Using technology to increase student (and faculty satisfaction with) engagement in medical education

Pedagogical and teaching strategies used to teach writing to pre-licensure students enrolled in health professional programs: a scoping review protocol

OBJECTIVE

The objective of this review is to map the existing literature on pedagogical approaches and teaching strategies used to teach academic and professional writing to pre-licensure students who are enrolled in health professional programs.

INTRODUCTION

Health professional programs are intended to develop competence in both academic and professional writing. Effective academic writing skills prompt critical reflection and engagement with research communities, while professional writing skills are used to document interventions and communicate across health systems. Despite the importance of these 2 forms of writing, there are ongoing concerns that practitioners are entering practice without adequate writing skills. Given these concerns and the importance of writing across health disciplines, there is value in identifying the pedagogical strategies and approaches used in health professional programs to develop writing skills and to transfer such skills from one communicative context to another.

INCLUSION CRITERIA

This review will consider research on the pedagogical approaches and teaching strategies used to teach academic and professional writing in pre-licensure health professional programs.

METHODS

This review will be conducted in line with the JBI methodology for scoping reviews. The search strategy will aim to locate published literature using MEDLINE (Ovid), Embase, CINAHL with Full-Text (EBSCOhost), ProQuest Nursing & Allied Health (ProQuest), and ERIC (EBSCOhost), along with gray literature (using databases/search engines). Papers published from 2010 onward in English and in French will be included. Extracted data will be reported in tabular format and presented narratively to address each review objective.

DETAILS OF THE REVIEW CAN BE FOUND IN OPEN SCIENCE FRAMEWORK

http://osf.io/9raxp.

Flipping the Teachers: Impact of a Standardized Physiology Curriculum on Neonatology Medical Educators

OBJECTIVE

 Academic physicians must teach elements in an Accreditation Council for Graduate Medical Education (ACGME)-mandated curriculum while balancing career development and clinical workload. Exploring educator perceptions on the learning environment and comparing two instructional methods (traditional didactics [TD] vs. flipped classroom [FC]) in one pediatric subspecialty may elucidate current challenges, barriers, and strategies to optimize learning and educator satisfaction.

STUDY DESIGN

 A randomized trial comparing effectiveness and learner preference for FC versus TD physiology teaching was conducted in ACGME-accredited neonatal-perinatal medicine (NPM) fellowship programs in 2018 to 2019. Educator preferences were elicited through online surveys pre- and postintervention. Free-text comments were provided for questions exploring strengths, challenges, and opportunities in fellowship education. Statistical analysis included comparisons of demographics and pre-post-intervention educator responses between groups. Thematic analysis of text responses was conducted to identify common subthemes.

RESULTS

 From 61 participating programs, 114 FC educators and 130 TD educators completed surveys. At baseline, all educators experienced professional satisfaction from teaching fellows, but noted challenges with time available to create and/or deliver educational content, limited content expertise amongst faculty, colleagues' limited enthusiasm toward educating fellows, and lack of perceived value of education by institutions given limited protected time or credit toward promotion. Postintervention, educators in both groups noted a preference to teach physiology using FC due to interactivity, learner enthusiasm, and learner-centeredness. FC educators had a 17% increase in preference to teach using FC (p = 0.001). Challenges with FC included ensuring adequate trainee preparation, protecting educational time, and providing educators with opportunities to develop facilitation skills.

CONCLUSION

 Overall, NPM educators in a trial evaluating a standardized, peer-reviewed curriculum report professional satisfaction from teaching, but described logistical challenges with developing/delivering content. Educators preferred instruction using FC, but identified challenges with learner preparedness and ensuring adequate educator time and skill. Future efforts should be dedicated to addressing these barriers.

KEY POINTS

· Many challenges exist for educators teaching neonatal-perinatal medicine fellows, including time, support, and recognition.. · Many educators preferred using flipped classroom methodology with a standardized curriculum due to interactivity and learner-centeredness.. · Benefits of a standardized, peer-reviewed curriculum include reduced preparation time, adaptability of content, and learning environment enhancement..

Swiss medical schools' experiences with online teaching during the COVID-19 pandemic in light of international experiences

BACKGROUND

During the pandemic, all universities had to switch to digital learning and teaching (DLT), the experiences were diverse. The advantages and obstacles of DLT are well reported in research. To ensure a sustainable DLT implementation, the requirements of institutions, educators and students should be aligned.

OBJECTIVE

This paper aims at identifying and describing the experiences made at the Swiss medical schools after having to switch from on-site to on-line teaching; in particular, the experienced issues, requirements, and solutions were investigated and compared to international literature.

METHODS

We conducted a literature review to derive themes and subthemes regarding the central aspects of the transition from on-site to on-line teaching. Also, we conducted semi-structured interviews with people responsible for the medical curricula at the Swiss Medical Schools. We used a purposive sampling method and invited eleven curriculum managers at the seven Swiss Medical Schools. The interviews were conducted in English, audio-recorded and transcribed. Subsequently the data was analysed with the software NVivo. We used a qualitative, deductive, content analysis to explore faculty experiences.

RESULTS

Twenty-four articles met the eligibility criteria and were included for full text screening. Of the included articles, 15 reported on DLT in general and nine articles reported on DLT during the Pandemic. The thematic analysis of the interviews resulted in four overall themes, requirements, obstacles, facilitators and advantages. Curriculum managers reported that institutions were relatively unprepared for the quick transition from onsite to online at the onset of the pandemic.

CONCLUSIONS

Our research reports a lack of institutional structures, communication, digital competences and literacy, teaching strategies, as well as a theoretical foundation for DLT implementation. A conceptual framework for DLT adapted to the Swiss universities beyond the current situation is needed.

E-learning in medical education: a perspective of pre-clinical medical students from a lower-middle income country

BACKGROUND

Many of the educational institutions in developed countries have shifted to online learning. While transition from traditional to electronic learning (e-learning) has remained a great challenge in low-middle income countries, where limited resources for teaching and learning are important factors. Medical education involves not only lecturing but also deep understanding through laboratories and patient exposure. The debate about the effectiveness of e-learning in medical education is still in contradiction due to its limitations. This cross-sectional survey was conducted to assess pre-clinical undergraduate medical students' perception of their first online learning in a lower-middle income country.

METHODOLOGY

The survey was conducted among the students who had participated in online learning during COVID-19 for at least a year. A total of 824 preclinical medical students who completed the survey from public and private medical universities in Sindh, Pakistan were included in the study. We used a validated online-based questionnaire, distributed through E-mail and social media platforms to assess the perception of students regarding their first online learning experience.

RESULTS

The response rate of the survey was 87.9%. The mean age of students was 20.7 ± 3.8 years. 392/824 (47%) were males and 57% were females. Our study indicated that 613/824 (75%) of students were experiencing online learning for the very first time while 631/824 (77%) were facing technical issues like internet accessibility and lack of IT-related skills. 381/824 (46%) were not satisfied with the institute's readiness for online teaching. However, 79% (654/824) of participants were of the idea that traditional learning is more effective in developing their practical skills as compared to e-learning. Of note, 668/824 (81%) showed overall dissatisfaction with e-learning.

CONCLUSION

Based on our study findings, we concluded that most students have a negative perception of e-learning. Difficulty in connectivity, electricity issues, less interaction with colleagues and teachers, and issues with the structure of online courses were the most frequently reported problems by the students.

The impact of online education during the Covid-19 pandemic on the professional identity formation of medical students: A systematic scoping review

Evolving individual, contextual, organizational, interactional and sociocultural factors have complicated efforts to shape the professional identity formation (PIF) of medical students or how they feel, act and think as professionals. However, an almost exclusive reliance on online learning during the COVID-19 pandemic offers a unique opportunity to study the elemental structures that shape PIF and the environmental factors nurturing it. We propose two independent Systematic Evidence-Based Approach guided systematic scoping reviews (SSR in SEBA)s to map accounts of online learning environment and netiquette that structure online programs. The data accrued was analysed using the clinically evidenced Krishna-Pisupati Model of Professional Identity Formation (KPM) to study the evolving concepts of professional identity. The results of each SSR in SEBA were evaluated separately with the themes and categories identified in the Split Approach combined to create richer and deeper 'themes/categories' using the Jigsaw Perspective. The 'themes/categories' from each review were combined using the Funnelling Process to create domains that guide the discussion. The 'themes/categories' identified from the 141 included full-text articles in the SSR in SEBA of online programs were the content and effects of online programs. The themes/categories identified from the 26 included articles in the SSR in SEBA of netiquette were guidelines, contributing factors, and implications. The Funnelling Process identified online programs (encapsulating the content, approach, structures and the support mechanisms); their effects; and PIF development that framed the domains guiding the discussion. This SSR in SEBA identifies the fundamental elements behind developing PIF including a structured program within a nurturing environment confined with netiquette-guided boundaries akin to a Community of Practice and the elemental aspect of a socialisation process within online programs. These findings ought to be applicable beyond online training and guide the design, support and assessment of efforts to nurture PIF.

