nhs porsche medbiq toolkit medev 2011 consent commons e-learning repository oer healthcare education ocw learnining resources practice based training technical good practice ukoer nelr consent oerporsche

1. Open educational resources - using and creating sharable teaching materials in health care - findings of the PORSCHE OER project Kate Lomax NeLR, London Deanery Lindsay Wood, [Suzanne Hardy], [Megan Quentin-Baxter] HEA MEDEV

3. Programme

5. "digitised materials offered freely and openly for educators, students and self-learners to use and reuse for teaching, learning and research” Hylén, Jan (2007). Giving Knowledge for Free: The Emergence of Open Educational Resources. Paris, France: OECD Publishing. p. 30

7. increased local ownership of education and training provision.

8. Simulation, eLearning and emerging technologies – TEL framework

9. shift towards skills networks, healthcare professionals empowered to deliver results"Times they are a'changing" AGAIN! (http://www.flickr.com/photos/lwr/4018985290/) / LEOL30 (http://www.flickr.com/photos/lwr/) / CC BY-NC-SA 2.0 (http://creativecommons.org/licenses/by-nc-sa/2.0/)

10. Is there room for OER in the NHS? Pressures for commercial partnerships and income generation opportunities But also doing at a national level only what is best done at a national level – leavingmaximum opportunities for flexible, local implementation and innovation;

11. Do once and share- making the best use of scarce resources

12. Making the case for OERs removing barriers and disciplinary silos of training and education resources. reduces duplication supports cross-institutional sharing promotes the concept of lifelong learning supports discovery of most used/highest quality resources Good intentions: improving the evidence base in support of sharing learning materials Lou McGill, Sarah Currier, Charles Duncan, Peter Douglas http://ie-repository.jisc.ac.uk/265/1/goodintentionspublic.pdf

15. 2000 resources uploaded to www.jorum.ac.uk

16. Recommendations included:

17. Authors ‘hallmark’ all content (whether to be made open or not) with CC licences

18. Consent everything (even where ownership and patient/non-patient rights appear clear) and store copies of consent with resource

19. Review institutional policies against good practice risk-assessment tools

20. UK HE enter into dialogue with publishers to increase potential for third party upstream rights (especially images, music and video)

21. Establish staff reward system (for recognition of sharing & reusing resources, PDRs, promotion criteria, etc.)www.medev.ac.uk/oer/ #ukoer #ooer #medev contact: suzanne@medev.ac.uk

22. Institutional policy recommendations That authors should ‘hallmark’ all their content with e.g. CC licences(e.g. CC ‘by’ attribution only) Consent everything-even where ownership and patient/non-patient rights appear clear, and store consent in NHS record (patients) or with resource Review institutional policies against good practice Include disclaimers in resources UK HE enters a dialogue with publishers to increase the potential for re-using upstream copyrights Seek to replace, over time, any questionable material Have sophisticated‘take-down’policies

23. Pathways for Open Resource Sharing through Convergence in Healthcare Education (PORSCHE) Seamless access to academic and clinical elearning resources cc: by Tony the Misfit http://www.flickr.com/photos/tonythemisfit/2580913560/ contact: lindsay@medev.ac.uk www.medev.ac.uk/ourwork/oer/ #porscheoer #ukoer #medev

24. 3 www.jorum.ac.uk www.elearningrepository.nhs.uk/

25. Consent Commons ameliorates uncertainty about the status of educational resources depicting people, and protects institutions from legal risk by developing robust and sophisticated policies and promoting best practice in managing information. consent commons

27. Uploaded to VLE

28. No evidence of consent

29. No access to patient record

30. Location of risk unclear

31. Doctor collects consent

32. Recordings taken

33. Consent for recordings stored with patient record

34. Clear guidance availableWe all want to do the right thing!

36. Accepts a basic human right to refuse their image/voice appearing and, where they have previously consented, their right to withdraw their consent

