Developing my teaching is extremely important to me. The main thrust of this development has been to leverage the opportunities afforded by technology, to enhance my teaching and student learning, as well as to deliver on UNSW 2025 Strategy Theme A2:Educational Excellence, Objective 4. My OSPIA platform and CWAapp represent this at a macro scale, but even within these examples of simply deploying technology into the curriculum, there are further examples of benefits I have been able to implement to further enhance the student experience, the feedback they receive and the learning they derive therefrom.

For example, the OSPIA platform in some respects, is just another ‘venue’ for students to interact with patients (simulated patients, in this case). However, through my educational leadership, I initiated a collaboration with the Faculty of Engineering at University of Sydney, to not only create a system that ameliorated the administrative burden of ‘delivering’ this new venue to students, but also dramatically enhances the learning within online interactions. Working with my team, we created a platform that has individualised, multimodal student feedback as a core feature. For example, during interactions, an online SP can use the click of the mouse to indicate ‘good moments’ but also moments where they feel distanced from the interaction (perhaps when an emotional cue is ignored), indicating this with emoji (see Fig 1). Alternatively, the SP can enter free text at any point during the interaction, making detailed comments on any action the student takes (or fails to take) during the interaction. The student does not get this feedback in real time during the interaction, since this would be too distracting to them. However, on later review of the ‘compressed video’ (meaning the student sees both themselves and the SP ‘side-by-side’) these moments of feedback are visible on a timeline of the video. Hence the student can ‘click into’ each moment of feedback – emoji or text comment – and review the video leading up to and around that point and which led to the relevant piece of feedback. Thereby they can see what behaviours they displayed and how this relates to the feedback received. This helps to reinforce positive skills, as well as develop poorer skills; encouraging the student to attempt different behaviours in any future interaction.

Beyond this, though, lies a highly innovative feature that utilises computer vision algorithms to analyse the OSPIA videos and create an output on non-verbal communication behaviours (NVB). NVB are considered extremely important in the doctor-patient interaction and conveys considerable meaning in such communication exchanges. Consequently, it is imperative that students learning communication skills are aware of NVB and the impact on the quality of the interaction. In the past, teaching on NVB was laborious: entailing video of live interactions, annotating recordings, and then later on, teaching using these outputs to illustrate specific points. In OSPIA, this process is automated, sped up and meaningful outputs are delivered straight to the student for review. NVB analysed in this way includes smiling, head nodding and shaking and turn-taking. The latter informative parameter relates to how well students facilitate ‘patient talk’ – associated with successful ‘patient-centred’ interactions (see Fig 2). From the visual output, students get immediate data on the extent to which they are allowing the patient to talk and tell their ‘story’.

A similar refinement of the educational process has occurred with the CWAapp. Whilst the digitisation of paper forms has obvious advantages in terms of precluding loss or alteration of assessment data, and creates a reliable record of completions, the opportunity to enhance learning also exists. To complete Kolb’s learning cycle, I wanted the student to also reflect upon the activity and determine a hypothesis for improvement which could be tested in future interactions. Hence when a communication skills assessment takes place in e.g. the student’s hospital, on the CWAapp, the completed form is then presented back to the student, with a reflection process. The form comprises three questions which guide the student to reflect and must be filled out with free text in order to complete the assessment task overall.

Evidence of Impact:

Development of my teaching has created purposeful technology enhancement of innovative educational tools to maximise personalised student learning e.g.

• CWAapp has facilitated reflective writing on many thousands of student-patient communication assessments in the clinical setting
• Research on OSPIA (discussed in Research section) indicates that review of NVB outputs by students leads to subsequent conduct of significantly more successful interactions.
• I have presented on OSPIA and CWAapp at Faculty and UNSW level education meetings, most notably my recent Scientia Education Fellow lecture (Mar 2019). I presented on OSPIA at University of Melbourne (Apr 2019) and at Kings College London (Sept 2018).
• Multiple international conference presentations on OSPIA and CWAapp at medical education, simulation and communication-in-healthcare focused conferences.
• Creation and activation of an international online collaboration for development of technology enhancement of medical education, particularly focused on clinical workplace-based assessments. This group presented a conference workshop at OTTAWA 2020 and at AMEE 2020 (preeminent global medical education conferences) in order to share best practice on the use of technology for this purpose.