Who is seeking information about traumatic brain injury? Characterizing online course participants.

Accessible, up-to-date information on traumatic brain injury (TBI) can be challenging to find and is needed to address TBI knowledge gaps and improve outcomes for people who experience a TBI. The Understanding TBI Massive Open Online Course (TBI MOOC) was developed to increase TBI knowledge across a diverse global audience. We sought to characterize the TBI MOOC participant cohort, to understand the reach of the course among this target audience. Examining the characteristics of TBI MOOC enrollees showed that participants came from a wide range of demographic backgrounds, had a variety of TBI experiences and had multiple reasons for enrolling in the MOOC. The majority of course participants shared some characteristics with other groups of health information seekers. Four distinct demographic profiles were identified among TBI MOOC participants (education seekers, TBI-aware participants, TBI care providers and retirees) using a novel approach combining chi-squared tests and network modularity. Participants assigned to the TBI-aware and retiree profiles were most likely to complete all modules of the MOOC, and the TBI-aware profile was more highly represented in more recent iterations of the MOOC. Together, these data indicate that the TBI MOOC provided information to a wide range of people, and particularly engaged participants with personal or family experience of TBI. However, engagement with this course was minimal among some hard-to-reach populations, including men and people with low levels of education, indicating that additional strategies are needed to ensure equity in health promotion.

Assessing the Efficacy of a Novel Massive Open Online Soft Skills Course for South Asian Healthcare Professionals.

In healthcare professions, soft skills contribute to critical thinking, decision-making, and patient-centered care. While important to the delivery of high-quality medical care, soft skills are often underemphasized during healthcare training in low-and-middle-income countries. Despite South Asia's large population, the efficacy and viability of a digital soft skills curriculum for South Asian healthcare practitioners has not been studied to date. We hypothesized that a web-based, multilingual, soft skills course could aid the understanding and application of soft skills to improve healthcare practitioner knowledge, confidence, attitudes, and intent-to-change clinical practice.In September 2019 a needs assessment observing soft skills practices was conducted in several Indian states. We developed a communication-focused soft skills curriculum that comprised seven 10-minute video lectures, recorded in spoken English and Hindi. Participants consisted of any practicing healthcare professionals and trainees in select South Asian countries age 18 and over. Participant knowledge, confidence, attitudes, and intent-to-change clinical practice were evaluated using pre- and post-course tests and surveys. Statistical analyses were performed using STATA and SPSS.From July 26, 2021 to September 26, 2021, 5750 registered and attempted the course, 2628 unique participants completed the pre-test, and 1566 unique participants completed the post-test. Participants demonstrated small but statistically significant gains in confidence (𝑝<0.001), attitudes toward course topics relevance (𝑝<0.001), and intent-to-change clinical practice (𝑝<0.001). There was no statistically significant gain in knowledge. A digital soft-skills massive open online course for healthcare practitioners in South Asia could serve as a viable approach to improve the quality of soft skills training in low-to-middle income countries.

Development, Feasibility, and Knowledge Impact of a Massive Open Online Course on Radiation Safety: A Multicentre Prospective Cohort Study.

