Backchannel Communication to Improve Instruction and Learning

by Claire Calcote, PharmD, PGY1 Pharmacy Practice Resident, St. Dominic Jackson Memorial Hospital

If you are unfamiliar with backchannel communication, it involves using secondary ways to communicate “behind the scenes” of the primary method of communication, like during a lecture presentation. Its use within higher education has grown exceptionally, even before the COVID-19 pandemic. Backchannels have always existed within the classroom - like passing notes or private conversations with a nearby classmate. Now, multiple platforms allow students to submit comments, ask questions, or share supplemental materials without interrupting the primary communication channel (e.g., the teacher’s presentation). Essentially, the discussions and thoughts already occurring within the classroom are given an open environment to foster dialog. These channels don’t cure all problems - like distracting outside conversations, disengaged students surfing non-educational websites, and reserved learners who hesitate to ask for clarification or further explanation. However, a backchannel can create an additional outlet for discussions, engage both introverted and extroverted students, and reveal gaps in learners’ comprehension, which ultimately enriches instruction and enhances learning.

Several benefits of secondary communication through backchannels have been documented.^2,3 By providing an additional outlet for discussions and participation, student engagement is enhanced.² Backchannels also provide opportunities to engage those who are less likely to speak up during lectures or ask questions. Group collaboration can be facilitated when a backchannel is used.³ Additionally, these platforms foster an open environment for exchanging resources. Students can comment and clarify misunderstandings regarding lecture content.  And faculty can respond if needed.² This ultimately builds teamwork and collaboration skills, which are important outside of the classroom. Lastly, from an instructor perspective, the backchannel can reveal gaps in student comprehension, so efforts can be made to review or refocus specific content.³

While it is unclear when backchannel communication using modern technology first occurred, its formal use was described in the early two-thousands.¹ In 2006, a paper described a backchannel communication method using online chatrooms during graduate courses at the University of California, Berkley over a period of two years. Authors analyzed over 200,000 chat room entries, plotting chatroom communication over time to assess utilization trends.¹ They concluded that participation increased over time, with a small number of students participating most frequently.¹

I recently had some experiences working with a backchannel communication method during a course where I was the teaching assistant.  I wondered — is there a relationship between course performance and backchannel engagement? During this four-week course for second-year Doctor of Pharmacy students, a backchannel communication was available using a tool called Discord which includes Voice over Internet Protocol (VoIP) messaging, instant messaging, and digital media distribution platform. The instructor created a separate sever within Discord and enrolled the entire class, including teaching assistants and other faculty who contributed to the instruction. Additionally, students were assigned to small groups in the Discord community for active learning activities and other assignments throughout the course. During each class session, students had required to complete assignments or assessments that involved communicating with their group members in Discord. Individuals often used the general chat feature to communicate with other members of their group, the teaching assistants, and the instructors. Discord possesses helpful features like private messaging and both audio and video calling; therefore, students can contact anyone in the community to get clarification.  The system also provides a mechanism for urgent notification if emergent situations arise. Since Discord is popular among the gaming community, a select number of students were eager to engage on Discord as they were familiar with the platform.

During the first few days a majority of the class seemed hesitant to engage on Discord outside of the required in-class activities. However, as the course progressed, open discussions about lecture content occurred, with some students exchanging graphics and primary literature articles. Additionally, encouraging reminders before exams and amusing captioned pictures were exchanged between students and faculty. Students took the initiative to create topic-specific threads within the platform to organize the discussions for exam preparation. The experience aligned with the University of California, Berkley’s findings – backchannel communication participation increases over time, with a select number of individuals engaging the most.

By the second week of the module, particularly following the first exam, students were more likely to directly contact and communicate with the lead instructor and other faculty members. Questions became more specific and targeted as students began to study the materials. From a class administration perspective, in the event of a student emergency, participants were able to notify the faculty through Discord and devise alternative ways for the student to receive the instruction materials. These direct communication features were appealing from a faculty point of view, as they served as a more immediate way to communicate (when compared to email) and messages could be sent without disclose personal information. Platform use persisted until the conclusion of the four-week course, with students continuing to discuss and clarify lecture content prior to their final exam. After grades were finalizing, it was noted by the lead instructor that those who engaged the most within the backchannel were the highest performers within the course.

