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

Virtual laboratories complement but should not replace face-to-face classes: perceptions of life science students at Dundalk Institute of Technology, Ireland

Virtual laboratories (VLs) enable students to experiment, analyze data, or interact with digital content in a nonphysical space. VLs include simulations, electronic notebooks, videos, and augmented reality. As part of the "VL Project," comprising five academic institutions in Ireland, we sought to determine how VLs might enhance practical learning in undergraduate life science students at Dundalk Institute of Technology (DkIT). From 2021 to 2024, we exposed students to VLs in multiple degrees (e.g., BSc Bioscience, BSc Pharmaceutical Science, BSc Biopharmaceutical Science). We focused on Labster simulations and Lab Archives electronic notebooks. Over 600 students performed VLs in 14 modules from first to fourth year (e.g., Biotechnology, Immunology, Bioanalytical Science). We surveyed students before and after using VLs and conducted focus groups to evaluate emergent themes in depth. Among respondents (n = 263), the most beneficial component of laboratory experiences, as indicated by 58% of students was experimental work (as opposed to prepractical talks or postlaboratory assessments). Ninety percent of students agreed with the statement: "VLs enhanced my level of confidence with experimental science." Seventy-five percent of students stated VLs should only be used to complement face-to-face (F-2-F) teaching. Thematic focus group analysis revealed students valued VLs as prelaboratory tools, allowing repeated engagement with, and troubleshooting of experiments in a safe, nontime-limited manner. In conclusion, students reinforced they valued hands-on experience, in-person instructor guidance, and real-world demonstration for experimental work. VLs can complement but should not replace F-2-F laboratory experiences in undergraduate life sciences.NEW & NOTEWORTHY This study represents the largest and most systematic analysis of student perceptions of life science virtual laboratories conducted in Ireland. Our findings provide student-centered feedback on the potential benefits and challenges of using virtual laboratories to enhance life science learning and have wide implications for how these resources might be best utilized in other institutions in the future.

Health science staff and student experiences of teaching and assessing clinical skills using digital tools: a qualitative study

INTRODUCTION

Once considered a supplement to traditional teaching approaches, digital tools now play a pivotal role in building core clinical competencies. This study aims to explore staff and student experiences of navigating the challenges of teaching and assessing clinical skills using digital technology. It also aims to provide insight into what skills, or aspects of skills, may be best suited to digitally enhanced teaching, thereby advancing the future of health science education.

METHODS

This qualitative study comprises the second phase of data generation for a mixed-methods research project entitled DEPTH (Digitally Enhanced Practical Teaching in Health Science). Health science staff and students expressed interest in taking part in the current study during the first stage of data collection. Qualitative data was collected in January 2022 through semi-structured group interviews and individual semi-structured interviews. An interpretivist qualitative research design underpinned by a critical realist epistemological position was used. Themes were generated following Braun and Clarke's 6-step process for reflexive thematic analysis.

RESULTS

Overall, 10 staff and 8 students across 11 health science disciplines participated in this research. Fourteen hours of transcripts were analysed and 4 themes generated. Our findings highlight the suitability of digitally enhanced teaching for low-stake skills requiring visual and auditory training, while skills requiring tactile training require in-person practice to build student competency. Importantly, our findings indicate a desire for increased remote teaching. While our work was not specifically aimed at documenting experiences related to the Covid-19 pandemic, all participants had lived experience teaching or learning during the pandemic and many spoke specifically about this.

CONCLUSIONS

The timing of this paper captures a novel moment in the history of clinical pedagogy. Staff and students advocate for the continued integration of technology into health science education generally, and clinical skills teaching specifically. For this to be successful, judicious selection of methods, skills, skill components and technology, that can be appropriately mapped onto specific learning outcomes, is required.

Providing the choice of in-person or videoconference attendance in a clinical physiology course may harm learning outcomes for the entire cohort

