A Multidisciplinary Assessment of ChatGPT's Knowledge of Amyloidosis: Observational Study.

BACKGROUND: Amyloidosis, a rare multisystem condition, often requires complex, multidisciplinary care. Its low prevalence underscores the importance of efforts to ensure the availability of high-quality patient education materials for better outcomes. ChatGPT (OpenAI) is a large language model powered by artificial intelligence that offers a potential avenue for disseminating accurate, reliable, and accessible educational resources for both patients and providers. Its user-friendly interface, engaging conversational responses, and the capability for users to ask follow-up questions make it a promising future tool in delivering accurate and tailored information to patients. OBJECTIVE: We performed a multidisciplinary assessment of the accuracy, reproducibility, and readability of ChatGPT in answering questions related to amyloidosis. METHODS: In total, 98 amyloidosis questions related to cardiology, gastroenterology, and neurology were curated from medical societies, institutions, and amyloidosis Facebook support groups and inputted into ChatGPT-3.5 and ChatGPT-4. Cardiology- and gastroenterology-related responses were independently graded by a board-certified cardiologist and gastroenterologist, respectively, who specialize in amyloidosis. These 2 reviewers (RG and DCK) also graded general questions for which disagreements were resolved with discussion. Neurology-related responses were graded by a board-certified neurologist (AAH) who specializes in amyloidosis. Reviewers used the following grading scale: (1) comprehensive, (2) correct but inadequate, (3) some correct and some incorrect, and (4) completely incorrect. Questions were stratified by categories for further analysis. Reproducibility was assessed by inputting each question twice into each model. The readability of ChatGPT-4 responses was also evaluated using the Textstat library in Python (Python Software Foundation) and the Textstat readability package in R software (R Foundation for Statistical Computing). RESULTS: ChatGPT-4 (n=98) provided 93 (95%) responses with accurate information, and 82 (84%) were comprehensive. ChatGPT-3.5 (n=83) provided 74 (89%) responses with accurate information, and 66 (79%) were comprehensive. When examined by question category, ChatGTP-4 and ChatGPT-3.5 provided 53 (95%) and 48 (86%) comprehensive responses, respectively, to "general questions" (n=56). When examined by subject, ChatGPT-4 and ChatGPT-3.5 performed best in response to cardiology questions (n=12) with both models producing 10 (83%) comprehensive responses. For gastroenterology (n=15), ChatGPT-4 received comprehensive grades for 9 (60%) responses, and ChatGPT-3.5 provided 8 (53%) responses. Overall, 96 of 98 (98%) responses for ChatGPT-4 and 73 of 83 (88%) for ChatGPT-3.5 were reproducible. The readability of ChatGPT-4's responses ranged from 10th to beyond graduate US grade levels with an average of 15.5 (SD 1.9). CONCLUSIONS: Large language models are a promising tool for accurate and reliable health information for patients living with amyloidosis. However, ChatGPT's responses exceeded the American Medical Association's recommended fifth- to sixth-grade reading level. Future studies focusing on improving response accuracy and readability are warranted. Prior to widespread implementation, the technology's limitations and ethical implications must be further explored to ensure patient safety and equitable implementation.

Thematic analysis of stakeholder perceptions for co-creative healthcare XR resource design and development; traversing a minefield of opportunities.

Introduction: The expansive curricular volume of healthcare education makes a necessity the incorporation of innovative methods and immersive media in it. The core challenge in such approaches is the timely development of relevant immersive content such as Virtual, Augmented or Mixed Reality (VR/AR/MR) resources for healthcare topics. There is currently significant interest in the use of co-creative methods for streamlining immersive content development. Methods: A core research pursuit in this translational research field is the formulation of evidence-based, optimized workflows that streamline immersive content creation allowing for rapid expansion of innovative educational approaches in healthcare curricula. The purpose of this paper is to aggregate the perceptions of healthcare technologists and educators who participated in a series of co-creation sessions in order to elicit their best practice insights for design and development of XR educational resources using co-creative methods. Results: According to our thematic analysis, findings of the qualitative study demonstrated that a rigorous organizational approach is required to maintain a constructive exchange of information and to keep the design process alive for both content and technical experts. In addition, rapid prototype and display of co-created features can empower their contributions and help them design more efficiently. Discussion: Co-creative content production can benefit from adaption of existing frameworks and lightweight authoring environments that can facilitate generalized XR content development use cases.

Stakeholders' Perspective on the Key Features of Printed Educational Resources to Improve the Quality of Clinical Communication.

