Name: bridging the technology divide in the covid-19 era: using virtual outreach to expose middle and high school students to imaging technology
Uploaded: 2022-09-28T12:30:00
Duration: 9 min 55 s
Description: Watch this Scientific Journal Video about Bridging the Technology Divide in the COVID-19 Era: Using Virtual Outreach to Expose Middle and High School Students to Imaging Technology at JoVE.com

This research was supported by a Science Education Partnership Award (SEPA) grant from the National Institute for General Medical Sciences (NIGMS) at the National Institute of Health (NIH) under award # R25GM129617. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. UAMS College of Medicine funds were used to purchase some of the equipment used in this study (e.g., the anatomy visualization table and the clinical ultrasound laptop device).

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The authors have no conflicts of interest to disclose.

Federal grant-funded STEM outreach activities utilizing portable imaging technology resources available at the author&#39;s university were used to provide in-person, small-group, hands-on STEM sessions for middle through high school students. These efforts align with and bolster the already rich, university-sponsored K-12 STEM pipeline activities that are designed to increase the diversity of students entering STEM fields in Arkansas. The restrictions to campus access that arose in response to the COVID-19 pandemic forced everyone to reimagine hands-on STEM activities as virtual outreach events. Although small-group, hands-on interaction with technology should always be the goal for recruiting students into STEM fields, the use of virtual outreach sessions can help to broaden participation and bridge the divide in access to imaging technology. The research team in this study simply recruited students and teachers through online postings, existing community contacts, and through working with the University diversity affairs office.
Broadening participation is especially important in a rural state such as Arkansas. Medical schools are an important resource for modern imaging technology that can be used in virtual outreach settings to increase teacher and student knowledge of STEM concepts. The STEM outreach team in this project benefited from university investment of significant funds to obtain state-of-the-art ultrasound and CT imaging equipment (e.g., the anatomy visualization table) dedicated for educational activities. A federally funded grant supplemented these technologies with the purchase of wireless EEG headsets and associated software packages that allow for imaging of the localization of EEG activity. Models and anatomical specimens were incorporated in each session since the anatomical sciences form the foundation for understanding the images obtained using modern imaging modalities such as ultrasound and CT imaging. The protocol outlined in this paper provides details on how a minimal investment in some key, additional, broadcast-related equipment will allow professional-looking livestreaming of these imaging technology resources in virtual, STEM-focused outreach events that will captivate and engage students.
The purchasing of high-quality video cameras, some switchers, and accessory items and the availability of other laptop computers allowed the team to provide high-quality video feeds for virtual outreach sessions. In the protocol described in this paper, six separate cameras were used in the outreach sessions (three for the ultrasound scanning, two for the anatomical specimen and model station, and one for the anatomy visualization CT imaging station). A high-quality transmission is important to maintain student interest, especially since the students will likely be watching the presentation on their classroom smart board or projector screen, both of which will likely result in a decrement in overall image quality. Lighting is important, but high-quality cameras may obviate the need for additional photographic lights.
The video switcher and multiple cameras are the most essential pieces of the system since they allow for the PIP capability. Replacing the built-in laptop computer video camera with the video switcher input provides the advantage that a larger portion of the screen is utilized for the livestreaming than would occur if the video presentation software was simply screen-shared in a live input from these technologies alongside the presenter camera. Studies have shown that live-composite video lectures where the lecturer&#39;s image is combined with slides or other content result in a better subjective experience for the students31,32. A separate high-quality mobile microphone will enhance the auditory experience and will be required if the presenter is moving from station to station during the session at distances remote from the actual laptop being used to broadcast the virtual session.
