The Use of Live Video Streaming (LVS) as a Technological Innovation for Paediatric Simulation Events.

Tuesday, May 15
09:45 - 10:45

Context: Simulation learning is well embedded in paediatric medical emergencies and has good evidence to support its use (Eppich, Adler and McGaghie, 2006). Calhoun, Sigalet, Burns and Auerbach (2016) have argued that simulation for paediatric healthcare is integral to the profession and is needed in different ways, in increasing complexity, at different levels of the undergraduate paediatric curricula. However, some pragmatic consideration in the use, facilitation and debriefing of paediatric simulation is needed. Only a limited number of students can directly visualise the mannequin in most simulation events, with the traditional 360-degree visual field being somewhat obscured for some participants. This can only increase as the number of paediatric students increase. In fact, the Children and Young People’s Nursing students cohort has doubled in the past two years at Coventry University, UK.

Therefore, a new way to be part of the simulation event is suggested. Learning by watching has a strong evidence base to support its use, even from the earliest works of Bandura and his infamous Bobo doll experiment (Bandura, 1993). These same educational psychology principles may be applied to the paediatric simulation event and therefore the use of a Live Video Streaming (LVS) strategy may prove useful and pedagogically sound.

Description: A LVS environment is very different from the more traditional online learning environment (such as Moodle or Blackboard). The LVS environment is intended to simulate the actual environment, through the use of streamed content. Streaming is the name for the technology that allows the transmission of audio and/or video data as a continuous media flow to an end-user. However, it must be noted that streaming requires a comparatively fast internet connection. A standard definition video requires at least two megabits per second to avoid skipping or buffering stops. The use of LVS is relatively new in simulation learning and teaching and the literature is therefore, scant. However, in some categories of learning, the viewing of motion has been shown to facilitate understanding of subjects (Wisher and Curnow, 1999). Therefore, this use of an LVS environment was piloted in an undergraduate Children and Young Person’s Nursing curriculum in the period between September and April 2018, to evaluate feasibility and educational appropriateness.

Observation/Evaluation: Although a proprietary software, Echo 360™, was used for this evaluation, other live streaming platform or software could have been used (e.g. FaceTime, Facebook Live).

The selected software provided an excellent opportunity to live streaming at a good quality level with two cameras recording at the same time. Therefore, students could simultaneously watch the simulation from two different angles and have a broader view of what happened during the scenarios. Moreover, Echo360 allowed live streaming as well as re-play of the recording which was very useful, especially for debriefing purposes. Live streaming allowed an immersive participation of all the students without having the necessity to be physically in the simulation environment and therefore, enhancing the authenticity of the scenario and reducing peer-pressure and stress related to the performance.
Although audio recording was at good quality in most of the simulation sessions, volume and synchronizing with the video have caused issues on a few occasions.

Discussion: The use of a LVS environment can be supported by reflecting on the cognitive aspects of viewing comprehension. It could be argued that the key aspect of any simulation tool is how it presents information. Different simulation strategies present information in different ways and there is good evidence to support the use of this medium as one of a spectrum of paediatric simulation events. Although processing narrative information involves significant working memory, thereby excluding those who’s working memory is not as well developed, the learners’ data processing mechanisms should not be overburdened. Therefore, this use of LVS as a paediatric simulation tool may support the use of a wider participant for increasing cohorts of trainees.

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