A simple feedback loop, applied in school zones in a small Californian suburb, “cut fatal injuries by about half.” (WIRED) By revealing speeding drivers’ speed to them via a giant on-street speedometer, “drivers slowed an average of 14 percent.” This effectively unraveled decades of law-enforcement dogma by proving the superior efficacy of feedback loops over punitive police surveillance, the traditional approach. Modern education has been moving slowly in this direction, but perhaps it lacks some of the tools that would enable this kind of feedback.

So what are feedback loops, what makes them so powerful, and how can they be applied to what’s going on in education thesedays?

40 years ago, Stanford professor Albert Bandura demonstrated that giving individuals clear goals and, more importantly, a means to evaluate their progress in real time, hugely boosted the likelihood that they would complete their given task. Bandura’s work has been confirmed and extended across psychology, epidemiology, military strategy, environmental studies, corporate training, engineering, and economics. The science behind the self-correcting magic of feedback loops can be broken down to four steps:

1. Collecting the data
2. Processing the data so it resonates with the subject
3. Assigning weight or consequence to the data
4. Recalibration of action as informed by the data

To use a very simple example , think about a tennis or volleyball player making a serve. If she observes the ball plow into the net, her brain instantaneously:

1. Collects the data that the serve was no good,
2. Does so in a way that makes sense to the player,
3. Tells the player that she lost a point, a consequence of the mistake,
4. Tells the player that she must strike the ball with more elevation on the next serve.

Enough serves and the player will be a top-level server due to the countless calibrations and recalibrations in this feedback loop. Ten thousand hours and all that…

What about feedback in educational programs – what problems can it solve? Consider the growing shortage of health professionals in countries like Canada. This excerpt from a 2016 Globe and Mail article sums it up best:

“The sum of all the numbers is a tightening nursing labour market,” says Karima Velji, president of the Canadian Nurses Association (CNA), said in a statement. “Immediate action is needed to stave off the potentially long-lasting trend of a shrinking [registered nurse] work force and its consequences for population health.”

What’s causing the shortage in labor supply? One theory is that numerous adult learners are unable to commit enough time to traditional face-to-face classes due to economic and family pressures. To some extent, online courses can help, but these courses don’t give the student the practice they need to perform clinical skills.

Basically, online learners need feedback and even on-campus students could use a lot more practice and feedback.  The main roadblock to more and better feedback loops in clinical programs has historically been data collection. Clinical educators have had to be present to see students performing skills and to give them the briefest of verbal feedback. Now that we’re in an age of video anywhere, anytime with smartphones and YouTube, surely there’s a way to use video for practice and feedback in clinical education. WeVu.video is betting that asynchronous video for practice and feedback at precise moments on student videos will become indispensable for skills training at scale. Using learner-recorded video uploaded to the WeVu platform, face to face student-to-teacher time can decrease considerably, lowering costs, time commitments, and even the program’s environmental footprint. But students will get more practice and more feedback that sticks with the learner.  Online education with this kind of video-for-skills-learning may mobilize thousands of mature students unable to commit to a traditional schooling hours.

Feedback is really the central element of any skills learning program across many disciplines and professions. If technology can help us get more and better feedback, it will make a huge positive impact in our education systems. Fortunately, educators are now starting to see that video technology can contribute to the active, doing, part of education, not just the watching and listening part.

Asessment of Video Assignments

Feedback. Learning during production and learning from production of video assignments.

The digitization of educational content is important, but there’s little that’s pedagogically innovative here. Digitization really just changes the knowledge delivery channel. Don’t get me wrong: this is transformational and liberating for populations that found traditional materials inaccessible, as the tremendous success of the Rumie project demonstrates. But with a focus on content, our industry misses a tremendous opportunity to swim with the tide of research in education that has completely upended the knowledge-focussed paradigm of the last thousand years. The revolution that Ryan Craig is talking about in College Disrupted: The Great Unbundling of Higher Education and the teaching that Cathy Davidson champions in The New Education is fundamentally about the triumph of skills – hard, soft, all kinds of skills – over knowledge.

Even Virtual Reality and Artifical Intelligence, front and center recently at @EdtechXEurope, @ReimagineEducation, @SXSWedu, and @GSV, is only pedagogically innovative to the extent that it’s built for personalized- and competency-based learning.  Most applications of VR and AI remain grounded in a pedagogy that emphasizes mastery of bodies of knowledge. Some are explicitly marketed as technology that promotes better scores on traditional knowledge-oriented exams. By their very nature, VR and AI in education are directed to learning or doing things that are well-defined by educational content creators. To be sure, they may be very effective tools to speed up the acquisition of knowledge, but they do little to contribute to an education that gets students to know when and how to use the knowledge and then actually do the things they are learning to do.

