Creative Commons: to pay for sharing??

What a bitter sweet discovery I made today by reading the instructions for authors of a well-established scientific journal: the journal has a subscription for readers, why I should pay 3000-5000 dollars to share openly my work on an well-known scientific journal? I don’t understand this..

A number of open access journals have fees for publication (I always thought in a certain way about it..but ok, I will not discuss that here) but at least there is a rationale behind why it should be open and why you should pay (to keep the journal going..).

Some of the open access journals state that materials published under the CC license can be reproduced and modified by other users.. Does it mean that you can re-use/adapt results and data??

It’s obvious that I’m missing something in the whole rationale, but can you please help me to understand?


A late reflection on Digital Literacy

I went back to the David White’s videos (1, 2) and to the JISC guidelines on digital literacy (3), and everything is much clearer now after completing the other topics in the ONL course.

I always considered myself quite good” in using a pc and in navigating in Internet, but I realize only now that my perspective was quite limited, especially regarding the use of digital tools in education and research. I always considered the web a powerful tool to look for reliable information and for tools to ”take out” to my ”real life” to ease teaching and projects development. And to show the results of my work in ”conventional” places like PubMed.

I realize just now that my view was extremely limited, and simply because I knew very well the rules in my ”institutional” environment among the walls of my hospital and in the community of people working on my research interests, but ignored all the rest..

I considered valuable only what was published on the journals with highest impact factor (and of course I still believe that research content must be accurately peer-reviewed) but I ignored a huge amount of information, which I could use at least as hypothesis-generating sources. I did not consider these aspects before..

As well as I considered the web only a source of nice pictures and videos to show to my students, not really a ”place” where to meet my students and an instrument to use together to improve learning in active ”digital” way.

I should define my self as a ”visitor”, the big challenge will be to reach out for the ”residents” and to help them learn in a better, funnier and more effective way.



  1. David White: Visitors and residents (part 1)
  2. David White: Visitors and residents – Credibility (part 2)
  3. Developing digital literacies (2014) JISC guide.

Future Perspectives -Open Networked Learning

This course is about to end and it’s time to draw a few reflections:

  • It was a very interesting and quite special course for me: when I signed I thought it would have been more about learning new techniques and digital tools; instead if there is something I will really bring with me is the importance of designing an online course with a clear structures, clear moments (individual and group work) and with clear feedbacks / evaluation sessions; learning about the tools was also very interesting, but tools are tools, the important is what we do with them.
  • The concepts I learned are already influencing my practice as a teacher, as I think much more on how to improve communication and access with my students, also via online and flexible tools. I’m definitely more aware of the complexity and difficulties in using these tools, but also of the potentials and advantages.
  • I’m very positive about the possibility to use technology in my context: for instance I’m thinking about the possibility to run clinical case simulations and reversal sessions online, in real-time with group of 7-8 students and with iconography/animations to easy learning and problem-solving.
  • There is an ongoing discussion in my institution on how to improve learning by using online and digital tools; after the course I feel I can contribute to this discussion and I would be very happy to test a ”beta”-eLearning course for the discipline I’m responsible for.
  • In this context, the suggestion I will always bring to the discussion in my group is the need of a clear structure, with a clear flow of information and goals; it would be a mistake to think that technology will do the work for students and teachers. It is a tool with powerful possibilities, but needs to be used in a structured and oriented way to be effective.

Flexible and mobile learning. New dimensions for students and teachers

If I think what the word ”learning” evokes in my thoughts, the image of my teacher in the elementary class showing on a chalkboard how to write letters and numbers is probably one of my sweetest and dearest memories. She was used to say: ”you will always remember this, because this is where everything you will learn started”. The school was a sort of ”holy place” (or damned.. depending on the mood of the day.. )  but it was clearly ”the box” where I learned. Did it changed over the high-school and the university..? Apart from practical sessions in laboratories and at the hospital.. no! Learning has been for me a quite straightforward process: class – study – examens – vacation, with very defined places and time-points.

