Brief Communication
Online Education About Herbs and Dietary Supplements: Margin or Mission?
Journal of Evidence-Based Complementary & Alternative Medicine 2015, Vol. 20(1) 80-81 ª The Author(s) 2014 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/2156587214553305 cam.sagepub.com
Kathi J. Kemper, MD, MPH1 and Sejal Patel, MBBS1
Abstract Background: Online education is increasingly used to train health professionals, but little is known about how variations in cost affect use of elective training. We assessed whether offering registration for free increased the number of modules consumed in both absolute terms (# modules consumed per person, pp) and relative terms (# modules consumed per # modules registered). Methods: We analyzed results of the ‘natural experiment’ on learner’s use of the OSU Center for Integrative Health and Wellness online elective curriculum, Introduction Herbs and Dietary Supplements Across the Lifespan, in which costs varied based on monthly discounts for students, faculty, staff, alumni, and members of selected professional associations. Results: Over 7 months there were a total of 905 registrants for 8553 modules. Most (847/905, 94%) registered for free; they completed 1505 (18%) of 8344 modules for which they registered. Fewer (58/905, 6%) people paid for registration; they completed a significantly higher percentage 90/209 (43%, P < 0.001) of modules for which they registered; those who paid full, non-discount rates had the highest completion rates (62%, P < 0.001). Free and paid registrants completed about the same average number of modules per person, pp, (1.8 pp free vs.1.6 pp paid). Conclusion: Although it may not contribute to financial margins, offering free online elective training addresses the institutional mission of increasing the number health professionals trained and the number of modules consumed compared with charging for training. Additional research is needed to determine the impact of pricing on educational outcomes and ultimately on patient care. Keywords education, herbs, dietary supplements, cost Received August 21, 2014. Accepted for publication August 26, 2014.
In an earlier study of online training about herbs and dietary supplements for health professionals, we found that those who paid for continuing education credit used significantly more learning resources than those who did not.1 After updating the curriculum and moving it to a new server at a different university, over 7 months (November 2013 to June 2014) we offered several months of ‘‘free special offers’’ to local students, faculty, and staff, as well as 1 month of ‘‘90% off’’ for members of a professional organization, 20% discount rates for alumni, and 50% discounts for faculty and staff. Learners could register for 1 to 14 individual learning modules. We report here the results of this ‘‘natural experiment’’ on learners’ use of the curriculum to better understand the impact of discounted costs for registration on the number of modules consumed in both absolute terms (number of modules consumed per learner) and relative terms (number of modules consumed per number of modules for which the learner registered). During this 7-month period, there were 905 registrants for 8553 modules in the elective program, Herbs and Dietary Supplements across the Lifespan (http://herbs-supplements.osu.edu). The registrants included 389 nurses, 151 physicians, 113 administrative staff, 43 therapists, 37 researchers, 35 dietitians, 19 pharmacists,
15 students, 15 psychologists and counselors, 9 public health professionals, 7 social workers, 5 dentists, and 67 others. Most (85%) were practicing professionals, and 15% were trainees. The web platform for the curriculum tracked registrations for a module (registrations) and modules that were ‘‘in progress’’ and modules for which evaluations had been ‘‘completed.’’ To simplify analysis, we combined ‘‘in progress’’ and ‘‘completed’’ as a single category, ‘‘consumed.’’ The 847 registrants who received free registration consumed 1505 (18%) of the 8344 herbs and dietary supplements modules (9.8 modules per person) for which they registered. The 58 registrants who paid for registration consumed 90 (43%) of the 209 modules (3.6 modules per person) for which they registered. The difference in relative module consumption between
1
The Ohio State University, Columbus, OH, USA
Corresponding Author: Kathi J. Kemper, MD, MPH, Center for Integrative Health and Wellness, Department of Pediatrics, The Ohio State University, 1581 Dodd Dr, Columbus, OH 43210, USA. Email: [email protected]
80 Downloaded from chp.sagepub.com at University of Ulster Library on February 25, 2015
