digital_videoconferencing by James Hill

Digital Videoconferencing Applications Across the Disciplines Carol C. Dudding James Madison University

The purpose of this article is to describe the technologies and applications of digital videoconferencing (DVC) within the realm of communication sciences and disorders. The discussion includes (a) a brief description of videoconferencing, (b) an explanation of the types of DVC available along with the advantages and disadvantages of each, (c) applications of DVC in preservice and in-service settings, and (d) a discussion of potential applications in research venues. DVC can occur at varying levels, requiring differing technologies, support, and funding. Educators, practitioners, and researchers in communication sciences and disorders are encouraged to consider the application of DVC in the training and supervision of future professionals, in provision of services through telepractice, and in consultation models and in research endeavors. Keywords:

intervention strategies; technology; supervision; video conferencing; telepractice

ell phones, blogs, Bluetooth technologies, instant messages, Blackberries, and iPhones—the world in which people live is one in which it is possible to be “wired” and “connected” from anywhere at any time. People’s lives have been transformed by the explosion in technologies that allow one to search the Internet while sitting on a park bench, instantaneously take and send photos to friends, and “chat” with people across the world, literally within the palms of their hands. A survey indicates that 97% of the college students of the “millennial” generation (those born between 1983 and 1994) own a computer and 94% own a cell phone (Junco & Mastrodicasa, 2007). This generation of technology users is referred to as “digital natives” in that digital technologies have been in existence for their entire lives. Yet surveys on technology use within the field of communication sciences and disorders reveal a much different view of the extent and nature of digital technology use in training and service delivery. A search of the American Speech-Language-Hearing Association’s (ASHA) Web site indicates that 22 of 243 ASHA-accredited programs in speech-language pathology offer some online course work, and only 6 offer all required course work online. Furthermore, 9 out of 71 audiology programs offer some course work online (www.asha.org). In terms of how the disciplines use digital technology in service delivery, ASHA conducted a survey of members to determine use of telepractice for service delivery. Of the 1,667

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respondents, 11% reported using telepractice to deliver services (ASHA, 2002). According to the ASHA (2002) Survey Report on Telepractice, the most frequently used technology for telepractice was “telephone (93%), followed by e-mail (74%); web-based information/resources (40%); web-based conferencing such as streaming video, bulletin board, or chat room (13%); and video teleconferencing (8%)” (p. 11). These statistics are not to imply that our disciplines are lacking in the use of digital technologies. Advances in certain technologies have affected the way hearing and speech professionals diagnose and treat clients with suspected communication disorders. The area of augmentative alternative communication has benefited from advances in computer programming, interface design, and digital voice synthesis. Digital imaging systems have allowed for the improved visualization of vocal structures as employed in voice and swallowing protocols. Audiology has realized the growth in digital technologies in the advancement of programmable digital hearing aids, along with amazing advancements in cochlear implants and assistive technologies. Certainly researchers have come to employ a variety of advanced technologies in the expansion of the knowledge base of communication sciences and disorders. This article attempts to encourage the consideration of digital videoconferencing (DVC) as another technological tool in advancing the work of our discipline.

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DVC Videoconferencing refers to the real-time sharing of video and audio information between two or more points. Videoconferencing allows persons to communicate synchronously while being able to view the person at the other location. Beginning in the 1980s, videoconferencing has been accomplished through digital means, yielding a higher quality and efficiency of transmission as compared to earlier analog methods. Earlier transmission methods of DVC often required ISDN (integrated services digital network) lines, which are dedicated lines for the transmission of the audio and video data. ISDN lines have an associated cost for installation and usually require a usage fee similar to a telephone line. With the expansion of the Internet and the availability of higher bandwidths, videoconferencing over IP (Internet protocol) or Webbased videoconferencing has become increasingly popular. Videoconferencing over IP refers to transmitting video and audio data in real time over the Internet. This method of transmission has the benefits of no added costs and accessibility in that many locations have access to the Internet. A major disadvantage is that the available bandwidth is shared with other users and transmission quality may be inconsistent. Regardless of transmission methods, there are generally three types of videoconferencing: (a) desktop conferencing, (b) group conferencing, and (c) broadcast conferencing. Desktop conferencing typically involves â&#x20AC;&#x153;video chatsâ&#x20AC;? between two persons and employs a Webcam, computer, and Internet connection. This type of conferencing typically provides a headshot of the people involved and can be of limited audio and video quality. The benefits of this type of videoconferencing are that it is inexpensive (Webcams averaging costs of less than $50) and accessible in that a number of Internet service providers offer software and hosting to allow for desktop videoconferencing. Desktop videoconferencing is readily used for social exchanges between friends and family members, for collaboration between professionals, and to conduct interviews. The next level of DVC is group conferencing. As the name implies, this type of conferencing allows for group meetings of more than two people. If more than two locations are involved, it is referred to as multipoint conferencing. The group size to be accommodated depends somewhat on the equipment and available bandwidth for transmission. That is, group-level conferencing often requires dedicated videoconferencing equipment and high bandwidth connections. The larger the groups, the greater the equipment costs and the higher the bandwidth needs.

