By Grant Wilson, M.Ed., CST, FAST, Surgical Technology Program Director, Calhoun Community College and President, National Board of Surgical Technology and Surgical Assisting (NBSTSA)
As educators, we have just finished our most challenging semester yet. Some programs have been relatively fortunate, while others have faced unimaginable burdens and losses. I personally have found this semester to be a challenge and a learning opportunity.
As I reflect over the last three months and look forward, my observations fall in two categories: the importance of providing students with support and the need to focus learning on outcomes. In addition to this, I have learned a great deal about managing a virtual classroom, online exam security, activities to keep students current while the lab is closed and coordinating clinical site placement.
These are challenges educators across the country are facing, and I hope that sharing my experience and suggestions help you think about your own approach to these hurdles.
Giving Support and Focusing on Outcomes
More than ever, our students need stable support and understanding. Stable is defined as the ability to stay — to stay where you are when you are uncomfortable, to stay calm during an emergency and to stay dependable during hardship. We must be stable and reliable mentors to students, especially for those who do not have other mentors in their life.
I have also focused on outcomes instead of routines and rituals. Students need direction that is communicated by clearly defining expectations (outcomes). They also need a path that is communicated through clear, relevant and specific objectives. Confusion is mitigated by concise, clearly written guidance especially when teaching online.
To help students know they are on the right path, early and frequent assessments are needed. For students who are not performing well, proactive and early action is particularly important. Students are facing more difficulties than they were three months ago. Any concern you have about them is worth follow-up by email, phone or video conference.
Navigating the Virtual Classroom
I was surprised by how well students participated in virtual meetings. I expected I would need to attach points to class meetings, to ensure attendance, but that was not necessary. Students looked forward to staying connected.
I used Skype Business with one cohort and Microsoft Teams with another. Skype worked better for students using the app on a cell phone; whereas, Teams worked for those joining by computer. I preferred Microsoft Teams due to its integrated white board. However, it was easier to see typed questions from students on Skype.
I met with each cohort twice per week, for one to two hours per class. We focused on reviewing difficult concepts and making important connections. For related topics that could stand alone, lectures were recorded a week early for students to watch in advance. These sessions ranged from 15 to 45 minutes.
Tips for Virtual Classroom Management
Keep it short. On average, students retain 5% of information presented by lecture alone. Trying to cover everything students should know through lecture is ineffective and not rewarding. Use virtual classroom time to build relevance and conceptual understanding of the material.
Record all classes. Recordings will allow students to review lecture material at their own pace or fill in gaps they missed due to lapsed network connections. I convert the recording using TechSmith Relay, a lecture capture program provided by my college that makes for simple sharing on our learning management system (LMS). Your program may have similar software that you can utilize.
Make it personal. This is top of the list when it comes to student engagement and success. At first, it can be awkward to see yourself speaking on video. However, facial expressions allow students to interpret your communication and help them feel connected.
Have fun. I took advantage of working from home and wore fun clothes. Some of my favorites were a Grumpy T-shirt, Alabama football jersey and a Hawaiian shirt. When time permitted, I offered students an opportunity to share their home life. Students introduced us to their pets, children and hobbies. My co-instructor led a weekly exercise challenge group. The conversation often varied but was always enjoyable.
Testing: Meeting Students Where They Are
As we shifted to online testing, exam security and the potential for academic dishonesty was a chief concern. However, I chose not to focus on test security as much as test availability.
I started with Respondus Lockdown Browser with Respondus Monitor for one cohort, but found it was incompatible for cloud-based devices like Chromebook. In these cases, I used Honorlock monitor. I liked its easy-to-use LMS add-in and its feature that records the student and their computer screen. Students with older computers had difficulty running this program, however. In the end, I loaded every exam in both formats so the students could use what was best for them.
As I reviewed video of the students taking exams, I found that online testing was not easy for them. It created burdens for those in crowded homes or with limited access to technology. While this did not lessen any standard for exam security, it gave me a better understanding of how students are managing in this new environment.
Tips for Testing Virtually
Start with a mock exam or quiz. This lets you work out issues before giving a scored exam. Some students are more computer challenged than others and need assistance.
Limit the size of exam when possible. Up to 100 questions seems to work best. Large exams or ones with graphics need more bandwidth and are more prone to freeze during the exam.
Consider increasing other forms of assessment and decreasing the weight of unit exams. For my summer semester surgical procedures class, I plan to increase the weight of case studies and JOMI (Journal of Medical Insight) video discussions, and reduce the weight of exams. The case studies and video discussions are time consuming to grade, but they give a good idea of how well a student can apply important information.
What Do We Do About the Lab?
When we were not able to meet in person in the laboratory, videos were our go-to resource. My co-instructor and I recorded a number of instructional skills videos for students, and our college developed two more with the assistance of our college television production program. The videos from our television production program included performing a surgical hand scrub and donning a sterile gown. These are on the Calhoun Community College YouTube channel, available for anyone to use.
For skills easily performed at home, such as gowning and gloving, students were asked to submit a video performing the skill before coming to lab. Other students critiqued videos before being evaluated by an instructor, to foster peer-driven discussions.
Other skill practice required creativity. To help students practice loading a needle holder, they were mailed a needle holder, some silk ties and a pack of eyed needles. The eyed needles worked well since they can be used repeatedly. If they ran out of suture, they could practice with a heavy weight sewing thread. To accompany this, I uploaded a video to YouTube for my students to review the process.
When we returned to the lab just a few short weeks ago, we instituted strict screening and policy guidelines. Student were required to review videos of the skills to be performed before arrival, as well. Student arrivals were staggered so they entered one at a time, with no more than three students in the lab, and all in different areas. They each received focused one-on-one time with instructors and time to practice individually. The scheduling process has required a significant time commitment on the instructor’s behalf, but it has been rewarding for everyone to have this opportunity.
Finding Safe Opportunities for Clinical Work
Two of my students were granted access into clinical sites in mid-May. Thus far, the experience has required significant communication with clinical sites and students. It has been like flying a kite during a tornado. It takes attention, effort and adaptability. Just one example: The trunk of my car currently serves as a PPE distribution point, to ensure students have masks to wear at clinical sites, proper protective eyewear and a small bottle of hand sanitizer.
The primary goal of clinical at this time is to safely provide opportunities for each student to complete the clinical case counts assigned. Most sites in the area are slowly returning to normal, and I hope to see the clinical case numbers build. For now, it is a time-intensive effort to manage the additional student needs, clinical requirements and fluctuating opportunities.
Keep Doing What You Do
It is time for courageous leadership among educators. The word courage is derived from the Latin word cor (heart) and it means to bring about heart — or as I like to say, “put your heart into it.” The word does not mean to be without fear or to have all the right answers.
I hope that you will be of good courage and keep doing what you do. You are needed more than ever.