March 29, 2016

Showing rather than telling at UW’s School of Dentistry

First-year dental students learn big lessons thanks to strong storytelling videos

Four years ago, UW School of Dentistry associate professor Donald Chi traveled to a remote Alaska Native community in the Yukon-Kuskokwim Delta region to find out what was rotting young keggutet, the Yup’ik word for teeth.

What Chi learned in the field perfectly illustrates why he has replaced traditional paper case studies with videos in first-year public dental health classes—it is often better to show rather than tell students how complex dental health issues may someday challenge their professional lives, and the lives of their patients.

“When I was a dental student here at the UW, we had lectures and paper case studies that we discussed in small groups,” says Chi, who teaches in the Department of Oral Health Sciences. “We studied a different case each week, but they didn’t feel tangible or real to me.”

Video case studies illustrate complexities of real-world health disparities

The videos elicited a more visceral and more humane response from students, and also increased student engagement and learning, he says. The videos are used in the “Introduction to Dental Public Health Sciences” course, which familiarizes first-year dental students with public health concepts such as barriers to dental care, behavioral and social determinants of oral health, and the development of multi-level solutions to reduce oral health disparities. These are areas in which Chi has experienced issues firsthand in Alaska and in other communities as a researcher and dentist.

Case studies play a central role in introducing students to real-life scenarios. It may show, for example, high numbers of cavities among children in an area where there’s no fluoridated water but plenty of sugary drinks. Throughout his Alaska research, Chi met these children and their families, and saw how shocked and surprised parents were after realizing their children had been consuming 16 times the maximum amount of added sugars recommended for children.

“These case studies put dental health care in perspective. They allow students to follow a scenario, discuss barriers to health and potential solutions with their peers. But I thought we could do it better with video,” Chi says.

Chi returned to teach at the UW in 2010, when pedagogical approaches also were making a strong case for video in some circumstances. He wanted to see if videos could make the case study approach an even more powerful learning experience, and he started with a modest goal of three videos to test the waters.

The videos piloted shortly after his arrival. One tells the story of a teenager of American Indian descent with mouth sores caused by tobacco products; another follows a non-English speaking pregnant woman frustrated by dental forms she can’t understand; a third focuses on a Medicaid-enrolled preschooler with a non-English speaking mom. All three are still in use today, with six others now part of the dental library. Chi said there are plans to make more videos, including one that discusses dental problems faced by the homeless population.

Student data showed videos resulted in better learning than paper case studies

“I’m big on evidence-based teaching,” says Chi, who co-authored a study comparing video vs. paper cases. The data revealed that dental students who received a video case for study reported better affective, cognitive and overall learning outcomes than students who received a paper case. “We found significant statistical differences. Across all measures, the videos were much better at improving student outcomes.”

Students who watched the videos reported a higher understanding of public health problems and how these issues might affect their own careers as dentists. Compared with students who studied from paper cases, the video students also had more empathy toward vulnerable individuals and a greater appreciation of how health disparities impacted real people, Chi says.

Through visual storytelling, the individuals and their problems become more real to students—some of whom have never even had a dental cavity. The videos, he says, lead to deeper, more empathetic thinking toward people dealing with health disparities.

“When we made the videos, I didn’t realize at first how powerful they were and how much they affected the thinking of so many students,’’ says Chi. “Many were outraged by the situations they saw in the videos. They were affected in a very profound way.”

Chi’s suggestions for producing case study videos:

Aim for quality over quantity: Chi recommends starting small, and focusing on producing only one or two videos at first. Students are accustomed to technology, and savvy about video. They know if something is poorly made when they see it. Chi and colleagues narrowed their focus and chose three dental health topics that could be made into short, well-made videos.

Assemble a team and access UW support: Chi suggests involving people with expertise in producing videos and not being afraid to ask for help. UW Video provides services to the entire University community; faculty can also tap hourly videographers or Communications grad students who are adept at visual storytelling and need a project. Chi says volunteer actors, film editors and videographers often need the practice and are happy to participate in this type of project. He recruited his sister, who had finished studying film at the UW, to direct and produce the videos. They worked together with a team of psychologists to craft the story and dialogue. Video expertise, from writing to filming to acquiring talent (actors), is more likely to produce positive results, with videos that will engage students.

However, there are costs involved in producing high-quality video. Chi sought funding from multiple sources to support his project, putting together a business plan based on three pilot videos, and making a strong case for visual storytelling as a pedagogical tool. As evidence, he cited the Commission on Dental Accreditation, which encourages the use of technology such as video to enhance the educational experience of dental students while improving the learning environment.

Keep it short: Students don’t need one-hour videos. A typical video in the dental school is about 10 minutes long. That’s plenty of time for a detailed narrative that won’t overwhelm.

Remember that video isn’t a substitute for face-to-face teaching: Video does not stand alone. In problem-based learning, video is another tool for learning. It is most effective when supplemented with group discussions led by a facilitator.

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