Aboard the USS Bowfin (Pearl Harbor, Hawaii, United States of America). Personal collection.

Implementation of guidelines, officially

Reda Sadki Global public health

This is everything that the World Health Organization’s Handbook for Guideline Development says about implementation. 

Implementation of a guideline should be taken into account right from the beginning of the guideline development. Implementation is generally the responsibility of national or subnational groups, which explains why their participation in guideline development is critical. WHO headquarters and regional and country offices can support implementation activities by promoting new guidelines at international conferences and providing guideline dissemination workshops, tools, resources and overall coordination [emphasis mine].

Implementation strategies are context-specific. The basic steps for implementing a guideline are:

  • convene a multidisciplinary working group to analyse local needs and priorities (looking for additional data on actual practice);
  • identify potential barriers and facilitating factors;
  • determine available resources and the political support required to implement recommendations;
  • inform relevant implementing partners at all levels; and
  • design an implementation strategy (considering how to encourage theadoption of the recommendations and how to make the overall context favourable to the proposed changes). Implementation or operational research can help inform field testing and rollout strategies to promote the uptake of recommendations.

There is a range of derivative documents or tools that can be developed to facilitate implementation. These can be distributed with the guideline, or local guideline implementers can develop them. Such documents or tools may include a slide set re ecting the guideline content; a “how to” manual or handbook; a flowchart, decision aide or algorithm; fact sheets; quality indicators; checklists; computerized applications; templates, etc.

Source: World Health Organization. WHO Handbook for Guideline Development, 2014.

Image: Aboard the USS Bowfin in Pearl Harbor, Hawaii, United States of America. Personal collection.

Keys abord the USS Bowfin

I want them to read it

Reda Sadki Thinking aloud

“So… can you tell me how you would like people to use the guidelines?”

“Well… it is difficult to say… I am not sure.”

“What is the change that you are hoping to produce?”

“Well… I don’t know. It was so much work putting these together already! Now they are available and people in countries just need to start using them.”

“So… what do you mean by ‘using them’? Can you tell me what that looks like…?”

“I want them to read it.”

That is our point of departure.

Image: Aboard the USS Bowfin in Pearl Harbor, Hawaii, United States of America. Personal collection.

 

USS Bowfin diving plane control levers

From guidelines to impact

Reda Sadki Global public health, Thinking aloud

Most global public health organizations issue guidelines that are of a high methodological quality and are developed through a transparent, evidence-based decision-making process. However, they often lack an effective, scalable mechanism to support governments and health workers at country and sub-country level in turning these into action that leads to impact.

Existing activities intended to help countries build public health capacity carry potential risk for these organizations, as they rely on high-cost, low-volume workshops and trainings that may be characterized by startling disparities in quality, scalability, replicability, and sustainability, often making it difficult or impossible to determine their impact.

In some thematic areas, stakeholders have recognized the problem and are developing their own frameworks to improve quality of training and improve capacity-building. A few stakeholders are experimenting with new capacity-building approaches to empower local actors and strengthen the resilience of communities.

The global community allocates considerable human and financial resources to training. The delivery of this training, however, has not kept pace with the increasing cost and complexity of global challenges.[1] Furthermore, a reductive focus on formal training is unlikely to lead to improvements in service delivery.[2]

Digital learning offers new ways to scale and open learning. However, existing digital learning platforms appear to be premised on the one-way transmission of knowledge – when it is the co-creation, adaptation, and application of knowledge that are needed to achieve double-loop learning – and  from the center (HQ, capital city) to the periphery (countries, villages, volunteers). The transmitted knowledge is often abstract and decontextualized, while the value of existing local knowledge, practices and understanding is not recognized or incorporated into the learning experience.

Progress toward the global health goals will remain elusive if the prevailing paradigm for capacity-building remains unchanged.

[1] The Bill and Melinda Gates Foundation. “Framework for Immunization Training and Learning.” Seattle, USA: The Bill and Melinda Gates Foundation, August 2017.

