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Collabora’ve learning in Evidence Based Healthcare (EBH): A poster of first year dental students on the use of video in dental educa’on Grewal A, Zhou Z, Holder Y, Ashby C, Kanabar H, Alhakim R & Shembesh T Introduc*on Tradi*onally, clinical educa*on revolved around undergraduate dental students’ receiving improvised feedback 1 and having to only rely on the observa*on of skilled clinicians performing opera*ve procedures. We are constantly finding new ways to u*lize exis*ng technology for educa*onal purposes, and looking for solu*ons for shortcomings in order to enhance the learning experience for dental students. As videos, databases and equipment become more accessible, can this technology play a role in modern dental educa*on??. Loop mounted video cameras have the poten*al to enhance the students’ experience when demonstra*ng an opera*ve procedure and could provide a valuable teaching aid 3 . The importance of feedback has been well established in not only the medical field but in all other aspects of teamwork and solo skills development where it has proved to be vital in improving not only the perceptual skills but the speed and accuracy of the performance 4,5 . This poster will look at the use of cameras in feedback, and how this could affect prac*cal skill development in undergraduate dental educa*on. Aims 1. Engage in research literature, and develop skills in searching and cri*cally appraising evidence. 2. Explore evidence on the impact of implemen*ng video in prac*cal skills development for undergraduate students. 3. Explore evidence from other professions on the use of video in the feedback process.. Video feedback It has been shown that individual video feedback sta*s*cally improves skills from one try to the next more than group feedback 6 . Type 1 - Unsupervised video feedback (UVF) Type 2 - Individual video feedback (IVF) Type 3 - Peer review (PR) • When UVF and IVF were compared, they showed no sta*s*cally significant improvement in the students skills 7 . However, there was a difference in the par*cipants aStudes towards each method, with a strong preference for IVF. UVF is less *me consuming so would make a more realis*c op*on, but should be used alongside other feedback methods so that the student does not have an inaccurate perspec*ve 8 . • Peer feedback has been shown to improve results more than faculty feedback. Peer feedback can be similar to that of the teacher if provided with some sort of guide, such as a checklist. It is likely that the student gains from both receiving feedback and giving it 9 . Conclusion Collabora*ve learning on this project is useful methodology to engage in EBH and develop relevant skills. U*lisa*on of video technology is useful in prac*cal skill development, largely due to the impact of gaining feedback. However, in healthcare there are several cri*cal issues to consider, such as data protec*on, pa*ent confiden*ality and consent. Further research is impera*ve to its implementa*on in dental undergraduate educa*on. 1- Rowe AD, Wood LN. Student percep*ons and preferences for feedback. Asian Soc Sci. 2009;4(3):P78., 2 - Massey D, Byrne J, Higgins N, Weeks B, Shuker MA, Coyne E, Mitchell M, Johnston ANB. Nurse Educ Today. 2017 Apr 20;54:56-61. doi: 10.1016/j.nedt.2017.02.024, 3 - Videotaped Feedback Method to Enhance Learning in Preclinical Opera*ve Den*stry: An Experimental Study.Shah DY 1, Dadpe AM 2, Kalra DD 2, Garcha VP 2., 4 - Lee A, Keh N, Magill R. Instruc*onal effects of teacher feedback in physical educa*on. J Teach Phys Educ. 1993;12:228-243., 5 - Chris*na R, Barresi J, Shaffner P. The development of response selec*on accuracy in a football linebacker using video training. Sport Psychol. 1990;4:11-17., 6,7 - NESBITT, C., PHILLIPS, A.W., SEARLE, R. and STANSBY, G. (2015). Student Views on the Use of 2 Styles of Video-Enhanced Feedback Compared to Standard Lecture Feedback During Clinical Skills Training. Journal of Surgical Educa*on, 20150702, Sep-Oct, vol. 72 (5), pp. 969-973 ISSN 1878-7452; 1878-7452. DOI 10.1016/j.jsurg.2015.04.017 [doi]., 8 - Zevin, B. (2012). Self Versus External Assessment for Technical Tasks in Surgery: A Narra*ve Review. Journal of Graduate Medical EducaDon, 4(4), 417–424. hop://doi.org/10.4300/JGME-D-11-00277.1 , 9 - VAUGHN, C.J., KIM, E., O'SULLIVAN, P., HUANG, E., LIN, M.Y., WYLES, S., PALMER, B.J., PIERCE, J.L. and CHERN, H. (2016). Peer video review and feedback improve performance in basic surgical skills. American Journal of Surgery, 20151122, Feb, vol. 211 (2), pp. 355-360 ISSN 1879-1883; 0002-9610. DOI 10.1016/j.amjsurg.2015.08.034 [doi]., 10 - LEIJEN, Ä., LAM, I., WILDSCHUT, L., ROBERT-JAN SIMONS, P. and ADMIRAAL, W. (2009). Streaming video to enhance students’ reflec*on in dance educa*on. Computers & Educa*on, 1, vol. 52 (1), pp. 169-176 ISSN 0360-1315. DOI hops://do i.org/10.1016/j.compedu.2008.07.010, 11 - BOYER, E., MILTENBERGER, R.G., BATSCHE, C., FOGEL, V. and