Interning with Open.Michigan at MSIS

Marissa Rivas-Taylor is a second-year MSI student at the University of Michigan’s School of Information. She began interning at Open.Michigan in January 2015 because of her interest in OER and publishing. Her personal research surrounds diversity within education and the social benefits of educating women, first-generation students, and multicultural students in America and in the Global South. 

A brighter world will surface once education is available to all who seek it. My undergraduate education embedded itself into this ideology, from our class discussions to influential conference speakers to global service projects. However, the how was often left to one’s own imagination, passions and determination. As I deciphered my next steps for after graduation, others around me joined organizations to move to North Korea, India, Cambodia and many other places to teach English, Music and other skills for a few years. Others joined organizations that advocate female rights to education, such as Girl Rising. As a Gates Millennium Scholar and a first-generation college graduate, I started working on various writing projects that advised first-generation students on getting into college. But getting published seemed like a daunting task, full of rejection letters and uninterested editors. Young and disoriented, I decided to go to graduate school to delay my venture into the professional world.

(2011_Education_for_All_Global_Monitoring_Report)_-Government_primary_school_in_Amman,_Jordan_-_Young_girls_readingThe University of Michigan’s School of Information Master of Information Science program interested me during my final year of college, mostly due to its reputation of producing highly trained professionals for varying successful jobs as well as its emphasis on practical and engaging internships. By my second month into the program, the power of education ideology introduced itself to me once again, but in the form of Open Access. The University of Michigan’s libraries partnered with the School of Information to host a week-long conference about open access and the effort to make globally available educational materials. By the end of the week, the concept of open access intrigued me, and I sought for ways to get involved.

Within a few months, Open.Michigan, who supported the Open Access Week, opened a few positions within their publishing office and soon I joined the Open.Michigan team. My position as an OER operations assistant is also my MSI internship for my Master’s Degree, which opened up a mentoring relationship with the Open.Michigan OER Publisher and UMSI alumnus Dave Malicke.

I remember during my interview with Dave struggling with two thoughts: Will I be able to do everything this role requires? & I REALLY want this job! I finally found a position where my personal interests, liberal arts educational background, and helping the global education mission all aligned beautifully.

By working with Open.Michigan, my knowledge in the areas of publishing platforms, digital formats, medical education, copyright laws, social media promotion, website management, and accessibility needs exponentially increases every week. Some of my past projects include:

  1. Creating iBook and EPUB versions of Open.Michigan books
  2. Working with Michigan Publishing to create effective tweets for their open access materials to be published with the Open Michigan Twitter
  3. Privacy rights & copyright clearance with the photo materials of the An Atlas of Orthopaedic Pathology
  4. Learning about the Creative Commons & Apache open licenses, and helping with different consultations appointments, copyright clearance for educational materials, and a permission form.
  5. Formatting and publishing these courses on the Open.Michigan website:
  6. Researching different publishing formats (.epub, .mobi, .iba, .azw3, .mobi, etc.) in an effort to expand the potential of Open.Michigan OERs through eBook reader devices.
  7. Researching different Subtitle/Caption processes & softwares and helping to subtitle all of video OER materials.
  8. General copy-editing support for our upcoming books as well as some biographical writing on our authors.

As I enter my final year at UMSI, I will continue my internship with Open.Michigan. I will graduate next May 2016 as a strong and confident woman, knowledgeable about various ways to promote global education as well as be equipped by UMSI and my Open.Michigan internship with the skills to effectively help this mission. Sometimes, I dream about bringing the Open.Michigan model to my undergraduate college as well as other educational institutions.

To sum up my internship experience with Open.Michigan in one idea: Colleges and Universities with the desire to promote global education and open access materials should adopt an Open.Michigan-like model to support their faculty, staff and students in publishing their educational resources for free of use.

Photo by Tanya Habjouqa (UNESCO) [CC BY-SA 3.0-igo (], via Wikimedia Commons.

