Effect of a remote facilitator on small-group problem solving: Potential uses of two-way video technology in decentralized medical education

Background: As more of medical education becomes decentralized to off-campus sites, the ability of campus faculty to monitor the development of student problem-solving skills becomes more limited. Purpose: This study addressed the acceptability of providing a remote facilitator by telephone or full-motion interactive video, as well as measuring the effect on group process in each of the three facilitator arrangements. Methods: Three groups of clerkship students were facilitated first on site, then by interactive video, then by telephone only. Results: Both off-site methods proved acceptable, but students felt that they increased their content knowledge more in on-site and video sessions. There were no differences in group interactions. In the on-site and telephone groups, the facilitators tended to be the predominant questioners; in the video group, the students asked more questions of the facilitator. Conclusions: In the sequence used, interactive video technology had the same or more positive effects on measured variables when compared to an on-site facilitator.