Blended learning in basic medical laboratory courses improves medical students' abilities in self-learning, understanding, and problem solving

Continuing medical education for attending physicians in anesthesia: Feasibility of an innovative blended learning approach

Continuing medical education plays a pivotal role in fostering and upholding the standard of excellence in medicine. Both SPOC (small private online course) and BOPPPS (bridge-in, learning objective, pretest, participatory learning, posttest, and summary) methodologies are rooted in the same educational and learning theories, emphasizing active student engagement, interaction, and feedback. Using ultrasound-guided spinal anesthesia as an exemplar, we aimed to investigate the feasibility of blended teaching (combination of BOPPPS and SPOC) for anesthesiology clinicians and explore trainees' and trainers' perspectives towards the innovative method. Twenty-seven attending anesthesiologists were randomly divided into experimental group (n = 14, blended teaching method) and control group (n = 13, traditional teaching method). The questionnaire was administered before and a week post-training. Their operative skills (measured by operation time) were assessed. The students' cognitive evaluation of the blended teaching mode was conducted in the experimental group. The experimental group demonstrated notably higher theoretical scores compared to the control group [(46.42 ± 5.345) vs (41.92 ± 5.219), t = 2.213, P < .05]. The operation time in the experimental group was significantly shorter than that in the control group [(84.79 ± 28.450) seconds vs (114.23 ± 35.607) seconds, t = -2.383, P < .05]. Most participants preferred blended learning as it was more effective than traditional learning. Suggestions for enhancement included enhanced online interactivity with trainers and the inclusion of case analysis. Integration of blended teaching incorporating BOPPPS and SPOC methodologies holds promise for enhancing the efficiency of skill training among anesthesiologists. Blended learning may become a viable and well-received option among anesthesia clinicians in China.

Chinese anatomy educators' perceptions of blended learning in anatomy education: A national survey in the post-COVID-19 era

Blended learning, which combines face-to-face lectures with online learning, has emerged as a suitable teaching approach during the COVID-19 pandemic. This study used a national survey of anatomy educators in Mainland China to evaluate the changes in the implementation of blended learning in anatomical pedagogy. A total of 297 responses were collected from medical schools across all provinces. Respondents included 167 males and 130 females, with an average age of 44.94 (±8.28) and average of 17.72 (±9.62) years of professional experience. The survey showed adoption of online teaching and assessment by Chinese anatomy educators increased by 32.7% and 46.8%, respectively, compared to pre-pandemic levels. Perceptions of blended learning outcomes varied, with 32.3% and 37% educators considering it superior and inferior to traditional teaching, respectively. Faculty training programs related to blended learning increased significantly, fostering a collaborative learning environment; however, challenges remained in achieving satisfactory online assessment outcomes. Anatomy educators' attitudes reflected a strong preference for classroom learning (4.941 ± 0.856) and recognition of the importance of relevant technology (4.483 ± 0.954), whereas online learning received lower acceptance (4.078 ± 0.734). Female anatomy teachers demonstrated effective time management in online teaching. Meanwhile, educators with over 15 years of experience encountered difficulties with relevant technology, consistent with negative attitudes toward blended learning. Overall, this survey highlights the persistent challenges in implementing blended learning in anatomy education and provides insights for enhancing the pedagogical model in the post-COVID-19 era.

Mobile application-assisted graded exercise practical: a remote teaching strategy to promote motivation and experiential learning in exercise physiology

Practical classes are critical instructional activities in facilitating learning and motivation in health sciences education. With increasing pedagogical activities being conducted in virtual or remote settings, this study assessed how a remote practical assisted by physiological monitoring smartphone applications impacted student motivation and the achievement of intended learning outcomes in exercise physiology teaching. A total of 24 students (out of 30; 80%) were surveyed via a mixed-methods questionnaire containing 27 closed-ended, and 3 the traditional in-class practical in randomized order. Unpaired Student's t tests were performed for comparisons between interventions with a significance level set at P < 0.05. Students reported that both remote and in-class practicals strongly facilitated the achievement of learning outcomes. Self-reported scores for student satisfaction and perceived achievement of learning outcomes were similar between the two practical methodologies. Student motivation scores assessed using the Lab Motivation Scale revealed that students were more motivated during the remote practical, particularly in the effort domain (P < 0.05). This was in line with the identified themes from the qualitative responses that indicated that the remote practical was more engaging than the in-person practical, with greater opportunities for experiential learning and class involvement being the main factors underlying these findings. Taken together, remote practicals can be critical aspects of a blended learning curriculum that encourages student engagement and experiential learning. With further advancements in physiological monitoring wearables and smartphone technologies, remote practicals can be potential alternatives to traditional in-person practicals in exercise physiology teaching.NEW & NOTEWORTHY Remote practical classes, supported by physiological monitoring smartphone applications, were assessed for their utility in facilitating learning and raising student motivation in health sciences education in this study. A comparison of remote practicals with traditional in-class practicals revealed that a remote practical is an effective method for reinforcing physiology learning objectives with the added advantage of increased student motivation. The added value of remote practicals may be attributed to more experiential learning opportunities and increased engagement levels.

