- Email: [email protected]
Teaching global health using crowd-sourcing with Missing Maps
Nurse Education Today 60 (2018) 1–2
Contents lists available at ScienceDirect
Nurse Education Today journal homepage: www.elsevier.com/locate/nedt
Big Ideas Teaching global health using crowd-sourcing with Missing Maps
MARK
1. Background of the Innovation Generation-Y or the ‘Millennials’ currently make up the vast majority of the tertiary student population and in 2025, they will comprise 75% of the workforce (Forbes, 2016). So how do Millennials learn and what drives them? Millennials are creative, team-players with short attention spans and they value feedback. They skillfully employ technology and are motivated by believing they can collectively make a difference. Learning-wise, they are digital-natives and desire interactivity, active-learning and edutainment (Bostrom, 2003) (Smith, 2008). This can be challenging for Gen-X and Baby-Boomer educators who are more likely to want to inform and equip students with the learning resources to be self-directed. But if you want Millennials to engage, you have to combine fun with learning, employ cutting-edge, multi-media technology and integrate teamwork with meaning. Considering Millennials insist on meaning and pay attention to organisational purpose, it might be worth reviewing your hospital, university or organisational philosophy and mission statement. For example, at Monash University, we aspire to graduate global citizens who interact with the world, exhibit cross-cultural competence and use critical thinking and innovation to address complex problems creatively. This broader aim aligns well with a concurrent call to improve public health literacy in health professional education. Public health considers health from a population rather than individual perspective and acknowledges that health is heavily impacted by globalisation requiring health professionals to consider broader politico-economic-societal environments factors that influence health (Freedman et al., 2009). 2. The Innovation As a component of the curriculum many nursing and midwifery students study global health, cultural competence and vulnerable populations. In the past, my students have expressed frustration and felt disempowered when learning about extreme health inequity in the world, particularly among vulnerable populations such as refugees and asylum seekers, indigenous peoples and people living in extreme poverty in developing countries. This year, we decided to act on that feedback and provide students with an opportunity to channel the energy generated by learning about inequalities, into an activity that would benefit vulnerable populations in developing countries. This would take the form of a world-first, crowdsourcing event using a new app, aiming to put vulnerable populations on the map where they weren't before, so that humanitarian actors can access them to provide emergency assistance in the event of crises. While our challenge was to create a meaningful activity that would satisfy the students desire to do something about global health inequity, humanitarians were facing another problem in that they were struggling to locate vulnerable populations in need of humanitarian assistance because there were no detailed, up to date and accurate maps of the places where they lived. Meanwhile, a German geo-informatics academic was working on a web-based prototype crowdsourcing tool to solve both problems, which was picked up by Medecins Sans Frontieres (MSF) and further developed into an app called ‘MapSwipe’. MapSwipe is a smart phone application to derive geographic information from satellite imagery and to facilitate detailed mapping in ‘Open Street Map’. In MapSwipe, volunteers are asked to classify tiles of satellite imagery into four different classes (“No”, “Yes”, “Maybe”, “Bad Imagery”). By tapping and swiping on the mobile device they can signal whether they were able to spot human settlements. The users can choose between several projects in different countries (Herfort et al., 2017). While traditional ‘Missing Maps Mapathons’ require volunteers with mapping skills (e.g. geography students) to create maps, the ‘MapSwipe’ app allowed nursing and midwifery students to do something about international health inequity without diverging far away from their learning objectives around cultural competence, vulnerable populations and global health. The ‘Missing Maps Project’ in the UK, connected the nursing and midwifery school in Australia with the Geo-informatics department in Germany and assigned the students an area that required urgent mapping in Nigeria according to MSF-UK and MSF-Australia. The Missing Maps project is a collaboration between MSF-UK, the Red Cross and the Humanitarian Open Street Map Team that aims to create detailed maps of regions in the world that are currently unmapped, so that humanitarians can access vulnerable populations in the event of natural disasters, disease outbreaks and conflict. While many people especially in high-income countries assume everyone is on google maps, that is unfortunately not the case. There are in fact vast regions of the world that are unmapped, even in areas described by archaeologists as the oldest places on earth, such as rural Nigeria which was the focus of this teaching event. Missing Maps employs a three-stage process that starts with a crowd of remote volunteers who identify structures, usually buildings and roads and mark them on satellite imagery. The second stage involves volunteers on the ground verifying these structures and adding details. The third stage requires GIS professionals to create detailed maps. The result is a resource that humanitarians from any organisation can access if they aim to address the needs of vulnerable populations in that location. Regions are prioritised by MSF-UK and assigned to Missing Maps according to current and projected humanitarian needs.
http://dx.doi.org/10.1016/j.nedt.2017.09.013 Received 27 June 2017; Accepted 22 September 2017 0260-6917/ © 2017 Published by Elsevier Ltd.
