Impact case study database

The EEG software tool was first deployed in 2016, on 40 patients at two residential care homes in Cambridgeshire (Askham Village Community, Doddington) and Hertfordshire (Gardens and Jacobs long-term residential rehabilitation centres in Sawbridgeworth) [c, e, f, g]. Since then, its rollout has gathered significant momentum, involving a further 160+ patients at the Coma Science Group in Liege, Belgium, ( 2017-present) [b]; and 26 patients at the Therapiezentrum Burgau rehabilitation centre in Germany ( 2018-present) [d].

The results of the EEG software assessments allow clinicians to form a detailed brain-based profile of a patient's state of awareness and cognitive function. This allows more tailored care and therapy to best meet the needs of the individual patients. The tool has made a significant impact on clinicians, patients and their families in the UK and Europe, by:

• advancing the clinical approach to brain activity assessments,

• improving severe brain injury rehabilitation and care practices, and

• increasing understanding and involvement amongst patients’ families.

The co-director of Europe’s leading centre for clinical assessment, management and treatment of patients diagnosed with prolonged disorder of consciousness (Coma Science Group) explains how ‘The adoption of the technology has informed our knowledge, patients’ families understanding, and, most importantly, the overall care of the patients we treat’ [b].

Advancing clinical assessments

Feedback from clinical staff indicates that the EEG software tool has had a significant practical impact on the assessment of brain activity in severely ill patients. For example, the Professor of Anaesthesia at Addenbrookes Hospital has described how the software has ‘advanced the clinical practice of brain activity assessments, improving practitioners’ and specialists’ understanding of the recovery of consciousness after severe brain injury’ [c].

One of the UK’s leading clinical experts in neurorehabilitation has stated that not only is the technology ‘helping to inform clinical practice in real-life settings across several specialist hospitals in the UK and Europe, with the potential for more on the horizon’, but also noted that she has ‘benefitted from its value in allowing me and those I work with to more accurately quantify the level of activity associated with consciousness’ [a]. She highlighted how the research ‘has fostered new knowledge around how brain activity assessments can reduce the rate of misdiagnosis of consciousness’ and is informing ‘our current thinking for how to make the technology more readily available to patients and advance what we do in the future’ [a].

Advancing rehabilitation and care practices

Prior to the uptake of the EEG software tool, many of the patients in the Cambridgeshire care setting were treated at Addenbrooke’s during the acute period after an injury, before being transferred to the centre for prolonged rehabilitation. The transferral process made patient follow-ups more difficult as it required bringing them back for frequent assessments and intervention. In his supporting letter, the Professor of Anaesthesia from Addenbrooke’s explains how the software has ‘bridg[ed] this clinical and translational gap between acute and chronic stages of recovery after brain injury by facilitating a way to manage patients at their bedside and avert the need for transportation’ [c]. In addition, he states that: ‘Using Dr Chennu’s technology, clinicians have been able to identify the most useful time points during a patient’s rehabilitation when they can benefit from such scans, thereby significantly reducing the cost of care and specialist assessments by many thousands of pounds, while simultaneously improving timeliness and efficacy’ [c].

Describing the changes made to their clinical practice as a result of the EEG software tool, the co-director of the Coma Science group explains that ‘the technology’s capacity to assess patients alongside other brain-based assessments like magnetic resonance imaging [which] has improved and often guided the care of our patients, thereby also informing our clinical decision-making and its outcomes’ [b]. He states that ‘Dr. Chennu’s research and expertise […] is useful to us as clinicians in informing how we can respond to the challenges faced in caring for patients with brain injury, as the tool that his work has led to is both easy-to-use and also improves the processes of our care’ [b].

A survey of families of patients at two of the participating rehabilitation centres corroborates this impact on the care received by patients. Responses highlighted how ‘It is much better to have the EEG at the bedside it does not interfere with the care of my relative,’ and ‘No disruption is caused to [the patient’s] routine’ [h].