The equipment costs begin at approximately $3,000 for each unit (in most cases, a unit is required at each end) and can increase substantially. The units are self-contained and generally do not require a computer. It is important to consider needs and resources in selecting a dedicated videoconferencing unit. The advantages of group-level videoconferencing include improved video and audio quality, remote control of far camera (e.g., the ability to control the view of the other site), and expanded viewing area. Refer to Dudding and Justice (2004) for a more complete description of the technologies. The third type of conferencing, referred to as broadcast conferencing, requires substantial financial and technical support. Although there are viable uses of broadcast conferencing within communication sciences and disorders, it is not the subject of discussion in this article.

Preservice Application of DVC ASHA has published the Speech Language Pathology Educational Summit Proceedings (Robinson, Creaghead, Hooper, Watson, & McNeilly, 2007), which highlights the issues facing graduate programs in speech-language pathology. The report recognizes fiscal constraints of graduate programs as limiting recruitment of PhD level faculty, student enrollment, and program innovation. Those same proceedings recognize that technology has a role in transforming our graduate programs to meet the changing future needs of our students, faculty, and clients. The proceedings suggest that alternative teaching models, including distance education, could meet the needs of our increasingly diverse student population. The proceedings also recommend increased student training in technology, increased use of simulations in academic and clinical training, and research on the pedagogy involved in the use of technologies for student training. DVC offers some solutions in terms of training and education of our graduate clinicians in both academic and clinical preparation. DVC is frequently used for teaching at a distance. This application requires either high-level group conferencing or broadcast conferencing technologies. The technology allows for instructors and students separated by space to meet and share a meaningful learning experience and to engage in cooperative learning (Bates, 2005). Research suggests that the application of DVC technology for teaching has proven benefits (Bates, 2005; Brown & Leidholm, 2002; Gillies, 2008; GuriRosenblit, 1999). Videoconferencing provides greater accessibility, flexibility, and efficiency (Bates, 2005; Gillies, 2008). Its limitations are related primarily to technology failures, limited flexibility, and restricted

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pedagogical styles (Bates, 2005; Darabi, Sikorski, & Harvey, 2006; Gillies, 2008; Laurillard, 2002). Technology failures or poor quality of audio or video transmission may limit the social presence experienced in videoconferencing (Gillies, 2008). Videoconference is somewhat limited in its flexibility in that it requires students to be at a certain location at a designated time. Another limitation occurs when instructors continue to maintain the same pedagogical format (i.e., lecture) without a realization of the importance of interaction with the students (Laurillard, 2002). Those interested in delivering academic content via DVC are directed to resources on pedagogical “best practices,” such as Videoconferencing in Higher Education (Pitcher, Davidson, & Napier, 2000) and the Videoconferencing Cookbook (http://www.vide .net/cookbook/cookbook.en/). For programs that are not formally engaged in distance learning, videoconferencing can be incorporated into traditional classrooms. “Guest speakers” can be incorporated into courses through videoconferencing technologies. It is an efficient means of allowing interaction between experts in the field and students in the classroom. In the case where the expert does not have access to the equipment, the program may opt to send loaner equipment through a shipping company. This usually proves more economical than providing travel expenses for the speaker. In the area of clinical preparation, DVC has been successfully used in supervision (i.e., e-supervision) of graduate clinicians in off-campus clinical placements (Dudding, 2006a, 2006b). E-supervision allows for a certified clinician to supervise, in real time, a graduate clinician providing intervention at a site at a distance from the supervisor. Dudding’s (2006a, 2006b) research findings suggest that students involved in e-supervision report similar experiences with traditional and videoconferencing methods of supervision. Findings further suggest that the supervisory relationship was the key influence on the students’ perceptions of the supervisory process regardless of the technology employed. E-supervision is supported in the recently revised ASHA position statement, “Clinical Supervision in Speech Language Pathology” (ASHA, 2008). The application of DVC for supervision has positive implications for increasing the availability of practicum sites and in serving a more diverse group of students, including clientele that may not otherwise receive services (e.g., persons from rural areas), along with the potential to realize financial efficiencies. The same technologies offer increased opportunities for observation of unique and diverse settings. A videoconferencing unit placed within an operating room

