eLearning Lessons from Across the Globe by dylan romero

“Women are not dying because of untreatable diseases. They are dying because societies have yet to make the decision that their lives are worth saving,” Mahmoud Fathalla, Past President of the International Federation of Gynecology and Obstetrics.

In March 2013, my supervisor stopped by my desk to let me know about an upcoming project. I would soon meet with a group of residents and doctors who received a grant to develop multimedia content on women's health issues.

This seemed straightforward enough and my supervisor thought I would be a good fit for the project. Though the details about the project were vague (and the scope large), I knew I had an incredible opportunity over the horizon. I had no idea...


This blog post is a way for me to reflect on the three years spent working on this project. I was fortunate enough to work with a group of doctors who may just be the hardest working, bravest people I have ever met. Armed with knowledge from their UCSF Obstetrics and Gynecology residency, a cohort of residents travel to Uganda every summer to provide women's healthcare services in areas with limited resources.

ObGyns can travel to Uganda multiple times a year through the UCSF program, for as short of a visit as a few days. Previously, residents were handed a PDF with training and best practices for providing care in Uganda and boarded a 20+ hour flight across the Atlantic.

The goal was to create an online, interactive, case-based series on critical aspects of national and global underserved women’s health issues.

Flash-forward to March 2016, and I have now spent hundreds of hours on this one project. The final product consisted of 4 modules with a total of 17 videos, multiple gantt charts, 3 online self-assessments, dozens of 8 am meetings at the Library, Saturdays spent editing in the dark, a multi-touch book created in iBooks Author, and an online course hosted in the UCSF Collaborative Learning Environment (or CLE), powered by Moodle.

Now UCSF ObGyn residents can bring their iPads on-board, view the 17 videos on the flight to Uganda, and continue to access the content after they arrive without the need of an internet connection.

Three year later, I had completed the largest project of my life. I tried to use previous work when describing the project to friends and family to provide perspective; comparing it to work I did for my graduate thesis or designing a children's book. But this new project overshadowed any other I have ever worked on; like the Yosemite Valley sitting in the shadows of El Capitan. To get to the point, this project was BIG. Bigger than anything I have ever developed.


The goal of the project is to train residents on the following issues as it relates to providing care for women in Uganda, as well as other areas with limited resources:

  • Overview of Underserved Women's Health Care
  • Maternal Mortality
  • Cervical Cancer and Dysplasia
  • Family Planning
  • Obstetric Fistula
  • Infectious Diseases
  • Skills Prep for Low-Resource Settings
  • Refugee and Immigrant Women's Health Issues
  • Special Health Topics for Refugee and Immigrant Women
  • Female Genital Cutting

The project also included a section on the following women's health issues in underserved areas in the United States:

  • Racial Disparities in Healthcare
  • Context of Illicit Substance Use in Pregnancy
  • Practical Considerations in Caring for Women Who Use Drugs During Pregnancy
  • Obesity
  • Incarcerated Women
  • Homelessness


I did my homework and started with a needs assessment using pen and paper before touching a computer. This led to the development of an overall instructional goal and individual learning objectives for the project.

Assessing the needs of the learners also gave me a much better understanding of how the residents were accessing the training. We had the opportunity to improve the content AND make it more accessible in low-resource settings.

A BIG thank you to my Systematic Approach to Instructional Design Professor, Dr. Brian Beatty, for providing the tools and resources needed to get a project of this scale up and running!


Each video is 5-18 minutes long and was scripted and narrated by a member of the UCSF Obstetrics and Gynecology residency training program. Developing 17 videos with a consistent theme that the group was happy with provided a significant challenge.

After a kickoff meeting to define the scope and meet the group members, we got to work on a prototype video and developed a workflow that we would replicate 16 times over the next 3 years.



Subject Matter Expert writes script in Microsoft Word


Subject Matter Expert adds script to PowerPoint and storyboards video


Subject Matter Expert narrates script using Audacity software


I would search for images available on Creative Commons and download vector graphics from Noun Project


I would use Adobe Photoshop and Illustrator to design original images and edit assets


I would combine and edit the audio and multimedia assets in a Camtasia project (Mac version 2)


I would upload the video to Box@UCSF to collect, document, and incorporate feedback from group


Once the videos were finalized, I uploaded the MP4 video files to Kaltura for video hosting


We developed 3 self-assessment modules using Articulate Quizmaker


I used iBooks Author to create a multi-touch book that residents could use to access videos without the need of an internet connection


The videos, self-assessment, multi-touch book, and course content were added to the UCSF Collaborative Learning Environment (CLE) course as the final deliverable


The prototype phase was incredibly valuable. You could clearly see our progress when we would meet. We would review the prototype, make suggestions for improvement, and repeat. We eventually had a single video that we could use as a model to estimate how much time each video would take to develop (I found 1 min of video = 1.5 hours of editing and design), and the appropriate length for scripts (warning: those online narration calculators are not always accurate!). This also gave us a better estimate of the time and staffing commitment required from our department.