LEBLANC, L. (2009). VIDEO MODELING BY EXPERTS WITH VIDEO FEEDBACK TO ENHANCE GYMNASTICS SKILLS. Journal of Applied Behavior Analysis, vol. 42 (4), pp. 855-860 ISSN 1938-3703. DOI 10.1901/jaba.2009.42-855, 12 - RYSTEDT, H., REIT, C., JOHANSSON, E. and LINDWALL, O. (2013). Seeing through the den*st's eyes: video-based clinical demonstra*ons in preclinical dental training. Journal of Dental EducaDon, Dec, vol. 77 (12), pp. 1629-1638 ISSN 1930-7837; 0022-0337. DOI 77/12/1629 [pii]., 13 - WANG, J., SUENAGA, H., YANG, L., KOBAYASHI, E. and SAKUMA, I. (2016). Video see-through augmented reality for oral and maxillofacial surgery. The InternaDonal Journal of Medical RoboDcs + Computer Assisted Surgery : MRCAS, 20160609, Jun 9 ISSN 1478-596X; 1478-5951. DOI 10.1002/rcs.1754 [doi]., 14 – Hirvikangas H, et al. The use of recordings by a loupe-mounted video camera in training of fixed prosthodon*cs on models, Helsinki. 2014., 15 - Zevin B. Self versus external assessment for technical tasks in surgery: a narra*ve review. J Grad Med Educ. 2012;4(4):417-424, 16 - Ward M, MacRae H, Schlachta C, et al. Resident self assessment of opera*ve performance. Am J Surg. 2003;185(6):521-524., 17 - Cummings, T. and Chang, B. (2017). Clip-on opDcal mounDng structure. US 6493136 B2., 18 - Mackworth, N. and Thomas, E. (1962). Head-Mounted Eye-Marker Camera. Journal of the OpDcal Society of America, 52(6), p.713. , 19 - Backstein, D., Agnidis, Z., Sadhu, R. and MacRae, H. (2005). Effec*veness of repeated video feedback in the acquisi*on of a surgical technical skill. Canadian Journal of Surgery, (48), pp.195-200. Fig 2: hop://www.loupecam.com/tes*monials Methods Searching for relevant studies using online databases, such as PubMed and Web of Science using [MeSH] terms (e.g. Video recording*, Educa*on,Dental*, Teaching/methods), as well as a targeted search from references Excluding any ar*cles or studies which were not relevant to our aims Thoroughly evaluate research; achieved using CASP tools for cri*cal appraisal of research, and member checking Limita*ons Pa’ent consent – valid consent is required, and pa*ents may be uncomfortable with this. Cost – purchasing loupe-mounted video camera technology would add an extra expense. However, newer and cheaper alterna*ves are being developed, such as video cameras which aoach to normal glasses 17 . If the recording is being used for self-review the student might be making a mistake unknowingly. This may be corrected by aoaining help from a peer or a tutor. Restricted view - the pa*ent may not be within the view of the camera. If this is the case, a special camera which tracks eye movement could be invested in 18 . Effec’veness - a study evalua*ng the effec*veness of videotaped feedback for surgical students shows no significant difference in the speed of acquisi*on of the skill 19 . Examples Other professions, like den*stry, also require similar levels of intricacy and refined skills and may be good indicators of how successful video camera feedback can be for undergraduate dental students: • Dancers: the use of video recording allows them to capture their performance and gives the opportunity to reflect on their movements and view themselves in the eyes of the audience 10 . • Gymnasts: it has been reported that video feedback can shorten teaching hours for gymnasts, as well as maintaining higher performance levels over*me 11 . Findings from other professions should be treated with cau*on when applying them to a dental environment. This is because, their performance and movements can be judged subjec*vely and whether the improvement has been seen is all down to each individual unlike with den*stry, where clear targets need to be met. Strengths 1. Easier to integrate theore’cal knowledge with vital clinical skills 12 • However, the study was done in Sweden, where cultural differences such as preference for video recording and teacher led feedback seminars may have exaggerated the posi*ve impact the videos had on students’ clinical skills and understanding. • One of the main reasons students preferred this method was because of how easy it is to visualise procedures and if the UK doesn’t have as advanced technology as Sweden, this may not be the case. 2. Easy to download and good quality 13 • 1mm overlay difference between video tracking of the procure and the actual tooth model. It is unclear whether this is precise enough for dental students to greatly benefit from such specific and small scale tasks. • The data provides 3-5 frames per second. 3. It provides good self-assessment, promo’ng independent learning 14 • Videotaped feedback opens doors for self assessment which is necessary for embarking on lifelong con*nual development as a healthcare professional 15,16 . The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been corrupted. Restart your computer, and then open the file again. If the red x still appears, you may have to delete the image and then insert it again.

