Introduction to Traumatic Brain Injury Course- Evaluation Report

Summary

From October 21st, 2019 to November 30th, 2019, Physiopedia successfully delivered a Massive Open Online Course (MOOC) entitled “Traumatic Brain Injury Programme” via the Physioplus online learning platform. This MOOC aimed to provide a basic theoretical understanding of the management of traumatic brain injuries (TBIs) to equip physiotherapists with sufficient knowledge to manage a person following a traumatic brain injury. The programme consisted of four courses, which included:

1. Introduction to TBIs
2. the assessment and classification of TBIs,
3. management of TBIs assessing impairments and
4. an overview of the management of TBIs and specific therapeutic interventions for TBIs.

In each course, the learner completed the required learning activities and a final quiz that tested the knowledge gained from the course. To complete the overall TBI programme, the learner had the option to submit and pass a written assignment.

Course Type: Free, Open, Online

Institution: Physiopedia

About this course: the MOOC aimed to provide a basic theoretical understanding of the management of traumatic brain injury in order to equip physiotherapists with sufficient knowledge to manage a person following a traumatic brain injury. The course provided the learner with information on how to: assess impairments, activity limitations and participation restrictions, set appropriate goals of treatment, formulate evidence-informed treatment plans, and implement and evaluate treatments.

Target audience: these courses were written for physiotherapy clinicians, students, and assistants. Other healthcare professionals interested in this subject were also welcomed to participate.

Time commitment: 16 hours over four weeks (with an optional extra 8 hours)

Date: October 21st – November 30th, 2019, (the course remains available on the Physioplus platform to all members)

Requirements: participants were required to complete online learning activities, engage with additional resources, and complete the course evaluations (quizzes). 

Assessment: there was a final quiz, and participants could optionally complete a final assignment to demonstrate the knowledge gained from the four courses.

Awards: 4 course completion certificates awarding a total of 18.3 Physioplus (P+) points.

Accreditation: each of the programme was accredited by Federation of State Boards of Physical Therapy (ProCert; 4CCUs) and South African Society of Physiotherapy (6 General CEUs Level 1).

Registrations: 20,522

Countries represented: 185

Acknowledgements

The Traumatic Brain Injury MOOC was developed and delivered by Physiopedia and interested individual stakeholders following a private donation that specifically asked to educate physiotherapists globally in the management of traumatic brain injuries.

Course coordinator:

• Rachael Lowe

Content contributors:

• Naomi O’Reilly
• Anna Zeimer
• Wendy Walker
• Jennifer Quartano
• Gavin Williams
• Leanne Hassett
• Megyn Robertson
• Joan Leung
• Zillah Whitehouse
• Ahmad Rifai Sarraj
• Jaunati Metha

Course facilitators:

• Rachael Lowe
• Tony Lowe
• Naomi O’Reilly
• Anna Zeimer
• Wendy Walker

Special thanks to the generous private donation that made this course possible and to Nicole Hills for writing up the report.

For any information regarding this report, please contact: Rachael Lowe - [email protected]

Introduction

During October and November 2019, Physiopedia ran its 8th Massive Open Online Course (MOOC) entitled the “Traumatic Brain Injury Programme.” The MOOC was delivered as a programme of four courses and an optional written final assignment.

The Traumatic Brain Injury Programme aimed to provide a basic theoretical understanding of the management of traumatic brain injuries (TBIs) to equip physiotherapists with sufficient knowledge to manage a person following a traumatic brain injury. The course included education on assessing impairments, activity limitations and participation restrictions, setting appropriate goals for treatment, formulating an evidence-based treatment plan, implementing treatment, and evaluating treatment success.

The four-week-long courses presented different topics through a variety of learning activities to suit all learning styles.  The required learning activities within each course were developed 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 short orientation period before the course started provided participants with an opportunity to become familiar with the delivery platform and the topic via the provided pre-course resources.

The course was delivered through the Physioplus (P+) online learning platform; an innovative platform specifically developed to provide online education and support learners with a personalised learning dashboard. For each course, the related learning activities were released on a specific course page. Participants engaged with each course learning activity, and their activity was recorded and displayed in their personal learning dashboard.

A course was considered complete once the learner finished all required learning activities and successfully passed the final quiz that tested knowledge gained each week. There was also an optional written assignment designed to demonstrate the knowledge gained from all four courses.  On completion of each course the participants had the option to download a completion certificate and export a record of their learning from their activity log.