Social and healthcare professionals often feel ill equipped to effectively engage in difficult conversations with patients, and poor proficiency negatively affects the quality of patient care. Printed educational resources (PERs) that provide guidance on sustaining complex clinical communication may be a source of support if thoughtfully designed. This study aimed to describe the key features of PERs in order to improve the quality of clinical communication according to the perspective of meaningful stakeholders. This was a descriptive secondary analysis of data collected by three remote focus group discussions that involved 15 stakeholders in the context of developing an educational booklet to support professionals in complex communication scenarios. Focus groups were audio-recorded and transcribed verbatim, and an inductive thematic analysis was performed. Three key features of PERs that aim toward quality improvement in clinical communication were identified: (1) having the potential to provide benefits in clinical practice; (2) facilitating, encouraging, and enticing reading; and (3) meeting the need of professionals to improve or update their knowledge. These findings suggest that PERs relevant to professionals' clinical priorities and learning needs may make their efforts to apply learning in practice more likely and consequently result in improved healthcare quality.

Superbugs online: co-production of an educational website to increase public understanding of the microbial world in, on, and around us.

Digital tools and online presence have become a cornerstone in public engagement and involvement strategy and delivery. We here describe the co-production process behind launching a new multilingual resource for schools in the United Kingdom and beyond, jointly between university scientists, engagement professionals, primary and secondary teachers, and web designers. The 'Superbugs' website aims at raising awareness and increasing the public understanding of the microbial world in, on, and around us-with a focus on infection, hygiene, and antimicrobial resistance-and attracted >19,000 online visitors, >33,500 page views, and > 775,000 Twitter impressions over the past 24 months. Superbugs.online is available in English, Welsh, Irish, and Scottish Gaelic, thus making it accessible to everyone in the United Kingdom and Ireland, regardless of the language in which they receive and deliver their science education. The website is easy to navigate and features background information, quizzes, animations, videos, illustrated stories, interactive timelines, games, and protocols for home experiments. All materials are presented in a non-prescriptive way, aimed at allowing flexibility for the materials to be adapted to the individual needs of teachers and pupils alike. Our study has led to a demonstrable impact on the co-production team and on pupils and teachers as key stakeholders, based on a comprehensive evaluation of the co-production process itself, the impact of the end product, and the creation of lasting relationships with stakeholders and co-producers, for the mutual benefit of everyone involved.

Patient and physician perspectives on treatments for low-risk prostate cancer: a qualitative study.

BACKGROUND: Patients diagnosed with low-risk prostate cancer (PCa) are confronted with a difficult decision regarding whether to undergo definitive treatment or to pursue an active surveillance protocol. This is potentially further complicated by the possibility that patients and physicians may place different value on factors that influence this decision. We conducted a qualitative investigation to better understand patient and physician perceptions of factors influencing treatment decisions for low-risk PCa. METHODS: Semi-structured interviews were conducted among 43 racially and ethnically diverse patients diagnosed with low-risk PCa, who were identified through a population-based cancer registry, and 15 physicians who were selected to represent a variety of practice settings in the Greater San Francisco Bay Area. RESULTS: Patients and physicians both described several key individual (e.g., clinical) and interpersonal (e.g., healthcare communications) factors as important for treatment decision-making. Overall, physicians' perceptions largely mirrored patients' perceptions. First, we observed differences in treatment preferences by age and stage of life. At older ages, there was a preference for less invasive options. However, at younger ages, we found varying opinions among both patients and physicians. Second, patients and physicians both described concerns about side effects including physical functioning and non-physical considerations. Third, we observed differences in expectations and the level of difficulty for clinical conversations based on information needs and resources between patients and physicians. Finally, we discovered that patients and physicians perceived patients' prior knowledge and the support of family/friends as facilitators of clinical conversations. CONCLUSIONS: Our study suggests that the gap between patient and physician perceptions on the influence of clinical and communication factors on treatment decision-making is not large. The consensus we observed points to the importance of developing relevant clinical communication roadmaps as well as high quality and accessible patient education materials.

Development of an open access, virtual bioinformatics lab for students in medical laboratory sciences.