Look at the Tyton Partners Time for Class 2017  report. It’s an industry-leading report on the state of technology in higher education. Or that’s what it’s supposed to be. But it turns out to be a report on “use and perceptions of”… wait for it… “digital courseware”. The first bullet point in the report mentions “expanding options for “digital learning delivery”. Delivery. The rest of the report is heavily focussed on content delivery; the word “skills” doesn’t appear once. It’s important to understand the pace of adoption and satisfaction with digital courseware, but it’s only a preliminary part of what we now think of as a total learning experience.

Then turn to the Unizin consortium, linking the leading public higher education insitutions of the US Midwest. Unizin is supposedly pushing an ambitious agenda to “improve the learning experience with technology”. Yet its website’s “Solutions” area consists of “Content”, “Data Management”, and “For the Learning Environment”. I imagined that the latter would be about technology built to facilitate learning how to think and do, rather than learning as knowledge. But disappointingly, the link there is to “Course Material Delivery” and the words “Content” and “Deliver” appear twelve times in that short webpage.

And then consider TopHat’s attempt to ‘disrupt’ the publishing industry and Perusall’s platform that allows annotation of textbooks. Rather than innovating and leaving the 20^th century world of textbooks behind, these platforms buy into that out-of-date pedagogical model.

The examples are too numerous to catalog. Delivery of content still dominates the mainstream understanding of higher education.

We can look at Finland’s transformation of the pedagogy in its education system, in step with current research, and now being copied in China, to see where education is really heading. The Finnish system’s focus on phenomena-based learning, co-creation, and multidisciplinary problem-solving is where education is heading, there can be no doubt. This means that edtech must innovate to produce tools that facilitate this kind of learning.

Certainly, any tool that enables social and peer learning is going in the right direction. Eric Mazur, the Harvard Physicist who famously gave up on lectures, turned to peer instruction, and built the Learning Catalytics application to make it happen in traditional classrooms, is an example of someone whose pedagogy drove the creation of educational technology.

It might be surprising that putting technology to the service of deep learning of skills and competencies is natural in some of the most traditional subjects – Philosophy and English Literature. You would think that content would be king here, but in these subjects teachers have for a long time used techniques to develop students’ analytic, argumentation, and writing skills. That’s cleary demonstrated in the best book on teaching in higher ed, James Lang’s, Small Teaching; Lang is an English Professor.  And the UBC Centre for Teaching and Learning partnered with faculty from these departments to develop COMPair and Studiorium, tech tools that have nothing to do with ingesting content and everything to do with active learning of skills for persuasive, effective writing.

Counter-examples of this progress abound, unfortunately. The gamification of learning, with technology like Gradecraft, is mostly designed for content ingestion so that students perform better on traditional assessments – exams.  To be sure, deep gamification can lead to deep competency learning, as in this gamification of learning ultrasound techniques. But at present most of it is like the profusion of digital flashcards, built to help students succeed in the current, traditional  pedagogical environment. And who can blame those who build these tools and the parents and students who use them.  Tools for the gamification of fact-learning are squarely at the revenue end of the revenue-innovation trade-off.

One area that’s clearly underserved by edtech is the learning of hard and soft skills, both individual and interpersonal. For skills learning, we’re not even talking about innovative pedagogy. There’s no doubt that the only way to learn skills is to do them, over and over, reflecting each time, modifying techniques along the way, getting better along the way and learning what you’re capabable of doing.  We still have a system of apprenticeship for skilled trades that dates back thousands of years and relies on repeated practice and coaching. The pedagogy of apprenticeship is in fact more relevant in higher education than many realize, in fields from the creative and performing arts to health professions to business and law. So why aren’t we seeing edtech building more tools for learning of hands-on skills or skills that involve some kind of interpersonal interaction?

There are a few such tools. Learning technologies used for simulation-based education in the health professions and public safety are important, but they are very expensive and involve an on-site hardware installation, like the products offered by CAE Healthcare. Startups like GoReact, Practice.xyz, and WeVu.video are using the fact that video recording is now accessible to anyone to build tools for practice and feedback over time and space, including for the skilled trades.  We need more and better tools for collaborative, discovery-based skills learning, for educators to more easily put design thinking into practice at scale, and for real reflection and integration of learning like ePortfolios promised.

An educational model dominated by content delivery was a function of pre-digital, print technology. Technological innovation has given us a world where anything and everything can be digital, shared, and collaborative. How frustrating it will be if those building, buying, and using educational technology remain stuck in a pre-digital, pre-internet pedagogy and their technological innovation actually deepens the bias to a content-focussed model of education.

