Elearning initiatives in Dermatology Dr Maria Gonzalez Sonia Maurer Nan Zhang

The Project Dermatology Surgical Skills Projects I and II Project I –Video Linkage of surgical theatre to seminar room Project II –Use of video capture software (Mediasite) to stream surgical sessions and lectures online and store them for on-demand viewing

Context Teaching and learning of surgical skills in dermatology is important Historical standard for this is apprenticeship model with direct participation in the Operating theatre

Context Limited access – rationing of training in certain skills Use of live video/webcasting democratises this process Enhanced opportunity to observe the expert Previously undergraduates did not have access to surgical theatres in dermatology Limited number of postgraduates had access in an ad hoc fashion

Main benefit Democratisation of access to knowledge –Groups benefiting: Undergraduates Post graduates in full time courses All dermatology trainees and consultants in Wales Alumnus – Dermatology Continuing Professional Development Society Distance learners

The Diploma in Practical Dermatology 400 GPs mainly from the UK and the Asia Pacific region

Instantaneous or real-time communication via the internet between dispersed learners using text and/or audio

1 tutor facilitates a group of 6-8 doctors The learning objectives and ‘talking points’ provided several weeks before scheduled meeting Meetings always held on Sunday mornings Tutor uses audio communication while students use text communication only

Logistics of running 104 online meetings per academic year: Students and tutors dispersed all over the world Different time zones Different levels of technical knowledge and skills In house staff required to work on Sundays

Technical skills of students and staff Typing speed of students – fastest typists are the loudest voices “Naughty” students – copy and pasting answers, talking out of turn Tutors’ facilitation skills variable – important that they ensure all voices heard

Dermatology Surgical Skills Project - Requirements Live video link from operating theatre to seminar room, with 2-way audio Software to stream sessions live to Internet Software management system for later on-demand access to recordings

In addition to live video link: Live streaming Content management system User management system – control access to recorded content Record seminar room lectures (PowerPoint slides and video of lecturer) Flexible screen template

Initial research Identified four audio-visual companies capable of setting up video-link (VideoSouth, Touchvision, Starkstrom, Drake) Identified two software systems that could deliver requirements (Mediasite, Echo360) Detailed talks, site visits

VideoSouth / Mediasite Operating Theatre –One high quality camera on moveable arm –Radio mic –Preview monitor Seminar Room –Wall mounted camera, microphone –Mediasite on separate computer, hardwired into system –Integration into touch panel

Surgery Recording

Seminar Room – lecture recording

Student Feedback “It is a good introduction to dermatological surgery” “Very useful as different surgical skills like local anaesthetic injections, excision technique and suturing technique can be learnt.” “It was very nice that the surgeon was communicating with us, asking us questions and explaining the procedure as well.” “It is useful because it allows one to understand what is happening during the procedure and why things were being done.”

One year on… Diploma in Dermatological Sciences –Record all lectures in Dermatology Seminar room –Record weekly live surgery sessions Record lectures at annual meeting of Dermatology Alumni society Record dermatology registrar meetings Building up library of recordings –course websites, CPD and “Dermacademy” sites

Demos 23:30

Synchronous Online Meetings Important part of Diploma in Practical Dermatology since 2002 Technology developed

2002 Text Chat Simple text chat – Foolproof!

2005 Elluminate Live Virtual Classroom

More clever features… Whiteboard –(PowerPoint, drawing tools, pointing device) Polling Audio catch-up Breakout rooms Recording

But… Elluminate website - 3 pages java troubleshooting alone!

Java problems Students needed to download and install Java Virtual Machine (7Mb) and Elluminate (3Mb) Impractical on 2005 PCs Search for alternative meeting room (with audio) –Main criteria: no download / foolproof download, platform independent.

Talking Communities Small plugin for Internet Explorer / Firefox Nearly always worked first time.

Very nice Flash software –Most PCs already had Flash pre-installed Problems: –Sound quality not brilliant –Large-scale meetings …although huge respected company, the hosted solution had severe reliability problems 2006 Adobe Breeze (Connect)

2007 Talking Communities Return to Talking Communities But… Small US company Support and reliability problems starting to crop up with “new version”. (Sunday mornings in UK) Starting to look old-fashioned

Alternatives Elluminate(Java) Wimba(Java) Spreed(Flash) Adobe Connect(Flash) DimDim(Flash)

2009 Return to Ellumniate Elluminate product not greatly changed since 2005 – still most fully featured –but Internet caught up. Java improved! 24 hour international support line Integration into eLearning Platform (D2L) – single sign-on

Fewer technical problems than Talking Communities Students and tutors love it 2009 Return to Ellumniate

Sonia Maurer Learning Technologist