[2] Sadki, Reda. “Quality in Humanitarian Education at the Crossroads of History and Technology.” In World Disasters Report 2013: Technology and the Effectiveness of Humanitarian Action. Geneva: International Federation of Red Cross and Red Crescent Societies, 2013.

Image: Personal collection. These levers control the diving planes which allow the vessel to pitch its bow and stern up or down to assist in the process of submerging or surfacing the boat, as well as controlling depth when submerged. USS Bowfin, a Balao-class submarine, was a boat of the United States Navy named for the bowfin fish. It is now stationed in Pearl Harbor, Honolulu, Hawaii, USA.

Seventh Epidemiological Training Workshop for Biologists Draws 48 Participants from Outside Organizations

New learning for radiation emergency medical preparedness and assistance

Reda Sadki Events, Presentations

My presentation for the Geneva Learning Foundation at the 15th meeting of the WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN), World Health Organization, Geneva – 3-5 July 2017.

The 15th meeting of the WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) Geneva 3–5 July 2017

The 15th meeting of the WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) Geneva 3–5 July 2017

Featured image: Participants of the Radiation Effects Research Foundation’s (RERF) Seventh Epidemiological Training Workshop for Biologists. The objective of the RERF is to conduct research and studies for peaceful purposes on medical effects of radiation and associated diseases in humans, with a view to contributing to maintenance of the health and welfare of the atomic bomb (A-bomb) survivors and to enhancement of the health of all humankind.

Flowers in my garden

#DigitalScholar Reboot Day 1

Reda Sadki #DigitalScholar

On Monday, July 3rd 2017, an expanded course team from three continents, supported by LSi’s Scholar Apprentices, began to trial a completely new approach to the development of digital learning.

This is the story of how we came to reboot the amazingly successful #DigitalScholar initiative offered by the Geneva Learning Foundation just one year ago.

Earlier this year, new #DigitalScholar course team member Iris Thiele Isip-Tan built the Learning Module (Scholar account required to view) for the 2016 #DigitalScholar course. This is more than just an archive.

  • A learning module describes the sequence of events and includes all resources in a course.
  • It includes all learning resources and activities, including the projects and their rubrics.
  • In addition, the learning module provides guidance (metacognition) for the facilitator or course team.
  • A learning module may also be used to support blended and self-guided learning.
  • It can also be used to replicate and localize the course.
  • Every element in a Learning Module can be pushed to a Community, where its members can respond to it as they collaborate and progress through dialogue and project development.
  • The sequence and content of activities remain flexible, as they can be edited and remixed as soon as they are shared with a Community.

Digital Scholar Learning Module

With the Scholar Approach, everything is about dialogue driven by activities (Community) and projects (Creator). The question is: “What does the learner get to do?” Unlike content-driven digital learning that requires front-loaded media-intensive resource development, we simply map out day-by-day the learners’ guided learning journey, structured by the Creator project rubric.

This affords us amazing flexibility to tailor activities in response to the behavior of the cohort. It is akin to agile development used in software development. It is a wonderfully creative and adaptive process. However, it also means that as we are building the course just-in-time, some learners lose the visibility that they expect as to what happens next.

The Learning Module resolves one dilemma that results from Scholar’s adaptive, agile learning development. If we had run a repeat of last year’s course, every participant would gain visibility of the entire set of activities.

And, in fact, this is what we were going to do with the second run of #DigitalScholar in 2017. The Learning Module is comprehensive. The first run of the course in 2016 was amazingly creative and productive. So it was tempting to just do a repeat.

However, we have learned so much in the past year about the design and execution of Scholar-based courses that we launched a reboot on Monday.

Google Hangout with the #DigitalScholar Team

Google Hangout with the #DigitalScholar Team

With transmissive MOOCs or Moodle-based courses, the focus is on content collection and curation prior to the start of the course. The question is: “What content do we prepare for the learner to consume?” This means that no matter how dynamic, interactive, or gamified the course activities, the content remains fixed. Updating a resource is a momentous event. Double-loop learning becomes improbable as there is no way for learners or teachers to reshape content and activities without undue stress and effort. This is the content trap that George Siemens described with amazing acuity over a decade ago, and that scholars such as Bharat Anand have more recently written about.

