Online Teaching: Approximating In-person Teaching Virtually

Good afternoon and welcome everyone um i am filling in to provide the introduction today for dr wicker as she has a conflict with our new faculty orientation um we're excited to have you all here for our health professions educators series as a quick reminder please type your name in the chat box for attendance tracking also this session is eligible for both faculty development related to teaching and cme credit so please make sure to look in the chat box for the link and instructions for obtaining credit today's session online teaching approximating in-person teaching virtually is being facilitated by a wide range of expert presenters we are excited to have with us dr diana willem and buckaloo from the department of public health and health care leadership at radford university carillion dr kimberly delaney from community and family medicine at curling clinic dr david halpin instructional designer at radford university carillion and dr emily nguyen from pediatrics at carilion clinic we intentionally selected a diverse group of individuals who teach in different venues to speak as a part of this session in order to provide different perspectives on teaching in the virtual environment i'd like to thank all of our presenters for sharing their time and expertise expertise with us today as it hand things off to our panel please take it away okay so that would be me first um is everybody seeing my powerpoint i want to make sure i have two screens but it's powerpoint and not email and notes it's up there thank you so we're talking about approximating in-person teaching um virtually and so i'm just once again i'm david halpin i work for ruc radford university carilion which is now part of radford university formerly jefferson college of health sciences i am an instructional designer there so i support the faculty and staff in designing courses and utilizing the technology and just generally trying to make things easier on them and for students and so i'm going to talk a little bit about how we transitioned our our face-to-face learning to online learning when when the pandemic hit so back in march because of the pandemic we were forced to basically shut down everything and move everything online it was you know it was it came up pretty quick we knew it was coming but it was still kind of a shock and as we did that we had to provide a lot of support to our faculty to make that move and we identified three main components that we had to to look at one was the content delivery because if you're not meeting with your students in person you've got to figure out how you're going to deliver your content and then student engagement you know how are you going to remain engaged with your students when they're basically gone and at home and away from the school and then the matter of assessment which i won't be talking about a lot today i think because that's a whole other topic but that was a major issue because if you're giving assessments to students in person and suddenly you have to do it online there's all sorts of issues that that crop up um when you're doing that and as we did that so with those three areas we had to provide three areas of support to go along with that one was instructional to support which is you know pedagogy and learning strategies and best practices just in general of designing course content and then the technology support was you know how to utilize the technology to to you know put the content online and engage with students and make sure faculty are comfortable using that technology some of them were and some of them weren't so you know some folks were fairly comfortable making that switch and others were had been you know strictly face to face and maybe had been resisting technology until they they absolutely had to and then there was the ongoing support as they were using it throughout the the remainder of the spring semester and the summer and then rolling through fall is to you know to to provide that scaffolding to people you know as they're implementing these these tools and best practices um again a lot of our folks were um were ready for that um but others weren't diana who will be following me she's been teaching online for a long time she has an entirely online program i think and so she was fairly comfortable already in that in that space whereas others were were more hesitant and they had to be pushed into the into the deep end of the pool there um you know a little resistance well i'm out on that board i don't know if i want to do online but you know that you're going in you're going into the pool so that's what it was back in march it was you know everybody's going in the pool into the online pool whether you like it or not um and when you're talking about content delivery you have to talk about synchronous versus asynchronous and here's some some pluses and minuses for each of them here i won't review them all but you know there's issues of engagement how well you can engage with students face to face versus online and then the technical issues that came up that we that we learned about as we were as we were implementing these tools um we learned that a lot of faculty and students had various technology issues that that made it more difficult for them to to administer their courses um entirely online and when you're and if you want to continue with synchronous um you have to make another choice about whether you're going to be face to face or virtual and in a lot of cases because of the pandemic that was dictated to us so in spring and summer it was you know we had to be virtual so we we couldn't could no longer do face-to-face instruction and this is where zoom came into the picture you know thank goodness for the technology we have these days to allow us to do this so we all became zoom experts very very quickly um and zoom you know the zoom people stockholders became rich overnight at the same time um but you know after finishing up spring and summer the zoom boom turned into zoom fatigue you know you start realizing that this is not so easy you know zoom makes it seem easy but it's not so easy for our students and our faculty and as we rolled into fall radford university and and ruc they expressed a commitment to going back to in-person classes some schools decided not to every school was a little bit