My observations coincide with experiences reported in a 2020 case study at the University of Aizu in Aizuwakamatsu, Japan.⁴ Professors used external personal social networking systems (SNS) like Twitter, Facebook, and Line for backchannel communication, which allowed students to interact and collaborate on assignments. Participants included those in four Japanese undergraduate English as a Foreign Language (EFL) courses and they were observed over one academic year.⁴ Interaction via the backchannel could be in any language of the students’ choice.  Initially, participants were hesitant to use the various SNS options for backchannel communication; however, reluctance was overcome once students realized the privacy of the backchannel. The study ultimately concluded that backchannel communication provided a comfortable outlet to engage with other classmates who they most likely would not interact with face-to-face.⁴

Backchannel communication can be used to overcome various classroom obstacles. Although multiple platforms exist, a single backchannel would be easier for faculty to maintain, monitor, and respond to. Students will need to learn about backchannel communication etiquette and faculty will need to set expectations on when and how to use the system.  Ideally, the backchannel would be used during the main channel (e.g. the lecture time) to prompt student engagement. This should be continued through several lectures to overcome potential participation hesitancy. Additionally, instructors should routinely send prompts in the backchannel that requires student response or collaboration related to the learning objectives of the course.  Creating a backchannel communication channel can increase classroom discussions, heighten student participation, and reveal misunderstood content.  In so doing, instruction and learning are ultimately enhanced.

References:

1. Yardi S. The Role of the Backchannel in Collaborative Learning Environments. In Barab S A , Hay KE, & Hickey DT. (Eds.), The International Conference of the Learning Sciences: Indiana University. 2006;(2):852-858.
2. Bruff D. Active Learning in Hybrid and Physically Distanced Classroom. In: Vanderbilt University Center for Teaching [Internet]. 2020.
3. Bruff D. Backchannel in Education – Nine Uses. In: Agile Learning: Derek Bruff’s blog on teaching and learning [Internet]. 2010.
4. Ilic P. Exploring EFL Student Use of Digital Backchannels During Collaborative Learning Activities. JALT CALL Publications. 2021;64-74.

Benefits of “Near-Peer” Teaching

by Allison Graffeo, PharmD, PGY-1 Pharmacy Practice Resident, University of Mississippi Medical Center

Near-peer teaching involves students learning from more senior peers, individuals who are one or two years ahead of them in school or post-graduate training.¹ It is a well-established model used by medical education programs; however, not fully established in pharmacy education. Some educators criticize this method, stating that it would lower the quality of teaching, be difficult to implement and be unethical to use students as teachers. However, using near peers in the classroom, practice labs, and experiential learning environment allows pharmacy students to learn from a peer who has been through similar (and recent) experiences. In addition, it contributes to the more senior peers’ growth to teach and develop their professional skills.²

There are two distinct types of near-peer teaching models most commonly employed: classroom-based and experiential learning. The classroom-based model incorporates senior peers to lead lectures, discussion, and other activities in classes or practice labs serving as an assistant to the faculty member. This model engages students to learn from their senior peers who use a similar language. When using near peers in the experiential learning setting, the instructor integrates learners (often at multiple stages of development) to address real-world problems or to gain research experience. Over the last decade, many authors and researchers have investigated the applicability of these near-peer teaching models in pharmacy education.