Clinical Physiology 1 and 2 are flipped classes in which students watch prerecorded videos before class. During the 3-h class, students take practice assessments, work in groups on critical thinking exercises, work through case studies, and engage in drawing exercises. Due to the COVID pandemic, these courses were transitioned from in-person classes to online classes. Despite the university's return-to-class policy, some students were reluctant to return to in-person classes; therefore during the 2021-2022 academic year, Clinical Physiology 1 and 2 were offered as flipped, hybrid courses. In a hybrid format, students either attended the synchronous class in person or online. Here we evaluate the learning outcomes and the perceptions of the learning experience for students who attended Clinical Physiology 1 and 2 either online (2020-2021) or in a hybrid format (2021-2022). In addition to exam scores, in-class surveys and end of course evaluations were compiled to describe the student experience in the flipped hybrid setting. Retrospective linear mixed-model regression analysis of exam scores revealed that a hybrid modality (2021-2022) was associated with lower exam scores when controlling for sex, graduate/undergraduate status, delivery method, and the order in which the courses were taken (F test: F = 8.65, df1 = 2, df2 = 179.28, P = 0.0003). In addition, being a Black Indigenous Person of Color (BIPOC) student is associated with a lower exam score, controlling for the same previous factors (F test: F = 4.23, df1 = 1, df2 = 130.28, P = 0.04), albeit with lower confidence; the BIPOC representation in this sample is small (BIPOC: n = 144; total: n = 504). There is no significant interaction between the hybrid modality and race, meaning that BIPOC and White students are both negatively affected in a hybrid flipped course. Instructors should consider carefully about offering hybrid courses and build in extra student support.NEW & NOTEWORTHY The transition from online to in-person teaching has been as challenging as the original transition to remote teaching with the onset of the pandemic. Since not all students were ready to return to the classroom, students could choose to take this course in person or online. This arrangement provided flexibility and opportunities for innovative class activities for students but introduced tradeoffs in lower test scores from the hybrid modality than fully online or fully in-person modalities.

Exploring EFL Teachers’ Emotions and the Impact on Their Sustainable Professional Development in Livestream Teaching: A Chinese Case Study

Due to the impact of COVID-19, most Chinese universities have launched livestream teaching. Faced with this significant change of teaching mode, teachers experienced different emotions, including predominant negative emotions such as anxiety, stress, and anger, alongside a few positive emotions like satisfaction, love, and happiness. With the rising attention on teacher emotion research, this study explores the emotional experiences of five Chinese English as a foreign language (EFL) teachers in livestream teaching. Drawing from data collected via interviews and case documents, it examines the causes of these teachers’ emotions and the impact thereof on their sustainable professional development. The findings suggest that teacher emotions were produced through the interaction between teachers’ goals and the environment, which included students’ performance, features of livestream teaching, and the institutional livestream teaching requirements. The impacts of teacher emotions on their sustainable professional development were identified: deepening teachers’ understanding of online teaching, shaping teacher identities, and motivating teachers to take action. Implications regarding developing teachers’ coping strategies for various emotions and sustaining their professional development in online teaching are also included.

The baroreceptor reflex brought to life outside the classroom - an e-learning based asynchronous laboratory class using a non-supervised modified Active Standing Test

BACKGROUND

E-learning based laboratory classes can replace or enhance in-classroom laboratories. They typically offer temporal flexibility, self-determined learning speed, repeatability and do not require supervision or face-to-face contact. The aim of this feasibility study was to investigate whether the established in-classroom laboratory class on the baroreceptor reflex (BRR) can be transformed into a new e-learning based asynchronous laboratory class for untrained, non-supervised students without medical equipment. The BRR is a fundamental cardiovascular process which is regularly visualized in physiology during in-classroom laboratories by a student-performed Active Standing Test (AST). During this voluntary provocation of orthostatic stress, the BRR reliably causes a solid rise in heart rate (HR) and a stabilization or even increase in blood pressure (BP).

METHODS

The conventional AST was modified by omission of BP measurements which would require medical devices and was embedded into a framework of interactive digital material allowing independent student performance. With specific adaptions, this instrument was implemented to 1st and 2nd year curricula of human medicine, dental medicine, midwifery and pharmacy. An audience response system was used to collect the students' data on HR, epidemiology, technical problems, satisfaction and orthostatic symptoms. As primary outcome, we investigated the students' correct performance of the modified AST regarding textbook conformity of the HR data. Secondary outcomes included technical feasibility, the students' satisfaction and consistency of HR data within predefined subgroups (e.g., gender, curricula). Descriptive statistics are reported.

RESULTS

The class was completed by 217 students (mean age: 23 ± 8 [SD], 81% female, 19% male). Mean reported rise of HR during standing was ~ 20 bpm (~ 30%) which is highly concordant to textbooks. Reported feasibility (~ 80% negated any technical issues) and students' satisfaction (4.4 on 5-point Likert-scale) were high. The HR data were consistent within the subgroups.

