The development of medical MOOCs in China: current situation and challenges

3D reconstructed models based on real cervical cancer cases for undergraduate gynecological oncology education: a pre- and post-test study

BACKGROUND

The landscape of medical education is rapidly evolving, driven by advancements in technology. This evolution has ushered in a new era characterized by digitization, connectivity, and intelligence. In this era, traditional teaching methods are being augmented with innovative technologies such as virtual learning, artificial intelligence platforms, and access to cloud-based health platforms. One notable advancement is the integration of three-dimensional (3D) reconstructed models into medical education, particularly in fields like gynecological oncology.

METHODS

This study introduces 3D reconstructed models based on real cervical cancer cases as a teaching tool for undergraduate gynecological oncology education. Participants were fourth-year Clinical Medicine students of Wuhan University, China. Using student identity document numbers for grouping, half were assigned to the control group (odd numbers) and the other half to the 3D reconstructed model teaching group (even numbers). All the students completed the pre-tests before receiving traditional teaching on cervical intraepithelial lesions and cervical cancer. The control group completed the post-tests after traditional teaching alone, while the 3D reconstructed model teaching group completed the post-tests after receiving the additional 3D reconstructed model teaching. Feedback on this innovative teaching tool was collected. The pre-tests and post-tests covered cervical intraepithelial lesions, cervical cancer and staging system, and female pelvic anatomy.

RESULTS

This study includes 267 students, with 134 in the control group and 133 in the 3D reconstructed model teaching group. The pre-test scores of the three tests between the control group and the 3D reconstructed model teaching group showed no statistical difference (p > 0.05). Compared to the control group, the post-test scores of the 3D reconstructed model teaching group in theoretical knowledge of cervical intraepithelial lesions and cervical cancer, female pelvic anatomy and 2018 International Federation of Gynecology and Obstetrics staging system for cervical cancer increased significantly (p < 0.05). Feedback from students underscored the visual benefits and engaging nature of the models, with many expressing that the 3D models provided a clearer representation of cervical cancer and enhanced their learning experience.

CONCLUSION

The integration of 3D reconstructed models into medical education represents a promising approach to address the complexities of teaching intricate subjects in anatomy such as gynecological oncology. These models offer a more intuitive and thorough visualization of anatomical structures and pathological processes, fostering a hands-on and exploratory learning experience for students.

Medical and nursing students' satisfaction with e-learning platforms during the COVID-19 pandemic: Initial findings of an experimental project in China

Satisfaction with learning management systems (LMSs) is an essential indicator of students' e-learning experiences and reflects the quality of e-learning. Applying the technology satisfaction model, the present study aimed to investigate medical and nursing students' satisfaction with LMSs and its predictors. We conducted our survey at a medical university located in East China and received a total of 329 effective responses. Structural equation modelling was used to analyse the data. Our findings confirmed that perceived ease of use and perceived usefulness were two direct predictors of medical and nursing students' satisfaction with LMSs. Furthermore, the influence of perceived usefulness on satisfaction was more powerful than that of perceived ease of use. This study also substantiated that computer self-efficacy and perceived ease of use can indirectly impact medical and nursing students' satisfaction with LMSs. Our research effectively links the theoretical hypotheses with empirical findings, highlighting the central role of Computer Self-Efficacy (CSE), perceived ease of use, and perceived usefulness in shaping medical and nursing students' satisfaction with LMSs. Our findings contributed to the understanding of the technology satisfaction model and medical and nursing students' e-learning during the COVID-19 pandemic.

Assessing the effectiveness of massive open online courses on improving clinical skills in medical education in China: A meta-analysis

Massive Open Online Courses (MOOCs) are a new phenomenon in education worldwide. In China, MOOCs have been widely used in medical courses. However, the effects of MOOCs on improving clinical skills are controversial. Therefore, we conducted the study to verify whether the application of MOOCs in medical courses can improve participants' clinical skills in China. A systematic literature search was carried out using the PubMed, Embase, Web of Science, CNKI and Wanfang databases according to the predetermined criteria. The Hedges' g and its corresponding 95% confidence interval were selected to assess the effects of MOOCs on participants' clinical skills. Subgroup analyses, sensitivity analysis and publication bias test were performed in the study. A total of thirty-two records (thirty-two studies) with 3422 participants were identified in our study. There was a significant improvement in clinical skill scores of participants in the MOOC group compared with the control group. Subgroup analyses showed similar results in different student groups. Our study supported the notion that the MOOC-based teaching method appeared to be a more effective method than the conventional teaching technique for the improvement of participants' clinical skills in China.