Comparison of academic performance of medical undergraduate students between routine class room teaching and online assisted teaching in biochemistry during COVID pandemic

The new curriculum of competency based medical education (CBME) implemented for phase1 medical undergraduates could not go on to completion due to the sudden outbreak of the COVID-19 pandemic. The educational institutions therefore resorted to online teaching modalities over conventional class room teachings. Hence this study aimed to compare the academic performance of students between routine classroom teaching and online assisted teaching with assignments.94 phase 1 MBBS students admitted in the year 2019-2020 was divided into low (<50%), medium (51%-70%) and high performers (71%-100%) based on the average marks in the initial formative assessments. Academic performance of students in three types of teaching modalities namely classroom teaching (CRT), classroom teaching with assignment (CRA), and online assisted teaching (OAT) were compared using ANOVA. Wilcoxon signed ranks test was used to find the difference in marks between CRT and CRA which was calculated as gain 1 and that between OAT and CRT is gain 2. Out of 94 students, 19 were low performers, 53 were medium performers and 22 were high performers when grouped at baseline. All these groups performed significantly well with OAT compared to CRT and CRA. The overall performance of girls was found to be significantly higher. There was no significant difference between Gain 1 and Gain 2. All group of students scored high in assessments following online teaching compared to conventional classroom teaching. The gain of online teaching did not outweigh the conventional teaching methods implying that face to face lectures is still an effective teaching modality.

Threshold concepts in health professions education research: a scoping review

Threshold concepts (TCs) are increasingly used in health professions education (HPE) research. TCs are claimed to be conceptual gateways which are often traversed with substantial difficulty. In this paper, we report on a scoping review investigating the following research question: What is the scope and nature of the currently available research on threshold concepts in health professions education literature? We employed Arksey and O'Malley's model for scoping reviews. A search for literature on TCs in HPE research between 2003 and 2020 yielded 999 records of which 59 were included in the review. The data set was subject to quantitative descriptive analysis of article characteristics as well as qualitative thematic analysis of the scope of research on TCs. Among the 59 articles selected for review, there were 30 empirical, 26 conceptual and three reviews. A majority were published in 2015 or later. Almost half of the included articles attempted to identify possible TCs within HPE. Others investigated how TCs can be traversed or suggested how TCs could influence curriculum design. Some critically appraised the framework of TC. Although TCs are increasingly utilised in HPE, the present review identified how researchers came across methodological challenges related to identifying possible TCs and definitional challenges around identifying the essential characteristics of TCs. Before embracing TCs as the next go-to theory for learning in HPE, we acknowledge the need for methodological stringeny and rigour as well as more data to support TCs. Until then, any implementation of TCs in HPE curricula should be done cautiously.

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.

Threshold concepts in medical education: A scoping review

INTRODUCTION

The threshold concept framework (TCF) was first described nearly 20 years ago, but its application in the field of medical education has recently seen a significant growth of interest with a diverse range of literature published on the subject. The transformative nature of threshold concepts (TCs) offers potential for the design of learning experiences and curricula across the medical education continuum. A scoping review was conducted to map the extent of the current literature regarding TCs in medical education-to describe the types of available evidence and its focus-and identify research gaps.

METHODS

The review followed the JBI Manual for Evidence Synthesis approach for scoping reviews. Four databases and two additional websites were searched for articles exploring TCs in medical education. Data were analysed using quantitative and qualitative thematic approaches. A framework of conceptual change was used to synthesise the TCs identified.

RESULTS

Thirty-six papers, spanning undergraduate, postgraduate and continuing medical education, were included in the final analysis. The most frequent application of the TCF was in the identification of TCs, which related to basic scientific knowledge, ways of thinking and ways of practising in medicine. Uncertainty, patient care, clinical reasoning and professional identify formation were themes that emerged at multiple stages of training. Several papers evaluated the use of the TCF in teaching.

CONCLUSION

The understanding and embodiment of TCs increases in complexity across the medical education continuum, with TCs recurring with changes in clinical environment and responsibilities. This lends support to a holistic approach to curriculum design spanning all stages of training. Further research is needed to develop a consistent approach for describing and applying the TCF in medical education and to address how the TCF can be used in teaching and how threshold crossing can be measured.