Similarly, a survey of clinical staff across the two centres established that the software tool allowed clinicians ‘to consider the patients conscious state in more depth and provide more beneficial interaction’ and ‘reduces risks for patients – risk of infection for transport/moving, pressure sores, more convenient, less disruption to patient’s normal routine’ [i].

Increasing families’ understanding and involvement

By including a digital visualisation of the brain’s activity in a way that previous methods could not, South Newton hospital’s clinical expert believes that the EEG software tool ‘improves both the clinician and patients’ family and carers understanding of a patient’s brain activity’ [a]. She confirms that the technology has ‘enabled me and my colleagues to more easily communicate the meaning and impact of these assessments to the patients’ family and carers. Further, it often increases the extent of their understanding of the patient’s diagnosis/situation’ [a].

This beneficial impact on families’ involvement and understanding is supported by clinicians at the Coma Science Group . Because the software has identified a minimal state of conscious despite a patient’s behaviour indicating an unresponsive wakeful state, for instance, not only have clinicians in Liege ‘then proposed to intensify care’ but also ‘in such contexts, together with the family [they] have used the findings to inform and discuss’ patient treatment options’ [b]. The technology, they argue, ‘enhances the capacity for collaborative thinking with patient families and is a valued port of information amongst all parties, as it is often combined with the knowledge that patients’ families have of the patient to establish a best cumulative purview of the whole situation’ [b].

Advancing OpenStack’s commercial innovativeness and efficiency

Chadwick was invited to the OpenStack summits in the USA in 2012 and 2013 to discuss the Kent research on FIM, educating and informing OpenStack stakeholders on its processes through the discussion of key blueprints [a]. As a result, in November 2013 Chadwick’s novel FIM design was implemented in the ‘H’ phase of OpenStack, adding federated access to Keystone (OpenStack’s identity manager) [a][b]. The Kent FIM protocol was the first (and remains the only) system to have introduced federated identity to OpenStack, and since its implementation in November 2013 Chadwick has continued to support OpenStack and its developers and users via his advisory role in the Keystone working group ( 2011-2017).

In response to Chadwick’s continued contribution and support of the Kent FIM, OpenStack’s Keystone Project Lead, Steve Martinelli, stated: ‘David [Chadwick] and his team[‘s …] expertise and guidance in the area of Federated Identity has been priceless. I can confidently say that their collaboration and background on the subject has helped accelerate and shape Keystone's support of Federated identity […] David's opinion is sought out when discussing Keystone issues on OpenStack's mailing list, where his deep understanding of security, and identity management is made evident. The same can be said about David's involvement at OpenStack summits (our bi-annual design conferences), where he is involved in the architectural design of new Keystone features’ [c].

Jisc – a company supporting institutions of higher education and research in the UK – also benefits, as stated by Stefan Paetow, Jisc’s Research Liaison Coordinator: ‘University of Kent readied the Openstack software stack for use with federated identity technologies, including Moonshot, by piloting Openstack with the pre-Assent Moonshot pilot infrastructure and the UK Access Management Federation, submitting fixes to Openstack and Jisc where required, and driving the web-based use case for Moonshot forward’ [d].

Improving OpenStack developer proficiency

Many developers are interacting with OpenStack in order to use its interface. Of these developers, Chadwick has advised and educated many as a result of his consultancy via the OpenStack summits and working group mailing list. His Kent team has also generated many new lines of code or patches, for instance, to enhance the usability and proficiency of the software. A senior manager at RackSpace identified that between 2011 and 2014: ‘University of Kent has contributed 1400 lines of code, 102 reviews, 71 patches, 14 blueprints [and…] have been approachable subject matter experts, whose knowledge was widely adopted by the Keystone community’ [e]. Similarly, an engineer from RedHat in 2017 stated that: ‘Professor Chadwick was essential in enabling the project to properly implement Identity Federation, a set of features without which OpenStack would be unusable by a great many organizations […]. As a software engineer at Red Hat, I have seen a direct correlation between the success of our implementation and the work that Professor Chadwick and his team contributed to the project’ [f].