37. Would work like Creative Commons in that you hallmark material with the consent status and when consent needs to be reviewed (if ever)

38. Has levels of release (e.g. Closed; ‘medic restrict’; review [date]; fully open)

39. Terms of the consent needs to be stored with/near the resourcewww.medev.ac.uk

40. Accredited Clinical Teaching Open Resources (ACTOR) Partners: University of Bristol, University of Cambridge, Hull York Medical School, Newcastle University, Peninsula College of Medicine and Dentistry. www.medev.ac.uk/oer/ #ukoer #actor #medev cc: by-nc By Maxi Walton http://www.flickr.com/photos/maxiwalton/898138774/ Contact: gillian@medev.ac.uk

42. Icebreaker

43. personal experiences of current practice Breakout: group work (20 minutes)

44. Feedback to group

45. Pre-workshop areas of interest “appropriate and accurate” “what you don't know” “separating the facts” “pros and cons of sharing e-learning” “responsible for the authenticity of the content “ “use of images and other materials - copyright issues” “sharing and copyright issues”

47. CONSENT

48. www.medev.ac.uk October 2010 cc: by-sa

51. financial benefits

52. benefits for institutions, and collaboration between institutions

53. potential advantages for student recruitment, satisfaction, and retentionSharing openly: benefits www.medev.ac.uk/ourwork/oer/value/

55. Transparency and accountability

56. Equality of access

57. Increased utility

58. Increased applications & better retention

59. Recent blog post: It turns out students do use OER and it does save time http://blogs.nottingham.ac.uk/learningtechnology/2011/02/08/it-turns-out-that-oer-does-save-time-and-students-do-use-them/www.medev.ac.uk/ourwork/oer/value/

60. One of the benefits of being explicitly ‘open’ is that it removes the need for people to ask before re-using stuff. Without it, everything boils down to ‘am I allowed to do this?’ type question and many forms of re-use will stop at that hurdle because the costs of getting the answer are too great Andy Powell comment on David Wiley’s blog http://opencontent.org/blog/archives/1735

61. Mitigating risk by adopting good practice to save time and money OER is irrelevant (but a nice by-product )

63. IPR & Copyright issues Open Educational Resources

65. Patents protect what makes things work (e.g. engine parts, chemical formulas)

66. Trade marks are signs (like words and logos) that distinguish goods and services in the marketplace

67. Designs protect the appearance of a product/logo, from the shape of an aeroplane to a fashion item

68. Copyright is an automatic right which applies whenthe work is expressed (fixed, written or recorded)

69. Copyright, Design and Patents Act, 1988

70. Copyright arises automatically when an original idea (author uses some judgment or skill) is expressed/created

72. Original literary works such as novels or poems

73. Original dramatic works such as dance

74. Original musical works, i.e. the musical notes

75. Original artistic works such as graphic works (paintings, drawings etc.), photographs and sculptures, including sound recordings, films and broadcasts

76. Typographical arrangements of published editions

77. An exception is an employee who creates a work in the course of their employment (employer owns)

79. Economic rights cover copyright owner acts, including rights to copy the work, distribute (e.g. making it available on-line), rent, lend, perform, show, or adapt it

80. Owners can waive, assign, licence or sell the ownership of their economic rights

81. Moral rights can be waived (but not licensed or assigned) and include the right to

82. Be identified as the author

83. Deny a work (that an author did not create)

84. Object to derogatory treatment of the work

86. Copy it and/or issue copies of it to the public

87. Rent or lend it to the public

88. Perform or show it in public

89. Communicate it to the public

90. Secondary infringement may occur if someone, without permission, imports, possesses or deals with an infringing copy, or provides the means for making it

91. Material found on the internet is subject to copyright

93. Copyright has expired (e.g. for literary, dramatic, musical or artistic works = 70 years from when the last author dies)

94. Your use of the work (which must be acknowledged) is fair dealing as defined under the 1988 Copyright Designs and Patents Act (UK)

