When good intentions may not be good enough Reflections on a case study of collaborative development of digital open educational resources in bioethics in the Nordic region

This reflective article sets out to illustrate some of the difficulties involved in developing capacity in Nordic collaboration. The project involves the development of digital open educational resources (OER) focused on bioethics in the Nordic region through a close collaboration between five universities. The article presents a case study and details the rationale for the development of the digital OER, describing how they were developed, tested and implemented. The article uses a framework of change management to identify current shortcomings, challenges and critical areas for further development. can be said to come internally from local cultures, but also through structural inertia brought through path dependency. This article identifies the development of digital open educational resources (OER) as a way to enhance capacity and collaboration in the Nordic region, and focuses on a case study of a project of collaborative development of digital OER in bioethics by a consortium of five Nordic HEIs. This article has two main aims: i) to describe how the project was designed and developed to promote organisational change and educational development by means of virtual mobility and internationalisation-at-home; and ii) to discuss and reflect critically on the shortcomings of the project from an organisational change perspective. As such, the article aims to offer insights into how such capacity-building endeavours may be more successful at translating ideas into implementation. The article uses a modified form of a descriptive case study (Yin, 2009), and presents a) a rationale for the project, b) a descrip-tion of the development of the different elements of the project, and c) reflections on the process so far. The article begins with a brief overview of elements of organisational change as a driving force for sustainable educational development. It then addresses some key internationalisation concepts and values that may be seen as adding additional value to digital interventions. Virtual mobility is introduced as a way to identify a possibility for students to take part in other participating institutions’ cultures and educational offerings, but from their current physical location. The article then outlines how an open educational resource was developed in a collaborative setting and how the same resource was tested.


Introduction
Globally, but also in the Nordic context, there is a surge in interest in the digitalisation of core societal services, from postal services to the healthcare sector, trade and industry, and not least the educational sector (Larsson & Teigland, 2019;McGrath & Åkerfeldt, 2019). The ongoing Covid-19 pandemic has recently led to university education in Sweden moving to varying degrees of digital learning, and similar responses can be seen throughout the Nordic region, as well as mainland Europe. While this should be seen as an immediate response to an ongoing crisis, the interest in the digitalisation of society is part of a more general trend. In 2018, for example, the European Commission launched a digital education action plan that acknowledged the importance of supporting the use of technologies in education (European Commission, 2018). The action plan is intended to identify key aspects of how the digital transformation of the educational sector will be brought about. The Nordic countries, for their part, are well situated to bring about such changes, with interconnected histories and traditions, and similarities in societal structure, including how the educational sector is organised and funded. Collaboration between higher education institutions (HEIs) dates back at least to the 1970s, when the Nordic Council of Ministers signed agreements enabling the freer mobility of students in the Nordic region (Elken, Hovdhaugen, & Wiers-Jenssen, 2015). For the higher education sector, the key similarities Vol. 15, No. 4-2020, p. 274-284 ISSN Online: 1891 extend to the universities being state-owned or subsidised, but where the HEIs retain institutional autonomy in many areas. Higher education remains largely free for nationals and EU/EEA citizens. The similarities extend further to high levels of state investment, strong emphasis on equality concerning the institutional landscape, and how public resources are allocated throughout the system. The Nordic states have traditionally also offered quite favourable student support schemes with the aim of stimulating high participation rates in the sector (Maassen, Moen, & Stensaker, 2011).
In a European context, the Nordic countries are among the best in terms of access to bandwidth and connectivity, and have a comparatively high student-to-computer ratio (McGrath & Åkerfeldt, 2019). Denmark, Finland and Sweden are among the top three countries for advanced digital economies according to The Digital Economy and Society Index (European Commission, 2017). Consequently, the Nordic countries are well placed to avail of new and emerging educational technologies with the ability to achieve educational outreach and organisational change.
While there are many good arguments and possibilities for collaboration across Nordic countries, it is still well established that organisational change is notoriously difficult to bring about, and the promise of digitalisation may, in reality, be a long way from being fulfilled. One example from recent history of a potentially disruptive digital educational technology is provided by Massive Open Online Courses (MOOCs). While the emergence of MOOCs was predicted to have a profound effect on the educational landscape, we can conclude that their impact has been limited in the Nordic region (Barman, McGrath & Stöhr, 2019). The factors identified as obstacles to the advancement of educational technologies in the Nordic region include: structural dimensions, for instance, how the educational sector is financed; path dependency, the fact the organisations tend to repeat practices and may have an aversion towards disruptive and abrupt changes; and public procurement laws, which means all vendors in the public procurement of services compete in an open market on similar terms, leading to a harmonisation of services across the sector (Barman, McGrath & Stöhr, 2019;McGrath & Åkerfeldt, 2019). Obstacles to organisational change can be said to come internally from local cultures, but also through structural inertia brought through path dependency.
This article identifies the development of digital open educational resources (OER) as a way to enhance capacity and collaboration in the Nordic region, and focuses on a case study of a project of collaborative development of digital OER in bioethics by a consortium of five Nordic HEIs. This article has two main aims: i) to describe how the project was designed and developed to promote organisational change and educational development by means of virtual mobility and internationalisation-at-home; and ii) to discuss and reflect critically on the shortcomings of the project from an organisational change perspective. As such, the article aims to offer insights into how such capacity-building endeavours may be more successful at translating ideas into implementation. The article uses a modified form of a descriptive case study (Yin, 2009), and presents a) a rationale for the project, b) a description of the development of the different elements of the project, and c) reflections on the process so far. The article begins with a brief overview of elements of organisational change as a driving force for sustainable educational development. It then addresses some key internationalisation concepts and values that may be seen as adding additional value to digital interventions. Virtual mobility is introduced as a way to identify a possibility for students to take part in other participating institutions' cultures and educational offerings, but from their current physical location. The article then outlines how an open educational resource was developed in a collaborative setting and how the same resource was tested.
The article also shares the tentative outcomes of the project and discusses its shortcomings.

