How can E-Learning Pedagogy be applied in Nutrition and Dietetics courses?

Our School plays an important role in the professional training of dietitians.  How can e-learning pedagogy help in the provision of nutrition and dietetics courses? To understand this area, the E-Learning Team interviewed Dr Ma Wendy Lynn, Senior Programme Director of College of Life Science and Technology, on Monday, 10 June 2019.  She shared her experience in and valuable best practices of the use of Virtual Reality (VR) in the Dietetics programme. Below is a record of our conversation.
How is E-Learning Employed in Dietetics Courses?
Recently, VR has been added as a novel teaching mode in our Postgraduate Diploma in Dietetics programme. We were very fortunate to work with the E-Learning Team to develop a VR application for our dietetic students who are preparing for clinical placements in hospitals. This application is designed to develop students’ clinical practice knowledge and observation skills through a number of case scenarios. With the employment of VR technology, students are able to ‘walk through’ the processes of advising a client/patient in an outpatient setting. Case scenarios cover patients of various ages such as an infant, a young child, a middle-aged white-collar worker, and an elderly person with various problems.
In this application, a student will ‘experience’ what it is like to be advising a client from the viewpoint of a dietitian. The student will lead the patient through a set of checking processes.  For example, they will take the patient through the correct identity verification process in order to avoid any clinical error, take a set of anthropometric measurements such as body weights and heights so as to calculate body mass indices and, where appropriate, measure body fat percentages. Students are each provided with a VR headset; they are able to select cases to view and work through. Students are asked to make decisions at each step of the consultation process; the application will provide them with feedback on whether their selection is correct or not. An explanation is offered when the selection is incorrect. Therefore, students are able to learn and ‘experience’ what it is like to walk into a clinic, ‘use’ different kinds of clinical equipment, and observe the dietetic consultation. For example, infants cannot be weighed on scales designed for adults and there are special techniques needed to accurately measure an infant’s length. Another example is if an elderly patient has a pacemaker, certain kind of equipment should not be used to measure their body fat. Thus, students will learn to make the correct choice of equipment and the application responds based on the selection.
In the virtual environment, students will be able to feel what it’s like when a dietitian asks questions, fully immersing themselves in the dietitian-patient interaction, and the dietetic advice at the end of a consultation session. Students find this experience really useful, particularly for those who have never been in a clinical setting before.
Students learn with the use of VR application
Students learn with the use of VR application
In our programme, we arrange a one-day clinical attachment for our students. Each student spends a whole day in the hospital in the early stage of their studies. In the past, our students did not really know what they were observing when they went on clinical attachment in the early stages of their studies because the attachment was new to them. Now, with VR application in place, students can be better prepared and have more confidence to start their clinical placements and enrich their learning processes.
Debriefing sessions are conducted after students have completed each VR case. Students are taught to strengthen their observation skills which are important to their learning when they are on placement. Students need to understand the reasons why certain questions are asked and why the dietitian responds in a certain way. We have to integrate critical thinking into our training too. Students are trained to have good observation skills that are vital to a professional dietitian. With this application, students find that they can benefit a lot as they practise observation continuously.
Another advantage of the VR introduction is that practice and preparation for students can be carried out in groups instead of in a one-on-one mode. It saves a lot of time and the training practice becomes much more efficient and effective.
Furthermore, students like technology. We developed the prototype of the application and asked students for feedback. We improved the prototype according to their comments. Student feedback was very important in enhancing the tool to ensure that it would meet students’ learning needs and be user-friendly.


How do you plan to use VR in your programmes?

My original plan was to use VR as a tool to help students “feel” and “practise” before they commenced placement. However, I am now considering using this technology in two phases:

  • Before students’ clinical attachments, which helps develop their observation skills and enables them to benefit more from the attachment; and
  • On students’ clinical placements.

It is my hope to, in the future, set up a VR application using in-patient hospital settings, though it will be more complicated and certainly involve more investment.


What are the challenges encountered?

Finding time to write scripts for each case scenario was the most challenging task for me. I had to develop different cases from the course contents with the various intended learning outcomes achieved. It was really time consuming.


How long did it take to prepare for this VR tool?

It took around one year from scratch to the final deliverables.


What is your advice to Programme Teams who are considering incorporating E-learning into their programmes?

They should be very clear about their aims and objectives. Technology may be alienating to them, the E-Learning Team is always ready to help and give them guidance and support.


What do you want to improve in your programme by using e-learning?

As mentioned before, I would like to develop an in-patient VR application.  However, it will be very challenging in terms of material resources, scenario designs, and financial implications. To develop an in-patient setting, we need to film/photograph a hospital ward with inmates in bed.
With a simulated in-patient environment, we are able to teach students what to do with the provision of dietetic consultations to patients in a hospital ward and what to look for on assessing patients. Information collection in a ward setting is quite different from outpatient settings and dietitians must vary their skills and tactics. Patients may either be sitting out or lying down during the information collection process. Dietitians need to conduct full nutritional assessments and may include nutrition-focused physical examinations. Certainly, this in-patient VR setting will be more complicated to develop but more beneficial to students with little or no experience in hospital settings.


As a teacher, what are the benefits of using technology in your teaching, and what are the challenges?

Using technology in teaching replicates and provides a simulated environment similar to the one that students will face in the future. It not only gets students prepared for difficult situations with supported details, but also helps build their confidence in dealing with their patients and handling equipment.
My major concern is what if the technology fails during class.  In the early stages, I was fortunate to have on-site support from the School’s E-learning Team for fixing issues that arose in class.  Now, we are more familiar with the VR equipment and are capable of using it without on-site support. In addition, more user-friendly and easy-to-use equipment has been put into operation.

Dr Wendy Ma's photo
Dr Wendy Ma