different but they were they were committed to doing in person classes so that brought you know new challenges now we're trying to move everybody back into the classroom um but we had some limitations there were limits on the number of students you could have in a classroom so if you had a classroom that held 30 students and you have 50 in a class you had to make some some some changes to how that was done and at the same time fact some faculty were not comfortable coming back to face-to-face um some students weren't or they may not have you know necessarily be able to maybe they have some health conditions that just you know it was not worth the risk for them and so bringing students back into class knowing that you you can only have a limited number of students so we started looking at what they call a high flex model and there's all these terms about you know online and hybrid and things like that blended but we started working on a high flex model and what that means is you have students who are in class doing a live class and at the same time you have students who are attending that live class remotely and these remote students may be in another classroom down the hall or they may be at home depending on their situation we have students who had to quarantine so they have to be at home other students they come to come to school but because of the limitations in the main class they have to attend a satellite classroom down down the hall and those rooms are connected together with zoom not ideal but it's it's what we had to do to to make this face-to-face happen and while you're doing that you're recording these sessions so you're making this available to students giving them flexibility that they can attend live in in the class or down the hall or they can attend remotely from home or if they for some reason they can't attend live they can get the recording so there's a lot going on there in these types of classrooms not every class had this set up some were entirely online or or you know maybe a combination of the two so we had to maintain the the six foot distance as we set up these classrooms and and this is this is our largest classroom at ruc so you'll notice we have a kind of a plexiglas shield for the instructor here this room is outfitted with is a zoom room and has a crestron panel um and some monitors here and the the chairs are are highly limited only half the chairs that we would have normally had and they're marked with the this tape here to indicate where students can sit and so you can't do any small group sessions or anything like that in these rooms now this is we only have a couple rooms with this advanced setup most of the rooms got one of these these all-in-one computers and you'll notice at the top of the computer it's got this camera built into it and so that allowed here's a close-up of the camera the dinosaur is optional but the camera allowed you it swings around so it can face the instructor or it can swing around and face the class so this allows a little more flexibility for students who are attending remotely and it also has a microphone built into it so the students are attending remotely can hear the instructor and hopefully hear the other students in the class if there's discussions going on now after some time of practicing this in the fall we realized the students who were attending remotely were not able to hear as well the students in the class and so we went back and installed speaker microphones in the ceilings in a lot of these rooms so that it would pick up the students in the room and also help pick up the instructor better so that's some some revised things that we did now lab we also have lab courses since we're health sciences school a lot of our classes have a lab component and they presented a unique challenge because that's not something you can do easily remote with students at home because they need to be in there they need to see what the instructor is doing the instructor has to demonstrate a process and the students need to recreate that process using the tools and the chemicals and the models that are there in the labs and so what we ended up doing and again in these labs you have a limited number of students so we had to split the labs so you had half the students in one lab half the students in another lab down the hall and then we built these carts with a laptop and a gooseneck with a webcam on it that can be wheeled around the the lab and the instructor can point that camera down and demonstrate something or point it at a model or or just show the students what's going on and then the students can can work on their own to recreate that so we had to we still have the students in there but they can't you know huddle around the instructor the lab instructor um as they would have in previous days and so and again this was a matter of cost again we we didn't have a whole lot of funds to throw into this to make this happen so you know rit folks spent a lot of time building these carts getting the cart getting the gooseneck getting the webcam getting the laptops putting them all together and building them um here in their offices and they probably had at least 40 probably more that are have been wheeled around to various places and just to kind of wrap up my thing um as we went through the fall a lot of faculty i think realize that lecturing using this high flex model for hours at a time is not necessarily the most beneficial to students and so they started to look at maybe doing more of a combination going back to the old flip model where you you post a lot of your content online and then limit your your face-to-face class time but use that time to dig into that material more to make it more meaningful to students instead of just spending hours lecturing at them over zoom it's already hard enough for students to watch you know a two-hour lecture in person but when you're doing it through zoom you know that's when they start really really tuning out so um that's just the the the flip model there and using that and then again no matter how you're doing this you've got to look for ways to engage the students so that's that second part that i was talking about um and i'm gonna i'm all stop and flip it over to diana now um who i think is going to talk about more about engagement now so um diana there we go some reason so welcome everybody good