95. Your use of the work is covered under a licensing scheme that you and the copyright holder have subscribed to

96. The copyright owner has given you permission

98. The material you wish use (title, author name etc.)

99. The exact content to be duplicated (i.e. page numbers)

100. The number of copies you wish to make

101. How the copies will be used (i.e. for an event, course work)

102. Who the copies will be distributed to (i.e. students)

103. For most published works this will be the publisher

104. Permission is needed for each and every purpose

105. Fees may be charged to copy the item, or for administering the request to copy the item

107. Research and private study

108. Instruction or examination

109. Criticism or review

110. News reporting

111. Incidental inclusion

112. Accessibility for someone with, e.g. a visual impairment

113. There is no simple formula or % that can be applied –instead use licencedmaterials, or ask for permission

115. Licensing schemes (such as Creative Commons) that both authors (owners) and users can access for free

116. If both sides observe the rules then both parties are instantly protected

117. Owners licence others to use their content

118. Users obey the terms of the licence

119. Creative Commons provides different licences that can be combined together

121. Introduction to open licensing and creative commons Open Educational Resources

122. http://creativecommons.org/

123. 

124. Creative Commons: creativecommons.org/about/licenses/

125. Other open licensing models? Open Government license e.g. from the Department of Health website: http://www.dh.gov.uk/en/Copyright/DH_4067693

126. http://www.nationalarchives.gov.uk/information-management/uk-gov-licensing-framework.htm

127. Demonstration of finding openly licensed resources online Open Educational Resources

129. www.jorum.ac.uk

130. MedEdPORTAL Live demo http://www.mededportal.org/

132. www.nottingham.ac.uk/xpert/

133. www.google.co.uk/

134. http://creativecommons.org/

135. Medical images ?

136. Remember to check the terms and conditions http://www.photolibrary.nhs.uk/TermsAndConditions.php

137. Open Educational Resources Recordings of people (especially patients and their families, healthcare workers, actors, students, etc.) in learning materials

139. Recognises the need for more sophisticated management of consent for recordings of people (stills, videos, audios, etc.)

140. Teachers (academics, clinicians, practice/work based learning tutors, etc.)

141. Students and ‘product placement’ (branded items)

142. Role players/actors/performers/hired help (including recording crew)

143. Patients/patient families/care workers/support staff/members of public in healthcare settings (sensitive personal data)

145. Consent for use in teaching Patient or non-patient participation in the development of teaching materials is not ‘in their best interests’ If it can be copied digitally then you have to assume that it is ‘open’ There is no such thing as ‘anonymising’ patient or other information

147. "1 Personal data shall be processed fairly and lawfully and, in particular, shall not be processed unless -

148. (a) at least one of the conditions in Schedule 2 is met, and

150. "Conditions relevant for purposes of the first principle: processing of any personal data

151. 1 The data subject has given his consent to the processing.

153. GMC guidance Making and using visual and audio recordings of patients 2001 Referred to clinical care and research, did not refer to teaching Making and using visual and audio recordings of patients 2011 Does refer to teaching

156. make recordings only where you have appropriate consent or other valid authority for doing so

157. ensure that patients are under no pressure to give their consent for the recording to be made

158. where practicable, stop the recording if the patient asks you to, or if it is having an adverse effect on the consultation or treatment

159. anonymiseor code recordings before using or disclosing them for a secondary purpose, if this is practicable and will serve the purpose

160. disclose or use recordings from which patients may be identifiable only with consent or other valid authority for doing so

161. make appropriate secure arrangements for storing recordings

164. Images of internal organs or structures

165. Images of pathology slides

166. Laparoscopic and endoscopic images

167. Recordings of organ functions

168. Ultrasound images

170. Children and vulnerable adults may or may not be in healthcare treatment but should always be considered under the 'sensitive' part of the Data Protection Act 1998.

171. The NHS guidelines recommend at least three or possibly four (Scotland) levels of consent, ranging from none to 'publication' NHS level III consent.