Incorporating MOOC and COVID-19-Related Scientific Papers into Veterinary Microbiology Teaching to Enhance Students' Learning Performance and Professional Recognition

The COVID-19 pandemic has exerted a huge adverse influence on global teaching activities and students' psychological status. Veterinary microbiology is mainly concerned with bacterial and viral diseases, including coronavirus diseases. An innovative online-to-offline teaching approach for this course was established to stimulate students' learning initiative and mitigate their anxiety about COVID-19. A well-established massive open online course (MOOC) was first adopted as preview material before class, followed by in-person teaching. Additionally, COVID-19-related scientific papers were also used as pre-class reading material in veterinary microbiology and were further explained in class. The effect of this innovative teaching mode was systematically evaluated by final examination scores and questionnaires. The average score (81.75) and excellence score rating (> 85 scores, 37.3%) resulting from this blended teaching mode were not statistically higher than those of the online-only (79.19, p = .115; 28.6%, p = .317) or offline-only (79.47, p = .151; 27.9%, p = .269) teaching modes. This may be due to the sample size investigated; however, the results indicate that the innovative teaching mode did not decrease teaching quality. Additionally, most subjects (72.9%) were satisfied with the blended mode and supported its future use. Intriguingly, the introduction of COVID-19-related scientific papers helped students understand virology, relieve their anxiety, and increase their professional identity. Collectively, the innovative approach to teaching veterinary microbiology in this study provides a beneficial reference for other teachers to maintain and improve teaching quality.

[Chances and challenges of increasing digitalization of teaching in the discipline anesthesiology from the perspective of students]

BACKGROUND

The coronavirus pandemic caused a sudden change in medical education worldwide and induced a shift towards digital teaching. Previously, most courses were organized for students in physical presence on campus, while a few institutions already complemented these with blended learning methods, combining digital teaching with clinical presence; however, the use of digital teaching was heterogeneous, ranging from the use of PowerPoint slides to the application of virtual patients and telemedicine.

OBJECTIVE

This study aimed to identify challenges and opportunities arising from the different tools used in digital teaching, such as recorded lectures or online seminars, and the role of hands-on clinical experience. In addition, the study examined student attitudes and experiences with the nearly all-digital semester beginning in spring 2020. These findings may help to better understand the impact of digital teaching on students and provide guidance on how to optimize digital medical teaching in the future.

METHODS

A questionnaire with a 5-point Likert scale was developed to assess students' experiences with digital teaching at the onset of the COVID-19 pandemic in a cross-sectional study. The questionnaire was distributed to all medical students at the University of Mainz, Germany, who attended an anesthesiology course with asynchronously recorded lectures replacing traditional on-campus lectures during the pandemic. A total of 766 students in 4 courses met these criteria and received the online questionnaire for anonymous and voluntary response.

RESULTS

A total number of 141 students responded, resulting in a response rate of 18.4%. Almost all students had access to the appropriate technology to participate in digital courses and 80.9% indicated seeing more recorded lectures compared to previous face-to-face lectures on campus. Moreover, 67.4% reported that they paused the asynchronous lectures to look up additional information and 95.7% stated that they appreciated the possibility to view lectures regardless of time and location. Hence, 84.3% said they would prefer digital lectures over face-to-face lectures in the future; however, 28.4% missed the interaction with teachers during lectures. Thus, 94.3% of the students appreciated the online seminars in terms of theoretical knowledge but the majority missed the practical aspects in the courses. Overall, 78.0% responded that the digital availability of material and digital teaching formats helped them to enhance their independent learning abilities.

CONCLUSION

This study highlights several opportunities and challenges associated with digital teaching. The availability of prerecorded lectures at any time and place seems to facilitate access and increases student motivation. It also promotes individualization of student learning. Main disadvantages are the lack of communication with teachers and other students as well as the missing opportunity to reinforce the theoretical knowledge through application in practical courses, which, however, are essential for medical education. Therefore, a possible solution in the future could be the introduction of the "inverted classroom" concept, as it focuses on application and deepening of clinical skills in interactive classes, while the theoretical knowledge acquisition is taught in a digital teaching environment. The present study proposes the introduction of blended learning concepts to enhance the benefits of digital teaching while minimizing the identified disadvantages.

Incorporating modified team-based learning into a flipped basic medical laboratory course: impact on student performance and perceptions

BACKGROUND

Basic medical laboratory courses (BMLCs) play an essential role in medical education and offer several benefits to students. Although various student-centered and active learning strategies have been increasingly incorporated into medical education, their applications in BMLCs are limited. This paper aimed to explore the educational effects of a flipped classroom (FC) combined with team-based learning (TBL) strategy in BMLCs at Zhejiang University School of Medicine.

