Open Educational Resources: The New Frontier

Introduction

Open educational resources (OERs) are “digitized materials offered freely and openly for educators, students, and self-learners to use and reuse for teaching, learning and research” (Organisation for Economic Co-operation and Development, 2007, p. 30). While there are many free educational resources available, especially on the Internet, most free resources are often associated with a licensing scheme (i.e., a copyright) that prevents modification or reuse. This is problematic since restricting modification and reuse of educational resources can hamper learning outcomes; altering and sharing educational resources is frequently a core aspect of critical learning (Yuan, MacNeill, & Kraan, 2008).

For example, an instructor may find a YouTube video that would be an ideal instructional tool but it requires some editing before use (e.g., fixing some errors, dubbing some inappropriate language, updating information). However, under the standard YouTube video license, the instructor cannot legally change or modify the video, nor can they redistribute it to other educators. The same is often true of textbooks, worksheets, or even course designs—once it is copyrighted, then it cannot be modified and redistributed to students.

Alternatively, OERs are licensed to allow everyone to reuse, modify, and redistribute the resource. Beyond being free, an OER allows for modification in order to best meet the needs of the learning opportunity. An openly licensed video (still possible on YouTube if an alternate license is selected) would allow anyone to modify and redistribute the video, enabling correction of errors or reaching audiences without access to the Internet. An OER textbook would not be just free but can also be passed from instructor to student and onward, with the legal right for anyone to make an improvement to the book.

OERs encompass a range of educational resources, including textbooks, readings, lessons plans, curricula, assignments, labs, simulations, homework, lectures, case studies, projects, tests, video, and animations. In the United States, the National Association of College Stores (Libertowski, 2017) claims that, for 2016-2017, the average student spends $579 on textbooks annually. Other research suggests that OER leads to the same or better student outcomes when compared with traditional, educational resources (Fischer, Hilton, Robinson, & Wiley, 2015; Robinson, Fischer, Wiley, & Hilton, 2014). Consequently, adopting OERs in order to remove the financial cost of course materials, while also potentially improving student learning (Hilton, Robinson, Wiley, & Ackerman, 2014).

Removing the financial cost of course materials is critical to providing better access to higher education. Between January 2006 and July of 2016, the Bureau of Labor and Statistics found that prices for college textbooks increased by 88% (Bureau of Labor Statistics, U.S. Department of Labor, 2016). The average cost of commercial textbooks in courses that commonly use OER are approximately $140.85 (Wiley, 2014). The burden of textbook cost is frequently a barrier for low and lower-middle income students who are often waiting for student loans and grants past the course start dates, resulting in students delaying or not purchasing books required for courses. This can ultimately result in less effective learning, taking fewer courses, and delay of graduation (Buczynski, 2007; Goodwin, 2011; Provasnik & Planty, 2008). Many financial aid packages do not cover course materials (e.g., Pell Grants) and students can be forced to go without access to course materials until they have access to loans. This places financially disadvantaged students, who are often at higher risk to dropout, at an educational disadvantage at the beginning of a course (Skinner & Howes, 2013). In community colleges, where tuition rates are already low, course materials can also represent a critical determinant as to whether a student can afford higher education (Okamoto, 2013). Students who need to save money on course materials may also elect to use an older edition of a textbook or share it among their peers, potentially hampering their learning if they do not have access to the materials when referenced in the course. This is especially important for courses that rely on textbooks having the latest content.

In health education and public health, not only do OERs offer free and modifiable resources, but use of OERs can address some of the specific challenges such as keeping up with health data, which regularly changes faster than the rate at which publishers can produce a new edition of a textbook. This precludes instructors from covering emergent topics or to find additional resources. Some recent examples of this include information on emerging infectious diseases such as, Ebola and Zika—vitally important subjects in health education but lacking coverage in most textbooks. Even the ranking of causes of mortality and life expectancy in the United States can change from year to year, especially among narrow subgroups. In 2017, unintentional injuries surpassed chronic lower respiratory diseases as the third leading cause of death (Kochanek, Murphy, Xu, & Arias, 2017). This shift also slightly lowered overall life expectancy, mainly due to emerging health threats, such as the opiate epidemic. Only a textbook that is published after each ranking is released could reflect these changes, and would still potentially be out-of-date within a year or sooner due to the time it takes for publishing. Furthermore, other vital information such as annual U.S. government statistics and incidence and prevalence information on diseases are particularly problematic to keep current. Because OERs are licensed to permit change, an instructor can update the resources to accurately represent the most current public health information, and then redistribute the resources to other instructors and students.

Health Education and OERs: A Symbiotic Relationship

There is an ideological symbiosis between the values of OER and public health. One of the goals in public health is to reduce health inequities by providing information, education, and care; OERs exist to reduce learning inequities by providing information, education, and learning opportunity (Treviranus, 2018). In addition, OERs can directly reduce barriers to access of knowledge and cost to public health courses, indirectly reducing health inequities.

