 2003, De Groote and Dorsch found that, at the University of Illinois at Chicago, 95% of the users of health sciences library (medical students, faculty, and residents) reported having access to a computer with Internet access outside of the library, and 53% of these users reported that they searched MEDLINE at least once a week. This study also found that only 16% of users depended entirely on the library to access its online resources, while 39% of users never entered the library to access online resources. In an especially remarkable attitudinal change, 71% of users indicated a preference for online over print resources when possible (De Groote and Dorsch 2003).

Potential benefits and some challenges of e-learning

The reusable learning object

E-learning, or technology-enhanced learning has grown in popularity because of ever-improving quality, convenience, and flexibility, increasing availability of computers, and students’ familiarity with them. Many researchers have predicted that future students will be educated in a context where considerable time is spent online, regardless of their educational institutions’ locations. Some researchers suggest that e-learning will fundamentally alter traditional modes of higher education. Rather than being affiliated with a single institution, learners will be associated concurrently with multiple content providers throughout the world. The “reusable learning object” approach is the most powerful feature of e-learning. For example, the same learning object created in one educational institution can be used by different teachers and learners in different ways and may be reused a number of times in different learning contexts. This scenario assumes unbundled education, with students having greater control over their educational experiences and programs that fit their own special needs for content, length, delivery mode, time, and location.

Harden and Hart (2002) summarize the benefits of e-learning for students, partner institutions, and society (Figure 51.1). The benefits involve important aspects of e-learning such as quality, flexibility and cost-effectiveness, innovation, responsiveness to social needs, and collaboration nationally and internationally.

Global perspectives and universal delivery

 Learning About Neuroethics Through Health Sciences Online: A Model For Global DisseminationClick to view larger

Fig. 51.1 Benefits of e-learning. Adopted from Harden and Hart (2002).

Benefits of remote access for students include a high-quality unique education program, with expert-designed learning systems. Such online programs can offer a global perspective, (p. 884) with students becoming part of an international community offering cultural diversity, a flexible and adaptive curriculum to fulfill individual needs, a wide range of learning opportunities and approaches, home-based learning (with the benefit of saving on relocation costs), experience gained with new technologies, preparedness for lifelong learning, and continuous professional development (Harden and Hart 2002).

Other obvious advantages of electronic formats include essentially universal delivery of high-quality information and learning materials at nominal costs, with the benefits of desktop access, searchable text, and flexible editing options, and without the inconvenience and costs of accessing information at traditional libraries. These costs can be both individual (both time and opportunity costs, often quite steep for trained health providers), and institutional, as libraries can decrease their commitments to subscribing, shelving, reshelving, binding, and housing a given journal title (Blansit and Connor 1999).

Computer-assisted instruction (CAI) is an efficient means of conveying knowledge to large numbers of health professionals given the small marginal costs of providing access to already-developed computer-based materials. This is especially the case if connectivity, hardware, and software are already present (an increasingly common situation). While the cost of educating a physician in developing countries is far less than in industrialized countries, the relative expenditure for educating a physician, adjusted for per capita GNP, can be very high. For example, relatively speaking, Vietnam spends 2.8 times the US average (Bicknell et al. 2001). Further, while educating the 100th student in a bricks-and-mortar institution costs nearly as much as educating the 10th student, the cost of educating an additional health provider using computer-assisted instruction is zero for material development and can be negligible for material distribution and usage. While the current cost of computers and Internet access still limits their use by many health professionals in less-developed countries, these limits will shrink as the costs of handheld devices with Internet access, PCs, and CDs continue to plummet and Web access grows.

(p. 885) Effectiveness and quality

New learning technologies and e-learning will clearly have an increasingly important role to play in neuroethics and other aspects of medical education. However, the extent and the nature of developments in the area of e-learning are difficult to predict. The scientific world is only beginning to investigate the possibilities offered by the Internet for education, and is coming to recognize its strengths and limitations (Freeman et al. 2000). The need to foster the development of truly international learning experiences and make that learning universally available has been described previously (Harden and Hart 2002). A recent US Department of Education publication entitled Evaluation of Evidence-Based Practices in Online Learning: A Meta-Analysis and Review of Online Learning Studies revealed many interesting findings over 1000 empirical studies conducted between 1996 and 2008. In particular, it reports that students in online learning conditions perform better on average than those receiving face-to-face instruction (U.S. Department of Education 2009)

Extensive research has shown that online learning is at least as effective as traditional classroom formats (Lewis et al. 1999; Levine 2002), and that CAI may be superior to traditional didactic techniques (Chan et al. 1999; Phipps and Merisotis 1999; Greenhalgh 2001; Mazmanian and Davis 2002). But what of integrating and applying knowledge to practice (Giani and Martone 1998) in the context of CAI? This may be accomplished by blending CAI with face-to-face and community/skills-based learning. E-learning need not replace traditional forms of learning, but it clearly can complement and enhance training, and improve continuing education (Harden and Hart 2002). Online education or supplementary online courses can enhance learning particularly in such fundamental medical sciences as human anatomy. Experiences in the dissection laboratory allow researchers to conclude that such comprehensive online programs could also be effective in other disciplines where human resources for teaching are a limiting factor (Granger et al. 2006).