Planning and implementation of participant-centric group activity on research methodology: perceptions of postgraduate medical students in physiology

Knowledge about the key steps in "research methodology" is necessary for all postgraduate students who are enrolled in the medical profession. The objective of the present study was to plan, design, and implement a participant-centric postgraduate skill development activity to inculcate the key principles and components of research methodology. It included 3 goal-oriented component group exercises, namely, 1) framing a research question, 2) critiquing a research article, and 3) writing a research protocol. Out of 25 eligible postgraduate students of our department, 20 participated in all three component group exercises, and they were included in the study. Feedback was obtained from them on a five-point Likert scale after the group exercises. In addition, students were also asked to provide open-ended comments for further improvement of the session. Data from participants' feedback suggested that the majority of the participants expressed satisfaction regarding the plan, conduct, and learning experience of the postgraduate activity. Therefore, participant-centric group activity could be an innovative approach in postgraduate medical education to inculcate the basics of research methodology. It can provide additional emphasis on the components of self-directed learning through individual exercises and unsupervised group dynamics. Supervised group dynamics can inculcate skills in critical thinking, acceptance, communication skills, and teamwork.NEW & NOTEWORTHY Postgraduate medical education is underpinned by supervised and unsupervised learning processes. The current study incorporates an innovative approach to inculcate the basic skills of "research methodology" through three goal-oriented participant-centric group exercises, namely, 1) framing a research question, 2) critiquing a research article, and 3) writing a research protocol. The activities encompass components of self-directed learning through unsupervised group dynamics. They focus on critical thinking, acceptance, communication skills, and teamwork during supervised group dynamics.

Developing research skills in medical students online using an active research study

BACKGROUND

Developing research skills and scholarship are key components of medical education. The COVID-19 pandemic necessitated that all teaching be delivered online. We introduced an approach to small group teaching in the academic year 2020-2021 online which involved students in an active (ongoing) research study to develop their research skills.

METHODS

We acquired student feedback to evaluate their perspectives quantitatively on development of research and scholarship skills, teaching content and format, and tutor performance using this teaching approach. In addition, we captured free text responses from both students and tutors on the positives and negatives of our course, and their suggested improvements. We also compared summative assessment marks for the online/active research course (2020-2021) with those obtained from previous (2017-2019) and subsequent (2021-2023) teaching sessions.

RESULTS

Students were largely positive about most aspects of the online course utilising an active research study (n = 13). Students agreed that they were able to acquire research skills, particularly related to data analysis, transferable skills, and giving scientific presentations. A one-way ANOVA revealed no significant difference for assessment marks across all five teaching years (two years prior and two years following the online/active research course), indicating that the course achieved the learning outcomes. Students enjoyed the convenience of online teaching and the availability of course resources, but least liked the lack of in-person interaction and laboratory training. Tutors enjoyed the collaborative aspects of online teaching, but least liked the lack of face-to-face interactions with students.

CONCLUSIONS

Our study demonstrates that delivering online teaching which involves students in active research engages and motivates them to develop their research and scholarship skills. We recommend that educators consider incorporating a current research study in their undergraduate courses as this can enhance the student learning experience as well as the research project itself.

Student engagement in health professions education: AMEE Guide No. 152

This guide aims to support our colleagues to have comprehensive understanding of student engagement in health professions education. Despite the universal agreement about the significance of student engagement, there is lack of uniformity in conceptualizing and operationalizing this emerging construct. We review the theoretical basis explaining student engagement from three main perspectives: behavioral, psychological, and socio-cultural. In addition, we propose a contemporary and comprehensive framework for the student engagement in higher education, which is applicable to health professions education contexts. Drawing from this framework, we explain the conceptualization of the construct and its preceding factors, mediators, dimensions, spheres, and outcomes of student engagement. The proposed framework introduces student 'engagement through partnerships' as a novel component compared with the existing models of student engagement in higher education. This way, we are proposing a mixed model that not only considers the student as a 'customer' but also as a 'partner' in education. Engagement of students through partnerships include four areas: (1) provision of the education program, (2) scholarly research, (3) governance and quality assurance, and (4) community activities. This guide will provide practical applications on how to improve student engagement in health professions education. Finally, we highlight the current gaps in areas of research in the student engagement literature and suggested plans for future directions.[Box: see text].

Migraine, associated factors, and functional disability in medical students at a peruvian university during the COVID-19 pandemic: An analytical cross-sectional study

Background

It is unknown whether the confinement caused by the coronavirus disease 2019 (COVID-19) pandemic may influence migraine triggers. This study aimed to determine the frequency of migraine and their associated factors in medical students at a Peruvian university. The characteristics of migraine episodes and degree of functional disability caused by migraine were also evaluated.

Methods

An analytical cross-sectional study was conducted on medical students of a Peruvian university. The suspected migraine was determined with the Migraine Screen Questionnaire. Sociodemographic, confounding, and COVID-19 pandemic-related variables were included as possible associated factors. Poisson regression models were used, and crude and adjusted prevalence ratios with 95% confidence intervals were estimated.

Results

The participants comprised 327 students, and 30.3% (n = 99) had suspected migraine. Sex, clustered semesters, having family members with migraine and COVID-19 risk factors, and hours in front of the computer were associated with a higher probability of migraine. However, having more hours of sleep per day was associated with a lower probability. Moreover, most students with migraine had a severe functional disability (41.4%).

Conclusions

The high frequency of migraine in medical students could be due to COVID-19-related quarantine. Certain pandemic-related factors increase the probability of having migraine. A high level of disability should promote timely diagnosis and follow-up in affected students.

Anaesthetic National Teaching Programme for Students (ANTPS)

The COVID-19 pandemic has significantly undermined undergraduate anaesthetic teaching in spite of the vital role of the specialty against the pandemic. Anaesthetic National Teaching Programme for Students (ANTPS) was designed to meet the evolving needs of undergraduates and tomorrow's doctor by standardising anaesthetic training, preparing for final exams and equipping competencies vital for doctors of all grades and specialties. Our Royal College of Surgeons England-accredited University-College-Hospital-affiliated programme consisted of six-biweekly sessions were delivered online by anaesthetic trainees. Prerandomised and postrandomised session-specific multiple-choice questions (MCQs) assessed students' improvement in knowledge. Anonymous feedback forms were provided to students after each session and 2 months following the programme. 3743 student feedback forms (92.2% of attendees) across 35 medical-schools were recorded. There was a mean improvement in test score (0.94±1.27, p<0.001). 313 students completed all six sessions. Based on 5-point Likert scale, students who completed the programme showed an improvement in their confidence in knowledge and skills to face common foundation challenges (1.59±1.12, p<0.001) and thus felt better prepared for life as junior doctors (1.60±1.14, p<0.001). With an increase in confidence in students to pass their MCQs, Observed Structured Clinical Examinations and case-based discussion assessments, 3525 students stated they would recommend ANTPS to other students. Unprecedented COVID-19 factors impacting training, positive student feedback and extensive recruitment, demonstrate that our programme is an indispensable learning resource which standardises anaesthetic undergraduate education nationally, prepares undergraduates for their anaesthetic and perioperative exams and lays strong foundations for implementation of clinical skills required by all doctors, to optimise training and patient care.

Preferences for printed books versus E-books among university students in a Middle Eastern country

Background

Learning styles vary among the students at the university level which has changed from traditional to more technology pervaded strategies involving digital gadgets. The Academic libraries are being challenged to upgrade from old fashioned hard copy resources to digital libraries including electronic books.

Purpose

The main purpose of the study is to assess the preferences of using printed books versus e-books.

Methods

A descriptive cross sectional survey design was used to collect the data. A total of 607 students were included in the study. Data collected was analyzed using descriptive and inferential statistics.

