The Pedagogical Shift During COVID 19 Pandemic: Online Medical Education, Barriers and Perceptions in Central Kerala

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Beyond COVID-19: the impact of recent pandemics on medical students and their education: a scoping review

INTRODUCTION

Over the past two years, coronavirus disease (COVID-19) has greatly altered medical student education as well as daily life. Medical schools across the world were disrupted and had to immediately adapt the educational experience to the online environment in order to continue the delivery of quality medical education. However, COVID-19 was not the only recent pandemic. This posed the question, were similar disruptions and adaptations also seen in recent past pandemics such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) that could have prepared medical educators for COVID-19? This scoping review investigated the educational and personal impact of recent pandemics on medical students.

METHODS

This review followed the PRISMA-ScR guidelines for scoping reviews. Nine databases including PubMed, ERIC, and EMBASE were systematically searched using keywords and subject headings related to medical students and SARS, H1N1, MERS, Ebola, Zika, and COVID-19. Studies were limited to research studies published between 2000 and 2020 and in English. Based on exclusion and inclusion criteria, all studies were independently screened by two reviewers first by the title/abstract and then via full text. Data were extracted from the included studies and analyzed qualitatively using thematic analysis.

RESULTS

A total of 174 studies fit the criteria. Seven major themes emerged from those studies: educational adaptations and online modifications, knowledge and attitudes of students, mental wellness of students, student involvement and use of telehealth, student vaccination, physical wellness of students, and stigma.

CONCLUSION

This review provided insights into how medical students were affected by recent pandemics and their perceptions of pivoting to online education, mental health, and knowledge of the diseases. Additionally, this review showcases the various educational adaptations that emerged uniquely during the COVID-19 pandemic, such as telehealth services or video conferencing tools, that can be utilized in a post-pandemic environment.

Innovations in online classes introduced during the COVID-19 pandemic and their educational outcomes in Japan

BACKGROUND

The novel coronavirus disease (COVID-19) pandemic emerged in Japan in February 2020, forcing the adoption of online education by university medical schools across Japan. The advantages and disadvantages of online education have been studied in Japan; however, the educational outcome of online classes conducted during the COVID-19 pandemic has not been completely evaluated. In this study, we examined the relationship between lecture format (e.g., face-to-face or online) and performance of third-year university students in their organ-specific cardiovascular course examination.

METHODS

This retrospective, nonclinical, and noninterventional comparative educational study included 550 third-year medical students who took a cardiovascular course between April 2018 and May 2022. Cardiovascular coursework was conducted in-person in 2018 and 2019, online in 2020 and 2021, and again in-person in 2022. The course comprised 62 lecture and 2 problem-based learning (PBL) sessions. A quiz was set up in advance on Moodle based on all lectures conducted in 2021 and 2022. A written examination was administered at the end of the course to evaluate the knowledge of students. The student online course evaluation questionnaires were administered in 2020 and 2021. Examination scores and proportion of failures in each year were compared.

RESULTS

The mean examination scores were significantly higher in 2021 and 2022 than in 2018, 2019, and 2020 (p < 0.05). Univariate and multivariate analyses adjusted for the class type, online quiz, and PBL revealed that only online quiz was significantly associated with better examination results (p < 0.05). A student course evaluation survey indicated that the online format did not interfere with the students' learning and was beneficial.

CONCLUSIONS

The introduction of online classes into medical education due to the COVID-19 pandemic was as effective as face-to-face classes owing to learning management system and other innovations, such as online quizzes. Online education may confer more benefits when provided in a combination with face-to-face learning after COVID-19 pandemic.

Short- and Long-Term Retentivity of Knowledge by Various Teaching Methods in Medical Education and Perception of Students Towards Them: A Comparative Study in a Medical University Hospital of Northern India

BACKGROUND

To develop doctors with appropriate knowledge of health and diseases, reasonable medical abilities, and a positive attitude toward patients and their families, it is important to reexamine the methods used to educate and train medical school students. To establish which is best for both medical students and professors, the various teaching and learning methodologies must be compared and analyzed. This study attempts to determine the preferred medical education techniques among medical students as well as the caliber of the classes they attend.

