Stress and behavioral changes with remote E-exams during the Covid-19 pandemic: A cross-sectional study among undergraduates of medical sciences

Learning Environments in Undergraduate Nursing Education During COVID-19: A Scoping Review

BACKGROUND

The COVID-19 pandemic radically changed nursing education.

PURPOSE

To map the existing literature on learning environments (LEs) in undergraduate nursing education during COVID-19 and identify the LE elements based on the 4 domains of Gruppen's conceptual framework: personal, social, organizational, and physical and virtual spaces.

METHOD

Eligible articles were reviewed using the Joanna Briggs framework.

RESULTS

The search retrieved 5003 articles, of which 80 met the inclusion criteria. Most studies were cross-sectional and conducted in the United States. Of the studies included, 68 studies focused on the personal component of students, 67 investigated physical and virtual space components, 19 examined the social domain, and 15 examined organizational aspects.

CONCLUSIONS

The COVID-19 pandemic significantly influenced the LE of nursing students. Based on the current review of LE in nursing education, nurse educators and researchers can develop interventions to maintain the quality and accessibility of nursing education in future crises.

Investigating the impact of remote neuroanatomy education during the COVID-19 pandemic using online examination performance in a National Undergraduate Neuroanatomy Competition

Neuroanatomy is a notoriously challenging subject for medical students to learn. Due to the coronavirus disease-19 (COVID-19) pandemic, anatomical education transitioned to an online format. We assessed student performance in, and attitudes toward, an online neuroanatomy assessment compared to an in-person equivalent, as a marker of the efficacy of remote neuroanatomy education. Participants in the National Undergraduate Neuroanatomy Competition (NUNC) 2021 undertook two online examinations: a neuroanatomically themed multiple-choice question paper and anatomy spotter. Students completed pre- and post-examination questionnaires to gauge their attitudes toward the online competition and prior experience of online anatomical teaching/assessment. To evaluate performance, we compared scores of students who sat the online (2021) and in-person (2017) examinations, using 12 identical neuroradiology questions present in both years. Forty-six percent of NUNC 2021 participants had taken an online anatomy examination in the previous 12 months, but this did not impact examination performance significantly (p > 0.05). There was no significant difference in examination scores between in-person and online examinations using the 12 neuroradiology questions (p = 0.69). Fifty percent of participants found the online format less enjoyable, with 63% citing significantly fewer networking opportunities. The online competition was less stressful for 55% of participants. This study provides some evidence to suggest that student performance is not affected when undertaking online examinations and proposes that online neuroanatomy teaching methods, particularly for neuroradiology, may be equally as effective as in-person approaches within this context. Participants perceived online examinations as less stressful but raised concerns surrounding the networking potential and enjoyment of online events.

Generalized anxiety disorder in Brazilian undergraduate dental students during the COVID-19 pandemic: A cross-sectional study

OBJECTIVE

Explore the prevalence of generalized anxiety disorder (GAD) and associated factors in undergraduate dental students during the first wave of the COVID-19 pandemic in Brazil.

MATERIALS AND METHODS

Cross-sectional study. A semi-structured questionnaire addressing the variables of interest was shared with dental students between July 8 and 27 2020. The outcome was determined using the seven-item generalized anxiety disorder (GAD-7) scale. A 'positive' diagnosis was defined as a total of ≥10 points on the scale. Statistical analysis involved descriptive, bivariate and multivariate analyses, with the significance level set at 5%.

RESULTS

Among the 1050 students evaluated, 53.8% had a positive diagnosis for GAD. The multivariate analysis revealed that the prevalence of symptoms was higher among individuals who resided with more than three people, those enrolled at teaching institutions that suspended all clinical and laboratory activities, those who did not have an adequate home situation to maintain distance learning, those who had been diagnosed with COVID-19, those who felt anxious about having to see patients with a suspicion or diagnosis of COVID-19 and those who preferred to interrupt in-person academic activities until the population is vaccinated for the COVID-19 virus.

CONCLUSION

The prevalence of GAD was high. Aspects related to the composition and organization of the home, the suspension of academic activities, a history of COVID-19 contamination, feelings of anxiety in providing dental care to patients with symptoms/suspected of COVID-19 infection and the preference to interrupt in-person academic activities until the population is vaccinated for COVID-19 were factors predisposing the students to anxiety during the first wave of the pandemic.

The impact of the COVID-19 pandemic on academic performance: a comparative analysis of face-to face and online assessment

Introduction

Survey studies yield mixed results on the influence of the COVID-19 pandemic on academic performance, with limited direct evidence available.

Methodology

Using the academic platform from the Italian university system, a large-scale archival study involving 30,731 students and 829 examiners encompassing a total of 246,416 exams (oral tests only) to scrutinize the influence of the COVID-19 pandemic on the likelihood of passing exams was conducted. Examination data were collected both in face-to-face and online formats during the pandemic. In the pre-pandemic period, only face-to-face data were accessible.

Results

In face-to-face examination, we observed a lower probability of passing exams during the pandemic as opposed to pre-pandemic periods. Notably, during the pandemic we found an increased chance of passing exams conducted through online platforms compared to face-to-face assessments.

Discussion and conclusions

These findings provide the first direct evidence of an adverse impact of the COVID-19 pandemic on academic performance. Furthermore, the results align with prior survey studies underscoring that using telematics platforms to evaluate students' performance increases the probability of exam success. This research significantly contributes to ongoing efforts aimed to comprehend how lockdowns and the widespread use of online platforms impact academic assessment processes.

Beyond COVID-19: the impact of recent pandemics on medical students and their education: a scoping review

INTRODUCTION

Over the past two years, coronavirus disease (COVID-19) has greatly altered medical student education as well as daily life. Medical schools across the world were disrupted and had to immediately adapt the educational experience to the online environment in order to continue the delivery of quality medical education. However, COVID-19 was not the only recent pandemic. This posed the question, were similar disruptions and adaptations also seen in recent past pandemics such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) that could have prepared medical educators for COVID-19? This scoping review investigated the educational and personal impact of recent pandemics on medical students.

METHODS

This review followed the PRISMA-ScR guidelines for scoping reviews. Nine databases including PubMed, ERIC, and EMBASE were systematically searched using keywords and subject headings related to medical students and SARS, H1N1, MERS, Ebola, Zika, and COVID-19. Studies were limited to research studies published between 2000 and 2020 and in English. Based on exclusion and inclusion criteria, all studies were independently screened by two reviewers first by the title/abstract and then via full text. Data were extracted from the included studies and analyzed qualitatively using thematic analysis.

RESULTS

A total of 174 studies fit the criteria. Seven major themes emerged from those studies: educational adaptations and online modifications, knowledge and attitudes of students, mental wellness of students, student involvement and use of telehealth, student vaccination, physical wellness of students, and stigma.

CONCLUSION

This review provided insights into how medical students were affected by recent pandemics and their perceptions of pivoting to online education, mental health, and knowledge of the diseases. Additionally, this review showcases the various educational adaptations that emerged uniquely during the COVID-19 pandemic, such as telehealth services or video conferencing tools, that can be utilized in a post-pandemic environment.

