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Educational Methodologies |
Key words: computer-assisted instruction, video streaming, computers, web-enhanced, interactive, educational software, education
Submitted for publication 08/05/04; accepted 10/19/04
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Abstract |
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Foundation didactic knowledge is traditionally taught using a lecture and textbook format, while the corresponding laboratory section teaches dental motor and discrimination skills using a "show then do" or demonstration format. Because most teaching institutions have customized laboratory courses with corresponding manuals, the ability to deliver high-quality still and video images within the manual has the potential to improve the effectiveness of the laboratory manual as a teaching tool by improving the quality and quantity of information delivered.
Hoban and Van Ormer1 found that the use of moving images helped students improve retention of concepts, facilitated thinking and problem solving, and in some cases functioned as well as an instructor in communicating facts or demonstrating procedures. Goodyear and Steeples2 noted that video can provide vivid descriptions to articulate tacit information and knowledge difficult to describe through text. Dale3 believed the moving image could balance the "over-verbalization" he saw as endemic in education. Moss4 felt that video could help tilt the balance away from teacher-centered instruction toward learner-centered study.
Teaching preclinical restorative dentistry is a resource-intensive endeavor. The large number of techniques requiring demonstration and the high student to faculty ratio make one-on-one instruction difficult. In addition, because students learn at different rates and have different learning styles, instructor time and talent quickly become taxed. Time and resource limitations affect the availability and quality of instructor demonstrations. It is important for dental educators to recognize that students have different learning styles and should consider ways of accommodating different learning preference modalities.5 Therefore, the goals of this project were to provide high-quality digital multimedia resources (still images and video) in the form of an interactive web-based manual that would lessen the teaching burden on faculty and allow students to develop in a self-paced, student-directed learning environment.
The widespread use of video in education has always been limited by production costs and delivery difficulties. However, the availability of high-quality digital cameras and desktop video editing software combined with the growth and development of broadband Internet video streaming technologies allows for the creation and use of high-quality web-based video in dental education.
This article describes the development of a web-enhanced online manual that was developed with off-the-shelf software and delivered using a web-based course management system (Blackboard). It transformed a freshman restorative preclinical technique course from a lecture-only course into an interactive web-enhanced course. The interactivity provided students with opportunities for self-paced learning by providing "anytime, anywhere" access and control over the study materials and learning environment. Students had access to the material inside the school via the local intranet and from remote locations using a broadband Internet connection. A library of video materials provided the student with choice and control by providing on-demand viewing with the ability to start, stop, pause, skip, and review the material.
I accomplished all work on the project during a three-year period of development, implementation, and annual revision. During the first year, a comprehensive laboratory manual for the freshman operative and prosthodontic courses was developed that included revisions of outdated sections of previous manuals and addition of newer customized sections. The manual, developed as an MS Word document and converted to PDF format, was made available as a web-interactive resource with selected sections provided as hard copy for reference during the laboratory session. During year two, the visual content of the manual was improved by incorporation of high-quality color images within the document text. In year three, streaming video was developed and incorporated into the manual as hyperlinks, which provided the students with on-demand viewing. It was determined, based on previous evaluation of the students, that the entering freshman possessed the basic computer skills necessary to access the online teaching material without the need for additional training.
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Methods |
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A system designed for video editing requires a powerful processor (Pentium IV or AMD Athlon XP 1800 or higher) capable of handling a heavy processing load. A minimum of 512 ram (random access memory) is required to minimize freezing of the system during video editing and rendering. Video acquisition requires the use of a FireWire for importing digitized video or the ability to digitize analog video (VHS, HI-8 tapes) using a video capture card. A large capacity hard drive (100 GB or greater) with a large slave drive for archival purposes and a CD rewriter (CDRW) for transfer and backup of large files is essential. All work for this project was accomplished using a PC-compatible machine with the following specifications: AMD Athlon XP 2000Mhz, Windows XP Professional operating system, 512 MB 2100DDR ram, ATI All-in-Wonder 8500DV video capture card with 64 MB video Ram, 100 GB master drive, 160 GB slave drive for video archives, DVD Rom at 16X, and CDRW at 48X.
