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

Changes in medical student attendance at in-person teaching sessions: a systematic review

INTRODUCTION

The COVID-19 pandemic has had a significant impact on medical education, with many institutions shifting to online learning to ensure the safety of students and staff. However, there appears to be a decline in in-person attendance at medical schools across the UK and worldwide following the relaxation of social distancing rules and the reinstatement of in-person teaching. Importantly, this trend was also observed before the pandemic. While reflected within the literature, there is currently no systematic review describing these changes. We aim to find out how medical students' attendance is changing as documented within the literature and its impact on their educational outcomes.

METHODS

This systematic review followed the guidelines of the Centre of Research and Dissemination, Moose and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched the major databases of Medline via Ovid, Embase via Ovid, Scopus, Web of Science, British Education Index via EBSCOhost and ERIC via EBSCOhost in September 2023. Two reviewers independently screened each paper and extracted the data, with a third reviewer for dispute resolution. All studies reporting on medical students from various universities, both graduate and undergraduate, and describing changes in attendance and/or students' educational outcomes were included. Risk of bias in individual studies was assessed using the Agency for Healthcare Research and Quality tool. A narrative synthesis of the findings from all included studies was done.

RESULTS

12 papers were included in the analysis.

PRIMARY AIM

Of the eight papers that measured attendance data over more than one academic year, only one paper demonstrated a statistically significant decrease while one paper demonstrated a statistically significant increase in attendance over the observational period. Other papers either did not perform statistical tests or did not demonstrate statistical significance. Secondary aims: Most papers showed a general positive correlation between attendance and educational outcomes. No studies explicitly explored reasons for changes in attendance seen. Only one paper outlined a possible strategy to address changes in attendance, a mandatory attendance policy, which has mixed outcomes.

DISCUSSION

Despite widespread anecdotally reported attendance decline post-COVID-19, overall, there was no consistent change in attendance noted. However, there was a large heterogeneity in the studies included. Further research is required to elucidate trends in attendance and its impact on medical education.

The Impact of Patient-Centric Interactive E-Module in Pathology Among Medical Undergraduates

Introduction

COVID pandemic shifted healthcare-related education to digital platforms. With the widespread availability of learning management systems like MOODLE, many opportunities exist to create innovative e-modules. Its success depends on the interactive multimedia resources and structural framework. The present study aims to create two patient-centric e-modules on Diabetes and Alcoholic liver disease in Pathology by a medical undergraduate facilitated by faculty and to assess its impact on learning outcomes and learners' perceptions in relation to student seminars.

Methodology

This mixed-method intervention study combines quantitative and qualitative research methods to gain deeper insight into learners' experiences. By random allocation, half of the second-year medical undergraduates (n = 60) attended an e-module, and the other half listened to a student seminar on the same topic with the same specific learning objectives. Pre- and post-test scores and feedback questionnaires were quantitatively analysed. Student-led focus group discussions (FGD) for learners' experiences underwent thematic analysis.

Results

Pre- and post-tests for both learning techniques were statistically significant, while the feedback questionnaire's responses favoured e-module. Four focus group discussions yielded six themes for the e-module: Patient-driven holistic learning experience, Inquiry-based learning, Immersive learning, Higher level cognitive skills, Flexibility, repeatability and accessibility, and No human involvement. The five themes for the seminar were: Peer-driven camaraderie learning dynamic, Teacher-centric synchronous learning, Active vs passive listening, Basic learning, and Teacher-student interaction.

Conclusion

While both learning techniques had comparable effects on test scores, they have merits and demerits. Hence, blending both techniques where seminars impart basic knowledge and e-module for deeper reinforcement will benefit the students.

Differences between students in various programs in a biochemistry course in lecture attendance, engagement, and academic outcomes

The positive relationship between lecture attendance and academic outcomes may be changing in the era of lecturing recordings. The objective of the study was to test this and to determine whether it varied between student cohorts. Consenting students in biochemistry from pharmacy, biomedical science, medical laboratory science, and nutrition programs, which had access to lecture recordings, signed in when attending lectures. Attendance was related to academic outcomes by regression analysis. Average attendance was low (≤19%) and declined significantly between years for most weeks. The students who attended ≥50% of lectures (≤17%) had higher marks than those that attended <50%. Overall regression analysis showed there were positive associations between most academic outcomes and lecture attendance or engagement (attendance and lecture recording access). However, these associations were weak or moderate for students in the pharmacy and biomedical science programs and were not apparent for students in the medical laboratory science and nutrition programs. In a separate survey, the most common reason for attending lectures was "I think I learn more by attending" and for not attending, was "Work commitments made it difficult to get to lectures." The main conclusion is that students of biochemistry should be encouraged to attend lectures, as the limited evidence suggests that attendance may still be associated with better academic outcomes and that some students find them beneficial.

