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Webcasts for Resident Education

2011; Elsevier BV; Volume: 119; Issue: 1 Linguagem: Inglês

10.1016/j.ophtha.2011.08.037

1549-4713

Sandeep Grover, Amy T. Kelmenson, Kakarla V Chalam, Deepak P. Edward,

Healthcare Systems and Technology

The Accreditation Council for Graduate Medical Education (ACGME) requires a certain number of hours of formal teaching in particular subjects in a fully accredited ophthalmology residency program. Fifty-two of 114 (45.6%) ophthalmology residency programs in the United States enroll 2 or 3 residents per year. These small programs may have limited expertise and resources to meet ACGME requirements in some subspecialties. They either send their residents for courses or invite experts from different institutions. Either method is expensive and requires time away from other responsibilities–both for the residents and the invited speaker. Webcast conferencing has been used as a tool for business communication/conferencing and education in fields like nursing, family medicine, and pathology.1Klock C. Gomes Rde P. Web conferencing systems: Skype and MSN in telepathology.Diagn Pathol. 2008; 3: S13Crossref PubMed Scopus (16) Google Scholar, 2Markova T. Roth L.M. E-conferencing for delivery of residency didactics.Acad Med. 2002; 77: 748-749Crossref PubMed Scopus (24) Google Scholar However, most of this conferencing in the medical field is based on archived recorded lectures, typed chat-room/telephone communication, or one-way webinars without speaker audience interaction.2Markova T. Roth L.M. E-conferencing for delivery of residency didactics.Acad Med. 2002; 77: 748-749Crossref PubMed Scopus (24) Google Scholar, 3Yagi Y. Ahmed I. Gross W. et al.Webcasting pathology department conferences in a geographically distributed medical center.Hum Pathol. 2004; 35: 790-797Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar, 4Westwood M.A. Flett A.S. Riding P. Moon J.C. How to webcast lectures and conferences.BMJ. 2009; 338: 352-354Crossref Scopus (5) Google Scholar There are isolated reports of using live interactive video conferencing in medical education5Jones R.B. Maramba I. Boulos M.N. et al.Use of live interactive webcasting for an international postgraduate module in ehealth: case study evaluation.J Med Internet Res. 2009; 11: e46Crossref PubMed Scopus (21) Google Scholar and none for “live” webcast lectures being used in ophthalmology residency programs. Hence, this pilot study was conducted to evaluate the effectiveness, cost, and feasibility of live interactive video webcasts for ophthalmology resident education. Thirty-eight live webcast lectures were given to 2 residency programs with a total of 6 residents each over 2 years. The lecture topics covered by 5 different speakers included ocular pathology (n = 24), inherited retinal diseases and electrophysiology (n = 6), optics (n = 4), ocular pharmacology (n = 2), and 1 each on clinical genetics and glaucoma. The webcast required an online browser-based web conferencing and collaboration application that allows sharing presentations between multiple users with any internet-ready computer. A webcam and microphone were the only other required accessories. The computer was connected to a large screen or Smart Board in the classroom (Smart Technologies, Calgary, Canada). PowerPoint presentations, virtual pathology slides scanned on Aperio slide scanners (Aperio Technologies, Vista, CA), and videos were used for the lectures. The residents viewed the presentation on the screen along with a streaming video view of the speaker. The speaker could visualize a live video of the residents as well. The audio system using voice-over-internet protocol allowed for 2-way live communication between the residents and speaker. In the last 18 months of the study there were 61 anonymous evaluations of 13 lectures by residents, evaluating both “webcast quality” as well as the speaker. The webcast was evaluated for the quality of the slides, video, and audio, the clarity of the presentation, the overall quality of the talk, and the duration of the talk. The speaker was then evaluated on whether the goals were stated clearly, presentation skills, knowledge and expertise, question and answer period, quality of slides, material presented, and rapport with the audience. The residents ranked each of these areas on a scale of 1 = unsatisfactory, 2 = below average, 3 = satisfactory, 4 = exceeds standards, and 5 = outstanding. The overall average “webcast evaluation” was 4.72 (range, 4.33–4.94) and the “speaker evaluation” was 4.84 (range, 4.72–5.00). As a control, this was compared to 61 evaluations for in-house classroom lectures in various subjects and the average for the “speaker evaluation” was 4.85 (range, 4.72–4.98) Tables 1 and 2 (available at http://aaojournal.org). The cost of the entire set-up was minimal since each program had facilities for internet-ready computers in the lecture room with an attached screen. The only additional cost incurred included a webcam with audio and video capabilities (<$100). The annual subscription for the web-conferencing application was $400. The system was relatively simple, convenient, inexpensive, and easy to use. Interaction with questions and answers between speakers and residents occurred consistently during the lectures. Although this feature was not used in the study, there is capability for recording the lecture and listening to it later on. Both programs that evaluated the system were in the same time zone. There may be certain limitations when more programs are involved in different time zones in the country or internationally. There were isolated incidents of audio/video loss. Since the lectures were held during the routine didactic time, there were no duty hour violations. This pilot study showed that “live webcast” was as good as the classroom lecture, if not superior to it in certain aspects. A larger number of programs and residents need to participate in these webcasts to objectively evaluate the effectiveness of this tool, which can then be used globally to provide standardization of curriculum throughout the world within duty hour guidelines. Table 1“Webcast” Evaluation by ResidentsEvaluation criteriaScoreQuality of slides4.94Quality of video4.76Quality of audio4.33Clarity of presentation4.73Quality of presentation4.74Duration of talk4.80Overall4.72Scores are based on a scale of 1 through 5: 1 = unsatisfactory; 2 = below average; 3 = satisfactory; 4 = exceeds standards; 5 = outstanding. Open table in a new tab Table 2Comparison of “Speaker” Evaluation by Residents: Live Webcast Vs Live Classroom LecturesEvaluation criteriaScore - WebcastScore - ClassroomStating goals clearly4.754.79Engaging presentation skills4.724.84Relevant knowledge & expertise5.004.98Sufficient Q&A period4.734.80Quality of slides4.924.72Interesting & informative material4.904.90Rapport with the audience4.844.92Overall4.844.85Scores are based on a scale of 1 through 5: 1 = unsatisfactory; 2 = below average; 3 = satisfactory; 4 = exceeds standards; 5 = outstanding. Open table in a new tab Scores are based on a scale of 1 through 5: 1 = unsatisfactory; 2 = below average; 3 = satisfactory; 4 = exceeds standards; 5 = outstanding. Scores are based on a scale of 1 through 5: 1 = unsatisfactory; 2 = below average; 3 = satisfactory; 4 = exceeds standards; 5 = outstanding.