2020 was a pretty dismal year all round, but it gave us the opportunity to develop something we had been planning for some time - online courses. Our course participants know us best for our face-to-face teaching, but as academics we have also been involved with distance learning for a very long time having taught a Master of Science degree in MRI via this route between 1996 and 2019.

Having a 20 year background in web-development, distance learning and mobile learning I wanted to make sure that we could provide an online learning experience that replicated our face-to-face delivery, but could also offer certain advantages to the participants that are not possible on a live course. With any teaching tool, it is very important to play to the strengths of the modality. Distance-learning is considered by some cultures (and indeed by some educational establishments) as being a kind of "second best". 30 years ago that was possibly true, teaching materials were still paper documents posted out to the students each term. Computers and computer-based learning has changed all that. The functionality of computers has come a very long way. Compare, for example, the photo-realism of a PS5 game compared to a pixellated Mario jumping on mushrooms back in the 1990s. Network subscriptions for computing devices provide a useful snapshot as to their penetration into the general population. Laptop and personal computers are fewer than 500 million globally, whereas mobile device subscriptions exceed 7.9 billion (Ericsson, 2020). Computer-based learning and mobile-learning have come into their own. The heutagogical skill lies in harnessing this ubiquitous technology to provide a learning experience that offers advantages to traditional methods rather than being a flaky alternative. Technology-based learning is ideal for didactic topics such as MRI physics, so my first thoughts were that this would be quite an easy task, but in the end it was somewhat challenging.

The Challenges

Our first idea was to go down the usual route of presenting the lectures live via webinar. As senior lecturers in higher education this is something we had both been doing for years, however it became clear that this was not an option for the MRI in Practice course. All of the webinar platforms offer presentation options, via PowerPoint or PDF, and these work fine for a few bullet-points or images, but our course uses a lot of CGI animation and high definition video. Over a webinar these looked very jerky because the frame-rate of the webinar software could not keep up with slide animations. The other main issue with webinars (generally) is that the entire meeting relies on the stability of the host’s internet connection and any glitches in that connection can end the presentation for all concerned. A robust course delivery system therefore needs to be located server-side, independent of local connection disruptions. It needs to deliver the materials consistently, in a way that can be accessed from anywhere in the world, and (for our purposes) synchronously to match the daily course programme. This can be achieved by having the programme automatically synchronised to the time-zone of the participant, or by having the lectures pre-programmed to magically appear on the programme page at a set time zone determined in advance. The first option could be used for a totally autonomous course delivery with no human interaction required. The second option is needed when there are participants attending from multiple time zones to ensure that the lectures are synchronised for everyone and the revision/Q&A sessions can therefore slot in when everyone has finished watching a particular session. 

The Solution

One of my favourite "Oblique Strategies" (Eno and Schmidt, 1979) is "when faced with a choice - do both"

With live presentations out of the question, our solution was to make streaming videos of the lectures and combine these with live webinar sessions for Q&A, revision quizzes and discussion sessions. This "best of both worlds" approach was a major undertaking, requiring months of script writing, video production and editing. We ended up writing over 100,000 words of script and the video editing alone took 6 months, resulting in the equivalent of 10 feature-films worth of lecture material. Why would seasoned educators need a script? In a nutshell - ease of video editing.
When a lecture is live, there is always a certain amount of "dead air", or times where the lecturer may veer slightly off-topic or a discussion ensues. This is all good in the live face-to-face scenario, but for a video, leaving something out, or saying the wrong word makes life very difficult when you have already completed the first edit. Re-recording and stitching in updated narration never works well. It sounds a bit like those dodgy cinema adverts with a professional voice over cut in with (insert name of local Indian restaurant here).
Furthermore, it seems to me that an advantage (necessity?) of video is that you can make every second count. It doesn't matter if the content is fairly concentrated because the participant can always rewind and review if they start to get lost. Finally, when a lecture is committed to a recording that may not be updated for a year or so and may be watched by thousands of people it has to be perfect (or at least as good as you can make it).

Hosting the video content is also quite an involved process. I had hoped that our new website would be able to serve the videos, but at such high quality the streaming was sub-optimal even with a decent broadband connection. Having up to 100 participants all accessing the videos simultaneously would have made too much of a demand on the server. Of course we could have hosted them on YouTube, or Vimeo, but both of these platforms are very insecure, permitting downloads of the video content. Vimeo has some amazingly good features and claims to be secure, but having put it to the test, this was not the case. To my dismay (having just paid them a substantial sum of money) I was able to rip the content from Vimeo using a free chrome plug-in in less than ten minutes. If you need to protect your intellectual property, Vimeo is not the best choice.