So on Day 1 of the reboot, we disarmed the content trap. Can’t wait for Day 2.

Images: Flowers in my garden (July 2017). Personal collection.

Dawn in Trigonos, Snowdonia National Park, Caernarfon, Wales

4 rules for the digital transformation of partnerships

Reda Sadki #DigitalScholar, Learning strategy

This is a recorded version of my presentation, followed by Catherine Russ‘s report on a session that I presented and facilitated at the Remote partnering workshop held on 23-26 January 2017 in Caernarfon, Wales.

Here is what Catherine Russ wrote in the workshop’s Report on Technology and Learning.

In this session we delved into the reality that partnerships often become remote because those involved can no longer afford to meet together physically. Increasingly, collaboration, dialogue, and feedback are simply assumed to take place from a distance. What do we lose – and is there anything to gain – when the rules have changed:

  1. Sharing physical space is no longer a necessary condition to partnering.
  2. Sharing physical space is increasingly a medium in which we can no longer afford to develop partnerships.
  3. The value of shared physical space is primarily cultural, a rapid way to accrue social capital that underpins social relations.
  4. What we are enabled to do from a distance using technology is changing rapidly – more rapidly than what we can do in a shared physical space – leaving us confused, and perhaps even fearful, of what this change means for the quality or even the future of our partnerships.

In addressing the use of technology at the Remote Partnering Project Design Lab, the irony did not escape us that sixteen or so of us were sitting face-to-face. The plan had been to bring some participants in from other continents on a remote basis to input as and when possible, but several factors prevented this from happening. Experience and advice has suggested in the past that combining remote and face-to-face can often cause more problems than opting for one or the other and this experience seemed to confirm that advice.

Reda Sadki, who leads a partnership that is tackling such questions to improve digital learning, was invited to facilitate a session to explore the current challenges being experienced by those working remotely and uncover some of the emerging solutions. The idea that working remotely is a ‘second cousin’ to and ‘second best’ option to face-to-face had already been challenged and (somewhat) deflated in previous sessions and therefore this session focussed on how to leverage the new economy of effort that technology allows for working remotely as outlined in the following affordances (literally and figuratively what we can ‘afford’ to do).

So, rather than addressing technology from the perspective of trying to replicate what partners produce when face-to-face and addressing the shortfalls of these, Reda proposed that participants think through how their partnering work is already being transformed by digital technologies. Could partners – who mostly seem to experience remote working as a constraint – leverage this transformation to resolve dilemmas inherent in such common partnership challenges as:

  • Moving from strategy to implementation
  • Putting reporting practice to use
  • Documenting experience (e.g. case studies) o Fostering collaboration across silos
  • Bringing static knowledge to life (e.g. making global guidelines relevant and useful to communities)

In fact, Reda provided practical examples of an emerging approach (known as the “Scholar Approach”) that aims to connect partners, from centre to periphery, to strengthen networks through peer-to-peer collaboration:

  • The Norwegian Red Cross mobilized a global community of action, convening over 800 pre- hospital emergency workers from 70 countries to co-develop over 70 case studies of violence and risk in four weeks.
  • The World Health Organization connected public health officers from 30 countries to develop country-specific action plans based on new global guidelines for routine immunization.
  • The Geneva Learning Foundation mobilized over 900 participants from over 100 countries to jointly develop 94 new digital learning initiatives – effectively showing how this approach could be replicated and democratized.

In Reda’s words: “This collaborative, flexible, motivating, participatory and supportive approach is not simply a nicer, kinder and gentler form of learning: Its pedagogical patterns closely emulate the core competencies of 21st century humanitarian workers, who are expected to be able to manage complex, overlapping knowledge flows, to work in networked configurations (rather than command- and-control structures) and to use participatory methodologies to partner with affected populations.”

You can learn more about the Remote Partnering Project on its web site.

Image: Dawn in Trigonos, Snowdonia National Park, Caernarfon, Wales (personal collection).