OBJECTIVE: This study reports the development of an innovative, interactive Massive Open Online Course (MOOC) teaching radiation safety principles in the vascular workplace, using stepwise e-learning with multiple choice question tests (MCQs), educational videos, and a serious game. The aim was to study the MOOC impact on radiation safety knowledge and assess its feasibility and acceptability. METHODS: An international multicentre prospective study included team members active in the hybrid operating room. The MOOC was offered voluntarily via a secure online learning platform. A standardised MCQ test (15 questions) assessed radiation safety knowledge pre- and post-course (range 0 - 100%). Acceptability and feasibility were tested via the previously validated, Evaluating e-learning system success (EESS) model, using five point Likert scales. RESULTS: In eight centres across four countries, 150 of 203 invited endovascular team members consented. Over a seven week study period, surgeons (28%, including vascular surgery trainees and consultants), nurses (27%, including scrub, circulating and anaesthetic nurses), anaesthetists (43%, including trainees and consultants), and radiographers (3%) participated. Of those, 67% completed the course. The average radiation knowledge improved by 22.8% (95% CI 19.5 - 26.0%; p < .001) after MOOC completion, from 48% to 71% (standard deviation [SD] 14 and 15% respectively), requiring a mean time investment of 169 minutes (SD 89 minutes). In centres with a radiographer, mean knowledge gain after MOOC completion was significantly smaller (14%, SD 19% vs. 24%, SD 16%, p = .036). The course was deemed feasible and acceptable according to the EESS model with a total mean score of 3.68/5. CONCLUSION: This newly developed, multimodal MOOC was deemed feasible and effective across multiple international centres. The MOOC significantly contributes to radiation safety education of the entire endovascular team, improving radiation safety knowledge. The course may optimise workplace radiation safety behaviour and therefore enhance team and patient safety.

The irreplaceable role of medical massive open online courses in China during the COVID-19 pandemic.

BACKGROUND: Massive open online courses (MOOCs) have become innovative open-learning approach in medical education. This study aimed to evaluate the dynamic changes in the construction and application of medical MOOCs before and after the coronavirus disease 2019 (COVID-19) pandemic in China. METHODS: The dynamic changes of usages about medical MOOCs before and after 2020 were mainly searched on the Smart Education of China Higher Education platform, and the detailed learning profiles and outcome indicators were further analyzed using 40 national first-class medical MOOCs from 'zhihuishu' platform. RESULTS: A total of 2,405 medical MOOCs were exported from the Smart Education of China Higher Education platform, of which 1,313 (54.6%) were launched since 2020. The total and average numbers of participants of 141 national first-class medical MOOCs peaked during the initial spread of COVID-19 in 2020. We further analyzed the dynamic usage of MOOCs from 2018 to 2022 based on 40 national first-class medical MOOCs launched on the 'Zhihuishu' platform. The findings revealed that the number of registered learners (3,240 versus 2,654), questions and answers (27,005 versus 5,116) and students taking the final examination (2,782 versus 1,995) per semester were significantly higher since 2020 compared to these before 2020. Especially, the number of registered learners, registered schools, questions and answers, and students participating in online discussion, taking the unit quiz, taking final examinations and passing final examinations all peaked in the 2020 spring-summer semester. Pearson's correlation analysis found that the number of questions and answers and the number of learners who participated in online discussion were both positively correlated with the number of students who passed the final examination, and the correlation was especially strong since 2020. Moreover, the number of publications on medical MOOC research has soared since 2020 and has maintained a continuous upward trend. CONCLUSIONS: High-quality medical MOOCs have been launched rapidly since the COVID-19 pandemic in China. The number of participants and online interactions of medical MOOCs peaked during the initial spread of COVID-19 in 2020. MOOCs are reliable and valid digital sources that facilitate medical higher education and play irreplaceable roles in emergency management.

Semi-flipped classroom-based learning interventions in a traditional curriculum of oral medicine: students' perceptions and teaching achievements.

BACKGROUND: In recent years, flipped classes have emerged and become popular in college medical education. However, due to the huge medical learning system and the limited pre-class study time of students, it is difficult to implement in all courses. And then we adopted the semi-flipped classes (SFCs) to evaluate its teaching effect. This study analysed three educational methods that can be used in oral medicine courses: online education, offline education, and semi-flipped classes. METHODS: We used two surveys to evaluate the three educational methods. In the first survey 46 teachers and 238 undergraduates shared their experience of the live-streaming and traditional offline courses offered in the different oral medicine curricula; we used anonymous questionnaires to evaluate their class experience. In the second survey 94 students shared their experience of the semi-flipped and traditional classrooms. Students who attended the SFCs in the experimental group learned about the oral mucosa disease by themselves using an online video course and then participated in offline interaction with teachers. The evaluation of the above educational methods was conducted using the anonymous questionnaires and final exam assessment. RESULTS: According to the first survey, teachers and students both agreed that the overall teaching experience and learning effectiveness in offline education are superior to those in online education. According to the second survey, students who participated in the SFCs performed better in the final exam than those who participated in the simple offline classes. Additionally, the survey showed that the new teaching method helped students gain more knowledge and positively influenced their clinical practice. CONCLUSIONS: Compared with the online and offline educational methods, the SFC showed better results in both the questionnaire and final exam assessment. Hence, the effectiveness of medical education can be improved by adopting a teaching mode that combines online and offline teaching methods. Scientific and logical SFCs designs, along with their effective implementation, would eventually make SFCs an important tool for medical education.