Student academic performance in non-lecture physiology topics following the abrupt change from traditional on-site teaching to online teaching during COVID-19 pandemic

BACKGROUND

During the COVID-19 pandemic, pre-clerkship medical education, including all physiology classes, was obliged to change to online teaching due to limitations of on-site (face-to-face) classes. However, the effectiveness of online teaching in non-lecture physiology topics during the COVID-19 pandemic has not been thoroughly investigated.

METHOD

We conducted a prospective study to evaluate the students' academic achievement and opinions on online teaching during the COVID-19 academic year. Academic achievement of 312 students in the COVID-19 year was compared with that of 299 students in the pre-COVID-19 year. Student opinions regarding social interactions and the preferred learning method were also collected.

RESULTS

We found that student academic achievement in the non-lecture physiology topics, assessed by summative scores, was 4.80±0.92 percent higher in the pre-COVID-19 year than in the COVID-19 year (P < 0.01, Cohen's d = 0.42). Students rated that online classes tended to reduce their interactions with peers and teachers; however, students preferred online learning over traditional on-site learning.

CONCLUSIONS

This study pointed out that students' academic performance related to the physiology topics taught by online non-lecture methods during the COVID-19 pandemic was lower than their performance when the topics were taught by the traditional (on-site) methods, although students reported that they preferred the online teaching. Hence, we suggest that medical teachers should deliberately plan and utilise a variety of tools and techniques when developing online non-lecture classes to preserve the interactivity of the classes, which might overcome this gap in students' academic performance.

Dental students' and faculty perception of online exams with e-invigilation in Cyprus

INTRODUCTION

During the recent pandemic, e-learning and e-assessment methods have been implemented worldwide, providing opportunities for further implementation in the dental curriculum. This study aims to research the dental students' and dental faculty's perceptions of online exams with e-invigilation.

MATERIALS AND METHODS

Online questionnaires were developed and delivered, after three semesters of online exams, to all students and faculty. Descriptive statistics were performed, and answers were grouped into Principal Components (PC) using Principal Component Analysis (PCA). Statistical significance was set at p < .05.

RESULTS

Two-hundred and sixty dental students (83.7%) and 24 dental faculty members (63.1%) answered the online questionnaires. PCA of students' responses revealed 4 PC, 'University support to students', 'Comparison between online and face-to-face exams', 'Preparation for the online exams' and 'Attitudes towards the technology used for the online exams'. PCA of faculty responses revealed 5 PC: 'Comparison between online and face-to-face exams', 'University support to faculty', 'Faculty attitudes towards the exam procedures', 'Human factors associated with the exam procedures' and 'Exam invigilation'. The overall satisfaction was high for both staff and students (higher for students and female staff). Students with previous experience in online exams scored more positively than first-year students. University support, process-related stress and e-invigilation were highlighted.

CONCLUSIONS

The overall satisfaction with the e-exams was high, despite the technical problems, time-consuming processes and related stress. University support (training, IT support and resources) and mock exams emerged as important elements of online exams, as was the e-invigilation, which students perceived as efficient and non-intrusive.

Knowledge and attitude toward oral health behavior of overseas students during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has impacted overseas students, including their oral health. Due to movement restrictions, limited living allowances, dental treatment costs, and health insurance fees, overseas students might be more concerned about their oral health. The objective of the present study was to determine the association of knowledge and attitude toward oral healthcare behavior of overseas university students staying in Thailand between January 2020 to July 2022 and explore the experiences of their oral health problems.

METHODS

A cross-sectional study was conducted using an online survey in English operated through the Google platform by convenience sampling among overseas Chulalongkorn University students. A newly developed self-administered questionnaire on knowledge and attitude toward oral health-related behavior and experiences in oral health problems was completed voluntarily. Descriptive statistics, Chi-square test, t-test, ANOVA, and Pearson correlations were employed using IBM SPSS version 29.

RESULTS

Of 311 overseas students, 55.6% were male. The average age of students was 27.5 ± 4.5 years. 68.81% of students were from ASEAN countries, and 73.31% studied in non-health science programs. The study fields, health and non-health sciences, were associated with knowledge score (p < 0.001) and attitude score (p = 0.004), whereas the type of health insurance had an association with behavior score (p = 0.014) and the student's perspective about dental visits (p = 0.014). Three hundred fifty-nine cases of oral health problems were experienced by 47.3% of overseas students. These problems consisted primarily of tooth hypersensitivity (21.2%), gingivitis (15.3%), caries (14%), cracked or broken tooth (10%), severe toothache (9%), fallen out filling (8%), and wisdom tooth pain (7.8%). There was an association between oral healthcare behavior and oral health problems (p < 0.001), and a negative correlation was found between behavior score and the number of oral health problems (p < 0.001, r=-0.204).

CONCLUSION

The oral healthcare habits of overseas university students correlated positively with knowledge and attitude. A negative correlation was observed between behavior and the number of oral health problems. Furthermore, studying in health science programs impacted students' knowledge and attitude toward oral health, while dental treatment coverage insurance affected decisions for dental visits.

Online laboratory practices and assessment using training and learning activities as teaching methodologies adapted to remote learning. Student satisfaction and improved academic performance

This article presents new teaching methodologies implemented in subjects in the Ground Engineering Area. Specifically, it focuses on a series of activities carried out due to the appearance of the COVID-19 pandemic that resulted in restrictions on class attendance. The new teaching methodologies brought about substantial changes in the way students learn and are assessed. For the practice sessions, a series of videos were prepared so students could attend and take part in the laboratory practices remotely. As regards the final theory exam, a comprehensive multiple-choice question bank was made available to students prior to the exam to consolidate the concepts seen in the master classes, which we call training and learning. We evaluated the impact of these new methodologies, implemented during two academic years, through the analysis of voluntary and anonymous student surveys and a series of indicators related to the results of the final exams. After analyzing the impact of the new teaching methodologies, we conclude that students are positive about the video experience for laboratory practices, but only as a complementary activity to in-person laboratory sessions. The students also stated that they would like the multiple-choice question bank to continue to be available in successive academic years. Improvements in the final grades of the theory exams demonstrate the success of this new teaching methodology.

The COVID-19 related stress and social network addiction among Chinese college students: A moderated mediation model

Based on social cognitive theory and gender differences, this study verified a moderated mediation model to explore the relationship between the COVID-19 related stress (CRS) and social network addiction (SNA) and evaluate the mediating role of fear of missing out (FoMO) and the moderating role of gender. A questionnaire survey was conducted, including 702 Chinese university students.This study used PROCESS to test the hypothesis model.The results showed that the CRS significantly and positively affected the SNA of college students and FoMO played a complementary mediating role. Moreover, the analysis of the moderated mediation model showed that gender moderated the relationship between FoMO and SNA; the effect of FoMO was stronger on the SNA of male college students than that of females. The results not only enhanced our understanding of the internal influencing mechanism of the relationship between CRS and SNA but also considered gender differences. In addition, some suggestions were proposed.

