JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic demonstrated the global need for accessible open-access educational content to rapidly train healthcare workers during health emergencies. The massive open-access online course (MOOC) format is a broadly embraced strategy for widespread dissemination of trainings. Yet, digital literacy, weak technical support, access to the internet, limited cellular coverage, and language and cultural barriers prevent access to these MOOCs for many frontline health workers globally. There is tremendous potential for MOOC developers to increase the global scale and contextualization of learning; however, at present, few studies examine the adaptation and sharing of health MOOCs to address these challenges.

Objective:

The World Health Organization’s Learning and Capacity Development Unit in the Health Emergencies Programme and the Stanford Center for Health Education’s Digital Medic initiative collaborated to survey learners from four emergency health MOOCs on the OpenWHO platform to determine (1) how health education MOOCs are being used and shared by learners; (2) how health workers adapt global health education MOOC content to meet local health education training and information needs; and (3) how content adaptations can help frontline health workers overcome the barriers to using health education MOOCs.

Methods:

This study analyzes survey responses from 926 global learners from four MOOCs with 96,395 total enrolled global learners.

Results:

Of the enrollees who indicated their country of residence, half were from lower-middle income countries (LMICs) (43,168/85,882, 50%) and another 9% (7,146/85,882) from low-income countries (LICs). The majority of all survey respondents shared the course content (819/926, 88%) and used it in official trainings (563/926, 61%). Respondents were more likely to share and use course content for trainings in lower-middle-income countries (LMICs) than high-income countries (HICs) (91% vs. 81%, P=.001). Learners in LMICs also shared content with more people on average compared to learners in higher-income countries (9.48 vs. 6.73 people, P=.084). Compared to learners in HICs, they were more likely to adapt materials to distribute via offline formats or technologies, such as WhatsApp or SMS (31% vs. 8%, P<.001), to address cultural, linguistic, or other local contextual needs (20% vs. 12%, P=.076), and to meet local guidelines (20% vs. 9%, P=.010). Learners in LMICs indicated greater accessibility challenges with the four MOOCs due to technological and linguistic barriers.

Conclusions:

Learners commonly share content from MOOCs about public health emergencies; this is especially true in low-income countries (LICs) and LMICs. However, content often is adapted and shared via alternative formats. Our findings identify a critical opportunity to modify the design and dramatically scale the impact of MOOCs to better meet diverse global needs.