Hi-def distance education system links 19 sites in 2 provinces

Medical education in Canada got a shot in the arm, as an extraordinarily innovative high definition video conferencing system went online in September, 2010, linking 19 sites at two university campuses and, soon, four New Brunswick hospitals, in Dalhousie University’s new Dalhousie Medicine New Brunswick program, established in collaboration with the Government of New Brunswick, the University of New Brunswick and the Horizon Health Network.

“A key principle is that all students must have a comparable learning experience,” said John Robertson, Dalhousie’s director of academic computing services and Med IT in charge of the project. “So whether a student is sitting in Saint John or Halifax, that student must have the same access to the educational content, the same quality of information, and the same ability to interact with the lecturer or classmates in other locations. The challenge is to achieve that objective of comparability,” he said.

Theatre A large screens    Lecture Theatre A confidence monitors

Three 11-foot projection screens (left) and reverse angle showing presenter's set of three 42-inch confidence monitors in Lecture Theatre A at Dalhousie's Halifax campus

The program’s mandate is to deliver lectures and educational content from any one of the school’s 19 medical facilities to one or more of the other facilities, offering students an experience comparable to a face-to-face lecture, including high quality visuals and audio, and enabling participants at various sites to engage in interactive discussions.

“In sheer complexity and performance, I’m not aware of anything quite like this in video conferencing distance education in all of Canada,” said Philip Giddings, president of Engineering Harmonics Inc. who designed the Dalhousie video conferencing system and earlier distance learning systems at the University of Toronto, St. Michael’s Hospital, Queens University, the University of Western Ontario, the University of Waterloo, and other institutions.

The firm specializes in simplifying the labyrinthine difficulties of video conferencing across multiple sites, a task made even more complex by the impending switchover from analog to digital broadcasting next year. Unlike conventional analog systems, digital video distribution incorporates HDCP copy protection that restricts the number of displays and other destinations that video can be sent to—and that can shut down an entire video conferencing system if not properly managed.

On top of the standard prescription for a good video conferencing system—proper acoustics, lighting, sightlines, and a lightning fast, reliable network connecting facilities across hundreds of kilometers—Engineering Harmonics wrote a massive amount of custom software to manage the entire process behind the scenes, while offering users a simple, intuitive control interface on touch screens.

“We have some very traditional teachers in our program who literally could not imagine how they were going to be able to teach without a blackboard and chalk. If we hadn’t had Engineering Harmonics on board, we never would have been able to get our teachers to understand how they can teach better with this technology,” said Joanne Power, policy and planning officer in the office of Dalhousie’s dean of the faculty of medicine.

“We learned a great deal from the other schools that have already gone down this path,” said Robertson. “We’d like to think that the bar has been raised with this installation.”

An innovative feature never before implemented in video conferencing systems is host switching. Control of the entire video conference can be transferred in real time to another site in the network, including control of the currently active microphone queue, cameras, lighting, sources and content.

Lecture theatres at the Halifax and Saint John campuses mirror each other with three screens at the front of the room displaying in high definition the lecturer, educational content, and students at the remote location. The images are crisp and very easy to see—high contrast DNP Supernova front-projection screens in the large theatre each measure over 11’ wide.

“The projection screens are so clear they look more like plasma displays,” said Engineering Harmonics’ project manager Andrew Kozak, who has helmed nine of the firm’s previous distance learning and medical education projects, and whose experience was heavily leveraged at Dalhousie. He noted that the new screens are twice as bright and offer close to seven times the contrast of standard front-projection screens. The smaller classrooms are equipped with 85” flat panel plasma displays.

Lecturers have their own duplicate set of 42” confidence monitors mounted immediately in front of the lectern in each room so they never have to turn around to view what students are seeing. A camera focused on the lecturer from the back of the room shoots over the top of the student-screen in the centre of the lecturer’s set of three confidence monitors, so that when the lecturer looks at a remote student’s image on screen, the eye-line is such that it appears the lecturer is making eye contact. Eliminating parallax in this way is a very necessary requirement in achieving the objective of comparability for participants in remote locations.

Microphones on student desks can be activated either automatically or manually to allow for questions or class discussions. Cameras mounted at the front of the room are tied into the microphone switching system so that when a student speaks, that student’s image is automatically displayed on the student-screen at the remote location, while a second camera moves to focus on the next student in the microphone cue. An automatic microphone matrix system eliminates feedback by reducing the level of microphone signals in nearby loudspeakers, regardless of the number of active microphones or their locations in a room.

A pair of 30-seat video conference rooms at the Halifax campus equipped with two screens each are set up to facilitate clinical education with similarly equipped rooms at the Saint John Regional Hospital, and ultimately Moncton Hospital, Miramichi Hospital, and Dr. Everett Chalmers Hospital in Fredericton. In each room, one screen displays the content under discussion, and the other shows the participants in the remote location. A number of smaller video conference rooms are similarly laid out at the Dalhousie and University of New Brunswick Saint John campuses.

Room lighting was designed to be easily switched for use in video conferencing, presentation, and low light theatre situations, and room layouts were designed to incorporate optimum sightlines so that all participants have a clear view of everything displayed at the front of the room. In the largest lecture theatre, additional flat panel displays mounted below the main projection screens permit easy viewing by those in the first few rows of seats.

The system was designed for ease of use by professors, students, technicians, administrators and lay people, groups with widely disparate interests and aptitudes. That meant putting extensive effort into designing all rooms to have a common look and feel, as well as automating room lighting, projection and microphone switching, and camera operations, so that all the technical aspects recede into the background, allowing the essential business of medical education to remain the primary focus.

“The fact that the consultants wrote the software programming is probably the most important—and exciting—contributor to the success of the project. For example, microphone queuing across multiple sites and associated camera control would probably not have been implemented if an integrator had provided the programming, because the client’s unique set of requirements wouldn’t have been as fully elucidated as it was in the continuous exchange of ideas that is unique to the consulting relationship,” Kozak said.

“Because we had a great client with a great vision, the end result clearly shows what can happen when you couple that with an experienced, knowledgeable team. Together we have produced an amazing system that is going to pay off in providing tremendous health care benefits to the larger community through expanded medical education in Maritime Canada,” he added

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