At the University of Toronto, near-peer teaching was assessed in an experiential teaching model that was led by a clinical pharmacist/preceptor and assisted by a recent graduate PharmD student with 3 years of previous hospital experience.  The learners included a pharmacy resident who had been with the institution for 6 months, a third-year pharmacy (cooperative “Co-op”) student, and a fourth-year pharmacy (Structured Practical Experience Program “SPEP”) student. The recently graduated PharmD and resident were considered the senior peers to the third- and fourth-year students. These clinical experiences consisted of patient-care rounds on a hemodialysis unit with a medical team. The lead pharmacist would provide articles on specific topics to the students and residents to prepare for patient and therapeutic discussions. Senior learners led the discussions, and all members of the group were expected to be in attendance to bring various experiences to discussions. This allowed the senior peers to use concepts and language that the third- and fourth-year students could more easily understand and relate to while also having the preceptor available to explain concepts more deeply and fill in the gaps. These sessions occurred at least three times a week and included minimal direction from the pharmacist to allow the senior peers to take the lead.² Although the expected hierarchy was for the students to rely on the resident, it turned into a collaborative group with each member of the team contributing. This method provided a unique and positive approach, particularly with regard to collaboration with healthcare teams and the students reported that they greatly benefited from having a near-peer role model. They explained that they felt comfortable approaching the recently graduated pharmacist and resident and they developed a better understanding of pharmacy interventions.

The Oregon State University College of Pharmacy recently assessed the effectiveness of a classroom-based near-peer teaching model.  They measured third-year pharmacy students’ knowledge and confidence related to frequently prescribed medications. There was a total of 98 third-year pharmacy students involved in the “RxReady” near-peer teaching series which occurred immediately prior to their advanced pharmacy practice experiences (APPEs). Twenty-four students were randomly selected and were required to study a certain medication and present a 10-minute presentation to other students (with a faculty member present). Students who participated in the presentation had to complete pre- and post-quizzes (test of knowledge) as well as a survey to determine the effectiveness (change in student confidence) of this teaching style.³ Out of the 96 students who took part in the pre- and post-quizzes and surveys, there was a 15% increase (p<.001) in post-scores compared to the initial quiz and survey. Additionally, 96% of students achieved a higher score on the final knowledge assessment compared to the initial ones. Student confidence scores significantly improved after the presentations (IQR [(0-0.5) – 1]; p<.05).² Targeted questions on the surveys included recalling dosing and formulations, side effects, pharmacokinetics and pharmacodynamics, drug-drug interactions, and counseling points.³ This method may be a useful way to assist students with learning gaps and prepare students to give presentations and engage in patient education during the APPEs.

Lastly, a review article examined six educational research studies that assessed the various models for near-peer teaching. The paper examined near-peer teaching activities in pharmacy schools. Of the six studies included in the review, surveys and questionnaires were used to assess knowledge, problem-solving skills, attitudes, and values towards near-peer teaching methods. These studies revealed that near-peer teaching was accepted and had a positive impact on students’ experiences. Students strongly agreed that near-peer teaching promoted collaboration and that they were excellent role models.¹

The purpose of experiential learning is for students to see real-life situations which reinforce drug knowledge, help develop communication skills, and provide opportunities to practice problem-solving. Near-peer teaching enhances student experiences by providing mentorship and assistance from a senior peer. However, barriers remain within pharmacy programs to implement near-peer teaching as a structured teaching model. To be most effective, senior peers should be assigned a faculty preceptor to ensure all daily responsibilities are being met and are receiving adequate feedback. Additionally, senior peers could create “notebooks” including classroom-based and experiential learning activities which they can pass down and updated annually, aiding the transition from student “learner” to senior “near-peer” teacher. If pharmacy schools routinely had near-peer teachers throughout their curriculum, it would not only provide a unique learning environment for students and residents but help to increase the confidence and clinical skills of pharmacists.^1,2,3

 

References: 

1. Aburahma MH, Mohamed HM. Peer teaching as an educational tool in Pharmacy schools; fruitful or futile. Curr Pharm Teach Learn. 2017;9(6):1170-1179.
2. Leong C, Battistella M, Austin Z. Implementation of a Near-Peer Teaching Model in Pharmacy Education: Experiences and Challenges. Can J Hosp Pharm. 2012;65(5):394-398.
3. Tsai T, Vo K, Ostrogorsky TL, McGregor JC, McCracken CM, Singh H. A Peer-Teaching Model to Reinforce Pharmacy Students’ Clinical Knowledge of Commonly Prescribed Medications. Am J Pharm Educ. 2021;85(5): Article 8451.