Introducing E-learning in Epidemiology Course for Undergraduate Medical Students at the Faculty of Medicine, University of Belgrade: A Pilot Study

Comprehensive qualitative evaluation of the first ever full-time online course for medical students in one middle-income country

The measures to control the COVID-19 pandemic in the academic 2020/2021 included full-time online courses for medical students in Serbia for the first time since the faculty was founded in 1920. The purpose of this study was to examine the attitudes and opinions about the full-time online course among medical students and their teachers. A qualitative study was carried out in the autumn of 2021. In-depth interviews were conducted with 38 participants (27 students in the 4th study year and 11 teachers who teach in the 3rd study year) about their experiences in the past academic year. To select study participants, purposive sampling was employed. The interviews were audio-recorded and transcribed verbatim. Qualitative content analysis was applied. Five topics emerged: 1) Theoretical online learning, 2) Practical online learning, 3) Motivation, 4) Technical aspects of online learning and 5) Evaluation of knowledge. Overall, students' attitudes toward theoretical classes were mostly negative, but the attitudes of teachers were mostly positive. However, the attitudes of both students and teachers toward practical online classes were mostly negative. Students were, in general, less motivated to follow online classes compared to conventional courses, even though the teachers felt that they had to put more effort into making a suitable online course. Most participants considered that the online classes had a negative impact on their knowledge and practical skills, but their academic achievement was not inferior compared to previous years. The full-time online course should include conventional on-site teaching. The relevance of acquiring practical skills is strongly emphasized.

The Integration of Prelaboratory Assignments within Neuroanatomy Augment Academic Performance, Increase Engagement, and Enhance Intrinsic Motivation in Students

The study of neuroanatomy imposes a significant cognitive load on students since it includes huge factual information and therefore demands diverse learning strategies. In addition, a significant amount of teaching is carried out through human brain demonstrations, due to limited opportunities for cadaveric dissection. However, reports suggest that students often attend these demonstrations with limited preparation, which detrimentally impacts their learning. In the context of student learning, greater levels of engagement and intrinsic motivation (IM) are associated with better academic performance. However, the maintenance of engagement and the IM of students in neuroanatomy is often challenging for educators. Therefore, this study aimed to explore the role of prelaboratory assignments (PLAs) in the improvement of academic performance, augmentation of engagement, and enhancement of IM in occupational therapy students enrolled in a human neuroanatomy course. One cohort of students in the course was expected to complete PLAs prior to each brain demonstration session. The PLAs contained a list of structures, and students were expected to write a brief anatomical description of each structure. Another cohort of students who were not provided with similar PLAs constituted the control group. Students who completed PLAs had a higher score on the final examinations as compared to students who were not required to complete PLAs. These students also demonstrated greater engagement and IM, and indicated that they perceived PLAs to be valuable in the learning of neuroanatomy. Therefore, PLAs represent a useful teaching tool in the neuroanatomy curriculum.

Learning How to Order Imaging Tests and Make Subsequent Clinical Decisions: a Randomized Study of the Effectiveness of a Virtual Learning Environment for Medical Students

RATIONALE AND OBJECTIVES

Two critical skills that medical students must acquire during undergraduate education are the ability to order imaging tests and make clinical decisions based on their results. We implemented an e-learning course in Moodle specifically designed to teach these skills to medical students. The aim of this study was to assess the effectiveness of our course.

MATERIAL AND METHODS

We randomized 26 undergraduate medical students to an experimental group that had access to the virtual learning environment and a control group that did not. Three weeks after the course, we evaluated its effectiveness through a blinded objective structured clinical examination. To avoid any bias in favor of the experimental group, the assessment considered scores on two pre-specified subscales: one related to the contents of the course and the other to new clinical scenarios.

RESULTS

Students that completed the e-course performed better overall than controls (mean score ± standard deviation 59.3 ± 6.2 vs 41.8 ± 10.2, p = 0.0020). This better performance was observed in both types of skills assessed (ordering imaging tests, and making diagnostic and therapeutic decisions based on test results). More importantly, this better performance of the experimental group was observed consistently both with items related to the course content (1.7 times higher, p = 0.0034) and new scenarios (1.3 times higher, p = 0.0098).

CONCLUSIONS

Through an ad - hoc e-course, undergraduate medical students learned effectively how to order imaging tests and make optimal subsequent decisions. Moreover, they were able to apply these skills to new clinical scenarios.