afternoon i'm diana william buckley i'm at department of public health and health care leadership at ruc um as david alluded to earlier i have been teaching online for a very long time probably 12 13 years at least and i teach exclusively online for the past five to six years and what i want to do now is just expand on what david has already started and talk a little bit about engagement and things that you can do to really bring the students in and help to take what you normally do in a classroom and incorporate that into what you do in an online class and if you don't remember anything else from my what i present today the thing that's key to teaching online is to be present and be engaged the students need to feel and sense that you're there you're in the classroom on a regular basis with them one of the best things that you can do is model what you do in an online environment with what you normally do in a face-to-face classroom so if you give a lecture and you get to a certain point in lecture and you stop and you say i want to share you know an experience i have a story that i had i want to pull the students i want to do a case study discussion you can incorporate all of those things in how you design your online course because the whole key within with online and teaching virtually is that you have to do a little bit more to get those connections students want to see their instructors they want to engage with their instructors they want to engage and see the other students in the classroom so there's things that you can do by incorporating both synchronous and asynchronous activities that help to bring about that connection between you and the student and the students with each other so i'm going to just go through some tips and tools that will hopefully help you create that engaging online class and i'm going to share from some of the things that have worked for me i often hear from students that my online classes are just about as close as you can get online to actually being in a face-to-face classroom so the first thing is to have really good communication with students it's not just sending out that email to them on monday morning and say okay i'm done but you need to communicate with them a few times a week it doesn't mean bombard them every day with something but i like to send out my weekly announcement and i actually do a weekly video announcement so they see me speaking to them about what's happening this week follow up on some things that um from the prior week and then later on in the week maybe share something of interest maybe there was something in the news that happened that's related to what you're talking about that week in class you found a great article that you'd like to share with them or some other type of current event send that to them so that they can be looking at it and reading it but don't just send it out and say oh i found this i'm sharing it with you make sure you explain to them why you're sharing it and what caught your eye and why they would find benefit and also looking at whatever it is that you are sharing with them whether it be a video or an article online studies um i mean surveys of online students have shown time and time again that students want to see and hear from their instructors you know we always say don't reinvent the wheel and of course there's lots of videos out there on youtube that we could already use and put in our class and it would save us time from creating those videos and it's okay to use some of those but i want to encourage you to create your own videos for the students because they like to see and hear from you just like they like to see and hear from other students in the class depending on your learning management system one thing you could do is is instead of typing out feedback on assignments you could actually do video or audio feedback on assignments it's also i found a little quicker than just sitting there typing everything out to just create those little videos the other thing and david mentioned this kind of just that zoom fatigue is that you don't want to create lectures that are an hour long and that students have to click on it and just listen to you talk for an hour long whether it's in a zoom in a zoom session you're having with students or something that you have created and you're posting in the learning management system for the students to watch you want to do things if it's uh to to break that down so don't just talk for an hour straight if you're creating a lecture for that students to watch and you're posting it on blackboard or d2l what's recommended is you do something called chunky where you chunk your lectures into these multiple small pieces where you actually only create a lecture that's 15 minutes but you may have four or five 15 minute lectures students if you have an hour long lecture what they tend to do is click on it they'll scroll through it find something well listen to then keep on scrolling and they don't really always spend the time listening to that full one hour lecture that you spent a lot of time preparing and creating by chunking it they're more likely to listen to that little short 15 10 or 15 minute lecture and then they can come back and listen to them at multiple times to finish up the whole lecture series for that week when it's convenient for them the other advantage is that if for some reason you want to change something you don't have to re-record this whole hour-long lecture you can actually go in and just update one of the lectures because i know when i create them i don't want to be creating new lectures every single year but sometimes i want to modify them a little bit so chunking helps the instructor as well to make it easier to have those lectures available and modify them as you go along the other thing i really recommend is creating micro lessons and micro lessons are little short video lectures typically less than five minutes long but you definitely don't want to go over 10 minutes so think about when you're lecturing on this topic where do students usually have questions is there a topic that they tend to really struggle with or find challenging this is a great time to use a micro lesson where you just come in and you create this little video to talk about that specific thing or maybe you want to share a story about a patient that you saw or a case that you worked