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Page 1: Collaborave learning in Evidence Based Healthcare (EBH) · PDF fileStudent percep*ons and preferences for feedback. Asian Soc Sci. 2009;4(3):P78. ... Restricted view - the paent may

Collabora'velearninginEvidenceBasedHealthcare(EBH):Aposteroffirstyeardentalstudentsontheuseofvideoindentaleduca'on

GrewalA,ZhouZ,HolderY,AshbyC,KanabarH,AlhakimR&ShembeshT

Introduc*onTradi*onally,clinicaleduca*onrevolvedaroundundergraduatedentalstudents’receivingimprovisedfeedback1andhavingtoonlyrelyontheobserva*onofskilledcliniciansperformingopera*veprocedures.Weareconstantlyfindingnewwaystou*lizeexis*ngtechnologyforeduca*onalpurposes,andlookingforsolu*onsforshortcomingsinordertoenhancethelearningexperiencefordentalstudents.Asvideos,databasesandequipmentbecomemoreaccessible,canthistechnologyplayaroleinmoderndentaleduca*on??.Loopmountedvideocamerashavethepoten*altoenhancethestudents’experiencewhendemonstra*nganopera*veprocedureandcouldprovideavaluableteachingaid3.Theimportanceoffeedbackhasbeenwellestablishedinnotonlythemedicalfieldbutinallotheraspectsofteamworkandsoloskillsdevelopmentwhereithasprovedtobevitalinimprovingnotonlytheperceptualskillsbutthespeedandaccuracyoftheperformance4,5.Thisposterwilllookattheuseofcamerasinfeedback,andhowthiscouldaffectprac*calskilldevelopmentinundergraduatedentaleduca*on.

Aims1.  Engageinresearchliterature,anddevelop

skillsinsearchingandcri*callyappraisingevidence.

2.  Exploreevidenceontheimpactofimplemen*ngvideoinprac*calskillsdevelopmentforundergraduatestudents.

3.  Exploreevidencefromotherprofessionsontheuseofvideointhefeedbackprocess..

VideofeedbackIthasbeenshownthatindividualvideofeedbacksta*s*callyimprovesskillsfromonetrytothenextmorethangroupfeedback6.Type1-Unsupervisedvideofeedback(UVF)Type2-Individualvideofeedback(IVF)Type3-Peerreview(PR)•  WhenUVFandIVFwerecompared,theyshowednosta*s*callysignificant

improvementinthestudentsskills7.However,therewasadifferenceinthepar*cipantsaStudestowardseachmethod,withastrongpreferenceforIVF.UVFisless*meconsumingsowouldmakeamorerealis*cop*on,butshouldbeusedalongsideotherfeedbackmethodssothatthestudentdoesnothaveaninaccurateperspec*ve8.

•  Peerfeedbackhasbeenshowntoimproveresultsmorethanfacultyfeedback.Peerfeedbackcanbesimilartothatoftheteacherifprovidedwithsomesortofguide,suchasachecklist.Itislikelythatthestudentgainsfrombothreceivingfeedbackandgivingit9.

