4.1 MOOC participation
There were 3,858 registrants enrolled in the two sessions of the MOOC. 2,470 (64%) completed the first quiz; 1,944 (50.4%) the second; 1,832 (47.5%) the third; and 1,304 (33.8%) completed the fourth quiz. At the end of the MOOC sessions, 1,163 (30.15% of the total initially enrolled and 89.2% of those who completed the course) met all the requirements for the course including submission of the final project outline, achieved the mandatory pass mark, and received a certificate of completion.
4.2 Demographics of enrolled learners
Registrants came from 115 different countries, See Fig. 1. The most represented LMICs with more than 1% of registrants were Nigeria (1191/30.9%); India (373/9.7%); Uganda (192/5%); Ghana (155/4%); Kenya (143/3.7%); Nepal (141/3.65%); Cameroon (124/3.2%); Malawi (121/3.1%); Sudan (106/3.1%); Ethiopia (91/2.4%); Myanmar (66/1.7%); Colombia (61/1.6%); Honduras (57/1.5%); Rwanda (53/1.4%); Tanzania (51/1.3%); The Philippines (49/1.3%); Sri Lanka (42/1.1%); and Zambia (39/1%).
The majority of the registrants were from the WHO African region (62.4%). 17.7% were from the WHO South-East Asian region, mainly from India (56%), 9.9% of registrants were from the WHO Americas region, 5.5% were from the WHO Eastern Mediterranean region, 2.8% were from the WHO European region and 2.2% were from the WHO Western Pacific region. Apart from India, which represented 9.7% of the registrants, very few registrants were from the other BRICS (Brazil, Russia, India, China and South Africa) countries: 0.5% for South Africa, 0.4% for Brazil, and 0.2% for China. The Russian Federation was not represented at all. The majority of registrants came from English speaking countries (87.2%) followed by Spanish (7.7%), French (4.6%) and Portuguese speaking countries (1.4%). Note that the total is slightly higher than 100% as some countries are considered bilingual (e.g. Cameroon and Rwanda) and it was not possible to identify the countries of origin.
Men were more commonly represented in the WHO African region (63.4% versus 36.6% for women); however, in the other WHO regions, women were equally or more commonly represented than men. In terms of age profile, the majority of registrants were between 20 and 40 years old (77.5%). Women were slightly younger than men: 39.6% of women were under 30 years of age as compared with 31.8% of men.
The highest education level reached by the registrants was an MSc degree (1649/41.5%) followed by a Bachelor degree (983/24.7%), and a PhD (418/10.5%). 680 (17.1%) enrolees had a Medical Doctorate (MD). There were no differences in gender except for PhDs which were held by a higher number of women (55.7% versus 44.2% for men). Registrants were mainly public health researchers (45%) followed by public health officers (15.5%), general practitioners (11.1%) and students (11%). Women were more often public health officers and students than men (51.6% versus 46.5% and 56.8% versus 43.3%, respectively). Women were less often public health researchers (41% for women versus 59% for men) and general practitioners (43% for women versus 57% for men).
4.3 Demographics of learners who completed the course
In total, TDR obtained demographic information for 546 learners who completed the MOOC. Completers, who passed the course came from 56 different countries. The most represented LMICs with more than 1% representation were Nigeria (108/19.8%), India (92/16.8%), Uganda (52/9.5%), Nepal (38/7%), Ghana (37/6.7%), Kenya (24/4.4%), Cameroon (20/3.7%), Malawi (18/3.3%), Myanmar (12/2.2%), Rwanda (12/2.2%), Philippines (11/2%), Ethiopia (9/1.6%), Sri Lanka (8/1.5%), Tanzania (7/1.3%), Honduras (5/0.9%), Zambia (5/0.9%), Zimbabwe (5/0.9%), Ecuador (4/0.7%), Burkina Faso (4/0.7%), and Democratic Republic of the Congo (4/0.7%).
The majority of the completers came from the WHO African region (59.3%); 28.8% came from the WHO South-East Asian region mainly from India and Nepal (58.6% and 24.2% of registrants who came from the WHO South-East Asian region, respectively); 7.5% originated from the WHO Americas region, 2.5% from the WHO Western Pacific region; 1.6% from the WHO European region and 0.1% from the WHO Eastern Mediterranean region. Apart from India which represented 16.8% of the completers, the number of completers was very low for the other BRICS: 0.1% for South Africa, 0.3% for Brazil and 0.1% for China. The Russian Federation was not represented at all. A majority of the completers came from English speaking countries (86.2%) followed by French (9.3%), Spanish (4.2%) and Portuguese speaking countries (0.3%).
Globally, 53% of completers were men, and 47% were women. Men were more represented (60.6%) than women (39.6%) in the WHO African region, although women were equally or more represented than men in the other WHO regions. In terms of age profile, the majority of completers were between 20 and 40 years old (84.5%). Women were, on average, slightly younger than men, with 34.7% of women under 30 years of age as compared to 38.7% of men.
