The power of a networked approach towards building a curriculum that is appropriate for the South African context
Dr Michael Held is the Director of the Orthopaedic Research Unit in the Faculty of Health Sciences at UCT and a founding member of the Learning Innovation through Orthopaedic Networks (LION) initiative. He currently teaches orthopaedics to undergraduate students and postgraduate trainees and runs a fellowship for knee surgery, accredited by the South African Orthopaedic Association.
Through the work of the LION initiative, he aims to provide an interactive educational platform for medical students and primary care providers in Southern Africa.
Michael is passionate about student-centred collaborative learning, and believes in the power of a networked approach towards building a curriculum that is appropriate for the South African context. In February 2019, Michael received a grant from the DOT4D project to support the development of the Orthopaedics for Primary Health Care open textbook.
What is the problem he is trying to address through open textbook development?
One of the main educational challenges for medical students is the limited contact time they have to acquire skills and knowledge in orthopaedic surgery. As such, the brief exposure students get to orthopaedic surgery in their undergraduate studies is inadequate in terms of the preparation they require for clinical work. This problem is amplified by the fact that internships and community service work in South Africa have a large orthopaedic component, with a high percentage of trauma patients suffering orthopaedic injuries.
Current orthopaedic learning resources are mainly based on guidelines and textbooks from the Global North. There is therefore a severe lack of African learning materials which are tailored to local pathology and circumstances, and written by local experts.
The Orthopaedics for Primary Health Care textbook aims to provide accessible learning material that is practical and relevant to undergraduate medical students in Southern Africa and can be used as a continuous learning or reference resource by primary care physicians.
What is his authorship approach?
Michael adopted a multi-authorship approach to content development, involving students, academics and practitioners, with himself in the role of author and editor.
The process of scoping and developing content for the Orthopaedics for Primary Health Care textbook was intrinsically linked to the curriculum transformation process for the undergraduate orthopaedics course. In line with this approach, a Delphi consensus study was run with a target group of medical students and primary care physicians in order to establish which cases, knowledge and skills were deemed most important to include in the curriculum.
Once these topics and areas of interest were identified, local authors were approached to establish collaborative authorship relationships with students to avoid expert blind spots. The layout of the chapters was designed by former students who have since entered careers in Medical Education. Their focus was a clear, intuitive and visual design.
The review process involved a number of academic orthopaedic surgeons as well as medical students. Still in the final stages of refinement, the textbook can be accessed via links to chapters on the UCT Orthopaedic Department website. Content is currently hosted on the UCT learning management system, Vula, in order to ensure that South African medical students can benefit from the zero rating of this site and access afforded through the data packages offered by their universities. The website/LMS publishing approach was adopted because it allows for constant and easy updating of content as well as the addition of new chapters.
The file sizes of downloadable chapters are kept as small as possible as an additional measure to extend access. Links to the chapters have been shared with other South African orthopaedic departments and the AO Foundation, a large international orthopaedic alliance with special educational focus in Southern Africa.