The manual was created in Microsoft Word by digitizing and incorporating pertinent sections of existing manuals using optical character recognition (OCR) software and flatbed scanning. New sections of the manual were written directly into the Word document. Pictures were obtained by flatbed scanning and digital photography. High-quality still color images were incorporated into the document and formatted using "tight" layout (Figure 1
). Tight layout wraps text around the object allowing for free movement of the image in the document during editing and annual revision. The color images were used to create sections called "slide galleries" that contained examples of practical exams (Figure 2). Sections called "slide series" provided the students with detailed instructions for performing the laboratory projects (Figure 3).
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) during text editing was important because it allowed for the creation of headings in the Word document. During conversion to PDF format using Adobe Acrobat Writer 6.0, these headings became navigation bookmarks. The creation of these bookmarks was essential because it allowed for easy navigation through the large PDF document and helped students keep track of their location in it (Figure 5). Annual updates to the manual can be performed directly in Word, and the original bookmarks are retained during conversion to PDF format. Security can be set in the PDF file limiting printing and preventing unauthorized changes.
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The incorporation of images into the manual improved the quality and quantity of the visual information that could be delivered and was well received by the students. However, it was a static format with limitations. Students commented negatively in annual course evaluations about the lack of in-class demonstrations by instructors. The next phase in the development of the manual was the incorporation of streaming video that could be accessed on demand from a central video library or through hyperlinks embedded in the text of the document.
I digitized VHS and Hi-8 format tapes using the Radeon All-in-Wonder 8500DV capture card. Videos were captured in the MPEG-1 format. Video editing using Pinnacle Studio 8 produced video segments suitable for streaming over the net as well as still images and video suitable for insertion into PowerPoint presentations. The program also allowed sound editing and the addition of subtitles that could be placed as overlay items or title pages in the video (Figure 6).
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). Since the rendered video file, MPEG or WMV format cannot be edited, it is important to save the edited video as a "Pinnacle Project" allowing for future editing.
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Once edited, a video must be rendered and encoded in the proper format for delivery. Encoding has two purposes: compression for web delivery and saving in a suitable video file format. How you encode your video depends on two main questions: 1) what media player will be used, and 2) what Internet connection speed will be available. Because of the high detail required in the videos, video for broadband PAL (1500 Kbps total) was chosen as the rendered format (Figure 8). This format is viewable on a PC-compatible computer using a broadband connection (DSL or cable). The ability to view video on both a PC-compatible (Windows operating system) and Macintosh computer would require the use of QuickTime video format. Video titles, copyright, authorship, and short descriptions can be added to the video before final rendering.
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). Registered students accessed the site to view the syllabus, print posted lecture notes, view videos from a central video library, and link to recommended web-based resources using navigation buttons. The use of Blackboard (a web-based course management system) was important because it allowed interactivity and integration. Interactivity was achieved by linking computer technology with video technology, allowing the student control over the pace and direction of the learning. Integration was achieved by using the web to interlink the video with slides, supporting texts, and resource links, creating a virtual learning environment. The use of hyperlinks within the manual, created using the "insert hyperlink" tool found on the tool bar (Figure 10), further increased the interactivity and integration.
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). The created hyperlinks were retained during the format conversion and provide the students with the ability to link/interact with the uploaded video and recommended external URL sites.
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Faculty opinion regarding the effect of the manual was obtained through informal conversations during the course and a short survey completed shortly after the course ended. Likert-type questions elicited faculty perceptions of the following issues: course organization and flow, stress levels in the students and faculty, changes in the quality of student’s work, and possible changes in student learning style and faculty teaching styles. Faculty were encouraged to provide written comments expanding on each of the questions. Six of nine faculty responded, and all six were instructors in the course throughout the three-year development period.
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Results |
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Regarding the enabling criteria, 65 percent of the students reported that they were able to view the videos at home. Forty-five percent of students had cable connection, 41 percent had DSL, and 14 percent had a dial-up connection. Students with cable connections had the fewest problems with remote viewing. Students with dial-up connections could not view the videos at home, and 50 percent of the students with DSL had problems. Problems with DSL seemed to be related to file size and time of day. Shorter videos with smaller file size were easier to view. Late evening viewing was more successful than daytime viewing, indicating traffic volume was a problem. Sixty-seven percent of the students unable to view the videos at home reported they could successfully view the videos using the computer lab in the school. Thirty-seven percent of the students reported reviewing 75–100 percent of the available videos, 28 percent reviewed 50–75 percent, 21 percent reviewed 25–50 percent, and 16 percent reviewed 0–25 percent. Most of the videos were integrated into PowerPoint presentations and shown during scheduled lecture sessions. Several students reported reviewing the videos online was not necessary because they had already viewed them during lectures.