New learning and leadership for front-line community health workers facing danger

Reda Sadki Global public health, Learning design, Scholar Approach

This presentation was prepared for the second global meeting of the Health Care in Danger (HCiD) project in Geneva, Switzerland (17–18 May 2017).

In October  2016, over 700 pre-hospital emergency workers from 70 countries signed up for the #Ambulance! initiative to “share experience and document situations of violence”. This initiative was led by Norwegian Red Cross and IFRC in partnership with the Geneva Learning Foundation, as part of the Health Care in Danger project. Over four weeks (equivalent to two days of learning time), participants documented 72 front-line incidents of violence and similar risks, and came up with practical approaches to dealing with such risks.

This initiative builds on the Scholar Approach, developed by the University of Illinois College of Education, the Geneva Learning Foundation, and Learning Strategies International. In 2013, IFRC had piloted this approach to produce 105 case studies documenting learning in emergency operations.

These are some of the questions which I address in the video presentation below:

  • Mindfulness: Can behaviors and mindfulness change through a digital learning initiative? If so, what kind of pedagogical approach (and technology to scaffold it) is needed to achieve such meaningful outcomes?
  • Leadership: How can learners become leaders through connected learning? What does leadership mean in a global community – and how does it connect back to the ground?
  • Diversity: What does leadership mean in a global knowledge community where every individual’s context is likely to be different?
  • Local relevance: What is the value of a global network when one’s work is to serve a local community?
  • Credential: What is the credential of value (badges and other gimmicks won’t do) that can appropriately recognize the experience of front-line humanitarians?
  • Pedagogy: Why are MOOCs (information transmission) and gamification (behaviorism)  unlikely to deliver meaningful outcomes for the sustainable development or disaster preparedness of communities?

The video presentation below (31 minutes):

  • examines a few of the remarkable outcomes produced in 2016 and
  • explains how they led to growing the initiative in 2017.

To learn more about or join the #Ambulance! activities in 2017, please click here. You may also view below the selfie videos recorded by #Ambulance! course team volunteers to call fellow pre-hospital emergency health practitioners to join the initiative.

Image credit: #Ambulance! project course team volunteers.

Chivito

Learning technologists are obsolete

Reda Sadki Thinking aloud

These are some notes on one of several blog posts that are churning in my head about what digital transformation means for learning and leadership. Warning: these are the kinds of wild, roughshod, low-brow, unrefined contentions that might just make the reasonable and respectable Mister S. choke on his Chivito.

Many of the pionneers of “e-learning” fought long and hard to have the value of technology for learning recognized and new tools put to use by educators. Their achievements are significant. Today, for example, many universities now have teams that support teaching staff in the effective use of learning technologies. (Ironically, the former may provide one of the rare occasions for the latter  to examine their teaching practice, but that is a different topic…). However, when I speak to young professors from fields outside of education, they describe such services as peripheral or marginal. At best, the learning technologies people help them set up a WordPress site to host their course content, or maybe transfer their syllabus into Moodle. That is not insignificant, but it is unlikely to be transformative.

Cathy Davidson and David Theo Goldberg pointed out almost a decade ago in The Future of Learning Institutions in a Digital Age that “modes of learning have changed dramatically over the past two decades — our sources of information, the ways we exchange and interact with information, how information informs and shapes us. But our schools — how we teach, where we teach, who we teach, who teaches, who administers, and who services—have changed mostly around the edges.” Institutions of higher education, if only by virtue of their financial position (think Harvard’s endowment) are built to endure change, unlike the newsroom or the record industry. “It seems as though online learning” wrote Burck Smith three years later, “is simply a ‘feature enhancement’ that allows colleges to make their offerings attractive to more people.”

Admittedly, interesting things can and do happen in the margins. In fact, the modesty and constance of learning technologists who actually deliver new ways of doing new things are two characteristics that stand at stark odds with the snake oil that characterizes a Silicon Valley flavor of edtech littered by empty boasts of technological solutionism.

Furthermore, this change around the edges is no failing of the often talented, dedicated, and passionate individuals who have advocated for more effective use of learning technologies inside their institutions.

It is, rather, that the rate of change they produced turned out to be far slower than that of the tidal wave of Digital Transformation that is spilling over our societies.

