The University Hospital of Cologne has a training centre with a sophisticated new audio video system which enables medical students to practise consultations and procedures of different types, then follow these up with detailed analysis of their own performance using video and audio recordings. Supplied and installed by inSynergie, a German specialist in multimedia control solutions, the complete AV package is a combination of inSynergie's own .net based software with Geutebruck re_porter and GeViScope video platforms.
The practice facilities in the training centre include an operating theatre, two trauma rooms, two emergency treatment rooms as well as six patient consulting rooms. Training exercises may involve patients or actors as well as students and the whole process can all be recorded by teaching staff from four central editing desks. The equipment in the editing suite and the seminar rooms have special touch-screen user interfaces developed by inSynergie for the purpose. From the editing suite cameras in the practice rooms can be selected individually and synchronous recordings made from groups of cameras at once. Video from selected cameras can be streamed live to any of the lecture rooms. Video can be displayed on monitors in split screen mode or via projectors in the seminar or lecture rooms.
Crucially, teaching staff can insert markers into the live recording during the exercises. This enables particular sequences to be pulled up again quickly during the subsequent analysis and feedback sessions. Since these markers can be tagged they are useful tools for research and teaching. All video recordings (complete with markers) are stored in the database and filed according to user, location and date. Material from this database can be accessed from computers in the various lecture rooms as well as from the editing suite within the secured network.
In the medical education environment this video technology saves time. It reduces problems caused by crowded courses and lecture theatres and a shortage of teaching staff. It allows for the analysis of body language which may be important to diagnosis, and when supported by error-marking, it provides perfect conditions for the self-critical review and discussion after an exercise which promote more effective learning. Recorded video is also useful because it can be exported as a hand-out and offers the potential for internet broadcasting - data protection and other regulations permitting.
The recording functions available to the controlling editors include: the selection of individual cameras; insertion of title and screen text; display of live preview pictures; start/stop control of video and audio; the insertion of bookmarks for easy retrieval. In addition the system supports the delivery of audio announcements.
Teaching staff can now make recorded and live images available to students in several locations at once, while retaining central control over the approved material. Replay functions allow staff to access any of the approved recordings and to jump from marker to marker. Besides controlling volume and projectors, teaching staff can also control building functions such as lights and blinds.
●Video platform selection
For this project InSynergie needed a video platform which offered both a specific range of functions and the ability to integrate with other devices and their own software. The system needs to produce multi-channel lip-synch audio and video recordings, and to produce different types of output simultaneously. For example, the documentation of events in a practice room with 4 cameras and audio recording, might mean producing 4 video streams with audio for viewing in a 2x2 matrix format; plus the same footage as an H.264 file and a further copy in a format suitable for loading onto a lecturer's notebook for use in subsequent courses. With Geutebruck's policy of providing free SDKs and free development assistance it was relatively straightforward for inSynergie to increase the standard single video channel with lip synch audio to a group of four with audio.
Dr Boldt, the university hospital's director of SkillsLab and Simulation is very proud of the new facilities. “Feedback is now seen as having a very positive effect on learning, especially when the student can review his own actions,” explains Dr Boldt who cites both international academic research and his own student evaluation forms which bear this out. After a 7-week course in the new facilities one student commented: “Super course, the best in the whole study programme […] because you learn such a lot. It would be really great if there were a week of this in each clinical term! Lecturers were very committed, everything was organized perfectly. The video monitoring and evaluation could be expanded because it is so helpful being able to see yourself in conversation with patients.”
Dr Boldt believes the A/V system to be higher quality and more capable than any other on the market. “No competitor was able to offer the quality and the desired flexibility for developing the overall system,” he reports.