Anxiety and heart rate in a real-life class test in undergraduates choosing real-time or prerecorded oral presentations

Most studies on acute stress stem from works conducted under artificial laboratory conditions. Inducing stress for experimental scrutiny is problematic and can be unethical. In this study, a 'research methods' course's curriculum included a demonstration study testing anxiety and heart rate responses to the midterm test. Fifty-four university students (35 males and 19 females) presented a research topic in-person (n = 14) or prerecorded while being present (n = 40). Students selected a test format they could change until the week before the midterm test. The measures were trait anxiety, test anxiety, state anxiety, heart rate (HR), the last two being measured before and after examination, and grades. All students manifested decreased state anxiety and increased HR from before to after the test. Females exhibited higher HR and state anxiety than males. Real-time presentations were associated with higher HRs but not higher state anxiety. Those who changed their planned presentation mode from in-person to prerecorded exhibited higher test anxiety but not trait anxiety than those who presented as planned. Students who presented in-person obtained lower grades than those who prerecorded their presentations. Grades were negatively correlated with state anxiety after the test, but test anxiety did not significantly mediate the grades. Pre-test state anxiety was positively associated with both trait anxiety and test anxiety. The findings suggest that test anxiety is unlikely to affect grades, but test-anxious students need more control over academic evaluation. A choice in test format could be helpful in this regard.

Initial impacts of the COVID-19 pandemic on tobacco use among college students in California

Objective: To evaluate the change in tobacco use by college students in California during the COVID-19 pandemic. Participants: Young adults (18-24 years) currently enrolled in a California college or university (N = 212). Methods: Students recruited through social media posts and by student tobacco advocate members completed an online survey of 59 questions in Spring 2021. Results: Almost 80% of current tobacco users reported a change in tobacco use during the pandemic. Most current tobacco users who changed their tobacco use reported an increase in use during the pandemic (43.2%) and 38.7% reported a decrease in use. Conclusion: As a result of COVID-19, many college students changed their tobacco use. As students return to campus and COVID-19 regulations are lifted, this may be an ideal time for prevention and cessation messages, which could include information on health risks associated with tobacco and e-cigarette use, and healthy methods for stress reduction.

Attitudes toward mathematics/statistics, anxiety, self-efficacy and academic performance: an artificial neural network

Mathematics and statistical skills are crucial to daily life. However, many students found mathematics difficult to learn and understand. This research aimed to find relationships between mathematics and statistical attitudes and emotional dimensions, such as anxiety or self-efficacy. The sample consisted of two groups: the first group was formed by 276 Spanish students (75.7% female with an average age of 19.92 years) from different degrees at the University of Granada and the second one by agroup of 19 secondary school students from of a Secondary School in Granada, Spain (57.9% male students between 14 and 16 years of age from a public school). The instruments applied were a scale of attitude toward mathematics, a scale of attitude toward statistics, a scale to assess mathematical anxiety, and a scale to assess self-efficacy. An artificial neural network for the backpropagation algorithm was designed using dependent variable. The results showed a negative impact of anxiety on those attitudes, while self-efficacy had a positive impact on those mentioned attitudes. Therefore, emotional education is important in the well-being, and teaching in mathematics. The usefulness of the innovative neural network analysis in predicting the constructs evaluated in this study can be highlighted.

The adoption of non-pharmaceutical interventions and the role of digital infrastructure during the COVID-19 pandemic in Colombia, Ecuador, and El Salvador

Adherence to the non-pharmaceutical interventions (NPIs) put in place to mitigate the spreading of infectious diseases is a multifaceted problem. Several factors, including socio-demographic and socio-economic attributes, can influence the perceived susceptibility and risk which are known to affect behavior. Furthermore, the adoption of NPIs is dependent upon the barriers, real or perceived, associated with their implementation. Here, we study the determinants of NPIs adherence during the first wave of the COVID-19 Pandemic in Colombia, Ecuador, and El Salvador. Analyses are performed at the level of municipalities and include socio-economic, socio-demographic, and epidemiological indicators. Furthermore, by leveraging a unique dataset comprising tens of millions of internet Speedtest® measurements from Ookla®, we investigate the quality of the digital infrastructure as a possible barrier to adoption. We use mobility changes provided by Meta as a proxy of adherence to NPIs and find a significant correlation between mobility drops and digital infrastructure quality. The relationship remains significant after controlling for several factors. This finding suggests that municipalities with better internet connectivity were able to afford higher mobility reductions. We also find that mobility reductions were more pronounced in larger, denser, and wealthier municipalities.

Supplementary Information

The online version contains supplementary material available at 10.1140/epjds/s13688-023-00395-5.

Dental education profile in COVID-19 pandemic: A scoping review

INTRODUCTION

This scoping review aimed to determine the frequency of different teaching methodologies, tools and platforms applied in dental education during the COVID-19 pandemic.

MATERIALS AND METHODS

The search strategy was performed in six databases and grey literature. A total of 28 questionnaire-based studies were included, without language or time restriction, from 20 different countries.

RESULTS

Six thousand five hundred sixty-five participants were assessed: 84% undergraduates, 9% of faculty members, 5% of postgraduate students/residents/trainees and 2% of dental schools/residency programs. The pooled eligible data for teaching methodologies were 62% of a combination of different methods (95% CI, 35.5% to 82.3%), 23% a combination of synchronous and asynchronous formats (95% CI, 8.2% to 50.2%) and 15% for only synchronous lectures (95% CI, 4.3% to 42.2%). The reported tools were laptops (40%), smartphones (40%), tablets (40%), desktops (20%), Blackboard (20%), Respondus Lockdown Browser (20%), eProctor (20%) and PowerPoint (20%). The most used platforms were Zoom (70.6%), Microsoft Teams (23.5%) and Cisco Webex (23.5%). A better time management (17.9%; 95% CI, 7.9% to 35.6%) and the possibility of revision with additional notes (14.3%; 95% CI, 5.7% to 31.5%) was the greatest advantages related to dental e-learning, while the increased levels of anxiety/stress/burnout/exhaustion (35.7%; 95% CI, 21% to 54.2%) and internet connection problems (35.7%; 95% CI, 21% to 54.2%) was the most cited disadvantages.

CONCLUSION

This scoping review showed promising blended teaching methodologies, tools and platforms in the dental education profile. The evidence suggests that e-learning technologies can widely contribute to dental education during the COVID-19 pandemic. Therefore, this study makes a major contribution to research by assessing the impact of COVID restrictions on dental education and further studies are needed to identify how restrictions in dental practice will affect future professionals.

Psychological impacts of transition to distance learning due to COVID-19 on nursing students

The purpose of this study was to assess the psychological impacts of the abrupt transition to distance learning due to COVID-19 and associated factors among Jordanian nursing students. A cross-sectional online survey with a sample of 224 nursing students in three universities was carried out. The survey measured students' depression, anxiety, stress, post-traumatic stress disorder (PTSD), academic self-efficacy, and demographic and distance learning-related data. Students have moderate levels of depression, anxiety, and stress. Depression, anxiety, stress, and PTSD were significantly associated with various demographic, disease-related, and distance learning-related variables. Further work is required to prepare professional psychological help for nursing students and develop future teaching plans that take into consideration factors underlying students' negative symptoms.

Stressors and mental health impacts of COVID-19 in dental students: A scoping review

OBJECTIVE

The COVID-19 pandemic has led to mental health hazards to healthcare providers in general and to undergraduate dental students. The present study undertakes a scoping review to identify and discuss the mental health issues and stressors impacting dental students globally during the COVID-19 pandemic.

METHODS

A systematic search following the Joanna Briggs Institute's framework for scoping reviews was conducted on Embase, MEDLINE by Ovid, Web of Science, PsycInfo, CINAHL, and ERIC to identify peer reviewed publications published globally since the onset of the COVID-19 pandemic in March 2020 until June 22, 2021. Manual search was also performed on Google scholar. Eligible studies were selected based on the predetermined set of criteria and focused specifically on mental health issues experienced by undergraduate dental students in the context of COVID-19.