There is an enormous volume of readily accessible Web-based health information resources, allowing health professionals to retrieve current information with unprecedented ease and speed. These attributes can be of particular assistance to clinicians and scientists working in areas in which scientific and clinical developments move quickly (Peters and Sikorski 1998) or are new and fast-developing (such as neuroethics). However, an immediate limitation is that the quality of these resources is variable. Given the evolving state of the Internet, it may be difficult or even inappropriate to develop a static tool or system for assessing health-related websites (Kim et al. 1999). Users may feel overwhelmed by the range and variety of information and uncertain about which resources are most useful in their specialty areas.

A second limit is that providers who are more familiar with older print media may not have the skills to use new databases and information formats efficiently and correctly. In fact, one study shows that while many clinicians have adapted quickly to the new digital environment, at least 59% experience difficulty navigating or searching for biomedical information (Richwine and McGowan 2001). The situation is even more difficult in developing countries, where limited Web-use skills are often exacerbated by technical access and cost issues, reducing the quality and quantity of accessed materials even further.

Third, there are issues around the extent to which CAI can produce active learning. A review of medical teaching web sites for evidence of active learning showed that although (p. 886) most sites met criteria for a “general informational website,” only 17% had all components of the “learning paradigm” that involves the critical thinking, independent learning, evidence-based learning, and feedback that are so important for health sciences education (Cook and Dupras 2004).

Access

Digital libraries represent the most common form of online access to current medical information. Many biomedical libraries and publishers have set up remote access to their collections, allowing physicians to use online resources from their campus office, hospital workstation, and off-campus office computers, whether the physical library is open or closed (Beam et al. 2006). Medical information is also increasingly portable—physicians can quickly download, email, and save content to computers or personal digital assistants. Access to online health-sciences libraries can offer comprehensive collections of credible, up-to-date resources, and create opportunities for quality research, education, and patient care for healthcare professionals and students (Sheffield 2006). One study demonstrated that information services provided by hospital librarians in support of clinical decision-making had a significant positive impact on healthcare outcomes, as measured by the physicians’ self-reported evaluation of impact of the library’s information on diagnosis, choice of tests and drugs, reduced length of hospital stay, and advice given to the patient (Marshall 1992). It has become ever more important to explore new and more effective ways of information delivery to ensure that all healthcare providers have good access to necessary information to support their decision making, regardless of their geographic location.

The importance of online access to health sciences information cannot be overstated, especially in the context of rural, sparsely populated, medically underserved areas. Clinicians in remote and rural areas (even in developed countries) face geographic isolation. Health professionals in those settings often lack training and proper academic support due to distance from large, central hospitals and academic centers of excellence (Richwine and McGowan 2001). Professionally isolated health practitioners may fall behind in their continuous professional development. Distance education courses can reverse this sense of isolation and, in this context, learner support is vital, and social interaction and virtual collaboration become highly desirable features of the learning product (Boulos et al. 2006). A virtual library implemented in rural areas in southern Indiana confirmed that the impact of the project for healthcare outcomes was comparable to that found in the Marshall study (Richwine and McGowan 2001). The authors reported that two elements of the virtual library project contributed to its success: (1) well-organized and appropriate electronic resources that support clinical decision making; and, (2) training offered to facilitate use of the resources (Richwine and McGowan 2001).

In past few years, the medical community also has witnessed a rapid increase in the use of Web-based “collaborationware,” so-called Web 2.0 tools: wikis, blogs, and podcasts. These applications have been increasingly adopted by many online health-related professional and educational services. They offer the opportunity for powerful information sharing and ease of collaboration. Wikis are Web sites that can be edited by anyone who has access to them. The word “blog” is an online Web journal that can offer a resource-rich multimedia environment. Podcasts are repositories of audio and video materials. These audio and video files can (p. 887) be downloaded to portable media players that can create “anytime, anywhere” learning experiences (i.e. mobile learning) (Boulos et al. 2006).

