Is Dental Education Ready for MOOCs?

In this month’s Charting Progress, Dr. Rick Valachovic answers some questions and asks many more about massive open online courses.

Is Dental Education Ready for MOOCs?

Some of you are probably asking, “What is a MOOC?” so let’s start there. In a nutshell, massive open online courses, or MOOCs, give thousands of students from across the globe access to university courses, via the Internet, for free.

• How massive are MOOCs? Some have registered more than 100,000 students.
• How open are they? Anyone with an Internet connection may enroll, and at least 2 million people internationally have done so.
• What do MOOCs mean for institutions of higher learning, which are under fire for their high costs and less-than-stellar graduation rates? How these online courses will affect institutions of higher learning is less clear, but there is no doubt that this new educational paradigm has the potential to be profoundly disruptive.

In February of this year, my colleagues at the Federation of Associations of Schools of the Health Professions (FASHP) and I received a tutorial from a MOOC pioneer on this new approach to delivering education. Dr. Daphne Koller is a professor of computer science at Stanford University and the cofounder of MOOC provider Coursera.

As of April, Coursera, a for-profit provider that has attracted $22 million in venture capital funding, had partnered with 60 elite universities to offer 400 courses and had attracted more than 3.2 million users. In other words, Coursera and other MOOC providers appear to be well on their way to fulfilling at least part of their vision: to make some of the best university courses in the world available to everyone.

If that vision weren’t ambitious enough, Dr. Koller and her colleagues also aim to transform education in the process. They are not simply looking for ways to get traditional content to more people; they are looking for ways to make it “stick.”

Dr. Koller talked to us about the 2 Sigma Problem articulated in 1984 by Dr. Benjamin S. Bloom. His research compared student learning across three modes of delivery: the conventional lecture-based classroom experience; mastery learning, which augments conventional instruction by requiring that students show that they understand each concept and skill before moving on to the next; and one-to-one tutoring.

Dr. Bloom found that the students in the mastery learning group performed one sigma or a standard deviation higher than the students in the lecture group, and that the students who received tutoring performed two sigmas higher than their lectured peers. Most strikingly, 98% of students who were tutored performed above the midpoint for those in the lecture group. Looking at these findings, Dr. Bloom raised this question: How can we provide group instruction that is as effective as one-to-one tutoring?

Dr. Koller sees a significant role for MOOCs in answering this challenge. She points out that computer-based instruction lends itself well to mastery learning. While a student who doesn’t understand a concept would be hard pressed to ask his or her instructor to go over the same material more than twice, as Dr. Koller put it, “You can watch the video five times, and the computer does not become judgmental.” (You can hear Dr. Koller talk more about computer-based instruction and mastery learning by viewing her TED Talk or a lecture she gave at the University of Virginia’s Darden School of Business.)

If you enroll in a MOOC—and you should just to see how they differ from traditional online courses—you’ll find that video lectures are typically broken into short, digestible chunks and interspersed with questions, problem sets, and longer quizzes that students can complete for instant feedback. If they answer anything incorrectly, they can review the videos and slides and resubmit the assessments until they get them right.

While it seems reasonable to question the validity of this approach—one might ask whether students have really learned the material or simply memorized the tests—Dr. Koller says that students who take this approach do better on subsequent assessments than those who don’t. Her inference is that the repetitive, mastery-learning approach is improving their ability to learn along with their test scores.

Helping us get a better handle on how students learn is, to my mind, one of the most promising features of MOOCs. Collectively, the data MOOCs provide will give us an unprecedented look at how people learn. The technology lets MOOC providers record every click as thousands of learners take part in a given course. The sheer volume of this data allows patterns to emerge that would be invisible in a traditional classroom. When two thousand students make the same mistake in solving a problem, the data may alert the professor to common misconceptions and guide him or her in reframing the way specific content is taught. Data patterns should also help faculty to customize their courses for different kinds of learners by providing modules for those who need greater preparation and modules for those who desire enrichment.

Coursera currently has the furthest reach of the MOOC providers, but the company is not the only player in the MOOC space. Udacity, another for-profit provider with Stanford roots, offers a little more than two dozen courses, primarily in computer science and mathematics. Leading technology firms are partnering with Udacity to sponsor the development of these courses, and students who take them can position themselves for recruitment by these employers. Udacity invites students to create profiles and upload their résumés to a database that the company’s corporate partners can search. The company also offers some proctored exams so students can demonstrate their mastery of a topic in conventional terms.

