(Disclaimer: This entry is rather in-depth. For an abbreviated version, jump down to “The Prototype” section, which begins near the middle of the post.)
Mobile seemed to be a buzzword of 2011 (as well as 2007-2010 actually) and it will likely stay that way in 2012. Mobile continues to attract attention (including within U-M), particularly in discussions of social issues like education, health, and economic development. The eTransform Africa report, released in December 2011 by the World Bank Group, the African Development Bank, and the African Union includes mobile among the affordable technologies that have potential to transform education. Why? What’s unique about mobile is the combination of these characteristics:
- Affordability of hardware compared to other computing devices such as netbooks, desktops, and laptops
- Affordability of service, with many providers offering pay-as-you-go service via SIM cards instead of through flat-rate monthly contracts (long-term mobile contracts are much more prevalent in the U.S. than in other countries)
- Portability due to their small size and light weight
- Power efficiency and ability to operate for hours without charging
- Scalability of infrastructure, as it takes much less labor and capital to set up a mobile broadband network to for a given area than to cover the same physical area using fixed (wired) broadband
These characteristics led development economist Jeffrey Sachs to label mobile phones as “the single most transformative tool for development.” The World Bank has even conducted econometric studies suggesting a correlation between number and growth rate of mobile subscribers in a country and its gross domestic product.
Just how prevalent are mobile phones around the world? Today there are over 5 billion mobile connections and over 80% of the world’s population is within mobile coverage. According to the International Telecommunications Union, 45.2% of the population in Africa has mobile phone subscriptions and 2.5% subscribes to mobile broadband, compared to only 1.5% who own landline phones. With over 600 million mobile phone users, there are more mobile users in Africa than in the U.S. or in Europe.
Numerous projects have tried to harness mobile technologies for health or education. The eTransform Africa education sector study notes that in the education realm, “Significant uses include educational quizzes, multimedia content to solve puzzles (for example, for mathematics), interactive literacy programmes, simple question-and-answer activities, text- and/or audio-based short lessons, alerts by schools/teachers to students or parents, and provision of support to teachers and learners. They can also play an important role in informal education, for example to provide health education information.” There’s a rapidly growing collection of using mobile health applications, some which focus on content delivery, sensors or other diagnostic plug-ins, or enhanced communication between healthcare professionals and patients. (See the mSummit annual conference or MobileActive for some current hot topics and MobileMonday for mobile design community chapters worldwide.)
Within the content delivery category, some notable applications for general and health education mentioned in the eTransform Africa education sector study and the 2011 mHealth Education report from the iheed Institute include:
- BridgeIT – designed for primary school teachers in Tanzania download short educational videos in math, science, and life skills over the 2.5/3G mobile network and then connect to a computer screen to share with the class
- Relief Central – free web-based application from Unbound Medicine that provides information to public domain (yay, open content!) health information from the U.S. Central Intelligence Agency (CIA), the Field Operations Guide from USAID, the CDC Health Information for International Travel, as well as licensed (copyright-restricted) content from MEDLINE journals, Red Cross, and others; designed for iPhone, BlackBerry, Android, and Windows Phone devices
- TulaSalud – in this project in Guatemala by Ministry of Health and the Cobán School of Nursing, mobile phones are combined with traditional teleconference services (with the facilitator using Premiere Global as a conference call provider and speakerphones from Phoenix Duet Executive collection – both tools that we use here at Enabling Technologies for teleconferences) to do real-time audio-based training sessions; they also use a SMS-based system to aggregate patient data (e.g. about high risk pregnancies) into a central database
- GUIDE – an online-offline hybrid reference service by AED – SATELLIFE in South Africa that contains medical guidelines, protocols, diagnostic tools, drug formularies, and other publicly available health information services
- eMocha – an Android-based application by Johns Hopkins University that is being used in the U.S., Uganda, and Afghanistan that uses a local area network model to collect and analyze patient data as well as to deliver training materials in the form of videos (MP4) and quizzes
- Virtual Nursing School – project by African Medical and Research Foundation that uses telephone tutorials and Java-based delivery of eLearning materials for nurses in Kenya and Uganda
What does all this mobile stuff have to do with Open.Michigan? In December, I mentioned that one of the aims of Open Educational Resources (OER) is to make materials widely available. You may have noticed that the distribution flow diagram for the African Health OER Network that I referenced in my blog post included mobile. Why? With our partner institutions in Ghana, for example, though a slight majority of medical students and residents are believed to have personal laptops and though there are some student computer labs on campus, the penetration of smartphones and other mobile phones are far greater. For this reason, participants in our health OER tech group have long been talking about taking some of the HTML-based openly licensed learning modules that were designed for access on desktops/laptops and experimenting with delivering that same content on a mobile device.
