Material editing

In his error recovery theory Dror (58) described the use of interactive video clips to enhance error detection. He used interactive flash files, progressing from simple exaggerated mistakes to more hidden errors. Trainees had to come with the possible recovery plans at the end of the process after being offered such plans earlier in the training. This would eventually help trainees to recognise their own mistakes and reduce them (58). I was advised early in my project, by Durham University

Educational IT Department, that such interactive flash files will not be supported by the expected adaptation of the HTML5 in World Wide Web in the near future. HTML5 is a programming language used, since October 2014, to present the content

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on the World Wide Web. Any content not supported by this language will simply not work online. As a result, the interactive flash file creation plan was unpractical in the light of the approaching technology change in the World Wide Web. I opted, with the Durham University Educational IT Department’s support, to use simple images and video clips integrated within my multiple choice, extended matching items and single-line free text questions.

I used Paint software to process the images. I downloaded the images using the Print Screen button and pasted them onto a Paint software blank file. I then enlarged the images to facilitate deletion of any marks or arrows with minimal effect on the images. I split the coupled laparoscopic/anatomical images into their separate components to use them as matching items, as will be described in the next chapter.

Many of the uploaded videos on YouTube were already processed to present the hazards or the anatomy variation. They included music, live comments, labels and integrated explanatory images or diagrams. Those additions rendered these videos as not suitable as they revealed the answers. There was a need to remove such additions to allow the materials to be incorporated in the assessment. To do that, videos had to be downloaded first and then processed with a dedicated video editing software.

YouTube video clips were downloaded using the https://en.savefrom.net/ website. The video files were then edited using Windows Movie Maker 2012 (Build 16.4.3528.0331). This is a free application in the Windows Essentials 2012. The software was used to select certain parts of the whole operation file and remove the

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rest of the operation. Those parts were merged to create a shorter video file containing the intended hazard. Music and comments were deleted except in one video where the comment served to stress the message from the clip.

As the software enabled me to have full freedom in processing the videos, I managed to cut the labelled sections and inserted explanatory images. I opted to use some of those images and sketches for the feedback after the questions to further stress the message. This process required careful planning and early integration of those videos in the early versions of the assessment materials as per the example in Appendix 6. Some clips required two to three small sections to be selected and merged while others required more cuts to shorten the operation, especially in the Common Bile Duct injury and Complication section of the assessment (Appendix 7). While processing and planning this particular question I felt the need for further visual clarification to stress the bile duct injury classification. This led me to contact the anatomical chapter author for permission to use the bile duct injury images as described in the previous image section. Those images were processed again using the same image methodology described above.

Video processing was quite demanding and required a computer with high

specifications. I initially processed the videos using Windows Movie Maker on an old computer with Pentium Dual-core processor 2.6 GHz and 4 GB Random Access Memory (RAM). The process worked normally and the software presented the intended sections normally. It was only when I checked the resulting saved video files that I realised the problem. The resulting video files were pixilated and unclear.

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The whole process was repeated using a newer laptop with Core i5-3230M 2.6GHz processor and 8 GB RAM. This computer held enough processing power to produce good quality output video files.

One unpermitted video clip was deemed essential as no alternative video clips were found with the same hazard. It presented erroneous clipping of the right hepatic artery, identifying the mistake by realising the liver ischemic signs, removing the clips and showing liver ischemia recovery. The copyright holder of this clip was not contactable and the decision was made to use this clip as streaming but to highlight the essential moments in a comment under the link to allow trainees to skip parts of the video to save time without missing those key moments (Appendix 6). Other less important unpermitted clips were labelled as nonessential extra examples.

Initial question drafts were further refined. Web links and section times were

replaced with the name of the processed output videos. Questions were regrouped in pages to convey clearer unified messages and reduce brain shifting further.

Unpermitted streaming videos were grouped together after each corresponding section: Artery, Bile duct and Complication. A button was created next to the

optional extra video title to enable trainees to email the YouTube links to their email addresses for future review if they choose to do so.

Multiple checks were carried out by supervisors and colleagues to check the content, spell check the questions and check the shortened clips’ clarity, prior to confirmation of the final draft. This draft, along with the processed images and videos, was then

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sent to the Durham University Educational IT Department to be uploaded on the University website. Uploading the material was carried out by one of Durham University Educational IT experts, it required a couple of correction cycles before the online Cognitive Hazard Training module was ready. This online module,

described in the next section, was then piloted with two external experts before being used in the feasibility study.