Designing a Massive Open Online Course (MOOC) in face-to-face sessions. A blended design to teach practical histology.

Teaching histology, through virtual microscopy in educational strategies, undeniably moved towards the digitization and distancing of teaching. The setting up of the Massive Open Online Course (MOOC) entitled "Introduction to Histology: exploring the tissues of the human body" made it possible to exploit the potential to share digital resources with a wider audience while being integrated into the teaching on-campus students. This article described the pedagogical choices prevailing during the design of the MOOC and its combination with face-to-face sessions to achieve specific learning outcomes. The pedagogical alignment of learning outcomes described according to their cognitive levels, with online and face-to-face learning activities and evaluation methods has been demonstrated. The impact of such a blended design into an academic program has been ascertained using perception and performance data. Student satisfaction and engagement as well as motivational cues were identified. The level of performance was maintained in the educational strategy implemented and made it possible to achieve the objectives expected by the teachers. The benefits of integrating a MOOC with classroom-based teaching were highlighted, as well as barriers that could hinder the successful implementation.

Massive open online course adoption amongst newly graduated health care providers.

Massive Open Online Courses (MOOCs) are flexible offerings that deliver content to a large audience in a virtual platform. MOOCs are increasingly accessed by health professionals to support their own professional development. Despite the agreed usefulness of MOOCs, the rates of adoption are still extremely low. This study sought to understand the personal and social factors associated with MOOC adoption. Participants were newly graduated occupational therapists who registered for a leadership skills development MOOC. Qualitative interviews were conducted to understand unique perspectives of participants who did and did not complete the MOOC. Data were analyzed using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. Participants reported they found the MOOC content beneficial in providing a foundational framework on which to develop their leadership skills. Even though MOOC content was organized into multiple small components, participants shared that they would engage with the material once a week for up to two hours. Participants reported a high level of comfort accessing the technology to complete the MOOC, however they reported that they would have preferred more interactive or synchronous learning opportunities. MOOCs are an efficient way to offer a wide variety of educational offerings to health professionals. Despite their asynchronous nature, MOOC developers should consider maximizing opportunities for learner interaction and content application learning opportunities within MOOCs to increase their overall adoption.

Exploring perceptions of eating with dementia: Findings from a massive open online course.

People with dementia are at high risk of malnutrition as a result of progressive symptoms that affect eating. Maximising opportunities to enhance nutrition and strategies to encourage eating are a crucial part of providing care. Caregiver knowledge and a person-centred approach to eating is essential to reduce symptom burden and maintain quality of life. There is currently limited research investigating first person perceptions of eating with dementia, particularly beyond small sample sizes. Therefore, this paper aims to explore community perceptions of how best to encourage eating for people with dementia using findings from an online course. Within the Understanding Dementia Massive Open Online Course, responses to the following statement were collected: 'If I had dementia, the things that might help me to eat include…'. A total of 3,651 participant responses were collected from the 2018 and 2019 course enrolments and analysed using structural topic modelling and secondary thematic analysis. The majority of participants were female, tertiary educated Australians over 50 years old. A third were paid caregivers. Thirteen topics were isolated from topic modelling that can be reduced into six broad categories: food type personalisation, meal choice, meal presentation, eating environment, eating assistance and end of life nutrition. Participant responses demonstrated diverse awareness of important aspects to encourage eating in dementia. Findings support the need for improved uptake of nutritional strategies in practice and education on eating with dementia to support caregivers.