Copyright and Digital rights Management

Copyright protection is very important to us because we have very serious ongoing issues with intellectual property theft. Contributors to unethical websites (I'm being polite here) such as RadiologyKey and RadTechOnDuty regularly steal our intellectual property and (illegally) present our written materials (and my diagrams) as their own teaching materials - presumably to generate advertising revenue.
The latest edition of the MRI in Practice book was pirated before it even hit the bookshelves.
To protect our course content we settled for a host that uses Amazon web servers (AWS). These are the severs used to screen Amazon Prime Video and can stream to thousands of viewers at high-quality with no buffering issues. For copyright protection we opted for a platform that permits high-quality streaming and is compatible with a wide range of devices. The Digital Rights Management is to ISO/IEC 23001-7:2012 standards and is used by Netflix and most of the major Hollywood studios. This service doesn't come cheap and we have to pay for every minute watched by every participant - but there was no better option that I could find. An additional benefit of this hosting solution is that every video is uniquely watermarked with a unique identifier of the person watching, so in the event of copyright infringement, we can immediately determine who was responsible. The hosting also allows us to completely block the content from certain locations - namely every country who has ever stolen our intellectual property in the past!

The "Back End"

Having sorted out the hosting and digital rights management the next stage was to create a website to deliver the course. I wanted to keep it very simple for the end-user and with this in mind I created a single webpage that can synchronously deliver the entire course over the full four days – and in any global time-zone. The benefit of this strategy is that participants only need one link to access everything they need. This was the most ambitious web page I have ever created and took about three months. It not only screens each lecture at the appropriate time, but it allows participants to sign in for CPD requirements and also ask questions about the lecture content on the fly without even having to leave the page. The most appreciated aspect of this method of lecture delivery (commented on in our feedback) is the fact that there is extra time built into the automatic programme. Having watched the lecture the participants have 15-20 minutes to revisit sections and watch parts of the presentation again. Another unique advantage is that (unlike a live course) participants can pause the lecture if they need a break.
There is, however, a need for a "Plan B", because no matter how robust the delivery system, the final user-experience will also depend on the participant's own equipment and internet connection. If local connection issues prevent a participant from completing a lecture, we also have a webpage linked to a content-management system (Total CMS by Joe Workman) that allows us to toggle content on and off from a browser window. This acts like a "catch-up TV" channel from which a participant can re-watch anything they missed at their leisure. The CMS is very useful because it allows us to make changes to the lecture server on-the-fly without having to republish any of the website via FTP. I am probably being over-cautious here, but as the course relies on a good independent connection from all of the participants to our server, a corrupted file upload during the course delivery could wreck everything. The take-home message here is to crash-test everything in advance and once the course has started LEAVE IT BE.

The Verdict

We have run the online course three times (to date). The first one was a real nail-biter because having invested almost 9 months of effort and tens of thousands of pounds in time and resources I was concerned that participants might not like it. Happily, the feedback has been very positive. We always receive a satisfaction score of over 90% for the live course, and the online course has a score of 96%, which is a great relief. We are now rolling it out across the world – basically to all of the locations where the live course was hosted. The Australian course is coming up soon and North America and Canada to follow. We hope to implement a Central European course by the end of the year, and are looking to include other locations over time. In fact, having "courses for each country" is no longer meaningful. There is no reason why someone from (for example) the United Arab Emirates cannot attend the UK course - they just tune in 4 hours later than the UK programme timing.

Future Developments

More interactivity! With the introduction of HTML 5 we can now build in a lot of functionality that was previously only available from plug-ins such as Adobe Flash (now discontinued). I have already included some revision sessions that are user-controlled quizzes and my next project will be an accompanying web application. Web applications behave exactly like the mobile apps that reside on your smartphone, but are located on a remote server. They can be downloaded to the device as home-page apps and if the content does not exceed a certain amount of data they can be accessed off-line too.  A few years ago we created a series of mobile apps for Apple devices, but development and update times were too long and the process of publishing was onerous. Web apps are ideally suited to replace these. Updating is very easy and they work across all platforms (no need to develop separate Apple and Android versions). Our textbook already provides participants with "the course notes" the web app will provide additional revision materials and some key animations. I plan to make the web app part of the deal when someone enrols on the course and this will hopefully be available by the end of 2021.

In Conclusion

I hope that any MRI educators out there will find our experience helpful. Webinar software alone is great – but you can do much better with (a lot of) time and effort! I also hope that this post will reassure any potential course applicants that the online course gives a very authentic learning experience and in some ways offers advantages that the live course does not have. Getting a front-row view, pausing and revisiting sections of the lectures, getting the same CPD accreditation and all from within the safety and comfort of home. 

We hope to “meet” you on a forthcoming course in 2021.