172. "Many NHS Trusts have patient consent forms which specifically designate 'level III consent' (public access including the internet). If this applies, then Open Access in the sense of sharing materials publicly clearly would fall within this permission.

173. Level I consent is for use within the patient record only.

174. Level II consent is for teaching and learning but with restricted access only.

177. Have a policy/disclaimer

178. Clearly publish your policy and keep it up to date

179. Train your staff in the use of the policy

180. Follow your policy (do what you say you will do)

181. You may also want a disclaimer ‘this resource has been provided… use it at your own risk. If you have any concerns about any material appearing in this resource please contact…’

182. Actively manage your risks

185. Consent everything-even where ownership and patient/non-patient rights appear clear, and store consent in NHS record (patients) or with resource

186. Review institutional policies against good practice

187. Include disclaimers in resources

188. UK HE enters a dialogue with publishers to increase the potential for re-using upstream copyrights

189. Seek to replace, over time, any questionable material

191. e-Learning resource ‘’elements’’ and source Wipe board activity Clinician? NHS/HE contract? In-house filming/ external contractor? Contract? Original content? Permission to film from Trust, etc.? Staff, students, public, relatives, etc.? Role-player, patient?

192. www.medev.ac.uk MEDEV good practice toolkit learning resource metadata collection content comparison against good practice guidance on copyright/IPR, consent and quality assurance sign-off/auditing learning resource ‘put in many places’ syndication through APIs

193. MEDEV good practice risk assessment toolkit www.medev.ac.uk/ourwork/oer/toolkits/

194. www.medev.ac.uk/ourwork/oer

204. Using attribution tools to acknowledge creators Open Educational Resources

205. ‘’Good’’ attribution? Author? Original source? URL? + licence

206. ‘’Good’’ attribution?

207. Attribution facilitation tools http://openattribute.com/

208. Drop down gives HTML or plain text options to copy into your resource

210. SHARING RESOURCES BETWEEN ACADEMIA AND HE

211. Discussion Technical and cultural barriers Repositories Getting content in and out PORSCHE ‘open collection’ How it could be used? Cross-search feature? What do end users like? Authentication issues Deposit process? Automated content ‘pushing’ into LMS (using ‘API’/’feeds’)

212. Post-session evaluation Please complete this online evaluation (5 mins, 10 questions) http://www.surveymonkey.com/s/PORSCHE

213. www.elearningrepository.nhs.uk/ richard.osborn@londondeanery.ac.uk kate.lomax@londondeanery.ac.uk twitter.com/nhselearning www.medev.ac.uk/oer/ suzanne@medev.ac.uk lindsay@medev.ac.uk twitter.com/hea_medev

214. Links in response to questions Creative Commons licence embedding during content creation https://creativecommons.org/about/downloads Creative Commons licence embedding in Adobe media http://bit.ly/paJR33 JISC OER starter pack and model templates http://www.web2rights.com/OERIPRSupport/starter.html JSIC OER IPR Support Licence Compatability Wizards http://www.web2rights.com/OERIPRSupport/creativecommons/

216. http://www.elearning.nhs.uk/

217. http://www.medev.ac.uk/ourwork/oer/toolkit/

218. http://www.nottingham.ac.uk/xpert/attribution/

219. http://ocw.mit.edu/index.htm

220. http://oerwiki.iiep-unesco.org/index.php?title=UNESCO_OER_Toolkit

221. http://www.creativecommons.org

222. http://wylio.com/

224. The JISC OER pages: www.jisc.ac.uk/oer

225. The OER InfoKit from JISC InfoNet: openeducationalresources.pbworks.com

226. The OER Synthesis and Evaluation Report: www.caledonianacademy.net/spaces/oer/

229. [PHORUS – HSaP]

230. Phase 1 OER project

231. 250K - Apr 2009-Mar 2010

232. Investigated institutional practice, developed toolkits, disseminated widely

233. 15 UK partners

234. www.medev.ac.uk/oer/

235. PORSCHE & ACTOR

236. [SWAPBox – SWAP]

