obstetrics elearning through th

8/10/2019 Obstetrics Elearning Through Th

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The 10th International Scientific Conference

eLearning and software for EducationBucharest, April 24-25, 2014

10.12753/2066-026X-14-008

OBSTETRICS ELEARNING: THROUGH THE USE OF VIDEO AND OTHER

MEDIA TO ENHANCE LEARNING STYLES IN OBSTETRIC STUDENTS.

Donnchadh COFFEY, Dr. Sabin TABIRCA, Prof. Richard GREENEUniversity College Cork, Department of Computer Science

Cork, Ireland, Department of Obstetrics and Gynaecology, UCC .

[email protected], [email protected], [email protected]

Abstract: This paper presents an insight into the use of eLearning in Obstetrics Education and its

advantages for practical application. The content available to existing obstetrics students attending practical and theoretical classes are established as the paper progresses into beneficial factors of videoand eLearning as a source of valuable subject matter for these students as well as scope for new mediainteraction. Interaction in edifying methods promotes learners' efficiency, motivation and cognitiveefficacy. A well designed e-learning programme can motivate learners to become more engaged withthe content through assimilating cognizance, skills and postures more expeditious. E-learners have

been shown to demonstrate incremented retention rates and ameliorated utilization of content, resultingin a more preponderant achievement of objectives.

Keywords: Obstetrics, Education, eLearning, Video Technology.

I. INTRODUCTION

Technology is an integral part of society today. Advances in technology are apparent in every

discipline a few more acute than others but ultimately most have some technologic application. The

field of medicine tackles an array of technological sources and there are advances in every field of this

study. Video technology has been used universally in medical education.

The use of video in medical education encourages teaching and learning in an array of

different environments. Video Technology is a widely used medium for demonstrative, training and

educational purposes. Video has been used in medicine since the 1950’s providing a signal reference

for CRT (cathode ray tube) technology. As video is a more viable and obtainable technology resource,

it is used extensively in medicine. Video is now easily compiled and distributed through the means of

online support making it an accessible interactive type of learning for medical students. Medical

education has adopted video technology as an essential learning resource next to online learning,

online learning tools and video tutorials are more prevalent in the curriculum of major Universities.

The need for visual demonstrations are essential in medicine, operations and surgical skills

must be taught but are constraint to theatres and practical classes. Along with these constraints a

consent for surgery review is undertaken; this practice can be dearly time consuming giving students’

insufficient time for reflective learning. Video technology with the collaboration of online resources

give students an outlet for additional learning of uncommon visually documented procedures. These

uncommon procedures could be taught to students using video with additional audio narration and

textual information. The benefits of these web based video tools stretch to further assist students

studying online e.g. online courses and general revision. Alongside video, eLearning grants a user thecapability to access a broad range of learning styles to strengthen the users’ knowledge and skill. The



addition of eLearning in medicine promotes learning not solely being an outlet for knowledge

distribution.

Student learning research has shown that visualisation with elegantly designed visual tools can

result in students learning in a shorter time and can foster long term learning (McClean, Johnson et al,

2005). In obstetrics training simulation techniques has been used extensively. However, the

visualisation of the movement of a baby through the birth canal is something that cannot easily be

captured on film. Equally other procedures are not easily captured. Therefore the introduction of a

multimedia learning tool to aid the understanding of the birth processes for students without placing

the mother or baby at risk was suggested by a consultant obstetrician involved in the education of

medical students at UCC (University College Cork).

Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and

their children during pregnancy (prenatal period), childbirth and the postnatal period.

Elearning tools have the added advantage of moving forward or backward during the learning

process eradicating static boundaries of learning. Learning experiments carried out by researchers such

as Richard E. Mayer have shown that multimedia learning works because adding animation to the

usual form of teaching through text had positive effects on students understanding (Mayer, 2005).

Studies have also shown that memory retention is improved compared to traditional teaching methods

(Vernon and Peckham, 2002). One would most likely remember a pictorial observation more so than awritten document. Sources of obstetric video material for students take the form of video lectures

including 2D still image representation of deliveries and procedures. Online platforms such as

“Youtube” offer some tasks involved but miss the narrative elements needed to educate an Obstetrics

student. Online resources such as OBGYN-101 (Brookside Associates Medical Education Division,

2008) offer videos and tutorial presentation slides for students but at a price.

II. METHOD

A study on the teaching of Obstetrics through the use of an eLearning platform was carried in

the Medical University of Bialystok (Póljanowicz et al, 2012), there were positive results for the

platforms usage with Obstetrics students. The results are as follows:

Accurately arranged teaching materials placed on virtual platform boosts the opportunity to

prepare students for the credits and final examinations in their individual field of knowledge. Theorganization of classes in both forms (eLearning and traditional) was highly rated by students

engaging in the study.