Results

Results showed that 86.8% of the students were in undergraduate program with 48.9% students in the second year of the program, 95.6% in the age group of 17-26 years and 59.5% of them being females. The study concluded that 74.6% of students prefer e-books in terms of easy to carry and 80.6% of them spent more than 1 h reading from e-books, while 66.7% of the students preferred printed books due to the ease in studying and 67.9% favored as it is easy to make notes. However, 54% of them felt studying from the digital copies difficult.

Conclusion

The study concludes that the students prefer e-books as they spent more time reading from e-books and are easy to carry; while traditional printed copy is comfortable to use and easy to take notes and study for exams.

Implications for practice

As many changes are happening in the instructional design strategies with the introduction of hybrid methods of teaching and learning, the findings of the study will guide the stake holders and educational policy makers to design novel and modernized educational design that has a psychological, and social impact among the students.

A comparison of medical and pharmacy student perspectives of a clinical interprofessional home-visit versus a virtual interprofessional workshop

Background: No Place Like Home is a clinical interprofessional education (IPE) activity whereby pharmacy and medical students conduct home visits under the guidance and supervision of a clinical preceptor to homebound patients. Purpose: We examined pharmacy and medical student perceptions of mastery of interprofessional competencies during an in-person clinical home visit pre-COVID-19 pandemic versus a virtual IPE learning activity consisting of didactic and case discussions in response to the global COVID-19 pandemic. Methods: We administered the same modified Interprofessional Collaborative Competency Attainment Survey (ICCAS) instrument, which uses a five-point Likert scale, to both the in-person and the virtual IPE students following their learning activity.   Results: We received a total of 459 completed survey responses with an overall response rate of 84%. For both groups of students, the in-person format was preferred, however, to our surprise, the results indicated that students in the virtual group reported greater perceived gain in interprofessional skills than students in the in-person group. In addition, pharmacy students perceived greater gain from the interprofessional activity and offered more thoughtful reflections about their experience. Conclusions: Even though both groups of students preferred the in-person visit, the IPE objectives were equally (for medical students) or better (for pharmacy students) absorbed in the virtual environment than the in-person clinical home visit.

Online practical assessment in biochemistry designed on Bloom's taxonomy to assess the student's competency: Prior exposure of the students to online tools beneficial

Online assessments are needed during the prevailing pandemic situation to continue educational activities while ensuring safety. After conducting the online practical assessment (OPrA) in Biochemistry, we analyzed the students' responses. The blueprint of the OPrA was prepared by the faculty, referring to the various levels and domains of Bloom's taxonomy. Four components were chosen for the online assessment: digital spotters, enumerating the steps of objective structured practical examination, interpretation of quantitative estimation, and case discussion. Each faculty assessed about 12-13 students in separate breakout rooms over 15-20 min on all four components. Feedback on the conduct of the examination was collected from the students and faculty anonymously and analyzed. Out of the 200 students who attended the online assessment, only one scored less than 50%, majority of them scored between 71% and 90%. Under the individual exercises, the average score of students in "Spotters" was 9.8 out of 10; in "OSPE," 8.7 out of 10; in "Quantitative experiments," 15.2 out of 20 and in "Case discussion," 22.4 out of 30. Around 20% had previous experience attending the OPrA. They differed in their opinion from the rest of the students on five aspects; time allotted for the assessment (p value = 0.02, χ²  = 5.07), students using unfair means during the online viva (p value = 0.02, χ²  = 5.57), their computing skills (p value = 0.001, χ²  = 19.82), their performance (p value = 0.001, χ²  = 8.84), and overall conduct of the examination (p value = 0.001, χ²  = 15.55). OPrA tools may be designed referring to Bloom's taxonomy, and prior exposure to the online tools may benefit the students.

Online Instructor Clusters: Implementation Frequency of Instructional Activities

The purpose of this study was to group instructors based on their patterns of implementing activities in their online courses, to examine factors that influenced differences within clusters, and to explore whether cluster membership affected instructor satisfaction. Data were collected from faculty at a university in the western United States with the use of three instruments that measure pedagogical beliefs, implementation of instructional activities, and instructor satisfaction. Latent class analysis method was used to identify instructor groups and examine how the groups differed in pedagogical beliefs, characteristics, and satisfaction. The resulting two-cluster solution includes two orientations: content and learner-centric. Of the covariates examined, constructivist pedagogical beliefs and gender were the significant predictors of cluster membership. Results also showed a significant difference between the predicted clusters pertaining to online instructor satisfaction.

"Starting from the Image": A Tele-pathology Pre-graduate Course Aimed at Motivating Medical Students

In the tele-course entitled "Starting from the image", medical students are confronted with practical tasks in relevant professional contexts. Initially, a macroscopic or microscopic image of a patient case is presented to learners who then receive relevant information on the patient's history, clinical findings, and other laboratory tests. A pathologist actively discusses the pathological findings; then, a clinician explains their implications for the patient's individualized treatment and prognosis. In this way, pathology's interaction with other medical specialties is highlighted. Students declared that through these simulated professional practice experiences, they strengthened their decision-making skills. Educators should consider upgrading from information-based teaching to practice-focused instruction.

Medical Education in the Context of the Eastern Mediterranean Region: Professional Development Activity of Health Professionals

Background

The development and maintenance of a high-quality medical education workforce depend on continuing medical education (CME). Traditionally, CME is delivered face-to-face, but due to COVID-19 and geographical distances, it is challenging to conduct professional development activities for several days. Using a webinar on advancement in medical education in the context of the eastern Mediterranean, we aimed to assess the participants' perspectives towards the professional development activity using a synchronous learning approach.

Methods

We used a cross-sectional survey-based study design. We invited faculty members from King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and United Arab Emirates University for Health Sciences (UAEU). We assessed their perspectives on the relevance of the content and effectiveness of the activity on their knowledge and skills after the two days' webinar series. A self-designed questionnaire was administered post-webinar immediately. Open-ended responses were analyzed thematically.

Results

One hundred thirty-six registered healthcare professionals attended day 1, and 97 registered participants joined on the second day of the webinar. Most participants appreciated the diversity of the contents, the quality of the presentations, and the expertise of the facilitators. They reported that the content optimized their knowledge and understanding of new concepts such as assessment in simulation teaching, programmatic assessment, insight into the implementation of IPE and EPAs in CBME, and so on. The e-learning platform's user accessibility, online tutor interaction, and the addition of more scenario-based case studies were all recommended for improvement.

Conclusion

Overall the two days webinar series presentations were informative and highlighted the transformation in medical practices. Suggestions to improve the quality of the webinars and content were discussed.

Students' and lecturers' perspectives on the implementation of online learning in medical education due to COVID-19 in Germany: a cross-sectional pilot study

Background

During the coronavirus disease 2019 (COVID-19) crisis, many things changed in universities around the world. In-person learning was not possible. Instead, courses were offered in digital form. The sudden change posed enormous challenges to universities, students, and teachers. The aim of this study was to investigate the disadvantages as well as the advantages and opportunities of digital learning.

Objective

This study investigated the evaluation of an elective module by medical students and teachers in the traditional in-person and virtual teaching forms during the COVID-19 pandemic.

Methods

Using the elective module "Sports Medicine," which includes both lectures and practical units, the opinions of the medical students about conventional teaching compared to digital instruction were evaluated. In the winter semester of 2019/2020, all classes were taught face-to-face but had to be switched to virtual teaching in the summer semester of 2020 on an ad hoc basis due to the pandemic. The students were asked to answer questions on general conditions, participant behavior, instructor evaluation, skill acquisition, topic selection, and overall evaluation after both forms of teaching. Likewise, the lecturers of both courses were queried in semiqualitative interviews about the same topics. Descriptive data analysis was performed to process the data.

Results

The students perceived digital teaching to be superior in most subareas compared to in-person teaching in terms of framework, instructor evaluation, skill acquisition, topic selection, and overall rating. Medical students seemed to feel better with digital teaching in most areas of evaluation. The lecturers found the new form of teaching rather unsettling and criticized the lack of verbal and especially nonverbal communication as well as the short preparation time for the new challenge. The instructors were uncomfortable with some aspects of the virtual teaching format.

Conclusion

In the wake of the COVID-19 pandemic, medical schools should rapidly digitize their teaching offerings and support faculty members in their computer-based competence with continuing education opportunities and time resources.