Enhancing OpenStack users’ security and cost-effectiveness while reducing administrative burden

Users save time and effort while increasing security, because with FIM, users do not have to create and remember a large number of different passwords. Having to create and memorise numerous passwords leads users to choose weak and easily crackable passwords. With FIM, they need to create and maintain only one strong password.

Over 135 international organisations are currently utilising OpenStack, and running their jobs and applications off it. We carried out a survey of OpenStack users to assess the impact of having FIM integrated into Open Stack [g]. Sixty per cent of the respondents (n=14) stated that adopting FIM makes the system more (or much more) secure. A Cloud Manager from a national computer network for universities and research noted: ‘[we] don’t have to manage safety of credentials, since we store none. We are not subject to brute-force, since services are accessed via identity tokens only’ [g]. The Head of Identity Management of the same institution noted further: ‘No passwords inserted in web forms, no passwords kept in the keystone, no recovery/force-passwords-on-the-phone, etc.’ [g].

Traceability is important as part of implementing security, and this is facilitated by FIM. A System Administrator at a small company highlights the benefit of FIM: ‘We will get to know who accesses what and when’, while a researcher pointed out: ‘R&S and Sirtfi [Security Incident Response Trust Framework for Federated Identity] helps. Also using the institutional accounts helps with traceability’ [g]. Similarly, an organisation’s security relies on a proper audit of their users. For example, it is imperative to revoke access from former employees who had left the organisation. Evidently, the advantage of FIM is clear, as further established by one Network Engineer: ‘We can audit access controls from a central system and we can easily require MFA (Multi Factor Authentication) for user logins’ [g]. This is echoed by an Administrator/Architect from an American telecommunications company dealing with several thousand users: ‘Old account remove quicker’; this echoes the view of a Technical Architect at another organisation, who states: ‘revocation is central. Centralized group management assignment are key as well’ [g].

In addition, FIM offers a potential for saving time and money. The time-saving benefit of having FIM is highlighted by a Cloud Manager from a European institution: ‘Registration time is just few clicks wrt [with respect to] alternative procedure for identity verification’ [g]. An Administrator at a large American telecommunications company elaborated further: ‘Multiple Operation people were spending >30% of their time just managing accounts before we implemented hooking into corporate Active Directory System’ [g]. Meanwhile, a Cloud Architect at a UK Government agency believed that FIM reduces operational costs, affording a saving of ‘0.5 of a person to maintain the identity proxy’ [g]. Similarly, a System Administrator at a small company noted a saving of ‘roughly $5000’, while the Head of Identity Management at a European institution reported a saving of ‘0.2 FTE’ [g].

Administrative burden can also be reduced by using FIM, with 47% (n=11) of the respondents suggesting that there is less or much less administrative burden in running their system. A Senior Software Engineer at a public open cloud exchange project commented: ‘A unified authentication management has allowed us to let users use the same accounts for OpenStack and OpenShift, which we are operating. So we and users don't have to deal with multiple accounts or systems of access management […] Also we can offload verifying a user to the identity providers they are coming from’ [g]. A Technical Specialist at a European organisation pointed out: ‘when a user leaves the home organisation, and his account is deactivated, this user cannot log in anymore in the open stack environment. Effectively, his permissions are revoked while openstack maintainers don't know (and now don't care) that he is gone’ [g]. A Cloud Platform Architect at a multinational telecommunications company summarised the impact in reference to his 3,600 users: ‘No more account management, users shall do it for us’ [g].

Based on his FIM research and as a result of the growing recognition of his expertise in this field, Chadwick was an invited expert to the nascent W3C Verifiable Credentials working group in 2017. His contribution led to his co-authorship of the Recommendation and its associated Implementation Guidelines [h] and Data Model [i]. In 2019, the University created a spin-out company, Verifiable Credentials Ltd, to capitalise on the implemented Proof of Concept.

