Managing Children with Cerebral Palsy Course - Evaluation Report

Original Editor - Username Top Contributors - Esraa Mohamed Abdullzaher, Kim Jackson and Candace Goh

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Summary

In September/October 2016 Physiopedia and the International Committee of the Red Cross (ICRC) successfully delivered the Managing Children with Cerebral Palsy Massive Open Online Course (MCCP MOOC) via the Physiopedia Plus online learning platform.

Course Type - Open, Online.

Course Co-ordinators - Barbara Rau, Rachael Lowe.

Collaborating Partners - International Committee of the Red Cross (ICRC) and Physiopedia.

About this course - This online course covers basic theoretical knowledge of managing children with cerebral palsy.

Who was invited to take part - Physiotherapy and Physical Therapy clinicians, students and assistants; other interested professionals such as prosthetists/orthotists, occupational therapists, nurses or medical doctors interested in this subject were welcomed to participate.

Date that it ran – 5 September to 31 October 2015

Time commitment - 24 hours over 8 weeks.

Requirements – Participants were required to complete online learning activities, engage with additional resources, take part in the conversation online and complete the course evaluation.

Assessment - There was a final quiz and participants were asked to complete an assignment to demonstrate their learning.

Awards - Completion certificate plus 24 Physiopedia Plus (PP+) points. Accreditation - The course was accredited by the South African Society of Physiotherapy (SASP).

Acknowledgements

The MCCP MOOC was developed and funded as a collaboration between Physiopedia and the International Committee of the Red Cross.

Key content contributions were made by:

• Cerebral Palsy Association, South Africa.
• Enablement, Netherlands.

Course co-ordinators:

• Rachael Lowe (Physiopedia).
• Barbara Rau (ICRC).

Course facilitators:

• Zeon De Wet, P&O, ICRC.
• Verbena Bottini, PT, ICRC, Afghanistan.
• Yvonne Frizzell, PT, Pakistan.
• Greg Halford, P&O, ICRC, Gaza.
• Lucia Bernhard, PT, ICRC, Democratic Republic of the Congo.
• Lorena Enebral Perez , PT, ICRC, Afghanistan.
• Ghassan Husni Ali, P&O, ICRC, Iraq.
• Naomi O'Reilly, PT, Physiopedia, Ireland.
• Estibaliz Garcia, OT, Handicap International, Belgium.
• Lurinda Prinsloo, OT, Cerebral Palsy Association, South Africa.
• Roelie Wolting, PT, Enablement, Netherlands.
• Simon Lalor, P&O, Royal Children's Hosp.

Contents Summary

• Acknowledgements.
• Contents.
• Introduction.
• Aim of the Course.
• Course Learning Objectives.
• Intended Audience.
• Cost to participants.
• Demographics of the participants.
• Role.
• ICRC staff and partners.
• Platform.
• Course textbooks.
• Discussion Forum.
• Quizzes.
• Final Assignment.
• Assessment.
• Certificates.
• Course Accreditation.
• Course Evaluation.
• Impact of group work.
• Impact on clinical practice.
• Future.
• Contact details.
• Appendix 1 – Course participants countries.
• Appendix 2 - ICRC participants.
• Appendix 3 – Course evaluation: specific responses.
• Appendix 4 – Course evaluation: what were the best elements of the course (selected responses).
• Appendix 5 – Course evaluation: how could this course be improved (selected responses).
• Appendix 6 - Course evaluation: how has the course changed your practice.

Introduction

During September and October 2016 Physiopedia ran their fifth Massive Open Online course titled Managing Children with Cerebral Palsy (MCCP MOOC). The MCCP MOOC was developed and delivered as a collaboration between Physiopedia and the International Committee of the Red Cross (ICRC).

The aim of the MCCP MOOC was to train the distributed team of ICRC staff and partners to have a basic understanding of the theoretical knowledge that underpins the management of children with cerebral palsy. The content of the course was designed appropriately for physiotherapists in any global context, all healthcare workers were invited to participate. Being open for anyone to participate allowed for global conversation around the topic and enabled peer-to-peer learning across contexts and experiences.