RESULTS

Fifty-five publications were retained. Fifty-one reported stress, anxiety, or depression experienced by undergraduate dental students during the pandemic. Twenty-five studies employed validated psychometric instruments to explore mental health status among the same students. A total of 28 publications reported that the predominant concern for students was fear of infection, especially during patient interaction. Adapting to virtual learning, clinical skill deficit due to lack of/limited practical training and social isolation were other majorly reported stressors.

CONCLUSIONS

Many mental health issues and stressors related to the COVID-19 pandemic have been identified. Mitigation of COVID-19-related stressors on dental students' mental health should be a priority across all dental academic institutions. Continued efforts should be made to create a supportive learning environment.

Relationships Between Remote Learning Modalities and Nursing Students' Perceptions of Their Sleep Quality During the COVID-19 Pandemic

BACKGROUND

The relationship between learning modalities and nursing students' sleep quality during the coronavirus disease (COVID-19) pandemic is unknown.

PURPOSE

This study examined the relationships between remote learning and the sleep quality of nursing students during the COVID-19 pandemic.

METHODS

Using a cross-sectional descriptive design, 890 nursing students were surveyed online to identify sleeping habits and learning modalities.

RESULTS

There were no significant correlations between remote learning hours, self-reported sleep hours, and sleep quality. The asynchronous-only group reported better sleep quality than the in-person and online hybrid group after controlling for health conditions and grade point average. Students who reported that remote learning had impacted their sleep had poorer sleep quality.

CONCLUSIONS

This study provides insight into how different learning modalities impact nursing students' sleep quality during the pandemic.

A daily examination of perceived stress and coping strategies used among college students during COVID-19

This study examined inter- and intra-person level associations between stress and overwhelm and adaptive coping strategies used by college students during COVID-19. Participants were 55 college students (Mage = 23.31, SD = 4.49; 87% White, 85% Female), who completed a 21-day daily diary study. The common coping strategies endorsed were media use, relaxation techniques, and exercise. Variability among feelings of stress (ICC = .520) and overwhelm (ICC = .530) were similarly explained by between and within-person differences. Daily stress and overwhelm were positively associated with relaxation techniques, media, and total coping strategies. Further, daily stress was positively associated with connection with others to cope. At the between-person level, average stress was associated with avoidance strategies such as taking a break from news to cope. These findings may prove useful in the development of interventions to increase the practice of adaptive coping strategies to reduce stress and overwhelm.

How do students cope with stress during remote learning due to COVID-19 pandemic? Biological and psychological factors-protocol of the study

Introduction: The COVID-19 pandemic negatively affected the mental health of the Polish population. Students are the group with a high risk of developing mood disorders. The scientific data suggest the usefulness of biological substances as potential biomarkers of psychiatric disorders. Saliva is non-invasive, quick to obtain material and a promising fluid for measuring stress and depression severity. In this paper, we present the protocol of our study, which aims to assess the utility of concentrations of biological fluids as potential biomarkers of the stress response and risk of developing depression and anxiety disorders among students of Lublin.

Materials and methods: Total number of 80 students were included in the study. Participants were asked to collect saliva samples simultaneously with responding to the questionnaires concerning their mental state. Afterwards, the samples were examined with an ELISA test to assess the level of fibroblast growth factor (FGF-2), cortisol and chromogranin A (CgA). The relationship between biomarkers and severity of stress, depression, anxiety will be examined.

Results: Cortisol on its own is not a good material to investigate the stress reaction in saliva due to its variable levels among people during stressful situations. Scientific data indicate the usefulness of other biomarkers or their combination to indicate the potential risk of developing depression and/or anxiety.

Conclusions: Introducing objective tests, helpful for mood symptoms recognition, would improve the prevention and diagnosis of psychiatric disorders in vulnerable populations.

Determining attitudes toward e-learning: what are the attitudes of health professional students?

Aim

The research was carried out to determine the attitudes of nursing undergraduate students toward e-learning implemented during the COVID-19 pandemic.

Subject and methods

The study sample consisted of 320 undergraduate students studying at the Faculty of Health Sciences, Nursing Department of a state university. Personal Information Form and the Test of e-Learning Related Attitudes were administered to the research participants.

Results

Of the students, 68.8% were female and 51.6% were between the ages of 21-24. The attitude of 55.3% (177) toward e-learning is negative. Attitude scores of students aged 25-29 were significantly higher compared to those aged 17-20 and 21-24 years old (p = 0.002). The attitude scores of the students who have a computer are significantly higher than those who do not (p = 0.001). Most students did not agree with the statement "E-learning will provide me with better learning opportunities than conventional learning methods." (disagree n = 121; 37.8%, strongly disagree n = 110; 34.4%).

Conclusion

It is noticed that e-learning is not sufficient in subjects such as conducting clinical and laboratory practices in health sciences fields with practical training like nursing, and students' attitudes are generally negative. For undergraduate health sciences education, face-to-face and online education for support purposes can be used together in theoretical courses. In addition, it is recommended to use effective online communication techniques in online courses.

Effects of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations: a systematic review of the literature

OBJECTIVES

This study sought to conduct a systematic review of the literature on the impact of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations, understudied geographic regions including with regards to sleep health.

SETTING

A systematic literature search of studies published from inception to 27 March 2022 was conducted on multiple databases using developed keywords.

PARTICIPANTS

Studies were included if they (1) investigated one or more aspects/dimensions of sleep health as an outcome (eg, sleep duration, sleep quality, sleep problems); (2) measured the impact of a COVID-19 pandemic-related domain (eg, impact of quarantine, work from home, lifestyle changes); (3) focused on at least one MENA region population; (4) were peer-reviewed; (5) included ≥100 participants; (6) were written in English and (7) had full-text article publicly available.

PRIMARY AND SECONDARY OUTCOMES MEASURED

Primary outcomes were sleep duration, sleep quality and sleep problems.

RESULTS

In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 164 studies were included for data extraction. The Newcastle-Ottawa scale for cross-sectional studies was used to assess the quality of the studies. Overall, the COVID-19 pandemic significantly impacted sleep duration, sleep quality and presence and severity of sleep disorders in MENA populations, including adults, children, students, healthcare workers and people with chronic illnesses. The directionality and strength of associations, as well as the determinants of sleep health, varied by subpopulations.

CONCLUSIONS

Longitudinal studies are needed to understand the longer-term impact of the COVID-19 pandemic on the sleep health of MENA populations. Sleep health interventions and policy measures should be tailored to the need of each subpopulation.

PROSPERO REGISTRATION NUMBER

CRD42022321128.