Nurses' motivation, knowledge, and satisfaction with a neonatal pain assessment e-learning course

PURPOSE

To analyze nurses' motivation to learn, motivation to transfer, knowledge acquisition, and satisfaction with an e-Learning course about neonatal pain assessment.

DESIGN

Quantitative, longitudinal, quasi-experimental study, conducted in a university affiliated hospital in São Paulo, Brazil, between April and October 2018.

METHODS

Upon consent, nurses received two questionnaires electronically ("Demographics Survey" and "Motivation to Learn Survey") and were granted access to the e- Learning environment. During the 10-module course, nurses completed a "Pre-Test Questionnaire" (in unit one), and the "Post-Test Questionnaire", "Satisfaction Evaluation Survey", and "Motivation to Transfer Knowledge Survey" at completion of the course. Data were analyzed using R, version 3.6.2.

RESULTS

30 nurses were enrolled, the majority were female (93.33%), mean age 42.8 years (±7.6). The motivation to transfer knowledge (mean 4.09, ±0.53) was greater than the motivation to learn (mean 3.44, ±0, 33). There was significant increase in nurses' knowledge (p<0.0001) when comparing Post- and Pre-Test scores. Participants' satisfaction was overall positive regarding tutoring, virtual environment, self-evaluation, contents and activities, visual communication/layout.

CLINICAL IMPLICATIONS

e-Learning allows nurses to increase their knowledge, to access evidence-based information, while offering a space for critical thinking, clinical reasoning, and decision-making in nursing care, ultimately contributing to quality of care and patient safety.

CONCLUSIONS

The e-Learning course contributed to participants' knowledge acquisition, resulting in a positive impact on nurses' motivation to implement new knowledge about neonatal pain assessment in their clinical practice. The course was considered to be in a suitable environment, easy to handle, interactive and dynamic.

New approach to learning medical procedures using a smartphone and the Moodle platform to facilitate assessments and written feedback

Background: To overcome communication obstacles between medical students and trainers, we designed serial learning activities utilizing a smartphone and web-based instruction (WBI) on the Moodle platform to provide clear and retrievable trainer feedback to students on an objective structured clinical examination (OSCE) item. Methods: We evaluated students’ learning achievement and satisfaction with the new learning tool. A total of 80 fourth-year medical students participated. They installed the Moodle app (the WBI platform) on their smartphones and practiced an endotracheal suction procedure on a medical simulation mannequin while being evaluated by a trainer regarding competence in clinical skills on the smartphone app. Students’ competency was evaluated by comparing the scores between the formative assessment and the summative assessment. The degree of satisfaction and usefulness for the smartphone and WBI system were analyzed. Results: The means (standard deviations, SDs) of the formative and summative assessments were 8.80 (2.53) and 14.24 (1.97) out of a total of 17 points, respectively, reflecting a statistically significant difference (P<0.05). The degree of satisfaction and perceived usefulness of the smartphone app and WBI system were excellent, with means (SDs) of 4.60 (0.58), and 4.60 (0.65), respectively. Conclusion: We believe that the learning process using a smartphone and the Moodle platform offers good guidance for OSCE skill development because trainers’ written feedback is recorded online and is retrievable at all times, enabling students to build and maintain competency through frequent feedback review.

The effectiveness of combining e-learning, peer teaching, and flipped classroom for delivering a physiology laboratory course to nursing students

The Internet and 5G era makes e-learning a vital part of modern education, and extensive evidence has shown that peer teaching and flipped classroom contribute to increased success in medical teaching. However, the applicability of these pedagogies in laboratory courses remains largely unexplored. This study aimed to evaluate the academic performance, proficiency in procedural skills, and perception of nursing students in physiology laboratory classes delivered with nontraditional classroom (NTC) pedagogies comprising the combination of e-learning, peer teaching, and flipped classroom. Each class was subdivided into two equal halves by successive student identification (ID) number and randomly assigned to the control or NTC group. Compared to the control class, NTC teaching significantly enhanced mean score of six preclass tests (67.77 ± 9.83 vs. 62.94 ± 9.70), with "B" graders increased obviously, suggesting that preclass e-learning was more effective than textbook-based preview, especially for general grasp of the topic. Similarly, average scores on postclass quizzes in the NTC group were improved (79.40 ± 9.12 vs. 74.43 ± 8.88). Lesser time cost and higher success rates were observed in trachea, artery, and heart catheterizations in the NTC group, although no disparities were found in ureteral intubation. The majority (∼74%) of students supported the reform and shared positive experiences with NTC methodology. They reported that virtual experiments and self-paced procedural skill videos affected pre- and in-class learning outcomes most, respectively. These findings indicated that NTC pedagogy was workable to improve students' subject scores and proficiency in complicated and direct-viewing procedural skills and was favorable to students.