The highest levels of education achieved by those who completed were an MSc degree (230/42.1%) followed by a Bachelor degree (174/31.8%) completers, and a PhD (60/10.9%). Sixty-two (11.3%) completers held a Medical Doctorate (MD). Completers were mainly public health researchers (53.1%) followed by students (17.3%), public health officers (11.7%) and general practitioners (5.5%). Interestingly, women were less often public health researchers than men (28.9% versus 71.4%) but were more often students than men (58.7% and 13.2%, respectively).
4.4 Results of the MOOC completion survey
An anonymous exit questionnaire was sent at the end of each TDR MOOC session to identify potential improvements in the registrants’ IR knowledge. Five hundred and seventy-four (574) registrants responded to this questionnaire (responders). They came from 52 countries, and the ten most-represented countries were identical to those found at the registration phase except for an unexpectedly high response rate from learners in Myanmar.
The majority of responders were from the WHO African region (67.5%), reflecting a similar proportion to those of the registrants. Compared with the registrants, there was a higher representation of responders from the WHO European region (9% versus 2.8%) and less representation from the WHO South-East Asian region (9.9% versus 17.1%). 58% of responders were men, and 42% were women. They were public health researchers (36.8%), public health officers (10.7%), general practitioners (13%) and students (16.4%). Altogether these results showed that the population of responders was similar to the population of registrants.
4.5 Reaction of the learners to their experience of the course
Of the responders, 72.3% indicated that, to a large extent, the MOOC met their expectations. The expectations of the responders were not at all met for only 0.2%, to some extent for 9.3% and to a moderate extent for 18.2%. The vast majority of responders rated the MOOC as excellent (52.2%) or very good (40.7%). Among the different components of the MOOC, the videos, readings and the assessments, including quizzes, contributed the most to the learning. The discussion forum was identified as the element that contributed the least to the learning, and it was evident that registrants underutilised this interactive opportunity.
4.6 Factors influencing the receipt of a certificate of completion
Among the 574 responders, 438 obtained a final certificate of completion and 136 did not. The number of women was lower in the group who got a certificate than in the group who did not get a certificate (39.8% versus 47.4%).
The responders who received a certificate and those who did not are similar in terms of education level as they were mainly Master’s degree holders (53.6% of those who received a certificate versus 51.1% of those who did not). In terms of age, there was little difference between those that obtained a certificate and those that did not. 69.3% of responders who received a certificate were less than 40 years old while 72.5% of responders did not qualify for a certificate were in the same age group.
There were no differences in responders’ familiarity with the use of online training programs and whether or not they received a certificate. The number of online courses previously taken by responders who did or did not obtain a certificate was similar. Results show that 44.2% of responders received a certificate, and 47.4% of responders never participated in a MOOC.
There was no marked difference in the length of field experience between the responders who received a certificate and those who did not. Of those who worked for less than ten years in the field, 72.8% of responders obtained a certificate, and 68.1% did not. Also, of those who worked between 10 and 20 years in the field, 21% of responders received a certificate in comparison to 26.7% of those who did not.
The only difference found between the responders who did and did not obtain a certificate was with their occupations. Public health researchers were more likely to receive a certificate than not (45.2% versus 41%), while public health officers were less likely to receive a certificate than not (10.7% versus 19.7%). Students were also more represented in the group of responders who received a certificate as compared to the group who did not (16.1% versus 10.6%).
4.7 Improvement of the understanding of IR
On completion of the MOOC, participants were asked to assess how much their knowledge of IR had improved using a five-point scale to self-assess both their prior and current knowledge. The following scale: was used 0: none, 1: weak, 2: moderate, 3: strong and 4: very strong IR knowledge before and after the MOOC.
On average, participant knowledge increased by approximately 2 points, equivalent to a shift from 1.1 (weak knowledge) at the beginning of the course to 3 (strong knowledge) on completion of the course. There was no difference found between gender. The mean knowledge increased by 1.1 (weak) before the course to 3.1 (strong) after the course for men and from 1.1 (weak) before the training to 3.4 (strong) after the course for women.
On average, public health researchers’ knowledge increased by approximately 2 points, equivalent to a shift from 1.1 (weak knowledge) at the beginning of the course to 3.2 (strong knowledge) on completion of the course. The self-reported knowledge increase was slightly less for public health officers and students with an increase from 1.1 at the beginning of the course to 2.9 on completion of the course. Regardless of occupation, there were no gender differences.
In all the groups tested (i.e. public health researchers, public health officers and students), the number of responders who indicated an improvement in IR knowledge was consistently higher in the group of responders who obtained a certificate than in the group of responders who did not. A majority of the public health researchers (84.3%) who received a certificate indicated strong/very strong knowledge after the MOOC as compared to 66% of the public health researchers who did not receive a certificate. Similarly, 81.8% of the public health officers who obtained a certificate indicated strong/very strong IR knowledge after the course as compared to 43.9% of the public health officers who did not. Finally, 88% of the students who obtained a certificate showed strong/very strong knowledge in IR after the MOOC as compared to 64% of the public health researchers who did not obtain a certificate.