Creating Open and Free Medical Education Resources.

Abstract

Purpose: Open Educational Resources (OERs) are published in public domains or permissively licensed (i.e., Creative Commons [CC]) materials that allow for open sharing and free accessibility. 1 The absence of a common structure for OER materials has been identified as a barrier to collaboration among educators and a source of inefficiency. 2 Both MedEdPORTAL and the Association of American Medical Colleges (AAMC)’s Clinical Teaching and Learning Experiences 3 collection of educational materials lack a standard format that would allow resources to be directly integrated into medical school curricula without significant modification. The rise of virtual education with COVID-19 has made OERs more pertinent and accessible. Transition to Residency (TTR) courses have become increasingly popular as they seek to improve skills just before the increase in responsibility seen when students become first-year residents. 4 TTR courses should work toward common content between institutions because most students matriculate to residency programs outside of their medical school alma mater. Approach: We sought to create an OER collection specific to TTR courses containing standard formats, allowing course directors to interchangeably use materials and more easily share materials between institutions. Keywords of “Transition to Residency,” “bootcamp,” “internship preparation,” and “capstone” were used in multiple searchable collections of OERs (BCcampus, Oasis, OpenStax, MERLOT, and MedEdPORTAL) to search for existing TTR-related materials. Few resources were identified and either required significant modification to be used in a TTR course or were specific to 1 specialty. 5 A 12-participant convenience sample from 8 different medical schools and the AAMC MedBiquitous program used consensus discussion to draft a set of standards for faculty guides and teaching materials. A website (www.ttreducators.com) was created as a hub for collaboration and a platform for future distribution of materials. A pilot conversion of 10 existing materials from our local TTR course uncovered key considerations and process steps needed to create TTR OERs. Results: A standard structure for faculty guides (i.e., title structure, learning objectives, MESH terms, etc.) was identified. Five specialty groupings were selected for specialty-specific material: Emergency Medicine, Internal Medicine, Obstetrics–Gynecology, Pediatrics, and Surgery. Ten different educational delivery formats were identified as commonly adopted in TTR courses: “long-case” and “short-case” case-based learning, lecture, panel discussion, game, workshop/procedural skills training, peer role-play, simulation – standardized patient role-play, simulation – manikin/low-fidelity, and simulation – manikin/high fidelity. Each type was assigned a standard duration (1 or 2 hours), ideal group size (3, 4, 10, or infinite), a facilitator/student ratio (1/4, 1/6, 1/10, 1/infinite), and an ideal learning setting (classroom, virtual, simulation center). The “game” delivery format was not assigned standards due to the variability and complexity of games being delivered in TTR courses. Pilot conversion of local materials identified numerous key steps for ensuring compliance with CC licensing and OER best practices: ensuring web accessibility for the disabled, reverse image searching to ensure embedded content from external sources is open access, and documenting a CC license. 1 Additionally, an author consent was created and reviewed by our institution’s legal team. Discussion: A draft set of standards was created for TTR course curricular materials that will help ensure OERs are more easily usable by courses from different medical schools. We feel this approach was successful due in part to similar TTR course goals across schools, ensuring OERs can be freely modified after dissemination, and openness of educators to relinquish some personal control for the greater good. Our approach could be adapted by other educational domains in both undergraduate and graduate medical education, potentially saving a significant amount of time from teaching faculty. Significance: Creating standardized formatting of TTR course materials will make OER distribution, implementation, and exchange easier and more widely adopted.