Impact of the COVID-19 Pandemic on Funerals: Experiences of Participants in the 2020 Dying2Learn Massive Open Online Course.

A Massive-Open-Online-Course (MOOC) on death and dying (Dying2Learn) was offered in 2020, designed to build conversations about death as a natural part of life. In week 1, the content focused on how today's society engages with death through the language we use, humour, public mourning and funerals. This study investigated 2020 MOOC participants' responses to an online activity reflecting on funerals and memorials during the time of COVID-19. From this activity, n = 204 responses were analysed qualitatively. Themes included the positives and negatives of virtual funeral attendance (e.g. opportunity to have a way to participate when travel barriers existed, versus a sense of impersonal voyeurism); and the challenges related to the inability to physically comfort the bereaved due to physical distancing requirements. Comments made as part of this MOOC activity provide a unique insight into the community's experience of funeral changes necessitated by COVID-19, with important implications for the grieving process.

Evaluating Course Completion, Appropriateness, and Burden in the Understanding Multiple Sclerosis Massive Open Online Course: Cohort Study.

BACKGROUND: Massive open online course (MOOC) research is an emerging field; to date, most research in this area has focused on participant engagement. OBJECTIVE: The aim of this study is to evaluate both participant engagement and measures of satisfaction, appropriateness, and burden for a MOOC entitled Understanding Multiple Sclerosis (MS) among a cohort of 3518 international course participants. METHODS: We assessed the association of key outcomes with participant education level, MS status, caregiver status, sex, and age using summary statistics, and 2-tailed t tests, and chi-square tests. RESULTS: Of the 3518 study participants, 928 (26.37%) were people living with MS. Among the 2590 participants not living with MS, 862 (33.28%) identified as formal or informal caregivers. Our key findings were as follows: the course completion rate among study participants was 67.17% (2363/3518); the course was well received, with 96.97% (1502/1549) of participants satisfied, with an appropriate pitch and low burden (a mean of 2.2 hours engagement per week); people living with MS were less likely than those not living with MS to complete the course; and people with a recent diagnosis of MS, caregivers, and participants without a university education were more likely to apply the material by course completion. CONCLUSIONS: The Understanding MS MOOC is fit for purpose; it presents information in a way that is readily understood by course participants and is applicable in their lives.

Implementation research training for learners in low- and middle-income countries: evaluating behaviour change after participating in a massive open online course.

BACKGROUND: Implementation research (IR) can play a critical role in the delivery of disease control interventions, particularly in low- and middle-income countries (LMICs). The growing demand for IR training has led to the development of a range of training programmes and university courses, the majority of which can not be accessed by learners in LMICs. This article reports on the evaluation of the massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases hosted by WHO on the topic of IR with a focus on infectious diseases of poverty. This study followed the Kirkpatrick Model to evaluate training programmes with a specific focus on post-training changes in behaviour. METHODS: MOOC participants were invited to take part in an anonymous online survey examining their knowledge of IR and how they applied it in their professional practice approximately 1-1.5 years after completing their course. The survey contained 43 open-ended, multiple choice and Likert-type questions. Descriptive statistics were calculated for the quantitative data and responses to the open-ended questions were thematically coded. RESULTS: A total of 748 MOOC participants responded to the survey. The demographic profile of the survey respondents aligned with that of the MOOC participants, with nearly 70% of respondents originating from Africa. Responses to the quantitative and open-ended survey questions revealed that respondents' knowledge of IR had improved to a large extent as a result of the MOOC, and that they used the knowledge and skills gained in their professional lives frequently and had consequently changed their professional behaviour. Respondents most often cited the problem-solving aspect of IR as a substantial area of behavioral change influenced by participating in the MOOC. CONCLUSIONS: These findings indicate that the MOOC was successful in targeting learners from LMICs, in strengthening their IR knowledge and contributing to their ability to apply it in their professional practice. The utility of MOOCs for providing IR training to learners in LMICs, where implementation challenges are encountered often, makes this platform an ideal standalone learning tool or one that could be combined with other training formats.