The six week course presented different topics each week through a variety of learning activities to suit all learning styles. The required learning activities each week were proposed to take between 4-6 hours depending on the participant's learning style and optional activities were provided should the participant wish to take part in additional learning. A two week orientation period before the course started provided participants with an opportunity to become familiar with the delivery platform and the topic via the course textbooks.

The course was delivered through the Physiopedia Plus (PP+) online learning platform, an innovative platform specifically developed to deliver online education and provide learners with a personalised learning dashboard. Each week the new learning activities were released on a specific course page and participants were informed by email and social media. As participants engaged with each learning activity it was recorded and displayed in their own personal learning dashboard.

To complete the course participants were required to complete all the identified required learning activities, a final quiz that tested knowledge and an assignment to demonstrate their learning. On completion of the course the participants could download a completion certificate and also export a record of their learning from their activity log.

This report evaluates the experiences and engagement of the participants on the MCCP MOOC.

Aim of the Course

This course aims to align global understanding of Cerebral Palsy. It will provide a framework to develop introductory level principles of the management of children with Cerebral Palsy relevant in all contexts. The global network formed through this course will allow for shared knowledge and experiences to support good health care and better quality of life for children with Cerebral Palsy around the world.

Course Learning Objectives

At the end of this course participants should be able to:

1. Describe how the brain influences movement and posture in individuals with Cerebral Palsy.
2. Differentiate between normal child development and the development of a child with Cerebral Palsy.
3. Recognise and appropriately evaluate a child with Cerebral Palsy.
4. Describe the global prevalence of Cerebral Palsy.
5. Describe the roles of the interdisciplinary team working with a child with Cerebral Palsy.
6. Explain different therapeutic approaches to managing a child with Cerebral Palsy.
7. Demonstrate optimal positioning for a child with Cerebral Palsy.
8. Demonstrate good handling of a child with Cerebral Palsy.
9. Describe methods for appropriate communication with a child with Cerebral Palsy and explain the clinical reasoning for these.
10. Describe methods for appropriate feeding of a child with Cerebral Palsy and explain the clinical reasoning for these.
11. Explain the importance of appropriate positioning and stimulation during everyday activities and play.
12. Demonstrate activities that promote communication, movements, social and emotional skills, and learning.
13. Explain principles underlying orthotic use and describe the most commonly used orthotics.
14. Describe specific therapeutic interventions for a child with Cerebral Palsy.
15. Recognise the challenges faced by an individual with Cerebral Palsy through the lifespan.

Intended Audience

This course is suitable for all Health Care Professionals especially Physiotherapy or Physical Therapy Professionals including clinicians, assistant or students who have a good understanding of the key principles of Physiotherapy but little prior experience in Cerebral Palsy. It will also be of interest to any professionals (e.g. Prosthetists, Orthotists, Nurses, Occupational Therapists, Speech Therapists, Medical Doctors) motivated to upgrade their knowledge on Cerebral Palsy.

Cost to participants

The course was free to all participants.

Demographics of the participants

Country

14,010 participants formally registered for the course before the end date of 31 October 2016. They represented 179 countries (see Appendix 1). The most represented countries were:

India	1,912
Egypt	1,428
Pakistan	1,048
United Kingdom	703
Nigeria	690
United States	635
Saudi Arabia	560
Canada	550
South Africa	512
Australia	466

Profession

84% were physiotherapists.

Physiotherapist	11,759
Occupational Therapist	749
Other	722
Medical Doctor	405
Prosthetist / Orthotist	237
Nurse	143

Role

57% were clinicians and 25% were students.

Clinician	11,759
Student	3,468
Educator	696
Assistant	658
Manager	559
Researcher	240

ICRC staff and partners

1276 individuals identified themselves as ICRC staff. They represented 106 countries (see Appendix 2). The most represented countries were:

Egypt	347
Pakistan	99
India	86
Saudi Arabia	75
Afghanistan	63
Palestinian Territory	46
Nigeria	35
Vietnam	34
Syria	32
Jordan	23

Platform

The course was described through a page on Physiopedia (http://www.physio-pedia.com/Managing_Children_with_Cerebral_Palsy). This page was visited a total of 50,311 times before the final date of the supported course on 31 October 2016. This page directed participants to set up an account with Physiopedia Plus where the course was delivered. Participants had to login to this platform to access the course.