2014: A Year in Review

Open.Michigan covered the launch of a new open access journal, and expanded services for publishing open and print-on-demand textbooks and books. It was a good year for MOOCs as well with three Coursera courses offered by U-M faculty that increased their use of Creative Commons licensing for their materials. Our staff traveled quite a bit too, giving presentations locally, nationally, and internationally. One of our most successful collaborations with the U-M Department of Family Medicine wrapped up a multi-year platform conversion and OER project. We celebrated our sixth anniversary, and there are other highlights from the Open.Michigan office, not to mention from around the University and the country!



Open Access Diabetes and Endocrinology Journal

Clinical Diabetes and Endocrinology cover imageThrough a unique publishing collaboration, the University of Michigan and BioMed Central have launched a new open access journal, Clinical Diabetes and Endocrinology, which is now seeking submissions and set to begin publishing in the first quarter of 2015. The journal is led by Editor-in-Chief Meng H. Tan, Professor of Internal Medicine in the Division of Metabolism, Endocrinology, and Diabetes at the University of Michigan. All articles published in this journal will be CC 4.0 or CC 1.0. Read more on the Open.Michigan blog and learn more about Open Access Journals from Wikipedia.


Open.Michigan Contributors Publish Open Access Article

Open.Michigan is pleased to share a win for Open Access, thanks to the Journal of Academic Medicine. Kathleen Ludewig Omollo and Airong Luo co-authored an article “Lessons Learned About Coordinating Academic Partnerships From an International Network for Health Education” for the journal’s November 2013 issue. According to the official copyright agreement the journal held a 12-month embargo on the article before it could be shared as Open Access. Omollo wrote to Journal of Academic Medicine to request their permission to add an earlier version to the University of Michigan institutional repository, Deep Blue. According to Omollo, “The journal gave us a happy surprise when they permitted the official version to be immediately available as free, public access.”


Statistics 250 Workbooks

Two new statistics open workbooks by Brenda Gunderson (@bkgundy) are available on the Open.Michigan website with a BY-NC-SA 3.0 license. Interested in a hard copy? They are also offered print-on-demand via Amazon: Interactive Lecture Notes and Lab Workbook.


Children and Teens with Cancer Tell Their Story

Chronicling Childhood Cancer book coverChronicling Childhood Cancer: A Collection of Personal Stories by Children & Teens with Cancer. Trisha Paul (Open.Michigan alum), kids and teens use their own words and drawings to share their cancer experiences. You can purchase the book on Amazon, and excerpts from the book are freely available on the Open.Michigan website. Proceeds will be split between Block Out Cancer, and the Child and Family Life Program at C.S. Mott Children’s Hospital. Follow Trisha on Twitter @trishakpaul2.



Three U-M MOOCs Shared with Creative Commons Licenses

Three U-M Massive Open Online Courses (MOOCs), “Instructional Methods in Health Professions Education,” “Teaching and Assessing Clinical Skills,” and “Programming for Everybody” have applied Creative Commons licenses to their downloadable course materials. Two of the course’s authors, Dr. Caren Stalburg and Dr. Chuck Severance, sat down with Open.Michigan to discuss their MOOCs and to share their motivations for publishing Open Educational Resources (OER).

Check out the discussions on the blog:



Sharing Med Ed Materials, Limited Internet & Electricity

Medical Schools in sub-Saharan Africa commonly struggle with limited availability, high subscription costs, and unpredictable transmission rates of Internet and electricity. Many institutions also lack sufficient staffing to maintain and support networking or other technology services on campus. These barriers make it difficult for students and instructors to access, create, and integrate digital learning materials into their education and research activities.

To address this, Open.Michigan has been exploring, evaluating, and deploying models for sharing digital learning materials at institutions with no or limited bandwidth, no or limited electricity, and limited on-site support for technology. We experimented with two models for a portable, easily customizable wireless area network that can broadcast digital learning materials to anyone in range, regardless of whether Internet and electricity is available. The two devices selected for wireless access points are TP-Link MR3020 and a Raspberry Pi model B. Both devices are small in size (approximately 7 cm x 7 cm x 3 cm), cost under US$50, and can be configured to create a wifi hotspot that broadcasts the contents of a connected USB storage device. From a web browser, people can browse and search the learning resources, as well as other advanced services such as tracking usage over time.

To date, 20 of these devices are currently deployed in Ethiopia, Kenya, and Liberia. For more information about this initiative, please refer to our poster and our wiki.