Early this year, Udacity began a pilot for-credit arrangement with San José State University, and in May, the company announced a groundbreaking partnership with the Georgia Institute of Technology (Georgia Tech) College of Computing to offer the first professional online master’s degree in computer science to be delivered entirely by MOOCs. According to the announcement, the courses will be available to Udacity users free of charge, but only tuition-paying students enrolled at Georgia Tech will be eligible to earn the degree. This is an experiment well worth watching.

edX, a nonprofit enterprise created by the Massachusetts Institute of Technology (MIT) and Harvard University, appears equally committed to bringing “the best of higher education to students around the world” and to studying how technology can transform learning. edX also ran a pilot with San José State University, which supplemented its course on circuits analysis with MIT-developed content delivered via MOOC. Pass rates in the course jumped from 55% to 91%, a startling accomplishment.

One interesting aspect of the edX approach is its focus on hybrid or blended learning, sometimes called the “flipped classroom.” Students have online access to readings, video tutorials, interactive exercises, quizzes, and tests as they would with other MOOCs, but they meet in class for more in-depth discussion, group work, or hands-on learning led by a local professor. This approach may hold potential for dental education, given our heavy focus on clinical training. In this model, the MOOC doesn’t replace the need for faculty but does potentially change their role.

edX began by offering courses in engineering but has since broadened its catalog to include courses in the sciences, humanities, business, and social sciences. These include titles such as Health in Numbers: Quantitative Methods in Clinical & Public Health Research, adapted from classes developed at the Harvard School of Public Health. Given that many of the core public health courses—epidemiology, biostatistics, environmental health, and community health—are required of dental students as well, edX’s expanded catalog illustrates the potential relevance of MOOCs to dental education.

Which brings me back to the question, “Is dental education ready for MOOCs?” I can’t speak for all ADEA members, but I do know that Dr. Steve Young, Dean of the University of Oklahoma College of Dentistry and Chair of the ADEA Board of Directors, is intrigued by the idea.

“There have been online courses, yes,” he told me when we discussed MOOCs back in May, “but to potentially have a global student body, global professors—it’s so different from what we think of as higher education, especially in dental education, which is so hands-on.”

Steve told me that he has talked about MOOCs informally with other deans, and they see possibilities for using this method to deliver at least some of the didactic components of a dental education. Schools are under pressure to do more with less, and recruiting sufficient faculty is always challenging. Steve sees potential for MOOCs to alleviate some of these pressures. He and the other deans in his region have been talking about ways they might share resources for years. MOOCs might give them another way to achieve the same ends.

“If an expert in a specialty topic like temporomandibular joint pain is already delivering lectures at several of our schools,” Steve told me, pointing to just one example, “perhaps MOOCs might be a vehicle for sharing that expertise.”

Harnessing this technology to facilitate collaboration between our institutions sounds inviting, but Steve readily acknowledges, and I agree, that a host of questions remain about this new educational paradigm.

• How will institutions ensure the quality of MOOCs and the validity of assessments?
• When students are logged onto computers thousands of miles away, how will course providers know who is doing the work?
• How will students receive credit for these courses?
• How will professors be compensated for developing and delivering them?
• If providers offer MOOCs at no cost to students, how will these ventures stay in business?
• And, more importantly to our members, how will universities stay in business if MOOCs offer the same product for free?

This last question, which has gotten a lot of attention in the popular press, is well worth pondering, but a more immediate question might be this one: 

• Will MOOCs work with traditional students enrolled in degree-granting programs?

The vast majority of Coursera students thus far have been nontraditional students, typically lifelong learners who already have one or more degrees under their belts. Some take courses to advance their careers, others to broaden their horizons, and the majority who sign up, drop out. These practices shouldn’t be surprising given that there are so few barriers to enrollment and no economic downside to dropping a course.

Those who have completed MOOCs say they require a high degree of self-motivation and self-discipline. Some students have introduced a social component, such as arranging a local study group, to keep themselves on track.

So, is dental education ready for MOOCs?

That is a question our community will have to answer in the months and years ahead. For now, I think it’s fair to say that the dental education community is ready to start discussing this topic. The conversation may not be massive, but I’m sure it will be open, and I suspect it may already be taking place online in some of our Sections and Special Interest Groups.I know for a fact that this topic will be a major part of the discussions at the ADEA Fall 2013 Meetings in October (the theme of the meeting is Taking Advantage of the Rapid Changes in Technology) and at the 55th Annual ADEA Deans’ Conference in November (the theme of that meeting is Dentistry in Primary Care). Between now and then, you may want to check out a new Coursera MOOC on CAMBRA (CAries Management by Risk Assessment), which will begin next month led by Dean John D.B. Featherstone at the University of California, San Francisco, School of Dentistry.

As you can see from the discussion above, MOOCs take different forms and are still evolving. Nevertheless, these online courses strike me as a logical extension of the work our community is doing to expand our reach globally and interprofessionally and to share resources through the Curriculum Resource Center, MedEdPORTAL, and the new MedEdPORTAL service, iCollaborative. There has been pushback from many in the higher education community, but we will watch to see where this all lands over the coming months and years.