Unique individuals that accessed at least one learning activity………………..……..…..…..3,639

Total learning activities engaged with……………………………………………………………….123,700

Course textbooks

There were three course textbooks. The copyright owners made online access to these books free for the duration of the course:

1. Finnie NR. Handling the young child with cerebral palsy at home. Elsevier Health Sciences; 1997.
2. Shepherd RB. Cerebral palsy in infancy. Elsevier Health Sciences; 2013 Sep 20.
3. Hinchcliffe A. Children with cerebral Palsy: A manual for therapists, parents and community workers. SAGE Publications India; 2007 Feb 6.

Participants were particularly grateful for this aspect of the course. The publishers have reported that it is evident that making books available online in this way during an online course has a significant impact on direct sales of the hard copy of the book.

Discussion Forum

Participants were required to participate in the discussion forum on a weekly basis. This was made a requirement as it provided a rich learning experience through self-reflection on learning and exposure to global discussions about cerebral palsy. This was the task that participants found most difficult to complete. The discussion forum was hosted on the Physiopedia Plus platform where participants were asked to comment on the weekly guided discussions. It was clear that not all people engaging with the course joined participated in the discussions.

Number of people who introduced themselves in the forum ............................................... 2,628

Number of people that contributed on a weekly basis (median)…..................................... 1,335

Total number of discussion posts………………..………..………..………..………..………..…….....23,074

Quizzes

Each week participants were given the opportunity to assess their knowledge and understanding of the topic through multiple-choice quizzes. Participants received immediate feedback on right and wrong responses making this a rich learning experience. In the final week participants were invited to attempt the final multiple-choice quiz. This quiz was designed to assess knowledge and no feedback was given. The pass mark was 80% and they could attempt the quiz as many times as they liked.

Number of individuals that attempted the quiz ……………………………………………........... 1,066

Number of quiz attempts ………………………………………………………………………………..….. 2,397

Number of individual passes ………………………………………………………………….....………...… 977

Final Assignment

Reflecting on their learning and using the knowledge gained throughout the course participants were asked to submit an assignment.

Completed the assignment before 31 Oct 2016 ………………………………….………...……....… 784

Passed assignment ……………………………………………………………………………….......…...…….. 712

Failed assignments ……………………………………………………………....………………....………...….… 72

Participants were able to choose from 5 different assignments which allowed for different academic skills and learning styles. The patient case study and the exercise programme were the most popular assignments:

Patient case study	320
Exercise programme	200
Knowledge translation resource	81
Physiopedia page	70
Discussion summary	54
Pilot project	40
Training resource	18

Assessment

In week 6 participants were directed to complete 2 final tasks that were assessed. Provided that they passed the quiz and the assignment, and engaged with all the required learning activities they were considered to have passed the course.

	Completed	Passed
Final quiz	1,066	977
Assignment	784	712

Certificates

Course completion certificates with 24 PP+ points were provided by Physiopedia to all participants that passed the course.

Course Accreditation

The South African Physiotherapy Society (SASP) accredited the course and awarded CEU points to South African physiotherapists.

Course Evaluation

Participants were asked to complete an online course evaluation at the end of the course (see specific responses in Appendix 5).

The number of participants who completed the evaluation ..................................................... 973

Participants responded positively about the course (see Appendix 5).

They particularly liked:

• The videos and case studies, the quizzes to test knowledge, the Physiopedia pages.
• They also like the ability to converse and learn from with peers all over the world. Aspects that some participants did not enjoy included (see Appendix 6): ● The amount of work to complete each week, it was often stated that there was too much reading.
• The length and lack of diversity of the videos.

What is obvious from the feedback is that there are many different learning styles that partake in the course for example some people love the reading and others thoroughly object to it, some love the videos and ask for more others say they are lengthy and boring.

Impact of group work

We asked people to let us know of any group work that took place in parallel to the course. We were pleased to see several dedicated groups that used group work for peer support and practical skills. One example of this can be read about here - http://www.physiospot.com/2016/11/29/stories-from-goma-lets-continue-to-overco+me-educational-barriers/

Impact on clinical practice

Many people stated that there clinical practice had been positively affected (see Appendix 7).

Future

The plan is for this course to become part of the Global Health Certification that Physiopedia is developing. We are currently seeking funding to support this objective.