Journal of Nursing Education

Research Briefs 

Patterns and Perceptions of Asynchronous Video Discussion in a Graduate Health Sciences Course

Mollie Cummins, PhD, RN, FAAN, FACMI; Naresh Sundar Rajan, MS; Chad Hodge, MS; Ramkiran Gouripeddi, MBBS, MS

Abstract

Background:

Studies of graduate online education indicate a need for increased interaction among students and faculty. However, it can be challenging to foster a high level of scholarly interaction and engagement in fully online courses. The objective of this study was to evaluate student perceptions and participation patterns related to online, asynchronous video discussion in a graduate health sciences course.

Method:

An asynchronous video discussion was piloted in a 2014 interprofessional informatics course and students were subsequently surveyed to determine their perceptions of this approach. Participation patterns were analyzed using descriptive statistics and social network analysis.

Results:

The results indicate broad and inclusive interaction among students and faculty, with discussion characteristics perceived as equivalent to, or better than, traditional classroom discussion. The quality of student participation was high, and students spent additional time researching and preparing their contributions.

Conclusion:

This format for a seminar-style discussion holds good potential for effective teaching and learning in online graduate-level health courses and supports the development of students' critical thinking and scholarly communication skills. [J Nurs Educ. 2016;55(12):706–710.]

Abstract

Background:

Studies of graduate online education indicate a need for increased interaction among students and faculty. However, it can be challenging to foster a high level of scholarly interaction and engagement in fully online courses. The objective of this study was to evaluate student perceptions and participation patterns related to online, asynchronous video discussion in a graduate health sciences course.

Method:

An asynchronous video discussion was piloted in a 2014 interprofessional informatics course and students were subsequently surveyed to determine their perceptions of this approach. Participation patterns were analyzed using descriptive statistics and social network analysis.

Results:

The results indicate broad and inclusive interaction among students and faculty, with discussion characteristics perceived as equivalent to, or better than, traditional classroom discussion. The quality of student participation was high, and students spent additional time researching and preparing their contributions.

Conclusion:

This format for a seminar-style discussion holds good potential for effective teaching and learning in online graduate-level health courses and supports the development of students' critical thinking and scholarly communication skills. [J Nurs Educ. 2016;55(12):706–710.]

Seminar-style classroom discussion is an important learning modality for graduate-level informatics courses. It enables students and faculty to engage in higher level critical thinking and discussion, and face-to-face interactions foster a high level of engagement. Studies of graduate online education indicate a need for increased interaction among students and faculty (Pugh, 2010). Without face-to-face interaction, students can feel isolated and fail to develop a sense of community. In a series of disciplined case studies, Boling, Hough, Krinsky, Saleem, and Stevens (2012) identified a theme of Disconnection among students in online courses and programs, including the absence of a sense of community. Students who participated in the Boling et al. (2012) study viewed online courses and programs that were more interactive in nature, versus individualized, as more helpful.

Increasingly, fully online courses enable nontraditional students to enroll in informatics courses and programs that support workforce development in critical areas, such as health informatics (Feldman & Hersh, 2008; Fuji & Galt, 2015; Joshi & Perin, 2012; Paton, 2014). However, it can be challenging to foster a high level of scholarly interaction and engagement in fully online courses. This is a specific concern in the graduate education of degree-seeking health sciences students for whom knowledge transfer alone does not support important critical thinking and scholarly communication skills, nor does it consider student experience and perspective necessary for engaged pedagogy (Gunzenhauser & Gerstl-Pepin, 2006). In addition, biomedical informatics is characteristically interprofessional. It is the authors' firm belief that the ability of students from diverse professional backgrounds to build a sense of community and team identity is a critical component of graduate biomedical informatics education and is a specific challenge in the context of distance education. To address these challenges, the authors piloted the use of asynchronous video discussion in a primarily online graduate interprofessional informatics course. Further, patterns of student participation and perceptions related to asynchronous video discussion were examined in comparison to traditional, in-person classroom discussion.

Objective

The objective of this study was to evaluate student perceptions and participation patterns related to asynchronous video discussion in an interprofessional graduate health sciences course. The authors hypothesized that by using this approach, students would perceive a sense of community and engagement in learning similar to traditional, in-person classroom discussion.

Materials and Method

Setting

This institutional review board approved study was conducted during a single graduate-level informatics course. The course was offered by the academic health sciences center at the University of Utah. The course is jointly taught by college of nursing and school of medicine faculty and typically enrolls graduate students with diverse backgrounds, including medicine, nursing, pharmacy, computer and information sciences, and basic sciences. More than 80% of course content is delivered in an online, asynchronous format, meaning that students access the course content and complete learning activities at a time of their choosing. Online content is delivered using the university's standard learning management system, Canvas©.