Celebrating Open Access Week + Why Attribution Matters

Why Attribution Matters presentation slideInternational Open Access Week (OA Week, 20-26 October 2014) was an opportunity for the academic community to promote broader access to the products of research and scholarship. This year’s theme was Generation Open, highlighting the generation of students, citizen scientists and early-career researchers who have grown up learning and publishing on the open Web. Read more about the events on our blog, and see the slides from the MLibrary & Open.Michigan sponsored talk: Why Attribution Matters.


Bob Riddle travels to Texas for Open Ed Jam

Raspberry PiMSIS Technologist and Open.Michigan collaborator Bob Riddle presented at Open Ed Jam on Low-cost technology for distribution of OER using Raspberry Pi. Good thing Bob is resourceful. He had to overcome several last-minute setbacks on his way to Open Ed Jam 2014 with a malfunctioning Raspberry Pi. Learn more about the Raspberry Pi project on SlideShare.



William and Flora Hewlett Foundation’s Grantees Meeting

Open.Michigan team member Trisha Paul was invited to present at the William and Flora Hewlett Foundation’s OER Grantees Meeting, 22-24 April 2014. The meeting theme was “OER Value Proposition and Evidence of Impact in 2014” and it was hosted by ISKME (Institute for the Study of Knowledge Management in Education). Paul served as a student representative on a panel discussion entitled “OER Users & Makers,” which was moderated by Vic Vuchic. Paul, who received her Honors English degree from the University of Michigan (U-M) in May and will attend U-M’s Medical School starting this fall, shared her experience working at Open.Michigan and described her experiences with OER as an undergraduate.

At U-M Paul co-founded a student organization called “STEM Society,” where undergrads develop science curriculum for high school students. She introduced the STEM Society undergrads to OER, and by incorporating it into their learning materials, they discovered how to make them more exciting for the high school students. With a passion for literature and science, Paul enjoys exploring the intersection of narrative and medicine, and has CC licensed her blog Because of the CC license, educators have reached out to her and were able to reuse her blog materials. Paul also designed and taught a class for freshman at U-M called “Grand Rounds,” which focused on literary narratives around medicine. Paul feels it’s especially important to share resources and experiences in this area, as this field does not have a lot of resources available.

The “OER Users & Makers” panel discussion can be viewed here, with Paul’s remarks starting at around 25:30.


OCWC Global Conference and Published Open Praxis Journal

Open.Michigan data analyst, Jaclyn Cohen, travelled to Ljubljana, Slovenia in April 2014 to present at the OCWC Global Conference. Cohen presented on Open.Michigan’s Dynamic Metrics project and how the Drupal framework that supports the Open.Michigan website can be used to publicly share OER course and resources usage metrics, including total views, downloads, and the top nations visiting a course. The OCWC Global Conference organizers also collaborated with Open Praxis (a peer-reviewed open access scholarly journal focusing on research and innovation in open, distance and flexible education) to publish selected papers from the conference. Cohen’s paper outlining the Dynamic Metrics project, co-authored with fellow Open.Michigan team members Kathleen Omollo and Dave Malicke, was selected and published in this special issue of the journal: Open Praxis, volume 6 issue 2. Slides from the presentation can be viewed at:



A Collaborative OER Success Story

15 authors. 38 modules. 5 languages. 1,400  pages. 111,888+ YouTube views.

The Department of Family Medicine Education Module Transition is complete! What started as an assignment to find a new platform to host the Department of Family Medicine Education Modules, has evolved into a truly unique partnership between an academic unit, Open.Michigan, and a clinical unit, the Department of Family Medicine (DFM). Both are part of the University of Michigan Medical School. Learn more on our blog.


Spotlight on Our Collections

Risk Bites!

Risk Bites feeds your hunger for the science of risk with bite-sized videos. Learn about dioxane in drinking water, nanoparticles, and even alien blood! Have you ever wondered how safe electronic cigarettes are? Or whether HPV vaccines are a smart idea? Check out the Risk Bites YouTube Channel for answers to these interesting questions and more!


Open Health Collections

Our Open Health Collections  contain representative samples of available open health educational resources. Topics include textbooks, courses, audio and video, journals, images (including anatomic plates, illustrations, photos, and diagrams), datasets, and software. Find other health sciences tools on Twitter using the hashtag #openhealthcollections.