Regarding process criteria (students’ opinions of the learning experience), 48 percent of the students agreed or strongly agreed that the quality of the videos was excellent, 51 percent reported the video quality was adequate, and 1 percent reported that the quality was poor. Seventy-three percent of the students agreed or strongly agreed that the videos were an acceptable substitute for in-class demonstrations, 17 percent were neutral, and 10 percent disagreed or strongly disagreed. Most students who felt the videos were not an acceptable substitute wrote comments indicating that the videos were "useful, helpful and should remain in the course," but felt that live in-class demonstrations were also needed. Thirty-seven percent preferred videos with sound, 18 percent preferred videos with subtitles, and 45 percent reported the two were equally effective.
Videos were available as short clips (one to five minutes in length) and as compilation videos combining several clips edited to form a sequence (length forty-five to seventy-five minutes) of the entire procedure. Forty-three percent of students preferred the short clips, 8 percent preferred the compilation video, and 49 percent thought both were equally effective. Difficulty in navigating through the large compilation videos was cited most often by students as a reason they preferred the shorter clips. Links to the video clips were embedded into the text of the manual as hyperlinks allowing for interactivity while reading. This feature was noted as excellent by the students because it allowed for easy interaction with minimal navigation.
The online manual was made available as a complete document (11 MB) and also as individual sections or chapters with a file size limit of 600 KB. Because of slower download speeds, students with dial-up connections preferred downloading the individual sections of the manual. Students with faster connections initially downloaded the entire manual but later downloaded the individual sections as needed, reporting improved computer performance and easier navigation using the smaller sections rather than the entire manual.
Regarding outcome criteria, response to the open-ended questions provided the most specific feedback regarding student perceptions of the effectiveness of the online manual. The videos in particular were cited as extremely helpful in preparing students for upcoming laboratory sessions. Many students requested that the videos remain available to them so they could review procedures before performing them for the first time in the clinic. Students were quite specific in their written comments, with many reporting they felt less stress because they were more organized and prepared for lab, resulting in fewer laboratory mistakes requiring project remakes.
Faculty feedback was generally positive regarding the impact of the manual on course flow and organization and student organization and preparedness. Response was mixed regarding the effects on stress levels, quality of the student’s work, student learning behavior, and faculty teaching style. One faculty member commented: "The manual is an excellent resource that can only be successful if it is used by the students. Those students that used the manual seemed better prepared, and ways should be explored to encourage usage." Another commented the manual and video were especially helpful "for new faculty orientation and calibration." A third indicated the videos will function well as a supplementary resource compensating for faculty who are not entirely comfortable performing in-class demonstrations.
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Discussion |
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The process of becoming an expert is a learning continuum progressing from novice, to beginner, competency, proficiency, and eventually master.10 It could be argued that the educational development of dental students in a preclinical restorative technique course progresses along a similar learning curve from novice to beginner to competent. Beginning students can be defined as novices. They attend to what they are told is important and are almost entirely dependent upon faculty. Novice learners become frustrated when faculty do not create standardized circumstances and routines that allow them to follow the rules that will lead to satisfactory results.10 The online manual was intended to guide students along this early learning continuum in the preclinic.
Sections in the manual labeled "slide series" provided students with detailed instructions for performing the laboratory projects. The "cookbook" instructions provided students with enough detailed information to promote a self-paced learning environment that encouraged student-directed independent study. The detailed instructions were designed to answer the most frequently asked student questions and addressed causes and solutions for the common errors and problems encountered in the lab. Incorporation of the slide series into the manual provided the structure and detail required by beginning students.
The ability to have a paperless preclinic restorative manual was very appealing; however, previous work showed that students preferred a hard copy in the lab to allow for quick reference and note-taking. Selected sections of the digital manual were provided as hard copy to the students, eliminating the need for expensive individual printing by the student. The hard copy was printed directly from a CD by a commercial printer providing excellent image quality.