would allow audiology doctorate students to observe cochlear implantation. The technology could allow students to observe an experienced practitioner provide intervention on a Native American reservation. Through DVC, a researcher in England could share a recently developed protocol for accessing infant vocalizations with a group of students in the United States. These experiences are highly prized yet are often difficult to arrange logistically. With the use of videoconferencing equipment and an Internet connection, these opportunities can become available to a greater number of students.

In-Service Application of DVC The use of DVC technologies is not limited to universities and training programs. Given the availability and affordability of the technologies, practitioners can benefit from DVC for service delivery, consultation, supervision or mentoring, and professional development. ASHA has adopted the term telepractice to describe the provision of services and related activities (i.e., education and supervision) that occur through telecommunications technology (ASHA, 2005). As cited earlier, an ASHA survey of telepractice revealed that 11% of practitioners in speech-language pathology and audiology engage in some form of telepractice. Although telepractice is relatively new to audiology and speech-language pathology, telemedicine and telehealth are well-established practices in related fields of health care. There are a number of telepractice organizations, such as American Telemedicine Association, the International Society for Telemedicine, and the Association of Telehealth Service Providers. Additionally, the Health Resources and Service Administration within the U.S. Department of Health and Human Services (www.hrsa.gov/telehealth/) offers information, resources, and funding aimed at increasing the use of telehealth practices to underserved populations. Within the disciplines of audiology and speech pathology, telepractice is being used to address the shortage of qualified personnel in public schools (Forducey, 2006; Polovoy, 2008). An increasing number of school districts are contracting with university and private practitioners to offer services to children through telepractice who may not otherwise receive services. Although not without challenges, these programs are expanding across the country (Polovoy, 2008). Speech-language pathologists are using telepractice in home health venues in New York City to provide services to people who cannot travel to clinics or outpatient centers (Carpenedo, 2006). Krumm (2005) asserts that “aural rehabilitation, digital

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hearing aid programming, and cochlear implant programming or mapping also could be achieved through telepractice technology with few software modifications” (p. 22). Practitioners are providing voice intervention to military personnel at remote military medical facilities (Mashima & Holtel, 2005). DVC has great potential in providing follow-up to services provided at a clinic or medical facility. Consider the scenario of a child who has undergone cochlear implantation at a regional medical center and is then discharged to home more than 3 hours from the hospital. The home community does not have the trained personnel to provide follow-up services for this child and his or her family. Through videoconferencing technologies, the professional at the medical center could provide periodic follow-up consultation without the family bearing the expense and inconvenience of a trip to the medical center. Consultation and coordination of services with other professionals involved with the child’s care would also be possible. The consultative model of telepractice has implications outside the service delivery arena. DVC technologies can provide opportunities for consultation between colleagues in areas of research interests, business practices, and project development. It has great potential as part of a formal mentoring program aimed at fostering professional growth and leadership within the profession. ASHA currently sponsors two mentoring programs, one for students and one for new researchers. These programs incorporate e-mail communication. Webbased teleconferencing could be readily incorporated into these existing models of mentorship. Consider the benefits of Web-based DVC to professionals in the clinical fellowship year as they continue to develop clinical and professional skills. New graduates often find themselves employed in a setting in which they are the lone communication disorders specialist. DVC could offer the kind of emotional and professional support needed to make the experience positive for all parties. DVC is not just for the new professional or the “technowizard.” It is well within the realm of experience for the majority of communication sciences and disorders professionals participating in professional development activities. DVC offers opportunities to participate in live events with other participants located at vast distances from one another. Many professionals have participated in “Webinars” that may have included videoconferencing technologies. Platforms such as Elluminate and Wimba allow for Web-based meetings that include text, audio, and video options that are very user friendly. The advantages of DVC for professional development are similar to those cited in earlier applications of the technologies:

accessibility, real-time interaction, and efficiency of time and money.