Behavior analysis and formative assessments in online oral medicine education during the COVID-19 pandemic

BACKGROUND

During the coronavirus disease 2019 (COVID-19) pandemic, traditional teaching methods were disrupted and online teaching became a new topic in education reform and informatization. In this context, it is important to investigate the necessity and effectiveness of online teaching methods for medical students. This study explored stomatology education in China to evaluate the development and challenges facing the field using massive open online courses (MOOCs) for oral medicine education during the pandemic.

AIM

To investigate the current situation and challenges facing stomatology education in China, and to assess the necessity and effectiveness of online teaching methods among medical students.

METHODS

Online courses were developed and offered on personal computers and mobile terminals. Behavioral analysis and formative assessments were conducted to evaluate the learning status of students.

RESULTS

The results showed that most learners had already completed MOOCs and achieved better results. Course behavior analysis and student surveys indicated that students enjoyed the learning experience. However, the development of oral MOOCs during the COVID-19 pandemic faced significant challenges.

CONCLUSION

This study provides insights into the potential of using MOOCs to support online professional learning and future teaching innovation, but emphasizes the need for careful design and positive feedback to ensure their success.

The irreplaceable role of medical massive open online courses in China during the COVID-19 pandemic

BACKGROUND

Massive open online courses (MOOCs) have become innovative open-learning approach in medical education. This study aimed to evaluate the dynamic changes in the construction and application of medical MOOCs before and after the coronavirus disease 2019 (COVID-19) pandemic in China.

METHODS

The dynamic changes of usages about medical MOOCs before and after 2020 were mainly searched on the Smart Education of China Higher Education platform, and the detailed learning profiles and outcome indicators were further analyzed using 40 national first-class medical MOOCs from 'zhihuishu' platform.

RESULTS

A total of 2,405 medical MOOCs were exported from the Smart Education of China Higher Education platform, of which 1,313 (54.6%) were launched since 2020. The total and average numbers of participants of 141 national first-class medical MOOCs peaked during the initial spread of COVID-19 in 2020. We further analyzed the dynamic usage of MOOCs from 2018 to 2022 based on 40 national first-class medical MOOCs launched on the 'Zhihuishu' platform. The findings revealed that the number of registered learners (3,240 versus 2,654), questions and answers (27,005 versus 5,116) and students taking the final examination (2,782 versus 1,995) per semester were significantly higher since 2020 compared to these before 2020. Especially, the number of registered learners, registered schools, questions and answers, and students participating in online discussion, taking the unit quiz, taking final examinations and passing final examinations all peaked in the 2020 spring-summer semester. Pearson's correlation analysis found that the number of questions and answers and the number of learners who participated in online discussion were both positively correlated with the number of students who passed the final examination, and the correlation was especially strong since 2020. Moreover, the number of publications on medical MOOC research has soared since 2020 and has maintained a continuous upward trend.

CONCLUSIONS

High-quality medical MOOCs have been launched rapidly since the COVID-19 pandemic in China. The number of participants and online interactions of medical MOOCs peaked during the initial spread of COVID-19 in 2020. MOOCs are reliable and valid digital sources that facilitate medical higher education and play irreplaceable roles in emergency management.

A webinar series to educate applicants about the UK academic foundation programme: a longitudinal cross-sectional study

BACKGROUND

The UK academic foundation programme (AFP) is a competitive programme for medical graduates and forms the initial stage of the integrated clinical academic pathway. The application is complex and targeted education is beneficial. As online technologies improve, virtual medical education is becoming more common. Currently, webinar education, particularly that of webinar series, are poorly evidenced. An online course was created to investigate the acceptability and effectiveness of webinars for medical education.

METHODS

A six-part, one-hour sessional webinar course was developed following a focus group with academic foundation doctors. A pre- and post-course cross-sectional questionnaire study evaluated participant demographics, webinar opinion and self-rated understanding of the AFP via Google Form (Google, USA). Where applicable a five-point Likert scale (1-Strongly disagree to 5-strongly agree) was utilised and analysis using non-parametric paired statistical analysis.

