Two Master degrees were specifically established and developed for the purpose of this training: a Master of Public Health (Biosecurity) and a Master of Veterinary Medicine (Biosecurity). A key feature of this training program is that it was specifically designed for delivery by distance methods using Massey University’s Internet-based Learning Management System (LMS). This was used to deliver the majority of the course materials and instruction, which allowed candidates to complete the degrees without leaving their day-to-day employment. This was considered essential to avoid further depletion of already scarce in-country professional capability.

Prior to University enrollment for these degrees, the nominated candidates completed a preparatory course to familiarize the prospective students with the LMS and provide essential information on the program. In addition, it was useful as a benchmarking exercise to assess the capabilities of the candidates, particularly in English language competency and computing skills. Subsequent to this course, an inception workshop was organized in Singapore. This was an opportunity for the candidates and the program team to meet in person, to present the scope and objectives of the program, and to discuss expectations and requirements.

The degree programs consisted of eight courses which were taken consecutively (see Fig. 2). The courses were run over a 6-week period at an average of 20 study hours per week. The first four courses provided a foundation in epidemiology and public health, and were required to be taken by all candidates in a single learning environment: this was considered critical to achieving the ‘One Health’ objective. The remaining four courses in each degree addressed specialized topics related to human or animal health to recognize different professional competencies and requirements, and were taken only by the public health doctors or veterinarians, respectively. All courses were delivered online except the fourth foundation course, which had a small online component, but was primarily organized as a face-to-face study conference. As this formed the midpoint of the degree, it also presented a valuable opportunity to assess participants’ progress, and prepare for the specialty courses.

The curricula were specifically tailored to be appropriate for the target student demographic; to cover health issues of regional relevance; to include current and cutting-edge scientific knowledge, principles, and understanding; and to make the fullest use of the scientific literature and other learning resources. Two elementary considerations determined the teaching model and methods of instruction. Firstly, the prerequisite of developing a common terminology and understanding of epidemiology concepts (between candidates with different professional backgrounds as well as between candidates from different countries and environments within the South Asia region) resulted in a strong emphasis on effective communication and collaboration. Secondly, the courses were designed following current ‘best practice’ in pedagogical and distance education techniques, with an emphasis on problem-based learning using case studies and examples. Skills such as searching for, utilizing, and critically appraising the scientific literature and developing technical reports were repeatedly practised. Likewise, small group activities constantly reinforced communication, organization, and collaborative skills.

The degree courses were delivered by research groups at Massey University specializing in veterinary epidemiology (EpiCentre) and in public health (the Center for Public Health Research, CPHR) between the period of June 2010 and September 2011. In addition, a number of internationally recognized subject experts made significant contributions to development of the course content and study materials, as well as to the teaching of the courses. The face-to-face component of the fourth foundation course (which was held in New Zealand in December 2010) was structured as a study conference, at which eight international experts presented plenary lectures and subsequently facilitated a related workshop. As the foundation courses were developed and delivered conjointly by veterinary and public health epidemiologists, they sought to give adequate coverage for both MVM and MPH candidates.

All candidates were provided with a laptop to ensure and standardize computer availability. No high-speed broadband connection was required, but access to the Internet was essential due to the predominantly online delivery. The course content was designed to be as bandwidth-efficient as possible, and use of data-intensive applications such as live video, streaming audio, and real-time communications services was avoided.

Although use was made of three standard textbooks, few ‘off-the-shelf’ print-based resources could be identified that independently gave adequate coverage (in terms of relevance, scope, and applicability) of the course topics. For the ‘One Health’ foundation courses, this was a consequence of the need for texts that explicitly treated the subject matter in a unified way. The subsequent specialty courses aimed to cover current concepts, approaches and techniques, and in addition to provide content that was of direct relevance for the target audience. For example, the course entitled ‘The Interface of Human and Animal Disease’ explored pertinent ecological and social factors in human and animal populations that influence the spread of zoonotic disease, in addition to the more obvious factors related to pathogen biology, host pathology and classical epidemiology, or more traditional veterinary public health subjects. Massey University’s LMS, which is based on the open-source Moodle platform (Moodle 2012), provided a flexible and adaptable environment which could easily be designed to incorporate content from multiple sources.