Online Learning Stress and Chinese College Students' Academic Coping during COVID-19: The Role of Academic Hope and Academic Self-Efficacy

Colleges around the world have adopted emergency online learning to continue with teaching and learning activities during COVID-19. Existing research has indicated that this teaching mode is perceived negatively by many college students. The difficulty students encounter in emergency online learning can adversely affect their mental health and academic performance. To shed further light on how emergency online learning may have impeded college students' academic functioning and adjustment, this study examined the association between online learning stress and academic coping and the mediating roles of academic self-efficacy and academic hope. It was conducted in early 2021, a year after the outbreak of the pandemic. Ninety-nine Chinese college students in Hong Kong were recruited and they completed an online questionnaire for this study. Results showed that online learning stress was negatively associated with approach academic coping and social support seeking, and the associations were mediated by academic hope. On the other hand, online learning stress was positively associated with avoidance academic coping, which was not mediated by academic hope. The mediation effects of academic self-efficacy were all non-significant. In sum, college students used more passive and maladaptive coping to handle academic problems when they experienced more online learning stress, and this was partly explained by lower levels of academic hope.

Considering medical students' perception, concerns and needs for e-exam during COVID-19: a promising approach to improve subject specific e-exams

The COVID-19 pandemic forced a rapid shift to digital strategies including e-exams in medical schools. However, there are significant concerns, predominately from student perspectives, and further data is required to successfully establish e-assessment in the medical curricula. The objective of the study was to examine medical students' perceptions, concerns, and needs regarding e-assessment to establish a comprehensive e-exam based on these and previous findings and to evaluate its effectiveness in terms of examinee perceptions and further needs. During the 2021 summer term, a cross-sectional study using qualitative and quantitative methods was conducted among all 1077 students at the School of Medicine, Technical University of Munich. They were asked to provide information regarding their characteristics, preferred exam format, e-assessment perception, concerns, and needs in an online questionnaire. Based on these findings, a pilot e-exam including an e-exam preparation for the students were established and subsequently evaluated among 125 pilot e-exam examinees under study consideration via an online-questionnaire. Of the 317 pre-exam participants (73.2% female), 70.3% preferred in-person exams and showed concerns about the technological framework, privacy, and examination requirements. Qualitative analysis showed that these concerns lead to additional exam stress and fear of failure. The 34 (79.4% female) participants who participated in the evaluation survey showed a significantly more positive e-exam perception. The fairness of the platform, the independence from an internet connection, the organization including the e-exam preparation, and the consideration of participant needs were discussed as particularly positive in the open-ended comments. In both surveys, participants requested uniform platforms and processes for all subjects. This study provides evidence for a positive, complementary role of student participation in a successful e-exam implementation. Furthermore, when establishing an e-exam format in the medical curricula, e-exam training, equal accessibility, availability offline, and all-round fairness should be considered.

Emotional support received moderates academic stress and mental well-being in a sample of Afghan university students amid COVID-19

BACKGROUND

Academic stress experienced during the COVID-19 pandemic has triggered high levels of anxiety and depression and other severe mental health issues among university students around the globe. In Afghanistan, there is a paucity of research on the academic and mental health issues of Afghan university students and none pertaining to their academic stress and mental well-being amid the pandemic.

AIM

This research examines the potential stress-buffering role of emotional support received between academic stress and mental well-being in a sample of Afghan university students during the COVID-19 outbreak.

METHOD

The study sample comprised 508 Afghan university students. An online survey was developed for data collection. Model 1 of the PROCESS macro was used to conduct the moderation analysis.

RESULTS

These indicate that moderate and high levels of emotional support received may protect against the negative effects of higher levels of academic stress on mental well-being.

CONCLUSION

This research makes an important contribution to the literature on social support. It may be inferred from the results that Afghan university students who experience academic stress, but have strong emotional support are able to attain greater mental well-being during the COVID-19 outbreak as compared to those with weak emotional support. Results may encourage mental health practitioners, university counselors, education administrators, and faculty to jointly formulate strategies for offering emotional support to Afghan university students.

Implications of COVID-19 on the Teaching and Learning of Undergraduate Medical Imaging Students

To preserve public health and prevent the spread of COVID-19, academic institutions curtailed face-to-face instruction and learning after the outbreak. The traditional techniques for education were modified, and new ways of instructing students were implemented. It presented a number of difficulties for the educational system, particularly for universities offering healthcare education. Therefore, the aim of this research was to look into how COVID-19 affected the teaching and learning of undergraduate medical imaging students. The ScienceDirect, Oxford University Press Journals, Cambridge University Press Journals, and Taylor & Francis Online databases were searched, and a total of 14 papers met the inclusion and exclusion criteria and were selected for further analysis. The literature was analyzed using a thematic approach, with recurring themes brought to light. The effects of COVID-19 on medical imaging education include but are not limited to the more rapid adoption of online education and new approaches to assessing and guiding students. Online teaching for medical imaging students influenced their learning environment, interaction, and motivation. The new COVID-19 safety requirements and procedures in hospitals have profoundly impacted clinical practice. Additionally, students' research activities were also affected. We anticipate that the findings of this study will enable us to be better equipped to assist students in comparable circumstances in the future.

A Mixed-Methods Exploration of the Effect of Disabling Backward Navigation on Calculations-Focused Computerized Examinations

Objective. The aim of this mixed-methods study was to examine the effect of disabled backward navigation on computerized calculation examinations in multiple courses.Methods. Student performance on comprehensive pharmacy calculation examinations before and after implementation of disabled backward navigation were compared. Deidentified data from ExamSoft were used to determine median examination scores, passing rates, and time to completion for all three attempts given on comprehensive calculation exams held in a pharmacy calculations course (PharDSci 504) and in three applied patient care laboratory courses (Pharm 531, 541, and 551). An anonymous, voluntary student survey gathered student perceptions of disabled backward navigation. Qualitative data were evaluated for thematic findings.Results. The impact of disabled backward navigation on test scores and passing rates varied by course and test attempt. Students in Pharm 541 and 551 performed significantly worse on the initial test attempt after backward navigation was disabled compared to the previous year, with no significant differences in student performance seen on the retakes. Performance in PharDSci 504 and Pharm 531 followed the opposite pattern, with no significant difference in performance for the initial tests but significantly increased performance on the retakes. The amount of time spent on examinations either significantly decreased or remained the same. Student perceptions were generally consistent across all cohorts, with at least 74% agreeing that disabling backward navigation increased examination difficulty.Conclusion. Disabling backward navigation had a mixed effect on student examination performance. This may highlight how student behaviors change as backward navigation is disabled.

“Effects of the COVID-19 pandemic on university students’ physical health, mental health and learning, a cross-sectional study including 917 students from eight universities in Germany”

The COVID-19 pandemic has severely affected physical and mental health. Since its commencement in 2020, social distancing has become the “new normal”. Temporary lockdowns and distance learning have disproportionately affected young adults, including university students. To identify effects of the pandemic on university students’ physical and mental health and learning, this empirical study included eight universities in Heidelberg, Mannheim and Ludwigshafen. Data was collected in May and June 2020. The self-administered survey was filled by 1,246 university students. 917 students completed the survey in full. 80.6% were bachelor students (n = 738), the mean semester was 3.8 and mean age was 23.1 years. 51.8% (n = 472) were female students and 47.4% (n = 432) male students. 38.5% (n = 352) stated a deterioration in physical health and 53.1% (n = 485) in mental health. From 0 to 10, students rated mean levels of stress highest due to social distancing (5.6), spending most time at home (5.0) and e-learning (4.5). Compared to male students, female students’ mental health worsened significantly (58.7% vs. 46.8%). A logistic regression analysis identified gender having a significant effect on university students’ stress levels: males seemed to have a lower risk of moderate to high levels of stress compared to females (odds ratio = 0.698; 95% CI = 0.515 to 0.945). Age, city of university and semester did not show a significant effect. The results are important to both regional and international audiences as university students face similar physical and mental health challenges due to the pandemic and its public health measures. Low-threshold initiatives are needed to mitigate the effects of the pandemic. These may include measures to reinforce students’ locus of control, sense of belonging, relaxation and mindfulness as well as (online) counselling services. Gender-specific differences must be taken into account.