METHODS

This is a before-and-after study conducted among 480 first- (240) and second-year (240) undergraduate students. Students were divided into three groups. Each group was assigned a teacher who was responsible for teaching four short topics according to the common understanding and knowledge level of both year students in four different ways: traditional blackboard method, offline PowerPoint presentation, online PowerPoint presentation, and online annotative. Application-based learning and self-learning were the other two teaching methods conducted in a monitored environment. An MCQ-based pre- and post-test were taken to assess the improvement, and a feedback form was filled out by each student to assess their perception. To assess long-term retention, a surprise follow-up test was conducted after 15 days.

RESULTS

For all the teaching methods except for traditional blackboard and online presentation, there was a significant improvement in the post-test scores as compared to the pre-test scores (p<0.05). Retentivity was more remarkable in online application-based and self-learning methods. 77.2% of the study participants preferred offline presentation as the mode of teaching.

CONCLUSION

Retention was found to be highest in self-directed and application-based learning. So, students should be encouraged and motivated for self-study after every lecture, whatever the teaching method used by teachers.

Teaching in the "New Normal": Using an Evidence-Based Process to Determine Should It Stay or Should It Go (SISoSIG)

After pivoting to emergency remote instruction due to the COVID-19 pandemic, medical educators have added new techniques to their toolbox. As we welcome a "new normal," we may be able to teach even more effectively than we did before by adapting some of these techniques. This paper provides an evidence-based decision-making process for faculty to consider what should stay and what should go as they revise and enhance instruction from one semester to another. The SISoSIG process provides opportunities to reflect on lessons learned and discuss how to build on that learning to become even more effective practitioners.

The gaps in undergraduate medical education due to the ongoing pandemic: An experience from a private medical college in Kerala

The Covid-19 pandemic affected undergraduate medical education worldwide. By March 2020, colleges in India had to close following a national lockdown. Most of the colleges including ours started using e-platforms. Our earlier studies highlighted concern for lack of patient examination in clinical settings and successes of the online teaching programmes were limited to didactic teaching. The year 2020 also was the year in which the National Medical Commission (NMC) introduced a competency-based system, which was new to all stakeholders. We assessed the impact of Covid-19 on the ongoing teaching pattern in our institute. Actual coverage of theory classes and practical/clinical teaching sessions were gathered from departments across all years of undergraduate medical education and the gap percentage was calculated against the NMC/ Medical Council of India requirements. The gap percentage was calculated as missing classes divided by required classes multiplied by hundred. The heads of departments were consulted, and details of theory, practical and clinical classes taken for each batch before and after lockdown were gathered using a questionnaire. These were compared against the mandated teaching by the NMC guideline for theory, practical and clinics. The results showed a gap ranging from 2% to 83% for theory classes, the least being in anatomy and the highest being in medicine. As there were no practical or clinical sessions during the lockdown, the gap was zero. Various challenges were faced due to online medical education. There was a dilemma over choosing the type of training that would produce adequate numbers with low quality or a delayed training but of assured quality. Various solutions including suspending the ongoing course and converting it to short-term skill training sessions to deal with pandemic care and strategies to improve online teaching were considered.

Jordanian nursing students' engagement and satisfaction with e-learning during COVID-19 pandemic

BACKGROUND

Nursing education was affected by the COVID-19 pandemic as most institutions shifted to e-learning. The aim of the current study was to examine students' engagement and satisfaction levels with e-learning during the COVID-19 pandemic.

METHODS

A descriptive correlation design was used to guide this study. A voluntary response sampling method was used to recruit undergraduate nursing programs in Jordan. Data were collected using an electronic link to a self-reported questionnaire.

RESULTS

A total of 1,562 undergraduate nursing students responded to the questionnaire. The study showed that most students have high engagement in the emotional, skills, and performance subscales and low engagement in the participation subscale. Further, they were moderately satisfied with e-learning during the COVID-19 pandemic.

CONCLUSIONS

Students identified several issues regarding their e-learning, which must be considered to improve their engagement and satisfaction. Further, the study revealed several shortcomings in preparing students to attend e-learning classes.

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.

