Real-time, online teaching to enhance undergraduate learning


  • David C Howlett,

  • James P Connelly,

  • Tim Vincent

David C Howlett, Department of Radiology, East Sussex Hospitals NHS Trust, Eastbourne District General Hospital, Kings Drive, Eastbourne, East Sussex BN21 2UD, UK. Tel: 00 44 1323 417400 (ext 4015); Fax: 00 44 1323 414933; E-mail: David.Howlett@ESHT.NHS.UK

Context and setting

A real-time and interactive, online, case-based educational module, synchronised with course work, was introduced in 2008 at a UK medical school. The school offers a 5-year undergraduate programme in which 100 final-year students rotate through several regional centres. Students are able to complete case-based modules covering the entire Year 5 curriculum, including the core specialties of internal medicine, surgery, paediatrics, obstetrics and gynaecology, mental health, primary care, therapeutics and clinical investigations. Professional aspects, including consent, patient safety, medical ethics and law are also covered.

Why the idea was necessary

Increasing utilisation of online teaching techniques has been adopted within Year 5 to help provide equitable curriculum delivery at multiple geographically different sites. An interactive and real-time module was proposed to enhance the existing online initiatives within the medical school as a result of the perceived benefits of ‘live’ teacher–student interaction and the covering of large areas of teaching material in a short space of time. The medium acts as a vehicle for innovations in teaching delivery centred on web-based and video techniques and further diversifies the range of learning resources available to the students.

What was done

To coincide with the beginning of the 2008 academic year, a programme of real-time, case-based tutorials was introduced to cover all core Year 5 specialties. The programme ran for 1 week twice per month. Cases were all similar in format and included a brief history and images or video sequences supplemented by open questions to stimulate discussions. These interactive tutorials were created on an open-source, social network virtual learning environment plug-in accessed via the university network, which was easy to use, readily available and provided support for images and video media, as well as network security. A discussion room community was created and each case was entered by the module team as a new blog entry. Students were invited to comment and specialty moderators led online dialogue through the week. Case answers with annotated images were posted at the end of the week with detailed feedback and attached links to online learning resources.

Evaluation of results and impact

We have observed good levels of student engagement with the cases, with between six and eight students making 20–25 postings per case. Student feedback on an online questionnaire showed 73% of student users found the module a good or excellent adjunct to their learning. It was also clear from feedback that many more students observed the teacher–student interactions than actually posted comments. Innovative video simulations of computed tomography and radiology image series and foetal heart tracings during complicated labour worked well on the site and were particularly appreciated by the students. The real-time teaching process was labour-intensive for teachers, but the workload has been spread across several moderators. Overall, this new module has been a highly successful addition to other online initiatives and is a valued learning resource for the students.