Nurse Education Today 60 (2018) 1–2
Big Ideas
3. The Event Two mapathons were arranged for two hour periods involving 150 students at each event. Students who couldn't attend the mapathons due to timetable clashes where required to undertake a similar online activity which also involved mapping. A large flat teaching space was booked that was equipped with audio and projection equipment. Music, fruit, water and beanbags were supplied. A humanitarian speaker from MSF Australia was asked to talk about their experience working cross-culturally with vulnerable populations in conflict settings. At the first mapathon, an experienced neonatal nurse passionately described her experiences in Afghanistan and explained how small interventions such as kangaroo-care and simple airway manoeuvres can drastically improve neonatal survival. At the second mapathon, an anaesthetist outlined his struggle dealing with war trauma in Gaza with limited infrastructure and supplies and a severe lack of trained nursing staff. The humanitarian presentation was followed by mapping training using the app. The 3 step Missing Maps process was outlined and real satellite imagery were projected as examples of what the students were looking for. A demonstration outlined what students should do if they identified houses and buildings, if they weren't sure and what to do if there was poor imagery or if structures were not present in the grid. An emphasis was placed on quality mapping, rather than speed, highlighting the purpose of the mapping exercise as well as the links with the learning objectives for the global health unit. The students were then introduced to the area to be mapped in Niger State, Nigeria, which included and overview of the politico-economic-social environment and the current conflict situation, the demographic profile, health needs and current challenges populations face accessing basic needs and health care. When mapping began, a real-time data visualisation was projected to feedback to students how much of the designated area had been mapped and what the results were. Students were encouraged to take breaks, eat fruit, walk around, talk and share findings. Students were able to call on trained student volunteers who had mapping experience and other technical volunteers were available to assist with software hardware and connection issues. A relaxed environment was created with beanbags and, music, and the second mapathon was broken-up with some physical activity (7-min workouts), door-prizes and live-polling for real-time feedback. 4. The Impact Challenges experienced included a lack of certainty regarding whether the WI-FI could support the number of connections and app band-width however, turned out not to be an issue. A small number of students failed to link the event with the learning objectives of the unit, which may have been due their failure to undertake the preparation activity. During the week of the mapathons 75% of the designated area was completed which is considered very fast. This included 142,214 contributions made by 597 volunteers. The results show a high overall level of agreement (average: 0.89) among volunteers, which is an intrinsic quality indicator (Albuquerque et al., 2016). Overall, the volunteers helped to identify 639 km2 of unmapped but inhabited area. Student feedback was overwhelmingly positive. Many expressed gratitude in relation to being given the opportunity to do something about international health inequity rather than passively reading and writing about it. Students valued the interaction, the team-feeling and the relaxed environment. Live-polling during the event demonstrated that the majority of students agreed the missing mapathon improved their cultural competence, knowledge of global health issues and awareness about vulnerable populations. Links for Further Information
• You Tube video: MapSwipe Missing Mapathon, Monash University: https://www.youtube.com/watch?v=Sau2ULAtXaU https://www.youtube.com/watch?v=Sau2ULAtXaU • More about missing Maps: http://www.missingmaps.org/ Acknowledgements Pete Masters, Missing Maps and MSF-UK. References Albuquerque, J., Herfort, B., Eckle, M., 2016. The tasks of the crowd: a typology of tasks in geographic information crowdsourcing and a case study in humanitarian mapping. Remote Sens. 8 (10), 859. http://dx.doi.org/10.3390/rs8100859. Bostrom, A.K., 2003. Lifelong learning, intergenerational learning, and social capital: from theory to practice. Available at: http://www.diva-portal.org/smash/record.jsf?pid= diva2%3A199149&dswid=2967#sthash.PIXm4GW8.dpbs. Forbes, 2016. Workforce 2020 what you need to know. Accessed 27.6.2017 at: https://www.forbes.com/sites/workday/2016/05/05/workforce-2020-what-you-need-to-know-now/# 15434a552d63. Freedman, D.A., Bess, K.D., Tucker, H.A., et al., 2009. Public health literacy defined. Am. J. Prev. Med. 36, 446–451. Herfort, B., Reinmuth, M., de Albuquerque, J.P., Zipf, A., 2017. Towards evaluating crowdsourced image classification on mobile devices to generate geographic information about human settlements. In: Proceedings of the 20th AGILE. Smith, Stanton, 2008. De Loitte Development LLC. In: Decoding Generational Difference: Fact, Fiction or Should We Just Get Back to Work? (Available at: https://public.deloitte.com/ media/0507/250608/us_DecodingGenerationalDifferences.pdf).
Patricia Schwerdtle⁎ Nursing & Midwifery, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia Medecins Sans Frontieres Australia, Sydney, NSW, Australia E-mail address: [email protected] Benjamin Herfort Geo-Informatics Science Research Group, Heidelberg University, Germany
⁎
Corresponding author.