ConclusionCollabora*velearningonthisprojectisusefulmethodologytoengageinEBHanddeveloprelevantskills.U*lisa*onofvideotechnologyisusefulinprac*calskilldevelopment,largelyduetotheimpactofgainingfeedback.However,inhealthcarethereareseveralcri*calissuestoconsider,suchasdataprotec*on,pa*entconfiden*alityandconsent.Furtherresearchisimpera*vetoitsimplementa*onindentalundergraduateeduca*on.

1-RoweAD,WoodLN.Studentpercep*onsandpreferencesforfeedback.AsianSocSci.2009;4(3):P78.,2-MasseyD,ByrneJ,HigginsN,WeeksB,ShukerMA,CoyneE,MitchellM,JohnstonANB.NurseEducToday.2017Apr20;54:56-61.doi:10.1016/j.nedt.2017.02.024,3-VideotapedFeedbackMethodtoEnhanceLearninginPreclinicalOpera*veDen*stry:AnExperimentalStudy.ShahDY1,DadpeAM2,KalraDD2,GarchaVP2.,4-LeeA,KehN,MagillR.Instruc*onaleffectsofteacherfeedbackinphysicaleduca*on.JTeachPhysEduc.1993;12:228-243.,5-Chris*naR,BarresiJ,ShaffnerP.Thedevelopmentofresponseselec*onaccuracyinafootballlinebackerusingvideotraining.SportPsychol.1990;4:11-17.,6,7-NESBITT,C.,PHILLIPS,A.W.,SEARLE,R.andSTANSBY,G.(2015).StudentViewsontheUseof2StylesofVideo-EnhancedFeedbackComparedtoStandardLectureFeedbackDuringClinicalSkillsTraining.JournalofSurgicalEduca*on,20150702,Sep-Oct,vol.72(5),pp.969-973ISSN1878-7452;1878-7452.DOI10.1016/j.jsurg.2015.04.017[doi].,8-Zevin,B.(2012).SelfVersusExternalAssessmentforTechnicalTasksinSurgery:ANarra*veReview.JournalofGraduateMedicalEducaDon,4(4),417–424.hop://doi.org/10.4300/JGME-D-11-00277.1,9-VAUGHN,C.J.,KIM,E.,O'SULLIVAN,P.,HUANG,E.,LIN,M.Y.,WYLES,S.,PALMER,B.J.,PIERCE,J.L.andCHERN,H.(2016).Peervideoreviewandfeedbackimproveperformanceinbasicsurgicalskills.AmericanJournalofSurgery,20151122,Feb,vol.211(2),pp.355-360ISSN1879-1883;0002-9610.DOI10.1016/j.amjsurg.2015.08.034[doi].,10-LEIJEN,Ä.,LAM,I.,WILDSCHUT,L.,ROBERT-JANSIMONS,P.andADMIRAAL,W.(2009).Streamingvideotoenhancestudents’reflec*onindanceeduca*on.Computers&Educa*on,1,vol.52(1),pp.169-176ISSN0360-1315.DOIhops://doi.org/10.1016/j.compedu.2008.07.010,11-BOYER,E.,MILTENBERGER,R.G.,BATSCHE,C.,FOGEL,V.andLEBLANC,L.(2009).VIDEOMODELINGBYEXPERTSWITHVIDEOFEEDBACKTOENHANCEGYMNASTICSSKILLS.JournalofAppliedBehaviorAnalysis,vol.42(4),pp.855-860ISSN1938-3703.DOI10.1901/jaba.2009.42-855,12-RYSTEDT,H.,REIT,C.,JOHANSSON,E.andLINDWALL,O.(2013).Seeingthroughtheden*st'seyes:video-basedclinicaldemonstra*onsinpreclinicaldentaltraining.JournalofDentalEducaDon,Dec,vol.77(12),pp.1629-1638ISSN1930-7837;0022-0337.DOI77/12/1629[pii].,13-WANG,J.,SUENAGA,H.,YANG,L.,KOBAYASHI,E.andSAKUMA,I.(2016).Videosee-throughaugmentedrealityfororalandmaxillofacialsurgery.TheInternaDonalJournalofMedicalRoboDcs+ComputerAssistedSurgery:MRCAS,20160609,Jun9ISSN1478-596X;1478-5951.DOI10.1002/rcs.1754[doi].,14–HirvikangasH,etal.Theuseofrecordingsbyaloupe-mountedvideocameraintrainingoffixedprosthodon*csonmodels,Helsinki.2014.,15-ZevinB.Selfversusexternalassessmentfortechnicaltasksinsurgery:anarra*vereview.JGradMedEduc.2012;4(4):417-424,16-WardM,MacRaeH,SchlachtaC,etal.Residentselfassessmentofopera*veperformance.AmJSurg.2003;185(6):521-524.,17-Cummings,T.andChang,B.(2017).Clip-onopDcalmounDngstructure.US6493136B2.,18-Mackworth,N.andThomas,E.(1962).Head-MountedEye-MarkerCamera.JournaloftheOpDcalSocietyofAmerica,52(6),p.713.,19-Backstein,D.,Agnidis,Z.,Sadhu,R.andMacRae,H.(2005).Effec*venessofrepeatedvideofeedbackintheacquisi*onofasurgicaltechnicalskill.CanadianJournalofSurgery,(48),pp.195-200.

