With the increasing availability of synchronous video-based breakout rooms within online courses, a growing need exists to understand how to best leverage this technology for enhanced online education. To help address this challenge, this paper reports on a case study that explored student activity within online video-based breakout rooms via a Structured Paired Activity (SPA) methodology. SPA, which is adapted from the concept of Paired Programming, defines a general way to structure roles and activities for the participants within the breakout room. Initial qualitative results suggest that the use of SPA in online breakout rooms increases student engagement and process effectiveness. These results are potentially applicable to a broad range of web-based synchronous online courses.