Greenfoot is supported by its own channel on YouTube with instructional videos (4,850 subscribers and over 1 million views) [a] and two supporting websites, one for its end users, the students (40,000 subscribers and 200,000 page views per month) [b] and one for teachers entitled the ‘Greenroom’ (5,419 subscribers, 241 resources and 4,114 discussion posts) [c]. Greenfoot has been adopted in over 49 countries [d], the user interface translated into 13 languages (including Chinese, Portuguese, German, and Spanish), and the Greenfoot tutorials translated into seven languages (Brazilian, German, Greek, Indonesian, Italian, Russian and Spanish) – with all translations produced by volunteers [b].

Fig. 1: Total unique users of Greenfoot (from [d])

Subsequently, the international proliferation of Greenfoot across the computer science education community has generated diverse forms of pedagogical impact. Since August 2013, the software has improved the learning of programming and benefitted more than 3.9 million school students directly [d, e, Fig. 1]; enhanced the teaching capacity of over 5,000 teachers who have used it to improve how they teach programming innovatively [c, e]; influenced national curriculum design in the UK; and, informed the practices, philanthropic missions, and opportunities of key computer science stakeholder groups, including CAS, WJEC, Oracle and Technocamps [f, g, h, i].

Improving student learning and engagement internationally

Unlike the traditional programming platforms used in schools, the usability and accessibility of Greenfoot enables students to achieve more tangible results more quickly, and, through the increased motivation and satisfaction that this fosters, enhances students’ understanding of programming concepts. In commenting on how Greenfoot increased learners’ motivation and engagement, a teacher from Sutton Grammar School (UK) highlighted that ‘My pupil was never a good student until I taught him Greenfoot. He got so inspired that he asked his parents to buy him the book, read the whole thing, and shot up to the very top of the year group in my subject with exam scores averaging 90%. He will be in my GCSE course next year, and I could not be more proud!’ [e]. Similarly, a teacher from the Jesuit High School in Oregon (USA) noted: ‘This amazing program motivates my students to learn object-oriented programming, including inheritance, interfaces, and the use of list and array structures, in an engaging and very fun manner’ [e].

Additionally, as pointed out by other teachers from across the USA and Germany, Greenfoot also boosts creativity and discovery in student learning: ‘My students love developing games and discovering the true creativity that is required to design and develop fun and interesting software’ and ‘My pupils can be as creative as they want’ [e]. Such increased motivation and creativity nurtures greater enthusiasm in the subject of Computer Science, as another UK teacher contends: ‘I get more enthusiasm teaching Greenfoot than any other aspect of teaching from year 7 to year 13. I believe that the reason my GCSE programme is so popular is due to what we teach in year 9. Out of 135 students in a year group, 63 have opted for Computer Science next year’ [e].

Enhancing teaching capacity and pedagogy innovativeness

Greenfoot [b], its supporting textbook (16,000 copies sold) [R6], and the Greenroom (the aforementioned teachers’ community and support site) [c] also improve programming teaching practice and capacity. In contrast to the disengaging environments and language of traditional methods, Greenfoot enables teachers to teach software development principles and object orientation in a modern, graphical context. As a teacher from Vincent-Lübeck-Gymnasium (Germany) observes: ‘The pedagogy behind the development environment has continuously been improved over time and on occasions made massive jumps forward. I can produce all my teaching tools inside Greenfoot [and] hence encourage the pupil to dissect my project structures and code’ [e]. Further to increasing innovation in programming pedagogy, teachers note that their job satisfaction and ability to teach inspirationally is improved through using Greenfoot, as a teacher from Carl-Helbing-Schule Emmendingen (Germany) testifies: ‘I often experience situations when the lesson is over, but some students still stay on longer, creating their games. Is there anything more satisfying an educator can dream of? The concepts of object-oriented programming become so much more clear and understandable for the students. It makes teaching concepts of OOP absolutely effortless’ [e]. Comparably, beyond the Greenfoot site itself and in the context of the Greenroom, teachers remark on how the supporting material and community sites enhance their ability to use Greenfoot and connect with other teachers. This point is made by a teacher from Ann Arbor Huron High School in Michigan (USA): ‘The nicest feature of it, beyond ease of use, is that there is a textbook that is built around the program! I have benefited from BOTH the blueroom and greenroom discussion boards. Getting lessons, questions answered, etc. The support for the product has been nice!’ [e]. This view is echoed by the teacher from Vincent-Lübeck-Gymnasium (Germany): ‘Being able to exchange knowledge with a global community of people who use Greenfoot in radically different environments is a huge help’ [e].