METHODS

Four hundred eight 3rd-Year medical students were assigned to either the FC-TBL group (n = 235) or the FC group (n = 173) to complete three experiments on the respiration block of BMLCs. The two groups' immediate and long-term academic performance were compared, and the FC-TBL students' perceptions of different instructional strategies were surveyed.

RESULTS

Students in the FC-TBL group scored higher on the immediate post-tests after class and higher on the final exams in two of the three experiment sessions. They preferred FC-TBL to FC for its higher engagement, more feedback, and better learning environment. Students felt the FC with TBL blended instructional strategy stimulated their interest in learning and deep thinking.

CONCLUSIONS

Compared with the FC group, students in the FC-TBL group improved academic performance and had a more positive experience overall. Our findings support the feasibility and advantage of the flipped classroom with team-based learning as a blended learning strategy in the BMLC curriculum.

Online-Offline Teaching for Bio-Pharmaceutical Students During the COVID-19 Pandemic: The Case Study of Advanced Mathematics in Application-Oriented Universities of China

Background

With the development of the COVID-19 pandemic, the importance of online teaching is becoming more and more prominent, especially for the basic advanced mathematics majoring in bio-pharmaceutical in colleges. However, the only online teaching model loses efficiency when facing the undergraduates in application-oriented universities.

Purpose

How to improve the teaching quality of advanced mathematics has always been a concern because the mathematical abilities of students in application-oriented universities are not ideal. In this article, we develop a blending online-offline teaching model that combined online teaching and offline outcome-based education (OBE), as an alternative to traditional offline education.

Methodology

The comparative analysis experiment is carried out to the two classes of undergraduates. The control group and the experimental group are, respectively, the 2020 class students and the 2021 class students majoring in bio-pharmaceutical. The experimental group students receive the combined teaching method, while the control group students receive the traditional offline education.

Results

(1) From the comparative analysis, we can find that the students under the online-offline teaching model are more differentiated than those under the traditional offline education model. (2) The online-offline teaching model equipped with “case study + knowledge point + applications” process has achieved a good teaching effect in the author's university.

Conclusion

The proposed teaching model can well stimulate students' interest in advanced mathematics learning and resonate with students through actual cases, thereby arousing students' autonomous learning drive and allowing them to apply what they have learned to professional fields.

Virtual Pathology Education in Medical Schools Worldwide during the COVID-19 Pandemic: Advantages, Challenges Faced, and Perspectives

The COVID-19 pandemic shifted pathology education in medical schools worldwide towards online delivery. To achieve this goal, various innovative platforms were used by pathology educators and medical students, facilitating both synchronous and asynchronous learning. The aim of this study was to review the published evidence regarding remote pathology teaching at the medical school level during this period, present our own experience, and provide some perspectives regarding the best mode of pathology teaching post-pandemic. Among its advantages, virtual pathology education was considered among students and educators as convenient, flexible, and engaging, while learning outcomes were met and students’ academic performance was in general satisfactory. However, several challenges were faced. For instance, suboptimal internet connection compromised the flow of classes and was even associated with a lower academic performance. The lack of hands-on laboratory activities, such as operating the light microscope and tissue grossing, and the reduced student interactions among themselves and their instructors, were also pointed out as significant drawbacks of remote pathology education. Whereas online education has multiple advantages, experiencing the physical university environment, in-person interactions and teamwork, exposure to the “hidden curriculum”, and hands-on activities are vital for medical school education and future student development. In conclusion, the implementation of a blended approach in pathology education—where online and face-to-face sessions are jointly used to promote students’ engagement, interaction with their instructors and peers, and learning—could be the most optimal approach to pathology teaching in medical schools post-pandemic.

Perception of online and face to face microbiology laboratory sessions among medical students and faculty at Arabian Gulf University: a mixed method study

BACKGROUND

The COVID-19 pandemic has impacted all spheres of society including medical education and healthcare systems. In response to the pandemic, there has been a transition in medical education practice from traditional forms of teaching to online instruction delivery and virtual learning. Effective clinical microbiology education involves a combination of 'hands-on' practical learning and instructional delivery of scientific knowledge. Microbiology practical laboratories are critical learning environments offering 'hands-on' learning experiences that cannot be replicated through online learning. We conducted a mixed-methods study to understand the perception of online and face-to-face microbiology laboratory sessions among the medical students and microbiology faculty at Arabian Gulf University (AGU).

METHODS

The study participants were third and fourth-year undergraduate medical students and faculty involved in delivering microbiology labs at AGU. The questionnaire consisted of questions ranging from perceived learning style to attitude towards online delivery of microbiology curriculum. After the questionnaire administration (google form), focus group discussion (FGD) was conducted for students and microbiology faculty separately.

