Engaging Students in a Videoconference Classroom

by Kassidy Voinche, PharmD, PGY-1 Community Pharmacy Resident, University of Mississippi School of Pharmacy

Teaching and learning have looked different over the past six months. Due to the need for social distancing during the COVID-19 pandemic, many schools have turned to virtual classrooms. Using video teleconferencing for live educational seminars is a great solution to keep everyone safe and to keep learning on track. Indeed, there are many technologies available that can help bridge the distance between students and teachers. However, teaching at a distance, either synchronously or asynchronously, presents several challenges for both the instructor and the learner. It can be difficult to engage students in discussions, group work, and in-class assignments when they are home with lots of potential distractions. Although there are inherent obstacles, with some extra tools, creative thinking, and problem-solving, the online classroom can become a place for engaged learning.

According to an article in Teach for America (TFA), creativity, clarity, and self-reflection are key to being a great teacher in the virtual classroom.¹ It’s essential, particularly in an online environment, to establish clear learning goals and objectives. With so much digital communication to keep up with, expectations need to be well-defined to ensure everyone is on the same page. Instructor feedback on assignments should be more thorough. It's helpful to reflect on student engagement, both in and out of class-time, using these questions from the TFA article, 7 Tips for Being a Great Virtual Teacher:

• What trends do I see in student participation? Possible causes?
• What am I learning about my students as participants in my virtual classroom?
• What could I do to make learning more accessible, inclusive, and meaningful?
• How are we, as a class, doing physically, mentally, and emotionally? ¹

Checking in with yourself and the students allows for adaptation. Investigate what works and what does not, listening to and recognizing what the students seem to be responding to well.

Combining offline, asynchronous activities with synchronous videoconferencing can improve participation.²  Create brief recorded videos or other learning activities for students to complete before class. Then, use class-time to summarize this content. Students can divide into breakout rooms for problem-based learning.  Ask students to create a Google doc to keep them accountable. Allow students some autonomy over assignments and encourage them to experiment.  This can lead to richer discussions. ² Asynchronous participation could include allowing students to view other students’ work and asking them to give feedback with guiding questions. This method promotes peer-to-peer accountability. 

Incorporating personality with a little humor and fun goes a long way when capturing student’s attention. The article Don't Turn into a Bot Online: Three Easy Strategies to Let Your Personality Shine in Your Online Course provides several tips on how to add a personal touch to your virtual classroom.³ Let some of your personality shine through! This can be done using humor or relatable stories. Humor can be tricky, but in small doses, effective. Searching online for a popular meme or gif to throw into a PowerPoint presentation can provide a light-hearted visual. ³ An Inside Higher Ed article suggests allowing students to create various fun content in the forms of memes or tweets to summarize the discoveries made in the session. Instructors can then open the next class meeting with some of their favorites to recap.⁴

Teaching to a virtual classroom where no student has their camera on can seem like talking to a wall. However, students with their camera off could be more engaged than you think.⁵ Indeed, engagement may even be enhanced when the teacher allows students to turn off cameras. Students can record their break-out group sessions with cameras off and turn in the recording.⁵ Providing a choice of camera usage enhances student agency. Another option is to build in ‘camera-off’ time during a class session for students to reflect independently. Without the camera’s constant gaze, students are not rushing to the next step to prevent the awkward silence.⁵ This method provides a specified amount of time for students to work and develop an answer, then share when everyone regroups.  It is always a good idea to check in with students to assess their personal needs and preferences, asking them how they can most effectively interact with the class and material.

The impact of widely used virtual classrooms on student progression and success is unknown at this time, but a study done in 2019 found that the impact may be minimal. Based on eight years’ worth of data from Wingate University School of Pharmacy, investigators found that distance learning via synchronous videoconferencing did not impact performance in a basic biological sciences course among professional degree pharmacy students.⁶ These findings are consistent with several similar studies conducted with various student populations. While using video conferencing for a majority of classes may seem daunting, with the right mindset, support, and tools, students can perform as well as when classes are conducted in-person.

There a few tools built into many videoconferencing applications to improve student engagement, like polls and whiteboards.  But you can combine these tools with countless other online tools. Kahoot, Flipgrid, and Poll Everywhere are a few examples of other applications that can be used to increase student participation. When choosing a platform or method, always consider accessibility. Reach out to students to determine which technologies they’ve had previous experience using and are most accessible. Inviting students to provide input about technologies that will be used in a course can build a connection between teacher and learner. Periodic reflection, by teachers and students, can improve the virtual classroom and generate new ideas on ways to engage. With some thought and resourcefulness, teaching can work just as well and, in some cases, even better in the virtual environment.

In summary, here are six tips for enhancing student engagement through distance learning:

1. Communicate clear, detailed learning objectives and expectations.
2. Combine asynchronous and synchronous learning methods.
3. Allow students to create fun content to summarize what they learned.
4. Survey students about how they best engage with the content and their preferences.
5. Reflect on which strategies are working and how to continue improving.
6. Use tools such as polling and collaboration platforms.

 

References:

1. The TFA Editorial Team. 7 Tips for Being a Great Virtual Teacher. Teach For America [Internet]. 2020 Mar 24.
2. Minero E. 8 Strategies to Improve Participation in Your Virtual Classroom. Edutopia [Internet]. 2020 Aug 21.
3. Evans J. Don't Turn into a Bot Online: Three Easy Strategies to Let Your Personality Shine in Your Online Course. Faculty Focus [Internet]. 2020 Sep 08.
4. Crook A, Crook T. 6 Tips for Teaching Online and In Person Simultaneously. Inside Higher Ed [Internet]. 2020 August 26.
5. Seltzer K. Engaging Students in Virtual Instruction With the Camera Off. Edutopia [Internet]. 2020 Sep 14.
6. Dirks-Naylor AJ, Baucom E. Impact of distance learning via synchronous videoconferencing on pharmacy student performance in a biological science course sequence: an 8-yr analysis. Adv Physiol Educ. 2019;43(4):534-536.

