Learning about Hospital Ward Rounds with 360-Degree Video

Post by Terese Bird

Interest sparked in 360-degree video for learning

Since 2017, Leicester Medical School has been experimenting with 360-degree video for learning. Following the first live-streamed medical surgical operation done by Dr Shafi Ahmed (McGoogan and Murgia, 2016), medical students’ interest was ignited. Leicester Medical School’s student society MedRIFT (Medical Research into Future Technology), which I founded and oversee, decided to pursue this interest and find out how to maximise the affordances of 360-degree video for undergraduate medical education.

When Leicester Medical School first acquired its 360-degree video camera, an Omni Go Pro, the first idea was to capture live a surgical procedure, similar to what Dr Shafi Ahmed had done. In this use of the technology, the actions of nurses, operating department practitioners, and doctors, as well as all of the instruments and screens, are picked up on the camera, and all sound too. Students can learn from everything in the environment of the procedure before they are qualified enough to get that close to the action, acclimating them to aspects of the environment and human factors of surgery as well as demonstration of the procedure.

Rationale to create 360-degree videos of ward rounds

Filming surgical procedures was proving difficult in terms of getting permissions from everyone involved. We found that the patients were surprisingly willing, but not all the staff were, and it was hard to find time and situation to discuss this in advance and secure informed consent. So the students brainstormed other aspects of medical knowledge which could be helped by 360 video. They came up with the idea of filming ward rounds, in which the doctor visits the different patients on the ward, checking on them and administering and adjusting treatment as needed. Doctors teach medical students who join them on the round and teach them to document the patient’s case. But students often feel unsure of what to expect on ward rounds when they are just beginning clinical study. Anything can happen during a ward round, and doctors must deal with demands coming from all directions; hence students must learn this too. It was felt that the 360-degree camera would capture this aspect of demands coming from all directions and help acclimate students into the still-unfamiliar domain of clinical knowledge and practice, as in a model of domain learning (Alexander, 2003).

Initial research

When the Digital Innovation Partnership (DIP) scheme was launched by Leicester Learning Institute we saw our opportunity for supported research. The DIP scheme encourages staff and students to work together to trial learning innovations enabled by digital tools. We devised research to examine learning with 360-degree video, specifically learning to feel confident on the round, to document correctly, and to treat all patients and family members empathetically. The scenarios were actual events experienced by one of our teaching doctors. They were acted by members of a University of Leicester drama society and filmed with a 360-degree camera in the teaching area of the Leicester Royal Infirmary. Using actors to simulate the ward round solved the consent problem, and student actors brought a fresh energy to the project.

In the research, one group of students watched 360 video ward round scenarios using Google Cardboard devices. Another group learned about ward rounds by reading PowerPoint presentations, and a third group received no ward round information. All students were then sent into a live ward round situation simulated by actors. The participants were given the task of documenting patients in the live simulation, and then completing a survey which examined their confidence to face the real ward round, their level of empathy for the patients, and their impressions of how engaging the teaching material was. We then evaluated the documentation for accuracy, and also compared survey responses to responses to baseline surveys given before the intervention began.

Our research showed that all participating students found the 360 videos to be an engaging way to learn, especially when compared with more traditional methods like PowerPoint slides. 75% of participants felt that learning from the videos helped them to consider how they could show empathy.  Watching these videos were not seen as helpful to learn to document correctly, however. Because of this finding, the students decided to add into the 360 videos some further text which helps to ‘signal’ what they need to be noticing and learning about documenting, during that point in the scenario. This video is below. (Note: this is a realistic scenario of a patient at end of life.) You can experience the 360-degree view by dragging the image while the video is playing.

Bringing research findings into teaching workshops

We are now offering workshops to our year 1 and year 2 students, helping them to watch these videos with Google Cardboard devices and then discussing the aspects of confidence, empathy, and documentation accuracy. In our most recent workshop, after watching the videos, students put themselves in the place of the patient’s family, discussed all the ways the doctor showed care for the patient’s family, and came up with other ways to show empathy such as doing more to keep the scene private and alerting the other health care professionals to the condition and needs of the patient and family. Our next goal is to create an online learning environment offering this teaching wrapped around the edited ward round videos, so that students may watch and learn on their own.

With a price tag exceeding £4000, the camera and software were not cheap; however, the videos created can be used and re-used repeatedly and in different contexts. There is therefore a reasonable measure of sustainability in this model of 360-degree video for learning.

On the premise that there is nothing that can prepare one for a ward round except going on a ward round, we think these 360-degree videos are showing promise as an engaging way to help students prepare, because they are the next best thing to being there.

References

Alexander, P. A. (2003) ‘The Development of Expertise: The Journey From Acclimation to Proficiency’, Educational Researcher, vol. 32, no. 8, pp. 10–14 [Online]. DOI: 10.3102/0013189X032008010.

McGoogan, C. and Murgia, M. (2016) Watch the world’s first surgery streamed in virtual reality live from London [Online]. Available at http://www.telegraph.co.uk/technology/2016/04/14/watch-the-worlds-first-surgery-streamed-in-virtual-reality-live/ (Accessed 25 March 2017).

Acknowledgements

With thanks and acknowledgement of all the work of co-creating and carrying out filming and teaching sessions: Dr Nasif Mahmood, and students Vanessa Rodwell, Farhaana Surti, Ethan Tamlyn, Josh Sturgeon, Abina Dharmaratnam, Marcus Judge, Thanin Ong, Zarva Shahid, and Jakevir Shoker, and the members of LUTheatre

Terese Bird is the Educational Designer for Leicester Medical School, leading on the work of utilising iPads as a digital platform for learning, collaboration, assessment and feedback, and working with students to pioneer the use of 360-degree video and 3D printing for undergraduate medical learning. Twitter: @tbirdcymru

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