Highlights from the Open.Michigan Office

Happy Anniversary to Us!6th Anniversary Cake

We celebrated our sixth anniversary at the University of Michigan on April 29! It has been our pleasure supporting faculty, students, and staff in sharing their open educational materials. A big thank you to all of our collaborators!


International Program Manager Makes a Move

Kathleen Ludewig OmolloKathleen Ludewig Omollo is now the Strategy Officer with the U-M Department of Learning Health Sciences. During her time as Open.Michigan staff, Kathleen led a range of projects, most notably growing and supporting international partnerships in Sub-Saharan Africa, refining dScribe training, coordinating crowdsourcing translation activities, and developing offline approaches to sharing OER. Learn more about her contributions on our Alumni page.


Notable at the University of Michigan

Digital Education & Innovation Website

U-M Digital Education and Innovation websiteU-M Digital Education & Innovation launched a new site! Digital Education (DEI) enables engaged, personalized, lifelong learning for the Michigan community.DEI redefines elite public education with the creative use of technology and more!Check out DEI on Twitter @umichDEI, and using the hashtag #umdigitaled. Also see for the latest U-M MOOC offerings.


UMHS Applies CC License to Image Bank

The University of Michigan Health System (UMHS) has a newly-redesigned media bank site! Thanks for sharing this valuable collection with a Creative Commons (CC) BY-NC license.


Global REACH Report

Global REACH Activities Report (FY2013-14): Research, Education & Collaboration for Health (REACH) connects 100s of global health faculty working across 29 departments. Open.Michigan staff and contributions, including the collaboration with St. Paul Hospital Millennium Medical College (@SPHMMCAddis) and an openly licensed book entitled “Building Academic Partnerships to Reduce Maternal Morbidity & Mortality “ are featured on pages 28, 33, & 80.


Other News & Events

President Obama Highlights Open Education

“An educated population is a global asset.”

On 24 September 2014 at the United Nations, President Barack Obama marked the Open Government Partnership’s (OGP) third anniversary by announcing that in addition to the commitments outlined in the current U.S. OGP National Action Plan, “The United States will take additional steps to make our government more open, transparent, and accessible for all Americans.” Read more on the Creative Commons blog. For more information, see the White House Office of Science and Technology Policy blog post, “Promoting Open Education to Help Teachers and Students Around the World.”


Nature Communications Is Fully Open Access

Nature Communications became the first Nature-branded open access only journal. The number one open access journal in multidisciplinary sciences, Nature Communications is Nature Publishing Group’s flagship open access title. The journal ranks as the number three multidisciplinary journal in the world.


Wikimedia Commons Turned 10

Wikimedia Commons recently turned ten years old! Sharing on Wikimedia Commons helps to improve Wikipedia articles, and maximizes educational use of images. Watch this video to learn how to upload images to Wikimedia Commons.


New CEO for Creative Commons

The Creative Commons has named Ryan Merkley as their new Chief Executive Officer. According to Merkley, “A public commons, enabled by the open web, is the most powerful force to foster creativity, inspire innovation, and enhance human knowledge around the world. Those who believe in its potential need to join together in a global movement to ensure its success.”


OpenCourseWare Consortium Gets a Facelift

In May 2014 at their annual conference in Ljubljana, Slovenia, the OpenCourseWare Consortium announced its new name: the Open Education Consortium. According to the consortium “The new name embraces trends in higher education globally towards open sharing and scaling access to education through technology, tools and open content.”


Access to OER Expands in the Middle East and North Africa

US State Department announced it is expanding access to Open Educational Resources in the Middle East and North Africa and is sponsoring a special exchange program on OER for education leaders in the Middle East and North Africa. These OER will include course syllabi and materials, modules, textbooks, streaming videos, tests, and software.


Open Policy Network Launched by Creative Commons

The Creative Commons has announced the launch of the Open Policy Network, a coalition of organizations and individuals working to support the creation, adoption, and implementation of policies that require that publicly funded resources are openly licensed resources.

As textbook costs continue to rise, this CNN story describes how some colleges are offering free open source textbooks as course material.