VoiceThread

VoiceThread™ is a cloud-based interactive collaboration tool that enables users to communicate, collaborate, and connect with other users in a closed or open group. Users are able to post voice, image, document, and video files, to which other users can reply using any of those formats. The basic workflow of following, posting, and commenting within VoiceThread appears similar to popular social media platforms. Interaction between users is asynchronous but media based, including engaging voices, faces, and images, as in face-to-face or synchronous distance format discussions. VoiceThread is used as a Web-based or mobile application and can be used for a variety of purposes, including, but not exclusive to, education.

Several technologies can be used to accomplish asynchronous video discussion. Learning management systems feature the capability to post video within discussion threads, and social media platforms, such as Google™ and Facebook®, can be used to post and view participant-recorded video within groups. We chose VoiceThread because:

  • It integrates with the learning management system used by the university.
  • The pattern of user interaction closely resembles social media.
  • It can be used on mobile devices.
  • It features a variety of helpful tools for clipping, annotating, and commenting on video material.

For example, if a student wants to respond to a specific statement within a video, he or she can clip the relevant segment and record his or her own audio over that segment. In addition, tools exist that allow students to mark on video, documents, or slides while recording audio. This allows participants to visually point out specific content as they are talking about it. Finally, VoiceThread allowed the authors to create a closed group with instructor rights management. The authors were unable to identify any other software with comparable features.

Procedures

VoiceThread was used as the primary platform for seminar-style discussion in the course. Discussion was organized related to seven content modules and required meaningful student participation, defined according to relevant pedagogical literature (Conrad & Donaldson, 2004; Wishart & Guy, 2009), during each of the modules. Students were instructed and encouraged to use video format whenever possible and participation was required for each module, subject to both peer and instructor evaluation. No specific number or length of posts was required. Grading was based on fulfillment of student responsibility for ongoing participation and engagement, timely response, evidence of critical thinking, and demonstration of quality discussion characteristics, including a demonstrated understanding of course materials. The course required that students participate in discussion related to each content module during a specified time period approximately 2 weeks in length. The course did not require that every student participate in every discussion thread. Discussion was democratic in nature and students were encouraged to take the lead, initiating discussion and asking questions according to their interests. As the teaching team, the authors monitored the discussion and participated to add perspective, clarify material, direct students to additional resources, and ensure the coverage of key concepts.

When the course was concluded, the authors surveyed the students to determine their perspectives on the use of asynchronous, media-based discussion in the course. Students were asked to indicate their perceptions of asynchronous video discussion in comparison to their previous experiences of traditional, in-person classroom discussion, using 13 Likert-scale items corresponding to desirable discussion characteristics. Specifically, the authors sought to determine students' perceptions related to interaction and engagement.

The authors analyzed the survey data using descriptive statistics and frequency analysis of coded responses, and analysis and summary of open-ended survey feedback. To describe the patterns of student participation, the characteristics and pattern of VoiceThread postings during three modules, mid-course, were analyzed. The initial and final modules were excluded, due to potential confounding effects of the initial software learning curve and competing end-of-semester student deadlines. To visualize the interaction between students and instructors, student–student and student–instructor interactions during a single mid-course module corresponding to a 2-week time period were analyzed using methods of social network analysis (SNA). SNA is an approach to analyzing the structure of relationships and connections that is commonly, but not exclusively, applied to social structures. Methods of SNA are based on graphical representations of relationships among individuals or nodes. We conducted SNA, including visualization of interactions and community detection, using the igraph© R package. igraph is a collection of functions and code used to accomplish visualization of graph data and network analysis using the R statistical programming language.

Results

Participation

For three midcourse modules, there was a mean of six primary posts, and a mean of 65.34 responses. Video was used in the largest proportion of posts and responses versus audio or text (Figure 1). The length of primary posts within each module ranged from 14 to 249 seconds, with a mean of length 138.07 seconds (SD = 71.81). The length of responses within each module ranged from 14 to 343 seconds, with mean length of 137.20 seconds (SD = 69.01).


Medium used in primary posts and responses for three mid-course content modules.

Figure 1.

Medium used in primary posts and responses for three mid-course content modules.

Network Analysis. The authors visualized interactions for a single module as an undirected, acyclic graph (Figure 2). In Figure 2, the numbered vertices indicate participants, whether it be faculty or students. Edges—the lines between the vertices—indicate joint participation in an asynchronous media-based discussion. Community structure, detected on the basis of betweenness, is a count of certain types of connections within the network (Girvan & Newman, 2002) and closely approximates the population of participants (i.e., the entire class). Network transitivity was 0.93, average path length was 1.12, and eigenvector centrality was 19.73.


Network visualization of student and instructor interactions related to a single content module.

Figure 2.

