Using Video Technology to Educate Students, Patients, and Legislators
Nurse educator (NE) students will serve in roles that will require them to be both educators and leaders. As both, they will need to create engaging educational materials to influence the people and systems that affect their practice (Matthias et al., 2019). According to a report on higher education, students need to be taught real-world skills through engaging activities in order to improve their readiness to join the workforce (Adams Becker et al., 2017). Students who are learning to be educators benefit by using and practicing experiential activities, such as online video presentations, to learn techniques they will be using in their professional practice, as well as the content they are immersed in (Chollet et al., 2015).
Background and Significance
Students learn by experience—by doing, creating, and return demonstrating what they have learned. Students become more engaged when they are practicing skills they will use in their professional practice (Wrenn & Wrenn, 2009). According to Pereira et al. (2014), one of the most effective ways to help students gain practical competencies is to integrate skills they need into course content. One adult learning theory used to provide practical competencies is applied learning. Applied learning is considered learning by doing (and action). The action helps to reinforce what was learned (Kolb, 1984). Making meaning of the activity is done through reflection of the applied learning experience. Technology can be used to enhance applied learning experiences.
Technology has become ubiquitous but can be ineffective if not integrated into course work in a meaningful way. Oermann (2015) reported that teaching with technology is about how teachers decide which technology to use and how to integrate those tools into learning experiences. Davis (1989) proposed a model that if the technology is usable, the likelihood of adoption increases. Davis' technology acceptance model (TAM) has been found highly reliable (α = .80 to .88) and has been used in numerous research studies assessing ease of use and usability of various health care and academic technology (Maicana et al., 2019; Scherera et al., 2019). This model can be used to examine student's perceptions of video technology in course work.
Faculty and students are often hesitant to use video technology in course work for several reasons. Faculty need to be competent using video themselves and be able to create clear course instructions for the students. Students hesitate to use videos if they do not like how they look or sound while speaking. Although educators often speak in public, somehow seeing and hearing themselves on a video brings to light actual or perceived issues with delivery. Facial expressions, hand gestures, and speaking style become more obvious to both the student and the faculty when using video to present information. Practice is the key to a smooth performance in order to appear professional and to influence or educate others (Tillfors et al., 2008). By using videos to present information in course work, students can improve how they express themselves.
Study Objectives
In the NE program, students are required to take a course in informatics and a course in health policy. Although both courses are exclusive to NE students, neither course is directly focused on teaching adult learning theories. All the assessments in these courses were written; however, NEs need to use other methods to communicate information. Evidence shows that other methods to communicate are useful in order to influence others, including students, patients, and legislators (Crook et al., 2012, Dodson et al., 2015).
For this study, participants were asked to record and upload a video presentation on an informatics or legislative topic depending on the course in which they were enrolled. The intended audiences of the presentations were nursing students and legislators, respectively. This change in course assignment from discussion board to applied learning activity was intended to establish video technology usability. The assignment would also provide practice with technology that could reduce presentation anxiety and later be used by the student in their role after graduation (Tillfors et al., 2008).
The overall purpose of this study was to determine how participants would perceive the value of the applied learning activity, to compare expected challenges with experienced challenges, and to determine if they would describe the technology as usable.
Method
This mixed-methods convergent research design assessed students' self-reported usability of video technology, as well as their documented reflections pre- and postassignment. This study design was used so that quantitative and qualitative data would be compared to give a more complete picture of the value and challenges of the applied learning activity (Creswell & Clark, 2018). Institutional review board approval was received from the institution of record.
Sample
NE students from one section of an informatics and a health policy course were invited to participate in this study. All students were required to complete the assignment as part of their courses; however, each student was asked for consent to participate in the study allowing the investigators to use their reflections and usability scores. Twenty-two of 24 students consented to participate.
Measures
The TAM usability score is a 10-item scale using 5-point Likert-type questions, ranging from 1 = strongly agree to 5 = strongly disagree. Usability results were assessed for average scores. Participants completed open-ended reflection questions before and after the video assignment. Data from the pre-video and post-video reflections were reviewed by each investigator separately and then together to code the data and to identify categories and themes.
Procedure
For this study, the video presentation assignment was added to each course. Participants were asked to begin the assignment with an intention reflection. The intention reflection included questions about the ways the video assignment could be valuable in professional practice, previous experience with video technology, and any expected challenges. Participants completed a 3- to 7-minute video targeting education for students or advocacy to legislators depending on the course they were enrolled in. After the participants completed the video assignment, they were asked to complete a usability assessment and critical reflection. The usability assessment questions used TAM (Davis, 1989). The critical reflection included questions about ways the video assignment experience could be valuable in professional practice, how it would change future presentations, and any challenges encountered.
Participants were assigned these reflections via a link to Qualtrics® XM survey in the learning management system (Canvas). In order to maintain confidentiality, participants were sent an email with a unique identifier by a research assistant who did not have access to the survey data. The research assistant maintained these data in a separate password-protected Excel® spreadsheet and the investigators did not have access to it.
Results
Participants
Twenty-two students of 24 (92%) participated in the study. Approximately 68% (n = 15) of the participants reported little to no experience with using video technology to present information, whereas 32% (n = 7) of the participants had moderate to high levels of experience.