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those who received free training versus those who paid for training was highly significant (18% vs 43%, P < .0001). Among the 58 registrants who paid for registration, some paid the full retail amount ($25 per module), and some paid 10% to 50% of the full retail amount depending on the monthly discount; to simplify analysis, we combined all discount rates into ‘‘discount’’ to compare with ‘‘full fare’’ pricing consumption. Comparing the relative consumption rates for ‘‘full fare’’ with ‘‘discount’’ payments, we found 62% consumption for full fare and 35% consumption for discount rate, P ¼ .0003. Relative consumption rates for both full fare (62%) and discount (35%) rates were significantly higher overall than the 18% rate for those who received free registration (P < .05). The absolute number of modules consumed was slightly, but not significantly, higher (1.8 modules per person) among the free registrants than the paid registrants (1.6 modules per person). The number of people who registered was much greater for free registration than for any period or type of paid registration. Free registration was associated with consumption of 1505 modules by 847 people, whereas paid registration was associated with consumption of just 90 modules by 58 people. These data suggest that although free registration results in a lower relative rate of consumption per registration, it increases the total number of modules consumed and the number of learners who are reached. Learners consume relatively less of what they ‘‘take,’’ but since free pricing attracts many more learners who register for many more modules, it results in an overall increase in absolute consumption of the program. However, offering training in complementary therapies for free more effectively addresses academic institutions’ mission than their margin. This information may help inform decisions about how
to best disseminate evidence-based information about complementary therapies. Acknowledgments We thank all those whose dedication to improving health is evidenced by enrolling in continuing education programs. We thank the OSU Office of Geriatrics and Gerontology for their excellent work on the program Web site.
Author Contributions SP conducted the analyses and participated in interpretation and drafting and revising the article. KK conceived of the study idea, collected the data, participated in the interpretation of data, and supervised drafting and revising the article.
Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding The authors received no financial support for the research, authorship, and/or publication of this article.
Ethical Approval This project was approved by the OSU Institutional Review Board (2013B0611).
Reference 1. Woods CR, Kemper KJ. Curriculum resource use and relationships with educational outcomes in an online curriculum. Acad Med. 2009;84:1250-1258.
81 Downloaded from chp.sagepub.com at University of Ulster Library on February 25, 2015
Online Education About Herbs and Dietary Supplements: Margin or Mission?
Journal of Evidence-Based Complementary & Alternative Medicine 2015, Vol. 20(1) 80-81 ª The Author(s) 2014 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/2156587214553305 cam.sagepub.com
Kathi J. Kemper, MD, MPH1 and Sejal Patel, MBBS1
Abstract Background: Online education is increasingly used to train health professionals, but little is known about how variations in cost affect use of elective training. We assessed whether offering registration for free increased the number of modules consumed in both absolute terms (# modules consumed per person, pp) and relative terms (# modules consumed per # modules registered). Methods: We analyzed results of the ‘natural experiment’ on learner’s use of the OSU Center for Integrative Health and Wellness online elective curriculum, Introduction Herbs and Dietary Supplements Across the Lifespan, in which costs varied based on monthly discounts for students, faculty, staff, alumni, and members of selected professional associations. Results: Over 7 months there were a total of 905 registrants for 8553 modules. Most (847/905, 94%) registered for free; they completed 1505 (18%) of 8344 modules for which they registered. Fewer (58/905, 6%) people paid for registration; they completed a significantly higher percentage 90/209 (43%, P < 0.001) of modules for which they registered; those who paid full, non-discount rates had the highest completion rates (62%, P < 0.001). Free and paid registrants completed about the same average number of modules per person, pp, (1.8 pp free vs.1.6 pp paid). Conclusion: Although it may not contribute to financial margins, offering free online elective training addresses the institutional mission of increasing the number health professionals trained and the number of modules consumed compared with charging for training. Additional research is needed to determine the impact of pricing on educational outcomes and ultimately on patient care. Keywords education, herbs, dietary supplements, cost Received August 21, 2014. Accepted for publication August 26, 2014.