RESULTS

Among 168 students, 50.6% preferred face-to-face lab sessions as compared to 30.4% who preferred online labs, and 51.8% considered online labs to be an essential addition to face-to-face labs. Among the faculty, 85.7% preferred the face-to-face mode of teaching. All the faculty (100%) disagreed that all the microbiology labs teaching should be online. 57.2% considered online labs to be an essential addition to traditional face-to-face labs. Both faculty and students hold that a blended mode of instructional delivery is vital and indispensable for the transfer of skills and knowledge for microbiology students.

CONCLUSION

The blended mode of delivering microbiology laboratory sessions in medical school is successful and well-received by both students and faculty. Students take the responsibility for furthering their own learning and understanding of concepts. Instructors have also noticed that blending learning strategies also successfully enhances the development of cognitive skills and problem-solving abilities in students. A review of the microbiology lab curriculum is necessary to identify content areas that can be delivered effectively through online, face-to-face lab sessions, or both, supported with appropriate tools and infrastructure.

Teaching Reform to the Biology Major During the COVID-19 Pandemic: A Study of the Method of Teaching Industrial Innovation and Entrepreneurial Talents

The biology major has developed rapidly in recent years. Biology is a science that penetrates every aspect of human life and is one of the core majors in most agricultural colleges and universities. However, many teachers lack practical experience in the subject. To overcome this problem, in recent years, we have been trying to introduce new reforms into our teaching. This article provides some insight into the way that biology majors have been reformed, which will help educators in agricultural colleges and universities. At present, teachers implement the “Industrial Innovation and Entrepreneurship Talent Cultivation” (IIETC) model, but it is not clear whether this helps biology majors to master the course and improve their practical skills. In this study, the IIETC model is outlined, and the academic achievement and satisfaction of students taught under the IIETC model are assessed. A T-test is used to examine potential differences between IIETC and traditional teaching models. In-depth interviews and questionnaires were given to two groups of students who followed different teaching models as part of an exploratory study. The aim was to explore how effective IIETC is at helping biology majors master the course and improve students’ wellbeing. Our results show that compared with traditional teaching methods, the IIETC model has a significant positive impact on the academic performance and happiness of biology students. Students trained under the IIETC model were more active and scored more highly in their final exams. They were more likely to feel that they had achieved success and happiness through the course (P = 0.03). The outcomes of this research reveal a novel teaching reform that improved students’ enthusiasm for innovation and entrepreneurship during the ongoing COVID-19 pandemic. The effects are very encouraging and deserve further exploration and expansion in future work.

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.

Distant education in Moroccan medical schools following COVID-19 outbreak at the early phase of lockdown: Were the students really engaged?

The Coronavirus pandemic outbreak has induced many urgent adaptation measures in Morocco including medical education that had to abruptly adopt an exclusive distant education approach, without former sufficient preparation. The present study aimed to assess medical students’ engagement in their acutely implemented distant learning and to identify factors that could be associated to the students’ studying engagement levels. Medical students from 1st to 5th years of medical studies, enrolled in all Moroccan public medical faculties were invited to fill-in an anonymous online questionnaire.

3174 medical students took part in the study, with a mean age of 20.4 +/- 1.8 years old, and 65.4% of them were women. 90% of the participants reported moderate to drastic change of their sleeping habits and 65% suffered depression symptoms. 20.7% of students didn't engage at all in their learning, 26% studied for less than one hour daily, and only 53.3% studied for one hour or more daily. Only 46.4% of the participants had access to multimedia studying resources and only 20.9% were offered online interactive sessions with their teachers. 41.8% of the participants were unsatisfied from their distant learning experience. Lower studying engagement rates were significantly associated with older age, male gender, change of sleeping patterns, depression symptoms, and also with lack of access to multimedia studying resources and poor general satisfaction from the distant learning experience.

Distant Education needs to include more interactive activities and more multimedia studying resources to engage students more efficiently in their self-regulated learning.

Shift to emergency remote preclinical medical education amidst the Covid-19 pandemic: A single-institution study

The Covid-19 pandemic disrupted medical education, shifting it towards emergency remote delivery. This cross-sectional study aimed to assess the impact of the pandemic on preclinical medical education and identify predictors of the virtual learning experience and perceived stress. An anonymous survey was delivered electronically to the students of the authors' medical school that attended either histology or pathology. This survey contained two scales, the virtual learning experience (VLE) and the perceived stress scale-10 (PSS-10). A total of 173/255 (68%) responded, showing a positive perception towards the remote delivery of both courses. An exploratory factor analysis was performed on the VLE scale items and four new dimensions were formed: "course quality and learning outcomes", "student motivation", virtual against F2F learning", and "virtual laboratory sessions". The following significant predictors of enhanced VLE, in at least one dimension, were identified: female gender, pathology course, final examination grade >80%, lower perceived stress levels, studying in home country, and holding of another degree before medical school. In addition, the following predictors were significantly associated with higher levels of student perceived stress: female gender, pathology course, studying away from home, and suboptimal internet connection. Notably, the quality of internet connection was significantly associated with the students' final examination performance. Concerning the best mode for future delivery of both courses, most students proposed a blended, rather than an entirely on-campus or online approach. In conclusion, despite its problems, a high-quality remote preclinical medical education was possible in the authors' school and offered tremendous opportunities for future improvement.