The goal of the Open Textbook Project is to provide flexible and affordable access to higher education resources in British Columbia, Canada by making openly-licensed textbooks available. The Open Textbook is supported by BC Ministry of Advanced Education.

U.S. Copyright Office Releases Copyright Compendium

Monkey SelfieThis release is the first major revision in more than 20 years, and documents best practices for what is, and is not, copyright protected.

Highlight: Who Owns A Monkey’s Selfie? The U.S. Copyright Office says a monkey’s photo, that is, a photo taken by the monkey itself, cannot be copyrighted because it was not taken by a human being.


Open.Michigan and the Department of Family Medicine Education Modules, a unique OER Success Story

This is the final blog post in a three-part series about the partnership with our collaborators in the University of Michigan Department of Family Medicine and their Education Modules: Open.Michigan and the Department of Family Medicine team up to publish Open Education Modules! and Open.Michigan and Family Medicine: Update on a Thriving Partnership.

 15 authors.
38 modules.
5 languages.
1,400 pages.
111,888+ YouTube Views.


The Department of Family Medicine Education Module Transition is complete! What started as an assignment to find a new platform to host the Department of Family Medicine Education Modules, has evolved into a truly unique partnership between an academic unit, Open.Michigan, and a clinical unit, the Department of Family Medicine (DFM). Both are part of the University of Michigan Medical School.

Through this collaboration, the Department of Family Medicine successfully migrated their content from a closed (soon to be unsupported) platform to public-facing Google Sites.

Project Details

Fifteen authors had a hand in sharing their materials as open educational resources (OER). Facilitated by Open.Michigan, each faculty member chose the type of license that best suited their desired effect of how the materials were to be used. Learn how you can share your materials, too.

The project was completed ahead of schedule.  There are more than 1,400 pages of content, and the platform conversion was completed ahead of schedule. This was due in large part to the proven successful process, documentation, training, and marketing promotion procedures that Open.Michigan had in place. The most time consuming part of the undertaking came from educating the authors about the licenses and helping them select the license that met their needs.

The Modules are still being used for their original purposes (DFM Residency Program training).

This is the first series of materials in the Open.Michigan collection to have translations of both video captions and textual content. The Family Medicine videos have captions in (three languages) along side other Open.Michigan videos with multilingual captions on the Open.Michigan YouTube channel. Additionally, the Integrative Medicine Asthma module has the distinction of being the first complete module, including all the text on the Google Sites, to be translated by a volunteer and is now available in Romanian. The Japanese translation of the Musculoskeletal Knee Examination Module (膝の検査) and all the Musculoskeletal Examination video caption translations were made as part of the Shizuoka-University of Michigan Advanced Residency Training, Education and Research in Family Medicine (SMARTER FM) Project led by Michael D. Fetters, M.D., M.P.H., M.A., professor of family medicine, and supported by Shizuoka Prefecture and funded by the Community Healthcare Revival Fund.


Here are the highlights with a historical and present-day contrast:


  • Then: Closed, 32 separate modules, hosted on SiteMaker

  • Now: 38 openly-licensed, publicly available modules, united on one platform using Google Sites, as well as a presence on the Open.Michigan site


  • Then: Small audience, primarily DFM faculty and residents, occasional guests

  • Now: People from all over the world, including Japan and Africa


  • Then: Supplemental, self-guided learning for DFM residents, sometimes used as reference material by faculty members

  • Now: Remains supplemental, self-guided educational materials for DFM residents, but is more accessible as a reference to anyone, and the materials can be customized to suit individual needs



  • Then: 1 (English)

  • Now: 5 (American Sign Language, English, Japanese, Romanian, and Spanish)


To further the educational impact of the bilingual Sign With Your Baby illustrations developed by Michael D. Fetters, M.D., M.A., M.P.H., professor of family medicine, the images have been separately authorized under a CC BY-SA license and posted to both Wikimedia Commons and Wikipedia (on both sites, search for “baby sign” to find the bilingual collection or go to the “Baby Sign” article on Wikimedia Commons). The Romanian and Spanish translations were achieved through crowdsourcing efforts led by Open.Michigan and the U-M College of LS&AScreen Shot 2014-08-01 at 9.42.07 AM.png

This education modules project has been successful for many reasons: faculty champions and support from leadership in the Department of Family Medicine; a University of Michigan Medical School initiative that enables faculty, students, and others to share their educational resources and research with the global learning community; and dedicated staff members who take advantage of University Resources including the technology tools and branding.