Practice Reinforces Knowledge and Builds Confidence

by Shannon Buehler, Doctor of Pharmacy student, University of Mississippi School of Pharmacy

Summary and Analysis of: Manigault KR, Augustine JM, and Thurston MM. Impact of Student Pharmacists Teaching a Diabetes Self-Management Education and Support Class. Am J Pharm Educ 2020; 84 (3): Article 7621.

This article caught my attention because it involved student pharmacists implementing a diabetes self-management class for patients.¹ As a student pharmacist, diabetes is an interest of mine – something I think that will be important in my future career. This study attempted to demonstrate that students learn best by practicing in a real-life, authentic setting. The authors of this study compared two groups, one group received traditional instruction and experiences working with people with diabetes, the control group, and the other group, the intervention group, had an opportunity to apply what they learned by teaching a diabetes management class to patients. A study like this is needed to help determine what ways are most effective in teaching health professional students.

This study took place at Wellstar Atlanta Medical Center outpatient clinic. The investigators precept Doctor of Pharmacy students from the Mercer University College of Pharmacy during their fourth-year ambulatory care advanced pharmacy practice experience (APPE). This investigation took place from June 2016 to April 2018 and there were one to two student pharmacists participating in the experience each month. The control and intervention alternated each month so that there was an equal distribution of participants in the two groups. During the first week of the APPE, both groups completed two assessments: one on knowledge of diabetes and the other about their perceived aptitude and confidence. Both groups engaged in traditional patient care activities throughout the five-week APPE. The intervention group conducted a single diabetes self-management education and support (DSMES) class during their fourth or fifth week. Students in the control group did not.  During this investigation period, a total of 15 DSMES classes were taught. The DSMES classes typically had three to five patients participate.  The patients had been previously seen in the clinic by the student. These classes were in-person and lasted approximately two hours.  The students used the US Diabetes Conversations Map Kit provided by the American Diabetes Association (ADA) to help guide the class.² Immediately after conducting the class, the intervention group completed two post-intervention assessments – the same assessments that were administered during the first week of the APPE. Similarly, the control group received the post-intervention assessments in the 4^th or 5^th week.

The results showed that the intervention group substantially increased their level of knowledge and confidence. The intervention group students had a significant improvement in their knowledge (increased from 68.4% at baseline to 81.8%) while the control group did not (increased from 70.0% to 74.1%). Both groups showed significant improvement in aptitude and confidence from baseline. However, the change in mean aptitude/confidence scores was greater in the intervention group (11.9 point increase) when compared to the control group (6.7 point increase, p=.0026).

Measuring knowledge and confidence are two important constructs to assess. Both contribute to what makes a good healthcare provider, thus making this study relevant to APPE preceptors for student pharmacists. It is important to note that students in the intervention group put forth more time and effort and this likely explains why their knowledge gains were greater. Although the post-assessment confidence levels improved in both groups, a confidence boost might come from simply getting real-world experience when completing an APPE rotation. Both groups provided one-on-one counseling about diabetes to patients. This might explain the increased confidence in both groups. The intervention group had greater improvement in confidence which can be explained by their additional experience leading the DSMES class. 

The strengths of this study include using alternating months to enroll participants in the control vs. intervention groups and using consistent pre- and post-assessments. Although they were not randomly assigned by the investigators, students were not “selected” to participate in the intervention or control groups. However, there are some weaknesses including the fact that all participants (students, patients, and preceptors) were from the same clinic and the same school of pharmacy. Moreover, we don’t know if all students had similar experiences and patients may have had different issues or complications. Lastly, some students (20%) had previously participated in a diabetes management elective course offered during their curriculum.  Slightly more students in the control group had taken the elective course but it is unclear if this difference impacted the study results.

A similar study was previously conducted by Shrader and colleagues. Similarly, student pharmacists were engaged in teaching DSMES, but the study did not include a control group. Moreover, the investigators did not perform a comprehensive assessment – they only measured changes in student confidence.³ Another small study evaluated student pharmacists who participated in an interprofessional elective.  Again, the investigators only measured improvements in student confidence when providing DSMES to patients.⁴ In both of these studies, there were positive effects on student confidence levels.  It is perhaps not surprising that student confidence consistently improved in all of these studies as one would hope an educational intervention would improve how students perceive their ability to perform these tasks.

I believe this study provides solid evidence that practice, applying one’s knowledge, improves both knowledge and confidence. From my own experience, I know that putting my knowledge into action in “real” life truly solidifies my knowledge. Every preceptor should provide opportunities for hands-on, authentic practice. This article is a good example that could be applied during any ambulatory care APPE but it can be modified for experiences in other settings too. The key is to provide students with opportunities for more practice.  And this will increase their knowledge and confidence as they transition to independent practitioners. 

References:

1. Manigault K, Augustine J, Thurston M. Impact of Student Pharmacists Teaching a Diabetes Self-Management Education and Support Class. Am J Pharm Educ. 2020;84(3): Article 7621.
2. Diabetes Care. American Diabetes Association Standards of Medical Care in Diabetes – 2020 [Internet]. Diabetes Care 2020;43(1): S1-S212
3. Shrader S, Kavanagh K, Thompson A. A Diabetes Self-Management Education Class Taught by Pharmacy Students. Am J Pharm Educ 2012 Feb 10;76(1): Article 13.
4. Fazel M, Cooley J, Kurdi S, Fazel M. A co-curricular diabetes-specific elective with interprofessional students and faculty. Curr Pharm Teach Learn 2019 Feb;11(2):172-177.