OBJECTIVES: Despite the growing importance of bioinformatics in molecular diagnostics, not all medical laboratory sciences (MLS) programs provide instruction in this field. We developed and assessed a virtual laboratory learning unit to introduce basic bioinformatics concepts and tools to MLS students. METHODS: The unit included a video tutorial, written instructions for the online laboratory activity, and a postactivity review video. The effectiveness of the instruction was evaluated using preassessment and postassessment questions, performance of the online tasks, and a survey assessing the students' attitudes toward the learning unit. RESULTS: A prototype of the module was tested with 32 graduate and undergraduate students. Modifications were made based on the pilot test results and student feedback, and the refined version was subsequently evaluated with a different group of 20 undergraduate students. The participants responded favorably to the learning unit and successfully achieved the learning objectives, gaining familiarity with fundamental bioinformatics concepts and terminology, effectively employing basic computational tools, and developing an appreciation for the field. CONCLUSIONS: Our learning unit is a promising tool for introducing MLS students to the field of bioinformatics. As an open educational resource, it has the potential to be integrated into molecular biology education for MLS programs anywhere.

Contribuições para a mobilização social, comunicação e educação em saúde sobre a doença de Chagas no YouTube ­ percurso e notas sobre o canal Falamos de Chagas / Contributions to social mobilization, communication and health education on Chagas disease on YouTube ­ route and notes on the channel Falamos de Chagas / Aportes a la movilización social, comunicación y educación en salud sobre la enfermedad de Chagas en YouTube ­ trayectoria y notas en el canal Falamos de Chagas

A doença de Chagas crônica afeta seis milhões de pessoas em regiões endêmicas, com 30 mil novos casos anuais ­ logo, espaços de divulgação científica são muito importantes para ofertar informações de qualidade à população. As iniciativas envolvendo o controle da doença de Chagas não podem se limitar às pesquisas com enfoque biológico. Este estudo objetiva apresentar um panorama sobre o processo de construção do canal Falamos de Chagas, no YouTube, sua importância para a comunicação, a informação, a educação em saúde e a mobilização social, bem como refletir sobre a qualidade de uma subamostra de vídeos do canal. Trata-se de um estudo qualitativo, dividido em duas fases: criação do canal e análise qualitativa dos vídeos sobre a doença disponíveis no YouTube. Observamos que existe potencial nas redes sociais, enquanto recurso de comunicação, contudo é preciso cautela, uma vez que se faz necessária a certificação da qualidade do material

Chronic Chagas disease affects six million people in endemic regions, with 30,000 new infected cases an-nually ­ thus, initiatives involving science diffusion are relevant to offer qualified information to the people. Chagas disease control initiatives cannot be limited to the level of biological focused research. This study aims to present an overview of the construction process of the YouTube channel Falando de Chagas, its importance for communication, information, health education and social mobilization, as well as to reflect on the quality of a subsample of videos present in the channel. Qualitative in nature, the study was divided into two stages: construction of the channel and qualitative analysis of videos about the disease available on YouTube. We observed that there is potential for social networks as communication resources, but caution is needed in their use, since the quality of the material needs certification

La enfermedad de Chagas crónica afecta seis millones de personas en regiones endémicas, con 30.000 nuevos casos anuales ­ los espacios de divulgación científica son muy importantes para ofrecer información a la población. Las iniciativas de control de la enfermedad de Chagas no pueden limitarse al nivel de investigación con enfoque biológico. El estudio tiene como objetivo presentar un panorama del proceso de construcción del canal Falando de Chagas, en YouTube, su importancia para la comunicación, información, educación en salud y movilización social, así como reflexionar sobre la calidad de una submuestra de videos presentes en la canal. De naturaleza cualitativa, el estudio se dividió en dos fases: construcción del canal y análisis cualitativo de videos sobre la enfermedad disponibles en YouTube. Observamos que existe potencial para las redes sociales como recurso de comunicación, sin embargo, se requiere cautela en su uso, ya que se requiere certificar la calidad del material

Primary Palliative Care in the Emergency Department and Acute Care Setting.

Amidst a global COVID pandemic, the palliative care community and healthcare systems around the country continue to explore opportunities to improve early patient and family access to end-of-life care resources. They need not look any further than the Emergency Departments (ED) located on their campuses and around their communities for this chance. As advances in medical therapies continue to extend disease specific life expectancies and as the American population continues to age, we will continue to see older adults with chronic medical illnesses visiting the ED in their final stages of life (Smith et al. in Health Aff (Millwood) 31(6):1277-1285, 2012; Albert et al. in NCHS Data Brief 130:1-8, 2013). If the ED is to continue to be the primary portal of hospital entry for patients requiring emergent care for acute and chronic terminal illnesses, then it stands to reason that it should also be equally prepared to provide the earliest access to palliative care and advance care planning resources for patients and families who may want and benefit from these services. This chapter will explore the unique horizon of opportunities that exist for emergency medicine and the palliative care specialty to fulfill this obligation. Discussion will be centered around core principles in screening, assessment, and management of palliative care needs in the ED, importance of goals of care conversations, and the coordination of early palliative care and hospice consults that can facilitate safe transitions of care.