View the entire U-M Department of Family Medicine collection on the Open.Michigan site →

Author’s note: Ms. Dascola was invited to give two presentations about this project. Her talk is available on SlideShare with a CC BY license. She also had a poster presentation accepted for the inaugural Michigan IT Symposium. The poster is available for download in PDF and PPT formats on the Open.Michigan site.

Photo attributions:
1. Image by Bill Branson is in the Public Domain.
2. Grey’s Anatomy Slide 348, Public Domain.
3. Image courtesy of the University of Michigan Health System Japanese Family Health Program, CC-BY-SA.
4. Image courtesy of the University of Michigan Health System Japanese Family Health ProgramCC-BY-SA.

2013 Was a Good Year

Last year proved to be a productive one for Open.Michigan. The first-ever, fully openly-licensed massive online open course (MOOC) from the Medical School and Coursera launched in August; our repository grew, including a significant addition from the University of Michigan Department of Family Medicine; a mention in the New England Journal of Medicine; three books and a manuscript were published; and a highly-successful crowdsourcing effort that resulted in a significant number of translated video captions on our YouTube channel.

Number of visits to the Open.Michigan website in 2013 shown by city.
This map shows the number of visits by city to the Open.Michigan site in 2013.

 Our success can also be measured in visits to our website:

  • 188,807 unique visitors (78% were new visits!)

  • 682,804 total views

  • November 13, 2013, was our busiest day on record with 1,296 visits.

  • People from 174 different nations visited Open.Michigan in 2013.

MOOCs have been gaining popularity in the last couple of years, and the University of Michigan has teamed up with Coursera to make freely available online courses. Read an interview with Dr. Caren Stalburg, author of the first-ever, fully-licensed course from the U-M Medical School, “MOOC Creator Reflects on Lessons Learned and OER.” The second iteration of the course, “Instructional Methods in Health Professions Education,” starts February 3.

Made available to the public earlier this year, the University of Michigan Department of Family Medicine has 20 high-quality education modules written by experts (with more to come) on a broad range of clinical topics. The modules support the use of, redistribution, and remixing of the materials, and are in accordance with U.S. Copyright Law so as to maximize the ability to use, share, and adapt it. Learn more about the partnership.

The New England Journal of Medicine article, “Creative Commons and the Openness of Open Access,” by Michael W. Carroll, J.D., specifically mentions our work and its importance:

“The various creators of the online educational materials in the University of Michigan Medical School’s Open.Michigan database have adopted nearly the full suite of Creative Commons licenses. The broad adoption of these licenses reflects a belief that a work is not ‘open’ until it’s freely accessible on the Internet and under a public license offering more liberal terms of use than copyright law provides. Though options offered by Creative Commons licenses address the needs of copyright owners in various contexts, in the open-access context, the Attribution license in my opinion remains the gold standard.”

We continued exploring unique publishing models with three new openly licensed books.
  • ICD Connection contains a collection of stories from patients and their families who are living with an implantable cardioverter defibrillator.

  • Shapes of Memory Loss  is a collection of poetry, fiction, and narrative written by and about people with cognitive impairment or dementia.  The authors, all affiliated with the University of Michigan Health System, come forward to share their personal experience as they “navigate this unknown territory”.

And a manuscript of conference proceedings.

Since we launched the crowdsourcing translation campaign in January 2013, more than 50 people have volunteered, with 139 non-English video captions that have been translated into 18 different languages:

  • 53 in Spanish

  • 28 in Portuguese

  • 22 in Japanese

  • 14 in French

  • 7 in Russian

  • 5 in Romanian

  • 3 in Gandan

  • 2 each in Swahili and Arabic

  • 1 each in Danish, Chinese (Simplified), and Chinese (Traditional).

  • That is amazing!

Read about the impact volunteer contributions have made in increasing access to and visibility of these videos around the world, “An Interview with Eve Nabulya: Luganda Translations For My Community” on our blog.