2
Contents lists available at ScienceDirect
Nurse Education Today journal homepage: www.elsevier.com/locate/nedt
Big Ideas Teaching global health using crowd-sourcing with Missing Maps
MARK
1. Background of the Innovation Generation-Y or the ‘Millennials’ currently make up the vast majority of the tertiary student population and in 2025, they will comprise 75% of the workforce (Forbes, 2016). So how do Millennials learn and what drives them? Millennials are creative, team-players with short attention spans and they value feedback. They skillfully employ technology and are motivated by believing they can collectively make a difference. Learning-wise, they are digital-natives and desire interactivity, active-learning and edutainment (Bostrom, 2003) (Smith, 2008). This can be challenging for Gen-X and Baby-Boomer educators who are more likely to want to inform and equip students with the learning resources to be self-directed. But if you want Millennials to engage, you have to combine fun with learning, employ cutting-edge, multi-media technology and integrate teamwork with meaning. Considering Millennials insist on meaning and pay attention to organisational purpose, it might be worth reviewing your hospital, university or organisational philosophy and mission statement. For example, at Monash University, we aspire to graduate global citizens who interact with the world, exhibit cross-cultural competence and use critical thinking and innovation to address complex problems creatively. This broader aim aligns well with a concurrent call to improve public health literacy in health professional education. Public health considers health from a population rather than individual perspective and acknowledges that health is heavily impacted by globalisation requiring health professionals to consider broader politico-economic-societal environments factors that influence health (Freedman et al., 2009). 2. The Innovation As a component of the curriculum many nursing and midwifery students study global health, cultural competence and vulnerable populations. In the past, my students have expressed frustration and felt disempowered when learning about extreme health inequity in the world, particularly among vulnerable populations such as refugees and asylum seekers, indigenous peoples and people living in extreme poverty in developing countries. This year, we decided to act on that feedback and provide students with an opportunity to channel the energy generated by learning about inequalities, into an activity that would benefit vulnerable populations in developing countries. This would take the form of a world-first, crowdsourcing event using a new app, aiming to put vulnerable populations on the map where they weren't before, so that humanitarian actors can access them to provide emergency assistance in the event of crises. While our challenge was to create a meaningful activity that would satisfy the students desire to do something about global health inequity, humanitarians were facing another problem in that they were struggling to locate vulnerable populations in need of humanitarian assistance because there were no detailed, up to date and accurate maps of the places where they lived. Meanwhile, a German geo-informatics academic was working on a web-based prototype crowdsourcing tool to solve both problems, which was picked up by Medecins Sans Frontieres (MSF) and further developed into an app called ‘MapSwipe’. MapSwipe is a smart phone application to derive geographic information from satellite imagery and to facilitate detailed mapping in ‘Open Street Map’. In MapSwipe, volunteers are asked to classify tiles of satellite imagery into four different classes (“No”, “Yes”, “Maybe”, “Bad Imagery”). By tapping and swiping on the mobile device they can signal whether they were able to spot human settlements. The users can choose between several projects in different countries (Herfort et al., 2017). While traditional ‘Missing Maps Mapathons’ require volunteers with mapping skills (e.g. geography students) to create maps, the ‘MapSwipe’ app allowed nursing and midwifery students to do something about international health inequity without diverging far away from their learning objectives around cultural competence, vulnerable populations and global health. The ‘Missing Maps Project’ in the UK, connected the nursing and midwifery school in Australia with the Geo-informatics department in Germany and assigned the students an area that required urgent mapping in Nigeria according to MSF-UK and MSF-Australia. The Missing Maps project is a collaboration between MSF-UK, the Red Cross and the Humanitarian Open Street Map Team that aims to create detailed maps of regions in the world that are currently unmapped, so that humanitarians can access vulnerable populations in the event of natural disasters, disease outbreaks and conflict. While many people especially in high-income countries assume everyone is on google maps, that is unfortunately not the case. There are in fact vast regions of the world that are unmapped, even in areas described by archaeologists as the oldest places on earth, such as rural Nigeria which was the focus of this teaching event. Missing Maps employs a three-stage process that starts with a crowd of remote volunteers who identify structures, usually buildings and roads and mark them on satellite imagery. The second stage involves volunteers on the ground verifying these structures and adding details. The third stage requires GIS professionals to create detailed maps. The result is a resource that humanitarians from any organisation can access if they aim to address the needs of vulnerable populations in that location. Regions are prioritised by MSF-UK and assigned to Missing Maps according to current and projected humanitarian needs.
http://dx.doi.org/10.1016/j.nedt.2017.09.013 Received 27 June 2017; Accepted 22 September 2017 0260-6917/ © 2017 Published by Elsevier Ltd.