Findings
Reflections were analyzed comparing pre- and post-video comments, as well as participants' overall experience. When comparing pre- and post-video comments, the value of the assignment initially was using video technology. After the activity, comments centered on the value of practicing oral communication skills. The themes related to the challenges of the assignment were described similarly.
Overall Value
The comments on the value of the assignment were focused on the video technology and reviews of the presentation. Participants described how using video technology could enhance their choice of learning activities for their future students, or when communicating with legislators. Two themes that emerged regarding the value of using video technology. Video technology can enhance the student experience through accessibility, increasing learning outcomes, and connecting with students. Video technology can provide a way to streamline content by how it is presented and what kind of content is covered. The third theme related to the value of the overall assignment was the opportunity to present and receive feedback on the presentation. Participants valued the critical review by self, peer, and professor.
Overall Challenges
Themes relating to the overall challenges of the assignment included using the technology and presenting. Using the technology involved the quality of the video and time constraints. Presenting with confidence and communicating the content clearly and comfortably was identified as a challenge. A presenting subtheme concerned the challenge of presenting to an unfamiliar audience and wanting to make sure that the audience's needs were met.
TAM Usability
One a 5-point Likert scale where 1 = strongly agree and 5 = strongly disagree, the average score was 2.21, meaning the participants agreed or strongly agreed that the video platform they selected was usable. High usability scores are associated with greater technology adoption.
Discussion
The research questions related to how participants would describe the values and challenges pre- and post-applied learning activity, as well as how usable they found the video platform. One thing was very noticeable when looking at the narrative data as a whole, participants moved beyond the value and challenges of the activity as a comprehensive assignment to the value and challenges of using video technology as a future educator.
Prevideo Themes
Participants described using video technology as the value and challenge of the experience. They described advantages and ways in which video could be used in their professional role as educator, such as “I could use video presentation in the future to introduce students to scenarios they may not encounter in normal everyday practice.” Prior to actually using the video technology, the participants anticipated challenges related to using the technology. Comments included phrases such as “unfamiliar with new technology” and “technology information and navigation.” An instructional designer created the directions for how to select, create, and submit the video. Because these are an instructional designer's strengths, the directions were very clear, comprehensive, and user friendly. Faculty were also available to answer any questions via email, telephone, or in person. Ample support may have impacted the shift from video technology prevideo to presentation post-video. Also, once the participants interacted with the video technology, the fear of the “unfamiliar” was probably lessened.
Post-Video Themes
Participants described presentation skills as the value and challenge of the experience. Participants reported that they learned a lot about their presentation skills by being able to view themselves in the video. One participant reported, “I can watch myself afterward and learn what I need to do differently to make my presentations more effective and successful.” They also found peer and professor feedback to be helpful. There were many challenges identified, including “not talking with my hands,” “nervousness,” “looking at the script,” and “restarting my presentation numerous times.” Participants were surprised at how much they wanted to perfect their presentation.
Overall Themes
Six themes were identified for the overall experience. Participants described the value of the experience as using video technology to enhance their students' experience, streamlining content through video, and receiving critical review of their presentation. A subtheme of enhancing student experience reflected a sense that video increased the social presence of the presenter compared with handouts, reading, and writing. The themes derived from participant description of challenges included using technology and presenting. A subtheme of presenting to an unfamiliar audience (legislators) was identified as well. Generally, participants focused on their presentation skills and did not address challenges related to their audience. Experience with political activities might affect the concerns of presenting to legislators. Level of experience with political activities will be measured in the future to provide more information about this subtheme. Specific questions will be added to the intention and critical reflections for policy students to reflect on how their presentation may affect their ability to engage with legislators.
Usability was measured post-video and was found to be relatively high. This validates the comments participants made that shifted away from video technology being a challenge after having competed the assignment. The results of the usability assessment show that participants found the video technology in the assignment to be usable and therefore are more likely to use it in the future.
Participant reflection is also an important aspect of applied learning activities. Participants enjoyed this activity because it met their engagement needs as students. One participant commented, “I like the idea of a video assignment because it is a different approach to learning. I like creating things, such as a video, because I am a hands-on learner.”
Strengths and Limitations
The mixed-methods approach of this study was a strength. The concept of usability could be better described because of the qualitative data collected. This study was grounded in the TAM. This model helped in designing the activities and the study framework. Another strength of this study is that given the amount of technology present in everyday life, it is easy to assume students are more adept at using it. Personal practice with a technology is different than professional practice. This study demonstrated how students can use a common technology to gain skills in using it to enhance professional presentation skills.
A limitation of the study is that it included a small sample and students from only one program. In order to generalize the findings, a larger sample size and students from other programs would be necessary. Collecting demographic data to better describe the sample would help make comparisons among age groups.
Conclusion
Applied learning activities in an online environment can be challenging to create and manage. When teaching adult learners, it is important to create learning activities that are engaging and that can be applied to their professional lives. If NE students find value in the activity, they are more likely to retain the information and incorporate the information into their teaching and learning. These participants described many ways that this experience would be of value to them in their role as NEs. When designing an applied learning activity, it is useful to collect data on the expected and experienced challenges so that future iterations of the activity can incorporate instructions or learning materials on both. Participants are now better aware of the challenges related to video technology and presenting. Future research should look at other groups of students and how they find the value and challenges related to using video technology.
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