Physician Assistant Students' Perception of Online Didactic Education: A Cross-Sectional Study

PURPOSE

This study describes physician assistant students' perception toward online didactic education and highlights relationships between student characteristics and their preference for online learning.

METHODS

A previously validated survey questionnaire was administered online to physician assistant students enrolled in traditional, in-person training programs across the United States. The survey consisted of five Likert-scale statements measuring perceptions of online learning and was rated on a seven-point Likert scale. Students also reported their age, gender, history of taking an online course, and preferred learning style. Mean scores were reported for agreement with each Likert-scale statement; Pearson correlation coefficients, one-way ANOVA with post hoc Tukey tests, and independent samples t-tests were used to determine relationships between student characteristics and their preference for online learning.

RESULTS

A total of 391 completed surveys met the inclusion criteria for the study and were used in data analysis. The average age of respondents was 25.98 years, 81.1% (n = 317) were female, 96.2%, (n = 376) reported taking an online course previously, and preferred learning styles were reported as 36.1% (n = 141) visual, 7.7% (n = 30) auditory, 15.6% (n = 61) reading/writing, and 40.7% (n = 159) kinesthetic. Nearly a quarter of respondents indicated they preferred online courses, particularly students with a preferred learning style of reading/writing. No relationships were observed between age, gender, or history of taking an online course and preference for online education.

CONCLUSION

Most physician assistant students prefer in-person learning. However, a substantial number prefer online learning, and a significant number of these students reported a preferred learning style of reading/writing. More research is necessary to give educational institutions the ability to make data-driven, student-centered program development decisions. However, data in this study indicate a need for continued development of online/hybrid physician assistant programs to better align with current student preferences.

Medical Students' Perceptions Towards Online Teaching During the Covid-19 Pandemic: A Cross-Sectional Study from Saudi Arabia

Background

The Covid-19 has made a huge impact on higher education. Online teaching and learning became essential to deliver educational activities in all areas including medical education. In this study, we aimed to investigate medical students' perceptions on the role of online teaching and learning in facilitating medical education.

Material and Methods

A cross-sectional study using a self-administered online questionnaire was conducted. Students eligible were medical students across all years at Imam Abdulrahman Bin Faisal University, Saudi Arabia. Perceptions analysis was conducted using SPSS software.

Results

A total of 563 students participated in the study (prominent category female 64%, n = 361). There was a significant increase in the number of hours devoted to online learning during the pandemic. Live lectures/tutorials platform via zoom showed the highest rate of interaction compared to pre-recorded lectures and learning materials uploaded on blackboard. 50% of the students disagreed that online teaching is as effective as face-to-face teaching. The greatest perceived enjoyable aspect included the online accessibility of materials. Whereas the most frequent perceived barrier to online learning included internet connection. 17% of students reflected a poor understanding of scientific materials through online PBL. More than 50% of students revealed that online theoretical lectures are as good as classroom or better. Whereas the majority (70%) were unable to learn clinical skills online. The results indicated high impact on students' physical activities (80%). Impacts were higher on pre-clinical students' health and social life than on clinical students.

Conclusion

Our findings reported that during emergency situations due to the pandemic, online teaching enables the continuity of medical education and provides adequate efficiency. The use of live online platforms showed high level of interaction. However, some barriers need to be addressed especially at the clinical skills development level to maximize the benefit of online teaching and learning.

Medical students' adoption and evaluation of a completely digital general practice clerkship - cross-sectional survey and cohort comparison with face-to-face teaching

BACKGROUND

During the COVID-19 pandemic, the University of Leipzig completely switched to online teaching. Thus, we developed a practice-oriented digital substitute for a two-week mandatory general practice (GP) clerkship. Main components were processing of clinical cases and additional GP topics, visual diagnoses, information and examination videos, and regular remote exchanges with associated GP teachers. We took the chance to comprehensively evaluate the new teaching formats (acceptance, use, working enjoyment, learning gain, practical relevance, insights into general practice) and to compare evaluations with two previous semesters to gain insights for future blended learning concepts.

METHODS

Cross-sectional post-hoc online evaluation among fourth year (of six) medical students participating in the digital mandatory 2-week GP clerkship during summer semester 2020; additional cohort comparison with two previous semesters (face-to-face clerkship).

RESULTS

Out of 192 participants in the digital clerkship, 99 completed our questionnaire (response rate = 51.6%). Results were compared with 277 previous evaluations (face-to-face semesters). Most participants reported having enjoyed the online-based clerkship (87.9%), having learned a lot (89.9%), having gained insights into general practice (76.8%), and perceived high practical relevance (90.9%). Implementing the new teaching formats into future face-to-face clerkships was welcomed by 65.6%. Clinical cases, visual diagnoses, examination videos and communication with GP teachers were rated best regarding working enjoyment, learning gain, practical relevance and insights into a GP's work. Cohort comparison revealed somewhat better evaluations regarding knowledge transfer for the digital clerkship while imparting of skills and attitudes was reportedly worse.

CONCLUSIONS

Students welcomed the digital content and perceived relevant learning gain. Our results may help to develop future blended learning concepts. Clinical cases, examination videos and visual diagnoses appear to be particularly suitable as useful online complements which could enrich face-to-face teaching. As students especially valued the exclusive time for exchanges with their preceptor, this should be facilitated in face-to-face clerkships.

Opportunity Amid Crisis in Medical Education: Teaching During the Pandemic of COVID-19

Purpose

The pandemic of COVID-19 had reinforced adaptations in medical education. It was challenging, especially for developing countries where resources were scarce. This study examined the implementation of teaching and learning adaptation during the pandemic in a low-resource country as perceived by teachers. We also present the opportunities that arise from the adaptation process.

Participants and Methods

The participants of this study (n=24) were teachers in an undergraduate medical program. This study employed a qualitative approach using focus group discussions (FGDs) to collect the teachers' perceptions. Thematic analysis was performed to analyse the data.

Results

Teachers' perceptions were categorized into 19 subthemes and were accentuated into four general themes; learning facilitation, assessment during the pandemic, learning resources, and competence achievement. We discovered both challenges as well as opportunities in each theme due to the shifting of learning from offline to online learning. Flexibility and innovation were regarded as the most important opportunities and were perceived to hold potential for medical education in the future. Knowledge acquisition was most benefited from this adaptation. Facilitating skill acquisition and burnout were the major challenges.

Conclusion

Despite the challenges, including burnout, skills acquisition, and risk in academic integrity, innovations in medical education were strengthened during the pandemic of COVID-19. They also provided a positive influence regarding achievement in the cognitive aspect. Faculty development programs need to be encouraged to improve teachers' capacity in the future.

Perception of pediatric residents from a tertiary hospital in the city of México regarding their training during the COVID-19 pandemic

BACKGROUNDS

On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus (COVID-19) outbreak a global pandemic, which changed the residents' teaching and learning process. The purpose of this study was to determine residents' satisfaction and impressions on their training during the pandemic in a tertiary pediatric hospital.

METHODS

This was a descriptive cross-sectional study. An online survey was designed to determine residents' demographic and personal characteristics, as well as their perception about the theoretical and practical training, as well as about their emotional situation. The analysis separated medical students from surgical students in order to identify any differences existing between these groups, for which χ2 was calculated.

RESULTS

Overall, 148 of 171 residents (86.5%) responded to the questionnaire; 75% belonged to the medical specialty and 25% to the surgical specialty. Statistically significant differences were found in terms of those training aspects they were concerned about during the pandemic (p < 0.001) and about the difficulties associated with online learning (p = 0.001). Differences were also found regarding their satisfaction toward the time needed to complete their thesis (p = 0.059) and activities outside the hospital (p = 0.029). Regarding their degree of satisfaction in general, most medical specialty students felt slightly satisfied (43.2%) and surgical specialty students felt mostly neutral (37.8%). Regarding their feelings about their mental health, statistically significant differences were found between both groups (p = 0.038) although both groups reported the same percentage of overall dissatisfaction (2.7%) in this area.

CONCLUSION

The COVID-19 pandemic has brought significant challenges to medical education systems. Lack of practice in decision-making and maneuver execution are concerns for residents and may affect their future professional performance.

