A comprehensive Distance Learning program to upgrade
P+O practitioners in Latin America
Abstract
In Latin America, as in most developing countries, there are very few P+O training institutions and therefore most P+O practitioners have no formal training. The University Don Bosco, (UDB) with the support of the German Technical Cooperation GTZ decided in 1998 to challenge this situation by preparing a modular distance learning program for empirically trained technicians with the aim to improve the quality of the P+O services offered.
After analyzing the situation and the needs of the practitioners, a curriculum and a delivery model for the educational content was developed with a multidisciplinary working group at the UDB. In consultations with the ISPO, the WHO and the George Brown College (Toronto Canada) it was decided to develop a 2 year training course, consisting of 5 P+O modules that cover all important areas in the field, designed to achieve the ISPO category II recognition, which was achieved in the first final exams held in November 2004.
The tools to deliver the teaching content consist of a Internet Platform (www.ortoedu.com) Videos, CD’s, Clinical Case Presentations, Discussion Forums, Tutoring systems and a practical and theoretical evaluation seminar after each module. The first intake of students was in January 2002 and presently a total of 78 students from 9 Latin America countries are studying this course. It is important to note, that all of the students have to prove at least five years of practical experience in P+O in order to be excepted to enter the upgrading distance learning program.
Introduction/Background
The University Don Bosco and the support of the regional project UDB-GTZ “Rehabilitation of people with disabilities in Central America” has started the first formal training of P+O technicians in Central America in 1996 and the new initiative of a distance learning program in P+O is based on the experiences that the University gained in the field of education of Orthotists/ Prosthetists since this time.
The Internet has in the last years become a viable platform for teaching and learning. The enormous capacity of the Internet for delivering information and the increasing support for interpersonal communication has fostered a worldwide movement across universities and organizations to reexamine and evolve the current learning and educational infrastructure. Many applications have been developed that demonstrate the potential of the Internet for learning.
When we look at the existing infrastructure in developing countries, we realize that the access to the internet is still limited for most people; therefore we have to develop additional teaching materials and tutorial structures to guarantee access of all interested parties. Therefore the model we have developed is not a typical distance learning model but a blended learning system, adapted to the needs of students in developing countries, that have not always access to the Internet and depend on other, additional teaching tools like text materials, videos, CD’s and a comprehensive tutoring system in order to achieve there learning objectives.
Methods
Since June 2001 the multidisciplinary team at the University Don Bosco (UDB) has undertaken the following activities:
Formation of a multidisciplinary working group consistent of the following elements:
1. Graphic Design
2. Video Production
3. Education Department
4. Web Design
5. Computer Science
6. Administration and Logistics
7. Prosthetic and Orthotic department
Web Site:Development. A interactive Internet Web Site has been developed using PHP for the generation of the web content and MySQL for the databases of the web platform. (www.ortoedu.com)
CD’s : Each student receives at the begin of each module a CD’s that contain all texts and materials for module. This allows the students to study with a computer even if they should not have access to the Internet or a slow connection. The content of the CD’s can be printed to paper.
Videos and DVD’s: A set of videos is provided to the students in two forms. On is the traditional VHS format that allows students that don’t have access to more sophisticated equipment to study the fabrication process of P+O devices in a complex and well explained setting. Short supportive videos are included in the web site and on the CD’s and since a few month also on DVD’s in 4 different languages.
Books: The University Don Bosco has developed over the last 8 years extensive specialized literature in all areas of P+O. These books are available for the students and give them the possibility to study in the traditional way of reading and researching of literature.
Chatting: and Discussion Platform. On the web site a chatting channel is giving way to individual contact between students and teachers as well as discussion forums between the different students to identify and answer questions in the different subjects. The students can chat at any time and have the possibility to talk to there tutors during a set time for 1 hour every day.
Clinical case presentation. The students have to prepare in each module clinical cases of there daily praxis according to a given structure in the web platform. They describe the patient history and explain practical procedures by text and picture and move the content in an easy to use menu into the web page. This cases can than be seen also by other student as information and for discussion.
