Teaching (virtually) anywhere

We all recognize the feeling of belonging and connection that comes with learning with others. Institutions, including our own, are looking for remote learning options, so DFTB, with the help of the Twitter FOAMed community, has put together this guide for virtual teaching.

But first, some thoughts about adapting our teaching to the virtual classroom (ground rules for the teachers, perhaps).

Safety

Maslow theorized that learners need to meet some basic needs to be able to learn.

Safety is down at the foundations of the learning pyramid and is hugely important. In the virtual learning world, this probably doesn’t mean being safe at home, curled up on the sofa with freshly brewed coffee (although that surely must help), but feeling safe in the virtual classroom to engage with the fabulous teaching you’re giving them.

Social cues are lost in virtual learning spaces: the nuances of a smile, a nod, and a “Tell me more” expression are slightly lost when using the thumbs-up emoji. We suggest laying some ground rules for virtual learning to ensure all learners feel safe and, therefore, able to engage with the awesome learning you’re about to deliver. Have a look at ALiEM’s Rules of Engagement for some pre-briefing ideas.

Belonging

Another of Maslow’s fundamentals.

It’s that feeling of being connected when we learn with others. When planning your virtual teaching, think about whether you’ll deliver this to your group at the same time or whether you’ll set some time-independent learning tasks (quizzes to complete, blog posts to read, podcasts to listen to).

Whatever model you choose, and you may choose both at different times, think about how to keep your learners connected. Perhaps you can bring them together for a moderated discussion on the learning they’ve done, either at a set date and time or in a virtual messaging space over several days. Whichever you choose, strive to make your learners feel like they belong.

Helping learners learn

Some great learning can happen when the teacher and learner work together to facilitate learning (this is Vygotsky’s social constructivism theory). Hierarchies are flattened, and teachers help their learners learn. Without realizing it, you do this when you guide learners through a problem-based learning case. Ultimately it all boils down to this, as so eloquently put by our friends at St Emlyn’s: a teacher in constructivism facilitates and does not dictate. This is key to facilitated discussions in a virtual classroom.

But… this is a post on virtual learning. We’ll skip my favourite educational theory, Narrative Theory (maybe one day I’ll tell you why I love it so much), along with countless other educational theories and move on to the how of virtual learning. Firstly, what platform will you use?

Webinars

When we asked the Twittersphere for suggested virtual learning platforms, there was a surge of comments of experiences with different webinar platforms (have a read through the Twitter thread for suggestions and experiences from our Twitter friends and colleagues).

There are many different webinar platforms out there. Some hospitals will already have subscriptions with a particular platform—if so, great. If not, or even if you do but would like some handy tips on real-time video conferencing, have a look at the ALiEM Remote post on just this.

A piece of advice from an author who’s mainly IT-wary. If you’re unfamiliar with the software, have a play and run a trial session before your teaching event. Tapping the microphone with a puzzled look on your face while rummaging in a draw for headphones is not always the greatest way to spend the first few minutes of a Webinar.

Tessa is preparing for #DFTBCOVIDGLOBAL, an international DFTB webinar for healthcare workers looking after children during the COVID-19 pandemic, after running two national webinars this week in the UK and Australasia, #DFTBCOVIDUK and #DFTBCOVIDANZ. She chose WebinarJam after days of research and tested and retested the platform to pull off two events that together brought more than 400 healthcare professionals, helping them feel part of a connected community.

Moderated discussions

It’s not all about the webinar. Incredible learning can also be facilitated on discussion forums without needing a camera or microphone. Taking a DFTB module guide (more on those later), you could run a two-hour session on, let’s say, head injuries in children.

This is how I did just that for my department’s PED teaching this week:

1. First, choose your discussion space. We used Slack: it’s something I’m familiar with and use pretty much daily, it’s very intuitive and learners join by invitation only. Other suggestions from the DFTB team include WhatsApp and Google Hangouts.
2. Invite your learners. I sent email invitations to all our trainees and consultants. The rest of the PED team will also be included in our next session.
3. Set some simple rules of engagement and explain how the session will work.
4. I posted some pre-learning material. Using the DFTB Head Injuries in Children guide, I uploaded a mix of blog posts, articles, podcasts, and conference videos for the learners to read, listen to, and watch before the live event.
5. Set a date and time. Two hours on a Wednesday morning, our usual PED teaching, was perfect.
6. And then go for it! I moderated the conversation using case discussions to build on the reading, listening and watching our team had done, asking questions, letting the learners discuss and then guiding them back to key learning points. (There’s social constructivism for you – moderating, not dictating).