A blended learning exercise physiology theory module that supports student autonomy and improves academic performance

A limited number of studies have explored the impact of blended exercise physiology theory curricula on student learning and experience. This study aimed to investigate the impact of an exercise physiology blended learning theory module on student performance, engagement, and perceptions. The module, which comprised a range of elements (student guide, lecturer-recorded videos, supplementary videos, formative quizzes, workshops, and discussion forum), was implemented in a third-year subject taken by students in nonspecialist undergraduate science, technology, engineering, and mathematics (STEM) degrees. Students chose which elements to engage with to support their learning. Exam performance was assessed by comparing exam marks from fully face-to-face delivery to the blended delivery with an independent t test. Student perceptions were determined via an end-of-module questionnaire comprised of Likert-scale questions and open-ended questions. Descriptive statistical analysis was conducted on the Likert-scale responses, and qualitative content analysis was conducted on the open-ended responses. Student engagement with online resources was determined through analysis of access statistics from the learning management system. Student exam marks in the blended learning student group were significantly higher (P < 0.0001) than in the face-to-face group, even though the questions were of a higher Bloom's level in the blended learning group. Students preferred blended delivery over fully face-to-face delivery. Most students accessed the student guide, lecturer-recorded videos, and quizzes, with supplementary videos, workshops, and discussion forums accessed by fewer students. In conclusion, a blended exercise physiology theory module improved student exam performance and was positively perceived by students, and engagement with the elements of the module was varied.NEW & NOTEWORTHY Few studies have explored the impact of blended delivery of exercise physiology theory curricula on student learning and experience. This study investigated the impact of a novel blended model on student learning and experience. The module comprised a range of elements (student guide, lecturer-recorded videos, supplementary videos, formative quizzes, workshops, and discussion forum), where students were able to choose which elements to engage with to support their learning.

Learning Outcomes in a Live Virtual versus In-Person Curriculum for Medical and Pharmacy Students

Background

The coronavirus disease (COVID-19) pandemic has been a source of disruption, changing the face of medical education. In response to infection control measures at the University of California, San Diego, the hybrid in-person and recorded preclerkship curriculum was converted to a completely virtual format. The impact of this exclusive virtual teaching platform on the quality of trainee education is unknown.

Objective

To determine the efficacy of a virtual course, relative to traditional hybrid in-person and recorded teaching, and to assess the impact of supplementary educational material on knowledge acquisition.

Methods

A retrospective observational cohort study was performed to assess an introductory course, held mostly in person in 2019 versus completely virtual in 2020, for first-year medical students and second-year pharmacy students at the University of California, San Diego, School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences.

Results

The midterm and final examination scores were similar for the hybrid and virtual courses. There was no association between the hours of recorded lectures watched and final examination scores for either course. In the 2019 in-person and recorded course, students who demonstrated consistent on-time use of practice quizzes scored statistically higher on the final examination (P = 0.0066). In the 2020 virtual course, students who downloaded quizzes regularly had statistically higher scores on the midterm examination (P < 0.0001).

Conclusion

The similar examination scores for the hybrid in-person and recorded and exclusively virtual courses suggest that the short-term knowledge acquired was equivalent, independent of the modality with which the content was delivered. Consistent on-time use of practice quizzes was associated with higher examination scores. Future studies are needed to assess the difference between a completely in-person versus virtual curriculum.

The COVID-19 pandemic and its impact on medical teaching in obstetrics and gynecology—A nationwide expert survey among teaching coordinators at German university hospitals

Purpose

The COVID-19 pandemic has imposed severe challenges on medical education at German university hospitals. In this first German nationwide expert survey, we addressed the responsible university teaching coordinators in obstetrics and gynecology departments and investigated their experiences during the pandemic as well as their opinions on future developments, especially with regard to the broader implementation of e-learning in the standard curriculum.

Methods

The questionnaire included 42 items and was disseminated among teaching coordinators at all 41 departments of obstetrics and gynecology at German university hospitals via an email that included a weblink to the online survey provider. Responses were collected between 19 April and 7 June 2021.

Results

In total, 30 responses were collected from 41 departments across Germany and their respective teaching coordinators in obstetrics and gynecology. The general opinion of the medical teaching provided during the pandemic was positive, whereas the teaching quality in practical skills was considered inferior and not equivalent to the standard face-to-face curriculum. Lectures and seminars had to be substituted by remote-learning alternatives, while clinical clerkships were reduced in length and provided less patient contact. Students in their final year experienced only a few differences in the clinical and teaching routine. Teaching coordinators in obstetrics and gynecology stated that they intend to incorporate more e-learning into the curriculum in the future.

Conclusion

The medical educators’ views presented here may help to complement the already-thoroughly investigated experiences of students under the restrictions of the COVID-19 pandemic. Medical educators in obstetrics and gynecology at German university hospitals have successfully established online and hybrid teaching alternatives to their standard face-to-face courses. Building on recent experiences, digitalization could help to improve future medical education.

Assessing the Publicity and Reach of Peer-Led Online Medical Teaching: A Single-Event Evaluation

PURPOSE

The COVID-19 pandemic caused significant disruption to higher education, including medical studies. Online learner support became urgently necessary, and peer-support of learning was needed to supplement formal teaching. This study evaluates the impact and delivery media of OSCEazy, a student-led initiative supporting formal teaching across institutional and national boundaries.

METHODS

A survey was created on Google Forms and disseminated via the Zoom chat function to all the participants at the end of our event titled, "The Cardiology Station".

RESULTS

A large proportion (99.5%) of the students have a Facebook account and (98.7%) use it to keep track of medical events (p=0.45 for comparison). However, a very small proportion of use their other social media to keep up with medical events (p<0.0001 for comparison).

CONCLUSION

It is evident from our results, that most of our participants used Facebook to keep track of medical events. The use of their other social media platforms (Instagram, etc) to keep track of medical events was limited. Thus, it is important for any organisation, such as ours, who conduct online events to evaluate which platform is most suitable for them to use to publicise their events.

The perception of e-learning during the SARS-CoV-2 pandemic by students of medical universities in Poland - a survey-based study

BACKGROUND

In March 2020 lockdown due to the COVID-19 pandemic forced Polish Medical Universities to implement e-learning. The aim of the study was to evaluate the perception of e-learning by students of Medical Universities in Poland.

MATERIAL AND METHODS

Survey was performed nationwide via the Internet from 30th November 2020 to 10th February 2021. Six hundred fifteen (615) medical students completed the survey. The study questionnaire included questions concerning sociodemographic data, perception of lecturers' effectiveness, assessment of stationary and online classes, changes in learning habits and restrictions on education, and advantages and disadvantages of e-learning.

RESULTS

The respondents reported that 96.1% of lectures, 85.5% of seminars, and 40.0% of clinical classes were implemented by e-learning. The lectures conducted by e-learning were assessed as good and very good by 78.4% and seminars by 51.2% of respondents. While the clinical classes conducted by e-learning were assessed as bad and very bad by 62.9% of respondents. The most frequently indicated limitations of e-learning were the quality of the content and available materials (26.9%), restrictions in direct contact with the lecturer (19.6%), Internet connection (16.8%), and home conditions (13.8%). Only 4% of the students had to buy or retrofit computer equipment. Any other limitations were indicated by 9.7% of the respondents.

CONCLUSIONS

Students were highly accepting of lectures and seminars conducted in the form of e-learning, but not laboratory and clinical classes. The main problems in e-learning are the quality of the classes conducted and the Internet connection. The students expect e-learning classes to be conducted in real-time, with direct, face-to-face contact with the lecturer.

Student engagement in undergraduate medical education: A scoping review

INTRODUCTION

Student engagement is defined as behavioural, cognitive and emotional aspects of students' academic experience in teaching, learning and research through interacting with other students, faculty and community. Despite the growing interest in the field of student engagement, medical education research in this area is still fragmented. This scoping review aims to contribute to the understanding of measurements, drivers and outcomes of medical student engagement.

METHODS

The authors searched MEDLINE, PubMed, ProQuest, SCOPUS, ERIC, Science Direct and EBESCO for English articles published from 1990 until October 2021. In addition, we hand-searched key medical education journals and references in recently published articles. Using specific selection criteria, two authors independently reviewed the articles for eligibility, followed by data extraction using both quantitative and qualitative analysis.