A medical ultrasound laptop with HDMI output is required to provide a high-quality image for the virtual video platform broadcast. Commercially available 3D anatomy imaging tables such as the one used in the present protocol are a great resource that is available at many medical schools but are beyond the reach of most middle schools and high schools. The table used in this protocol has a virtual VH dissector program (not described in this paper) that allows for 3D and cross-sectional views of anatomy, which are useful in providing students with a reference point for understanding the anatomy that will be shown through ultrasound and CT imaging. The anatomy visualization table is connected to an Education Portal containing hundreds of cases of CT and MRI scans from real patients, which provides a perfect clinical focus for students. This allows the presenters to tie the CT imaging of the body organs with the US imaging and anatomical specimen demonstrations of the same organs. For example, using the CT views of the heart in different planes will help the students mentally construct a 3D image of the heart and its relationship to other organs like the lungs. Providing students access to an annotated list of free, online CT imaging resources will provide them with a way to re-engage on their own with the technology after the session.
One of the more important resources of a medical school is its faculty and students, which can serve as professional STEM role models. The availability of the faculty for STEM outreach events is always an issue given the ongoing competing needs at a medical school campus. A cadre of the core faculty forms the basis of the STEM outreach team, but this team sometimes also includes near-peer presenters when possible (e.g., Figure 3). Although one person can potentially handle the entire virtual broadcast with intermittent interruptions to change the camera angles and video switcher settings, it is preferable to have one dedicated staff member to handle the video switcher and video platform broadcast program, which allows the presenter to focus on the virtual outreach content. The switching of roles is easy to accomplish behind the scenes when the summary slides are being broadcast to the participants. It is highly recommended that a third person monitor the chat bar if students are individually signing in to the outreach session. Having someone whose role is simply to monitor the chat bar and answer individual questions or interrupt the broadcast to ask anonymous questions is very helpful to engage quiet students. Middle and high school students, in particular, may not want to ask questions in large group settings, especially in what can be an impersonal virtual environment. A friendly message sent to all participants at the beginning of the session by the chat bar monitor establishes a safe place for students to ask questions. The chat bar monitor can even log on remotely to reduce congestion in the broadcast room.
One of the major challenges to successfully conducting a virtual outreach session is the lack of personal interactions and the ability to gauge student interest by seeing their faces. It takes time for the presenter to get used to not seeing the participants since the monitors are there to provide the presenter with the broadcast image and not the group of participant viewers. The presenter must rely upon the behind-the-scenes staff to monitor the session to get a feel for the level of student engagement and what might need to be changed for next time. Success in capturing the students&#39; attention is evident when they lean forward in their chairs to seemingly get a better view. Intermittently asking for questions from the audience (e.g., just after the station summary slides) allows students time to process and reflect upon what they just learned. The student comments and teacher evaluation data provided in this paper support the conclusion that these types of virtual outreach sessions are effective in exposing students to new STEM and imaging technology content and provide students with a positive learning environment. These findings are in agreement with the results of other studies, which report that virtual outreach programs conducted during the pandemic can engage students just as much as in-person activities, allow for greater participation of students in STEM enrichment programs, and provide an avenue for building relationships between STEM professionals and students33,34,35.
This paper has provided an outline of the equipment needed to use imaging resource technologies that may be available in a medical school setting to provide virtual technology-focused outreach activities to stimulate student interest in STEM fields. A small investment in equipment, such as a few high-quality 4K cameras, and other accessory items, such as the video broadcast switcher, can effectively increase the interactive feel of the presentations and lead to visually pleasing virtual presentations that promote student engagement. Demonstrating live ultrasound scanning of a person, rotating 3D CT reconstructions of the body, and providing real-time EEG recording of brain activity help stimulate the STEM interests of middle and high school students. They also provide ways to counteract differences in access that rural students may have for resources at a regional medical school and for the loss of access by all students during the COVID-19 pandemic-associated restrictions.

