I have already (partially) followed some MOOCs on Coursera which have been of a very high quality and pedagogically speaking very convincing (my domains are communication and information sciences as well as cultural studies). I appreciate the quantity of work colleagues are accepting for producing such online courses. However, I agree also with you that online courses cannot replace "in praesentia courses" - especially not in experimental sciences (for example). I also have the feeling that the "MOOC fahsion" is a rather simplistic answer to the heavy economical constraints universities (in Europe) are actually facing.

Nevertheless, the public of MOOCs are not only students of universities - the public is much more broader (people interested in a topic, elder people, people looking for new knowledge and ideas, ...). MOOCs therefore play an important role in LLL.

In my opinion Peter, the relationship between MOOCs and the financial crisis is not so clear. The success of the MOOCs phenomena is more cultural than economical.

The MOOCs are here to stay!

Hi Alejandro, I think there are a number of issues here. Like Peter, I am in the process of taking two MOOCs on Coursera, The content is of a very high quality, interesting and the other participants engaged enough in the various interactive elements of the MOOC for me to feel I am part of a learning community. The course itself stitches together various technologies that have been around for years, video, forums and quizes but in an accessible way and layered on top a progress tracking system. What I think sets them apart as "new" is the quality of the input from the various Universities that sponsor them and the quality of course staff and their engagement with the course.

Online courses, the OC part are not new. BMJ and other organisations have been offering them for a long time, but on a pay to participate basis so the MO part is missing. Handing out the responsibility to a third party to deliver, as in your example, does not a MOOC make if they are restricted to say registered medical practitioners. They are just OC, Online Courses.

My thought about the MOOC is that it encourages the habit of continuing education where it may not have been not possible before. It expands the range of topics, at a very high level of quality, to people who could not previously have accessed that material. Best Wishes. Matt

Alejandro, I agree with you: there is certainly not a direct relationship between the financial crisis of our universitiés and the success story of MOOCs. And as Matt has pointed it out, OCs already exist since several years and MOOCs seems mostly to encourage continuing education or LLL (Life Long Leraning). However, MOOCs are also thought as possible replacements of "in preaesentia" courses and curricula which cannot be provided because of economic reasons ... This is, as I believe, one of the motivations of the french Ministry of Higher Education and research for having contracted with Edx.

Matt. Regarding the M, I'm right now taking a Coursera course named "Global Tuberculosis. Clinical Management and Research". It's so fascinating to be enrolled in a course together with more than 6000 participants, 80% from outside the US. An the most amazing part of it is that I'm sharing my experience not only with MD but also with nurses, researchers, etc, and learning from them. A truly global enriching experience.

I agree with you Peter and I cheer up the French Ministry for their decision. I wish the Spanish government could make a similar action but unfortunately this is highly improbable

Medical Education requests a personal contact master-student at clinical level centered on clinical method.

In the light of the paradigm change of medical science and medicine from a bio-molecular one to “Person Centered Medicine” , which revolutioned Medical Education and its Teaching toward a "Person Centered Medical Education" , sponsored in 2011 by WHO, courses in Medicine only made through internet can be valid only for a theoretical teaching and assessment of theories.

Health governance methods which completely endorse internet for physicians' continuing education make a error, due to the epistemological and methodological ignorance of “amateurs “.

Person centered clinical method , we teach from 1998 , (reliability 0,80-validity 0,81. the first investigation made in 2012 on a clinical method reliability and validity) which starts from a learning assessment of empathy and person diagnosis,cannot be taught and learnt through Internet.

To date there is some “amateur” in Medical Education that does not accept the idea of a change of the medicine paradigm, teaching method, assessment , and they continue to educate students , physicians, investigators on false epistemological , deterministic assumptions., error that is payed by patients and health systems. An other attitude of amatorial physicians is to reduce Person Centered Medicine,to alternative medicine, (like some acupuncturist) with the intuition that if a generalist applies Person Centered Clinical Method their private practice incomes risk to be reduced, http://www.unambro.it/html/pdf/Person_Centred_Clinical_Method_Teaching.pdf

There is some other clinical teacher who begins to experiment PCME and PCCM only starting from reading my theoretical papers, (1200 readings in Research gate !!!) It is an error because Person Centered Medicine Clinical Method requests in clinical application and in teaching and learning assessment a personal interaction with teacher, like a patient requests a personal interaction with the physician, not with a bio-molecular machine or Bio-technocratician who considers persons like "robots" for technical examinations, disease or recovery production,computerized diagnosis, and only bio-technical therapies, forgetting the interactionist lesson of basic science and the teleonomic nature of human persons, To date the risk is to build a schizophrenic medicine dissociated by its objective ethical and epistemological reality only for a stock market warrancy and good incomes. To date epistemological ignorance and reduction of Medicine to technics without an objective ethics which limits clinical and technical applications is very spread !

Our struggle to date is to form medical educators, clinical teachers and investigator in Person centered Medical Education, creating important opportunities where internet only is an usuful tool for a theoretical start-up like the teching method used in the International program in Person Centered Medicine.

You can build a partial idea on Person Centered Medical Education reading the paper on the subject I lead in Research Gate and consulting the International Program In Person Centered Medicine and the next updating courses in www.unambro.it .(home page)

I encourage you and your colleagues who will read this answer to update in Person Centered Medicine and Person Centered Medical Education, through our courses (unique in the world) ( the next at the end of November in Milan-info on the web site ) and to become true pioneers, members of the International Academy of Person Centered Medicine, delegates in their countries, in their school of Medicine and or Faculties or in physicians' continuing education for such revolution. Id like to meet some of you also in the Symposium

on Physicians' and School of Medicines acceditation in Person Centered Medicine.

(November 28) . Write directy to me if you are interested in such subject. [email protected]

Prof. Giuseppe R.Brera

Author of Person Centered Medicine Theory, Person Centered Cinical Method and Person Centered Medical Education Quality Procedures

Dean of the Milan School of Medicine and the International Academy of Person Centered Medicine