Using Technology to Provide Socially Distanced Professional Development and Continuing Education

Synchronous Video Conferencing

Synchronous video conferencing allows recognition of visual cues that help educators recognize participants' facial expressions that might indicate the need for additional clarification during the instruction. Video conferencing is accessible, easy to use, and fairly reliable given the current high demand for resources. Important to course delivery is recognition of the ability of the learner to have a strong internet connection for any video conferencing device they use. Providing the learner with an opportunity to ask questions video conferencing allows the learner to receive immediate feedback. It is difficult for participants to ask questions when using only a video demonstration, but this can be accomplished for a synchronous course with the addition of screen sharing to help clarify information that was not understood by the learner.

Synchronous video conferencing is also appropriate when helping nurses to learn new skills, to use new equipment, or to learn new procedures. Educators can demonstrate how to perform a task or procedure, and the nurse can perform the skill while the educator coaches the nurse and provides important suggestions for learner success. The ability of the educators and participants to share documents on the screen is important for learning. Using a whiteboard for illustration; providing slides, images, or lectures; and having the educators and participants present together requires video conferencing capability.

A variety of video conferencing platforms exist such as Zoom™, Microsoft Teams™, and the platform that we used, WebEx^®, to support a synchronous learning environment. Video conferencing software allows educator–participant interaction, screen and document sharing, and accommodates one-to-one, or group interaction. Two-way audio and video capability can be used with video conferencing. Basic functions of video conferencing include the flexibility of using computers, tablets, or smart-phones for connecting participants with the educator. For an educator to create and host a meeting, a video conferencing software account is required. Participants can join meetings without creating an account.

The number of users who can participate in video conferencing depends on the level of service for which the clinical agency has contracted, but most service levels can accommodate several hundred participants. Most video conferencing software will have tools that allow educators to chat with individuals, groups, or all participants. Video conferencing also offers the ability to record a class for later viewing, to share internally, or to live broadcast. Typically, video conferencing has a built-in polling feature and security settings with password protection available to discourage entry of un-invited participants during video conferencing.

Moving from Face-to-Face to Synchronous Course Delivery

Several steps should be taken when moving from a face-to-face course delivery to synchronous video conferencing. (Table 1). The first two steps are to determine what software to use, or how to obtain the software if the organization did not have distance accessible software or technology to provide education. Identify who may have access to scheduling meetings or classes via the software program (there may be limitations on what level of staff may have the software program installed on their computers or on their email program). If your organization does not have a required software, there are free, cloud-based, and paid versions for software selection.

If you do not have a meeting or classroom software program, there might be funding from the organization's foundation to purchase the necessary software program. Important to note is that privacy must be secured (Mukhopadhyay et al., 2020), so checking with your privacy officer, information technology (IT) department, and the other required stakeholders in your organization will help ensure that you are keeping health care information secure. If you have a partnership with a school of nursing, this might be an opportunity to use a shared resource.

The third step is to identify whether educators already have the necessary software programs on their computers. All educators must have a software program that is integrated into their electronic calendar, with the ability to schedule meetings through the software program and through the electronic calendar. It is important to identify how to gain meeting software access, how to schedule courses through the software, and how to receive training on the software.

The fourth step is to get software permission and access and then download the software to the educator's computer desktop (or have the IT expert download the software). Also be sure that you have a camera and microphone to use with the software on your computer; otherwise, you may need to request these items from your IT department.

Once the software is downloaded, the fifth step is to learn how to use the software itself, do internet scheduling, how to schedule through the calendar and email system for the particular video conferencing program, and gaining access to the software program (for one of the educators it meant contacting the audiovisual director and getting permission from her chain of command to validate the need for her to have the software program instealled). There will be internal and external resourcces to help educators learn how to use the software and schedule courses.

The sixth step is to learn how to conduct a course through the software program. Although the educators had participated in the organization's selected meeting software, neither one had taught courses with the software program that the hospital used or knew the logistics of delivering a course through the particular software program.