Developing a guide to climate & health justice education: Process and content.

Climate justice and health education can address the disproportionate health impacts of climate change on minoritized communities by providing frameworks to build awareness and instigate action on climate-related health inequities. The Envisioning Environmental Equity Educator's Guide to Climate and Health Justice provides a framework for educators, activists and health professionals to lead lessons on health and climate justice that center the experiences of those Most Affected People and Areas (MAPA) by climate change. Collaborators in Brazil, the Philippines, and Uganda engaged in stakeholder meetings to assess priorities and needs about climate and health with policymakers, doctors, activists, and students. These meetings informed the product: An educator's guide to climate and health justice that explores their dynamics from an anti-racist, anti-colonial approach. The guide serves as a recommended lesson framework fit with concepts, examples, and activities for educators teaching in primary and secondary learning settings. It is an innovative climate and health justice educational resource that draws on principles of anti-colonialism, critical thinking and consciousness, and engaged pedagogy. It offers a strategy for climate justice communication that targets diverse audiences across climate, health and social contexts by promoting educational approaches that center MAPA experiences, fit for diverse audiences.

Association Between Educational Resources and Pediatric Fellows' Mental Health Attitudes and Self-Reported Competence.

BACKGROUND/OBJECTIVES: Children with chronic medical conditions (CCMC) have high rates of mental health (MH) conditions. This study examines associations between MH educational resources during fellowship and 3 dependent variables: fellows' interest, perceived responsibility, and self-reported competence in assessing MH concerns of CCMC. METHODS: Subspecialty fellows taking the American Board of Pediatrics in-training examinations in February 2020 were invited to participate in a survey inquiring about MH educational resources. Logistic regression examined associations between MH educational resources and the 3 dependent variables, adjusting for demographics and program-level characteristics. RESULTS: Of the 97.7% (4216) fellows who responded, 3870 were included in analyses. About 37.5% reported formal MH teaching sessions; 36.7% reported on-site MH professionals engaged in teaching; 41.6% reported co-assessing patients with MH specialists; and 28.3% reported performance evaluation of their MH skills. All 4 resources were significantly and positively associated with self-reported competence in adjusted analyses, with odds ratios (OR) ranging from 1.28 (95% confidence interval (95% CI): 1.03-1.58) for formal teaching sessions to 2.14 (95% CI: 1.73-2.65) for performance evaluation. Resources were positively associated with the dependent variables in a "dose-response" pattern. Respondents who reported having all 4 educational resources compared to zero resources had an OR of 2.20 (95% CI: 1.74-2.78) for high MH interest, 3.18 (95% CI: 2.45-4.12) for high perceived responsibility, and 4.38 (95% CI: 3.43-5.60) for high self-reported competence CONCLUSIONS: Access to mental health educational resources was associated with higher interest, perceived responsibility, and self-reported competence; investing in these resources may improve fellows' skills in addressing the emotional needs of CCMC.

Higher education management in western regions by educational power strategy and positive psychology.

With the deepening of the strategy of strengthening the country through education, the innovation and development of higher education, system reform and teaching innovation in the western region have become the focus of researchers' attention, and the optimization of educational power strategy has always been an important basis for the development of teaching work. On the basis of fuzzy models Takagi and Sugeno (T-S), this paper constructs an educational resource recommendation model based on T-S fuzzy neural network, verifies the feasibility of the model, further combines the educational resource recommendation model with university teaching, and analyzes the application effect. The current situation of educational resources investigation in M College is analyzed. It is found that the full-time teachers' overall academic qualifications are not high, the proportion of young full-time teachers with certain experience is small, and the professional advantages of the school are not obvious. After applying the educational resource recommendation model, the accuracy of educational resource recommendation is obviously improved, and the design is feasible. The educational management mode with positive psychological emotions has a good teaching effect, which can greatly improve teachers' dedication and concentration. Positive psychological emotions can reduce the possibility of intensification of contradictions and the possibility of behavioral opposition. Teaching resource recommendation mode can improve college students' interest in the application of teaching resources to a certain extent, and their application satisfaction is obviously improved. This paper not only provides technical support for the improvement of teaching management resource recommendation mode, but also contributes to the optimization of teaching power strategy.