RE-AIMing COVID-19 online learning for medical students: a massive open online course evaluation.

BACKGROUND: Clinical training during the COVID-19 pandemic is high risk for medical students. Medical schools in low- and middle-income countries (LMIC) have limited capacity to develop resources in the face of rapidly developing health emergencies. Here, a free Massive Open Online Course (MOOC) was developed as a COVID-19 resource for medical students working in these settings, and its effectiveness was evaluated. METHODS: The RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework was utilized to evaluate the effectiveness of MOOC in teaching medical students about COVID-19. The data sources included the student registration forms, metrics quantifying their interactions within the modules, students' course feedback, and free-text responses. The data were collected from the Moodle learning management system and Google analytics from May 9 to September 15, 2020. The research team analyzed the quantitative data descriptively and the qualitative data thematically. RESULTS: Among the 16,237 unique visitors who accessed the course, only 6031 medical students from 71 medical schools registered, and about 4993 (83% of registrants) completed the course, indicating high levels of satisfaction (M = 8.17, SD = 1.49) on a 10-point scale. The mean scores of each assessment modules were > 90%. The free-text responses from 987 unique students revealed a total of 17 themes (e.g., knowing the general information on COVID-19, process management of the pandemic in public health, online platform use, and instructional design) across the elements of the RE-AIM framework. Mainly, the students characterized the MOOC as well-organized and effective. CONCLUSIONS: Medical students learned about COVID-19 using a self-paced and unmonitored MOOC. MOOCs could play a vital role in the dissemination of accurate information to medical students in LMIC in future public health emergencies. The students were interested in using similar MOOCs in the future.

Global digital social learning as a strategy to promote engagement in the era of COVID-19.

AIMS AND OBJECTIVES: To assess formative and summative milestones in a digital course and the reach to low- and middle-income countries of a Massive Open Online Course focussing on supporting nurses dealing with an emerging pandemic. BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has ravaged the globe and increased the need for timely and accurate information from reliable sources. Access to reliable and accurate information, as well as support, is important in achieving health systems strengthening. Using a Massive Open Online Course format, an educational resource aimed at large-scale interactive participation via the Internet, and participants were engaged in a course focussing on nursing in a time of crisis and involved using social learning principles. DESIGN: Observational descriptive study. METHOD: Routinely collected data were collated during the period of 18 May-18 July 2020 focused on both formative and summative milestones in the course. Data were separated and classified by income in accordance with the publicly accessible 2020 World Bank Open Dataset. RESULTS: During the 2-month period of observation (18 May-18 July 2020), 10,130 individuals from 156 countries enrolled in the course. More than 51% of participants were Active Learners. Thirty per cent completed over 90% of the course content by the end. There was widespread distribution of learners in low- and middle-income countries across Asia, Africa and Latin America. CONCLUSION: The COVID-19 pandemic has underscored the importance of reliable and valid information sources. The use of Massive Open Online Course format can facilitate dissemination. RELEVANCE TO CLINICAL PRACTICE: In the context of a dynamic global pandemic, leveraging digital resources to allow access to reliable information and resources is important. Incentivising participation through recognition of learning is important. Engaging in a social learning platform also has the power for reflection, promotion of resilience and capacity for health systems strengthening.

Massive Open Online Courses: enhancing caregiver education and support about dementia care towards and at end of life.