Student's perception of E-learning during COVID-19 pandemic and its positive and negative learning outcomes among medical students: A country-wise study conducted in Pakistan and Iran

Background

Since the emergence of coronavirus diseases 2019 (COVID-19) not only have social and the economical dimension of life been disturbed but it has also shattered educational activities as well. Due to fear of disease spread educational institutes are forced to implement online educational systems to teach their pupils. This study aims to explore the student's perceptions related to E-learning and their positive and negative outcome among medical students in Pakistan and Iran.

Method

ology: This cross-sectional questionnaire-based study was conducted at Rawalpindi Medical University, Rawalpindi, Pakistan, and Islamic Azad University of Medical Sciences Tehran, Iran. This study involved 402 medical students of Rawalpindi Medical University, Rawalpindi, Pakistan (n = 202), and Islamic Azad University of Medical Sciences Tehran, Iran (n = 200) who were actively involved in the online mode of education. A self-administered validated questionnaire was used for data collection. Descriptive statistics and chi-square analysis was used and analysis was done through SPSS V.23. A P-value of 0.05 was taken as significant.

Results

A total of 402 students were enrolled, 202 from Pakistan and 200 from Iran. About 68.2% of the students were acquainted with moderate levels of IT skills. About 75.8% of the students were not showing any previous experience with E-learning. The most common advantage of E-learning was the ability to stay at home. The technical problem was the most common disadvantage in our study. Finally, face-to-face learning in terms of increasing knowledge, skill, and social competence was considered the best mode of learning both by Pakistani and Irani students. Country-wise effectiveness of face-to-face learning in terms of increasing knowledge is statistically significant (p-value = 0.019). Acceptance of E-learning is statistically associated with the country of learning (p-value = 0.020). E-learning was rated as enjoyable by 51.5% of the students.

Conclusion

E-learning has its associated advantages and disadvantages as perceived by medical students but still face-to-face learning is considered the most effective form of learning as responded by medical students.

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The ability to stay at home was the most frequent advantage reported by 64.9% of the Pakistani students as compared to 32% of Irani students.

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Technical problems regarding e-learning were the most frequent disadvantage among Pakistani and Irani students.

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In terms of activity, 5% and 10.9% of students remain extremely inactive and extremely active respectively during traditional face-to-face learning.

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18.5% and 3.6% of students remain extremely inactive and extremely active respectively during e-learning and the results are statistically significant (p-value<0.00).

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Acceptance of e-learning is statistically associated with country of learning (p-value = 0.020) whereas it is not statistically associated with year of study (p-value = 0.679) and IT skills (p-value = 0.06).

Scoping review of published research on medical education in India during the Covid-19 pandemic

Background Medical educators in India made rapid adjustments to maintain continuity and integrity of medical education in the midst of disruption caused by the Covid-19 pandemic. However, there are concerns regarding achievement of competence by undergraduate medical students due to inadequate clinical exposure. We explored the focus of initiatives from medical educators in India by a scoping review of published articles on developments in medical education during the pandemic to map concepts, main sources and the literature available in PubMed. Methods We did this scoping review of published articles in PubMed database in four steps: (i) identification of research questions; (ii) identification of relevant studies; (iii) selection of studies meeting inclusion and exclusion criteria, and charting of data; and (iv) collating the summary and reporting of results. Manual content analysis was done to derive frequencies of variables. Results Of the 52 articles identified, 22 met the requirements. Most studies (68.2%) were published in 2020. Half of the studies were conducted among undergraduate students and the remaining among postgraduates (27.3%), faculty (18.2%) and interns (4.5%). All the studies were evaluations at Kirkpatrick level-1 (18; 81.8%) and level-2 (4; 18.2%). Most of the studies (9, 41%) focused on exploration of perspectives about online learning among students and faculty, 9 (27.3%) on teaching- learning, 4 (18.2%) on formative assessment and 3 (13.6%) on summative assessment. Conclusions Most studies were evaluations at Kirkpatrick level-1 and level-2 among undergraduate medical students with a focus on conceptual understanding.