This report evaluates the experiences and engagement of the participants on the Traumatic Brain Injury MOOC.

1.1 Aim

The programme of four courses aimed to provide a basic theoretical understanding of the management of traumatic brain injury in order to equip physiotherapists with sufficient knowledge to manage a person following a traumatic brain injury. The programme included knowledge on assessing impairments, activity limitations, and participation restrictions, setting appropriate goals of treatment, formulating an evidence-based treatment plan, implementing treatment and evaluating its success.

The global network formed through this course will allow for shared knowledge and experiences to support good health care and a better quality of life for individuals with a traumatic brain injury around the world.

1.2 Learning Objectives

At the end of this programme of courses, participants were able to:

1. Discuss the current burden of traumatic brain injury
2. Understand the risk factors and complex causes for traumatic brain injury
3. Understand and recognise the various clinical presentations of traumatic brain injury
4. Select appropriate assessment techniques and outcomes measures for traumatic brain injury
5. Evaluate the information gathered from the assessment of an individual with a traumatic brain injury in order to formulate a treatment plan
6. Demonstrate clinical reasoning when presented with impairments related to traumatic brain injury
7. Demonstrate an understanding of the range of therapeutic interventions for the management of traumatic brain injury
8. Critically analyse the literature related to traumatic brain injury assessment, management, and rehabilitation

1.3 Intended Audience

This course was suitable for all healthcare professionals but aimed at physiotherapy professionals including clinicians, assistants, and students. It was also of interest to other healthcare professionals (e.g. prosthetists, orthotists, nurses, occupational therapists, speech therapists, medical doctors) who were motivated to upgrade their knowledge on traumatic brain injuries.

1.4 Cost to participants

The course was free to all participants who completed the course within the 8-week timeframe the course ran and remains free to all residents of low-income countries.

1.5 Course availability

The programme of courses started on October 21st, 2019 when the first course was made available.  A new course was released each Monday for another 3 weeks.  Participants had until November 30th, 2019 to complete the courses under their free access to Physioplus. The course remains available on the Physioplus platform to members; membership is free to individuals from low-income countries and available at a discounted rate to individuals in middle-income countries.

1.6 Courses, Course Awards and Accreditation

Four individual courses were created for the Traumatic Brain Injury (TBI) Programme.

Course 1: Introduction to Traumatic Brain Injury

Course 2: Assessment of Traumatic Brain Injury

Course 3: Management of Traumatic Brain Injury

Course 4: Specific Therapeutic Interventions for Traumatic Brain Injury

Physiopedia provided course completion certificates to all participants that passed each of the four courses within the programme. The programme was accredited by Federation of State Boards of Physical Therapy (ProCert; 4CCUs) and South African Society of Physiotherapy (6 General CEUs Level).

2.1 Country

20,522 participants formally registered for the TBI Programme before the end date of November 30th, 2019 representing 185 countries. The top ten represented countries can be found in Table 1.  A full list of the countries and number of participants from each country can be found in Appendix 1.

Table 1: Top ten represented countries

Country	N
India	3565
United States of America	1858
Nigeria	1820
Canada	1587
Australia	1513
Saudi Arabia	1141
United Kingdom	1120
Pakistan	763
Egypt	629
South Africa	394

Data are numbers (N)

2.2 Profession

Table 2: Participants’ professional backgrounds

Profession	N (%)
Physiotherapy / Physical Therapy	16117 (78.5%)
Occupational Therapy	987 (4.8%)
Medical Doctor	898 (4.4%)
Nurse	484 (2.4%)
Prosthetics/Orthotics	117 (0.6%)
Other	1919 (9.3%)

Data are numbers (N) and percentage of total participants (%)

2.3 Role

Table 3: Current professional roles held by participants

Professional Role	N (%)
Clinician	12264 (59.8%)
Student	4881 (23.8%)
Educator	843 (4.1%)
Assistant	830 (4.0%)
Researcher	400 (1.9%)
Manager	310 (1.5%)
Other	994 (4.9%)

Data are numbers (N) and percentage of total participants (%)

2.4 Years of experience

Table 4: Participants’ years of professional experience

Experience	N (%)
No experience	5938 (29.0%)
Less than one year	5550 (27.0%)
One to five years	5536 (27.0%)
Greater than five years	3498 (17.0%)

Data are numbers (N) and percentage of total participants (%)

2.5 Participants reasons for registering for the course

Reason	N
To develop knowledge	17159
To improve clinical skills	15459
To try out a Physiopedia course	5269
To receive CEUs or CPD points	3792

Data are numbers (N). Participants were able to choose more than one reason for participating.