Another reason for incorporation of color images into the manual was to improve the effectiveness of visual learning beyond that which is available from line drawings and black and white images. Knowledge of the desired outcome would appear to be a major contributor to the acquisition of dental motor skills.11 Instructional approaches that result in the acquisition of knowledge about the desired outcome and the performance necessary to obtain it are important to facilitate the learning of student dental motor skill.11 Sections of the manual called slide galleries containing examples of practical exams were not printed but rather made available for viewing online. These slide galleries helped students develop discrimination skills by providing examples of common errors that occur during cavity preparation and restoration. Strategies were provided for correction and future prevention of these errors The use of streaming video provided the students with on-demand quality demonstrations in a format that allowed the course director to control both the quality and content of the demonstration. The ability to provide quality on-demand streaming video was an important goal of the project. All video production was accomplished by the author with the help of a fourth-year dental student. In order to minimize the volume of tape requiring editing, video production followed a predetermined script. I edited all the videos myself because it is my experience that production and editing are most efficient if performed by the same person.
Shooting video for streaming is a trade-off between quality and speed of connection. Streaming is a method of making video, audio, and other multi-media available relatively quickly via the Internet. The advantage of streaming is that the video is not downloaded in its entirety to the user’s computer before it can be played. With streaming, the file remains on the server. The initial part is copied to a buffer on the computer and then, after a short delay, starts to play and continues as the rest of the file is being pulled down.6 Because the video is never downloaded to the user’s computer, availability of hard-drive space is not an issue, and copyright concerns related to unauthorized copying and distribution are minimized. The server regulates the stream according to network congestion and thereby optimizes the presentation on the student’s computer.6 A better format to stream video for remote viewing might be a multiple bit rate profile for target audiences with dual-channel ISDN, LAN, cable modem, or xDSL connections. Bandwidth is between 100 and 500 Kbps.12 Accessibility would be improved, but the effect on quality may be unacceptable. For this project, excellent video quality was a higher priority than remote access because students were guaranteed access to the video using the local intranet. Therefore, video for broadband PAL (1500 Kbps total) was chosen as the rendered format.
Educational video is not a type of incidental learning; the learning still needs to be organized as part of a deliberate learning experience.13 The videos were organized in a video library with short narratives describing the content. The videos were available for on-demand, stand-alone viewing and were also accessible through hotlinks in the body of the text, making the videos an adjunct or supplement to the text. Students reported in the post-course survey that the ability to read about a procedure and immediately view a demonstration was extremely valuable.
Student responses in post-course surveys conducted at the end of each year were always quite positive. The survey in year three was particularly positive regarding the streaming video. Future direction of the project includes the development of a self-contained, CD/DVD-ROM-based delivery format or utilization of wireless Internet in the preclinic lab. Students commented in the survey that the availability of the material on a CD or DVD would eliminate most of the access problems. However, CD-based delivery rather than web-based might decrease integration potential by eliminating the ability to add or modify links to other web-based resources.
Regarding wireless connectivity, 55 percent of the students reported owning a laptop, and 72 percent indicated they would consider bringing their laptop to lab to access the manual if wireless Internet was available. Wireless Internet connectivity and successful video streaming have been pilot-tested and are possible in the preclinic laboratory; this would be a logical next step in the ongoing development of this project.
Regarding the evaluation process, it was never my intent to answer the question: Is computer-assisted instruction better than traditional instruction? This would have been a difficult endeavor, requiring a randomized experiment with at least one intervention group and one control group. Most randomized studies do not account for the effects of changes in the media and educational methods separately and are therefore confounded.14 In addition, it would be unethical to withhold a potentially beneficial educational methodology from a group of students.
The evaluation strategies were employed throughout the three-year project and were designed to obtain student feedback that could be used to guide the development and implementation phases of the project. In the future, the evaluation process will be expanded to determine whether the educational design achieves its goals and explore the reasons for success and failure. This would most likely require the help of evaluation specialists with training in instructional design. A study of student usage patterns using the course evaluation tools available in Blackboard would also be helpful. Student feedback to this point helped direct the development of this web-based manual and will certainly influence the future direction.
It should be noted that I do not have formal training in computer technology. As the course director for the freshman restorative dentistry preclinic technique course, I developed this project over a three-year period as my research, teaching, and university service schedules permitted. Overall, I consider the project a success because it helped change the preclinical experience of the students from a teacher-centered style of instruction to a student-driven experience.
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Summary |
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TopAbstractMethodsResultsDiscussionSummaryReferences |
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Acknowledgments |
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Footnotes |
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REFERENCES |
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