Medical school-sponsored K-12 pipeline programs for STEM exist because the low representation by underrepresented minorities (URMs) in the medical profession mirrors the lack of diversity in other STEM fields. The lack of diversity among researchers and health care professionals can contribute to health disparities. Many health care workers do not resemble the patients they serve, which can leave the patients feeling excluded1. Nationally, URMs represent 37% of the US population2 but only account for 7%-10% of professional school faculties3,4,5. The need for a diverse, culturally competent health care workforce is of primary importance in identifying, addressing, and eventually reducing health disparities. Diversity in the health professions can address health disparities through research dedicated to diseases with a disproportionate impact on racial and ethnic minorities and by helping increase the number of physicians willing to serve in typically underserved communities6.
There are a number of factors that impede URM students from enrolling in and successfully completing STEM degrees. These barriers include a small applicant pool due to reduced rates of completion of high school7, significantly lower completion rates of STEM majors in college and obtaining of advanced master&#39;s or doctoral degrees8, less persistence in school9,10 and lower overall graduation rates11, reduced exposure to high-level curricula and less qualified teachers in their communities12, and even differences in preferred learning styles in school (e.g., URMs prefer small-group, hands-on activities vs. lectures)13,14. It is well known that early educational encounters are extremely important in shaping the long-term educational experiences of URM students, who typically come from educational environments that are not supportive of, and are even indifferent to, minority students. Most URMs do not have a STEM role model in their extended family or even their local community. Recent studies have indicated that early exposure to STEM outreach programs is positively associated with establishing a STEM identity and seems to stimulate student interest in STEM15,16,17,18.
As the only allopathic academic medical center in the rural state of Arkansas, which has one of the highest rates of poverty in the US19, the author&#39;s university and its Division of Diversity, Equity and Inclusion has, over the years, established a robust K-12 pipeline to support the recruitment of URMs into its programs. Mentoring students at an early age has been shown to be an effective strategy in recruitment, retention, and graduation efforts. Pipeline programs at undergraduate schools across the nation have shown some successes in this regard (e.g., increased URM populations applying for medical schools6). Pipeline programs targeting middle and high school students have also shown some early signs of success20,21,22. Early intervention efforts to stimulate student interest in STEM can lead to diversity in the students interested in STEM-related fields and careers, which can lead to an increase in the number and diversity of high school students who enter college, choose a STEM major, and pursue a graduate degree in biomedical sciences and/or a health profession degree.
COVID-19 has caused many disruptions to K-12 education, including restrictions on access to medical campus facilities for middle and high school students and an interruption of in-person outreach visits to local schools. The pandemic has forced many STEM outreach providers to reimagine themselves from a paradigm design based on small-group, hands-on, focused approaches to one that involves virtual outreach23,24,25. The challenges that accompanied this change included the loss of personal interactions, the loss of hands-on interaction with technology, the lack of students&#39; ability to experience a visit to a medical school campus and its facilities in person, and fatigue with online learning platforms26. These challenges can be partially offset by the opportunities of providing virtual outreach, which include a chance to broaden participation and bridge the technological divide through exposing students across the state to sophisticated imaging technology not available in their classrooms.
Medical schools are an important resource for advanced imaging technologies and other commercially available educational technologies that are beyond the normal budget of middle and high school classrooms. Ultrasound is an excellent imaging modality for middle and high school students because it allows for peering inside the human body in real time. This can be very engaging for students, even when the presentation is virtual. In the USA, national science standards include learning about the properties of waves in middle and high school science classes26. Demonstrating ultrasound and its use in medical imaging is a great way to tie the outreach session to classroom lessons. Nothing can capture the attention of students more than the live scanning of a person&#39;s body, especially something that is moving-the heart, the contraction of a muscle, or peristalsis of the gastrointestinal tract. Access to X-ray and computerized tomography (CT) imaging technologies for STEM outreach events is not possible because of the high cost of the equipment, busy clinical use schedules, and safety issues.