RESULTS

Medical students (n=303) from 35 UK universities completed the pre-course questionnaire. Most students had not received targeted education on the AFP. They rated webinars useful for education (mean=4.2 s.d. 0.7). After the course, participants (n=66) expressed it was significantly convenient (mean=4.7), effective (mean=4.7) and suitably interactive (mean=4.4) (p<0.001 compared to neutral). Participants preferred short sessions over multiple days to the concept of a full-day event (mean=4.6 vs 3.1, p<0.001). Paired analysis of participants completing both forms (n=47) demonstrates a significant increase in self-rated understanding of AFP content, portfolio building, application process, acute clinical scenarios, interview technique and overall confidence in acquiring an AFP post (p<0.001). Follow-up identified 43 participants who completed the course were successful in their AFP application. This represents 7.8% of all successful AFP applicants in 2021.

CONCLUSIONS

This study evidences an accessible and effective webinar series for AFP education. Comprehensive webinar courses for similar topics and demographics may provide valuable utility in the provision of future medical education.

TRIAL REGISTRATION

Ethics requirements were waived for this study by Bristol University Ethics Committee. All participants in this study consented for anonymous use of their data. As such the trial is not registered.

An online course about cosmetics improves skin care practices and skin health

Background

The incidence of cosmetics-associated dermatoses is on the rise recently while the awareness and knowledge about proper utilization of cosmetics are insufficient in both the public and specialists due to limited education about cosmetics.

Methods

Our aim was to build and enhance the public's ability to select appropriate cosmetics, manage possible dermatoses and improve skin-care practices and skin health by offering access to medical information via free online courses. Consequently, we launched a massive open online course (MOOC), Appreciation and Analysis of Cosmetics. An online questionnaire was also sent to evaluate the effectiveness of the course.

Results

Nearly 540,000 learners were enrolled in the course since 2014. In the discussion forum, there were 8,383 posts and 73,014 replies in total, where learners were mostly concerned about topics of sun protection, cleansing and proper utilization of cosmetics in some skin diseases. 645 learners answered the questionnaire with 88.84% of the them changed skin care practices and 50.39% reported improvement in skin health. Moreover, participants who completed the course reported better understanding and utilization of cosmetics-related knowledge (p values < 0.05). 72.09% of respondents were willing to recommend this course to others.

Conclusions

Free online public courses are feasible for conducting public health education campaigns related to cosmetics and associated dermatology to lower the incidence of cosmetics-associated dermatoses.

Evaluation of a prerequisite course of histology implementation for Chinese students of eight-year medical programme: a mixed quantitative survey

BACKGROUND

Due to insufficient basic medical knowledge and inappropriate learning strategies, students of 8-year medical programme encountered many obstacles in the initial stage of basic medicine learning. This study was to determine whether a prerequisite course can improve basic medicine learning performance and adjust learning strategies to adapt to basic medicine learning.

METHODS

A prerequisite course of histology was constructed by a two-round modified Delphi study. Seventy-four students of 8-year medical programme were subjected to two groups: the prerequisite course group (PC group) and non-prerequisite course group (NPC group). The PC group take part in the prerequisite course by student-centred blended learning approach but NPC group not. The PC and NPC group underwent requisite histology teaching activities after prerequisite course. Examination of the prerequisite course and requisite histology course were carried out. Effect of the prerequisite course was evaluated by an empirical method using a questionnaire-based approach.

RESULTS

The results of examinations showed students' scores of the PC group were significantly higher than those of students of NPC group in both prerequisite course and requisite histology examinations (P < 0.05). The results of questionnaires showed that students were satisfied with the prerequisite course, which was beneficial for uptake in medical knowledge, cultivation of clinical thinking and scientific research ability and adaptation in learning strategies (P < 0.01). Furthermore, our prerequisite course is conducive to subsequent courses learning, especially for pathology (P < 0.01).

CONCLUSION

Our prerequisite course could effectively supplement knowledge of basic medicine, improve clinical thinking and scientific research ability and adapt their learning strategies. These findings suggest that the prerequisite course is useful and should be introduced in medical curriculum reform at the early stages of basic medical training.