We are so proud of the work we do here, and are grateful for all your support. We look forward to working with you this year!

Open.Michigan & Family Medicine: Update on a Thriving Partnership

Open.Michigan and the University of Michigan Department of Family Medicine have been working together for over a year to publish a series of modules and videos on topics such as musculoskeletal exams, integrative medicine, and women’s health. Several subjects are still under development, including clinical procedures, gastroesophageal reflux disease (GERD), joint injection, pain management, osteoporosis prevention, among others.

An image from the Complete Musculoskeletal Exam of the Knee YouTube video.

The education initiative has since expanded to include translations for captions that are available in English, Japanese, and Spanish (with more to come) for such videos as the Complete Musculoskeletal Knee Exam. Click on the closed captions (CC) icon to select the language.

Additionally, Philip Zazove, M.D., the George A. Dean, M.D. Chair of Family Medicine, professor, recently spoke about the significant impact of these efforts to a wide audience that includes chairs of family medicine from around the country, residency program alumni, and donors about the impact the units have on high-quality physician training.

The collaboration has been extended to include presentations. The Department of Family Medicine has a pilot project to make available select Grand Rounds lectures via webcast. Since the goal is to eventually share these with the public, lead faculty member, Elizabeth A. Jones, M.D., lecturer, worked with experts from Open.Michigan to learn about the proper use of images. In turn, Dr. Jones presented to the Department of Family Medicine faculty about how to license their own work, find Creative Commons licensed images, and how to correctly attribute those images.

Future enterprises are also being discussed; check back to see the progress. This has most certainly been an exciting relationship, and one that has flourished.

Learn more:

  • Open.Michigan is part of the Office of Enabling Technologies, a unit within the University of Michigan Medical School Information Services organization, that encourages researchers, learners, and instructors to maximize the impact and reach of their scholarly work through open sharing.
  • The Department of Family Medicine is also part of the U-M Medical School, and is celebrating their 35th year of working to meet the needs of patients, and serving as a model for primary care education and research.

Unique Publishing Collaboration Results in Patient-Authored Book

ICD Connection: Living with an Implantable Cardioverter Defibrillator is a collection of stories that describe what it’s like to live with an ICD—a device that is implanted under the skin to treat life-threatening heart rhythms that can lead to sudden cardiac arrest. The ICD Connection book contains chapters written by ICD patients, family members, and caregivers, and provides perspectives from various ages and backgrounds.

Living with an ICD

The inspiration for this book came from the Young ICD Connection Conference, hosted by the Samuel and Jean Frankel Cardiovascular Center (CVC) in the University of Michigan Health System. Young ICD recipients and their families come from all around the US to gather in person at this annual event. At each of these annual conferences, ICD recipients share their personal stories during a panel discussion. Feedback from these sessions has been overwhelmingly positive. Through hearing the stories of other ICD recipients, attendees have found encouragement and hope and the realization that they are not alone in their concerns, worries, or fears.

An ICD (implantable cardioverter defibrillator) is a device that is implanted under the skin to treat life-threatening heart rhythms that can lead to sudden cardiac arrest.

Patients Supporting Each Other

Helen McFarland, RN, works in the Device Clinic at the CVC, where she and her colleagues provide care and support for patients with pacemakers and ICDs. McFarland thought, why not share these patient stories in a book? She explains, “There are numerous books and articles available from a medical standpoint about ICD implantation, but they don’t help the patients understand the impact the ICD will have on their lives.” It is common for ICD patients to feel depressed or have anxiety, they can feel alone and isolated. McFarland adds, “They need to find their ‘new normal.’”

McFarland wanted to present a diverse collection of stories from people of different cultures, backgrounds, ages, genders, and with a variety of diagnoses so the book would provide something everyone could identify with. After doing a bit of research, she confirmed that nothing like this existed already so McFarland decided to pursue her own publishing venture.

Tackling the Publishing Process

McFarland tried moving the project forward on her own for about two years, and finally realized she needed some help. Assistance came in the form of Jasna Markovac, Senior Advisor for Publishing in the Medical School. Markovac, who works in the Office of Enabling Technologies within Medical School Information Services (MSIS), provides consultation services to faculty, staff, and students on all aspects of the publishing process, including exploring new publication opportunities such as self-publishing. Markovac also has close ties with U-M Library and has held numerous positions in the publishing world.

