Author Archives: Micki Leder

What We Should Learn from the Ebola Outbreak

Ebola doesn’t spread by mysterious means, we know how it spreads. So we have the means to stop it from spreading, but it requires tremendous attention to every detail.

 Tom Frieden, director, U.S. Centers for Disease Control and Prevention, August 25, 2014

The current West African Ebola crisis brings into sharp relief the challenges of pre-service and real-time workplace education for health workers in areas of greatest need.  Countries dealing with the Ebola crisis face multiple challenges, chief among them a shortage of trained and adequately equipped health workers.

Anthony Fauci, director, U.S. National Institute of Allergy and Infectious Disease, made this point in an August 13, 2014 article in The New England Journal of Medicine, titled Ebola — Underscoring the Global Disparities in Health Care Resources:

[T]he chance that the virus will establish a foothold in the United States or another high-resource country remains extremely small…[hospitals] generally have excellent capacity to isolate persons with suspected cases and to care for them safely should they become ill. Public health authorities have the resources and training necessary to trace and monitor contacts. Protocols exist for the appropriate handling of corpses and disposal of biohazardous materials. … Isolation procedures have been clearly outlined by the Centers for Disease Control and Prevention (CDC). A high index of suspicion, proper infection-control practices, and epidemiologic investigations should quickly limit the spread of the virus.

While some of the disparity can be alleviated by providing equipment and supplies, the heart of the problem lies in the breadth and depth of education and on-the-job decision support for health care workers.  High-resource countries are distinguished, in Dr. Fauci’s article, by their capacity to respond which is based largely on sound “training,” “protocols,” and “procedures.”

While there is no single remedy for global disparities in health care, the current Ebola outbreak draws our attention to the need for expanded deployment of the new generation of digital educational and decision support technologies, and in building related communities of practice.  These decision support and educational technologies have already revolutionized health care delivery in the United States and other high-resources countries (see July 16 post featuring UpToDate.com).

Finally, the current crisis in West Africa represents an opportunity to identify the most important elements of decision support for policymakers, program leaders, and frontline health workers and, to determine the most context-appropriate delivery systems for advanced preparation and real-time support in future outbreaks of viral hemorrhagic fever.

Health Professions Post-Degree Education Moves Deeper Online

The Khan Academy, which dominates K-12 test prep education with high-quality free content, is moving into professional test preparation with the launch of a set of lessons for future nurses.   In this case the Khan Academy’s signature video tutorials (voice over hand drawn graphics) were produced in collaboration with the Jonas Center and the American Association of Colleges of Nursing. The material available online includes 158 sample questions from the national licensing exam for nurses.

In many professions and occupations, there are three major segments of the post-degree education industry: 1) preparing for registration or certification exam; 2) continuing education required to maintain certification or registration; and 3) learning to augment or expand professional competence.

Sometimes the learning even overlaps, serving multiple purposes.

Online educational technologies — fielded by professional associations, non-profit colleges and universities, and for-profit companies — already have made significant inroads in all three segments.   For example, you can get online test prep for the architect registration exam from the Funkaar Institute, earn required continuing medical education credits online from Radiology Society of North American, or turn to Udacity for an online nanodegree if you want to develop the iOs application designer skills to get a job with AT&T.

Online post-degree education is particularly important in the health fields as professionals are increasingly shifting away from participation in conferences and seminars and toward online programs.  A 2012 survey found that 97% of clinicians were planning to either increase or maintain their participation in online continuing education programs during the next year.

This is much needed.  According to an Institute of Medicine study, a disorganized and fragmented system of continuing education providing offerings of varying quality plays a big role in the fact that the professional health workforce in the United States is not consistently prepared to provide high quality health care or assure patient safety.  Today, health professions continuing education is delivered by a patchwork of providers in many different formats, sponsored by hospitals, medical and other health professions schools, managed care organizations and professional societies, and often funded by the pharmaceutical industry.

New technologies and forms of knowledge organization provide a unique opportunity to improve post-degree education, to reach new users, and to allow providers to develop content-based brand and visibility.  A wealth of content already exists in not-for-profit health universities, professional societies, and for-profit training companies.   The online challenge in health professional education is to augment and convert content into new formats to draw users and enhance outcomes such that the health care workforce is consistently prepared to provide high quality health care and assure patient safety.