Students’ Perceptions of Gained and Lost Value: A Case Study of a Summer School That Had to Suddenly Move Online

The COVID-19 lockdown induced a sudden migration of traditionally presential learning activities to online domains, as was the case of inter-institutional summer schools. This research corresponds to a case study in which our organization had to reformulate, in less than three months, one of its traditional summer schools while trying to keep the original goals. Through qualitative and quantitative surveys, we aimed at identifying the impact of our reformulation through students’ perception of gained or lost value regarding four topics: (a) online teaching, (b) pre-recorded business cases, (c) online social events, and (d) technical solutions. By analyzing these four topics with emphasis on participants’ knowledge and learning experience, we identified some “tensions” leading to loss of value (i.e., belonging, performing, and organizing). These tensions suggest that future reformulations should be conducted considering students’ backgrounds and motivations.

Perception of e-learning in medical students and faculty during COVID time: A study based on a questionnaire-based survey

BACKGROUND

With the emergence of COVID, we are forced to use e-learning in form of arranging online classes for students. Medical educators all over the world are conducting online classes for students. This study aimed to evaluate the perception of online learning among MBBS students and teachers through a questionnaire-based survey.

MATERIALS AND METHODS

A cross-sectional study was done in the AIIMS, Bhopal. The study was based on questionnaire (online Google form) response received from 43 number of faculty and 156 number of students.

STATISTICAL ANALYSIS USED

Chi-square test and unpaired t-test were used for statistical analysis using statistical software Systac 13.2.

RESULTS

Handling software, technical issues, and lack of face-to-face interaction were more significant problems in students compared to faculty. The desire for the social site which causes disturbances in learning was a significant problem in the students compared to faculty. Giving and taking assessment problem was reported by 60% and 63.8% of faculty and students, respectively (P = 0.67). Both groups preferred the Google Classroom platform (P = 0.16). Students (65.3%) preferred audiovisual recording, while faculty (72%) preferred PowerPoint with narration. PowerPoint presentation without narration was the least preferred (10.8%). Both groups stressed the importance of training (P = 0.17) and infrastructure development (P = 0.85). Students, as well as faculty, strongly discouraged e-learning for practical/clinical teaching.

CONCLUSIONS

Students, as well as faculty, have mixed reactions toward e-learning. Most importantly affected in the present scenario is practical/clinical teaching and assessment. Every attempt needs to be done to strengthen infrastructure and impart training to students and faculty.

STEM vs non-STEM differences in university teaching and research during the COVID-19 pandemic: the case of Sri Lanka

Purpose

This study aims to explore the differences between science, technology, engineering and mathematics (STEM) and non-STEM disciplines in terms of the changes to teaching and research practices caused by the COVID-19 pandemic.

Design/methodology/approach

The paper analyses survey responses collected between July and November 2020 from 241 academics (excluding library staff) from the five oldest state universities in Sri Lanka. The analysis focuses on the differences between STEM and non-STEM faculty using multiple linear regression to control for demographic characteristics such as age, gender and designation as well as university-specific factors.

Findings

The paper finds significant differences in the teaching practices of STEM and non-STEM academics, both in terms of preparation time for teaching and tools used for online delivery. Significant differences are also observed in research practices, with STEM faculty being significantly more likely to engage in research collaborations, obtain research funding and be involved in more research projects. The authors do not find any evidence of the pandemic having differential impacts on research productivity between the broad disciplines.

Originality/value

This research provides insights into the differences between STEM and non-STEM disciplines in online teaching and research practices adopted since the onset of the pandemic, which are important for formulating appropriate policy responses to mitigate the impact of the pandemic on both students and staff. The contribution is particularly significant for developing countries where the creation of a skilled workforce is a key driver of the development process.

Influence of Professional Identity on the E-Learning Adaptability Among Chinese Nursing Students During COVID-19

Background

The traditional face-to-face education methods have been altered to E-learning due to the outbreak, and the E-learning adaptability of nursing students will directly affect the effectiveness of online education. The professional identity of nursing students refers to the positive perception, evaluation, and emotional experience of the nursing profession and identity to be undertaken, which may affect the E-learning adaptability of nursing students during the coronavirus disease 2019 (COVID-19). This study aimed to explore the impact of professional identity on the E-learning adaptability of the Chinese nursing students during COVID-19.

Methods

This study was conducted in three medical schools in Yunnan Province, China from August to October 2020. Data collection consisted of three sections: participants' characteristics, learning adaptability, and professional identity.