Health Sciences Online: a model for maximizing benefits and overcoming challenges of e-learning

Attributes

Maximizing the use of online education for healthcare professionals will save time, money, and other critical resources. In the past, the majority of online educational website course offerings have been devoted to a single area of expertise. Other sites are affiliated with associations or publishers and have educational content reflecting the specific focus of the association or periodical. As a result, before the advent of HSO (http://www.hso.info), healthcare practitioners needed to spend a considerable amount of time searching the Web for sites offering courses on their specific area of expertise, rather than going to a single site that serves as a clearinghouse for courses and offers one-stop services for information across many health-related disciplines. Systematically designed filtering mechanisms have allowed HSO to accumulate only high-quality, current and credible learning resources, using clearly-defined content criteria for relevance/independence, objectivity, credibility/currency, and design (Frank 2004). As pointed out by Garcia, a comprehensive online education portal site minimizes the amount of resources that clinicians and healthcare systems need to devote to education-seeking, thus improving patient care (Garcia 2000).

Martinez has suggested:

The dream to deliver personalized learning using learning objects that fit the real-time, anywhere, anytime, just-enough needs of the learner is about to become a reality…. The most obvious benefit of these innovations is the creation of a learning ecology that shares resources from large reservoirs of content where learning objects are shared individually, widely and more economically. (Martinez 2002, p. 24)

With founding collaborators and funders including the US Centers for Disease Control and Prevention, Emory University, the University of British Columbia, the Ulrich and Ruth Frank Foundation for International Health, the World Bank, WHO, and the American College of Preventive Medicine, HSO meets the emerging need for increased access to health sciences education with innovative thinking new learning technologies such as virtual reality, and an international perspective on health sciences education for the benefit of communities on a global scale. To this end, HSO’s audience is health professionals, researchers, and policy makers both in training and practice in developing countries. Its content covers topics in medicine, public health, nursing, dentistry, and other healthcare and health sciences disciplines, with learning objects including textbooks, journals, databases, and interactive media tools and is constantly being updated. In Table 51.2 we present sample online resources on neuroethics. (p. 888)

Table 51.2 Sample online resources in neuroethics

Title

Description

Content provider and URL

Neuroethics: Implications of Advances in Neuroscience

Online course with 4 modules

Columbia University, NY

http://ccnmtl.columbia.edu/projects/neuroethics/index.html

Neuroethics – A literature review prepared for Toi te Taiao: the Bioethics Council

Review of the current literature on neuroethics

Toi te Taiao: The Bioethics Council, New Zealand

http://ndhadeliver.natlib.govt.nz/ArcAggregator/arcView/IE1074184/http://www.bioethics.org.nz/publications/neuroethics-review-jul06/index.html

Health Sciences Online: Neuroethics Resources And References

Introduction to current topics and the landmark papers in neuroethics

National Core for Neuroethics, University of British Columbia

http://neuroethics.ubc.ca/National_Core_for_Neuroethics/Initiatives_files/NeuroethicsReferences&Resources.pdf

Filmed Course Lectures

Lecture Series on various neuroscience topics with neuroethics content

The Science Network

http://thesciencenetwork.org/search?q=neuroethics&x=0&y=0

Ethics in Medicine (Ethics and Law; Termination of Life-Sustaining Treatment; Confidentiality, etc.)

Online modules with case studies

University of Washington, School of Medicine

http://depts.washington.edu/bioethx/topics/index.html

Decision Making in a Case of Personality Change

Clinical Cases

American Medical Association, Virtual Mentor

http://virtualmentor.ama-assn.org/2008/03/ccas1-0803.html

Ethics Videos on The Web

Lectures, presentations, course and conference talks

University of San Diego

http://ethics.sandiego.edu/video/APA/Pacific/2002/index.html

Penn Media Seminar on Neuroscience and Society

Series of expert talks

University of Pennsylvania

http://www.neuroethics.upenn.edu/index.php/resource-center/videos-and-podcasts

Facts, Ethics, and Policy Guiding Neuroscience Today (Michael Gazzaniga, Hank Greely, William Safire)

Science and the City Podcasts

The New York Academy of Sciences

http://www.nyas.org/Publications/Media/PodcastDetail.aspx?cid=9a4d84cb-3bb9-47f9-9f24-47789e884a21

Gray Matters

Podcasts

The Dana Foundation

http://www.dana.org/danaalliances/programs/graymatters/

(p. 889) Limitations

Easy, reliable and affordable access to the Internet is crucial for incorporating online learning initiatives into basic and continuous education for healthcare professionals and successful implementation of HSO. Although the Internet is available in most countries and continues to expand rapidly, access to Web-based learning opportunities is limited in many countries—especially in remote and rural areas, where healthcare providers are most in need of current information and education. Thus, infrastructure shortcomings and the cost of telecommunications are key obstacles to using the Internet and Web-based learning.

