Episode 5: The classroom is everywhere

Dr. Claudia Krebs (audio pulled from a lecture video)
Let’s look at the lateral system, which is how we localize pain, engage the intensity. The primary somatosensory cortex.

Maria Vinca
You’re hearing a video where a woman in a white lab coat is standing in front of an examination table. On the table is a human brain, it’s a model but it looks pretty convincing. The woman is pointing to different parts of the brain while animations and graphics are appearing on screen.

Dr. Claudia Krebs (audio pulled from a lecture video)
And here on the medial aspect of the brain are the strongest.

Maria Vinca
This video was developed by Dr. Claudia Krebs, who teaches neuroanatomy at the University of British Columbia. She’s developed a series of videos and immersive learning tools like 3D and virtual reality experiences, that she uses to help her first year medical students understand neuroanatomy and other complex medical topics. Claudia noticed that her students were struggling with learning the material in her neuroanatomy classes. She knew that the abstract nature of the brain’s anatomy could be really overwhelming for students. And she wanted to improve the way she and other professors taught.

Dr. Claudia Krebs
Students struggle with neuroanatomy, because it is a very abstract and complex topic. We’re dealing with pathways that you can’t necessarily see, we’re dealing with very small structures, we’re dealing with clinical symptoms that need to be understood and put into the context of the anatomy of the brain. And there’s a lot of information to process, and that can lead to a lot of cognitive overload. So a lot of information that students need to process while keeping up with their curriculum.

Maria Vinca
Welcome to Fireweed from the British Columbia Institute of Technology, I’m your host Maria Vinca. We’re profiling innovators like Dr. Claudia Krebs, who has taken traditional medical school training and turned it on its head. So why Fireweed? Fireweed is the first plant to grow back after a wildfire. It symbolizes adaptation and reinvention, something all our guests have in common. Do you have a story of reinvention to share with us? Email us at fireweed@bcit.ca. In this podcast, we’re meeting thinkers and doers who are bringing an adaptive approach to their areas of influence. In this case, it’s Claudia influencing, you know, medical school, which is pretty traditional. But Claudia perseveres, because her work has an impact. She says sometimes medical students get a mental block when learning about the brain, which can be problematic later on in their medical careers. She calls this block, neurophobia.

Dr. Claudia Krebs
Neurophobia is a word that was coined a few years ago by educators who saw that students struggle with neuroanatomy. And in fact, they struggle so much that they become afraid of the topic and that has health consequences. Because if we have students who are afraid of neuroanatomy, it makes them more hesitant to approach patients with neurological and psychiatric disorders. Because that fear of not understanding the brain and not understanding the pathway can stick with them. That of course then has clinical implications in terms of understanding the clinical exam, and being able to refer appropriately.

Maria Vinca
Claudia is introducing new ways of teaching that are having a huge effect on her students. Suzanne Starkiewicz is Claudia’s student, and just completed her first year of medical school at UBC. She’s received in class instruction virtual this year, of course, plus benefited from the introduction videos and the interactive models that Claudia and her team developed.

What’s it like being a first-year medical student and knowing you have to learn all of this biology?

Suzanne Starkiewicz
The curricular component of medical school is really just the first two years, and then we move on to clinical placements. So we really do have to do a lot of our kind of academic book learning in those first two years. So first year, you’re learning a new system, meeting new people, learning all this new terminology, and trying to learn all of this anatomy, neuroanatomy, histology, radiology. All these different topics, as well as how to be a good empathetic competent physician. So it really, it really is like drinking from a firehose.

Dr. Claudia Krebs
Because of the complexity and the depth of the information, we wanted to provide resources that would take the students through them step by step. So we created a series of videos that are overview videos that don’t provide a lot of detail, but provide an introduction to certain subject areas of neuroanatomy. Accompanying those videos, we have interactive modules that then take those topics and go much more in depth. These interactive modules are completely learner driven. The learner goes and clicks on things for more information, can go through these modules at their own pace. In addition to that, we have a website that has additional information and links to other resources to really start creating that web of knowledge.

Maria Vinca
Sounds like these types of resources would be welcomed in just about any classroom. Especially when you consider that not every student has the same learning style. I asked Suzanne, how the videos and self-paced modules helped.