Case 1: Communication and Interview Skills

The Study:

A study conducted by Noordman, Vander Weijden and Van Dulmen (2010) examined the effects of individual video feedback on communication skills, clinical competence (adherence to practice guidelines), and interviewing skills of nurses working in primary care. The study involved 17 nurses and 325 patients in which nurse-patient consultations were video-taped at two sessions with an interval of 3-6 months. Before the recordings, nurses were allocated to a control or video-feedback group. Nurses allocated to the video-feedback group received video-feedback between the two sessions.

Findings:

The results indicated that nurses who received video-feedback appeared to pay significantly more attention to patient’s request for help, to accuracy in their head-to-toe examination,  and gave significantly more understandable information to the patient. Moreover, in regards to interview skills, nurses in the video-feedback group appeared to pay more attention to ‘agenda setting and permission seeking’ during their consultations. Effectively, the study demonstrated that video-feedback may be an effective method to improve the generic communication skills of practicing nurses in the health sector. “Although a single video-feedback session does not seem sufficient to increase all motivational interviewing skills, significant improvement in some specific skills was found.”

A full link to the study may be found here: https://www.ncbi.nlm.nih.gov/pubmed/24588648

Case 2: Working with a Human Patient Simulator

The Study:

A similar study was conducted by Grant, Moss, Epps, and Watts (2010) to evaluate the effect of video-facilitated human patient simulator (HPS) practice and guidance on a student’s clinical performance. Students were given various roles and were evaluated on behaviors related to patient safety, communication, prioritization of care, implementation of appropriate interventions and delegation other health care team members. The study had 20 students from nursing and nursing anesthetist programs who participated in HPS practice and guidance with video feedback compared to a group of 20 students who participated in HPS practice and guidance that used oral feedback alone, in order to identify performance indicators that were sensitive to improvement.

Findings:

The study showed that there was a significant difference between the the intervention group exposed to video feedback and the control group on three of the desired simulation behaviours: patient identification, team communication, and assessing vital signs. The highest number of desired behaviors were exhibited by the intervention group. Although there were no huge differences between the intervention group exposed to video feedback and the control group in total performance scores, the mean scores on the desired simulation behaviors were higher in the former.  This is great evidence that video-recording and feedback provides advantages in exactly the practices and skills that you would expect it to improve. Moreover, the students in the intervention group in this study expressed great satisfaction with the idea of viewing their performance on video and receiving feedback. We note that this was 2010, and the video recordings were not made available to the students on the internet and the feedback was not pinpointed to times on the videos, except by reference to the minute where it occurred.

A link to the full study may be found here: http://www.sciencedirect.com/science/article/pii/S1876139909005325

Case 3: Emergency Care

Method

A study was conducted by Anita Nystrom in 2014 on 44 undergraduate nursing students. The primary aim was to examine the experiences of nursing students being video-recorded during an examination and of receiving feedback on their performance. The examination involved providing proper and effective emergency care for a simulated patient. Descriptive in design, the study tested the effectiveness using a qualitative approach with written answers and open ended questions.

Findings

The study revealed a great deal about the usage of video-recordings and feedback. While some students reported feeling tension knowing that their examination would be recorded, many of the subjects felt the dialogue with and responses from the teacher in connection with visualized feedback were beneficial the process was an excellent learning opportunity for the process of emergency care. As reported by Nystrom

“The students described how this opened their eyes to their own actions, and that visualization provided an opportunity to increase self-knowledge, both as a person and regarding their role as a nurse. The video-recording allowed them to see clearly and reconnect to what they had done and what they had neglected to do, which enabled the students to prepare for their future professional role.”

A link to the full study may be found here: http://www.diva-portal.org/smash/get/diva2:648405/FULLTEXT03

Video-enabled learning is better for mastering skills

Overall, these case studies demonstrate that within the health sector, video-recording and video based feedback are viable valuable educational tools which promote dialogue, increased self-knowledge and professional growth for nursing students. They are very effective in bolstering students’ communication and interview skills, their abilities with HPS, and their ability to handle an emergent situation. However, as with other professions, the effectiveness of the feedback is heavily dependent on the feedback process, and the ability of the instructor to provide timely criticisms.   Giving students clear and constructive feedback on their work in progress is just as important as giving clear instructions for the assignment itself, and platforms like WeVu help provide a nuanced solution to this problem. The software not only allows for students to see what happened and learn from their experiences but also provides an effective outlet for instructors to give students feedback throughout the learning process. The accessibility of the video for student reflection, peer feedback, instructor coaching, and assessment – plus the comments appearing at the right time and place on the video – makes it even more likely that we will see learning gains from the use of video for skills learning.