The impact of patient skin colour on diagnostic ability and confidence of medical students.

Previous literature has explored unconscious racial biases in clinical education and medicine, finding that people with darker skin tones can be underrepresented in learning resources and managed differently in a clinical setting. This study aimed to examine whether patient skin colour can affect the diagnostic ability and confidence of medical students, and their cognitive reasoning processes. We presented students with 12 different clinical presentations on both white skin (WS) and non-white skin (NWS). A think aloud (TA) study was conducted to explore students' cognitive reasoning processes (n = 8). An online quiz was also conducted where students submitted a diagnosis and confidence level for each clinical presentation (n = 185). In the TA interviews, students used similar levels of information gathering and analytical reasoning for each skin type but appeared to display increased uncertainty and reduced non-analytical reasoning methods for the NWS images compared to the WS images. In the online quiz, students were significantly more likely to accurately diagnose five of the 12 clinical presentations (shingles, cellulitis, Lyme disease, eczema and meningococcal disease) on WS compared to NWS (p < 0.01). With regards to students' confidence, they were significantly more confident diagnosing eight of the 12 clinical presentations (shingles, cellulitis, Lyme disease, eczema, meningococcal disease, urticaria, chickenpox and Kawasaki disease) on WS when compared to NWS (p < 0.01). These findings highlight the need to improve teaching resources to include a greater diversity of skin colours exhibiting clinical signs, to improve students' knowledge and confidence, and ultimately, to avoid patients being misdiagnosed due to the colour of their skin.

ProvOER model: A provenance model for Open Educational Resources.

Open Educational Resources (OER) can be adapted and combined to create new resources that better meet the specific needs of different kinds of users and scenarios. In this sense, OER strongly contributes to generating and sharing educational knowledge. Due to the possibility of creating a new OER through the revision and remix activities, the original OER and the transformation process should be adequately identified. This way, the user of the OER has enough information about the history of the resource and, thus, can use it with confidence and security. In this context, determining data provenance, which describes the history of a data from its origin to its current state, becomes very relevant. For OER, there are examples of metadata standards and digital repositories that help to obtain the data provenance. However, the information collected is insufficient to identify the entire history of the provenance of OER. This article proposes a Provenance Model for OER called the ProvOER Model, which allows the documentation and identification of the provenance of OER. For this purpose, a minimum set of metadata was defined that reflects the OER intrinsic properties and the activities that created a new OER. The experiments showed that the ProvOER Model produced a suitable representation of the provenance of OER. In addition, the ProvOER Model allowed identifying the original OER used in a revise or remix activity and the continuous stretch used to create a new resource.

Fabricación de modelos anatómicos articulares para formación en intervencionismo ecoguiado / Anatomic joint models for eco-guided interventionism training manufacture

Introducción: El intervencionismo ecoguiado ha supuesto un cambio en la forma en que los especialistas de medicina física y rehabilitación se enfrentan al dolor musculoesquelético y a otros problemas como la espasticidad. La implantación de las unidades de intervencionismo ecoguiado mejora los resultados de los tratamientos mínimamente invasivos, habituales en la práctica clínica de nuestra especialidad. El mayor inconveniente de esta práctica es la larga curva de aprendizaje y la dificultad para llevar a cabo prácticas durante los cursos de formación. Objetivo: Desarrollar un sistema de fantomas que permita la práctica de intervencionismo en modelos anatómicos acortando los tiempos de aprendizaje y mejorando la certeza al alcanzar el objetivo de la práctica intervencionista. Métodos: Se describe el método de fabricación de modelos tridimensionales de articulaciones a partir de imágenes obtenidas de tomografía axial computarizada, y su inclusión posterior en moldes realizados con gelatina alimenticia, que permiten obtener unos fantomas similares a modelos articulares reales que posibilitan su estudio mediante técnicas de ecografía y la práctica del intervencionismo ecoguiado. Conclusión: Los modelos articulares tridimensionales con gelatina alimenticia son útiles en la práctica y aprendizaje de las técnicas de intervencionismo ecoguiado articular.(AU)

Introduction: Eco-guided interventionism has changed the way Physical Medicine and Rehabilitation specialists deal with musculoskeletal pain and other problems such as spasticity. The implementation of the Eco-Guided Intervention Units improves the results of the usual minimally invasive treatments in our speciality's clinical practice. The biggest drawback of this practice is the long learning curve and the difficulty of practice during training courses. Objective: To develop a system of phantoms that allow the practice of interventionism in anatomical models by shortening learning times and improving certainty by achieving the objective of interventionist practice. Methods: Describes the method of manufacturing three-dimensional models of joints with images obtained from computerized axial tomography, and their subsequent inclusion in gelatin's made molds, which allow to obtain phantoms, similar to real joint models, that allow to study using ultrasound techniques, and the practice of eco-guided interventionism. Conclusion: Three-dimensional joint models made with gelatin are useful in the practice and learning of joint eco-guided interventionism techniques.(AU)

[Anatomic joint models for eco-guided interventionism training manufacture]. / Fabricación de modelos anatómicos articulares para formación en intervencionismo ecoguiado.