A systematic review on trends in using Moodle for teaching and learning

BACKGROUND

The Moodle Learning Management System (LMS) is widely used in online teaching and learning, especially in STEM education. However, educational research on using Moodle is scattered throughout the literature. Therefore, this review aims to summarise this research to assist three sets of stakeholders-educators, researchers, and software developers. It identifies: (a) how and where Moodle has been adopted; (b) what the concerns, trends, and gaps are to lead future research and software development; and (c) innovative and effective methods for improving online teaching and learning.The review used the 4-step PRISMA-P process to identify 155 suitable journal articles from 104 journals in 55 countries published from January 2015 to June 2021. The database search was conducted with Scopus and Web of Science. Insights into the educational use of Moodle were determined through bibliometric analysis with Vosviewer outputs and thematic analysis.

RESULTS

This review shows that Moodle is mainly used within University STEM disciplines and effectively improves student performance, satisfaction, and engagement. Moodle is increasingly being used as a platform for adaptive and collaborative learning and used to improve online assessments. The use of Moodle is developing rapidly to address academic integrity, ethics, and security issues to enhance speed and navigation, and incorporate artificial intelligence.

CONCLUSION

More qualitative research is required on the use of Moodle, particularly investigating educators' perspectives. Further research is also needed on the use of Moodle in non-STEM and non-tertiary disciplines. Further studies need to incorporate educational theories when designing courses using the Moodle platform.

Quantitative study of lecture attendance and the association between this attendance and academic outcomes for nursing and nonnursing students in an introductory pathophysiology course

Since the availability of lecture recordings, there have been limited studies of any associations between face-to-face lecture attendance and academic outcomes. The aims of the study, in an introductory pathophysiology course, where lecture recordings were available, were 1) to quantify lecture attendance and any associations between academic outcomes and lecture attendance, and 2) to determine why students do or do not attend lectures. Data were analyzed for the whole cohort before separating the nursing (∼60%) and nonnursing students. Of 288 enrolled students, 205 consented to sign the attendance register, and 139 to undertake the online survey. Lecture attendance was higher (41%) before the midsemester exam than afterwards (24%), P < 0.001, due to higher attendance by the nursing than nonnursing students. Students who attended ≥50% of lectures consistently got higher academic outcomes than those that attended <50%, e.g., examinations, 11 percent points higher. Pearson's or Spearman's correlation coefficients for students from both the sign-in and survey showed that there were positive associations between lecture attendance and academic outcomes, which were mainly weak for nursing students (P ≤ 0.05), with no association for nonnursing students. From the survey, most students who attended lectures did so because they considered they learned more by attending lectures, whereas not liking the lecture time was the most common reason for not attending lectures. In conclusion, even though students have access to lecture recordings, lecture attendance is still a determinant of academic outcomes for some students of pathophysiology.

Evaluating Usability in Blended Learning Programs Within Health Professions Education: a Scoping Review

Knowledge was mapped about how usability has been applied in the evaluation of blended learning programs within health professions education. Across 80 studies, usability was explicitly mentioned once but always indirectly evaluated. A conceptual framework was developed, providing a foundation for future instruments to evaluate usability in this context.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01295-x.

Modified team-based and blended learning perception: a cohort study among medical students at King Saud University

BACKGROUND & OBJECTIVE

Medical schools have evolved toward competency-based education and active learner-centered strategies. Medical informatics course was introduced in 2011 in the 3rd year at the College of Medicine (CoM), King Saud University (KSU), to enhance future medical graduates with technological and information competencies. Modified team-based learning and blended learning were emphasized using face-to-face lectures, various e-learning technologies, workshop and seminars. The current study's main objective was to assess students' perceptions towards blended and modified team-based learning at the CoM in KSU.