On organisational change
The premise for this article is that universities, in particular in the Nordic region, are in a unique position to engage in sustainable and collaborative educational practices, using virtual mobility and the affordances of digitalisation to provide students with state-of-the-art education that also promotes core values which align with internationalisation efforts. Digitalisation affords new practices and forms of educational change. The literature on organisational change suggests that organisations react very differently to calls for change, and there is no consensus in the literature as to how change is best implemented (Amis, Slack, & Hinings, 2004). There is, however, consensus that organisations need to build a capacity for dealing with change (Meyer & Stensaker, 2006). More specifically, change capacity is defined in terms of three interconnected capabilities: a) the capability to maintain daily operations, b) the capability to implement a single change, and c) the capability to implement subsequent changes. A challenge for HEIs as well as other knowledge-intensive organisations lies in being able to balance these capabilities at the same time (Meyer & Stensaker, 2006). Further, it is argued that the successful implementation of one particular change initiative may harm subsequent change initiatives (McGrath, 2017). Those engaged in bringing about change in higher education may need to focus on change not as isolated events, but as a series of interrelated efforts, and build within the organisation a culture whereby change awareness is a conscious part of daily work (McGrath & Bolander Laksov, 2014;Meyer & Stensaker, 2006;Trowler, Fanghanel, & Wareham, 2005). This means involving a range of stakeholders who can identify realistic opportunities to bring about authentic changes. Kemmis et al. note that educational practices are built on an interconnectedness of student learning and teaching which should be seen as a complex whole (Kemmis et al., 2014). Accordingly, the development of sustainable OER ought to be done in conjunction with students, teachers and other relevant stakeholders.
In this project, Meyer and Stensaker's (2006) Change Process Prescriptions (CPP) were utilised to drive the project from idea to implementation: • framing-identifying and communicating what is to be done • participation-allowing the members of the organisation to be involved in planning • pacing and sequencing-pacing the rate of change • routinising and recruiting-recruiting people to take part and routinising the new elements with ongoing operations (Meyer & Stensaker, 2006) The CPP offer a simple but robust idea about the different steps involved when bringing about a change initiative. Later in the article, after the case study is presented, I will return to the CPP and reflect on the challenges for sustainable development of collaborative educational practices.