The project and time management tools were critical for the success of the project. In any given day I could be editing a video, working on scripts and narrations with subject matter experts, and collecting, documenting, and implementing feedback from the group. I relied heavily on the following tools to make sure I was tracking all of the work I needed to do and the deliverables I needed from individual group members:

  • Microsoft Excel to track feedback, changes, and manage a style guide for each of the 17 videos. I used one Excel worksheet, with a separate tab for each video. This provided a nice process for tracking and implementing changes over the three year development period.
  • Team Gantt was used as a project management tool to develop deadlines, schedule development, identify dependencies, and assign tasks.
  • We used Box@UCSF to provide feedback on video drafts. The social-networking features in Box such as commenting provided a great process for collecting feedback from group members - and we could protect these early versions using a password.
  • We met as a group every three months to check in, but we also took advantage of the Collaborate web conferencing system (and then WebEx) to facilitate meetings when a group member could not make it to an in-person meeting.


A question that I am sure you are asking, and one that I would ask myself is, “why did this take so long?” We started by producing six videos on Global Women’s Health and surveyed a group of residents before and after their work in Uganda. This data was collected in a Qualtrics survey and reported back to the department and grant funder. This process took a year and a half, and after the data was collected and analyzed, we were ready to move forward with the remaining 11 videos.

There were a few other reasons why the project took nearly three years. It was as if all of the stars aligned: it was a large project; I still had my core job responsibilities; we experienced staff turnover multiple times in the three years; also doctors have amazingly busy schedules!


Over the last three years I have just begun to learn about a few the challenges facing women in low-resource settings both globally and locally. I have also learned quite a bit about myself. I learned how far I can push myself, how hard I can work, and what it takes to complete a project of this scale.

To be perfectly honest, I was a bit self-conscious at the start of the project as a man sitting in a room of ObGyns, discussing women’s healthcare issues of which I had little or no knowledge. I was not sure if the disconnect between myself and the issues would hinder me from doing the job at hand.

I quickly became aware how nominal the disconnect really was and how I could use my skills and experiences to contribute to the project. I am the son to a woman, a husband to a woman, and a brother to a woman; these connections and experiences helped to motivate and inspire me in my work on this project.

During the three years spent working on this project, we lost my older sister in a tragic accident. While editing videos, I would think of the issues she faced in her life as a mother, and though she did not live in an area with extremely limited resources such as Uganda, I imagine the challenges she faced related to women’s healthcare were difficult at times.

San Francisco Zoo, circa 1984

The work I did on this project was in honor of my sister, with the hope that these videos can help, even in the smallest way, to educate others about the health issues facing women in every country in the world. I believe we can help improve the conditions our mothers, sisters, wives, nieces, grandparents, and friends face through education and awareness.

And finally you can access the Association of Professors of Gynecology and Obstetrics course, Clinical Care in Low-Resource Settings: Preparing Providers and Fostering Leaders, by clicking the link below (warning - some videos do contain graphic images):

Lastly, I cannot thank the following people enough for their hard work on this project and for their dedication to women's healthcare around the world:

  • Dr. Meg Autry, UCSF OB/GYN Department, Author, Presenter and Contributor
  • Dr. Emily Scibetta, UCSF OB/GYN Department, Author, Presenter and Contributor
  • Dr. Chemtai Mungo, UCSF OB/GYN Department, Author, Presenter and Contributor
  • Dr. Sara Whetstone, UCSF OB/GYN Department, Author, Presenter and Contributor
  • Dr. Suha Patel, UCSF OB/GYN Department, Author, Presenter and Contributor
  • Dr. Felicia Lester, UCSF OB/GYN Department, Author, Presenter and Contributor
  • Dr. Rebecca Jackson, UCSF OB/GYN Department, Author, Presenter and Contributor
  • Andrew Corpuz, UCSF Library, Multimedia development support
  • Gail Persily, UCSF Library, CLE support and encouragement
  • Brian Warling, UCSF Library, CLE support
  • Liz Taylor, UCSF Library, Articulate development
  • Sean McClelland, UCSF Library, Holding down the fort
  • Kirk Hudson, UCSF Library, Moral support
  • Dr. Evans Whitaker, UCSF Library, PHI training and support
  • Peggy Tahir, UCSF Library, Copyright training and support


“Safe Motherhood" by Trocaire is licensed under CC BY 2.0, “Uganda Map” by Andrew Corpuz, "Mosquito Proof Night" by Christophe is licensed under CC BY 2.0, “Angola” by Wikimedia “Looking Out to Irrigated Fields” by World Bank Photo Collection is licensed under CC BY 2.0, “A Modern Pharmacy - Liberia” by Erik Hersman is licensed under CC BY 2.0, “Doctors Office” by Morgan, CC BY 2.0, “Women in Prison” by OK Press is licensed under CC BY 2.0, “Landscape” by World Bank Photo Collection is licensed under CC BY 2.0, “Ouagadougou” by Wikipmedia, The National Alliance of Advocates for Buprenorphine Treatment, “Northern Uganda” by Mark Jordahl is licensed under CC BY 2.0, “Kids Walking” by World Bank Photo Collection is licensed under CC BY 2.0

Please note this is a personal blog post. The opinions expressed here represent my own and not those of my employer. Any views or opinions are not intended to malign any religion, ethnic group, club, organization, company, or individual. All content provided in the post is for informational purposes only.

Created By
Dylan Romero

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