Introducing an Open-Source Course Management System (Moodle) for Blended learning on infectious diseases and microbiology: A pre-post observational study

INTRODUCTION

Attendance at face-to-face courses is low in the 2nd and 3rd years of medical school in France, possibly because of a lack of interactivity. We used Moodle (an open-source course management system) to introduce blended learning on Infectious Diseases and Microbiology through interactive quizzes and sessions of online-based continuous assessment. This pre-post observational study assessed changes in students' attendance and student as well as teacher satisfaction.

METHODS

During the 2017-2018 academic session of Infectious Diseases and Microbiology, we used Moodle to include interactive quizzes during courses and to organize five continuous assessment sessions. Pre-post comparisons (2017-2018 vs. 2016-2017) were performed for the following outcomes: attendance rate, satisfaction questionnaire and exam performance. In addition, the students' and teachers' perception of Moodle-based interactive quizzes and continuous assessment sessions in 2017-2018 was assessed with Likert-like scales, closed and open-ended questions. A thematic analysis of the free comments was performed through inductive coding by two coders.

RESULTS

In 2017-2018 vs. 2016-2017, mean (±SD) attendance rate was higher [12.5 (±7.2) % vs. 7.9 (±3.5) % of students, P<0.001] and clinical case-based courses, which encompassed 93% of Moodle-based courses in 2017-18, were more frequently considered to improve teaching and learning (81.9% vs. 73.8%, P=0.01). Students more frequently judged the teaching organization and structure to be adequate (85.5% vs. 80.2%, p=0.03) and more frequently recommended to next-year students that they attend courses (96.1% vs. 42.1%, P<0.001).

CONCLUSION

Using Moodle for blended learning on Infectious Diseases and Microbiology improved student satisfaction and attendance at face-to-face courses.

Evaluation of e-learning for medical education in low- and middle-income countries: A systematic review

In low- and middle-income countries (LMICs), e-learning for medical education may alleviate the burden of severe health worker shortages and deliver affordable access to high quality medical education. However, diverse challenges in infrastructure and adoption are encountered when implementing e-learning within medical education in particular. Understanding what constitutes successful e-learning is an important first step for determining its effectiveness. The objective of this study was to systematically review e-learning interventions for medical education in LMICs, focusing on their evaluation and assessment methods. Nine databases were searched for publications from January 2007 to June 2017. We included 52 studies with a total of 12,294 participants. Most e-learning interventions were pilot studies (73%), which mainly employed summative assessments of study participants (83%) and evaluated the e-learning intervention with questionnaires (45%). Study designs, evaluation and assessment methods showed considerable variation, as did the study quality, evaluation periods, outcome and effectiveness measures. Included studies mainly utilized subjective measures and custom-built evaluation frameworks, which resulted in both low comparability and poor validity. The majority of studies self-concluded that they had had an effective e-learning intervention, thus indicating potential benefits of e-learning for LMICs. However, MERSQI and NOS ratings revealed the low quality of the studies' evidence for comparability, evaluation instrument validity, study outcomes and participant blinding. Many e-learning interventions were small-scale and conducted as short-termed pilots. More rigorous evaluation methods for e-learning implementations in LMICs are needed to understand the strengths and shortcomings of e-learning for medical education in low-resource contexts. Valid and reliable evaluations are the foundation to guide and improve e-learning interventions, increase their sustainability, alleviate shortages in health care workers and improve the quality of medical care in LMICs.

A Moodle-based blended learning solution for physiology education in Montenegro: a case study

This study evaluates the impact of web-based blended learning in the physiology course at the Faculty of Medicine, University of Montenegro. The two main goals of the study were: to determine the impact of e-learning on student success in mastering the course, and to assess user satisfaction after the introduction of e-learning. The study compared a group of students who attended the physiology course before, with a group of students who attended the physiology course after the Moodle platform was fully implemented as an educational tool. Formative and summative assessment scores were compared between these two groups. The impact of high vs. low Moodle use on the assessment scores was analyzed. The satisfaction among Moodle users was assessed by the survey. The study found that attendance of face-to-face lectures had a positive impact on academic performance. The introduction of Moodle in the presented model of teaching increased interest of students, attendance of face-to-face lectures, as well as formative and summative scores. High frequency of Moodle use was not always associated with better academic performance, suggesting that the introduction of a new method of teaching was most likely equally accepted by low- and high-achieving students. Most of the students agreed that Moodle was easy to use and it complemented traditional teaching very well, but it could not completely replace traditional face-to-face lectures. The study supports continuing the use of web-based learning in a form of blended learning for physiology, as well as for other courses in medical education.