The context of the project
The universities involved in developing the course are part of a Nordic consortium for master's programmes in biomedicine, NordBioMedNet, which was established in 2013. The consortium is an experienced, well-functioning collaboration between the Universities of Turku (Finland), Eastern Finland, Bergen (Norway), Southern Denmark and Karolinska Institutet (Sweden). With universities in four countries, the collaboration allows for sus-tainable education interaction and capacity-building around key issues. The group collaborates on a regular basis to efficiently raise the quality of education within the rapidly evolving field of biomedicine. With the project, the consortium aimed to develop a host of OER that provide education and training in different aspects of biomedicine research in areas where at least one of the universities needed capacity-building. The areas included computational biomedicine (e.g. bioinformatics, bioimaging), with a focus on analysis and interpretation of big data. In addition to biomedical modules, the consortium also wished to develop an open course in bioethics.
For the rest of this article, I will use the development of the course in bioethics as a case study for the collaborative development of digital OER. In the next section, I will present the rationale for the project.

Rationale for the project
Development projects, such as the one under analysis here, may be used as a way of integrating a range of practices, ideas and ambitions. Three such examples are presented here, showing how the project was informed by concepts and practices of internationalisation-athome, virtual mobility and capacity-building in highly specialised disciplines such as biomedicine.
On internationalisation-at-home Internationalisation played a key part in the design of the project. Essentially, internationalisation in the context of higher education is a hybrid concept that encapsulates a number of different ideas including international education standards, globally knowledgeable and interculturally competent graduates, recruiting and supporting international students, curriculum reform, and the marketing and export of education products and services (Knight, 1997). Others discuss the purpose of adding an international dimension to the curriculum for which the intended learning outcomes can be said to have an international outlook in relation to global concerns and transferable skills (Leask, 2004), but where teaching methods must also become more inclusive to cater for the plurality of student voices (Leask, 2005). Internationalisation-at-home (I-H) has been introduced more recently as a way to promote a number of the processes included in internationalisation, namely: cross-cultural competence and language skills among educators; refining intercultural teaching methods and evaluating skills; developing intercultural skills (Weimer, Hoffman, & Silvonen, 2019). I-H can be said to be a way to offer students opportunities to add globally important dimensions to their studies without necessarily traveling abroad.
The process of internationalisation in higher education has also been criticised, not least for the multitude of sub-concepts internationalisation seems to encapsulate. For example, some have argued that the concepts behind internationalisation may in fact be internally incompatible or even contradictory with one another (Stier, 2004). As such there is a risk that I-H is a reduced to a fashionable moniker that is expected to fulfil many goals at once. Another criticism has been raised from the viewpoint that internationalisation is a proxy concept for exporting the curriculum or colonial views on education, as it is said to promote a specific form of westernised knowledge creation (Deimann, 2015;Whitehead, Wondimagegn, Baheretibeb, & Hodges, 2018). This criticism notwithstanding, the project owners wanted the project to deliver I-H deliverables which aligned with broader intentions at their respective home institutions.