The psychological impact of social distancing related to the covid-19 pandemic on undergraduate and graduate students in Brazil

Aim: To evaluate the psychological impact of COVID-19 on undergraduate and graduate students of the Dental School of Ribeirão Preto, University of São Paulo. Methods: Three questionnaires were used: sociodemographic, WHO Abbreviated Quality of Life Inventory, and General Anxiety Disorder-7. Data were analyzed using Graph Pad Prism 7a (α = 5%). Mann-Whitney or Kruskal-Wallis and Dunn post-tests were used for statistical comparisons. The Spearman test was used as the correlation test. Results: 257 students responded to the online form that assessed their quality of life and anxiety level. On a scale from 1 to 100, with 100 being the best quality of life, the average obtained was 64.71 (± 13.36). In addition, 87.6% of the students rated their quality of life as good or very good. 74.7% reported good or very good health. The anxiety analysis resulted in an average of 10.04 (± 4.5), indicating moderate anxiety levels. There was an inversely proportional correlation between age and degree of anxiety (p = 0.008, r = -0.1628) and self-perceived learning and student commitment (r = 0.69). Conclusion: Despite the good quality of life and the students’ good self-perception of health, they showed a moderate degree of anxiety during the social distancing caused by COVID-19, also demonstrating a decrease in interest and commitment during distance education.

Experiences of academic and professional burn-out in medical students and residents during first COVID-19 lockdown in Belgium: a mixed-method survey

COVID-19 has presented a substantial burden on students and healthcare staff. This mixed-method, descriptive and correlational study aimed to: 1) describe academic; and 2) professional burnout levels; 3) their associations with working in COVID-19-related care; and 4) with perceived COVID-19 impact on studies and internships among medical students and residents. We hypothesized burnout levels to be high; those involved in COVID-19 care to experience higher impact of COVID-19 on studies and work, and to experience higher levels of academic and professional burnout than those not involved in COVID-19 care; academic and professional burnout to be higher when perceived burden due to COVID-19 was higher. During first lockdown in Belgium, a mixed-method cross-sectional survey assessed academic burnout (MBI-SS) and professional burnout in relation to internships and residency (MBI-HSS). Correlations and t-tests tested associations of burnout with involvement in COVID-19-related care and perceived impact of COVID-19 on studies and work (SPSS). Participants provided open-ended comments which were thematically analysed (NVivo). In total, 194 medical students and residents participated (79.5% female, M age = 24.9 ± 2.5). Emotional exhaustion and depersonalisation were high in professional burnout, but moderate in academic burnout. Those involved in COVID-19 related care perceived a higher impact of COVID-19 on their studies and internship/residency and have higher professional burnout, but do not show a higher academic burnout. Those who have a higher perceived impact of COVID-19 on their studies scored higher on academic burnout. Participants mentioned an increased workload (e.g., having to be constantly available and constantly adapt), distress (e.g., uncertainty, fatigue, fear for impact on significant others), fewer learning opportunities (e.g., cancelled internships, changing learning methods), lack of relatedness with patients and supervisors (e.g., lack of respect and understanding from supervisors, distance created by phone consultations with patients) and cynicism towards remote care or non-medical tasks (e.g., considering what they do is not useful or not what they trained for). Students and residents showed indications of professional and academic burnout in relation to the COVID-19 situation. Interventions are needed that can meet the needs of achieving learning outcomes, managing extreme situations and relatedness.

Pharmacy Students' Mental Health and Resilience in COVID-19: An Assessment after One Year of Online Education

COVID-19 has impacted mental health and affected education due to the shift to remote learning. The purpose of the current study was to assess the mental health of pharmacy students one year following the onset of the pandemic. A descriptive cross-sectional questionnaire was distributed to pharmacy students. The severity of depression, anxiety, and stress was assessed by the Depression Anxiety Stress Scale (DASS-21), and resilience was assessed by the Brief Resilience Scale (BRS). COVID-19-related economic, educational, and health stressors, and students’ vaccine attitudes were surveyed. Descriptive, bivariate, and multivariable analysis were used, and a p-value of <0.05 was considered significant. A total of 561 students participated; 37% had mild-to-moderate depression, 37% had severe-to-extremely-severe anxiety, and 52% demonstrated normal stress levels. Severe depression, anxiety, and stress were associated with smoking and feeling isolated due to COVID-19. Around 40% of students had low resilience, associated with smoking, being in the third or fourth year of pharmacy study, and the consumption of caffeinated beverages. The mean score of satisfaction with online learning was 60.3 ± 21.3%. Only 5% of participants were vaccinated, of which 87% trusted the benefits of vaccines and their role in controlling the pandemic. One year after the onset of COVID-19, depression, anxiety, stress, and low resilience were observed among pharmacy students; the investigation of the long-term mental effects of the pandemic on university students is warranted.

Anxiety, Stress Coping Styles and Hope for Success among Graduate Students and High School Graduates during the COVID-19 Pandemic: The Moderating Role of Remote Learning

The COVID-19 pandemic has significantly influenced the area of education, in terms of both teaching and learning effectiveness. The aim of the study was to compare groups of high school graduates and graduate students. The Coping Inventory in Stressful Situations (CISS), State and Trait Anxiety Inventory (STAI), Hope for Success Questionnaire (KNS), and our own questionnaire were used in the study. The results of the research show that the group of high school graduates, compared to the graduate students, was characterized by a higher level of anxiety, a style focused on emotions and a lower level of hope for success. People who passed the exam in the online form were characterized by a higher level of anxiety compared to the respondents who passed the exam in the stationary form. According to the results of this study, it can be concluded that the styles of coping and the level of hope for success may be both protective and risk factors related to the level of anxiety during distance learning.

Changes in Academic Performance after Transitioning to Remote Proctoring: A Before-After Evaluation

Remote proctoring is often used to ensure testing integrity in a distance education environment but may impact academic performance. This quasi-experimental study aimed to evaluate changes in examination scores after transitioning to remote proctoring during the COVID-19 pandemic. Student pharmacists (n = 384) served as their own controls in this before-after analysis of examination scores with in-person versus remote proctoring. To assess differences in examination scores among students with varying levels of testing anxiety, students were classified into low, moderate, or high testing anxiety groups based on their Cognitive Test Anxiety Scale–Second Edition (CTAS-2) score. Students were also stratified into two groups based on their cumulative grade point average (GPA). After transitioning to remote proctoring, examination scores significantly decreased for first-year (P1) students but significantly increased for second-year (P2) students. When stratified by CTAS-2 score, no significant difference in examination scores was found. When stratified by GPA, no significant difference in examination scores was found for P1 students, but a significant improvement was noted for P2 students with remote proctoring. The results of this study indicate that examination scores do not consistently improve or decline after introducing remote proctoring even when considering a student’s GPA and level of testing anxiety.