How it is today? Well, the amount of information we handle everyday is exponential higher compared to 15-20 years ago. I still remember when I bought my first cellphone.. it was a sort of walkie talky really..but it seemed to me revolutionary! Now I use everyday at least 2 VoIPs, 3 messaging systems, check my social media, listen to radios for around the world, music and watch football matches in a few inches from my iphone. Even the Transcoder Captain Kirk used in Star Trek looks like an electric razor in comparison..The so called internet of things (1) is changing our lives extremely fast everyday, and we are barely aware of this!

If this is true in finance, medicine, military, what about learning and teaching then? As with everything else, information and capacity of exchange information and communicate has assumed a multidimensional structure which is continuously evolving: new digital tools are available everyday (and we don’t even know that the most of them exist! Think for instance on how many apps are available for smartphones.. hundreds of thousands!), new technologies enter the market now and then (for instance smartwatches and home-robots!) but we still assume that learning is the product of a dialogue between/among students and teachers. The new dimensions offer anyway the possibility to delocalize learning (you really don’t need to sit at your bench and listen to your teacher.. at the contrary working from home or from somewhere else/everywhere else might be an added value) and books are not the main instruments (multi-mediality and digital tools are probably able to offer better educational materials, easier to assimilate, interactive and with the possibility to transmit knowledge in a much faster and effective way). Do we’ll need to wait for the bell to ring to say: ”it’s done for today”? No.. time is expanded and not anymore a scheduled serie of events.. you might virtually decide where/when to attend your classes! And creativity can actually offer huge possibilities to students who were left out of the classes because they had no class! Because of lack of possibilities that we believe given for anyone.. (what an amazing thing the Khan Academy)(2).

Very interesting topic, very interesting readings (3) and videos. I will try to see the possibilities, rather than my own limits in understanding the new environments.

  3. El-Hussein, M. O. M., & Cronje, J. C. (2010). Defining Mobile Learning in the Higher Education Landscape.Educational Technology & Society, 13(3), 12-21.


Designing learning environments: is virtuality so different from reality?

The sixth topic of the open network learning course was so far the most exciting for me, and I’ve got from it very good insights on the possibilities and limits/difficulties in designing learning online activities.

It’s quite funny, after 8 years of active work in the university system in 2 European countries, to find myself wondering: did I have ever had an organized structure in my teaching strategies? Did I ever use the best tools and did I make it easier/possible for my students to achieve their/my goals during and after my courses? Coming from the old school, and considering competition an added value in education, I always thought: ”I want to deliver the best classes, I want to engage my students in the best practical sessions and I want to have with me the best students to raise the best collaborators and shape the best group!”. How did I do that? Well, I did the way I learned myself from my supervisors: powerpoint presentations (very nice and up-to-date, of course), good practical sessions at bedside of patients, guiding my students and trying to improve their skills with patients, and by examining my students, trying to ensure that the most important concepts and informations for their careers was acquired.

Did I ever think about the structure of what I was doing and did I ever think if my pedagogic approach was right? Of course not! 🙂 I was aiming for the best! WHY I should have doubted? 🙂 In the best case, I was aware of my problem-solving based approach, but I never questioned ”the package” and charisma of my courses.

The ONL course has questioned these assumptions, as it did put me in a completely new learning environment: if I want to use online tools, then you better design before the framework in which I want me and my students to interact! Not only that..:

  • who are my students? It’s quite likely that they will not be a very well defined class with all the pro and contra which this implies. Online courses might be open to everyone, the selection criteria might not apply or be very different.
  • why do I want to do it? A very easy answer would be: to become even better. Yes… according to whom and according to which criteria? Evaluations and feedbacks are very different; moreover: how can I transmit enthusiasm and rely on my ”charisma” in virtual environments?? Media are meant to fill the gap in communication between teachers and students, but they make evident in this case that there is a gap!
  • How do I fill the gap? Am I the master of the tools or my students are actually much better than me? I’ll better be good and learn how to use them!
  • Will I be able to shape a nice and effective learning environment to facilitate discussion, problem-solving, experimental learning and concepts assimilation? What a challenge.. did I ever have this problem before..
  • how will I ensure that my students have got what they need from the course and, moreover, that I really contributed to their professional growth?

