MOOCs: Marvellous or Moot for Exercise Medicine and Physical Activity?

By Chris Oliver @CyclingSurgeon, Mairi Buchan, and Jo Hilton

Massive Open Online Courses (MOOCs) have become increasingly popular over the past few years. Especially after successful early MOOCs such as “Circuits and Electronics” by American Universities, Harvard and MIT [1]. In their simplest form MOOCs are vehicles for delivering information on a topic to an enormous number of people at any one time. Recent additions to the MOOC portfolio include MOOCs that offer education in Exercise Medicine and Physical Activity. For example, McGill University’s MOOC “Exercise is Medicine” was “created to provide the public with a reliable source of information and exposure to experts in the field” [2]. Whilst there are many positive aspects of these programmes, there are important considerations related to the benefits, challenges, and implications that these innovative e-learning programmes have for the sports and exercise medicine community, and the world at large. In this blog, we introduce some key themes of this debate.

Image courtesy of Chris Oliver

MOOCs: The positive story

An ancient Chinese proverb states “if you are planning for a year, sow rice; if you are planning for a decade, plant trees; if you are planning for a lifetime, educate people”[3]. Free access to education is a hot topic and in modern-day society. As we are increasingly aware of inequalities in all aspects of our lives, we want to allow everyone, regardless of background, access to this basic human right [4]. Some MOOCs have been created in order to bridge the access gap for populations from more socioeconomically deprived regions [5]. There are a plethora of positives surrounding MOOCs, particularly the focus on the appeal to human curiosity and a more relaxed approach to learning. Individual choice in study topic over a given timeframe is key in developing and maintaining an intrinsic motivation to learn. Many education critics believe intrinsic motivation is often lacking in formal educational settings [6].

What are the educational themes and why are these important?

Despite advantages of MOOCs, the accompanying educational themes are worthy of further investigation. Firstly, yes, the whole idea behind these projects is that they provide equal access opportunity to education by breaking down financial and infrastructural barriers; however, in general, the evidence so far is that people accessing these courses tend not to be from more socioeconomically deprived demographics [7]. Many of the MOOC participants are university-educated with a desire to further their knowledge and advance in their current careers [8].

Another inherent glitch is catering to the huge number of students. Some courses have had many tens of thousands of participants. In a formal education setting, physical or online, hundreds of tutors are required to cater to each student’s needs. The number of tutors involved in MOOCs is often very small and may struggle to match the personalised educational experience, expected in formal education [8]. In addition, the lack of funding to employ a greater number of tutors to support participants and to develop educational materials provides yet another challenge to the success of MOOCs [9].   The long-term economic sustainability of MOOCs will rely on a clear business case. The impact of use of intellectual property by MOOCs has still to be widely debated.

Whilst many people enjoy the experience of engaging in a MOOC, there are challenges for participants. Embarking upon a MOOC can be intimidating for those new to this style of learning [6]. Lists of recommended reading, participation in discussion groups and completion of weekly assignments may cause information overload issues. Some participants may not know where to begin or how to manage their time accordingly. The student may also be left to rely on guidance from connecting with other MOOC participants and gaining advice from their previous experiences. There is an assumption that students will be proactive and enthusiastic learners. However, if no-one contributes to discussions on a regular basis, the onus is on the individual to find their own way around the MOOC [6].

Future implications of MOOCs for modern-day higher education

Access to educational materials produced by highly-rated universities, can contribute to facilitating the economic, political, and social growth of developing countries. It would appear that MOOCs combine local access to e-learning that can be applied to practice in the field of sports and exercise medicine. Nevertheless, despite the access ideals behind MOOCs, it seems that one group may be benefiting more than the other from these courses: the developed world. This is likely in direct relation to evidence that suggests there is an early uptake effect of MOOCs by those who already have already experienced higher education.

Although initial subscription to and enthusiasm towards MOOCs is often high, the attrition rate is higher than that of conventional higher education settings [10]. The impact of low staff-to-student ratios, the relatively low personal investment and the high intrinsic motivation necessary to learn may all contribute to a high drop-out rate.

MOOCs are still valuable despite their limitations. However, they should not be viewed as the sole solution, or as a replacement for other initiatives that seek to increase access to quality education in developing countries. MOOCs may be best viewed as complementary to rather than competing with the traditional education setting, physical or online.

The inherent issues of financial and time resource constraints as well as the challenges MOOC participants face, need to be held in mind by all stakeholders with an interest in quality, low-barrier education opportunities.

In the field of exercise and physical activity, MOOCs appear to be here to stay. A next-step to collectively consider is the challenge of measuring their social, educational and financial impact long-term.


  1. Breslow L, Pritchard DE, DeBoer J, Stump GS, Ho AD, Seaton DT. Studying Learning in the Worldwide Classroom: Research into edX’s First MOOC. Res Prac Ass. 2013; 8: 13-25. Available from: [Accessed 10 October 2016].
  2. Griffin S, Shrier I. University of McGill massive open online course: pioneering sport and exercise medicine education. Br J Sports Med 2016;50:1101-1102. [Accessed 30 October 2016]
  3. Chinese Proverbs [Accessed 10 October 2016].
  4. The Universal Declaration of Human Rights. United Nations. [Accessed 10th October 2016].
  5. Kay J, Reimann P, Diebold E, Kummerfeld B. MOOCs: So many learners, so much potential. 2013; 52(1):49-67.
  6. Kop R. The challenges to connectivist learning on open online networks: Learning experiences during a massive open online course. The International Review of Research. In Open and Distributed Learning. 2011 Jan 13; 12(3):19-38.
  7. Christensen G, Steinmetz A, Alcorn B, Bennett A, Woods D, Emanuel EJ. The MOOC phenomenon: who takes massive open online courses and why? 2013. [Accessed 10 October 2016].
  8. Laurillard D. Five myths about MOOCs. Times Higher Education. 2014 [Accessed 10 October 2016].
  9. Hollands F, Tirtahli D. Resource requirements and costs of developing and delivering MOOCs. The International Review of Research in Open and Distributed Learning. 2014 5 October; 15(5). [Accessed 10 October 2010]

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