The relationship between mental and physical health: a longitudinal analysis with British student

Purpose

Previous studies in the field have highlighted a bidirectional link between mental health and physical health. Students may be at a higher risk of both mental and physical health problems because of unhealthy lifestyle behaviours and the commencement of university occurring at the same mean age of onset for many psychiatric disorders. This study aims to examine how physical health variables influence changes in mental health symptoms, and vice versa, over time, in a sample of British undergraduate students.

Design/methodology/approach

A longitudinal design over a one-year time period. A national sample of 430 British undergraduate students completed measures of mental health and physical health online at up to four time-points across their first two years of university.

Findings

General physical health and energy and fatigue predicted more severe depression, anxiety, stress and poorer general mental health over time. Depression and stress predicted poorer physical functioning over time. Greater anxiety predicted poorer general health and more severe pain over time. General mental health was not predictive of general physical health. Overall, poor general physical health appears to exacerbate mental health symptoms in students to a greater extent than mental health problems lead to a deterioration in physical health.

Originality/value

This study adds a longitudinal design to a field that is usually cross-sectional, as well as a lack of consideration of how this relationship may differ within student samples. Early interventions should integrate physical and mental well-being rather than focus on any single health-related behaviour.

Examining the effect of COVID-19 pandemic on exercise behavior and perceived academic stress among U.S. college students

Objective: The aim of this study was to capture the impact of COVID-19 on exercise behavior in U.S. college students. Exercise behaviors and perceived academic stress were examined from pre-COVID-19 (January-March 2020) and early-COVID-19 (April-July 2020) to continued-COVID-19 times (August-October 2020). Participants: One hundred and thirty-two participants completed the online questionnaires retrospectively. Methods: Two-way analyses of variance were used to examine exercise behaviors and academic stress perception over time between genders. Results: Participants spent much time in sedentary behavior and an increase in academic stress was evident in learning during the early-COVID-19 period. The time spent in sedentary behavior was reduced, but the stress involving coursework remained during the continued-COVID period. The impact of the COVID pandemic was observed to be universal across sex groups. Conclusions: Universities should consider how to support physical and mental health during lockdown and extended closure due to a pandemic.

COVID-19 pandemic: Direct effects on the medical education in Pakistan

•

To date, the medical education literature has focused on strategies for high-income countries to optimize online education.

•

Low- and middle-income countries' students face additional challenges in providing virtual education.

•

The main challenges LMIC students face are frequent internet and electricity outages and limited technology skills.

•

The COVID-19 pandemic placed novel emotional and financial pressures on medical students.

•

Here, we presented strategies for best practices in remote medical education, such as open-access medical education content.

Lifestyle behaviours and mental health and wellbeing of tertiary students during COVID-19 lockdown in Australia: A cross-sectional study

BACKGROUND

Australia experienced significant COVID-19 lockdown restrictions throughout 2020 that had an impact on mental health and disrupted health-promoting lifestyle behaviours. Lockdowns may have exacerbated existing mental health concerns among tertiary students, who experience higher levels of mental health concerns compared to the wider community. This study aimed to investigate the association between modifiable lifestyle factors and wellbeing of students at a Melbourne-based tertiary education institution during COVID-19 lockdown.

METHODS

This quantitative, cross-sectional study was conducted across campuses in Melbourne and Sydney. Data was collected via online questionnaire during the 7th week of a second-wave lockdown. Descriptive statistics were calculated for demographic variables (n = 239). Linear regression models were estimated to determine multivariate associations between lifestyle variables and psychological distress.

RESULTS

Participants were on average 30.98 years old (SD = 9.78), predominantly female, domestic students, undergraduate, not the first member of their family to attend university and living out of family home. Mindfulness, diet quality, sleep quality and moderate-vigorous physical activity (MVPA) were all inversely correlated with psychological distress. Unadjusted and adjusted models show that mindfulness, sleep quality, and MVPA were all independently inversely related to psychological distress. Greater mindfulness, sleep quality and engagement in MVPA were associated with lower psychological distress during COVID-19 lockdowns.

LIMITATIONS

As this study is cross-sectional and we cannot rule out reverse causality.

CONCLUSION

This study highlights the potential for lifestyle focused mental-health promotion delivered through tertiary education institutions to support students in times of crisis as well as more generally.

Female Sex and Living in a Large City Moderate the Relationships between Nursing Students' Stress Level, Perception of Their Studies, and Intention to Practice Professionally: A Cross-Sectional Study

One way to increase nursing retention is to expand the number of nursing education programs; however, a more cost-effective initial step would be to ensure that each graduate will start a professional career. Nursing studies expose students to prolonged and uncontrolled stress that negatively affects their professional identity and health. Two hundred and fifty-four nursing students participated in this study. The data were obtained using the Perceived Stress Scale (PSS-10), a proprietary questionnaire on the students’ perception of their study, intention to practice in the future, and other metrics. Among our sample, a dozen students were unsure that they would enter the nursing profession. Stress levels in women were higher than in men. Respondents indicated that they were afraid of the return of the pandemic. This analysis was significant among people living in large cities. Based on our findings, five themes should be prioritised: favourable study environment and adequate competencies (including implementation of stress management techniques, especially among women and students living and studying in large cities), appropriate working hours, quality of practical classes, and quality of personal protective equipment.

Maximizing Academic Integrity While Minimizing Stress in the Virtual Classroom

The article documents students' experiences with the shift online at the onset of the COVID-19 pandemic and provides informed recommendations to STEM instructors regarding academic integrity and student stress. Over 500 students were surveyed on these topics, including an open-ended question. Students experienced more stress and perceived a greater workload in online courses and therefore preferred in-person courses overall. Personal awareness of cheating during online exams is positively correlated with the proportion of cheating a student perceives. Fear of getting caught is the best cheating deterrent while getting a better grade makes cheating most enticing. Randomization of questions and answer choices is perceived as a highly effective tool to reduce cheating and is reported as the least stress-inducing method. Inability to backtrack and time limits cause students the most stress. Students report that multiple choice questions are the least effective question type to discourage cheating and oral exam questions cause the most stress. Use of camera and lockdown browser or being video- and audio- recorded caused the majority of student stress. Yet, nearly 60% agree that the combination of camera and lockdown browser is an effective deterrent. Recommendations: (i) Be transparent regarding academic dishonesty detection methods and penalties. (ii) Use online invigilating tools. (iii) Synchronize exams and (iv) randomize exam questions. (v) Allow backtracking. (vi) Avoid converting in-person exams to online exams; instead, explore new ways of designing exams for the online environment.

An Assessment of Various Challenges Perceived by Dental Students amidst the COVID-19 Pandemic: A Digital Questionnaire Study

The objective of our study was to evaluate dental students’ perception of the challenges faced during the COVID-19 pandemic related to their clinical work, education, performance, online examinations, psychological health, and teamwork. A validated online questionnaire consisting of closed ended questions was sent to all the undergraduate dental students at our institute. Data were collected and analyzed statistically using a chi-square test to compare responses of male with female and junior with senior students. A total of 317 undergraduate dental students (N = 317) participated in this cross-sectional study. The most common challenges perceived by the participants were related to their exam duration (77.3%), patient availability (66.9%), difficulty in understanding online lectures (58.4%), and a fear of losing grades (57.4%). Participants reported that the COVID-19 pandemic affected their performance in the courses (75.4%), teamwork (72.2%), educational aspects (67.5%), and psychological health (51.1%). A significantly greater proportion of female students reported the adverse effects of COVID-19 on their psychological health than male students (p = 0.031). Senior students perceived the negative impact of COVID-19 on teamwork significantly more than the junior students (p = 0.004). The majority of students reported challenges during the COVID-19 pandemic. Female students and senior students perceived more challenges than their counterparts. Future studies from other institutes of this region are recommended to establish a clearer picture of COVID-19 related challenges faced by dental students.