In an earlier study of online training about herbs and dietary supplements for health professionals, we found that those who paid for continuing education credit used significantly more learning resources than those who did not.1 After updating the curriculum and moving it to a new server at a different university, over 7 months (November 2013 to June 2014) we offered several months of ‘‘free special offers’’ to local students, faculty, and staff, as well as 1 month of ‘‘90% off’’ for members of a professional organization, 20% discount rates for alumni, and 50% discounts for faculty and staff. Learners could register for 1 to 14 individual learning modules. We report here the results of this ‘‘natural experiment’’ on learners’ use of the curriculum to better understand the impact of discounted costs for registration on the number of modules consumed in both absolute terms (number of modules consumed per learner) and relative terms (number of modules consumed per number of modules for which the learner registered). During this 7-month period, there were 905 registrants for 8553 modules in the elective program, Herbs and Dietary Supplements across the Lifespan (http://herbs-supplements.osu.edu). The registrants included 389 nurses, 151 physicians, 113 administrative staff, 43 therapists, 37 researchers, 35 dietitians, 19 pharmacists,
15 students, 15 psychologists and counselors, 9 public health professionals, 7 social workers, 5 dentists, and 67 others. Most (85%) were practicing professionals, and 15% were trainees. The web platform for the curriculum tracked registrations for a module (registrations) and modules that were ‘‘in progress’’ and modules for which evaluations had been ‘‘completed.’’ To simplify analysis, we combined ‘‘in progress’’ and ‘‘completed’’ as a single category, ‘‘consumed.’’ The 847 registrants who received free registration consumed 1505 (18%) of the 8344 herbs and dietary supplements modules (9.8 modules per person) for which they registered. The 58 registrants who paid for registration consumed 90 (43%) of the 209 modules (3.6 modules per person) for which they registered. The difference in relative module consumption between
1
The Ohio State University, Columbus, OH, USA
Corresponding Author: Kathi J. Kemper, MD, MPH, Center for Integrative Health and Wellness, Department of Pediatrics, The Ohio State University, 1581 Dodd Dr, Columbus, OH 43210, USA. Email: [email protected]
80 Downloaded from chp.sagepub.com at University of Ulster Library on February 25, 2015
Kemper and Patel
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those who received free training versus those who paid for training was highly significant (18% vs 43%, P < .0001). Among the 58 registrants who paid for registration, some paid the full retail amount ($25 per module), and some paid 10% to 50% of the full retail amount depending on the monthly discount; to simplify analysis, we combined all discount rates into ‘‘discount’’ to compare with ‘‘full fare’’ pricing consumption. Comparing the relative consumption rates for ‘‘full fare’’ with ‘‘discount’’ payments, we found 62% consumption for full fare and 35% consumption for discount rate, P ¼ .0003. Relative consumption rates for both full fare (62%) and discount (35%) rates were significantly higher overall than the 18% rate for those who received free registration (P < .05). The absolute number of modules consumed was slightly, but not significantly, higher (1.8 modules per person) among the free registrants than the paid registrants (1.6 modules per person). The number of people who registered was much greater for free registration than for any period or type of paid registration. Free registration was associated with consumption of 1505 modules by 847 people, whereas paid registration was associated with consumption of just 90 modules by 58 people. These data suggest that although free registration results in a lower relative rate of consumption per registration, it increases the total number of modules consumed and the number of learners who are reached. Learners consume relatively less of what they ‘‘take,’’ but since free pricing attracts many more learners who register for many more modules, it results in an overall increase in absolute consumption of the program. However, offering training in complementary therapies for free more effectively addresses academic institutions’ mission than their margin. This information may help inform decisions about how
to best disseminate evidence-based information about complementary therapies. Acknowledgments We thank all those whose dedication to improving health is evidenced by enrolling in continuing education programs. We thank the OSU Office of Geriatrics and Gerontology for their excellent work on the program Web site.
Author Contributions SP conducted the analyses and participated in interpretation and drafting and revising the article. KK conceived of the study idea, collected the data, participated in the interpretation of data, and supervised drafting and revising the article.
Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding The authors received no financial support for the research, authorship, and/or publication of this article.
Ethical Approval This project was approved by the OSU Institutional Review Board (2013B0611).
Reference 1. Woods CR, Kemper KJ. Curriculum resource use and relationships with educational outcomes in an online curriculum. Acad Med. 2009;84:1250-1258.
81 Downloaded from chp.sagepub.com at University of Ulster Library on February 25, 2015