RESULTS

Of the 2136 retrieved articles, 51 studies were selected for the review, and 94% of them were published in the past 8 years. The prevailing measures of student engagement failed to cover the multidimensionality of the construct with more focus on the behavioural dimension. Quantitative methods represented two thirds of the studies with a higher frequency of cross-sectional designs and using self-reports. The identified drivers of medical students' engagement are directed mainly to modifying the context of the learning environment. These factors increased student engagement by fostering relevance of learning, positive student relationships with peers and faculty, and enhancing student agency, and sense of competence. Cognitive engagement appears to be a positive predictor of academic achievement, but the relationship with other dimensions of engagement is controversial.

CONCLUSIONS

Student engagement in undergraduate medical education is an important, yet under-researched construct. The research that does exist suggests engagement to be malleable, something that can be modified by different types of interventions taking into consideration the context of education and practice. Further research is required, however, to address the gaps identified in this review.

Perceptions of Digital Teaching During COVID-19; A National Survey of 359 Internal Medicine Trainees

INTRODUCTION

The Covid-19 pandemic brought significant disruption to post-graduate medical education. Lecture-based training days were rapidly converted to webinars. This study aims to assess the perceptions of digital training in internal medical trainees.

METHODS

IMTs (internal medicine trainees) nationally were surveyed on their perceptions of digital training, ease of access, engagement, and interactivity via a 10-item questionnaire. A mixed-method approach using qualitative and quantitative questions was used. Likert scales were analysed using a mean result of above 3 to indicate agreement.

RESULTS

359 trainees responded. Trainees agreed that they preferred digital training to face-to-face teaching (mean 3.68); digital training was more engaging (mean 4.25), easier to access (mean 4.49), and as effective for learning as face-to-face teaching (mean 4.69). The most reported advantages were no travel (89%) and the ability to watch later on (88%). 63% of trainees reported loss of social interaction as a disadvantage.

DISCUSSION

This survey suggests that digital teaching has a potential role in IMT training beyond the pandemic.

Medical Students and Faculty Perceptions About Online Learning During COVID-19 Pandemic: Alfaisal University Experience

Background and Objectives

Off-campus online learning methods abruptly increased and gained popularity during the COVID-19 pandemic. Previous studies have highlighted the limitations of online learning mode; however, further studies on the experiences of medical students are needed. This study aimed to investigate the preclinical medical students and faculty members' experiences with online education and learning.

Subjects and Methods

In this cross-sectional study, data were collected using convenience sampling. Two hundred nine students and 13 faculty members who participated in the online courses offered during the spring semester of 2019–2020 completed an online questionnaire. A 30-item questionnaire for the students and a 25-item questionnaire for the faculty were used in this cross-sectional study.

Results

Overall, 30% of the student sample was satisfied; importantly, high-achieving students (GPA > 3.5) were less satisfied (25 vs. 32%; p = 0.006). Satisfaction was also low (35%) for student-faculty interaction opportunities. About half of the student sample agreed that small-group interactive sessions would improve learning (53%). The most favored course format was the blended mode (43%), followed by traditional (40%) and online modes (17%). Six out of 13 (46%) faculty members were satisfied with their online experiences. Most of them found virtual teaching applications convenient (77%). Conversely, few faculty members agreed to interact effectively (54%), while 69% favored a blended format.

Conclusions

The level of satisfaction in fully online courses offered during the COVID-19 pandemic remained low, especially among high-achieving students. Both students and faculty favored the blended format for future purposes. Small group active-learning strategies and web-based interactive tools may facilitate engagement and student-faculty interactions.

Fellows’ Perspective of Educational Changes in Medical Sports Medicine During the COVID-19 Pandemic

Background

As a result of the coronavirus disease 2019 (COVID-19) pandemic, graduate medical education, along with most of daily life, was disrupted. The goal of this study was to explore the experiences of fellows in primary care/medical sports medicine (MSM) and view the changes made to training programs through their eyes.

Methodology

A questionnaire was developed to collect qualitative and quantitative data regarding the fellow’s experiences in training from March to June 2020. Fellows on the American Medical Society for Sports Medicine list of current Sports Medicine Fellows in the United States and Canada were invited to participate. Of the 329 invited, 90 (27.4%) fellows returned questionnaires.

Results

MSM fellows highlighted positive adaptations as well as losses to their educational programs related to the pandemic. The biggest gain reported was additional learning time, and the greatest loss was to sports and event coverage. Most fellows reported attending collaborative sessions, and they noted an increase in didactics compared to pre-pandemic levels. The largest losses were noted in event coverage and training room exposures, with smaller declines in ultrasounds, procedures, and research experiences. They also described challenges, including changing clinical roles, managing social isolation and boredom, and balancing work and family responsibilities.

Conclusions

Fellows identified gains, losses, and challenges due to pandemic-related changes to their fellowship programs. Fellowship directors and educators in different fields can use this understanding of the fellows’ experiences to build on current resources, further develop collaborative efforts, create new educational opportunities, and provide additional support for fellow learning.

Natural Language Processing to Identify Digital Learning Tools in Postgraduate Family Medicine: Protocol for a Scoping Review

Background

The COVID-19 pandemic has highlighted the growing need for digital learning tools in postgraduate family medicine training. Family medicine departments must understand and recognize the use and effectiveness of digital tools in order to integrate them into curricula and develop effective learning tools that fill gaps and meet the learning needs of trainees.

Objective

This scoping review will aim to explore and organize the breadth of knowledge regarding digital learning tools in family medicine training.

Methods

This scoping review follows the 6 stages of the methodological framework outlined first by Arksey and O’Malley, then refined by Levac et al, including a search of published academic literature in 6 databases (MEDLINE, ERIC, Education Source, Embase, Scopus, and Web of Science) and gray literature. Following title and abstract and full text screening, characteristics and main findings of the included studies and resources will be tabulated and summarized. Thematic analysis and natural language processing (NLP) will be conducted in parallel using a 9-step approach to identify common themes and synthesize the literature. Additionally, NLP will be employed for bibliometric and scientometric analysis of the identified literature.

Results

The search strategy has been developed and launched. As of October 2021, we have completed stages 1, 2, and 3 of the scoping review. We identified 132 studies for inclusion through the academic literature search and 127 relevant studies in the gray literature search. Further refinement of the eligibility criteria and data extraction has been ongoing since September 2021.

Conclusions

In this scoping review, we will identify and consolidate information and evidence related to the use and effectiveness of existing digital learning tools in postgraduate family medicine training. Our findings will improve the understanding of the current landscape of digital learning tools, which will be of great value to educators and trainees interested in using existing tools, innovators looking to design digital learning tools that meet current needs, and researchers involved in the study of digital tools.

Trial Registration

OSF Registries osf.io/wju4k; https://osf.io/wju4k

International Registered Report Identifier (IRRID)

DERR1-10.2196/34575

The Association Between Distance Learning, Stress Level, and Perceived Quality of Education in Medical Students After Transitioning to a Fully Online Platform

Background: Before COVID-19, preclinical medical students traditionally attended didactic lectures in in-person settings. Due to social distancing, students were required to switch to online meeting platforms, such as Zoom. For medical students accustomed to in-person interactions, these changes may add more stress to the already stressful medical school experience. Furthermore, it was unclear if students’ stress levels were related to their preference for one learning modality over another. The purpose of this study was thus to explore associations between lecture modality (synchronous Zoom lectures versus live, in-person lectures) and stress in second-year medical students after they transitioned from a face-to-face learning experience to a fully online lecture platform.

Methodology: Cross-sectional data were collected from 112 second-year medical students enrolled in a large U.S. medical school using an anonymous questionnaire delivered electronically via social media and emails. The survey contained items pertaining to students’ attitudes towards different types of lecture modalities and how they relate to personal stress. Descriptive data and Spearman’s rank correlation tests were conducted using IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp.

Results: This study examined correlations between preclinical medical school lecture delivery and personality type, stress levels, attendance, and burnout. Overall, no significance was found between mode of delivery and personality type. On the other hand, the mode of delivery significantly affected stress levels, attendance, and burnout. Moderate to strong correlations were found between the item “Zoom lectures have reduced stress compared to in-person lectures” and preference for Zoom, quality of education using Zoom compared to the in-person lectures, belief that Zoom lectures should continue as part of the curriculum delivery method, staying motivated with lectures fully online with Zoom, and liking that Zoom lectures save commute time to campus.

Conclusions: Findings suggest that a fully online curriculum may play a role in reducing stress in medical students without compromising the quality of education.