Home-based physiology labs in the time of COVID-19 prove popular with medical students

The COVID-19 pandemic and the resulting "lockdown" have forced many medical schools to shift from traditional "face-to-face" teaching methodologies and embrace full online delivery. Although lectures and tutorials are readily communicated by this approach, the execution of laboratory exercises is much more difficult. To overcome these challenges, face-to-face laboratory sessions were replaced by a blended learning approach in which students were provided instructional material online and then required to conduct the laboratory exercises at home. These laboratory exercises made use of easily accessible household materials and mobile applications. A self-report survey was designed to assess students' perception of their learning experience and attitudes to the home-based laboratory exercises. The survey consisted of 16 questions that students had to respond to using a 5-point Likert scale. Students were also allowed to provide open responses to select questions. Overall, the 80% of students that completed the survey expressed strong satisfaction with their learning experience and were enthusiastic toward home-based laboratory exercises. However, concerns about not being able to complete particular face-to-face exercises that required specialized equipment were expressed. Several students proposed a combined approach going forward. Our results show that home-based laboratory exercises offer a multimodal option that enriches the learning curriculum by engaging students in "hands-on" bespoke practicals using inexpensive household materials.

Curiosity in Online Video Concept Learning and Short-Term Outcomes in Blended Medical Education

Background: A student's level of curiosity in a subject after learning about it through online videos has not been addressed well in the medical education field. The purpose of this study, therefore, was to investigate online learning's effect on the stimulation of curiosity and short-term learning outcomes in a blended framework of precision medical education.

Methods: A mixed-methods research design was used. During the 2020 academic year, all fifth-year medical students who, prior to class, viewed 6 video clips that presented 6 core concepts were invited to complete a survey and self-reflection on their learning process to assess their level of curiosity in each concept. For each group of medical students, teaching assistants helped collect anonymous survey data and summative assessment scores representing the students' learning outcomes. Video-viewing patterns, attained through an action log transformation, were also coded for analysis. Mann–Whitney U and Kruskal–Wallis tests were employed to compare differences between groups, and multiple linear regression was used to select the factors affecting learning outcomes. Qualitative data were content-coded through a descriptive approach using thematic analysis.

Results: Of 142 medical students, 136 watched the online videos, 124 responded to the questionnaires, and 92 provided comments. Students' curiosity levels after learning about each concept through online videos significantly correlated with the degree to which a concept was learned. Medical students spent a median of 1.6 h online, and pause frequency correlated with curiosity in certain concepts. Aroused curiosity was associated with short-term learning outcomes in inconsistent effect sizes and directions. Students' feedback revealed various dimensions of curiosity, including novelty acknowledgment, recognition of an information gap, and information-seeking requests.

Conclusions: Curiosity can be induced through online video learning platforms and has a role in short-term learning outcomes in medical education.

An Adaptive Blended Learning Model for the Implementation of an Integrated Medical Neuroscience Course During the Covid-19 Pandemic

The implementation of an integrated medical neuroscience course by technologically pivoting an in-person neuroscience course to online using an adaptive blended method may provide a unique approach for teaching a medical neuroscience course during the Covid-19 pandemic. An adaptive blended learning method was developed in response to the requirements necessitated by the Covid-19 pandemic. This model combined pedagogical needs with digital technology using online learning activities to implement student learning in a medical neuroscience course for year one medical students. This approach provided medical students with an individually customized learning opportunity in medical neuroscience. The students had the complete choice to engage the learning system synchronously or asynchronously and learn neuroscience materials at different locations and times in response to the demands required to deal with the pandemic. Students' performance in summative and formative examinations of the adaptive blended learning activities were compared with the previous performance obtained the previous year when the contents of the medical neuroscience course were implemented using the conventional "face-to-face" learning approach. While the cohort of our students in 2019 and 2020 changed, the contents, sessions, volume of material, and assessment were constant. This enabled us to compare the results of the 2019 and 2020 classes. Overall, students' performance was not significantly different between the adaptive blended learning and the in-person approach. More students scored between 70% and 79% during the adaptive blended learning compared with in-class teaching, while more students scored between 80% and 89% during the in-person learning than during the adaptive blended learning. Finally, the percentage of students that scored >90% was not significantly different for both Years 2019 and 2020. The adaptive blended learning approach was effective in enhancing academic performance for high-performing medical students. It also permitted the early identification of underachieving students, thereby serving as an early warning sign to permit timely intervention.