Well, this part of the course was amazing and, in a way, embarrassing, because it did question my role as a teacher.

Is it so different conceptually to apply the Kolb´s principle in reality and in virtuality? (Console G, The 7Cs of learning design –

If the goal was to improve myself as a teacher… well.. I learned something!


Respiratory Medicine – Resources for Students and Fellows


Please find on this blog the most useful links for the ones interested in Respiratory Medicine. It’s mostly about free educational materials and guidelines available online.



Guidelines from the American Thoracic Society

Guidelines from the European Respiratory Society

Guidelines from the British Respiratory Society

Guidelines from the Canadian Respiratory Society

Guidelines from the Swedish Respiratory Society (in Swedish)årdprogram

The New England Journal of Medicine – Specialty Pulmonary/Critical Care

The Lancet – Specialty Collection Respiratory Medicine

The Cochrane Library – Lung & Airways

Lectures in Respiratory Physiology by John West, UCSD

Anatomy of the Lung

Collaborative Learning and Empirical Learning, possibilities and problems

I’ve been attending a few pedagogical courses about how to improve my teaching techniques, they were all very interesting and changed somehow my way to look at teaching and students.

There is an increased need to engage students in practical activities and learning/reflection moments to improve their education with the ”Empirical Learning”: the assumption (or better, strategy) is to empower the ”learning by doing”, involving the students in practical sessions where they are the responsible of performing a professional task, under the supervision of a teacher; reflections and feedbacks afterwards are extremely important, to conceptualize the exercise and to offer new questions for development (Kinsella & Pitman 2012). On the other side,  I feel that students should have a solid theoretical base, and this requires time to individual studies or to develop knowledge in concepts and information, although I can sound very old by saying that, I know! This is surely because of my background and because of my profession (working with medical students).

On the other hand, new internet-based tools can be used in different ways and potentially might be extremely useful to reach a balance between the time to dedicate to theory and to empirical learning: a very interesting and structured way to teach students is the so called ”flipped classroom”, where frontal ”old-style” lessons are replaced by online courses, often in the form of video-recording of lessons where concepts are explained in a more or less classical way. There are many useful tools, even interactive, to empower a very good distance-learning. The best example is probably given by the ”Khan Academy”, now available in many languages and offering teaching materials in forms of video, practical online sessions and web-based exercises to learn (and teach!) mathematics. The ”flipped classroom” is so called because the teacher meets the students only in practical and reflection sessions, with small groups, where the concepts learned at home ”online” are then ”experimented” together to finalize the empirical learning process. By applying the concepts you learned at home with the IT-supports, you will understand and retain them much easier than with classical frontal classes and examinations.

It is even possible to meet in the cyber-space with students, so one could have digital classes and digital practical sessions in small groups to exercise and finalize the learning process.

This is all very exciting, of course, but I see a few problems I would need to face before to start these activities:

  • Structure: the course must be very well organized and learning moments and targets must be extremely clear to all; very often ”online” learning is intended as ”you do it when you want, when you have time”.. This would be of course a wrong approach. The technique should not imply that the evaluation of what the students get from it is less important, and the goal should always be to prepare the students for their professional life and competence. The goal can justify the technique, but not the contrary.
  • it might be difficult to replace digitally the human side of a profession: although the internet of things is entering medicine more and more every day, there are things that only the contact with patients and staff can give; in this sense, the digital tools should help to have more time for these moments, but I don’t think they can replace them.