From this study it is clear that eLearning is a beneficial approach to obstetrics education

providing a simple accessible means of viewing practical material without being physical present. This

allows students to avail of material in their own time and have ease of access. In University College

Cork, Obstetrics is taught to a great degree from its basic principles to materal and fetal medicine that

provide workshops and practical assessment of students. Clinical, Surgery and Delivery skills are

taught with practical observation and step by step tutorial guidelines with 2D still renditions of

procedures and deliveries. Students keep clinical logbooks of procedures and are counted towards their

final result of each module.

The introduction of eLearning resources are an asset to present-days contemporary student. An

influx of this format to University College Corks’ Obstetric Department would generate a positivedevelopment in the way Obstetric students consume information for practical classes. The preferred

online eLearning resource for these Obstetric students would primarily be a hub for video content

hosting narrated video complemented by other contributory media (textual information, interactive

imagery, etcetera). This resource provides Obstetrics students with a platform that offers videos of

procedures and deliveries that would be readily available as opposed to viewing the same type of

deliveries at a set time. Practitioners and lecturers could be able to add comments to these videos and

attach online assessments in relation to individual aspects. The prospect of an online assessment would

shorten the timeline of a Obstetrics course giving freedom for both students and lecturers to

concentrate on practical coursework and placement orientation.

Online eLearning resources have endless possibilities, connecting students and lecturers with

tools that bridge formulaic processes that consume time in practice. Simple tasks conducted in

coursework can be distributed online and completed online instantly. With the access to an online

resource with an array of capabilities an Obstetrics student can view deliveries and exams that would



possibly be a rarity to view in practical circumstances. Unusual deliveries including twin birth

deliveries can be a rare process to view as student. When documented and filmed practices like the

twin delivery can be visualised on the eLearning tool and freely accessed

III. CREATING THE ELEARNING CONTENT

The first milestone in creating the eLearning tool is capturing the footage needed to display onthe online resource. When filming deliveries and supplementary procedures like Caesarean sections or

placenta exams and removals consent is needed to film/photograph a patient for non-profit use

(educational). This action is processed by the patient’s authorization through the use of a patient

consent form. Once this form is approved by the patient preparation for filming can be conducted.

When filming a delivery, care is needed to not obstruct the practitioners in process and position of

lighting and cameras in appropriate stations within the delivery room. When choosing the type of

lighting conditions needed to produce a visible image, directional lighting and back lights are needed

to eliminate shadow and focus on the focal point of the video (the patient).

The camera would be adjusted to adhere to the lighting conditions, as the delivery rooms

lighting levels are high with the additional lights provided. The ISO settings in the camera determine

how sensitive the image sensor of the camera is to light. Noting the lighting conditions in the room the

ISO levels are moderately low to complement the image. A wide frame is used to view the full

delivery and to lessen the necessity for camera viewpoint changes. Changes in viewpoint consist of

close up and extreme close shots for c-sections and placenta examination/removal (Figure 1).

Figure 1: Lighting and Camera positioning

Each delivery and action when recorded would then be edited to suit the suitable online formats. Clips

are cut to shorten the period of delivery for continuity between each video clip as each deliveries

timeline may vary. Narration of each step of the delivery or procedure is added along the clips timelinethrough the use of video editing software (Final Cut Pro). Before preparing the individual video clip to

be added to the learning tool each video clip is converted to a web friendly format.

The creation of the resource application itself involves both interface design and

programming. Adobe provides an application that tackles both design and programming in a compact

manageable process (Flash). This applications output is also connected to a content management

system (CMS) developed through web development tools using hyper-text markup language (html)

code. The web developed structure acts as a container for the Flash developed learning tool. As the

web developed structures output is in a format developed for online capabilities it is the sole platform

of the eLearning resource application. Other features collaborating with the video clips are its online

assessment section held within the CMS’s interactive layout. These assessments are displayed and

students received feedback instantaneously once completed. This action has further capacity for

development.



3.1. eLearning tool’s Structure

The eLearning tool is created to hold fully interactive actions, all content tabs and video player

activators animate and react with the users input. The video player developed gives the student the

option of switching between different videos and textual information provided with the procedure

involved.

Figure 2: The eLearning tool Structure

The eLearning tool has its own navigation separate to the CMS navigation. Processes within

this navigation include the switch view action within the video player and the activation of separatemedia involved in the narration of the videos content. The design follows a clinical look making the

navigation easy to use and instructions clear. The animation gives each action an interactive feel and

these differ between various processes to establish a labelling of roles.

The CMS’s navigational structure adheres to webpage orientation lining tabs horizontally

above the eLearning tools’ content place holder. The style of the CMS matches that of the eLearning

tool to create a seamless blend of the two separate entities. Other navigational hotspots contained

within the CMS are the mentioned Assessment pages having their own separate page for processing

students input. A survey page is also connected to receive feedback from students about their

experiences with the eLearning tool.