INTRODUCTION: Eco-guided interventionism has changed the way Physical Medicine and Rehabilitation specialists deal with musculoskeletal pain and other problems such as spasticity. The implementation of the Eco-Guided Intervention Units improves the results of the usual minimally invasive treatments in our speciality's clinical practice. The biggest drawback of this practice is the long learning curve and the difficulty of practice during training courses. OBJECTIVE: To develop a system of phantoms that allow the practice of interventionism in anatomical models by shortening learning times and improving certainty by achieving the objective of interventionist practice. METHODS: Describes the method of manufacturing three-dimensional models of joints with images obtained from computerized axial tomography, and their subsequent inclusion in gelatin's made molds, which allow to obtain phantoms, similar to real joint models, that allow to study using ultrasound techniques, and the practice of eco-guided interventionism. CONCLUSION: Three-dimensional joint models made with gelatin are useful in the practice and learning of joint eco-guided interventionism techniques.

Exploring UK veterinary students' use of online resources as a tool for studying small animal internal medicine.

BACKGROUND: Despite an increase in the use of online resources, their use by veterinary students, especially in the study of small animal internal medicine (SAIM), remains poorly understood. METHODS: A questionnaire-based study consisting of 26 survey items and 263 responses from seven UK universities investigated the use of online resources among clinical veterinary students studying SAIM and whether this was affected by age, gender, year of study or entry status. RESULTS: Random internet searches were the preferred method of clarifying queries, except for graduate-entry students and age categories 18-21 years and 28 years and over who preferred traditional textbooks. Online searches were preferred over emailing instructors or contacting instructors in person. Despite 73.3% of participants not automatically trusting information from online sources, only 47.1% fact-checked, although this was higher among the graduate-entry group (62.5%). Frequent social media use was reported; however, only 44.8% of students reported using social media to discuss SAIM. Video clip usage was high, and 82.9% of students reported video clips were useful for understanding SAIM concepts. CONCLUSION: Online resources are a useful tool to complement traditional resources; however, a level of academic oversight may be required to ensure appropriate and effective use of these resources.

Faculty Motivation for OER Textbook Adoption and Future Use.

Most postsecondary instructors in the United States require students to use textbooks in their courses; however, the cost of commercial materials has increased, and copyright policies impede sharing, editing, and customizations of materials. The current study aimed to examine faculty motivation to adopt Open Educational Resources (OER) and how OER use relates to effective teaching practices. Survey data from 469 professors, instructors, lecturers, and research scientists were analyzed using structural equation modeling, which found that autonomous motivation (engagement with OER textbooks based on enjoyment, value) was the strongest positive predictor of current and future OER textbook use. However, use of OER textbooks was not related to self-reported teaching success. The results of this study contribute to better understanding faculty perceptions of and motivation for OER textbook use, along with informing OER adoption initiatives at postsecondary institutions.

What's in it for me? A mixed-methods study on teachers' value creation in an inter-institutional community on open educational resources in higher education.

The affordances of Open Educational Resources (OER) have resulted in various initiatives around the world, but most of them cease to exist once the initial project funding stops. Communities might be a means to create sustainable practices, yet, such communities can only function if their members perceive these communities as valuable. We applied the value creation framework of Wenger, Trayner, and De Laat to examine the value teachers ascribe to their engagement with an inter-institutional community on OER. In this community, 15 universities of applied sciences collaborated on sharing knowledge and resources across their institutional barriers. We collected data through user statistics, an online questionnaire, and semi-structured interviews. Major value creation occurred from teachers' personal needs, with dominant immediate and potential values. Findings on applied and realized values denote that it became easier for teachers to connect with peers, and to initiate collaboration projects across institutes. The framework we used is helpful to inform actions to further promote value creation in communities on OER. Recommendations relating to communities' aspirations, its relations with the wider organization, and adoption of OER are formulated to inform sustainable practices of inter-institutional communities.