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Erica Frank, MD, MPH

Founder, President, and Executive Director, www.NextGenU.org

Professor and Canada Research Chair, UBC – Faculty of Medicine

Kate Tairyan, MD, MPH

Senior Lecturer, Simon Fraser University

Director of Public Health, www.NextGenU.org

NextGenU.org the world’s first free university

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The first problem we’re helping fix: democratizing health sciences learning

• In 2006 WHO identified a need for 4.3 million more trained health workers globally

• WHO also said that this will require greater use of training innovation, especially through information and communication technologies

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A distributed, computer-assisted, and mentored model:computer-based knowledge transfer, coupled with peer-to-peer and local mentored experiences.

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How are we free?

• Cost-free

• Barrier-free

• Ad-free

• Carbon-free

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Founding Collaborators and Funders

American College of Preventive Medicine

Annenberg Physician Training Program

Centers for Disease Control and Prevention

NATO – Science for Peace

University of British Columbia

World Bank

World Health Organization

World Medical Association

Grand Challenges Canada

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“NextGenU is a visionary undertaking.” – Jeffrey P. Koplan, MD, MPH, Former Director, U.S. CDC

“NextGenU.org will help globally democratize health science knowledge.” -Carmen Carpio, Knowledge Mgmt Officer, World Bank

“NextGenU is an incredible resource for health professionals all over the world. Open access to health information should literally save millions of lives and lead to important new discoveries.” -Anne Margulies, former Executive Director, Open Course Ware, MIT

“NextGenU is expected to make a considerable contribution to the advancement of e-learning worldwide.” -WHO, Building Foundations for E-Health, 2006

“The internet at its finest… a bonanza… a boon… an incredibly worthwhile enterprise… a model of what Health 2.0 and Science 2.0 can be… one of the most altruistic and honorable health service resources on the planet.” -Online reviews, 2009

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2012-2013 Clinical Public Health and Prevention Trainings

= All core public health areas [Epidemiology, Biostatistics, Health Policy/Mgmt, Environmental Health, Health Education, co-sponsored by the American Association of Public Health Physicians and the Association for Prevention Teaching and Research]

= Adolescent Health [American College of Preventive Medicine, UBC]

= Adult and Pediatric Cardiovascular Disease Prevention [Emory University, Latin American Pediatric Association, Universidad San Francisco de Quito]

= Climate Change and Health [350.org, David Suzuki Foundation, Health Care Without Harm, International Society of Doctors for the Environment, Physicians for Social Responsibility, UBC]

= Physical Activity and Health [American College of Sports Medicine, Fundacion Sante Fe, U.S. Centers for Disease Control and Prevention]

= Preventive Medicine [American Association of Public Health Physicians, Public Health Foundation of India, and the Association for Prevention Teaching and Research]

= Prevention/Treatment of Alcohol Use Disorders [Annenberg Physician Training Program, UBC, UF]

= Prevention and Treatment of Tobacco Use [International Federation of Medical Student Associations, International Primary Care Respiratory Group]

= Trade and Health [Center for Policy Analysis on Trade and Health]

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2012-2013 Clinical Trainings

= Emergency Medicine [Emory University, Society for Academic Emergency Medicine, International Federation for Emergency Medicine]

= Family Medicine [MoH Sudan, U of Gezira, WONCA]

= Gynecology/Obstetrics and Perinatal Care [International Federation of Gynecologists and Obstetricians, Latin American Pediatric Association, Medical Women’s International Association]

= Occupational/ Physical Therapy [Rocky Mountain University of the Health Sciences, Kenyan Physical Therapy Association]

= Pathology [UBC Department of Pathology]

= Pediatrics [Latin American Pediatric Association]

= Preventive Medicine [American Association of Public Health Physicians, American College of Preventive Medicine, Association for Prevention Teaching and Research, USF Quito]

= Surgery (Orthopedic) [Presbyterian University of East Africa, College of Surgeons in East, Central and Southern Africa]

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2012-2013 Basic Science Trainings

= Anatomy: Dental

= Clinical/PH Genetics

= Immunology

= Physiology (cardiophysiology)

= Pre-health professionals certificate (biology, math, medical humanities, organic chemistry, physical chemistry, physics)

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Matching existing competencies with existing resources

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64 Languages Available• Afrikaans• Albanian• Arabic• Azerbaijani• Basque• Belarussian• Bulgarian• Catalan• Chinese (Tr)• Chinese (Si)• Croatian• Czech• Danish• Dutch

• Italian• Japanese• Korean• Latin• Latvian• Lithuanian• Macedonian• Malay• Maltese• Norwegian• Persian• Polish• Portuguese• Romanian

• English• Estonian• Filipino• Finnish • French• Galician• Georgian• German• Greek• Haitian Creole • Hebrew• Hindi• Hungarian• Icelandic • Indonesian• Irish

• Russian• Serbian• Slovak• Slovenian• Spanish• Swahili• Swedish• Thai• Turkish• Ukrainian• Urdu• Vietnamese• Welsh• Yiddish

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Interactive Activities Feedback Opportunities

Peer MCQs / cases Feedback form for each resource

Mentored activities Peer feedback for posted assignments

Discussion forums Guided & free text feedback in forums

Instantly translated chat rooms Course evaluations

Word Games: Crossword, Cryptex, NextGenU.org version of “hangman”