METHODS

A survey was distributed to medical students in three consecutive years: 2017-2019. The survey contains items regarding student perception of various types of blended learning techniques applied in the course. The survey was administered using i-Clicker; an interactive device that enables students to answer survey questions. Descriptive statistics were used to examine the perception of students on these blended learning dimensions investigated.

RESULTS

Seven-hundred and one student responded to the questionnaire (male; 69.5%, female 30.5%). Out of which, 59.1% of students found team interactions positively supported discussions and asked questions freely, and 48.1% expressed that working in groups facilitated their learning process. However, 56.0% of students chose face-to-face lectures as the most preferred class activities followed by discussion 23.8%. More than 78% of participants agree that online quizzes are good experience and enjoyable. Grade center where students can check for marks and attendance also received high perception (66.3%).

CONCLUSION

Introducing modified team-based and blended-learning are considered challenging, and therefore, investigating their perceptions can provide useful insights into how these methods could be used more effectively. The blended-learning technique is highly essential in teaching medical informatics to overcome challenges faced due to a large number of students and the need for various exposures to reach the course's learning goals. Moreover, it is noticed that students were engaged in face-to-face and online activities, furthermore, modified team-based learning reported facilitating learning and asking questions without embarrassment.

[Moodle, a credible alternative pedagogy for teaching medicine in a tropical environment to address large numbers and pandemic situations?]

INTRODUCTION

Moodle is an interactive online education platform, a true virtual amphitheater, breaking down geographical and space barriers, capable of offering continuous education even in times of war or pandemic.

AIM

To show the possible contribution of Moodle in the teaching of medicine in tropical environments to respond to large numbers and pandemic situations.

METHODOLOGY

It was a cross-sectional and descriptive survey. It was conducted in June 2019 at Joseph KI-ZERBO University of Ouagadougou in Burkina Faso. It consisted of a questionnaire submitted to Master 1 students of medicine and to their teachers. The survey focused on the solutions that students would propose to improve their learning conditions, the role that Moodle could play in improving their learning, as well as the prerequisites to be resolved before adopting Moodle. The respondent rate was 75.6% of the entire promotion.

RESULTS

For students Moodle is a good alternative to conventional education. However, prerequisites must be fulfilled such as the donation of computer to each student (90.3%), the availability of a good connection for all (96%), their training prior to the use of Moodle. Students found no harm in their online assessment via Moodle provided it was reliable and verifiable when needed. Teachers in 38% wanted teaching to remain traditional, face to face against 62% who advocated its abandonment in favor of new teaching methods like Moodle provided that the right conditions are in place.

CONCLUSION

Moodle is a credible e-learning that can facilitate the management of large numbers and ensure the continuity of lessons learned in a pandemic situation despite the need for containment. However, it must be a mastered technique, applied on prepared ground.

Massive Open Online Courses-based blended versus face-to-face classroom teaching methods for fundamental nursing course

An increasing number of studies focus on the effectiveness of Massive Open Online Courses (MOOC)-based blended learning, whereas none have yet studied using it for teaching fundamental nursing skills at an undergraduate level.To evaluate the effectiveness of MOOC-based blended learning versus face-to-face classroom teaching techniques within the fundamental nursing course at the Faculty of Nursing, University of Xiang Nan, China.This cluster randomized controlled trial enrolled 181 students and assigned them into either an MOOC-based blended or a face-to-face classroom teaching group, both involving the Fundamental Nursing course for undergraduate nursing students. The analyzed outcomes included test scores, critical thinking ability, and feedback received from the students on the Fundamental Nursing course.MOOC-based blended techniques versus face-to-face classroom teaching methods demonstrated higher daily performance (P = .014), operational performance (P = .001), theoretical achievements (P < .001), and final grades (P < .001) in Fundamental Nursing.Moreover, the mean change in the participants' critical thinking ability items between groups were, mostly, statistically significant. The items focusing on the feedback from the students demonstrated significant differences between the groups in terms of their satisfaction with the teaching they received (P < .001) and the overall learning effects (P = .030).This study confirmed that receiving MOOC-based blended learning was superior when compared against face-to-face classroom teaching techniques for learning within the Fundamental Nursing course.

Fostering teaching-learning through workplace based assessment in postgraduate chemical pathology residency program using virtual learning environment

BACKGROUND

The principle of workplace based assessment (WBA) is to assess trainees at work with feedback integrated into the program simultaneously. A student driven WBA model was introduced and perception evaluation of this teaching method was done subsequently by taking feedback from the faculty as well as the postgraduate trainees (PGs) of a residency program.