The seventh step is to schedule time with the software program expert in the organization (the expert first sent links of the company's online training for the educator to review, and then scheduled time to train the educator on the software program for use in the organization). It may be necessary to establish a virtual private network (VPN) connection for the clinical agency to allow remote access.

The eighth step is to test accessing the program, sending invitations to the course meeting, and ensuring that the video and audio connections work. It is helpful to have two people available to conduct this test, one who initiates the connection and the other who acts as a participant. It is also helpful to have a cohost for the program in case technology issues prevent one education from gaining access to the virtual classroom.

The final step is to conduct a rehearsal with the IT support team who can help troubleshoot problems and coach educators for effective use of the program. The rehearsal will also help educators become more familiar with the virtual environment and identify techniques for enhancing the virtual experience for the course participants.

Redesigning the Course for Video Conferencing

There are several technical considerations in moving a face-to-face course to a synchronous video conferencing platform. To facilitate access for the participants, the educator should determine how to set up registration through the learning management system (LMS). To maintain learner privacy, the educators developed a secure login that was tracked in the LMS. Detailed instructions were developed for nurses logging on to the LMS through the hospital website or through the VPN. Nurses were able to access the LMS and the instructions for synchronous video conferencing through the hospital's VPN, or through their employee access on the health system website.

Setting up the video conferencing software program virtual room requires thoughtful preparation. Preparation includes securing the room (allowing only registered participants in the classroom), determining whether participants should be placed in a virtual waiting room before entry into the class, muting participants' entry into the room, or allowing participant control of their audio and video participation. All participants will need to be aware of their internet connection strength to transmit audio and video signals. Participants may be joining the class from work in a clinic outside the hospital, inside the hospital, a computer laboratory, their home; or on their work computer, laptop, tablet, or smartphone. The hosts of the virtual classrooms need to have reliable internet connections to be able to transmit shared documents, video, and personal audio signals.

Course Delivery Considerations

Once the video conferencing system had been selected, the educators then considered how to restructure the course delivery. Hosting synchronous video conferencing using an unfamiliar software program for the first time requires the educator to hold a class practice session. Practicing course entry and checking the audio and video controls helps the educators work through course delivery. The practice session includes course entry, checking the audio and video strength, course delivery, identifying technologic or connection issues, sharing the screen, and operating the software program to provide a good participant learning experience. After a practice session, there may be enhancements to add to the course before holding it synchronously. Delivering the course includes student check-ins for any technological or other issues that are affecting their course experience. Course evaluations help educators to identify what personal barriers or issues may have occurred that the educators did not notice.

Postcourse Delivery Considerations and Lessons Learned

Educators must plan for technology failures, website link issues, and identify beforehand what alternative plans or sites might need to be options for content delivery. Educators should practice logging in and out of the course from different devices that the participants might use, such as computers, tablets, or smartphones. Computers may not be equipped with internal cameras and audio or have the capabilities to email articles back and forth during the course for discussion of articles that participants might not have access to in their health care role. Listen to participant feedback of what went well for them, what could have been done better, and their suggestions for improvement they might mention in the course evaluation.

Conclusion

The need for synchronous video conferencing will continue to ensure safe social distancing. Other situations also may arise that require educational offerings to be held virtually. All nurses should embrace technology, learn how to use it, and share their new knowledge with other nurses who are less comfortable with the digital world. Technology can alleviate challenges such as disruptions to continuing education and practice. The adoption of virtual technology may result in expanding professional development, continuing education long term, and may have unanticipated but positive consequences. Ensuring social distancing through using technology can help educators and faculty continue to provide effective education. A wide variety of platforms and technologies exist that educators, learners, and nurses can use. As health care never stops, synchronous course delivery mechanisms must be used to provide a positive learning environment that allows for successful collaboration during changing and challenging times.