Live technical support

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Mentored Activities

•Review with your supervisor how to take a focused history appropriate to ED complaints.•Review all your management plans with your supervisor.•Review with your supervisor the role of your ED in your community and access to care.•Review with your supervisor the costs of tests in your hospital.• Review with your supervisor normal and abnormal glucose levels for your institution.•Perform IV insertions under supervision.•Perform phlebotomies under supervision.•Watch any central lines performed by your supervisor.•Perform bag-mask ventilation under supervision until comfortable ventilating a patient.•Learn how to operate the defibrillator available to your institution from your supervisor.•Have your supervisor demonstrate NG tube insertion with you.•Have your supervisor review and demonstrate catheterization with you.•Have your supervisor review and demonstrate casting/splinting principles with you.•Have your supervisor review and demonstrate technique for incision and drainage.•Have your supervisor demonstrate proper C-spine immobilization.•Review the procedure with your supervisor if ultrasound is available at your institution.•Perform local anesthetic infiltration under supervision.•Review suturing technique with your supervisor.

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Competency 3.1 - Effectively communicate with patients, family members, and other members of the health care team.

Meet with a health care professional, other than a physician, who works in the emergency department (such as a nurse, respiratory therapist, or social worker).  Discuss with them what their role is in the emergency department, and gain a brief understanding of their training.  Write a short essay (250-500 words) on the role of this health care provider, and how their role helps you in managing your patients.

Evaluation criteria:1. 250-500 words2. Clearly outline the role of another health care professional (other than physician) in the ED3. Describe how the role of this health care provider is important in the care of emergency patients4. Describe how the role of this health care provider helps you in managing your patients

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Case #1

A 15 year old female presents to the ED with a ruptured ectopic pregnancy.  The gynecologist wants to take the patient to the operating room and requires consent for the procedure.  The patient’s mother is in the waiting room.  You have deemed that the patient is competent, and understands the risks and benefits of the procedure.  The patient has asked that you do not tell her mother about the pregnancy.

Is this patient eligible to give her own consent at age 15?  Would you tell the patient’s mother about her condition?  Write a short essay (300-500 words) justifying your decision, using ethical and legal principles.  Briefly outline the laws for age of consent in your country.

Evaluation criteria:1. 300-500 words2. Outline the law regarding age of consent in your country3. Attempt to justify your decision to either tell or not tell the patient’s mother about her condition4. Identify at least 2 ethical issues surrounding your decision-making process

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Case #2

A 35 male presents to your ED with fever, malaise, and cough.  He tells you that he has recently been diagnosed with HIV.  You suspect that he has pneumocystis jiroveci pneumonia. His wife is in the waiting room, and the patient tells you that she does not know of his HIV diagnosis, and asks that you do not tell her.  They are currently sexually active.

Would you tell his wife about her husband’s HIV status, despite the fact that he asked you not to, in order to protect his wife?  Are you obligated to report his disease to the local health authorities?  Write a short essay (300-500 words) about your decision making process, and justify your decision using ethical and legal principles.

Evaluation criteria:1. 300-500 words2. Outline the law in your country regarding HIV reporting3. Identify at least 2 ethical issues surrounding this case4. Attempt to justify your decision using ethical principles

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Research Metrics

• Name

• Email

• Prior degrees

• Current training

• Location

• Institution

• Job title

• NextGenU metrics

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Average for Quizzes 86%Final Exam 172/75 96%

Cumulative 188/210 89.52%

Student 2: Sample data for Quizzes and Final Exam

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Fullname # of Attempts Marks Percentage Last attempted onStudent1 1 59/75 78.7% April 26, 2012, 6:17 amStudent2 1 75/75 100% April 26, 2012, 6:35 amStudent3 1 72/75 96% April 26, 2012, 6:44 amStudent4 1 68/75 90.7% April 26, 2012, 7:25 amStudent5 1 72/75 96% April 26, 2012, 7:34 amStudent6 1 71/75 94.7% April 26, 2012, 7:39 amStudent7 1 69/75 92% April 26, 2012, 7:34 amStudent8 1 68/75 90.7% April 26, 2012, 7:42 amStudent9 1 66/75 88% April 26, 2012, 8:11 amStudent10 1 74/75 98.7% April 26, 2012, 8:07 amStudent11 1 69/75 92% May 4, 2012, 11:49 am

Cumulative 763/825 92.48%

Final Exam Sampling

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Quiz: Competency 6.1. Understand the approach to the approach to abdominal pain 10

66.66% 1

100.00% 9

Quiz: Competency 6.2. Understand the approach to altered mental status 10

66.66% 5

100.00% 5

Quiz: Competency 6.3. Understand the approach to cardiac arrest 10

66.66% 2

100.00% 8

Quiz: Competency 6.4. Understand the approach to chest pain 10

100.00% 10

Quiz: Competency 6.5. Understand the approach to gastrointestinal bleeding 10

66.66% 2

100.00% 8

Quiz: Competency 6.6. Understand the approach to headache 10

66.66% 1

100.00% 9

Quiz: Competency 6.7. Understand the approach to poisoning 10

33.33% 1

66.66% 3100.00% 6

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Trainee statistics as of this week

• Auditing students from 47 countries

• Credit/certificate students from 55 countries

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Erica Frank, MD, MPH efrank@NextGenU.org, erica.frank@ubc.ca

Founder and Executive Director, NextGenU.org Professor and Canada Research Chair, University of British Columbia

Kate Tairyan, MD, MPHktairyan@nextgenu.org, ktairyan@sfu.ca Director of Public Health, NextGenU.org