Informing UK computer science curricula

Since 2008, Computing at School (CAS) has collaborated with the Greenfoot team to accomplish its mission of promoting the teaching of computing at school across all school phases and supporting computing teachers with training and resources. Greenfoot is applied within several courses they run for teachers and since 2013 ‘has been an integral part of the Welsh Joint Education Committee (WJEC) GCSE curriculum’ [f]. The latter was part of the qualifications and reform programmes in England and Wales which saw the WJEC – a Welsh exam board – develop a new GCSE computer science qualification of which Greenfoot forms a part. In commenting on the benefits of Greenfoot’s integration into the GCSE, the WJEC highlight that the software ‘is used to develop an understanding of object orientated Programming using Java such that students can understand […] the concepts of inheritance and encapsulation’ [g]. The WJEC ‘value the use of Greenfoot as a component of the WJEC GCSE computer science qualifications, and the Greenfoot materials provide valuable resources for teaching’ [g].

In the same vein, the Vice-Chair of CAS also highlights that ‘across the last decade of computing resurging in UK schools, Greenfoot has contributed to the teaching of programming in school’ and ‘evolved to have a special place with pupils at KS4 and A level’ [f]. CAS testifies that ‘access to the innovative software encourages pupils to program: not only enhancing their interest in programming, but also enriching their understanding of computer science. The software provides an easily-understood interactive user interface, thus lowering the entry barrier to writing and understanding code, and has an active, supportive, worldwide community, tutorials, and teaching plans’ [f]. Correspondingly, for teachers ‘it has advanced the knowledge, skills and understanding of those teaching in the classroom’ [f]. CAS remarks in particular upon the innovativeness of Greenfoot in improving learning and teaching practice, asserting that ‘the pedagogical appeal and significance of Greenfoot in advancing the knowledge of and accessibility to computing is felt by both teachers and pupils; its technology has advanced the learning of staff and students in diverse ways’ [f].

Contributing to computer science philanthropy and NGO engagement initiatives

Oracle is an American multinational computer technology corporation headquartered in California that sells database software and technology, cloud-engineered systems, and enterprise software products. Since 2013 – as part of Oracle’s philanthropic mission to provide a wide range of free resources and works with institutions, educations and partners across the globe via their Oracle Academy education suite – Greenfoot ‘has been an important part of Oracle’s Academy’s curriculum’ [h]. As the Vice-President of Oracle confirms: ‘In the 2020 academic year to date, Oracle Academy Greenfoot related curriculum has been studied by thousands of students in over 70 countries’ [h]. Greenfoot, they argue, along with BlueJ and Stride, ‘collectively have the potential to bring programming to every student – not just those who aim for a career in software development or computer science’ [h].

Technocamps is a non-profit organisation started in 2003 with a mission to inspire, motivate, and engage people with computational thinking and promote Computer Science as underpinning all aspects of modern society. Technocamps have delivered more than 2,500 workshops to over 60,000 young people across Wales on programming, games development, and much more, and Greenfoot has been included as part of their workshop curricula. The Director of Technocamps states that: ‘in 2012 we developed our own workshop based on the Greenfoot material, and the reach of this workshop has increased substantially since 2013. Our Greenfoot workshop has been delivered to approximately 3,500 pupils over the past seven years across Wales, with 125 teachers undertaking CPD courses which include Greenfoot’ [i]. The workshop they go on and the interaction with the Greenfoot platform have ‘proven to be popular and valuable in influencing teaching pedagogy and student understanding […] Feedback from the teachers has suggested that the workshops are very beneficial for improving student learning and helped the teachers to guide their pupils through the GCSE’ [i]. Technocamps state that they have: ‘benefitted greatly from the Greenfoot software in supporting teachers and other classroom practitioners to deliver workshops on digital education and programming to young people in Wales’ [i].