The courses were structured around a set of instructional objectives and learning outcomes, which provided a framework that was fleshed out with web-based content synthesized from multiple sources. The courses linked directly into the Massey University library databases and e-journal collection, and the content strategically drew upon the relevant scientific literature, other web-based resources, and the expertise and experience of the candidates themselves. The courses frequently extended beyond strictly technical content to provide candidates with additional skills and knowledge that were considered relevant, for instance drawn from development studies (e.g., logical framework analysis for capacity development) and social science applications (e.g., cognitive mapping, Bayesian belief networks, and multi-criteria decision analysis to explore the concepts of risk and uncertainty). The emphasis of the teaching was very much on application of principles and techniques, and discussion of concepts and relevant case studies. This was supported by the LMS, which provides a rich environment not only for presenting web-based technical content, but for incorporating different activity-based options and for facilitating communication and small-group work. Candidates communicated using tools such as discussion forums, a messaging service, wikis, and real-time chat. Other specialized software and web-based applications were integrated at various points to enhance this environment, such as scenario-based learning software, interactive Flash-based tools and risk analysis software. The courses were intensively supported by teaching staff: each candidate had access to an epidemiologically trained tutor for the duration of each course (with a ratio of six to eight students per tutor), who played an important role in monitoring of the students’ activities, as well as for encouraging and facilitating discussion.

As an illustrative example which demonstrates some of the above, a scenario-based simulation exercise was developed within which students were required to play the role of a senior epidemiologist, analyzing data and attempting to determine the cause of an unfolding zoonotic disease outbreak involving human and animal populations. The scenario was based on a real-world event, but details were changed to prevent easy identification. This outbreak was presented in a series of ‘episodes’ that were developed using specialized e-learning software to present storyboarded scenarios. These ‘episodes’ were strategically interspersed amongst the teaching material; in each, students were confronted by a sequence of developments and required to react, to revise their hypotheses in response to the evolving patterns in the outbreak and to recommend further investigation and/or control measures. This was supplemented by a combination of group activities including a vote on the putative cause, small-group discussion in forums and the preparation of a report. Full disclosure of the outbreak followed in a face-to-face presentation and discussion during the fourth foundation course. The objectives of this exercise were to present a challenging and immersive learning experience, to provide an authentic insight into the impact of the outbreak on people’s lives and livelihoods, and to demonstrate the importance of trans-disciplinary ‘One Health’ collaboration.

Course assessment was performed using a variety of systems provided by the LMS, and included coursework assignments (usually in essay format), lesson schemas, and quizzes. The assignments, which made up the largest part of the overall assessment, consisted of a combination of individual and group work. Bespoke remediation and additional support was provided to students who required special assistance or were unable to complete activities due to time constraints or exceptional circumstances.

The attrition rate was low, with 66 of the 70 enrolled candidates receiving degrees. A total of 59 students were awarded Masters degrees (28 MPH and 31 MVM). Seven students who successfully completed the foundation courses but were unable to complete the specialty courses were awarded Postgraduate Certificates in Science. The remaining four students left the program or were unable to complete the foundation courses.

The foundation and specialty courses alike were generally very positively evaluated by the participants. From a total of 229 course evaluation questionnaires submitted by the candidates across all 12 courses, a total of 37candidates rated the courses as being excellent, 43 as very good, 20 as satisfactory, and 0 % as poor. Total 98 % of the candidates felt the learning outcomes had been adequately addressed. Approximately 90 % of the respondents considered the course content, course activities and tutor guidance to be highly relevant or quite relevant, with no differences between the foundation courses and specialty courses. The specialty courses were considered more challenging than the foundation courses, both in terms of the amount and the difficulty of content. This was consistent with the time spent studying, with 56 % of the responses from the specialty courses indicating they spent more than 20 h/week studying versus 29 % for the foundation courses. Participants tended to perform their studies in the evenings and weekends.