As the ageing population grows globally, the need for informal care-usually provided by family and friends-will continue to increase. Numbers of people with dementia also continue to rise, and much of their care will be provided by relatives. As such, more people who may themselves be older, will take on such caring roles. Consequently, more carers are likely to have education and support needs. Amidst government recognition of the need to provide good quality, person-centred education and support to carers, there are tensions between the potential for such provision to be resource intensive and whether existing services have the capacity to meet the needs of carers. Massive Open Online Courses (MOOCs) are a resource with scope to meet some of these educational and support needs. MOOCs enable flexible learning, are often free, and can be accessed anywhere in the world. Providing supportive dementia care requires carers to have an understanding of the condition, assistance to cope with the responsibilities of caring, and recognition of the importance of their own health and wellbeing as well as the person they support. In response to the needs of family carers of people with advancing dementia identified through a 5 year programme of research, we developed a MOOC-dementia care: living well as dementia progresses. This is an accessible source of relevant and engaging information; which enables carers to learn about advancing dementia, consider their own needs and create an interactive global forum of peer support.

Lessons learned on teaching a global audience with massive open online courses (MOOCs) on health impacts of climate change: a commentary.

BACKGROUND: The adverse health impacts of climate change are increasing on a global level. However, knowledge about climate change and health is still unavailable to many global citizens, in particular on adaptation measures and co-benefits of health mitigation. Educational technologies, such as massive open online courses (MOOCs), may have a high potential for providing access to information about climate change links to health for a global audience. MAIN BODY: We developed three MOOCs addressing the link between climate change and health to take advantage of the methodology's broad reach and accelerate knowledge dissemination on the nexus of climate change and health. The primary objective was to translate an existing face-to-face short course that only reached a few participants on climate change and health into globally accessible learning opportunities. In the following, we share and comment on our lessons learned with the three MOOCs, with a focus on global teaching in the realm of climate change and health. CONCLUSIONS: Overall, the three MOOCs attracted a global audience with diverse educational backgrounds, and a large number of participants from low-income countries. Our experience highlights that MOOCs may play a part in global capacity building, potentially for other health-related topics as well, as we have found that our MOOCs have attracted participants within low-resource contexts. MOOCs may be an effective method for teaching and training global students on health topics, in this case on the complex links and dynamics between climate change and health and may further act as an enabler for equitable access to quality education.

Self-regulated learning strategies in world's first MOOC in implant dentistry.

BACKGROUND: Massive Open Online Courses (MOOCs) have been often described as a major innovation Higher Education, but their application in the teaching of clinical disciplines is still very limited, while there is a lack of scientific evaluations in this domain. The aim of this study was to investigate learners' behaviours and correlate patterns of Self-Regulated Learning (SRL) with performance and achievement during a MOOC in Implant Dentistry. METHODS: The clickstream data of learners from the first run of the MOOC Implant dentistry by The University of Hong Kong were modelled and quantified based on Zimmerman's SRL model. The data were quantitatively analysed by means of k-means clustering for evidence of five SRL behavioural indicators of student activity. The clusters identified were then correlated with student engagement and learning performance. RESULTS: A total of 7608 individuals enrolled, 5014 engaged (active learners 65.90%), 1277 of them (25.47%) completed the course and 1232 purchased a certificate. Two major groups of learners emerged: Attentive (n = 1433) who were more likely to follow the prescribed pathway in the MOOC and Auditors (n = 3581) who accessed content selectively. There was significantly higher engagement, achievement and completion rates among Attentive than Auditors. Both groups included subcategories (Browser, Digger, Test-driven, Sampler, Persistent) which might reflect different SRL strategies. CONCLUSION: A MOOC in a clinical discipline can achieve high enrolment and completion rates as compared to current benchmarks. There appears to be a wide diversity of learning behaviours among learners, with two however dominant patterns. Learners with a linear learning pathway achieved significantly higher grades and completion rates than those who accessed content irregularly and selectively. Such differences however might be influenced by the demographic and professional background of the learner, as well as their motivation to attending the MOOC. Certain learning behaviours, in particular how learners access content in relation to assessments might be closer related to SRL.

Symposium report on "Examining the Changing Landscape of Course Delivery and Student Learning": Experimental Biology 2017.