Exams: Each teacher is preparing exams that are delivered constantly over the Internet. These exams are meant as an auto evaluation tool and help the student and the teacher to evaluate the progress and identify problem areas.
Practical Evaluation Seminars: At the end of each module a practical seminar of 8 days is hold, where the theory content is repeated and the key concepts in the practical work are discussed. Each seminars ends with a final practical and theoretical examination. The exams take place in or near the country of the student’s origin. At present exams are taken in Mexico, Colombia, Brazil and El Salvador.
Didactical Materials
Structure and content of the training program
The 2 year course consists of 5 modules that cover all main areas of P+O as described in the following chart 1. A module typically has a duration of 5 month and consists of 5 subjects, which are all related to the given module theme. The student will learn and understand each theme in a comprehensive way. In chart 2 you can see the subject of the first module “Lower Extremity Prosthetics.
Chart 1
Chart 2
Formal Recognition of the training:
Students that successfully finish all the modules have to sit for the final examination together with the students of the regular three-year training program at UDB in El Salvador. If they pass the exam they receive a University Diploma and an ISPO-International Society for Prosthetics and Orthotics category II recognition. External examiners from the ISPO are present at the final exams.
PRACTICAL EXAMS
Results
The first intake of students took place in September 2002 with a total of 35 students, of which 27 are still in the course and which at this point take there last module. The dropout rate was very low, when we compare to other distance learning programs. After a positive feedback from the students of the first course to other practitioners in there home, we started in May 2003 the first module again in Spanish for Latin America and in Portuguese for students from Brazil. As the need in Brazil in enormous, a second Brazilian course was started in January 2004 and at present about 30 students from Brazil are active in the course.
The students have now access to approximately 4000 pages of text material presented on the web and available also on CD’s. For all the practical content demonstration videos with clinical case presentations have been prepared and send to the students before each module for orientation.
We prepared questionnaires to find out which areas and methods of the program where difficult to understand for the students and what kind of improvements in content and delivery of the course are desired by the students. The results where mostly very positive and the course was well received and understood. The majority of the students is very motivated and has good results in the exams. They realized quickly how their improved knowledge contributed to a better overall understanding of P+O and a strengthened there relations to the prescribing doctors and the patients they treated. An other important factor mentioned by the students was their better self esteem and identification with the P+O profession.
For us it was very important to have reliable partner in the different countries, like the P+O associations of Mexico (SMOPAC) and Brazil (ABOTEC) , with whom we signed collaboration agreement for the preparation of the practical exams, the follow up and tutoring in the country, as well as logistical support wherever needed.
Conclusion
Regardless of the type of pedagogy model, distance learning programs have high initial costs and subsequent upgrade costs, but once developed the costs are very low and upgrading is dynamic and easy. We believe that especially in the case of developing countries where education is under-served and under-developed, Internet technologies have the potential to make education more accessible, scalable, and global.
We learned however, that it is important to develop a set of different didactical materials in order to allow all students to follow the course, regardless weather they have a frequent access to the Internet or not.
An other positive effect was that the newly developed materials can be used at the UDB also within the full time training program and for continuing education seminars. The adaptation and inclusion of new content is much more dynamic than what we are used to in more traditional methods.
The students of this program are able to keep on working and learn at there own path whenever they have time. Based on the results we have seen up to now, we are sure that we where able to improve the quality of the practitioners that participate in the program and the quality of the products they offer, which leads to a higher satisfaction of their clients and contributes to the growth of our profession in Latin America.
By offering distance learning programs we can contribute to close the gap of knowledge that still exist between industrialized and non industrialized countries.
Thank You
We would like to give special thanks the ISPO, the WHO, GTZ, GBC, SMOPAC, ABOTEC and all the individuals at the UDB and in the Latin American countries that contributed to the realization of this program, without whom our vision could have not become a reality.
For further information contact:
Heinz Trebbin
University Don Bosco
P.O.Box 1611
San Salvador
El Salvador
www.ortoedu.com
udbtop@navegante.com.sv
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