on something that happened that may have transformed how you do things those are great things from micro lessons helps to bring that more your more personal experience into things as well so i there's lots of different platforms you can do that but i know uh students really appreciate the micro lessons because they're short and they're to the point and they can just go back and watch the videos when they want so if you need to create a video there's lots of different things and i just put this up here there's many ways to things and tools out there that are either free or very low cost to create videos to embed in your classroom whether it be a lecture or whether it be a micro lesson so some other tips and tools then is that to have that engagement you really want to provide opportunities for students to engage with each other and david already mentioned that balance you know having synchronous and asynchronous components of your course this i find is very important you don't want to just have the students reading and looking at powerpoints you don't want to just have them listening to hour-long video lectures that you created having that mix breaks things up it gives students that variety they need to keep it interesting in the classroom so for synchronous discussions and everybody's different whether you want to have it weekly or you're required to have it weekly or you just want to have it four or five times six times throughout the semester right now i know that most of us are using zoom there are of course other things out there that can be used as well but when you're running this zoom session you should be if you're giving a lecture remember if you would normally be giving that in the classroom stop do some breakout rooms send students out to discuss certain topics do incorporate some activities maybe you want to go over case study and have them go into a break room or you want to do some polls just to check in and see how they're doing there's also some things activities you can do with qr codes where you put the qr code on the screen they use their cell phone take you know snap that qr code and it takes them to an activity to do as a whole class those are all things that can help you know keep the students engaged making sure that they're actively participating in that zoom session another thing that that tends to work really well in synchronous sessions is keeping the topics of you know something that you know the students are going to be interested in whether it's current events going on something controversial you know try to do something that's going to pique their interest because if you're peaking their interest you're giving them activities to do throughout your presentation like every 10 minutes take a break from the lecture incorporate some type of activity it just keeps them more engaged in your class and then you want to incorporate other asynchronous um things not just posting your things on your learning management system but what other ways can you do something asynchronously where they are engaging with you and other students so one thing that many of us use at ruc is something called voicethread it is a way for students to have a synchronous video discussions and i like to say voicethread is something they can use anytime anyplace anywhere there's an app on their phone if they've got five minutes you give them props they respond to prompts that are there they can then create threads and discussions with other students but it's all done asynchronously and to give you an exam my students love voicethread last semester um in my epidemiology class i had six students it was a small group that time and in one voice thread i had about 150 threads created by just those six students so they really get in and they engage in it the other great thing about using those asynchronous discussions is that if you have students in different time zones different parts of the country do i have some in different parts of the world they can be fully engaged in those discussions as well some other ways to have those asynchronous discussions and engagement is something called flip grid social media is also very popular with a lot of the younger students as well as some of the people that are very tech savvy but you don't want to just have it your facebook you want to create that social media page for your class and it's been shown it's a really good way to get students engaged i don't tend to use discussion boards but some faculty do i tend to do more asynchronous discussions using voicethread for those and again try to keep the things interesting i tend to throw in a little thing in there that's controversial or something that's going to spark their interest so that we can hear different things a couple things though you might want to avoid um as you're doing the going and teaching online one you don't want to again i've mentioned this don't create those long voice over slide presentations make sure you chunk your lectures the other thing is you want to give the students variety don't just do assessments by quizzes and exams that's it or say every week their assignment is read the text or here's a journal article and now submit a written assignment try to break things up try to give them that variety you also want to avoid infrequent communication again two or three times a week students should see you in the classroom know you're there communicate with them it's also very important that you're very timely and replying to your emails and calls and remember to that when you make a recording you don't have to be perfect and keep re-recording it and re-recording until it's just perfect because when we're standing up in a classroom we we aren't always perfect there either so it's okay to have some of those imperfections in your recordings in your class so in summary be present be engaged i just can't say how much that really means to the students if they know you're there that goes a long way in student satisfaction chunking your lectures and creating micro lessons having both synchronous and asynchronous discussions and opportunity and then have a lot of variety in there so those are just some of my tips and i put my email on there in case anybody has any questions later on you'd like to chat with me about thank you everybody thank you diana so let me just see if i can share my screen can you all