Dr. Missy Criss – Physical Therapy

Project Overview

My primary goal was to find a way to enhance student observation skills and the clinical decision making that stems from those observations. My target courses were our Foundations of Movement Science series (2 courses – one in spring of 1st year and the second in the fall of the 2nd year of the program). Knowing that students in the first year of our program do not yet have extensive knowledge about specific pathology or disease processes, I created a set of sub-goals that were related using observation and using anatomy and physiology knowledge that they already possess:

  • Improve student ability to identify and describe (oral or written) abnormal posture or movement pattern
  • Improve student ability to hypothesize which body systems might be contributing to abnormal posture/movements
  • Utilize evidence in decision-making

Planning Process

During our summer workshop, I worked with Lauren to look at various apps that would allow video analysis.  I was looking in particular for an app that allowed slow-motion playback of recorded video and annotation of the video (voice recording over the video, drawing or highlighting portions of the video etc.).  This was to enable students to watch movement at slower than normal speeds, with the hope that with practice throughout our program, they could start to see movement abnormalities in real time.  I also wanted them to be familiar with an app that they might continue to use while treating patients.

Additionally, I was looking for ways to collect evidence in one central location so students could create a repository of evidence-based information that can be accessed later.  My goal was to find something that allowed access after graduation, so I felt that Moodle was not the best option for this information.

After looking at several apps during our summer workshop, I decided to try Hudl Technique, which is an app for video analysis that is free.  I particularly liked the ability to play 2 videos side by side (to compare movement at one time to movement at another time), the variable speed for slow motion, and the annotation features.  Additionally, I decided to use the Google site feature for compiling information as students would have access to this after graduation plus many students have private gmail accounts and already use Google Drive for class projects.

Implementation

Part 1:

Although I wanted to start this project with the first year class, in the fall I only teach with second-year students.  So I started project implementation in Foundations of Movement Science II because it occurs in the Fall semester each year.  It was my “trial run” for the major implementation in Foundations of Movement Science I, which occurs in the spring.  I first became familiar with the Hudl Technique app myself by recording video and annotating it myself to practice.

I then decided which activity would use the app and redesigned the lab/activity to incorporate the new technology.  The lab I chose is used to practice movement observation with students watching each other perform certain movements. I added an activity where students watched videos on the app and compared the person moving at one point in time to another point in time.  While this person had a pathology (CVA) that the students had not studied yet, I had them focus solely on describing the differences they saw in the movements over time.  During the first part of the lab, I took small groups of students into another room, connected my phone to the screen, and walked them through use of the app.  I also scheduled assistance from Instructional Support on this day in case there were any problems, but for the most part, this went smoothly.  Students were able to complete the activity in class and made some nice observations about movement by using the app.

Part 2:

In the Spring of 2018, I used the app again, but this time for movement analysis in Foundations of Movement Science I.  This was the primary target for my Tech Fellow learning as we had been discussing redesigning some of the content already. My course redesign goal was to increase the amount of instruction about therapeutic exercise and also to increase evidence use when prescribing therapeutic exercise for strengthening. My tech fellow goal was to improve observation skills, which is essential for prescribing, teaching, and refining exercise with our patients.

Students were instructed to download the app and a short class session was placed on the schedule for learning about the app.  I also created a demonstration video explaining ways that students might use the app for their assignment.  The assignment was given at the beginning of the semester, which gave students approximately 6 weeks to complete it.  Students were placed into groups to research a muscle group and find the EVIDENCE that says which exercises activate the muscle the best. They were also required to:

  • create a video on Hudl describing the top 3 exercises for their muscle group
  • discuss start and end positions for the exercises on the video
  • discuss what they thought best posture and form were for the exercises
  • use the slow motion and annotation features to enhance their teaching of the exercises

In class on the day the assignment was due, groups taught the exercises to the class from their videos.  At the same time, the group and instructors circulated in class to watch and correct other students in real time.

Additionally, students had to create tables extracting the data about the exercises found in the literature.  These tables were uploaded to the class website so that students have access to them when not at Chatham.  A screenshot of the landing page of the student Google site is seen here:

And a screenshot of a document from one of the groups:

Assessment

Part 1:

I assessed student impression of the Hudl app by using the Feedback feature in Moodle.  35 out of 38 students completed the survey (they were given a few minutes at the end of the next class to complete this).  The results are presented below for the second year students who used the app during Foundations of Movement Science II.

I also asked students to reflect in a free text box on what they found the most and least useful for the app.  There were consistent comments that students liked being able to slow the video down to watch it, being able to rewatch as many times as needed without making a person do the movement over and over, being able to watch close up on a personal device rather than on the big screen in class.  The least favorite parts of the app were that some people had a hard time getting it to work due to low memory on phones or not functioning exactly as demonstrated on an iPhone (because they had an android device) and also that we only used it once in class.

Anecdotally, several students reported seeing this app used in the clinic for running analysis with clients.

Part 2:

The same questions were asked in my second semester of use to the first year students in Foundations of Movement Science I. First year students were more ambivalent about whether this app should be used more in class than the second year group, which is interesting.  Both groups thought the app was useful and helped learning. This group of students were asked about whether they liked the website where they could deposit information about exercise.  Overwhelmingly, they liked this concept.

The narratives from the first years students were similar to the second years:  they liked being able to slow down the video, liked having a video reference for exercises, liked being able to voice over a video to explain what was happening and slow down to watch. The least favorite things were also similar and dealt with difficulty of the technology (cannot rotate videos or cut portions out)and not being able to share as easily as they would have liked. Most students could not suggest a better website platform, although one person recommended YouTube as a better place for video storage.

Reflections and Next Steps

Hudl Technique Reflections:

  • There is a time lag between sharing a video and having it show up on the app for students to see. Share video the night before it needs to be used!
  • The free app does not allow more than 1 “team”… this will create a problem with each successive year because sharing a video will share it with students no longer in class. I could delete students from my team, but then they will not have access to the videos they used in class.
  • The free Hudl app does not allow downloading of video that is shared (which would be a way to solve the challenge presented above). I wanted to upload video to the class’ Google site as well and cannot do that by downloading videos from the app.  I could “film the film” as it is playing on my computer – but this is a time-consuming step and one I would rather avoid!  There are subscription versions of the Hudl application, but there is a cost associated.

Google Site Reflections:

  • Was very easy to set up
  • But – you need Google drive for any pictures or documents that you are going to upload. This may lead to an eventual storage problem of my Google Drive if I continue this year after year.

Next steps:

  • Determine what to do about the inability to download from Hudl Technique – either explore funding for more advanced version, look at other apps, or have students create on Hudl and then download to their computers and share via email/Google drive/youtube with me.
  • Look for other ways to use movement analysis app more than once during class (need to discuss with co-instructors and instructors of other courses in our program).
  • See if students as they transition to Foundations of Movement Science II like the app even more because they are familiar with it.
  • Look for other ways to utilize the app in class so that the learning occurs for more than one activity.
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