3.1 Platform

The TBI Programme and the associated four courses were delivered on Physioplus. Thirty-six pages  on Physiopedia were either created or updated for the learners to use during these courses. The related course pages received 91,221 unique views before the final date of the supported course (November 30th, 2019).

3.2 Learning Activities

4,028 learners began Course 1 (Introduction to Traumatic Brain Injury) of the Traumatic Brain Injury Programme, 39% of these learners completed the first course. The number of learners who began and completed each of the four courses can be found in Table 6.

Table 6: Course initiation and completion

	Course 1	Course 2	Course 3	Course 4	TBI Programme
Learners who started	4,028	1,822	1,319	1,088	502
Learners who completed	1,584	1,118	953	803	3

Data are numbers (N) of learners

The four courses included a total of 53 required learning activities (full list of learning activities can be found in Appendix 2).  To complete each course participants were required to fully engage with all the related required learning activities (Appendix 2) and pass the course quiz.  To pass the final course quiz learners had to receive a grade of 80% or higher. Once the quiz and all learning requirements were successfully completed, Physioplus points (P+; equivalent to hours of learning) and a completion certificate were awarded. A break down of the number of required learning activities and the number of learning activities that were completed in each course can be found in Table 7.

Table 7: Learning activities logged and Physioplus points awarded for each course

	Course 1	Course 2	Course 3	Course 4
Required learning activities	10	14	12	11
Learning activities logged	28,900	18,297	13,802	11,608
Total Physioplus points awarded	8,663	5,386	4,729	3,991

3.3 Discussion Forum

Each course contained an optional 3-5 discussions. Learners were encouraged to engage with knowledge users from around the world on different topics associated with the course. These discussions were intended to provide a rich learning experience to the learner through self-reflection and community engagement.. Table 8 presents the number of discussion posts for each discussion in each of the four courses. There were a total of 6,260 discussion posts over the course of the programme.

Table 8: Discussion forum posts

	Course 1	Course 2	Course 3	Course 4
Discussion 1	1431	474	363	228
Discussion 2	619	370	295	231
Discussion 3	410	361	279	76
Discussion 4	227	368	278
Discussion 5		137	113
Total	2687	1710	1328	535

Data are number (N) of individual posts.

3.4 Final Assignment

An optional final assignment was designed to have the learner reflect on their learning and use the knowledge gained throughout the courses. Participants were asked to follow the assignment guidelines on Physiopedia and the Physiopedia team assessed the submitted assignments.  To successfully pass the final assignment, learners needed to demonstrate: evidence of learning from the course, academic skill with evidence-based writing, and proper referencing. Assignments had to be written in English. A total of nine assignments were submitted, seven of which were patient case studies, and two were knowledge translation clinical guidelines. Of the nine submissions, three met the assignment requirements and were rewarded with a passing grade.

3.5 Engagement versus completion

Of the 20,522 learners who registered to take part in the TBI Programme, 4,028 (20% of register learners) began the first course before November 30th. Of the 4,028 learners that began the first course, 803 completed all four courses (20% of engaged learners). Table 9 displays the number of learners who began and completed the first and final course and the optional final assignment.

Table 9: Engagement and completion of the TBI Programme

	N
Learners who registered to take part in course	20,522
Began first course	4,028
Received first course completion certificate	1,584 (39%)
Started the final course	1,088 (27%)
Received final course completion certificate	803 (20%)
Began the final optional TBI Programme	502 (12%)
Completed optional final assignment	3 (0%)

Data are numbers (N) and percentage of total participants who began the first course (%)

Table 9: Engagement and completion of the TBI Programme

	N
Learners who registered to take part in course	20,522
Began first course	4,028
Received first course completion certificate	1,584 (39%)
Started the final course	1,088 (27%)
Received final course completion certificate	803 (20%)
Began the final optional TBI Programme	502 (12%)
Completed optional final assignment	3 (0%)

Data are numbers (N) and percentage of total participants who began the first course (%)

4.0  Participant Feedback

After the completion of each of the four courses, learners had the option to share their feedback on the course. The learners were asked to rate their overall opinion of the course on a 5-point scale ranging from excellent to poor. 82-86% of the respondents rated the courses as either great or excellent. Figures 1 to 4 display the results for each course.

Figure 1: Overall course rating for the Introduction to Traumatic Brain Injury Course (n=920).