Fortunately, there are different anatomy visualization imaging tables that are becoming widely available as a resource on medical school campuses28. These tables have databases of CT images obtained from real human patients that can be shown to students, including with 3D reconstruction capability. Middle and high school students will also be familiar with the electromagnetic spectrum (e.g., X-rays, light, infrared), which is included in the national science standards, so the use of this type of imaging technology again ties quite nicely into what they are learning in the classroom. Access to medical-quality electroencephalography (EEG) equipment for use in virtual STEM outreach events is difficult even in the medical school setting and would require skilled staff to prepare the subject for EEG recording. Relatively low-cost, commercially available headsets might not be available to individual middle or high school classrooms but are certainly within the realm of a medical school STEM outreach budget. These commercially available wireless headsets require minimal time to set up and offer software packages that allow for visual imaging of the EEG activity in the brain, which is ideal for the middle and high school target audience that is unfamiliar with this brain activity imaging modality.
Conducting effective virtual STEM outreach sessions requires more than a laptop computer, a camera, and a web-based video platform. The basic desktop or laptop computer will need to be supplemented with a variety of other equipment to enhance the experience and provide a high-quality, professional-looking broadcast. This paper describes an integrated three-station approach that has been used to provide synchronous, web-based, virtual outreach activities that include advanced imaging such as ultrasound and CT imaging, as well as the visualization of EEG activity localization in the brain.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>4-port HDMI switcher</td>
			<td>Iogear</td>
			<td>IOGHDSW4K4</td>
			<td>https://www.bhphotovideo.com</td>
		</tr>
		<tr>
			<td>4K video camera</td>
			<td>Canon VIXIA HDG50</td>
			<td>CAHFG50</td>
			<td>High quality 4K resolution video camera</td>
		</tr>
		<tr>
			<td>Accessory microphone</td>
			<td>Samson Meteor Mic</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>ATEM Mini Pro video switcher</td>
			<td>Black Magic</td>
			<td>BLSWATEMMP</td>
			<td>https://www.blackmagicdesign.com</td>
		</tr>
		<tr>
			<td>Ball head camera mount</td>
			<td>Glide Gear</td>
			<td>GG-33</td>
			<td>https://www.bhphotovideo.com</td>
		</tr>
		<tr>
			<td>Brain Viz software</td>
			<td>Emotiv</td>
			<td></td>
			<td>https://www.emotiv.com</td>
		</tr>
		<tr>
			<td>Dell laptop computer</td>
			<td>Dell</td>
			<td>13&#8221; Dell XPS laptop</td>
			<td></td>
		</tr>
		<tr>
			<td>Emotiv Pro software</td>
			<td>Emotiv</td>
			<td></td>
			<td>https://www.emotiv.com</td>
		</tr>
		<tr>
			<td>Excel (for MAC)</td>
			<td>Microsoft</td>
			<td>v. 16.16.27</td>
			<td>Data analysis</td>
		</tr>
		<tr>
			<td>High Speed HDMI cable with ethernet-15 foot</td>
			<td>Pearstone</td>
			<td>PEHDA-15</td>
			<td>https://www.bhphotovideo.com</td>
		</tr>
		<tr>
			<td>MacBook Air</td>
			<td>Apple</td>
			<td>13&#34;, 1.8 GHz Intel Core i5, 8 GB 1600 MHz DDR3</td>
			<td>https://www.apple.com/macbook-air/</td>
		</tr>
		<tr>
			<td>Mini UpDownCross converter</td>
			<td>BlackMagicDesign</td>
			<td>BLMCUDCHD</td>
			<td>https://www.blackmagicdesign.com</td>
		</tr>
		<tr>
			<td>mini HDMI to HDMI converter</td>
			<td>Liberty AV Solutions</td>
			<td>AR-MCHM-HDF</td>
			<td>https://www.bhphotovideo.com</td>
		</tr>
		<tr>
			<td>Overhead camera/light studio rig</td>
			<td>Proaim</td>
			<td>P-OHLR-01</td>
			<td>https://www.bhphotovideo.com</td>
		</tr>
		<tr>
			<td>PC laptop</td>
			<td>Dell</td>
			<td></td>
			<td>https://www.dell.com</td>
		</tr>
		<tr>
			<td>ProTeam massage table</td>
			<td>Hausmann</td>
			<td>7650</td>
			<td></td>
		</tr>
		<tr>
			<td>R Studio</td>
			<td>R Studio PBC</td>
			<td>2021.09.0</td>
			<td>Data analysis</td>
		</tr>
		<tr>
			<td>Remote slide advancer</td>
			<td>Logitech</td>
			<td>Spotlight presentation remote</td>
			<td></td>
		</tr>
		<tr>
			<td>SECTRA table</td>
			<td>Touch of Life Technologies</td>
			<td></td>
			<td>https://www.toltech.net; Cases [S003, 2099, U010)</td>
		</tr>
		<tr>
			<td>sheep, pig, and cow hearts</td>
			<td>Carolina Biological</td>
			<td>Perfect Solution Preserved</td>
			<td>https://www.carolina.com</td>
		</tr>
		<tr>
			<td>TVN Viewer Software</td>
			<td>GlavSoft LLC</td>
			<td></td>
			<td>Part of TightVNC</td>
		</tr>
		<tr>
			<td>Ultrasound laptop device</td>
			<td>GE</td>
			<td>NextGen LOGIQe laptop/cart</td>
			<td>https://logiq.gehealthcare.com</td>
		</tr>
		<tr>
			<td>Universal adjustable tripod</td>
			<td>Magnus</td>
			<td>MAVT300</td>
			<td></td>
		</tr>
		<tr>
			<td>USB3.0 to Gigabit Ethernet adapter</td>
			<td>Insignia</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>wireless controller</td>
			<td>Canon</td>
			<td>WL-D89</td>
			<td></td>
		</tr>
		<tr>
			<td>Wireless EEG headset</td>
			<td>Emotiv</td>
			<td>EPOC X</td>
			<td>https://www.emotiv.com</td>
		</tr>
		<tr>
			<td>ECG package</td>
			<td>GE</td>
			<td>3 lead USB-ECG unit</td>
			<td></td>
		</tr>
		<tr>
			<td>ZOOM software</td>
			<td>Zoom</td>
			<td>version 5.10.1</td>
			<td>Zoom.us</td>
		</tr>
	</tbody>
</table>