Our lives are now permeated by digital. It is embedded into everything we do, not just the tools we use but our way of life and culture. That impacts education, of course. In fact, it does so in ways that are more significant, far-reaching, and profound than anyone explicitly advocating the use of technology for learning. Explicit advocacy is, in a way, an admission that you are trying to effect change from the margins. The more deeply technology embeds itself into the fabric of our lives, the less such a position is likely to be tenable.

How could the role of education be limited to providing better tools, in the midst of a Fourth Industrial Revolution or Second Machine Age, in which a range of new technologies are fusing the physical, digital and biological worlds?

As a geeky teenager  learning to program in BASIC in the 1980s, I was an avid reader of BYTE Magazine, an amazingly thick (with ads), monthly compendium of the best technology journalism of the pre-Internet nascent personal computer industry. Technology was covered as an industry, mostly through the lens of markets, products, and specifications, by tech journalists whose names and personalities I began to recognize, from Mister Congeniality Leo Laporte to professional curmudgeon John C. Dvorak.  It wasn’t until 2011 that Nilay Patel and the rest of the crew at The Verge emerged as a new breed of fully-digital journalism at the intersection of technology and culture:

“The Verge is an ambitious multimedia effort founded in 2011 to examine how technology will change life in the future for a massive mainstream audience. Our original editorial insight was that technology had migrated from the far fringes of the culture to the absolute center as mobile technology created a new generation of digital consumers. Now, we live in a dazzling world of screens that has ushered in revolutions in media, transportation, and science. The future is arriving faster than ever.”

That kind of insight is what is missing from the “learning technologist” standpoint. It highlights both the centrality of technology in our culture and the increasing velocity of change.

In the Digital Transformation, if culture does not swallow up technology at breakfast, it will do so by dinner time. To be a learning technologist today – what may have been forward-looking or even courageous in the past – is to be on the wrong end of history.

 

Mission accomplished

Reda Sadki Thinking aloud

We won.

  • The former school teacher and humanitarian trainer who argued vociferously that nothing would ever supplant face-to-face training is now running a MOOC.
  • The training manager who refused to consider e-learning is now running a distance learning, scenario-based simulation. People he trains are now working remotely – and a simulation, dirt-cheap and run by e-mail, is closer to modelling the real world than is the artificially and unrealistically “safe space” of the high-cost, low-volume training room. Work went through digital transformation before “training” did.
  • The old-school learning and development manager is getting certified to run webinars. Through practice, she has surprised herself by how much she feels when running a session.
  • A digital course run ahead of a face-to-face workshop mobilized ten times as many (people), for ten times less (money). Course participants produced tangible artefacts, directly applicable to work, through collaboration and peer review. And they did not need to take time off in order to do so. The outcome of the physical-world, residential experience is less tangible. Or, with a double entendre, one could say: more virtual.

These are not stories of the superiority of one medium over another. They are stories of the accelerating pace of change.

These are not stories of victory. They are stories of experiencing our humanity in and through new, rapidly-changing spaces where we work, live, and grow.

This is how we learn.

Image: A metaphor for irony. Bush delivers a speech to crew onboard the USS Abraham Lincoln to declare combat operations over in Iraq, as the carrier steamed toward San Diego, California on May 1, 2003 (Larry Downing/file/Reuters).

Jack Welch photo in GE's Annual Report (2000)

Relishing change

Reda Sadki Quotes

Jack Welch in General Electric’s Annual Report, nearly two decades ago:

We’ve long believed that when the rate of change inside an institution becomes slower than the rate of change outside, the end is in sight.

The only question is when.

Learning to love change is an unnatural act in any century-old institution, but today we have a Company that does just that: sees change always as a source of excitement, always as opportunity, rather than as threat or crisis.

We’re no better prophets than anyone else, and we have difficulty predicting the exact course of change.

But we don’t have to predict it.

What we have to do is simply jump all over it!

Source: Welch, J., 2000. General Electric Annual Report 2000 (Annual Report). General Electric, Fairfield, Connecticut, USA.