Suzanne Starkiewicz
Well, the neuroanatomy videos are amazing. They’re a wonderful introduction into neuroanatomy, they’re really fascinating to watch, beautifully done as well. So I think starting off each topic, watching those just gets you really interested and intrigued in the topic. The modules in particular, are really amazing because they’re self-paced, and you can go back to them at any time, you can check things over. They have buttons for anatomy, there’s buttons where you can add and take away structures, there’s usually questions at the end where you can test your knowledge to make sure that you’re actually understanding these structures and how they function. And then there’s different visuals, which I found really helpful as a learner. So you can have an animation and then you can have an image of a cadaver. So you can see things in different ways with these modules. And just keep continue to go back. Because I think when you’re drinking from a firehose, you really do need the ability to go back and look at things in a different way or check your knowledge over and over.

Maria Vinca
Claudia’s work to bring this technology to her teaching practice is having effects in medical schools across the world, including the Cascadia Corridor where her materials are being used to encourage what she calls a flexible learning environment.

Dr. Claudia Krebs
With flexible learning, what we did is we created resources that the students can look at independently, and work on at their own pace. I feel sometimes when I’m giving a 45-minute lecture, a certain percentage of the students is with me every step of the way, because they can follow. And there’s a certain percentage of students who I lose along the way, because they, they didn’t ask questions or they didn’t know which question to ask. And then the moment had already passed. With the flexible learning modules, the students can really go at their own pace, they can go back, they can review an animation over and over again until they get that piece that they’re missing. And it’s empowering for them because they can really own their own knowledge. One of the things that we learned was that it is really important when creating these modules to give control to the learner. In our very first modules years ago, you would come on to slide and things would just appear. And the students were completely confused and said give us buttons like we want to trigger those things because we want to look at it. And then when we’re ready, we’ll click on a button to make things happen. And it was a real revelation. It’s so simple, but it changes the entire feel of a learning module with the learner and control.

Maria Vinca
Claudia’s success with the videos and modules led her to work with UBC’s emerging media lab to develop augmented reality experiences, which allows students to basically live inside a diagram of the brain.

Dr. Claudia Krebs
In 2017, I got the opportunity to try out the Microsoft HoloLens. We developed what we call the ‘Holo Brain’. So we imported 3D reconstructions from MRI scans into the HoloLens for a learning app so that students could learn the three dimensional anatomy there. One of the key things that we already knew from our previous work was that students want to be in control of the experience and be able to add and remove things. So that was one of the key features we put into there. When I first started working with the HoloLens, and we had the first holo brain in there, it was an amazing feeling, because I felt like somebody was in my head and could finally see what I saw. It took me years to get the three-dimensional picture of the brain into my head. And now I could share this with students. I think it’s a fantastic future facing technology to integrate this type of learning with the interactivity. And with clinical correlations moving forward.

Suzanne Starkiewicz
I think anytime you can just see something more three dimensional, closer to what it actually is like in reality instead of a flat page on a textbook. It’s just more interesting. It helps you understand how things actually relate in real life. And as a clinician, I think it helps you understand when there’s injuries or problems in those areas, how they all relate together.

Maria Vinca
You’re listening to Fireweed, a podcast brought to you by BCIT. Do you know of someone innovating in their field or taking an adaptive approach to problem solving? Email us at fireweed@bcit.ca or send us an Instagram message at life@bcit.

Welcome back, Claudia’s work, isn’t an example of using educational technology in a way that makes sense. She identified a problem and used technology to solve it, keeping the learner’s experience and outcomes in mind. James Rout is the Associate Vice President of Education Support and Innovation at BCIT. He studies technology in the classroom.

James Rout
I think there needs to be some consideration of the pedagogy behind the use of technology rather than an afterthought. In other words, technology itself does not support or enhance learning. It’s the ways in which we use those technologies that really makes the difference in the learning experience for students. And so to my previous point, that’s why, depending on how these tools and resources and technologies are used, you might find a very different learning outcome.

For example, Health Sciences discipline, versus, for example, Trades discipline, there are many commonalities, but they’re also very different practices. So I think first and foremost, what I would suggest, teachers and institutions should consider using technologies based on evidence and examples of effective practice, either through their own prior experience, or demonstrated evidence in the literature, that the tools that they are considering using are effective. And I think that’s one of the most important pieces is making sure that we don’t put the cart before the horse. Like considering using technology before we have any understanding as to whether it would be effective.

Maria Vinca
James told me that introducing technologies into the classroom is helpful if you can identify where it works, and where it’s just technology for technology’s sake.

