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“Course Hero.com” is one of several thousand sites selling academic support for baccalaureate and graduate students. The sites are unsupervised, presenting opportunities for several varieties of academic and commercial malfeasance. Course Hero’s funding—$14 million from private sources— and fee structure suggest that less than 1 million students buy the service. That’s a worrisome percentage of the roughly 21 million post-high school US enrollment.  It also suggests that the site’s claim to be “a platform of more than 10 million students and educators across the globe” might be inflated. Course Hero’s history suggests that many leave in disgust. Although it claims to offer valuable readings and tutors, and also to uphold an Honor Code, reviews are negative:

Overall, online reviews displayed negative feedback on the services provided by Course Hero. If you are paying for an education it is probably best just to do the work yourself or join a study group. (http://www.reviewopedia.com/course-hero-reviews)

A student reviewer summarized his complaints, “These guy's are getting rich at the expense of student's with little income. Stay away.” (sic) (http://talk.collegeconfidential.com/college-life/764986-course-hero.html,

Reviewing the Course Hero files for “managing healthcare organizations”, reveals a complete PDF of The Well-Managed Healthcare Organization, 7^th edition. (now out of print) and an unusably disorganized miscellany of student papers. None that JRG scanned would earn a passing grade at Michigan. When JRG asked for a tutor on managing healthcare organizations, an expert at Kenyatta University was offered.

Long story short, Course Hero and its competitors are an inescapable reality, but they are not a direct threat, except in two situations:

1. Beginning courses, (econ, stat, calculus, biology, etc.) where the student assessment questions are inescapably universal.
2. Other courses using Reusable Learning Objects (RLOs).

RLOs are standard questions with consensus answers.  They include true/false, multiple choice, and short answer questions, but also cases and assignments requiring consistent professional responses. If a student successfully substitutes a “pony”, from Course Hero or some other source, two things happen:

1. The student’s mastery is impaired.
2. The data on class or cohort mastery is impaired.

The bottom line is that anyone using RLOs must guard against ponies. The problem is well understood, and solid advice is available. (Best Practice Strategies to Promote Academic Integrity in Online Education. Version 2.0, June 2009, http://wcet.wiche.edu/sites/default/files/docs/resources/Best-Practices-Promote-Academic-Integrity-2009.pdf)

RLOs covering health care management are a valuable resource for all AUPHA members. They can provide:

• Major timesavers for instructors
• Questions pre-tested for clarity and graded by difficulty
• Evidence-based correct answers
• Web-accessible discussion of answers
• Data on student performance that can be used for cohort or program comparisons and continuous improvement of the academic program.

RLOs complement texts, reading assignments, and lectures that describe best practice, allowing the student cognitive mastery. Well-designed RLOs help students develop applications skills, implementing and documenting CAHME’s “Competencies”. Good RLOs should be action-oriented, applying professional best practice. Developing good RLOs takes time and effort. They can be individually or collectively developed. They can be and ideally should be, peer-reviewed. A file of peer-reviewed RLOs would be a valuable resource for AUPHA, but also for ACHE and other professional organizations. The goal of best practice is shared, and consensus on the RLO answers is essential to professionalization.

RLOs can be constructed so that students must think through professional actions, evaluate action alternatives, and design a response strategy. For example, in learning healthcare organization management, students can use a graduated sequence of application oriented RLOs:

• Professionally appropriate responses to common issues, answered by multiple choice, with immediate feedback (correct answer and discussion).
• Discussion questions on how cognitive material is applied in the workplace, including how to explain the origins and intents of best practice policies.
• “Assignments”, one or two paragraph real situations, where teams develop best practice responses.
• Peer grading of assignment solutions
• Gradable assignments with grading rubrics.

The full set is a powerful practice opportunity for beginning professionals. (An example is available from JRG, organized around WMHO8, but useful in any course teaching  professionally recognized best practice, provides each student with up to 15 simulated professional learning situations each week.) 

AUPHA should develop a topic-oriented library of RLO files, sharing with the professional organizations a system for peer review, including criticism, user commentary, and revising. The RLO file must be guarded against academic misconduct, like posting on Course Hero. Thus, if AUPHA, ACHE and other organizations pursue an RLO library, they must safeguard it.  The risk is neither unique nor great; some simple steps offer reasonable protection:

• There should be a managing committee responsible for rules governing:
  1. Selection and validation of new materials (peer review)
  2. Appropriate use
  3. Removal or correction of outdated materials
  4. Qualifications for access (presumably AUPHA faculty and appointed professional organization representatives)
  5. Pursuit of alleged or potential misuse
  6. Rules allowing sharing of student performance data for continuous improvement
• Copyright should be maintained.
• Reports of misuse should be systematically pursued.
• Sites such as “Course Hero” should be periodically surveyed for illicit sharing.

Some people will scoff at the RLO concept, probably more will groan. But it represents a safe, reasonable, constructive path to improve professional education and professional practice in health administration. It is actually inevitable; the question is not whether, but when.

These colleagues have emailed me their support for RLOs:

Joseph Horton, University of Utah, 7/10

Carol Molinari, University of Baltimore, 7/10

Robert Hernandez, University of Alabama Birmingham,  7/11

Christy Lemak, University of Alabama Birmingham 7/12

I welcome more.  Please comment, either in support or opposition.