hear me and see my screen yes okay thank you so uh just to give you um an overview of who i am and where i come from my name is emily when i'm a pediatric hospitalist by training and i've been here at curling for about a year and a half or so so relatively new to carillion and as a faculty member and within my clinical role i also have roles with teaching so we see medical students from both vtc som as well as vcom and then we also work closely with the pa students at radford and so those students in addition to the residence pedia within pediatrics family medicine and emergency medicine we have a lot of different learners and a lot of different stages in their training um as part of that i am also the associate clerkship director and i work specifically with the fourth year men's medical students who are interested in pediatrics to help them as they apply to pediatric residency programs in their fourth year so i do want to start by just giving a framework of what the pediatric rotation was prior to covid and how it was structured just to give you a sense of how all of that was changed and thrown for a loop as a result of the covet pandemic so the clinical awards block for you for our students and residents usually involves seven residents mostly pediatrics but again also family medicine and emergency medicine and typically on the inpatient wards we'll have three or four students at a time um as far as the medical the third year medical student pediatrics rotation classically that was six weeks broken down as you can see there and that was largely clinical but we would also have several in-person lectures sort of the traditional lectures from various faculty members within the pediatrics department we would also have in-person case-based discussions um using the flipped classroom model which i will get to and so while this talk is predominantly on online teaching and lectures i do think it is important to note what the clinical experiences were for our students and how that has changed as a result of coping so what were some of the challenges that we've seen as far as the clinical exposure while our colleagues on the adult side have been inundated with coveted patients and bed space issues resource issues at the beginning of the pandemic actually we were seeing a lower volume of patients on the pediatric side and that's something that we saw across the nation so as you can imagine the number of patients that our students and our residents were seeing dropped significantly which led to you know decrease in the exposure and the the training the both the breadth and the depth of clinical exposure the other thing that i think was unique to pediatrics was that students were not able to see puis which really meant that a huge chunk of these pediatric patients who are admitted to the hospital were not able to be seen by students and that's because as we all know covet can present in a variety of different ways but especially in children that would include fever cold symptoms cough sore throat difficulty breathing vomiting diarrhea which is without any um alternative explanation which of course would be a huge chunk of um those sick patients that have to be admitted to the hospital they were also um there were some limitations as far as infection control and having students come into the newborn nursery which again limited their exposure um and then there is also the need to prioritize infection control as we do family centered rounds by limiting the number of people who were allowed in patient rooms as we were trying to figure things out so how did we approach these challenges as far as the lower volume of patients it led us to rely more on formal didactics as well as utilizing the residents that we have that residences teacher model so if we had a handful of patients to see clinically we would often utilize our senior residents and have them instead of twiddling their thumbs making relevant uh powerpoints or teaching points for our medical and rpa students that were related to the patients that we did have or made up for something that the patient that the students weren't able to see and so we're able to provide further education for our students while still allowing our senior residents to work on their teaching skills as far as students not being able to see puis thankfully we've been able to work with the administration and they've been really receptive to allow for a little bit more flexibility on expanding those types of patients that we are allowed to have our students follow and i think that really has added to their learning additionally i think we've had to be especially thoughtful about um where to add on more online resources and more focus as far as our formal day tactics which i'll get into based off of the limitations from what they could see clinically and then finally we've had to get creative as far as family-centered rounds and actually using ipads for virtual rounds which has been a bit of a struggle but and it's still a work in progress but it allowed for our students to still be engaged in the patients that maybe they weren't able to see because of infection control reasons but still feel engaged and know what was going on and learn from those patients as well as far as the formal didactics and those challenges one of course we had to convert the didactic sessions into the virtual format so um those new traditional lectures um were paused or cancelled for the time being and we really tried to focus more on the case-based discussions and the flipped classroom model that diana and david had both spoken about there was of course the challenge of encouraging participation and discussion over zoom or webex so as you can see in that in that figure if the students weren't didn't have their video on or were and or were muted it was much easier for them to kind of surf the the web without us knowing on their phone um and really uh hurt the the engagement finally um instead of having the six weeks in person we actually had four weeks in person plus two weeks of online learning for vtcsom um and they may not may not have been um together so it could have been four weeks one time and then later in the year or even before their in person rotation would have two weeks online so that kind of forced us to do um a lot of the mixture between asynchronous and synchronous learning as well um as far