Are virtual physiology laboratories effective for student learning? A systematic review

It is unclear if the transition from traditional, in-person physiology laboratories to virtual alternatives has educational impacts on students. This study used a systematic review to critically evaluate research papers that investigated the effectiveness of virtual physiology laboratories for student learning. Eleven studies, retrieved from the Education Resources Information Center (ERIC) and Ovid MEDLINE databases, were selected for inclusion in this review, based on predetermined eligibility criteria. Subsequently, the studies went through a power analysis for potential biases before their results were synthesized and analyzed. This systematic review found that virtual physiology laboratories are effective for students' learning of concepts. However, it was inconclusive as to whether virtual physiology laboratories are effective for students' motivation for learning and learning of technical skills. It was found that blended models of virtual laboratories are at least as effective as in-person laboratories for conceptual learning. Overall, this systematic review provides useful insights for educators regarding the educational impacts of implementing virtual laboratories into the physiology curriculum and suggests research models for future evaluation of virtual laboratories.

International educators' attitudes, experiences, and recommendations after an abrupt transition to remote physiology laboratories

The COVID-19 pandemic triggered university lockdowns, forcing physiology educators to rapidly pivot laboratories into a remote delivery format. This study documents the experiences of an international group of 10 physiology educators surrounding this transition. They wrote reflective narratives, framed by guiding questions, to answer the research question: "What were the changes to physiology laboratories in response to the COVID-19 pandemic?" These narratives probed educators' attitudes toward virtual laboratories before, during, and after the transition to remote delivery. Thematic analysis of the reflections found that before COVID-19 only a few respondents had utilized virtual laboratories and most felt that virtual laboratories could not replace the in-person laboratory experience. In response to university lockdowns, most respondents transitioned from traditional labs to remote formats within a week or less. The most common remote delivery formats were commercially available online physiology laboratories, homemade videos, and sample experimental data. The main challenges associated with the rapid remote transition included workload and expertise constraints, disparities in online access and workspaces, issues with academic integrity, educator and student stress, changes in learning outcomes, and reduced engagement. However, the experience generated opportunities including exploration of unfamiliar technologies, new collaborations, and revisiting the physiology laboratory curriculum and structure. Most of the respondents reported planning on retaining some aspects of the remote laboratories postpandemic, particularly with a blended model of remote and on-campus laboratories. This study concludes with recommendations for physiology educators as to how they can successfully develop and deliver remote laboratories.

Effect of blended learning with BOPPPS model on Chinese student outcomes and perceptions in an introduction course of health services management

Although the teaching methods of the blended learning and BOPPPS (bridge-in, objective, preassessment, participatory learning, postassessment, and summary) model are proven to be successful and highly effective at improving the academic knowledge of the students, respectively, it is unclear whether blended learning combined with the BOPPPS model (BL-BOPPPS) could work well in an introduction course of health services management (HSM) for the health management students in China. The study investigated the perceptions and effects of implementing the BL-BOPPPS model on student learning outcomes in an introduction course of HSM. The intervention group consisted of 55 students introduced to the BL-BOPPPS model, while the control group consisted of 54 students who received a conventional lecture. After the end of course, the effectiveness of teaching was self-assessed with questionnaires by all students, and examination scores for the two groups were compared. The students' satisfaction levels of BL-BOPPPS teaching strategy were up to 81.8% in the intervention group. Compared with the control group, the intervention group showed significant elevation of perception scores of skills (P = 0.001), initiative (P = 0.002), self-control (P = 0.008), self-efficacy (P = 0.001), motivation (P = 0.004), and the academic performance (P = 0.001). The BL-BOPPPS model could stimulate the enthusiasm and interest of health students; boost students' skills, initiative, and motivation in learning; and improve the self-directed learning ability, academic performance, and teaching quality. The findings provide a basis of evidence for the promotion of the BL-BOPPPS model in various disciplines in Chinese colleges and universities.