An APS Teaching Section symposium entitled "Examining the Changing Landscape of Course Delivery and Student Learning" was offered at the Experimental Biology conference on April 24th, 2017, in Chicago, IL. The symposium focused on alternative delivery modes of physiology education, from undergraduate to professional programs. Lecture used to be the gold standard and proven method by which students learned, but the course delivery method is rapidly changing. While there is still significant skepticism about the quality and level of student engagement in online learning, it is being offered widely due to increased demand and due to other benefits, such as the flexibility and convenience. Universities with several campuses may now synchronize lectures between campuses, utilizing video conference technology, thus bypassing the need for instructors on each campus. Other modes of delivery include online lectures with laboratories scheduled on campus. Offering biology laboratories online is on the rise but to counter skepticism, more studies are needed to demonstrate that online laboratories effectively meet laboratory objectives. The Massive Open Online Course (MOOC) offers many courses for free and challenges the role of universities. Assessment of the effectiveness of MOOCs and online courses is critical, as some of the concerns raised about them include level of student engagement in learning and the social aspect of interaction with peers and faculty.

Health care professionals from developing countries report educational benefits after an online diabetes course.

BACKGROUND: Medical education is a cornerstone in the global combat against diseases such as diabetes and obesity which together affect more than 500 million humans. Massive Open Online Courses (MOOCs) are educational tools for institutions to teach and share their research worldwide. Currently, millions of people have participated in evidence-based MOOCs, however educational and professional benefit(s) for course participants of such initiatives have not been addressed sufficiently. We therefore investigated if participation in a 6 week open online course in the prevention and treatment of diabetes and obesity had any impact on the knowledge, skills, and career of health care professionals contrasting participants from developing countries versus developed countries. METHODS: 52.006 participants signed up and 29.469 participants were active in one of the three sessions (2014-2015) of Diabetes - a Global Challenge. Using an online based questionnaire (nine sections) software (Survey Monkey), email invitations were send out using a Coursera based database to the 29.469 course participants. Responses were analyzed and stratified, according to the United Nations stratification method, by developing and developed countries. RESULTS: 1.303 (4.4%) of the 29.469 completed the questionnaire. 845 of the 1303 were defined as health care professionals, including medical doctors (34%), researchers (15%), nurses (11%) and medical students (8%). Over 80% of the health care participants report educational benefits, improved knowledge about the prevention and treatment therapies of diabetes and furthermore improved professional life and practice. Over 40% reported that their professional network expanded after course participation. Study participants who did not complete all modules of the course reported similar impact as the ones that completed the entire course(P = 0.9). Participants from developing countries gained more impact on their clinical practice (94%) compared to health care professionals from developed regions (88%) (Mean of differences = 6%, P = 0.03. CONCLUSIONS: Based on self-reports from course participants, MOOC based medical education seems promising with respect to providing accessible and free research-based education to health professionals in both developing and developed countries. Course participants from developing countries report more benefits from course participation than their counterparts in the developed world.

[Results of the Massive Open Online Course (MOOC) on cancer diagnosis and evaluation of its impact on the perception of the pathology specialty]. / Massive open online course (MOOC) sur le diagnostic des cancers : bilan et évaluation de l'impact sur la perception de l'anatomie et cytologie pathologiques.

The Massive Open Online Course (or MOOC) "Diagnostic Strategies Cancers", was hosted in autumn 2016 on the platform "France Université Numérique" and had two levels of learners: students in the field of health and biology and the general public. Of the 5285 learners in 81 different countries, 1237 (23%) were successfully certified. This MOOC was also integrated into the teaching program of medical students of Paris Diderot University and Paris 13 University. Using anonymous questionnaires before and after MOOC, it has been shown that pathology is less known than other medical specialties. Participation in this MOOC led to a marked improvement in participants' knowledge of the place and role of the pathologist in the diagnosis of cancers. Regarding the students who have followed the MOOC as part of their university course, their comments were very positive, but it is necessary to make substantial adjustments in the amounts and contents of the campus-based courses.