CONCLUSION

This study demonstrates that the highly relevant BRR can be successfully addressed in an e-learning based asynchronous laboratory class implementing a non-supervised AST restricted to HR measurements embedded in digital material. The robust HR response and the adjustable complexity allow an application to different healthcare-related curricula. This class, therefore, provides a broad audience access to a fundamental concept of cardiovascular physiology.

Case Study: Using H5P to design and deliver interactive laboratory practicals

We describe the use of HTML5P (H5P) content collaboration framework to deliver an interactive, online alternative to an assessed laboratory practical on the Biomedical Cell Biology unit at the Manchester Metropolitan University, U.K. H5P is free, open-source technology to deliver bespoke interactive, self-paced online sessions. To determine if the use of H5P affected learning and student attainment, we compared the student grades among three cohorts: the 18/19 cohort who had 'wet' laboratory classes, the 19/20 cohort who had 'wet' laboratory classes with additional video support and the 20/21 cohort who had the H5P alternative. Our analysis shows that students using the H5P were not at a disadvantage to students who had 'wet' laboratory classes with regard to assessment outcomes. Student feedback, mean grade attained and an upward trend in the number of students achieving first-class marks (≥70%), indicate H5P may enhance students' learning experience and be a valuable learning source augmenting traditional practical classes in the future.

All-digital training course in neurophysiology: lessons learned from the COVID-19 pandemic

BACKGROUND

The social distancing and suspension of on-campus learning, imposed by the COVID-19 pandemic, are likely to influence medical training for months if not years. Thus, there is a need for digital replacement for classroom teaching, especially for hands-on courses, during which social distancing is hardly possible. Here, we investigated students' learning experience with a newly designed digital training course in neurophysiology, with intercalated teaching blocks in either asynchronous (unsupervised online lectures and e-labs) or synchronous (online seminars, supervised by instructors) formats.

METHODS

The accompanying anonymized prospective study included 146 student participants. At the beginning and the end of the course, students were invited to answer anonymous online questionnaires with 18 and 25 items, respectively. We conducted both qualitative analyses of students' survey responses and statistical analyses of the results of cohort-specific summative examinations. The summative assessment results were compared both between 4 current cohorts and with the respective historical cohorts.

RESULTS

Despite having little prior experience with e-learning (4.5 on the 1-7 scale), students adapted remarkably well to this online format. They appreciated its higher flexibility, time efficiency, student-oriented nature (especially when using inverted classroom settings), tolerance towards the individual learning style and family circumstances, and valued the ability to work through lectures and e-labs at their own learning speed. The major complaints concerned diminished social contacts with instructors and fellow students, the inability to ask questions as they occur, and the lack of sufficient technical expertise. The students valued the newly developed e-labs, especially the implementation of interactive preparative measures (PreLabs) and the intuitive lab design offered by the chosen software (Lt Platform from AD Instruments). The summative examinations at the end of the course documented the quality of knowledge transfer, which was comparable to that of previous classically instructed cohorts.

CONCLUSION

Despite the missing personal contact between the faculty and the students, inherent to online teaching, the all-digital training course described here proofed to be of good educational value and, in case the pandemic continues, is worse considering for the future. Some of the described building blocks, like digital lectures or interactive PreLabs, may survive the pandemics to enrich the medical education toolbox in the future.

Virtual delivery: a panacea for the financial and ethical challenges associated with physiology laboratory classes?

There has been a gradual shift in the delivery of physiology laboratory classes over the last 30 years. For many, wet-lab demonstrations using animal tissues have been reduced or replaced with student-led investigations where students are both subjects and researchers. Despite these changes, expectations remain that physiology courses should include a practical component to encourage deeper and higher-order learning. Wet-lab tissue experiments and student-based group research formats can be expensive to run, associated with various ethical constraints, and, as discovered in these times of COVID-19, difficult to operate while adhering to physical distancing. We address the proposition that online and/or remote delivery of laboratory classes using digital technologies may provide a solution to both financial and ethical constraints of on-campus laboratory classes. Our discussions, as an international group of 10 physiologists from the United States, the United Kingdom, Canada, and Australia, revealed that although some of the financial and ethical constraints of using animal tissues and student-led investigations were addressed by the introduction of online alternatives, the construction and maintenance of online delivery modes could also be expensive and ethical issues, not previously considered, included digital equity and student data security. There was also a collective perception that if face-to-face laboratory classes were changed to an entirely virtual mode there was a risk that some intended learning outcomes would not be met. It was concluded that the "ideal" approach is likely a hybrid model whereby student attendance in face-to-face, on-campus classes is supported with interactive digital content either developed in house or obtained through third-party providers.