Aspects that were particularly appreciated included the collaborative nature of the courses; the activities, which enabled direct application of the material and which represented a different teaching model than most of the candidates were familiar with; and face-to-face interaction during the workshop and study conference. The enthusiasm with which the public health and veterinary cross-communication occurred resulted in a growing spirit of collegiality and receptiveness to collaboration which was truly ‘One Health’ in nature. This was enhanced by the LMS, which not only facilitated the candidates’ increasing competence of the technical aspects, but provided an effective platform for collaboration; it fostered a sense of ‘community’ and reduced the feeling of isolation that could be experienced by students studying at a distance. A valuable flow-on effect is that this effectively initiated the linkages which will be further developed during the second phase of the program (see below).

Aspects that were less positively evaluated included the restrictions in connectivity and speed of the participants’ Internet connections, which affected candidates in several countries and limited the time that could be spent in the LMS. While the participants can continue to access the online courses and materials, a number of participants mentioned the lack of hard copy of study guides, readings and the literature, and other course materials as a limitation. Many people struggled to balance the study commitments with their daily workload. Finally, various elements related to specific content or activities within the courses were negatively evaluated by some individuals.

The general objectives of the training program were first and foremost to provide relevant training in epidemiology, public health, and biosecurity. In the block of foundation courses, the need to reconcile different priorities and focal points of public health and veterinary epidemiology, and make decisions on how to incorporate these into coherent subject matter that had relevance for the enrolled public health professionals as well as veterinarians, gave rise to substantial discussion, and at times exposed differences in perception and approach. The program aims to strike a balance of generic skills required by all, which are taught concurrently to individuals working in public health and in animal health, in a single teaching space, and specific skills required by the two professional disciplines. This required careful consideration.

Developing and delivering the program in such a large and diverse geographical region posed daunting challenges. Notwithstanding technology issues, a mix of languages, cultures and competencies needed to be accommodated. The candidates’ English language level was highly variable and at times hampered communication. The diversity of the candidates’ professional backgrounds, experience, prior learning levels, and level of seniority, while enriching discussion, influenced their interaction; this was most evident during the online small-group activities, which necessitated a degree of organization and coordination. From the perspective of the development team, a substantial challenge was to calibrate the courses to accommodate the large variability of the candidates’ pre-knowledge, such that candidates with little knowledge could be brought up to the minimum level required while simultaneously engaging and extending candidates that already possessed some competence. Other challenges included deciding how much content was required, and related to this, to what level the courses should be taught; which methods of instructionand techniques in the LMS were most effective (how to structure and ‘pace’ courses, how to present content and design effective activities); and which methods of assessment most accurately assessed the levels of proficiency acquired by the candidates. It was also difficult to develop unified content to illustrate certain principles. For instance, the inclusion of case studies as examples was considered a priority; however, it was frequently difficult to identify public health and veterinary case studies which were equivalent. In many cases, a single case study which best illustrated the matter in hand—whether it pertained to human health or animal health—was used.

The objective of Phase 2 is to build institutional capacity in epidemiology and biosecurity in the seven beneficiary countries and in the South Asia region. The focus of this phase shifts from teaching individuals within a university learning environment to supporting collaborative ‘One Health’ activities and applied training of a wider group of animal and public health professionals within a framework that strengthens the government institutions directly or indirectly responsible for diagnosis, preparedness, response, prevention, and control of Highly Pathogenic Avian Influenza (HPAI) and other zoonoses. ‘One Health’ Hubs (OHHs) provide the organizational and operational framework for this second phase and collaborative investigation projects provide the focus for applied activities and further training supported by an international network of epidemiologists.