Virtual mobility
Virtual mobility is a way to afford students the benefits of digitalisation in the educational landscape, brought about, in part, through the introduction of OER. Virtual mobility allows students opportunities to attend courses in other countries and at universities to which they may not currently have access. Virtual mobility enables HEIs to provide digital OER that reside in the public domain or have been released under an intellectual property license that permits their free use or repurposing by others (Atkins, Brown, & Hammond, 2007). They may come in the form of courses, but also as single modules that may be nested in others' courses. The reasons for HEIs to embrace the digitalisation of higher education include: universities worldwide need to respond to an increasingly complex and competitive environment (Daniel, 2015); the advancement of MOOCs has demonstrated the affordances and scalability of online education (Barman, McGrath & Stöhr, 2019); many universities worldwide have adopted learning management systems, which are evolving into more powerful data collection devices, and consequently the universities see more possibilities to offer online education.
Virtual mobility is seen as an important future-ready dimension of higher education. A key deliverable for this project was the delivery of virtual mobility to students in the partnering universities. It is important to understand that I-H and virtual mobility were essential parts of the project design.

Capacity building in Biomedicine
A third ambition, but by far the most important one, is related to developing educational capacity in the core disciplinary elements. The project set out to offer students state-of-theart education in bioethics. The field of biomedicine seeks to explain physiological and pathophysiological processes at the molecular and individual level. This is essential for the understanding of occurrence and progression of disease, and for the development of new treatments and therapies. The project outlined here had three specific objectives: to develop expertise in computational biomedicine; to enhance digital or elearning collaborative elements within the consortium; and finally, to bridge the gap in bioethics education identified in the consortium. The focus in this reflective paper is on the development of the specific OER in bioethics. The rapid technological developments within biomedicine (e.g. fast sequencing of genomes, new genetic testing methods combined with big screening programmes, and the emergence of personalised medicine) are accompanied by rapidly emerging ethical challenges in relation to protecting privacy, information ownership and practical applications. This means the science and practice of biomedicine are expanding more rapidly than the availability of courses and education in the ethical challenges posed by this growth. The educational development project therefore sought to use the complementary areas of expertise within the Nordic consortium to produce educational resources that could not have been produced by the individual universities alone, in particular in the field of bioethics.
The development project outlined here was to develop and subsequently offer OER in the form of a course which could be shared within the NordBioMedNet consortium, but subsequently with other collaborators, and in doing so also would fulfil the goal of enhancing I-H and increasing virtual mobility.

Developing the digital OER
In this section, I focus on some of the steps involved in the development of the OER, including mapping the outcomes, developing a course content, and testing for construct and face validity before testing was done on students.

Mapping the outcomes
The bioethics course was designed, developed and optimised in an iterative manner. The starting point involved formulating learning outcomes for the course and mapping the course content into those outcomes. In accordance with an outcome-based education approach, the course is governed by a number of intended learning outcomes. This has proven a necessary step when designing large-scale digital courses (Henningsohn et al., 2017). The lead philosophy teacher proposed a set of outcomes and these were discussed at a meeting of the NordBioMedNet consortium in order to ensure that the outcomes were appropriate for all five universities. This was seen as a key element in the design of the course and enabled its acceptance as part of the local curriculum for each university. After the consortium members agreed on the intended learning outcomes, content was developed to cover a number of important areas in relation to bioethics. A sample of them are presented in figure 1 below, which presents the main modules as well as submodules. Each module consists of components, such as video lectures, multiple choice questions, and discussion forums, that are designed to promote engagement among the students from the different universities. The questions were designed to follow standards for question formulation (Millard & Chavez, 2012). Different types of question formats were used: open-ended responses, multiple choice questions, and reflective questions to be discussed in the discus- • Treatment development • Gene ethical issues sion forums. By varying different question formats and by modifying the feedback that the students received, we aimed for a high level of interactivity. The feedback the students got was different depending on the response they chose, and contained tips for additional reading. It was also possible to limit the number of responses the students could choose, as well as restrict their progress in the course until specific questions had been answered correctly. The team has extensive experience of developing OERs and MOOCs and uses the short video format for video lectures  in order to best convey the concepts of the course. Different ethical cases are presented. Several discussions forums were designed to allow students to engage in dialogue with other students. A premise for the discussions forums was that the courses would run at the same time across the consortium, enabling students to engage in discussion. The modules were designed independently in a way that they can: a) be used as single stand-alone modules, allowing students to return to the specific modules; b) supplement existing courses to form blended learning courses; and c) be combined with each other to create novel self-paced online courses.