as the converting didactic sessions to virtual format one of the ways that that's actually helped was having our morning report and cases of the week be virtual so this really allowed a lot of our faculty members who are off-site to log in via webex and contribute to the discussions of each cases which is something that we we hadn't been getting for our in-person session so that was actually a really nice benefit um that came out of all of this as far as encouraging you know that participation diana spoke a lot about this um but an easy you know fix to engagement was ha requiring students to have their video on so that we knew they were engaged they weren't falling asleep or you know baking a cake or doing something else while the lecturer was on which i'm sure that they were tempted um and then also as diana mentioned taking breaks pausing for questions being uncomfortable with those awkward silences um that you might get on zoom and then uh prioritizing that flipped classroom model so that instead of us lecturing to them for an hour two hours straight we would have our students prepare ahead of time look through cases answer their own questions think about each case and then come prepared for the actual session to present to everybody else and have it be as much of a discussion as we can and then finally um as far as um trying to break things up we tried to get as creative as possible so using things like polling or breakout rooms or games we kind of considered all of those things one of the games that we decided to do is using heads up or charades for developmental milestones so having one person act out what a two-month-old could do or what an eight-month-old could do or what a two-year-old could do and have the remaining students guess what age patient was based off of those developmental milestones so i think it does keep things interesting and breaks things up while still providing a good learning opportunity and because of the um the switch breaking it up between four uh from six weeks to four and two weeks that kind of forced us to use more of the asynchronous tools um so using um existing resources that were out there we didn't have to invent the wheel but there are existing cases that are online that are meant for medical students to give them a broad range of pediatric cases to work through and then because our students weren't able to go in the newborn nursery at least initially we focused more on that with some of those websites for the asynchronous learning we're also exploring the use of some journal articles on health system sciences to simulate reflection and discussion in that asynchronous course as well and then as far as feedback we've been doing um verbal or in-person feedback midway through just to make sure that we get a sense of um what what suggestions they might have as this is all new for everybody so in summary some of the lessons that we've learned was really holding students accountable as adult learners um learning to be comfortable um with the sentences and pausing for questions and then trying to be creative as the suggestions that i had mentioned as well as diana to try and encourage learner engagement and then really being able to seek feedback and be flexible to different approaches so we were very cognizant and i think intentional about this is all new for for everybody so what feedback the students had for us in big or small i think we took very seriously through all of this and i know we're saving questions until the end and so with that i will turn it over to dr delaney hey everyone it's great to see you all i'm gonna share my screen also here and i'm with the department of family and community medicine and i teach the medical residents and also the medical students um and my disclaimer is that i'm a bit of a luddite and i i am not an expert on technology any way shape or form but i do spend a lot of time thinking about how to create community and connection um amongst the residents and the medical students we do online didactics now our weekly didactic sessions are online and i also help run the resident renewal and reflection groups which are kind of a to use um just kind of a broad term a spiritual formation group a professional formation group that meets based on the years so i help run those as well and connection is what that's all about so that's what i'm going to talk about today so um you know everyone has touched on a lot of content things that are just wonderful i got some great ideas actually from everybody who's spoken already so what i'm going to really talk about today is how to create the classroom feel and do all the things that normally would happen naturally when people are in a classroom together the residents on on our wednesday didactics you know they like to talk we had a meal it was a great social time so a great time to build community as well as you know have lots of content so how can we do that i am teaching mostly uh synchronous learning so we're using primarily zoom um and i want to focus on like how can we create a community on zoom that can actually flourish outside of zoom as well well there's my luddite tendency so i'm going to talk about five uh five things today just ways to create connection and we'll just run through these fairly quickly because i know we're short on time so the first one that may feel a little out of the box to a lot of people is actually connecting to your body and having the learners connect to their body we're teaching about bodies all the time but i think as healthcare professionals often we're pretty bad about paying attention to our embodies and it's just a recipe for inattention and not being focused when you're staring at a screen for a long time so a couple things you can do to really get people physically engaged with the learning experience one is to just start your session with a short embodied practice and we are actually beginning to do this at our medication assisted treatment clinic here in the family medicine residency with our group huddle as we start with a little mindfulness based session and we just do one to two minutes of learning a different breathing technique a mindfulness-based technique there's so much science coming out on that now and it's a great way to teach your learners some of these techniques another really fun one i was at a group um a lecture where there were