James Rout
Some of the most critical or important opportunities for using technology in the classroom involve subjects or disciplines that are difficult to teach or, in some cases dangerous, or there may be risk or damage to equipment, or things that are very, very complex. We’ll give you a few examples of that. You know, there may be examples of technologies like virtual reality or augmented reality where we can simulate very complex things that are very difficult to visualize, without seeing them. And by allowing learners to see them and visualize them in fully three-dimensional reality, it could actually help them with their understanding. It increases the time on task and increases the amount of time that learners can experience situations in a very realistic setting. But without being put into a position where they may be in a dangerous situation, they can actually simulate that, it doesn’t replace the real-world training that needs to happen. But it does definitely provide more opportunity to give time to that learning experience. Other examples would be things like dangerous goods, transporting dangerous goods via rail car or otherwise, sometimes there are accidents that happen and people need to come in and clean up those spills. Learning how to do that can be done through simulation very effectively, without having to put a student at risk.

Maria Vinca
And this is where education is really evolving. According to UBC Professor Patrick Pennefather. He says that well thought out technology can help students have better experiences and integrate abstract concepts.

Patrick Pennefather
For example, VR can provide for learning that can’t be learned in terms of more, I would say, more lecture based or even more screen based on the web type of learning or through videos, right. And one of those you touched on, which is allowing students to be more immersed in a completely different world than the physical one. It’s not to replace, and this is what’s important, right? It’s not to replace, in person training, or the more traditional training that’s essential, especially in medicine. But it’s, it’s supplementary, it’s an extension of it, because they may draw more from being actors within a simulation in which they get feedback. And that feedback can then be given to them through the choices they make through the actions they make in that simulated environment.

Maria Vinca
And guess what? Learning about the brain is pretty abstract.

Dr. Claudia Krebs
You look at it, and you can’t see the tracks, you need to know where they are. You might see a butterfly in a cross section of the spinal cord, and you need to start adding knowledge on to that it’s not intuitive.

Patrick Pennefather
So where it’s been successful in how teachers engage students to interact more with each other, with the prof and teacher themselves, and with the content.

Maria Vinca
Of course, not everything in medical school can be learned through an animation or virtual reality experiences. But it can help.

Dr. Claudia Krebs
So in that first cohort where we implemented these resources, when we did that study, we saw an increase in student performance. And really importantly, we had no students fail the course which was amazing. So we were able to help those students who are struggling and that was really our aim. And from the feedback that the students gave, the qualitative feedback, they were enjoying this. And that was amazing, because we have replaced the neurophobia, the fear of neuroanatomy, with engagement and interest. I mean, they were still overwhelmed because it still remains overwhelming. But they were not so overwhelmed that they would be afraid of it.

Maria Vinca
In Claudia’s case technology in the classroom makes sense. And the learning outcomes have improved. Still, James encourages us to carefully examine the usefulness of technology in the classroom and to do a cost benefit analysis.

James, how do you know which technology to use and, and why?

James Rout
One of the considerations in the field of educational technology is, is around the cost and the benefits of tools that we use, technologies that we use. So given, given a particular cost for a technology, if we can achieve the same learning outcomes, at lesser cost, that might be a preferred option, not necessarily always a preferred option, but it is certainly a consideration. And you know, that’s, that’s a major consideration for institutions, as well. Investing in educational technologies is critically important in today’s world. But we have to make those decisions based on a number of factors. So we need that evidence to show that, first of all, educational technologies can be effective for improving or a positive learning outcome for students. But we also may want to make sure that they’re cost effective, and not just, you know, a shiny new toy, so to speak.

Maria Vinca
James says when it comes to technology, and education, it’s about looking for the right technology, and using it as a tool in the right way.

James Rout
I do think that depending on how the technologies are used, they may have a limited effect, or no effect at all on the learning outcomes for students. And that’s because the first thing that really has to take place when considering the use of technology in the classroom is pedagogy. And what I mean by that is, it’s the theory and practice of learning and teaching and an understanding of the processes and the methods that influence a successful outcome for learners. And technologies are absolutely critically important in today’s world and integrating them into an effective learning experiences is very important. But first and foremost, we make deep considerations of learning design and the pedagogy behind how we will be using those technologies.

Maria Vinca
You’ve been listening to Fireweed, a podcast on innovation and adaptation from the British Columbia Institute of Technology. I’m Maria Vinca. Thanks so much to our guests today. James Rout and Patrick Pennefather, Suzanne Starkiewicz. And of course, Dr. Claudia Krebs. Got a comment? Please email us at fireweed@bcit.ca. Make sure to follow us on your favorite podcast platform. See you on the next episode of Fireweed.