It was a fun learning session with some great evidence-based and practice-challenging conversations. It’ll work perfectly for a virtual journal club, too, which is exactly our plan for next week. This was an incredibly rewarding teaching experience, and I’ll definitely be using it again.

DFTB modules

A little word about the library of paediatric modules developed by DFTB to help educators worldwide provide excellent quality, up-to-date and evidence-backed teaching sessions on all things Paediatric Emergency Medicine. These are incredibly versatile, with pre-learning, case-based discussion guides and simulation packages. And they are 100% adaptable for virtual learning.

Open forums

Those of us on social media love how conversations can grow, branch and interconnect. Twitter is a fabulous open forum for teaching, and it can (and has been) used for live group learning. You only have to search the hashtag #DFTB_JC to see how rich bringing together a group of people to discuss an article can be.

The rules are different in open forums: moderating using a hashtag takes some skill (have a look at the DFTB post on how to be a Twitter moderator), and helping your learners feel safe in the virtual conversation isn’t as easy as in a closed forum. However, many will be happy to watch the conversations unfold. It is a fabulous way of interconnecting people and enhancing that feeling of belonging.

Synchronous Games

Splicing fun into gamified education is a beautiful way to maintain staff morale. One way to do this is by running a live interactive quiz using voting and polling software.

I was thrilled to catch up with Vicky Meighan, EM Consultant in Ireland and co-organiser of last year’s IAEM conference, about her live quiz.

She told me she set a pre-quiz lung ultrasound video for her team and developed an on-topic quiz with some fun questions interspersed. She then set a time and date, and the quiz began. Vicky used Poll Everywhere, but Sli.do, Kahoot and many others could achieve the same thing.

When I jokingly told Vicky that I’m a secret fan of the cheesy music that goes with a Kahoot quiz, she told me that many of the platforms allow you to tag songs and insert video URLs in the quiz to sit alongside questions (I could imagine a question on B lines with some Spice Girls playing in the background).

Some questions were multiple-choice, some polls and some free text. A conversation ran in parallel via WhatsApp, but Slack would be a great platform to use here, too – learners could have two side-by-side windows open on their computer screen, one with the quiz and one with Slack.

A starting question, “Where are you right now?” helped bring the team together, and comments including “Hello from the Southside” and “Hello from bed!” flooded the WhatsApp group. In a time when staff needed to look after each other, Vicky said the quiz was a great way to connect the team.

Asynchronous Games

You can signpost your learners towards many time-independent tasks: you could write a Google Forms quiz and send the link to your learners and watch the answers flood in, or you could choose from the wide-reaching library of FOAMed out there. Look at the #DFTBquiz, n=1, or choose a couple of DFTB, Radiopedia, RCEMlearning or LITFL quizzes for your team (other quizzes also available ).

Pre-recorded teaching

Sometimes, bringing your learners together in the same virtual space at the same time is impractical, particularly with staggered rosters and increasing clinical demands. Pre-record your teaching and then share it with your learners, either on a hidden YouTube channel or on a shared workspace. Look at the comments thread to Eric Levi’s tweet about just that.

Virtual skills and drills

Grace told me about a Zoom teaching session she attended on paediatric chest drain insertion. But here’s an alternative platform my tweenage daughter is more familiar with than me: Instagram Live (HT @PEMDublin).

Instagram Live can be adapted for virtual education: a teacher streams a video of up to 60 minutes in real-time to their team, who can comment on the video and engage with the teacher and the rest of the networked learners. The video can be saved to Instagram Stories for later viewing. I can see this working for teaching practical skills: setting up for RSI, simulated lateral canthotomy, and applying a traction splint. It’s something to think about for sure.

Microteaching moments

Lastly, although we may not bring our learners together in one place, we’re still clinicians with a passion for teaching. Maximise those microteaching opportunities in the clinical environment.

If you’re asked to review a child with diabetic ketoacidosis, spend 5 minutes talking about the latest evidence for fluids in DKA.

If you’re setting up high-flow nasal cannula oxygen for an infant with bronchiolitis, educate your colleagues on the PARIS trial and the subsequent systematic review of HFNC.

If you’re using sedation to facilitate a procedure in ED, this is an excellent opportunity to chat through the latest RCEM ketamine paediatric procedural sedation guidance.

Run mini off-the-cuff skills and drills sessions. Teaching is your gift.

In these times of stress on our health and social systems, remember to keep those learning connections: we all need to feel like we belong.