METHODS

Descriptive multimethod study was conducted. A WBA program was designed for PGs in Chemical Pathology on Moodle and forms utilized were case-based discussion (CBD), direct observation of practical skills (DOPS) and evaluation of clinical events (ECE). Consented assessors and PGs were trained on WBA through a workshop. Pretest and posttest to assess PGs knowledge before and after WBA were conducted. Every time a WBA form was filled, perception of PGs and assessors towards WBA, time taken to conduct single WBA and feedback were recorded. Faculty and PGs qualitative feedback on perception of WBA was taken via interviews. WBA tools data and qualitative feedback were used to evaluate the acceptability and feasibility of the new tools.

RESULTS

Six eligible PGs and seventeen assessors participated in this study. A total of 79 CBDs (assessors n = 7 and PGs n = 6), 12 ECEs (assessors n = 6 and PGs n = 5), and 20 DOPS (assessors n = 6 and PGs n = 6) were documented. PGs average pretest score was 55.6%, which was improved to 96.4% in posttest; p value< 0.05. Scores of annual assessment before and after implementation of WBA also showed significant improvement, p value 0.039, Overall mean time taken to evaluate PG's was 12.6 ± 9.9 min and feedback time 9.2 ± 7.4 min. Mean WBA process satisfaction of assessors and PGs on Likert scale of 1 to 10 was 8 ± 1 and 8.3 ± 0.8 respectively.

CONCLUSION

Both assessors and fellows were satisfied with introduction and implementation of WBA. It gave the fellows opportunity to interact with assessors more often and learn from their rich experience. Gain in knowledge of PGs was identified from the statistically significant improvement in PGs' assessment scores after WBA implementation.

Utility of Real-Time Online Teaching During COVID Era Among Surgery Postgraduates

A cross-sectional study was conducted to assess the utility of online teaching for general surgery postgraduate residents at the end of 1 month of online teaching during the COVID-19 lockdown. A questionnaire related to different aspects of online teaching was developed on a 5-point Likert scale from “strongly agree” to “strongly disagree”. Following a pilot study, the questionnaire was shared among surgery residents, and response collection was done. The residents who did not attend at least 90% of scheduled classes were excluded. A total of 55 resident doctors without prior experience of online teaching program were enrolled in the study. All the participants responded to all questions and submitted their responses within stipulated time. On the basis of validity testing, questions 1 and 2 were found invalid and hence deleted. The median value for the total cohort was 4 indicating that majority of residents gave affirmative response. On segregating the result with the year of residency program, similar results were found in the 1st year and 2nd year group; however, the 3rd year group showed a median of 3, thus eliciting that only 50% of 3rd year residents liked online teaching. From the present study, it can be concluded that the online teaching is a feasible alternative to the physical class among surgical postgraduates. The questionnaire utilized in the present study can be used for assessing similar online teaching protocols.

Recommendations for working from home during the COVID-19 pandemic (and beyond)

BACKGROUND

There is a growing trend around the globe for having more people working from home, particularly in the current COVID-19 pandemic. Although it is widely implemented in a number of countries and types of companies, it has shown to have multiple challenges.

METHODS

In this article, we provide several recommendations on how to work from home, incorporating information from several publications.

RESULTS

The suggestions are: create routines, be organized, have an adequate home office, enhance your productivity, be responsible, avoid extreme multitasking, facilitate communication and networking, be balanced, use available computer programs and platforms, be creative with remote teaching, explore options for remote research and learn from the challenges.

CONCLUSIONS

These recommendations would help students, professors and researchers around the globe during the current COVID-19 pandemic, and beyond.

No apparent association between lecture attendance or accessing lecture recordings and academic outcomes in a medical laboratory science course

BACKGROUND

The effect of availability of lecture recordings on academic outcomes is not clear and it is not known whether these recordings change the association between lecture attendance and academic outcomes. Few surveys of lecture attendance or lecture recordings use by students are linked to academic outcomes. The aims were (i) to determine any association between lecture attendance and academic outcomes for students who had access to lecture recordings, (ii) to determine any association between accessing lecture recordings and academic outcomes and (iii) to use a survey to determine why students attend lectures and/or access lecture recordings in a course in medical laboratory science.

METHODS

Consenting students signed in when attending lectures and/or completed an online survey. Pearson's correlation coefficients were calculated to determine whether there was an association between attending lectures or accessing lecture recordings and academic outcomes.