Happily, intellectual property and copyright issues have not been impediments, and this is true for at least three reasons. First, because essentially all the learning objects HSO uses are from links already publicly posted on the Web (and our other learning objects were given directly to us), links that were posted expressly with the hope of being shared and used among the health sciences and health education communities. Second, because our efforts are legally and ethically considered “fair use”: it is our intention for http://www.hso.info to always be completely free and open to anyone with web access to learn about the health sciences, and this is also fair use. In Phase II, where we will begin to charge people small amounts for training and certification, we will also be considered fair use, as our activities will constitute the non-profit use of freely posted materials (and we will also email all authors whose materials we use for our charged-for trainings, to give them an opportunity to withdraw access. We have been advised that this meets or exceeds terms of fair use by Steve Carson (HSO Advisory Committee member who also is Senior Strategist at MIT’s Open Courseware initiative), and by our pro bono counsel, the international intellectual property lawyers at Latham and Watkins (a 2000-attorney firm with 29 legal offices around the world).

Accomplishments to date and future steps

In December 2008 we officially launched HSO, the first website to deliver authoritative, comprehensive, free, and ad-free health sciences knowledge (with over 50,000 hand-selected resources, and 1000+ visits/day). HSO has been well-received by reviewers, including the WHO stating as early as 2006 that “HSO is expected to make a considerable contribution to the advancement of e-learning worldwide” (WHO 2006a), and AltSearchEngines calling HSO in 2008:

The Internet at its finest… an incredibly worthwhile enterprise… a boon… a model of what Health 2.0 and Science 2.0 can be… a pioneering project in health sciences education and medical information dissemination. Let us hope that every major medical school in the world jumps onto the bandwagon… Projects like this give me hope for the future. (emphasis theirs, AltSearchEngines.com 2008)

For HSO’s next phase, we are beginning work with colleagues around the world to create what we hope will be one of the largest, most accessible, and best health sciences universities—all done with distance HSO-based didactics, local hands-on mentoring, and peer-to-peer distance feedback. In beta-testing until mid-2011, we have launched the world’s first free university.We plan to train many thousands of trainees at a time, particularly in developing (p. 890) countries, with the students remaining in their home environments to build capacity. Among our offerings in 2011 will be:

  • Residencies in Ob-Gyn, Women’s Health, Pediatrics, and Adolescent Health, in partnership with WHO, the international Federation of Gynecologists and Obstetricians, Medical Women’s International Association, the American College of Preventive Medicine, and others

  • A Master’s degree in Public Health offered with Jilin University (the 9th ranked Chinese University, with 1800 public health students), the Public Health Foundation of India (we’ll be using the same tests as their conventionally-trained MPH students for our students), and the American Association of Public Health Physicians

  • Hospital and Clinic-based Infection Control, in collaboration with WHO

  • Introduction to General Surgery, with Global Surgery at the Center for Surgery and Public Health at Brigham and Women’s Hospital, the University of Zambia, and the Education Committee of the College of Surgeons in East, Central and Sourthern Africa (who will authorize these graduates to take surgical boards in 9 sub-Saharan countries)

  • Exercise and Health, in partnership with the U.S. CDC, the American College of Sports Medicine, and the Fundacion Santa Fe Bogota

  • A Pre-Medical Curriculum and a training on the Prevention and Cessation of Tobacco Use, both with the International Federation of Medical Student Associations

  • Prevention and Treatment of Alcohol Abuse, in collaboration with the Betty Ford Institute, and the Annenberg Physician Training Program in Addiction Medicine

  • A comprehensive, competency-based training program in neuroethics in collaboration with the Canadian National Core for Neuroethics at the University of British Columbia

Conclusions

The demand for equal access to high-quality, health sciences education is enormous, especially in the developing world. HSO is designed to help meet this overwhelming educational need regardless of geographical location and field of study, specialization, or practice, by providing a critical means to improve the health of the developing and industrialized world through free online access to high-quality, up-to-date courses and references for health professionals in training and practice. HSO’s collection is vast spanning diagnostic and therapeutic advances in medicine, as well as over 400 resources in biomedical ethics to neuroethics. It is a model for far-reaching innovative learning throughout the world in neuroethics, and beyond.

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