With significant disparities in health indicators among specific racial and ethnic groups in the United States, education may be the way to directly address this inequity. Research indicates that increasing the number of health professionals from groups with poor health indicators will help eliminate disparities (Rosenstock et al., 2008). By using OERs, health education cost is reduced and more individuals, including those from groups with poor health indicators, can afford the education required to become a health educator. Consequently, we can consider OERs as a way to reduce not only educational disparities but overall health disparities.

The symbiosis between OERs and public health also manifests through current practitioners needing access to up-to-date educational materials. In the Institute of Medicine’s report, The Future of Public’s Health in the 21st Century, it highlights that the public health workforce must have appropriate education and training to perform its role (Institute of Medicine, 2003), including access to educational material. OERs enable educators to create more learning materials by leveraging the resources created by others. While there are quality, free health education materials available from well-respected organizations—both private and public—these materials are limited in number and access to them may be difficult (e.g., behind password protection, requiring registration). If public health education embraces OERs in order to provide more up-to-date educational materials, we may also expect greater participation in content creation which would then lead to an increase number of materials and reduced barriers to access (i.e., more websites with public health OER).

Challenges to OER Adoption in Health Education

There is an overall lack of awareness around OER. One study found that of faculty in the United States who were asked to self-report their awareness with OER, 56% were unaware or had only heard of OERs (Allen & Seaman, 2016). This lack of awareness is especially true within the health fields. In one nationally representative sample of faculty, only 1.9% of health-related faculty surveyed were “very aware” of OER with only 38% “somewhat aware” or “aware” (Allen & Seaman, 2014). Because of this limited awareness, the field of health education could be categorized as late adopters or laggers with OER, according to the diffusion of innovation model (Rogers & Shoemaker, 1971). Indicated by the field’s late adoption, OER implementation will first require educating faculty about basic OER knowledge (e.g., definition, design, challenges) and its differences from traditional course materials, and then persuading them to adopt OER into their existing curricula and courses. Along with educating faculty, it is important that administrators support OER initiatives, by providing training for faculty and grants to help create this content. Another key to OER adoption is assistance from instructional designers, who are experts in the necessary pedagogical techniques often required when using OER (e.g., integration of online resources, aligning instruction to new course materials) and support from campus bookstores who often directly advise students on what course materials are necessary.

Most OER adoption in higher education is less focused on a particular discipline and instead broadly targets students or the university itself. For example, Rice University’s OpenStax is a nonprofit that both offers OER and related technology. ¹ The University of Minnesota has the Center for Open Education, which provides curated and reviewed openly licensed textbooks. ² Countries in Europe and Africa have made nationwide efforts to adopt OER for higher education (Castaño Muñoz, Redecker, Vuorikari, & Punie, 2013; Thakrar, Wolfenden, & Zinn, 2009). However, these large efforts cannot directly address the unique benefits that particular disciplines may receive from using OER.

Although OER lead to lower costs for students and potentially increase access to materials, there is little research that indicates that OER are of the same or better quality as traditional resources. It is unknown if courses that use OER produce learning outcomes for students or increased comprehension of material as well as traditional course design. One study of nearly 5,000 college students in the United States found that students whose faculty chose OER generally performed as well or better than students who faculty assigned commercial textbooks (Fischer et al., 2015). Yet, more research needs to be conducted before any general conclusions can be made about the effects of OER on overall comprehension.

With any materials used in education, it is important to keep information up-to-date and accurate. An issue with adopting existing OER is that some have not been updated since their creation. This continual process of updating content is an important part of good pedagogy (Cavanaugh & Dawson, 2010). When utilizing OER content, an instructor may need to update outdated information, which could take time, a limited resource for almost all instructors. However, this will also be true to some degree for traditional resources, and as more instructors adopt OER, the burden of updating resources could be potentially reduced through shared distribution.

Another challenge to OER adoption is finding quality, appropriate resources. Simply put, while a traditional textbook is limited compared to an OER, an instructor does not have to engage in a determination of the quality of the textbooks. But OER adoption required an instructor to determine what OER is best and how they need to be altered. This analysis and adaptation could be entirely new skills for many instructors, suggesting that wide-scale OER adoption in public health will require accompanying professional development.

Conclusion

The ease of use of OERs can be debated. Finding existing materials to reuse or remix could be challenging. Currently, OER materials are available by multiple providers and platforms such as OER Commons, OpenTextbook Library, Openstax, and Open SUNY. Yet few materials specific to the discipline are available on these sites. But the hunt for OER should not be viewed as a chore, but as an opportunity for scholarship and creativity. The more relevant and interactive content is, the more likely students are to engage in reading and utilizing the content (Henrie, Halverson, & Graham, 2015). Faculty who are inexperienced with newer educational technology (e.g., simulations, virtual reality) may finally have the opportunity to improve their instructional skills through adoption of OER based on emerging technology.

As public health professionals, we have a duty to educate the next generation. This should be done by utilizing the most current information and continue to keep this information up-to-date for others to leverage, either as instructors or practitioners. One potential solution to keeping students and practicing health professionals current on information is through the use of OER. By adopting this type of learning material, we have the potential to not only reduce costs for individual students, but also affect the overall diversity of the public health workforce. As a profession of health educators, we need to place importance on educating others about OER, creating a centralized database for content, and implementing OERs into our curriculum.