With the creation of a multi-purpose video/media player, media aside from textual and image

orientated examples can be shown to coincide with the videos displayed. The introduction of 3Dsimulated videos of deliveries presents the process from an internal point of view, displaying the

correct position of the child and the movements it generates as it is delivered. 3D can be adapted to

show multiple deliveries including normal, ventouse and twin deliveries. This enhances the eLearning

tools ability to teach students a thorough practice in Obstetrics, giving students a visualisation of a

highly documented process to further support their progress within the course

3.2. Player’s Implementation

The eLearning tool implements one particular programming language while the CMS utilizes

three more. Actionscript 3.0 (as3) is the language used in adobe flash, like most programming

languages it generates events and functions to run applications.

The functions primarily used in as3 enable the videos imported into the program to swap and activate

when clicked. This generates multiple media interaction as the tabs reveal narration, commentary andvisuals. The CMS used a combination of html5, css, javascript and php to create its functioning layout.

Javascipt and php act as the CMSs’ main functionality processing the navigation and relevant pages

including its Assessment page. All content is stored on a server including the source files (php,

javascript, html5), video and textual documents. Each individual content is provided with a folder that

relates to a structured directory for easy access and content to code synchrony.

IV. USABILITY TESTING

The first stage of testing involved the online learning resource. Using Adobe run software

Dreamweaver, the site was opened server-side and code checked before the Build/Run option was

opted for. Red markers and warnings appear after line segments of code if they have incorrect syntax

or if code is placed in the wrong methods. This project‘s code ran smoothly and did not show anymarkers or warnings. This reassured the developer of the functionality of the site. This method was



also used in the publishing of the flash made learning tool where markers and warnings aid the change in

incorrect action script code.

The next step was testing the site compliance with W3Cs markup validation service

(validator.w3c.org). Two warnings appeared which were not threatening to the usage of the site i.e. the

Doctype hadn‘t been declared and it was unable to determine a parse mode. The reason for these

warnings was that the validation compared itself to standards involved in html4.0 which are

unnecessary in html5.

A group of students were asked to navigate the eLearning tool and complete three simple

tasks, after doing so the students were asked to complete the survey listed on the site. The students

were supervised during the tasks as follows:

1. Navigate from the main eLearning tool to an internal video page and back.

2. Interact with a video and open its related media.

3. Navigate to the assessment page and complete the exam.

All three students were able to navigate through the tool with ease, interacting with the videos

and its related media (3D or textual information) was unanimously positive. In respect to the

last task all students found the assessment page each achieving individual results in the online

exam.

The survey page provided as content on the CMS side of the eLearning tool platform assessedthe performance of the eLearning tool in the students perspective. The following figures represent the

results of the survey and selected questions:

Figure 3

This results in Figure 3 reveals the lack of interaction with online learning resources Obstetric

students have. The willingness to adapt to an online learning style was apparent clarifying the need for

more interactive web-based material in Obstetrics coursework

V. CONCLUSIONS

There is a future in Obstetrics eLearning, we have established the online tools on offer today

and presented a means of eLearning on an online platform. The online eLearning tool embodies the

potential of Obstetrics eLearning generating user-friendly interaction, new styles of learning andintroductions to new obstetric scenarios (3D simulation and device interaction). Possible future

developments of this resource include adaptation to other medical, science or health education

requirements.

References

[1] McClean, P., Johnson, C., Rogers, R., Daniels, L., Reber, J., Slator, B.M., Terpstra, J & White A (2005). Molecularand Cellular Biology Animations: Development and Impact on Student Learning. Cell Biology Education; 4(2),

168-179.[2] Mayer RE, ed. (2005) The Cambridge Handbook of Multimedia Learning. New York, NY: Cambridge University

Press

[3] Vernon, T and Peckham, D (2002) The Benefits of 3D modelling and Animation in Medical Teaching. Journal ofAudiovisual media in Medicine, 25 (4), 142-148.



[4] Wiesław Pół janowicz, Robert Latosiewicz, Sławomir J. Terlikowski (2012) The results of teaching of subject

“Obstetrics, gynecology and gynecological and obstetric nursing” with the use of e-learning platform at the Faculty ofHealth Sciences, Medical University of Bialystok in 2009–2012, 26(3), 191.

[5] University College Cork Book of Modules (2013/2014), Obstetrics and Gynaecology http:// www.ucc.ie/modules/

descriptions/page079.html[6] C.P. Obando, J.Maurer, G. Plantegenest (2011) Creation and use of online blended modules for third-year medical

students in the Obstetrics and gynaecology rotation.

obstetrics elearning through th

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