Testing the OER
Face and construct validity testing were conducted with an expert in instructional design, as well as teachers and students of biomedicine. Construct validity of the questions was achieved through consultation with the educational expert. Each question had to follow a set pattern, the questions had to be written unambiguously, and the responses were to be written as positive clauses containing no negations. The responses were ordered either alphabetically or numerically to avoid unnecessary prompts for the students and to discourage cue-seeking (Millard & Chavez, 2012). Face validation of the questions was performed with other staff in the consortium who are experts in the field of biomedicine, but not experts in bioethics. Validation was conducted since the bioethics course represents a new way of teaching and learning ethics, and to make sure that the final product was a good match for all of the participating universities. Validation targeted the relevance of material, and the authenticity of the biomedical examples. Face validity was achieved by testing the questions on colleagues. We invited colleagues-biomedical and ethical experts-to view the material. The participants were asked to navigate through the course and reason how they might best solve the questions, and what the best solutions were to each specific problem. This process gave the research team insights as to whether the questions were appropriately challenging, but also enabled it to assess what kind of associations and possible interpretations arose when addressing the questions. After validation testing, the experts were then invited to give oral feedback to the team. Afterwards, changes were made in the sequencing of the course and the questions were modified.
After the first full version of the OER was developed, we ran a small-scale proof of the course with students and used learning analytics and oral feedback for evaluation purposes. Using simple descriptive learning analytics, we could see where students were having difficulties. We then invited students to come and meet the development team and offer feedback on the course, the length of the videos, and the questions.
Discussion and reflections so far I will now move to the second aim of the article, which is to discuss and reflect critically on the shortcomings of the project from an organisational change perspective. In the discussion, I will comment on how the development of the digital OER adhered to the CPP framework outlined before, and I will discuss some of the shortcomings of the project and challenges that lie ahead.
Developing customised digital OER in a collaborative fashion is essential for its sustainable development. The initial cost of developing the bioethics OER was around 500 000 SEK (Henningsohn et al., 2017). In the broader context of the cost of education, this seems minor, provided the OER is used in an intelligent and cost-effective fashion. The project was designed by an educational developer and expert instructional design with a background in change management (Meyer & Stensaker, 2006). A wide range of stakeholders were involved in order to create the best possible outcome. Developing the digital OER also meant that the stakeholders themselves could get a better view of the process and develop an understanding of the bioethics course, which also meant they were more likely to engage with the final product. The CPP framework was used to enable a structured process (Meyer & Stensaker, 2006). By writing a project application, the team, with representatives from all five universities, could collaborate to frame the project and design it to suit their own needs. The framing, however, was subject to ambitious ideas of internationalisation-at-home and virtual mobility. The design process was incremental, with participation from several of the universities, allowing the members of the organisation to be involved in planning. Pacing and sequencing of the project were decided collaboratively and enabled modification of the course following a testing period. Elements of routinising and recruiting played a less prominent part in the process.
The course was intended to be distributed to a broader international community of students. No results of the final project outcomes are shared in this reflective article as the project is currently being rolled out. To date, (October 2020) and approximately one year after the final course was completed, a total of 201 students from the participating universities have enrolled, and most have completed the course. Participants from Finland (42.3%) and Sweden (39.8%) make up the majority of the students; the others are from Denmark (8%) and Norway (3%).