Enhancement of Medical Students' Performance and Motivation in Pathophysiology Courses: Shifting From Traditional Instruction to Blended Learning

Blended learning is a learning approach that combines face-to-face classroom lectures and e-learning. It has grown rapidly to be commonly used in medical institutions, especially in the local medical universities where there is lack of qualified teachers and instructional materials. Massive open online courses (MOOCs) are the latest revolution in e-learning and provides learners with access to quality educational resources. Nevertheless, there is seldom reports concerning how to effectively integrate MOOCs into blended learning in local universities, as well as the evaluation of knowledge outcomes. In order to achieve this aim, a blended learning approach was carried out in teaching pathophysiology in Guilin Medical University. This blended learning model was based on combination of Chinese University MOOC with case based learning (CBL), as an alternative to conventional learning. The medical students in the 2017 and 2018 classes received the blended learning method, while the medical students in the 2015 class received the traditional classroom instruction. The results showed that students in the 2017 and 2018 performed significantly better than students in the 2015 class at mid-term exam and the final exam. Perception surveys also revealed that both students and teachers had positive attitude toward blended learning, and they shared similar viewpoints of blended learning. A large proportion of students and teachers believed that the blended learning enhanced students' motivation to learn independently, improved their time management skills, and allowed them to experience personalized learning. Also, most students and teachers recognized that Chinese University MOOC provided substantial educational resources suitable for their need. In addition, teachers indicated that the blended learning improved student learning quality, facilitated interaction between teachers and students, and helped them to establish a student-centered model in teaching pathophysiology. Overall, the blended learning method that combines Chinese University MOOC with CBL is effective in enhancing students' achievement and motivation in pathophysiology than the traditional learning method, and helps to strengthen the cultivation of talent in local medical universities.

The Use of Blended Teaching in Higher Medical Education during the Pandemic Era

OBJECTIVE

This study aims to compare the effect of blended teaching and traditional teaching in higher medical education during the pandemic era.

METHODS

Taking the teaching of neurology as an example, 293 Yangzhou University Clinical Medicine 2016 undergraduate students were selected as the research subjects, and were randomly divided into 2 groups a blended teaching group (n = 148) and a traditional teaching group (n = 145), and received blended teaching and traditional teaching, respectively. The blended teaching was based on a Massive Open Online Course, problem-based learning, and case-based learning and supplemented by Tencent video conferences, QQ messaging groups, and other auxiliary teaching tools. At the end of the course, the teaching effect and satisfaction rate were evaluated through theory assessment, practical skills assessment, and an anonymous questionnaire survey.

RESULTS

There were significant differences in theoretical achievements (81.83 ± 6.23 vs 76.79 ± 6.87, P < 0.001) and practical skill achievements (84.74 ± 6.50 vs 78.48 ± 6.53, P < 0.001). In addition, significant differences in all aspects of satisfaction rate were observed between the two groups (all P < 0.001).

CONCLUSION

Blended teaching is beneficial to students' learning and stimulates their enthusiasm, cultivates clinical thinking ability, and improves teaching quality. Thus, it has played a positive role in the reform of higher medical teaching during the pandemic era.

Investigating Medical Student's Preferences for Internet-Based Healthcare Services: A Best-Worst Scaling Survey

Objective: This study aimed to investigate the importance of providing Internet-based healthcare services based on the preference of a sample of medical students in China. Methods: An online best-worst scaling (BWS) survey with Case 1 design was conducted. Balanced independent block design generated 12 choice task profiles for each participant to answer. Descriptive analysis was used to describe the respondents' characteristics; Multinomial and mixed logit regression methods were used to investigate the importance of Internet-based services based on respondents' preferences. Results: A total of 1,296 students completed the online survey and rated "Clinical Service," "Decision Aids," and "Public health" as the three most important services that should be provided through an Internet-based healthcare system. Providing "Medical Education" via the Internet was chosen as the least important service by the respondents. Subgroup analysis indicated that students studying clinical medicine and non-clinical medicine considered providing "Medical Education" and "Public Health," respectively, as more important services than others. Conclusions: This BWS study demonstrated that providing "Clinical Service," "Decision Aids," and "Public Health" through the Internet are the three most important services based on medical students' preferences in China. Further research is needed to investigate how to improve medical students' skills in using internet-based healthcare services in medical education programs.