COVID-19: Making the Best out of a Forced Transition to Online Medical Teaching-a Mixed Methods Study

INTRODUCTION

The first wave of the COVID-19 pandemic resulted in a decreed confinement in Spain from March until the end of term in June 2020, forcing an abrupt transition to exclusive distance learning in universities. We aimed to describe and analyze the perceptions and experiences of undergraduate medical students and faculty members as a consequence of this educational shift so as to identify the key elements for successful online medical learning.

METHODS

A convergent mixed methods design was employed, using both quantitative and qualitative data collected successively through Phase 1: Online teaching follow-up program; Phase 2: Discussion groups (two focus groups and a nominal group with students and faculty, respectively) and a survey of students from first to fifth year; and Phase 3: Triangulation of qualitative and quantitative data.

RESULTS

Thirteen strongly interconnected categories were identified. Four of them played an organizational role: course planning, coordination, communication, and pedagogical coherence. The remaining nine categories were learning outcomes, teaching methodology, online resources, evaluation, time management, workload, student motivation, participation, and teacher-student relationship. Among the key aspects of learning were those that promoted rapport between faculty and students, such as synchronous sessions, especially those based on clinical cases.

CONCLUSIONS

Promoting student motivation and participation at all levels were the main lessons learned for enhancing online learning and teaching experiences in undergraduate medical education. Key elements to reach this goal are, among others, planning, coordination, communication, and pedagogical coherence.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01518-9.

Evaluating e-Learning in the Pathology Course During the COVID-19 Pandemic

PURPOSE

Synchronous and asynchronous e-learning is a promising and effective educational method for the delivery of medical lessons. Due to the public health measures implemented during the COVID-19 pandemic, our Pathology Department faced the challenge of a total online transition of the lessons. Therefore, the aim is to evaluate the aspects of the applied e-learning method they received.

MATERIALS AND METHODS

At the end of the semester when e-learning was applied, we designed a structured questionnaire consisting of 17 items via Google Forms, which took the students between 5 and 7 minutes to complete. Of the 257 students registered on the Pathology course in the fifth semester, 207 students (80.5%) returned completed valid questionnaires.

RESULTS

Fifteen of the seventeen components of the e-learning Pathology questionnaire were evaluated highly by the vast majority of the students. The two remaining items, the HIPON platform and the Microlabs e-lessons, were evaluated highly by almost half the students. Approximately 93% of medical students answered that e-learning could be integrated with real class lessons in the medical curriculum: 62.8% (N = 130) of students answered to a great extent, and 30.4% (N = 63) answered to a small extent. Statistically significant differences were found between the demographic characteristics of the participants (gender, permanent residence, working status) and their evaluation of the e-learning items.

CONCLUSION

E-learning was successfully implemented for the delivery of the pathology lessons and was widely accepted by the students, providing evidence for its future integration into the medical curriculum. Our findings illuminate various aspects of the students' experience with e-learning, and we strongly recommend that the students' evaluation and perspective be taken into consideration by the faculty in the development of policies for higher-quality medical education.

Artificial Intelligence and Surgical Education: A Systematic Scoping Review of Interventions

OBJECTIVE

To synthesize peer-reviewed evidence related to the use of artificial intelligence (AI) in surgical education DESIGN: We conducted and reported a scoping review according to the standards outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis with extension for Scoping Reviews guideline and the fourth edition of the Joanna Briggs Institute Reviewer's Manual. We systematically searched eight interdisciplinary databases including MEDLINE-Ovid, ERIC, EMBASE, CINAHL, Web of Science: Core Collection, Compendex, Scopus, and IEEE Xplore. Databases were searched from inception until the date of search on April 13, 2021.

SETTING/PARTICIPANTS

We only examined original, peer-reviewed interventional studies that self-described as AI interventions, focused on medical education, and were relevant to surgical trainees (defined as medical or dental students, postgraduate residents, or surgical fellows) within the title and abstract (see Table 2). Animal, cadaveric, and in vivo studies were not eligible for inclusion.

RESULTS

After systematically searching eight databases and 4255 citations, our scoping review identified 49 studies relevant to artificial intelligence in surgical education. We found diverse interventions related to the evaluation of surgical competency, personalization of surgical education, and improvement of surgical education materials across surgical specialties. Many studies used existing surgical education materials, such as the Objective Structured Assessment of Technical Skills framework or the JHU-ISI Gesture and Skill Assessment Working Set database. Though most studies did not provide outcomes related to the implementation in medical schools (such as cost-effective analyses or trainee feedback), there are numerous promising interventions. In particular, many studies noted high accuracy in the objective characterization of surgical skill sets. These interventions could be further used to identify at-risk surgical trainees or evaluate teaching methods.

CONCLUSIONS

There are promising applications for AI in surgical education, particularly for the assessment of surgical competencies, though further evidence is needed regarding implementation and applicability.

Future Problem-Solving Practiced During COVID-19: Implications for Health Management Students' E-Health Literacy Identity

The current study describes the implementation of an online Future Problem Solving (FPS) program in the field of Health education and set out to explore its contribution to students' eHealth Literacy identity, by using two levels of teacher guidance: minimal vs. frequent. FPS was employed in two groups of Health students. In the research group, frequent weekly guidance was provided to the students centered on the enhancement of eHealth Literacy skills, whereas in the control group minimal guidance was offered by the lecturer. Data for the analysis were gathered from 113 Israeli undergraduate students of a Management of Health Service Organizations program, of whom 62 comprised the research group. Data were gathered twice, pre- and post-program implementation from both groups. Findings showed significant differences between the tests only for the research group, with increased levels of eHealth Literacy skills detected between the tests. The perception of the FPS program as meaningful contributed to students' perceived eHealth Literacy skills only in the research group whereas non-significant results were shown for the control group. This study mainly shows that the enhancement of skills in online educational environments requires frequent and personalized guidance. Faculty must recognize the role of the instructor as a facilitator of learning and design successful scaffolding strategies to nurture students' lifelong learning skills during distance learning.

Experiences with alternative online lectures in medical education in obstetrics and gynecology during the COVID-19 pandemic—possible efficient and student-orientated models for the future?

Purpose

The onset of the COVID-19 pandemic posed an eminent challenge for medical teachers worldwide. Face-to-face lectures and seminars were no longer possible, and alternatives had to be found. E-learning concepts quickly emerged as the only practicable solutions and also offered the opportunity to evaluate whether traditional face-to-face lectures could be translated into an online format, independent of the COVID-19 pandemic.

Methods

We offered an e-learning program consisting of lecture notes, screencasts with audio narration, and online webinars that covered topics normally taught in traditional lectures and seminars. To evaluate the learning behavior and quality of our e-learning program, we drafted a questionnaire that students completed at the end of the 2020 summer semester that had been designed to enable a comparative analysis of the different e-learning modules.

Results

Voluntary participation in the online courses was high. Survey analysis revealed high satisfaction with and a distinctive preference for the format, even under regular, COVID-19-independent conditions. In general, a positive appraisal of e-learning—especially as a substitute for regular lectures—was found. Students also reported higher studying efficiency. Exam results were equal to those of previous semesters.

Conclusion

Both acceptance of and satisfaction with our e-learning modules were high, and students displayed increased demand for this kind of e-learning format. We, therefore, conclude that e-learning offerings could serve as reasonable, efficient, student-orientated substitutes for certain medical courses, especially lectures. These curricular adaptations would correlate with the high digitalization seen in students’ everyday lives. This correlation may also hold true independent of the ongoing COVID-19 pandemic.

A new reality: Bedside geriatric teaching in an age of remote learning

Population ageing poses many challenges in the landscape of general medicine. One of these is the requirement for more geriatricians to minimise future strain on healthcare systems. Previous studies have identified that, while demand for geriatricians is on the rise, interest among medical students for a career in geriatrics falls behind. We utilised a new augmented reality technology (the Microsoft HoloLens 2) to deliver students a remote bedside teaching experience. Features of this teaching included bi-directional communication, exposure to physical signs, and use of holograms around the patient bedside as a teaching aid. Given its convenience, scope and engagement potential, this educational tool has potential to be used effectively throughout medical training.

A Comparison of the Flipped Classroom Model for Medical Student Education in Ophthalmology before and during the COVID-19 Pandemic

Background The coronavirus disease 2019 (COVID-19) pandemic has necessitated a shift of medical education to online learning in lieu of traditional clinic-based rotations. The flipped classroom model, which has been shown to be an effective approach to the medical student ophthalmology curriculum, shows promise as a method of learning that can be shared virtually. As such, the aim of this study was to investigate the effectiveness of a flipped classroom approach to the primary care-focused ophthalmology clerkship delivered entirely online in the face of the COVID-19 pandemic.

