U-M researchers create injury prevention online course for children and teens

The COVID-19 pandemic forced the hand of many. Schools, universities, businesses – nearly every organization that provides any form of in-person education either began offering or enhanced their online programming.

But even years before the pandemic, online learning was growing in popularity. In 2018, more than 100 million learners enrolled in massive open online courses (MOOC), formats that allow large groups to access free or reduced-cost educational material at their own pace.

None of those leading course providers, however, offered any open courses on pediatric injury prevention. This presented a significant issue for what the Centers for Disease Control and Prevention previously recognized as one of the most under-recognized public health problems in the country, said Andrew Hashikawa, M.D., an associate professor of pediatric emergency medicine at the University of Michigan Health C.S. Mott Children's Hospital and the lead for online medical education at the U-M Injury Prevention Center.

Not only is pediatric injury prevention under-represented in online education, but traditional online courses are often only delivered in a linear fashion. Teachers who might be seeking to learn about peer violence and bullying would have to go through the entire course to find the portion they need. We were uniquely positioned to challenge that model."

Andrew Hashikawa, M.D., Associate Professor of Pediatric Emergency Medicine, University of Michigan Health C.S. Mott Children's Hospital

Hashikawa led a team at the U-M Injury Prevention Center, which receives funding from the CDC, to create a MOOC titled, "Injury Prevention for Children and Teens." The project was a massive undertaking, with contributions from over a dozen U-M departments and institutes.

Building the course on pediatric injury prevention

The free course offers eight modules taught by 29 experts and covers dozens of injury topics tailored to different learner profiles, such as medical professionals, public health practitioners, social workers, and teachers. The lessons are offered in several formats, including interviews with national experts, animated videos, and practical safety demonstration videos.

Based on individual interests, learners can advance through the topics nonlinearly. All enrollees take an introductory module, which is considered the "trunk" of the course's tree structure. Then, they can proceed on any branch pathway – a learner's "choose your own adventure" model.

"It operates sort of like Netflix: you choose what you want to learn, and then you will have other topics suggested in which you may be interested," Hashikawa said. "Let's say you're a coach and you took a course on concussions. You may then be interested in looking at that same group of teens with driving safety and sharing the road. It's tailoring your education, and that's what I'm most proud of in this effort."

Hashikawa's team used the same content from the MOOC to create a private, two-week elective course for U-M medical students and pediatric residents who take the course in its entirety.

Gaining popularity

Using data from the course platform edX, Michigan Medicine researchers found more than 4,800 people from 148 countries enrolled in the course since 2018. Two-thirds of the learners were women, and the majority were between 26 and 40 years old.

The results, published in Medical Education Online, reveal 91% of 824 surveyed participants found presentations to be relevant to their work. Nearly three-quarters felt the course did "very well" or "extremely well" at addressing the implementation of evidence-based injury prevention practices.

"We really kept the learner's experience in mind when creating content and design," said Jessica Roche, M.P.H., managing director of the U-M Injury Prevention Center. "Due to our funding from the CDC and the resources here at the university, we have been able to provide educational opportunities that weren't available to our learners previously. Additionally, we are incredibly fortunate to be able to provide free continuing education credits for physicians, nurses and health education specialists."

The course averaged around 80 new learners per week during the start of the pandemic, compared to 20 in the weeks prior. Beyond catering to the growing appetite for digital learning, Roche said, the MOOC reduces financial and logistical barriers for those interested in continued medical education.

"Learners, both domestically and internationally, often miss out on opportunities for comprehensive, evidence-based injury prevention education," Roche said. "This may be because they don't have the means to pay for the courses, are unable to travel to an in-person training or even don't have time in their busy schedule to take traditional coursework. This course has the opportunity to reach those learners, and we saw that this was especially true during the pandemic."

Hashikawa's team continues to update the course, recently adding water safety prevention, adverse childhood experiences, and social determinants of health sections to the curriculum. He said the MOOC format allows the course to evolve and stay relevant over time to offer the most advanced practices.

"This is all about reaching new audiences and creative ways to share injury prevention science with people," Hashikawa said. "It's crucial to find new ways to disseminate evidence-based research, especially for pediatric injury prevention, which desperately needs more attention."