Fig2:hop://www.loupecam.com/tes*monials

Methods

Searchingforrelevantstudiesusingonlinedatabases,suchasPubMedandWebofScienceusing[MeSH]terms(e.g.Videorecording*,Educa*on,Dental*,Teaching/methods),aswellas

atargetedsearchfromreferences

Excludinganyar*clesorstudieswhichwerenotrelevanttoouraims

Thoroughlyevaluateresearch;achievedusingCASPtoolsforcri*cal

appraisalofresearch,andmemberchecking

Limita*onsPa'entconsent–validconsentisrequired,andpa*entsmaybeuncomfortablewiththis.Cost–purchasingloupe-mountedvideocameratechnologywouldaddanextraexpense.However,newerandcheaperalterna*vesarebeingdeveloped,suchasvideocameraswhichaoachtonormalglasses17.Iftherecordingisbeingusedforself-reviewthestudentmightbemakingamistakeunknowingly.Thismaybecorrectedbyaoaininghelpfromapeeroratutor.Restrictedview-thepa*entmaynotbewithintheviewofthecamera.Ifthisisthecase,aspecialcamerawhichtrackseyemovementcouldbeinvestedin18.Effec'veness-astudyevalua*ngtheeffec*venessofvideotapedfeedbackforsurgicalstudentsshowsnosignificantdifferenceinthespeedofacquisi*onoftheskill19.

ExamplesOtherprofessions,likeden*stry,alsorequiresimilarlevelsofintricacyandrefinedskillsandmaybegoodindicatorsofhowsuccessfulvideocamerafeedbackcanbeforundergraduatedentalstudents:•  Dancers:theuseofvideorecordingallowsthemtocapturetheir

performanceandgivestheopportunitytoreflectontheirmovementsandviewthemselvesintheeyesoftheaudience10.

•  Gymnasts:ithasbeenreportedthatvideofeedbackcanshortenteachinghoursforgymnasts,aswellasmaintaininghigherperformancelevelsover*me11.

Findingsfromotherprofessionsshouldbetreatedwithcau*onwhenapplyingthemtoadentalenvironment.Thisisbecause,theirperformanceandmovementscanbejudgedsubjec*velyandwhethertheimprovementhasbeenseenisalldowntoeachindividualunlikewithden*stry,wherecleartargetsneedtobemet.

Strengths1.   Easiertointegratetheore'calknowledgewithvitalclinicalskills12•  However,thestudywasdoneinSweden,whereculturaldifferencessuchaspreferenceforvideorecordingandteacherledfeedbackseminarsmayhave

exaggeratedtheposi*veimpactthevideoshadonstudents’clinicalskillsandunderstanding.•  OneofthemainreasonsstudentspreferredthismethodwasbecauseofhoweasyitistovisualiseproceduresandiftheUKdoesn’thaveasadvancedtechnology

asSweden,thismaynotbethecase.2.Easytodownloadandgoodquality13•  1mmoverlaydifferencebetweenvideotrackingoftheprocureandtheactualtoothmodel.Itisunclearwhetherthisispreciseenoughfordentalstudentsto

greatlybenefitfromsuchspecificandsmallscaletasks.•  Thedataprovides3-5framespersecond.3.Itprovidesgoodself-assessment,promo'ngindependentlearning14•  Videotapedfeedbackopensdoorsforselfassessmentwhichisnecessaryforembarkingonlifelongcon*nualdevelopmentasahealthcareprofessional15,16.

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