Nurse Education Today 60 (2018) 1–2
Big Ideas
3. The Event Two mapathons were arranged for two hour periods involving 150 students at each event. Students who couldn't attend the mapathons due to timetable clashes where required to undertake a similar online activity which also involved mapping. A large flat teaching space was booked that was equipped with audio and projection equipment. Music, fruit, water and beanbags were supplied. A humanitarian speaker from MSF Australia was asked to talk about their experience working cross-culturally with vulnerable populations in conflict settings. At the first mapathon, an experienced neonatal nurse passionately described her experiences in Afghanistan and explained how small interventions such as kangaroo-care and simple airway manoeuvres can drastically improve neonatal survival. At the second mapathon, an anaesthetist outlined his struggle dealing with war trauma in Gaza with limited infrastructure and supplies and a severe lack of trained nursing staff. The humanitarian presentation was followed by mapping training using the app. The 3 step Missing Maps process was outlined and real satellite imagery were projected as examples of what the students were looking for. A demonstration outlined what students should do if they identified houses and buildings, if they weren't sure and what to do if there was poor imagery or if structures were not present in the grid. An emphasis was placed on quality mapping, rather than speed, highlighting the purpose of the mapping exercise as well as the links with the learning objectives for the global health unit. The students were then introduced to the area to be mapped in Niger State, Nigeria, which included and overview of the politico-economic-social environment and the current conflict situation, the demographic profile, health needs and current challenges populations face accessing basic needs and health care. When mapping began, a real-time data visualisation was projected to feedback to students how much of the designated area had been mapped and what the results were. Students were encouraged to take breaks, eat fruit, walk around, talk and share findings. Students were able to call on trained student volunteers who had mapping experience and other technical volunteers were available to assist with software hardware and connection issues. A relaxed environment was created with beanbags and, music, and the second mapathon was broken-up with some physical activity (7-min workouts), door-prizes and live-polling for real-time feedback. 4. The Impact Challenges experienced included a lack of certainty regarding whether the WI-FI could support the number of connections and app band-width however, turned out not to be an issue. A small number of students failed to link the event with the learning objectives of the unit, which may have been due their failure to undertake the preparation activity. During the week of the mapathons 75% of the designated area was completed which is considered very fast. This included 142,214 contributions made by 597 volunteers. The results show a high overall level of agreement (average: 0.89) among volunteers, which is an intrinsic quality indicator (Albuquerque et al., 2016). Overall, the volunteers helped to identify 639 km2 of unmapped but inhabited area. Student feedback was overwhelmingly positive. Many expressed gratitude in relation to being given the opportunity to do something about international health inequity rather than passively reading and writing about it. Students valued the interaction, the team-feeling and the relaxed environment. Live-polling during the event demonstrated that the majority of students agreed the missing mapathon improved their cultural competence, knowledge of global health issues and awareness about vulnerable populations. Links for Further Information
• You Tube video: MapSwipe Missing Mapathon, Monash University: https://www.youtube.com/watch?v=Sau2ULAtXaU https://www.youtube.com/watch?v=Sau2ULAtXaU • More about missing Maps: http://www.missingmaps.org/ Acknowledgements Pete Masters, Missing Maps and MSF-UK. References Albuquerque, J., Herfort, B., Eckle, M., 2016. The tasks of the crowd: a typology of tasks in geographic information crowdsourcing and a case study in humanitarian mapping. Remote Sens. 8 (10), 859. http://dx.doi.org/10.3390/rs8100859. Bostrom, A.K., 2003. Lifelong learning, intergenerational learning, and social capital: from theory to practice. Available at: http://www.diva-portal.org/smash/record.jsf?pid= diva2%3A199149&dswid=2967#sthash.PIXm4GW8.dpbs. Forbes, 2016. Workforce 2020 what you need to know. Accessed 27.6.2017 at: https://www.forbes.com/sites/workday/2016/05/05/workforce-2020-what-you-need-to-know-now/# 15434a552d63. Freedman, D.A., Bess, K.D., Tucker, H.A., et al., 2009. Public health literacy defined. Am. J. Prev. Med. 36, 446–451. Herfort, B., Reinmuth, M., de Albuquerque, J.P., Zipf, A., 2017. Towards evaluating crowdsourced image classification on mobile devices to generate geographic information about human settlements. In: Proceedings of the 20th AGILE. Smith, Stanton, 2008. De Loitte Development LLC. In: Decoding Generational Difference: Fact, Fiction or Should We Just Get Back to Work? (Available at: https://public.deloitte.com/ media/0507/250608/us_DecodingGenerationalDifferences.pdf).
Patricia Schwerdtle⁎ Nursing & Midwifery, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia Medecins Sans Frontieres Australia, Sydney, NSW, Australia E-mail address: [email protected] Benjamin Herfort Geo-Informatics Science Research Group, Heidelberg University, Germany
⁎
Corresponding author.
2