237. Phase 2 OER projects

238. £125K & £20K respectively

239. Linking NHS and academic networks

241. APPENDIX PORSCHE OER Workshop

242. Understanding risk, using risk assessment toolkits and 'digital professionalism' Open Educational Resources

243. Policies, disclaimers and risk In order to safeguard yourself against litigation for copyright or data protection (consent) violation Have a policy/disclaimer Clearly publish your policy and keep it up to date Train your staff in the use of the policy Follow your policy (do what you say you will do) You may also want a disclaimer ‘this resource has been provided… use it at your own risk. If you have any concerns about any material appearing in this resource…’ Actively manage your risks Take out liability insurance

245. Consent everything-even where ownership and patient/non-patient rights appear clear, and store consent with resource

246. Review institutional policies against good practice

247. Include disclaimers in resources

248. UK HE enters a dialogue with publishers to increase the potential for re-using upstream copyrights

250. www.web2rights.com/OERIPRSupport/risk-management-calculator/

251. www.web2rights.com/OERIPRSupport/diagnostics.html/

252. http://medicalimages.pbworks.com/

253. Principles 1. Acknowledge that patients’ interests and rights are paramount. 2. Respect the rights to privacy and dignity of other people who are included in recordings, such as family members and health care workers. 3. Respect the rights of those who own the recordings and the intellectual property of those recordings, and check and comply with the licences for use. 4. Take professional responsibility for your making and use of recordings and alert colleagues to their legal and ethical responsibilities where appropriate. Email: d.hiom@bris.ac.uk

255. “learners' information literacies are relatively weak but learners have little awareness of the problem” Beetham et al 2009

257. Blurring of personal and professional identities online

258. Increasing need to manage issues of disclosure

259. Changing public expectations

260. Misunderstandings of digital spaces

261. Consequence

262. Permanence

264. Professionalism in Tomorrow’s Doctors:www.gmc-uk.org/education/undergraduate/professional_behaviour.asp

265. No reference to professionalism online: implicit? explicit in your curriculum? Hidden?

267. “most learners are still strongly led by tutors and course practices: tutor skills and confidence with technology are therefore critical to learners' development” Beetham et al, 2009

269. www.medev.ac.uk/oer/ lindsay@medev.ac.uk megan@medev.ac.uk suzanne@medev.ac.uk www.medev.ac.uk/blog/oer-phase-2-blog/

272. Chretien, K. C., S. R. Greysen, et al. (2009). "Online Posting of Unprofessional Content by Medical Students." JAMA 302(12): pp1309-1315.

273. Ellaway, R. (2010). "eMedical Teacher # 38: Digital Professionalism." Medical Teacher 32(8): pp705–707.

274. Farnan, J. M., J. A. M. Paro, et al. (2009). "The Relationship Status of Digital Media and Professionalism: It’s Complicated " Academic Medicine 84(11): pp1479-1481.

275. Ferdig, R. E., K. Dawson, et al. (2008). "Medical students’ and residents’ use of online social networking tools: Implications for teaching professionalism in medical education." First Monday 13(9). Online at http://www.uic.edu/htbin/cgiwrap/bin/ojs/index.php/fm/article/viewArticle/2161/2026

276. Thompson, L. A., K. Dawson, et al. (2008). "The Intersection of Online Social Networking with Medical Professionalism." J Gen Intern Med 23(7): p954-957.

278. [PHORUS – HSaP]

279. Phase 1 OER project

280. 250K - Apr 2009-Mar 2010

281. Investigated institutional practice, developed toolkits, disseminated widely

282. 15 UK partners

283. www.medev.ac.uk/oer/

284. PORSCHE & ACTOR

285. [SWAPBox – SWAP]

286. Phase 2 OER projects

287. £125K & £20K respectively

288. Linking NHS and academic networks