about 500 people on the zoom and what they did was they posted a link to youtube for a video like a music video and they encouraged us all to turn off our cameras get up and dance for it was about two minutes and when we turned back in um i was just so much more present and able to pay attention with just getting some physical activity in and it's super fun to think you're boogieing around to the same song that 500 other people are doing and you don't have to turn off the camera if it's an intimate group and people want to leave it on that's okay um you can also teach a few brief chair yoga moves and that's the picture i have here as just another way to connect the body another really great technique is the check in and check out and i think it's important to have all the learners turn their cameras on like emily was mentioning and what you do is you can post a check in in the chat if it's a large group you can do it verbally if it's a small group but if it's a larger group post a question in the chat it can be something personal that's also related to the topic what's your favorite part of the physical exam it could be something inquisitive and spiritual like what's been inspiring people lately or frivolous and fun what's your favorite way to unwind and learners just type their answers in the chat and the person who's running the presentation can kind of read those out loud this is a great thing to do also while people are logging into zoom and it's kind of that long dead silence while you're waiting for everybody to show up so it's a fun way to connect and use that space um at the end of the lecture you can also check in check out but with the same with a different question kind of in the same way post the question in the chat learners just type as they're logging out and this can take a little bit of time especially if you do it verbally but it's a wonderful bookend to any presentation and it really um kind of creates a container um that classroom space feeling of like we're starting now we're ending we're having this way of communicating with each other kind of on a personal level and um so even though it may take a little extra time it's really worth it i've been part of a lot of larger groups and smaller groups that begin in the meeting this way our faculty meetings we've been trying to start with a bit of a check-in um so it's a really fun practice to start start using breakout rooms a lot of folks touched on this just a few tips for using breakout rooms the smaller the better in general um so students can have a real chance to discuss things with each other having a focused case discussion we do a lot of case-based teaching with the residents and one kind of interesting thing we did recently was having breakout rooms divided along opinion lines so having a yes group a no group a maybe a group we were i think debating the merits of doing pelvic examinations on well-woman visits and so we broke them into groups and that sort of allows students who may not speak up if they have a differing opinion to feel safe to speak up if they're in a room with people who all agree with them and then you appoint someone to come back to the large group and kind of report what the group talked about and you can do that report back in the chat function uh you can do it verbally or you can use a polling feature which several people have touched on i just wanted to go over those a little bit more because they're really fun um the one i've used the most is menti meter these are just a few screenshots from several lectures that i gave where i use the polling feature and you can you can set them up to have different formats and how how answers appear but it's a great way especially if you're in breakout rooms that they can report back and you can get a sense of what everyone's thinking without having everyone verbally check in and it's very engaging and you can use your smart your smartphone to do it um polleverywhere.com is another one that a lot of our faculty use uh in our didactic lectures that works really well um so this is a little bit out of the box because i think in medicine we tend to keep it super clinical and not so personal but i wanted to just give a plug for making your lecture a little personal and i have a couple memes here that have been um very popular recently and the top one's michelle obama at the inauguration of course we all we we all want to be like michelle obama she's powerful she was impeccable she was capable like showing up all dressed to the nines so often we want our presentations to be like that but bernie's image this humble mitten clad guy really caught the public attention and why was that like it's it's really in everyone's imagination very everybody's really intrigued there's lots of funny memes and it's because he's very um it was very homey down to earth showed up just like he was um and that is very um appealing i think to people and i think that personal touch creates both connection and sort of shows the power of authenticity and we need both michelle and bernie and i think in medicine we're pretty good at doing the michelle show up like the polished all the clinical data all of that we're not as good at making it personal but that does make it very engaging and creates that sense of community so here's a couple bernie touches that i had at various lectures recently there was a lecture i was doing on anxiety management and i was mentioning yoga and some of the evidence behind yoga this is me and my son doing the bunk bed pose and then i actually gave a lecture on breast cancer and i myself am a breast cancer survivor and so in that lecture i was giving some of a patient story but also like being on the doctor's side a lot of the clinical evidence and so i shared a bit of my story and i also changed like lots of different head gear during the lecture to show like all the different things you could wear while you're going through chemotherapy and the residents thought that was really engaging and just a powerful way to combine the personal with also the topic and last but not least have some fun laugh a little emily touched on this too so you can play a game we've done charades which is really fun on zoom and then also 20 questions is another one we've done and we usually try to relate it to the clinical topic but sometimes it can be personal to you dressing up for the