From chalkboards to state-of-the-art learning technologies
Medical students gather in the operating room-style lab. The high-powered lights illuminate the cadavers set on the tables. All eyes are on the anatomist, who is about to make the first cut and take them through a tour of the chest cavity. He angles a miniature camera, set on an adjustable stem, into the open cavity.
At the corner of the teaching lab in the Medical Sciences Building in Victoria, one student is keen to ask a question before the tour gets underway — but instead of raising her hand, she shifts her hand to a small button. With the press of this button, her image appears on monitors in teaching labs in Vancouver, Kelowna and Prince George. The anatomist looks up, resting his scalpel momentarily, to hear what the student has to say.
Innovative delivery of medical education
High-speed videoconferencing technology is at the heart of the distributed medical education program. Transmitting at five to six times faster than industry average, the system has allowed for students in disparate locations to maintain a live, interactive connection with classmates at each of the distributed sites.
For faculty, teaching tools have quickly evolved from basic slides, whiteboards and dry-erase markers to a matrix of lights, cameras, robotics and audiovisual control systems. Today, lecturers must not only deliver their lesson, but control outgoing video imagery, including precise macro and micro camera views, into teaching labs across the province.
Such cutting-edge videoconferencing technology has enhanced the learning experience for many students, including Dr. Jody Anderson, who graduated from the Island Medical Program in Victoria back in 2010.
But the transition from chalkboards to innovative technology platforms didn’t happen overnight. Back in the early 2000s, teams of medical faculty, clinicians and technicians began exploring innovative technological solutions to support education at sites across the province and ensure that students at each site were afforded an identical learning experience.
It wasn’t long before enabling the necessary shift in program delivery became the priority. The process was highly experimental and would require multiple stages of development and consultation.
Bringing it altogether
For the plan to work there was a demand for interactive lecture theatres and labs that would require specialized infrastructure — beginning with architectural considerations, such as lighting and acoustics, moving through to the computer network, and on to the audiovisual and information technology components.
Those at the forefront of the shift — faculty, like Dr. Joanna Bates, former senior associate dean of the MD program, and Dr. David Snadden, the former associate dean of the Northern Medical Program — remember the early days well.
Dan Zollmann, Principal of AMBiT Consulting, came on board to serve as an inter-site technology lead.
With image quality being essential in the context of medical education, Zollmann, like others, quickly recognized that there was a need to design a network fast enough to deliver exceptionally crisp video.
One of the critical aspects of what we train and hire doctors to do is to use their eyes. If an instructor was showing an MRI scan in a lecture, it would be meaningless if the remote learner saw a jittering, distorted image at the other end. - Dan Zollmann
To meet the network demands, an isolated slice of the Internet was taken and given priority over any traffic on the system network. It was a delivery system built for speed, running at two to three megabits per second.
Teaching the teachers
Once the delivery system requirements were worked out, the greater challenge became how to approach teaching under the distributed model, being sure to take advantage of the breakthrough technology to deliver engaging and interactive learning experiences for all.
Prior to distribution, medical education at UBC followed a traditional teaching model, with lectures held in theatres, holding up to 128 students. Faculty members could bring their slides along with them to the classroom and make final changes to their presentations moments before a class began — a luxury that could no longer be afforded under the distributed model.
In 2003, with less than a year to go until opening day, construction at UNBC, UVIC, and UBC was rampant. The architects had translated their ideas for the buildings into CAD drawings and blue prints, lush 3-d renderings, scale models and ultimately bricks and mortar.
Yet many had their doubts: just what would the distributed program look like in action?
Testing, testing, 1 2 3
Only months before the launch date, Dr. Angela Towle, former associate dean of MD Undergraduate Education with the Vancouver-Fraser Medical Program, together with the rest of the province-wide team, decided to put the medical school’s new distributed model of learning to the test and planned a prototypical week. They invited scores of students, faculty and staff from the Vancouver campus to makeshift campuses in Prince George and Victoria, with the aim of delivering a week of curriculum.
Could such a distributed program offer the same learning experience for students at each site?
“When the students turned up in 2004, and we had been anxious for three years — would there be a program for them? Was there going to be a faculty member to teach them? Was there going to be a classroom to put them in? They just acted as though it had always been there,” says Bates. “They were oblivious to the fact that we had been running as hard as we could.”
We’re in a shift from a generation that was use to the chalkboards and transparency slides…towards a very keen generation who wants to use technology. - Dr. Sabrina Yao, MD '12
Over the years, presentation technology has evolved past videoconferencing alone. Today, a decade since the launch of the distributed program, faculty members are at the forefront of technology-enabled learning, having adopted various platforms – including mobile – to not only support the distributed teaching model, but truly transform and advance the learning experience for medical students across the province.
Technology in UBC’s MD Program
UBC Faculty of Medicine manages one of the most sophisticated videoconferencing systems in Canadian higher education. This system enables the delivery of innovative health education programs that are responsive to the needs of our communities. We also use our technological insight to develop new approaches to enabling learning in undeserved regions across the province.
Audience Response Systems (ARS) allow presenters greater opportunities to interact with their audiences regardless of where they are located in the province at the time of the lecture. For MD Undergraduate sessions, ARS can increase student participation and engagement, and enable faculty to instantly recognize where students are struggling.
The Virtual Slide Box is a computer server in Vancouver holding gigabytes of high-resolution images of microscopic slides that students can view during their classes. They are used in histology labs, replacing rows of microscopes.
Flexible Learning is currently offered in Neuroanatomy, where videos explaining and illustrating curriculum content are produced. Students are expected to watch and review the content at home, while the reinforcing work is done in the classroom.
Recorded lectures which are hosted online and are available on demand allow students to review information in their own time. This cuts down on “cognitive overload” for medical students, often overwhelmed with new vocabulary and heavy workloads.
What is Videoconferencing?
Videoconferencing (VC) allows for real-time video and audio communication. With the implementation of videoconferencing technology at each program site, faculty now deliver real-time interactive lectures and dissections by controlling the outgoing video imagery (macro and micro camera views) to students based in labs across British Columbia. Meanwhile, medical students at each site have the opportunity to watch dissections on large LCD or plasma monitors, consult with on-site clinicians, and engage with their fellow students and the lecturer with the press of a button.