Research Applications of DVC Research is yet another area of our disciplines that can find benefit in the use of DVC. It allows for collaborative research endeavors without the limitations imposed by distance. That is, a researcher in the Middle East can share information and data with a colleague in the United States without the need for extensive travel. Accompanying technologies such as “store and forward” and streaming servers allow for sharing of still and video images. Remote monitors could allow measurement of client performance at a distance. Researchers would have the opportunity to observe participants in natural environments and collect data without the effects of researcher presence. They could document outcomes of intervention within the home environment. The possible applications of DVC as a research tool are as vast as the number of research studies being conducted. It requires a basic understanding of the technology, planning, and organization of resources to make it successful.

Conclusion The disciplines of audiology and speech-language pathology are based on human interaction. With the advances in digital technologies and the ubiquitous Internet, DVC becomes a viable option for allowing that interaction to occur across distances. DVC can occur at varying levels, requiring differing technologies, support, and funding. Educators, practitioners, and researchers in communication sciences and disorders are encouraged to consider the application of DVC in the training and supervision of future professionals, in provision of services through telepractice, and in consultation models and in research endeavors.

References American Speech-Language-Hearing Association. (2002). Survey report on telepractice use among and audiologists and speechlanguage pathologists. Rockville, MD: Author. American Speech-Language-Hearing Association. (2005). Speechlanguage pathologists providing clinical services via telepractice: Technical report. Rockville, MD: Author. American Speech-Language-Hearing Association. (2008). Clinical supervision in speech-language pathology. Rockville, MD: Author.

182 Communication Disorders Quarterly Bates, A. W. (2005). Technology, e-learning and distance education. Abingdon, UK: Routledge. Brown, B., & Liedholm, C. (2002). Can Web courses replace the classroom in principles of microeconomics? American Economic Review, 92(2), 444–448. Carpenedo, D. J. (2006). Telepractice in the city: The story of the Visiting Nurse Service of New York home care. ASHA Leader, 11(14), 10–11. Darabi, A., Sikorski, E., & Harvey, R. (2006). Validated competencies for distance teaching. Distance Education, 27(1), 105–122. Dudding, C. D. (2006a). Distance supervision: An update. ASHA Division 11 Perspectives, 16(1), 16-18. Dudding, C. D. (2006b). The use of videoconferencing for supervision of graduate students. In (Eds.) C. Howard, J. V. Boettcher, L. Justice, K. Schenk, P. L. Rogers, and G. A. Berg (Eds.). The encyclopedia of online learning and technology. Hershey, PA: The Idea Group. Dudding, C. D., & Justice, L. (2004). An e-supervision model: Videoconferencing as a clinical training tool. Communication Disorders Quarterly, 25(3), 145–151. Forducey, P. (2006). Speech telepractice program expands options for rural Oklahoma schools. ASHA Leader, 11(10), 12–13. Gillies, D. (2008). Student perspectives on videoconferencing in teacher education at a distance. Distance Education, 29(1), 107–118. Guri-Rosenblit, S. (1999). Distance and campus universities: Tensions and contradictions. Kidlington, UK: Elsevier Science.

Krumm, M. (2005). Audiology telepractice moves from theory to treatment. ASHA Leader, 10(15), 22–23. Laurillard, D. (2002). Rethinking university teaching (2nd ed.). London: Routledge Falmer. Mashima, P. A., & Holtel, M. R. (2005). Telepractice brings voice treatment from Hawaii to Japan. ASHA Leader, 10(15), 20–21, 25. Junco, R., & Mastrodicasa, J. (2007). Connecting to the net.generation: What higher education professionals need to know about today’s students. Washington, DC: NASPA. Pitcher, N. D., Davidson, K., & Napier, J. G. (2000). Videoconferencing in higher education. Innovations in Education and Training International, 37(3), 199–209. Polovoy, C. (2008). Telepractice in schools helps address personnel shortage. ASHA Leader, 13(9), 22–24. Robinson, T., Creaghead, C., Hooper, C., Watson, J., & McNeilly, L. (2007). Speech Language Pathology Education Summit proceedings. Rockville, MD: American Speech-Language-Hearing Association.

Carol C. Dudding, PhD, is an associate professor and director of clinical education in the Communication Sciences and Disorders program at James Madison University. Her current interests include instructional technology, clinical education, and supervision.

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