Comparison of the influence of massive open online courses and traditional teaching methods in medical education in China: A meta-analysis

In the past 5 years, the MOOC-based teaching method has been extensively applied as an experimental educational method in medical education in China. However, the effects of this teaching method on medical education are still controversial and ambiguous. To assess the effectiveness of the MOOC-based teaching method in medical education in China, we conducted the meta-analysis. Literature search was performed through the PubMed, Embase, Web of Knowledge and CNKI databases through March 3, 2020. Studies evaluating the effectiveness of the MOOC-based teaching method in medical education in China were included in our meta-analysis. All data were pooled using a fixed- or random-effect model based on a heterogeneity test. Hedges' g was calculated to evaluate the effectiveness of the MOOC-based teaching method on the final exam knowledge scores of participants. Subgroup analyses were also carried out. There were 27 studies (25 records) identified in our meta-analysis. The final exam knowledge scores of participants were statistically higher in the MOOC group compared with the controls in medical courses in China (Hedges' g = 1.080, 95%CI 0.592-1.567, p < 0.001). Obvious heterogeneity across studies was found in the study. Further analysis demonstrated that a significant difference in favor of the MOOC-based teaching method compared with the traditional teaching method in medical students and doctors. The MOOC-based teaching method may be applicable to medical education in China, strengthening the roles of MOOCs in medical education.

Delivering an online course in emergency nursing education during the pandemic: What are the effects on students' learning?

Background

Online learning emerged as an auxiliary approach in 2013 when MOOCs were imported and popularized in Chinese universities, particularly in the duration of pandemic outbreaks worldwide. World health organization (WHO) had recommended online education to keep social distance which still needs further evaluation. This study aimed to examine whether an open online course is superior to conventional education in emergency nursing during the COVID-19 pandemic.

Methods

Two groups of conventional education students (CG) and two groups of students participating in an online course that utilized an application (called SuperStar) as the SuperStar Group (SSG) were studied to compare their abilities in the process of new knowledge acquisition. The SSG was divided into a blended group (S1) and an online group (S2). The emergency nursing course was scheduled in 16 independent classes, which contained stochastic tests at least eight times.

Results

The CG group showed better performance on the final exam than the SSG group, but there was no statistically significant difference. The CG group obtained better scores on the memory capacity tests while the SSG had better scores on the application capacity tests. The SSG group scored higher on the later tests during the process of education compared to the CG group.

Conclusions

Comprehension of an emergency nursing course was stronger in the SSG group than in the CG group. Horizontal comparison of subentry tests discriminated between the groups, with a better trend for the SSG group in application ability. There are potential effects on chronological learning through the use of the online course for emergency nursing education, not only during COVID-19 but also in the post-pandemic era.

Research Progress of Alzheimer's Disease Therapeutic Drugs: Based on Renin-Angiotensin System Axis

It is widely recognized that Alzheimer's disease (AD) has a complicate link to renin-angiotensin system (RAS). It is known that cerebrovascular disease has some connections with AD, but most of the studies are still conducted in parallel or independently. Although previous research came up with large number of hypotheses about the pathogenesis of AD, it does not include the mechanism of RAS-related regulation of AD. It has been found that many components of RAS have been changed in AD. For example, the multifunctional and high-efficiency vasoconstrictor Ang II and Ang III with similar effects are changed under the action of other RAS signal peptides; these signal peptides are believed to help improve nerve injury and cognitive function. These changes may lead to neuropathological changes of AD, and progressive defects of cognitive function, which are association with some hypotheses of AD. The role of RAS in AD gradually attracts our attention, and RAS deserved to be considered carefully in the pathogenesis of AD. This review discusses the mechanisms of RAS participating in the three current hypotheses of AD: neuroinflammation, oxidative stress and amyloid-β protein (Aβ) hypothesis, as well as the drugs that regulate RAS systems already in clinical or in clinical trials. It further demonstrates the importance of RAS in the pathogenesis of AD, not only because of its multiple aspects of participation, which may be accidental, but also because of the availability of RAS drugs, which can be reused as therapies of AD.