In one sense, the project has been successful-the course serves its purpose and provides students with a state-of-the-art digital OER in bioethics. Students take part and complete the course, but only students from certain regions and universities. There are, however, a number of shortcomings. Currently, the consortium has not developed know-how regarding how to run the courses with the help of teachers from other universities, and no such agreements are in place. There is, however, a broad sense of enthusiasm and many good intentions, but perhaps the good intentions may not be enough to solve remaining challenges. The lack of business know-how may prove to be a major obstacle to co-running the course. As mentioned before, one of the main aims of the OER project was to promote internationalisation-at-home and virtual mobility. For this to work, students would have to take the course in the same class in order to engage in cultural exchange and to promote a plurality of ideas. Currently, the consortium has not achieved operational maturity and is offering the bioethics course on an individual university basis, so there are few opportunities for discussion and cross-cultural exchange. As a consequence, students are taking part in the digital OER, but within their own course/programme cohort and may not really be making the most of the I-H dimension, or the affordances of virtual mobility. This is one of the remaining challenges and reflects the final elements in the CPP framework: routinising work processes (Meyer & Stensaker, 2006). This reflects also on the fact that universities do not employ people to deliver these types of open educational resources, and, without additional support, academics in biomedicine and ethics may lack the necessary know-how regarding how to deliver on the planned outcomes of the project. For the digital OER to truly avail of the power and affordances of digitalisation and simultaneously provide elements of I-H, the universities in the consortium have to find ways to collaborate on a daily basis. Given their national higher education systems' strong focus on workplan allocations and work hours, the participating universities will need to find a way to allocate work hours for these collaborative consortium tasks. Today, there are no mechanisms in place to facilitate that process.
It is frustrating that, after a significant investment in time and resources, the project is falling short due to difficulties in finding a way to pay a teacher in Sweden for marking the essays of students in Finland, or Norway and Denmark, or due to challenges in finding ways for the students from different universities to attend the course at the same time. However, educational programmes are path-dependent, are designed in advance, and follow long cycles. Subsequently, students accepted to a programme have the right to follow that exact programme, and major changes such as those developed in this project need to have a longterm implementation trajectory-perhaps up to two year-before they are ever delivered. Credit-sharing also presents a path-dependent challenge. If the bioethics course is offered by Karolinska Institutet in Sweden, how do the students from the other countries get credit? Is credit awarded by their home university or from Karolinska Institutet? While this may seem like a minor issue, it seems to be enough to hamper the development of similar projects. Consequently, educational programmes and departments need to address these obstacles and challenges in the framing of future projects in order to free up staff and resources that will facilitate the implementation of similar projects. The shortcomings described here also reflect the consortium's inability to appreciate the complexity outlined in Meyer and Stensaker's (2006) three interconnected capabilities-that is to say, organisations have difficulty understanding how the implementation of a specific change will affect its capability to maintain daily operations while anticipating further changes in the future. In the example presented here, the question is: now that the OER in bioethics has been made, how do we change ongoing practices to incorporate the OER into existing courses, and also see how the OER could be offered to all participating universities in the future given the challenges presented above? Moreover, the universities need to find ways to collaborate with course design and course planning in order to enable students to engage with the course material simultaneously. There are examples of this being done elsewhere (Groen et al., 2017), and within this project there is a sense of optimism that solutions will be found, and with the right stakeholder support, practical solutions are no doubt within reach.

Conclusion
This project set out to provide a solution to the challenge of capacity-building in the Nordic region by developing a series of digital OER. The latter included dimensions of internationalisation-at-home and incorporated a global dimension to the curriculum, learning outcomes, and inclusive teaching methods to enhance intercultural competence and digital learning environments in order to encourage collaboration across countries. The OER itself seems to work and is a high-quality learning resource. However, the challenge that lies ahead is perhaps less an academic one than an organisational one in which a wider selection of stakeholders, including management and administrative staff, should be involved in bringing about sustainable educational change. A final word of advice for anyone aiming to engage in similar projects is to look beyond the disciplinary dimensions of the project and to try to address the organisational dimensions from the very beginning, when enthusiasm is higher and significant organisational changes are more likely to be pursued.