bridging the technology divide in the covid-19 era: using virtual outreach to expose middle and high school students to imaging technology

Increasing the diversity of students choosing careers in science, technology, engineering, and mathematics (STEM) fields is an area of intense focus across the USA, especially in kindergarten through 12th grade (K-12)-focused pipeline programs in medical schools. A diverse STEM workforce contributes to better problem-solving and equity in health care. Two of the many major barriers for rural students are the lack of sufficient STEM role models and limited access to technology in the classroom. Medical schools often serve as an important resource for students in the local community who can easily gain access to STEM professionals and modern technology through on-campus, sponsored events and STEM outreach to the local classrooms. However, underrepresented minority (URM) students often live in socioeconomically distressed parts of rural states such as Arkansas, where access to STEM role models and technology is limited. Virtual learning in the COVID-19 era has proven that the imaging technology resources of a medical school can be harnessed to reach a wider audience, especially students living in rural areas far from the medical school campus.

Watch this Scientific Journal Video about Bridging the Technology Divide in the COVID-19 Era: Using Virtual Outreach to Expose Middle and High School Students to Imaging Technology at JoVE.com

Bridging the Technology Divide in the COVID-19 Era: Using Virtual Outreach to Expose Middle and High School Students to Imaging Technology

This article presents an overview of how synchronous web-based virtual outreach can be used to expose 6th-12th grade students to advanced imaging technologies such as ultrasound, computerized tomography, and electroencephalography. The paper discusses the methods and equipment needed to livestream integrated educational sessions for effective student engagement in STEM.

Increasing the diversity of students choosing careers in science, technology, engineering, and mathematics (STEM) fields is an area of intense focus ...

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