RESULTS

Consent rates were high for both the sign-in (90%) and survey (64%). The main findings were that in 2017 and 2018: (i) the average lecture attendance was 39 and 27%, respectively, (ii) there was no association between lecture attendance and academic outcomes, (iii) there was no association between accessing lecture recordings and academic outcomes. Survey respondents were almost equally divided between those attending lectures weekly, sometimes or not. Reasons for attending lectures included greater perceived learning and interaction with staff and other students, while reasons for not attending related to inconvenience or other commitments. Lecture recordings were accessed to clarify, revise or catch up on content, or as an alternative to attending lectures. One-third of students provided additional feedback on accessing lecture recordings, and the most common themes were 'flexibility' and 'useful'. Lecture slides (PowerPoints), independently of lecture recordings, were used extensively by the students.

CONCLUSIONS

From this study, it does not seem that either lecture attendance or accessing lecture recordings are major determinants of academic outcomes for most students. As students vary in their lecture attendance and use of online resources including lecture recordings and lecture slides, academic staff should continue to provide a range of resources for students.

No apparent association between lecture attendance or accessing lecture recordings and academic outcomes in a medical laboratory science course

BACKGROUND

The effect of availability of lecture recordings on academic outcomes is not clear and it is not known whether these recordings change the association between lecture attendance and academic outcomes. Few surveys of lecture attendance or lecture recordings use by students are linked to academic outcomes. The aims were (i) to determine any association between lecture attendance and academic outcomes for students who had access to lecture recordings, (ii) to determine any association between accessing lecture recordings and academic outcomes and (iii) to use a survey to determine why students attend lectures and/or access lecture recordings in a course in medical laboratory science.

METHODS

Consenting students signed in when attending lectures and/or completed an online survey. Pearson's correlation coefficients were calculated to determine whether there was an association between attending lectures or accessing lecture recordings and academic outcomes.

RESULTS

Consent rates were high for both the sign-in (90%) and survey (64%). The main findings were that in 2017 and 2018: (i) the average lecture attendance was 39 and 27%, respectively, (ii) there was no association between lecture attendance and academic outcomes, (iii) there was no association between accessing lecture recordings and academic outcomes. Survey respondents were almost equally divided between those attending lectures weekly, sometimes or not. Reasons for attending lectures included greater perceived learning and interaction with staff and other students, while reasons for not attending related to inconvenience or other commitments. Lecture recordings were accessed to clarify, revise or catch up on content, or as an alternative to attending lectures. One-third of students provided additional feedback on accessing lecture recordings, and the most common themes were 'flexibility' and 'useful'. Lecture slides (PowerPoints), independently of lecture recordings, were used extensively by the students.

CONCLUSIONS

From this study, it does not seem that either lecture attendance or accessing lecture recordings are major determinants of academic outcomes for most students. As students vary in their lecture attendance and use of online resources including lecture recordings and lecture slides, academic staff should continue to provide a range of resources for students.

Exploring how medical students learn with the help of a digital presentation: a qualitative study

BACKGROUND

The web-based presentation software Prezi was used to create a digital presentation in order to facilitate antibiotic knowledge in an undergraduate course on infectious diseases in the Karolinska Institutet Medical Programme. It was unclear how the students used this in their learning, and there is a lack of research on using Prezi presentations in higher education, as well as on learner-content interaction in blended learning in general.

METHODS

A qualitative study design was used for an in-depth exploration of the students' experiences of using the presentation in their studies. Students were interviewed using a semi-structured interview guide. The interviews were transcribed verbatim and analysed using qualitative content analysis.

RESULTS

Two main themes emerged from the analysis. Firstly, the students experienced that they own their learning: the presentation provided flexibility in studying and increased engagement in the learning process. Secondly, the presentation was part of a superficial learning process: students saw it as a complement to other educational activities, but expressed that there was an absence of pedagogical encounters which prevented the information in the presentation to be placed in a larger context.

CONCLUSIONS

The Prezi presentation when used as an e-learning tool was a useful part of and a complement to blended learning in medical education but cannot replace face-to-face learning situations, especially not when the content of the course is complex, such as in the case of antibiotics. The learning objectives should be connected to a learning theory and made explicit for the students. Students should receive instructions and support during the course on how to use new e-learning tools. Continuous pedagogical interaction with feedback and reflection between students, teachers, and patients should be provided to enhance deep learning.