Outcome-based student assessment enhances academic performance in basic medical laboratory course

Basic medical laboratory courses (BMLCs) play an important role in medical educational courses helping the student acquire three important skills of surgical operating, collaborative learning, and problem solving. The outcome-based student assessment (OBSA) is a learning evaluation method that establishes specific evaluation points based on performance of students in three aspects: surgical operating, collaborative learning, and problem solving in the BMLC curriculum practices. The purpose of the present randomized controlled trial study is to explore the efficiency of OBSA program in BMLCs. The 233 students attending BMLCs were randomly divided into 2 groups, 118 in the OBSA group and 115 in the control group. We conducted multiple-choice examination questions (MCQs) test and two questionnaires with the method of two-sample t test for statistics. The results of MCQs in total eight BMLC blocks showed that the academic performance of the OBSA group was significantly better than that of the control group (P < 0.05). In addition, the average scores of direct observation of procedural skills (DOPS) and mini-experimental evaluation exercise in OBSA group were significantly higher than those in control group (P < 0.05). The majority of the medical students preferred the OBSA and considered OBSA could effectively improve their surgical operating skills (83.9%), collaborative learning skills (92.1%), and problem-solving skills (91.1%). From the above, OBSA is an effective evaluation method for the implementation of the BMLC curriculum.

The impact and evaluation of COVID-19 pandemic on the teaching model of medical molecular biology course for undergraduates major in pharmacy

Molecular biology is a very important basic course for undergraduates major in pharmacy. During the novel coronavirus epidemic, we first adopted an online teaching of molecular biology course with rain class and tencent meeting for undergraduates major in pharmacy, following a blended teaching mode. Finally, we evaluated the effect of this special-time teaching by analyzing the anonymous questionnaire and final examination scores. Student feedback showed that most of students were satisfied with this online teaching, classroom teaching, and experimental teaching, and considered that postlecture quizzes were very helpful for their study. The majority of students supported that classroom teaching should be integrated with online teaching. Analysis of final examination scores showed that the effect of 2020-year teaching was not worse than that of 2019-year teaching, but even better in the excellence rate and rate of poor and failure. Here, we share the experience and thinking of blended teaching of medical molecular biology course during the novel coronavirus epidemic, and hope it helpful for other teachers' teaching.

Perception of Technology-Enhanced Learning by Medical Students: an Integrative Review

This review aims to explore the perception of technology-enhanced learning by medical students. From the initial 2947 records found, 38 studies from journals indexed in the Web of Science database were included after screening. Several main topics were isolated, based on a thematic analysis: student's attitude towards e-learning and modern technologies in medical education; social networks, video, and mobile devices as information source and communication tool; and barriers to the use of technologies in medical education. The results have shown that a positive attitude towards technologies in medical education and learning is prevalent among students. The popularity of blended learning was confirmed.

Factors affecting the acceptance of blended learning in medical education: application of UTAUT2 model

BACKGROUND

Blended learning is a new approach to improving the quality of medical education. Acceptance of blended learning plays an important role in its effective implementation. Therefore, the purpose of this study was to investigate and determine the factors that might affect students' intention to use blended learning.

METHODS

In this cross-sectional, correlational study, the sample consisted of 225 Iranian medical sciences students. The theoretical framework for designing the conceptual model was the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). Venkatesh et al. (2012) proposed UTAUT2 as a framework to explain a person's behavior while using technology. Data were analyzed using SPSS-18 and AMOS-23 software. Structural equation modeling technique was used to test the hypotheses.

RESULTS

The validity and reliability of the model constructs were acceptable. Performance Expectance (PE), Effort Expectance (EE), Social Influence (SI), Facilitating Conditions (FC), Hedonic Motivation (HM), Price Value (PV) and Habit (HT) had a significant effect on the students' behavioral intention to use blended learning. Additionally, behavioral intention to use blended learning had a significant effect on the students' actual use of blended learning (β = 0.645, P ≤ 0.01).

CONCLUSION

The study revealed that the proposed framework based on the UTAUT2 had good potential to identify the factors influencing the students' behavioral intention to use blended learning. Universities can use the results of this study to design and implement successful blended learning courses in medical education.

Is it time for transition from the subject-based to the integrated preclinical medical curriculum?

In the 60s of the last century, a number of new universities in the world began to apply an integrated program of medical education, the cornerstone of which was problem-oriented education. Thus, the Flexner model of higher education adopted by that time in most countries of the world, with its characteristic segregation of teaching of the theoretical and clinical disciplines, which had ceased to satisfy the needs of modern healthcare, was gradually replaced by a new system that put the student in the center of the educational process and opened the way to active methods of teaching being focused on the end result – training of graduates whose qualifications most fully satisfy the needs of society. Over the half-century history of its existence, this system has been adopted by most medical universities in different countries of the world, in many of which it has undergone significant modifications in accordance with the needs of national educational standards. Many medical universities in Russia and other countries of the former Soviet Union showed interest in this system, some of the medical faculties of our country accepted certain elements of it. However, up to date no integrated preclinical medical education program has been applied in any of the Russian universities. Hereby we are undertaking an attempt to analyze the reasons and assess the possible perspectives for the transition of medical universities in Russia to teaching of fundamental and biomedical disciplines using the integrated curriculum.