In September-November 2011, some colleagues of mine at U-M and University of Ghana and I completed a small mobile pilot for OER. Our main objectives were to:
- Gather information about types of mobile phones that students, staff, and lecturers use as well as any mobile development activities on campus at KNUST and University of Ghana
- Create a basic mobile prototype by converting content from an existing HTML-based module to meet the following requirements:
- Content includes text, images, audio, video, and quizzes
- The module must work across a variety of mobile devices and operating systems
- Content should be stored locally on the mobile device (i.e. not web-based)
- Solicit feedback from students and lecturers about the mobile prototype
Very soon after we started our work, we realized that 2b and 2c were significant constraints in terms of how we could structure the mobile prototype. Since we wanted it to work across a number of devices and to be available offline, we were left with the common denominator of packaging as HTML pages instead of doing official platform-specific apps (like iPhone, Android, Blackberry, or Symbian).
One significant barrier was that mobile devices vary quite a bit in terms of functionality. Some are simple bar phones that serve primarily for voice communications and do not have many other features beyond making and receiving calls. At other end of the spectrum, there are advanced phones (“SmartPhones”) with operating systems, full keyboards, and application stores or APIs. There’s a range of phones that read text, images, video, and audio. To further complicate matters, the types of mobiles phones that are sold and used in the U.S. differ greatly from Ghana.
While I was in Ghana in October-November last year, I had the opportunity to do a medical OER focus group with 6 students at University of Ghana and 5 residents at KNUST. As part the focus group, I was able to gather some feedback about the current use of and interest in mobile devices for learning. Both groups commented that audio is most convenient for mobile phone, then text, and videos third. Videos are better to watch on laptops or desktop computers. Some students already use handheld devices (mobile phones, iPod or MP3 players) to study by listening to audio recordings – including some from their own classes taken with the instructor’s permission – or by watching videos (such as from New England Journal of Medicine).
So, after all these investigation, design, development, and testing cycles (nitty gritty details covered in our design and technical notes), what did we come up with? It is still a prototype, but you can download the zip for offline access (the intended use) or view it online. The prototype is based on an obstetrics and gynecology OER created by University of Ghana. To date, we have tested it on the Nokia C3-00 Series 40, Samsung i900 Omnia with Windows Mobile, Samsung Galaxy XS with Android, and Blackberry (two models, both undocumented).
We found that our prototype worked pretty well across these four platforms, though we still have some lingering questions related to how to structure our learning module, including:
- Currently the video is accessed through a link in HTML, which opens the video in a native video app instead of the browser. This is useful for video controls and enables us to achieve full screen, but also means an additional copy of video is created each time it is accessed from the HTML.
- It is difficult to watch videos beyond 4 minutes on such a small screen.
- Some mobile devices have a file size limit for Bluetooth transfers – one test with a Blackberry had a 25 MB limit, and most videos exceed that limit.
- The small screen size doesn’t easily lend itself to multiple-choice questions with feedback.
- Though not in the prototype featured above, we discovered that it was feasible to view surgical videos with labels on the small screen size (see example video, adapted from a Caesarean section module CC BY NC Cary Engleberg and Richard Adanu), though ideally the content authors would have mobile design in mind from the start and create more close-up videos with larger labels.
This prototype is only the beginning of Open.Michigan’s experimentation with mobile delivery. We anticipate doing much more with mobile for OER over the next couple years. For example, we are already in progress of creating a mobile-friendly version of our Open.Michigan website. Other near-time plans envisioned included extending the prototype into a complete module and to pilot test it with a whole class at one of our partner institutions in Africa.
We are still fairly new to mobile delivery at Open.Michigan – especially for offline distribution – so any guidance from more experienced mobile designers/developers would be welcomed. We’re specifically interested in recommendations for how to display videos (is it actually better to display videos within the browser instead of the native video players?) as well as market information about SmartPhone penetration among health workers and university employees/students in African countries, including models and features.