Which qualities should built environment possess to ensure satisfaction of higher-education students with remote education during pandemics?

The COVID-19 pandemic has suddenly switched most education processes from face-to-face to remote mode, obliging millions of students to utilize their residences as study spaces. However, the characteristics of their residential built environments differ in terms of regional, social, cultural, and technological aspects. These differences should impact the students' performance and satisfaction which needs to be measured and studied. The present study aims to identify the effect of the residential built environment on students' satisfaction and academic performance during the COVID-19 pandemic. It was conducted in two countries, Kazakhstan (KZ) and Norway (NO), using a comprehensive online survey to gather data. An empirical assessment based on the structural equation model was employed to identify links between health, safety, and comfort of students' facilities and academic performance and satisfaction. We conclude that the built environment affects both satisfaction for remote education and their learning performance. Significant differences in readiness for remote education have been observed between urban and non-urban living areas: (1) The role of health-and-safety convenience seems to increase with the urbanization level of the respondents' living spaces; (2) in contrast, for non-urban residents, the provision of comfort facilities is dominant. In the meantime, an analysis "by regions" revealed that health-and-safety-related facilities in residences are more critical for remote education in Central Asia (KZ). In contrast, the comfort features of residences being more important for the students studying remotely in Northern Europe (NO). These results provide an understanding that would assist in improving remote education and preparing pandemic-ready living areas.

Distanciamento social por Covid 19: repercussão na rotina de universitários

Introdução: Necessitando de medidas de combate à pandemia por SARS-CoV-2, a Organização Mundial da Saúde orientou o distanciamento social como estratégia para mitigar seus impactos. Dentre as medidas adotadas para evitar aglomerações, universidades se adaptaram para modalidade de ensino online. O objetivo é refletir sobre a influência do distanciamento social por covid-19, na rotina de estudantes de ciências da saúde. Materiais e Métodos: É uma revisão integrativa, com buscas nas bases de dados Pubmed, MEDLINE, LILACS, WHO COVID, bioRxiv, e medRxiv, nos sites da Pubmed, BVS e Portal de buscas da Organização Mundial da Saúde para covid-19, com descritores nas seguintes combinações: “Infecções por coronavírus e estudantes de ciências de saúde” e “Covid-19 e estudantes de ciências de saúde”. Inicialmente encontrou-se 1069 artigos. Resultados: Após refinamento 23 artigos compuseram o estudo. Os resultados foram categorizados como 1-desordens nas competências emocionais, 2-ensino, 3-alimentação, sono e atividade física e 4-efeitos de natureza diversas. Manifestações frequentes: ansiedade, depressão, estresse, incerteza e angústia, mudanças no sono e atividade física. Vantagem ou desvantagem do ensino online, teve percentual de 50% cada. Conclusão: Conhecer como o distanciamento social influenciou na rotina dos estudantes é relevante para que as universidades desenvolvam programas de suporte para as necessidades apresentadas na realidade atual, e consigam projetar programas de enfrentamento para futuras crises epidêmicas, auxiliando na redução dos impactos resultantes.

Anxiety and fear of COVID-19 among nursing students during the COVID-19 pandemic: A descriptive correlation study

PURPOSE

The aim of this study was to assess current situations regarding anxiety and fear of coronavirus disease 2019 (COVID-19) level among nursing students.

DESIGN AND METHODS

A descriptive correlation design was adopted. The sample consisted of 234 nursing students. Data were collected using sociodemographic form, Beck Anxiety Inventory (BAI), and Fear of COVID-19 scale.

FINDINGS

The mean BAI score of the students was 26.56 ± 8.86 and Fear of COVID-19 total score was 18.95 ± 7.00. A positive correlation between total scores of the BAI and Fear of COVID-19. The results of this study reveal that anxiety and fear of COVID-19 levels were high among nursing students.

PRACTICE IMPLICATIONS

These findings have underlined there is an urgent need for interventions to reduce anxiety and fear of COVID-19 among nursing students.

Considerations and strategies for effective online assessment with a focus on the biomedical sciences

The COVID-19 pandemic in 2020 caused many universities to rapidly transition into online learning and assessment. For many this created a marked shift in design of assessments in an attempt to counteract the lack of invigilation of examinations conducted online. While disruptive for both staff and students, this sudden change provided a much needed reconsideration of the purpose of assessment. This review considers the implications of transitioning to online assessment providing practical strategies for achieving authentic assessment of students online, while ensuring standards and accountability against professional accrediting body requirements. The case study presented demonstrates that an online multiple choice assessment provides similar rigor in assessment to invigilated examination of the same concepts in human physiology. Online assessment has the added benefit of enabling rapid and specific feedback to large cohorts of students on their personal performance, allowing students to target their weaker areas for remediation. This has implications for improving both pedagogy and efficiency in assessment of large cohorts where the default is often to assess basic recall knowledge in a multiple choice assessment. This review examines the key elements for implementation of online assessments including consideration of the role of assessment in teaching and learning, the rationale for online delivery, accessibility of the assessment from both a technical and equity perspective, academic integrity as well as the authenticity and structure of the assessment.

Revisioning Assessment and Evaluation in Nursing Education Through Critical Caring Pedagogy: Using Authentic Examinations to Promote Critical Consciousness

Instead of instilling in nursing students critical thinking to challenge injustice and oppression in nursing practice, nurse educators often rely on outdated traditional approaches to education. This situation is certainly true in traditional methods of evaluation that often propagate a banking mode of learning. One of the most commonly used methods of evaluating students is traditional examinations, which have recently become a source of pedagogical conflict among educators. In this article, we outline how educators unknowingly encourage surface learning, uncaring practices, oppression, inequity, and cheating when they rely on traditional examinations. We draw on critical caring pedagogy and universal design for learning to advocate for increased use of authentic assessment in nursing education. A Supplemental Digital Content video abstract is available at http://links.lww.com/ANS/A31.

A Semester without Exams: Approaches in a Small and Large Course

Exams carry pedagogical downsides: they can create stress, decrease intrinsic motivation, and tend to reduce opportunities for creative problem-solving. Exams are also difficult to administer when flexibility is paramount, such as during remote learning, when students have special testing conditions, or during a pandemic when a subset of students are sick or in quarantine. To account for these shortcomings, I designed and instituted two completely exam-free undergraduate Neuroscience and Behavior courses in the Spring of 2021, one a large introductory-level course and the other a small upper-level elective course. In the large introductory-level course, I used several methods including Gradescope and new roles for my Teacher's Assistants to keep the grading load manageable. This exam-free approach was evaluated in four areas: creative thinking, interest in the material, stress level, and academic performance. Evaluation of success in these areas was completed via student feedback and by comparing final projects to final projects from previous semesters. The exam-free approach produced favorable or neutral results in every measured outcome. The framework for an exam-free course described here could be a useful starting point for other instructors who want to eliminate exams.