Network visualization of student and instructor interactions related to a single content module.

Survey

Ten students completed an evaluation survey and consented to the use of their survey data for education research, for a response rate of 47.6%. The characteristics of the participants are described in Table 1. The quantitative survey results are summarized in Table 2. The students ranged in age from 25 years to more than 50 years, with nearly two thirds of the class younger than 30 years. The gender ratio was even, but the ethnicity of the class was heavily skewed toward Caucasian, and were primarily English speakers. Most respondents were enrolled in master's degree programs (70%). The other students were enrolled in doctorate or certificate programs. Ninety percent of the participants had previously taken an online course where feedback and discussions used a text-based, message-board style format.


Survey Participant Characteristics (N = 10)

Table 1:

Survey Participant Characteristics (N = 10)


Student Perceptions of Asynchronous Video Discussion, Compared With Traditional in-Person Classroom Discussion

Table 2:

Student Perceptions of Asynchronous Video Discussion, Compared With Traditional in-Person Classroom Discussion

The distribution of survey responses is described in Table 2. For every item, the mode and distribution of scores indicates same or more for asynchronous video discussion than for traditional, in-person classroom discussion. The most variation in response related to the ease of participation (item 1) and frequency of contribution to discussion (item 2). For multiple items, all participants rated a 3 or higher, indicating universal agreement among participants that the discussion characteristic was the same or higher in their experience of asynchronous video discussion. Means and standard deviations are provided in Table 2.

Open-Ended Feedback. In addition to the quantitative items on the survey, the authors gathered open-ended feedback from the students. The content of the feedback indicated that the students had varied levels of comfort with video as a medium for discussion. Students felt they were able to take more time to gather and organize thoughts, and perform background research for contributing to the class discussions. The ability to see fellow students via the video posts allowed students to get to know each other better. Students noted there was a high time commitment required to participate in this type of discussion.

Discussion

Community and Engagement

In terms of learning community, participation data and single-module network analysis revealed broad participation of the class in asynchronous video discussion tied to a single content module, with many direct connections among participants. This may indicate that the asynchronous video discussion format is facilitating broad interaction among students. Community detection indicates that the class is interacting as a group, and that interactions in this module largely occurred at the class level rather than the level of smaller subgroups. Similarly, survey results indicate broad interaction among students from different backgrounds and programs. However, survey data indicate that students themselves largely did not perceive a greater sense of community with asynchronous video discussion versus traditional classroom discussion.

Video and Communication Skills

Students were encouraged to post videos versus audio or text. When asked which mode they preferred, only 40% favored the video mode, 30% preferred audio-only mode, and 20% liked neither, indicating text-only participation as their preferred mode of discussion. Clearly, video was not a comfortable medium for the students. National survey data indicate that communication skills are often lacking in college graduates, and verbal communication skills have been identified as a top priority among employers who hire college graduates (Adams, 2014). Although uncomfortable, asynchronous video discussion holds promise as a method for developing these skills in graduate informatics students. The video medium required students to organize and verbally present scholarly material on a consistent, regular basis throughout the course. Qualitative and quantitative feedback data indicate that students engaged in meaningful preparation and background research prior to participation. This type of active learning was enabled by the asynchronous video format.

Instructor-Perceived Challenges

The authors experienced some challenges in using this approach. It took some time and experimentation on the part of both instructors and students to learn VoiceThread, and both helpful features and limitations were discovered. Although text format posts can be quickly reviewed by both instructors and students, video posts cannot. Consequently, there was a substantial time commitment on the part of instructors and students. This is an important consideration in designing courses that uses asynchronous media-based discussion, so that instructors and students are not unduly burdened. In addition, some students felt uncomfortable and self-conscious using the video medium. The students were strongly encouraged to post in video format. However, not all students were comfortable in doing so and some frequently posted in audio or text format.

Limitations

These findings are based on observational and survey data resulting from a single, small pilot study and the faculty experience of teaching with this approach. The data serve to describe and characterize the experience of one course and one student group. Although the findings should not be considered generalizable, they do offer detailed insight into the experience of teaching and learning in this novel format.

Conclusion

Asynchronous video discussion constitutes a promising approach to achieving positive learning outcomes and preparing students with necessary critical thinking and communication skills. In this preliminary evaluation, students and instructors perceived the characteristics of this approach as equivalent to, or better than, traditional classroom discussion. It is imperative for the informatics education scale to meet the workforce needs of the health care sector. In informatics, individuals with diverse expertise work together and with technology to improve patient health, and informatics is often more about people than technology (Friedman, 2009). Online asynchronous courses overcome many student barriers to graduate education. However, to ensure effective, high-quality education and to adequately prepare students to interact with both people and technology, it is necessary to explore and evaluate innovative online teaching–learning approaches.