Methods Medical students who completed the 2-week introductory clinical ophthalmology clerkship from July 2019 to July 2020 were included in this study. The curriculum centers on a flipped classroom model and was delivered in person prior to March 2020, after which it transitioned to an online format for 5 months. A survey was administered to students completing this rotation, which utilized 6-point Likert scales to assess students' interest in the field of ophthalmology, perceptions of the flipped classroom curriculum, and confidence in evaluating ophthalmic complaints. The cohort that completed in-person learning was then compared with the cohort that completed online learning.

Results A total of 112 responding students were included in our analysis, with 68/82 students from the in-person cohort and 44/66 students in the online cohort responding to the survey. Students who participated in the online virtual clerkship were equally likely to feel comfortable evaluating eye complaints than those who participated in the in-person clerkship, and more likely to report that the course enhanced their interest in ophthalmology. However, online students were less likely to feel comfortable using the direct ophthalmoscope compared with those in the in-person cohort.

Conclusion Regardless of its mode of delivery, the flipped classroom model is able to impart confidence in evaluating ophthalmic complaints and interest in the field of ophthalmology to medical students. While online learning can never serve as a full replacement for learning physical examination skills and other important clinical experiences, there are aspects of the virtual flipped classroom that do not compromise student's learning and engagement and may be implemented into curricula even after clinical activities are allowed to resume.

Medical Student Experience and Outcomes, as Well as Preceptor Experience, with Rapid Conversion of a Preclinical Medical School Course to a Remote-Based Learning Format in the Setting of the COVID-19 Pandemic

OBJECTIVES

To assess student outcomes and experiences, as well as preceptor experiences, after emergently converting a preclinical medical school renal course to a remote setting during the COVID-19 pandemic.

METHODS

First-year medical student examination scores and responses to Likert-scale questions on end-of-course evaluations from the 2018-2019 (traditional) and 2019-2020 (remote) academic years were compared. Free-text responses from students and preceptors were analyzed using a qualitative summative approach to extract major themes in perceptions of remote learning.

RESULTS

Mean student scores on course examinations did not significantly differ between the traditional and remote settings (p = 0.23 and 0.84 respectively). Quantitative analysis of student evaluations revealed no significant difference across all items in mean Likert-scale responses. Student and preceptor free-text responses identified course leader engagement and responsiveness as essential to the success of remote-based learning. Optimal group size and online etiquette are areas that require attention.

CONCLUSIONS

Despite rapid conversion of a preclinical medical school renal course to a remote-based format in the setting of the COVID-19 pandemic, student scores and evaluations remain positive and largely unchanged.

Medical student education through flipped learning and virtual rotations in radiation oncology during the COVID-19 pandemic: a cross sectional research

Background

The COVID-19 pandemic has stripped many medical students worldwide of their right to quality education. In response, we developed hybrid courses involving aspects of both online and in-person teaching for radiation oncology medical student clerkship.

Methods

We entitled students to customize their own rotation schedule using Google Forms and developed a flipped learning online class, which consisted of at least one video clip on basic knowledge of radiation oncology per day (yonsei-radonc.com). Students were instructed to watch online videos before the next day’s discussion session. Required components of the medical education program (e.g., target drawing, site visits to treatment facilities) were also prepared and conducted in accordance with the appropriate level of social distancing measures. Finally, we conducted questionnaire surveys after the completion of the week-long course and clerkship.

Results

From March to June 2020, 110 fourth-year medical students undertook a clinical module in our 1-week radiation oncology program course. Each day, students completed the flipped learning prior to meeting with the educator and then participated in the online discussion session and conference. All activities were well performed as scheduled. Students’ motivation was high, as was their overall satisfaction with the course. The students were satisfied with the online contents, flipped learning strategy, and instructors.

Conclusions

We successfully integrated open and virtual educational platforms to improve access to and satisfaction with student clerkship. In the future “new normal,” minimized face-to-face learning interactions, such as flipped learning, should be actively utilized for medical and other students’ education.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13014-021-01927-x.

Impact of Covid-19 on undergraduate and residency training

BACKGROUND

The covid-19 pandemic has dramatically changed lives of residents and medical students. In particular, the learning process has undergone widely changes, especially due to the rules of social distancing which have forced universities and various institutes to modify lessons, work shifts and internships.

PURPOSE

The purpose of our review is to evaluate how the various institutes have faced the covid-19 emergency and guaranteed the perpetuation of the learning process of resident and students.

METHODS

A comprehensive search of the medical literature in PubMed and Google Scholar was performed including all the works explaining how the institutes have reorganized teaching for resident and undergraduate students.

MAIN FINDINGS

The use of internet for the dissemination of teaching material and educational meetings has built bridges, albeit virtual, between resident and teachers. New techniques for teaching and conducting exams have been introduced. The rotating team system allowed the continuation of the teaching activity in safety.

CONCLUSION

Thanks to remodulation of the teach modalities, the massive use of internet platforms, a wise distribution of work shifts, and others, universities and hospitals have not only reduced the impact on the learning process of resident and students but also turn this pandemic into a moment of personal and professional growth for the new generation of healthcare professionals.

Crashing from cadaver to computer: Covid-driven crisis-mode pedagogy spawns active online substitute for teaching gross anatomy

In early 2020, the Covid-19 crisis forced medical institutions worldwide to convert quickly to online platforms for content delivery. Although many components of medical education were adaptable to that format, anatomical dissection laboratory lost substantial content in that conversion, including features of active student participation, three-dimensional spatial relationships of structures, and the perception of texture, variation, and scale. The present study aimed to develop and assess online anatomy laboratory sessions that sought to preserve benefits of the dissection experience for first-year medical students. The online teaching package was based on a novel form of active videography that emulates eye movement patterns that occur during processes of visual identification, scene analysis, and learning. Using this video-image library of dissected materials, content was presented through asynchronous narrated laboratory demonstrations and synchronous/active video conference sessions and included a novel, video-based assessment tool. Data were obtained using summative assessments and a final course evaluation. Test scores for the online practical examination were significantly improved over those for previous in-person dissection-based examinations, as evidenced by several measures of performance (Mean: 2015-2019: 82.5%; 2020: 94.9%; P = 0.003). Concurrently, didactic test scores were slightly, but not significantly, improved (Mean: 2015-2019: 88.0%; 2020: 89.9%). Student evaluations of online sessions and overall course were highly positive. Results indicated that this innovative online teaching package can provide an effective alternative when in-person dissection laboratory is unavailable. Although this approach consumed considerable faculty time for video editing, further development will include video conference breakout rooms to emulate dissection small-group teamwork.

Medical and public health instructors' perceptions of online teaching: A qualitative study using the Technology Acceptance Model 2

Many universities in the U.S. shifted from in-person teaching to online teaching due to the COVID-19 pandemic. Instructors' acceptance of online teaching plays a crucial role, as the acceptance level can impact instructors' online teaching behaviors. This qualitative study examined medicine and public health instructors' perceptions of online teaching using the Technology Acceptance Model 2 (TAM2) model. Through semi-structured interviews with ten instructors in a Midwest university in the U.S., this study found that instructors had a high level of acceptance of online teaching. Instructors perceived the usefulness of online teaching in terms of learning objectives, assessment, instructional methods, and learning experience. Online teaching was perceived as useful overall, although challenges existed, such as online interaction, assessment, and hands-on practices. Regarding ease of use in online teaching, instructors perceived technology was easy to use; yet some pedagogical challenges existed, such as class engagement, the focus of learners' attention, and transforming hands-on lab or clinical sessions online. The blended model is recommended to use for teaching and learning in medical and public health education post the pandemic. Detailed implications for practice and research were discussed in the end.

Online conferencing software in radiology: Recent trends and utility

Videoconferencing platforms have recently gained wide attention due to the COVID-19 pandemic, both within and outside of the medical community. This article reviews various applications of online meeting technology to the radiologic community, not only in response to the recent pandemic but also thereafter. Various platform features are outlined and discussed, specifically with respect to collaboration, training, and patient care. Platforms reviewed are GoToMeeting, Microsoft Teams, Skype, WebEx, and Zoom.