Once McFarland and Markovac began their collaboration, the project came together quickly. Markovac introduced McFarland to Terri Geitgey, Manager for Library Print Services at Michigan Publishing, which is part of a larger array of publishing services offered by U-M Library. Michigan Publishing served as the official publisher of the book, which included assigning one of its ISBNs, managing the process of getting print copies made for local distribution, and making the work available for sale through print on demand. Geitgey recommended using CreateSpace, the self-publishing arm of Amazon. U-M Library has a U-M contract with CreateSpace, saving McFarland the trouble of setting up an account and figuring out the process on her own.

Markovac formatted the book, while Geitgey provided trouble-shooting guidance and helped navigate the CreateSpace process. When the final editing and formatting were complete, Geitgey set up the title with CreateSpace and released the book to Amazon.

A Successful Cross-Campus Collaboration

This unique publishing endeavor proved to be a great example of a successful cross-campus collaboration involving UMHS, the Medical School, and U-M Library, all contributing the best in knowledge and expertise from their areas. McFarland brought her clinical skills and experience with patients to the project, while Markovac provided publishing guidance. McFarland adds, “I felt like I was trying to move a mountain until I met Jasna. She knew how to make things happen.”

Geitgey commented, “This was such a rewarding project to be involved with; both for the touching and inspiring content and the collaborative aspect of the process. It was a great opportunity to work with the UM Health System and Medical School for the first time, and I’m happy that U-M Library was able to use its publishing services and expertise to help make the book a reality.”

A Mixed Model for Publishing

The project also demonstrated how open and traditional publishing could coincide as a mixed model. Markovac, who also works closely with Open.Michigan, a U-M initiative that encourages and supports the open sharing of educational resources and research, suggested using a Creative Commons license for the book. McFarland was glad to support the open sharing philosophy and explains, “I wanted my book to have the broadest impact and reach the largest audience possible, using the open license facilitates this.”

ICD book signing
Book authors autograph copies of ICD Connection at the Young ICD Connection Conference in September 2012.

Now Available on Amazon and Open.Michigan

Because it is openly licensed, the complete ICD Connection book, as well as individual chapters, may be downloaded by anyone from the Open.Michigan collection and freely shared with others. It is also available for purchase on Amazon, and an ebook version for the Kindle will be released soon. Since it was made available on Open.Michigan, the complete book was downloaded over 150 times; in addition, individual chapters have been downloaded over 70 times. Fifty copies of the book have been sold on Amazon.

Moving on to the next Project

The response to the book has been overwhelmingly positive, both from patients and from other healthcare professionals. McFarland now has two more projects in the works, providing the opportunity for further collaboration between Michigan Publishing, the Medical School, and UMHS. Her next books will focus on life for patients with ICDs from a men and women’s point of view. McFarland already has patients lined up who have agreed to share their stories.

Helping Patients See there is a Future

For McFarland, working on this book was her second job, and a labor of love. She concludes, “We can only host four support groups a year, and people don’t always want to be in a support group. ICD Connection is a great tool for patients, they can read in private and benefit from that form of support. They are scared, they don’t know what to expect, the book gives them context and puts things in perspective. They know they have a life they can look forward too.”

Mobile: A prototype spurred by the hype

(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.)

The Hype

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


The Prototype

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:

  1. 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
  2. Create a basic mobile prototype by converting content from an existing HTML-based module to meet the following requirements:
    1. Content includes text, images, audio, video, and quizzes
    2. The module must work across a variety of mobile devices and operating systems
    3. Content should be stored locally on the mobile device (i.e. not web-based)
  3. 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.

After some initial testing on a Nokia C3-00 Series 40 phone (a model which a colleague told us was common in Ghana), we realized that we couldn’t even assume that our target phones had touch screens nor that they could read Javascript or HTML5, which meant that we could not use slick development suites like jQuery mobile. We decided to focus on static HTML pages that would be transferred to and from phones via microSD card or Bluetooth.

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.