References

  • Adams, S. (2014, November). The 10 skills employers most want in 2015 graduates. Forbes. Retrieved from http://www.forbes.com/sites/susanadams/2014/11/12/the-10-skills-employers-most-want-in-2015-graduates/
  • Boling, E.C., Hough, M., Krinsky, H., Saleem, H. & Stevens, M. (2012). Cutting the distance in distance education: Perspectives on what promotes positive, online learning experiences. Internet and Higher Education, 15, 118–126. http://dx.doi.org/10.1016/j.iheduc.2011.11.006 doi:10.1016/j.iheduc.2011.11.006 [CrossRef]
  • Conrad, R.-M. & Donaldson, J.A. (2004). Engaging the online learner: Activities and resources for creative instruction. San Francisco, CA: Jossey-Bass.
  • Feldman, S.S. & Hersh, W. (2008). Evaluating the AMIA-OHSU 10×10 program to train healthcare professionals in medical informatics. AMIA Annual Symposium Proceedings, 6, 182–186.
  • Friedman, C.P. (2009). A “fundamental theorem” of biomedical informatics. Journal of the American Medical Informatics Association, 16, 169–170. doi:10.1197/jamia.M3092 [CrossRef]
  • Fuji, K.T. & Galt, K.A. (2015). An online health informatics elective course for doctor of pharmacy students. American Journal of Pharmaceutical Education, 79, 41. doi:10.5688/ajpe79341 [CrossRef]
  • Girvan, M. & Newman, M.E.J. (2002). Community structure in social and biological networks. Proceedings of the National Academy of Sciences, 99, 7821–7826. doi:10.1073/pnas.122653799 [CrossRef]
  • Gunzenhauser, M.G. & Gerstl-Pepin, C.I. (2006). Engaging graduate education: A pedagogy for epistemological and theoretical diversity. The Review of Higher Education, 29, 319–346. doi:10.1353/rhe.2006.0008 [CrossRef]
  • Joshi, A. & Perin, D.M. (2012). Gaps in the existing public health informatics training programs: a challenge to the development of a skilled global workforce. Perspectives in Health Information Management, 9, 1–13.
  • Paton, C. (2014). Massive open online course for health informatics education. Healthcare Informatics Research, 20, 81–87. doi:10.4258/hir.2014.20.2.81 [CrossRef]
  • Pugh, D. (2010). Student perceptions of experiences of interaction in online graduate education course (Doctoral dissertation). Marywood University, Scranton, PA. ProQuest, Document ID: 818763516
  • Wishart, C. & Guy, R. (2009). Analyzing responses, moves, and roles in online discussions. Interdisciplinary Journal of E-Learning and Learning Objects, 5, 129–144.

Survey Participant Characteristics (N = 10)

Characteristicn%
Gender
  Male550
  Female550
Age (years)
  25–30660
  30–35220
  35–40110
  >50110
Race
  Asian110
  Pacific Islander110
  White880
Degree sought
  Certificate110
  Master's770
  PhD110
  Other110
Platform use (multiple allowed)
  Mac®550
  Microsoft© PC660
  iPhone®11
  iPad®11

Student Perceptions of Asynchronous Video Discussion, Compared With Traditional in-Person Classroom Discussion

Survey QuestionFrequency

Definitely Less Than Classroom Discussion (1)(2)Same (3)(4)Definitely More Than Classroom Discussion (5)
1. It was easy to participate in discussion.12241
2. I contributed more frequently to discussion.11611
3. I took time to gather and organize my thoughts before contributing.00253
4. I interacted with students from different programs.00730
5. I interacted with students of different backgrounds.00820
6. I did additional background research and preparation before contributing.01441
7. I included references and resources to support my position.00532
8. I felt comfortable with the discussion format.02521
9. I felt engaged with the course content.02341
10. I felt a sense of community with fellow students.04600
11. I learned a great deal.00532
12. It took more time to participate in discussion.00361
13. I listened carefully to the perspectives of other students before contributing.00631
Authors

Dr. Cummins is Associate Dean of Research and PhD Programs and Associate Professor, College of Nursing; Mr. Rajan and Mr. Hodge are graduate students; and Dr. Gouripeddi is Research Assistant Professor, College of Nursing, University of Utah, Salt Lake City, Utah.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

The authors thank Dr. Pamela Hardin of the University of Utah College of Nursing for her comments.

Address correspondence to Mollie Cummins, PhD, RN, FAAN, FACMI, Associate Dean of Research and PhD Programs and Associate Professor, College of Nursing, University of Utah, 10 S 2000 East, Salt Lake City, UT 84112-5880; e-mail: mollie.cummins@utah.edu.

Received: May 09, 2016
Accepted: August 23, 2016

10.3928/01484834-20161114-08

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