holidays or having a funny hat or creating a funny background for yourself or just a way to sort of show up in a different way to catch people's attention and so that's all i have and i think maybe we have a little brief uh time for questions we do so thank you very much dr delaney and everyone else um so we have had two questions come through on the chat uh the first one being for you dr delaney um and it is about why not have the students with differing opinions in a small group to allow for their growth and after session sharing of new insights and that's from dr schlupner so are you asking oh why not have groups with differing opinions and that yeah you can do that too i think that's the way we usually do it is you just break it out randomly but we found that sometimes there were some students who weren't ever speaking up and this goes in sometimes in faculty meeting as well we were noticing there's some faculty who would never speak up and give their opinion so it was just one extra way of doing it a little differently than we normally do to kind of encourage students who might be shy about stating their opinion to um to open up a little bit more did that answer the question dr schlippener okay yes all right the other question that we oh sorry to her schluber the other question that we had from dr schmidt dalton is for dr nguyen um and she was inquiring about your ipad rounds and how did you go about ensuring that the patient family um consented to having a camera in the room to capture the encounter including the physical exam were these recorded yeah so um it wasn't an ideal uh setup by any means but given our limitations i think it was certainly better than nothing we used the video app which is the same app i think the outpatient folks are doing using a different app now but at least initially they were using the video app for telemedicine business so it was the same application on the ipad or on the iphone that was hipaa compliant and then at the beginning before rounds even started um after we introduced ourselves we talked about the family and let them know that we were trying their best to socially distance but still involve all of our team members so ask them verbally to if they were willing to consent with that process and tried our best to use the camera to dock or document or show parts of the physical exam while they the learners could still uh listen in on um you know the conversations with family members and share decision making and all of that um and they were not recorded so it was really just in real time um as if trying to um estimate basically if the fam the patient and the students were in the same room given our infection control limitations does that answer your question it does thank you we um in our family medicine office we have a couple of rooms with the mounted cameras in our ceiling um so that the downside of that is um you have to download the recordings um obviously you have to go through the carillion consent form but you have to download the recordings um i use that several times for some of my students that have medical conditions and um um were not able to participate in lace so i videotaped myself um through an afternoon in my own patient clinic and created kind of a virtual patient clinic for them but it took a lot of time um and in the processes of of having someone else download them and repost them so i liked the idea of something more portable more real time but just wanted to get some thoughts on the logistics and obviously thinking about patient confidentiality and along the way yeah that sounds like a great idea probably a lot more time constricting than what we had to deal with um but for us uh it was really more in real time and not necessarily recorded okay thank you [Music] all right and we have one last question here um that's come through on the chat and this i think can be for any of the panel members because i think you each have touched on um these uh different areas are features mentioned such as breakouts polling etc available on webex does is anyone familiar with the webex product um that we offer i'm assuming this is karelian specific um yeah i haven't used webex in a long time um so i can't tell you whether it has the breakouts in the polling when when i had used it before but that was years ago with carillion it i don't think it had those features but they may have added them recently so i don't know this is kate levesny we had a webex grand rounds um last thursday um in the department of psychiatry where our presenter used the breakout room feature within webex so it does have that capability i'm not so sure about the polling yeah so i i do know that yeah they have both polling and breakers i just don't think that they're as user friendly perhaps as a zoom um the zoom capabilities are but it's definitely something if you want to look into more you can contact tsg and have them you know walk you through how to how to implement that maybe effectively so does anybody else have any questions if so feel free to unmute and ask or you can put something in the chat here if you'd like and i would maybe encourage everyone before you go before we close up to type in a check out in response to the question what's something you heard today that you might start doing a little differently in your virtual teaching that is a great idea dr delaney i like that and as you guys uh type up your thoughts there in the chat i just want to thank everyone for joining us today um and thank you to all our presenters uh we hope that you each have learned something about approximating your teaching in a virtual environment i think that no matter what level of learner or what venue you're responsible for teaching in you're all faced with the challenges that came with pivoting to online teaching and hopefully this panel presentation provides you with some practical good ideas as you look at ways to improve your virtual teaching moving forward as a quick reminder if you haven't typed your name in the chat box please do so now for attendance and this session is also eligible for faculty development related to teaching and cme credit so um look in the chat box for the link and instructions for obtaining on that credit uh we hope you guys have a wonderful day if there are any questions before we wrap up go ahead and do so now but if not have a wonderful rest of the day.