Results

A total of 585 nursing students had a moderate level of E-learning adaptability. There was a positive correlation between E-learning adaptability and professional identity (r = 0.316~0.505, p &lt; 0.001). In addition, the professional identity was associated with predictors of the E-learning adaptability among nursing students (p &lt; 0.001).

Conclusion

There was a moderate level of E-learning adaptability among the Chinese nursing students during the COVID-19 crisis. Enhancing the professional identity is critical in improving the E-learning adaptability among nursing students.

Self-Directed Learning During the COVID-19 Pandemic: Perspectives of South African Final-Year Health Professions Students

PURPOSE

Self-directed learning (SDL) has been advocated for effective training of final-year health professions students. COVID-19 challenges conventional teaching, learning, and assessment in the clinical environment. This study aimed to identify and explore enablers and barriers to SDL among final-year health professions students training during the COVID-19 pandemic.

METHODS

Adopting the SWOT (strengths, weaknesses, opportunities and threats) framework, this study explored the clinical learning and training experiences of final-year health professions students during the pandemic. A survey was conducted via online platforms. Data from 155 respondents were thematically analyzed.

RESULTS

Personal attributes such as reflection, self-determination, motivation, resilience, and positive learning behaviors and skills were identified as SDL enablers. Collaborative learning networks and online learning platforms facilitate learning needs and goals. Fear and anxiety, untrusted learning sites, uncertainty about graduation, financial issues and challenges in the learning environments were the major themes related to barriers to SDL.

CONCLUSION

The importance of SDL as a skill for uncertain times warrants further investigation in the training of future healthcare professionals. Inclusive planning and engagement with final-year health professions students to address identified stressors, as well as the creation of shared platforms where students are part of the decision-making processes for clinical learning and training are recommended. Responsive curricula that optimize unpredictable disruptions in clinical training are needed to equip students to diagnose their own learning needs and implement appropriate learning strategies.

Taking the Learner on a Journey - An analysis of an Integrated Virtual CME Program in Epilepsy during the COVID-19 Pandemic

The COVID-19 pandemic has significantly changed the way we treat patients and educate healthcare professionals (HCPs). In summer 2020, the International League against Epilepsy (ILAE) implemented a virtual CME program with three integrated program elements addressing challenges in patient treatment as well as challenges caused by the forced transition to a virtual environment. Despite the highly competitive environment with exponential increase of webinars offered to HCPs, the program achieved high participation and satisfaction rates. Over 60% of participants indicated a change in their clinical practice after the interventions. With our outcomes evaluation, we aimed to better understand how well such an integrated program resonates with the learner and if it can make a difference in a highly competitive environment by supporting educators to become more adaptive and responsive to learner needs. Our pilot project was shown to be well accepted, achieving high satisfaction and perceived impact by the learner. In the light of an upcoming "digital fatigue" and a wish to return to face-to-face, we reiterate the value of the digital approach and recommend continuing along this successful path as we believe that taking a learner on a digital educational journey has been successful in a highly competitive and challenging environment.

Pedagogy and innovative care tenets in COVID-19 pandemic: An enhancive way through Dentistry 4.0

The global oral healthcare sector has now woken to implement Dentistry 4.0. The implementation of this revolution is feasible with extensive digital and advanced technologies applications and the adoption of new sets of processes in dentistry & its support areas. COVID-19 has bought new challenges to dental professionals and patients towards their customised requirements, regular dental health checkups, fast-paced and safe procedures. People are not visiting the dentist even for mild cases as they fear COVID-19 infection. We see that this set of technologies will help improve health education and treatment process and materials and minimise the infection. During the COVID-19 pandemic, there is a need to understand the possible impact of Dentistry 4.0 for education and innovative care. This paper discusses the significant benefits of Dentistry 4.0 technologies for the smart education platform and dentistry treatment. Finally, this article identifies twenty significant enhancements in dental education and effective care platforms during the COVID-19 pandemic by employing Dentistry 4.0 technologies. Thus, proper implementation of these technologies will improve the process efficiency in healthcare during the COVID-19 pandemic. Dentistry 4.0 technologies drive innovations to improve the quality of internet-connected healthcare devices. It creates automation and exchanges data to make a smart health care system. Therefore, helps better healthcare services, planning, monitoring, teaching, learning, treatment, and innovation capability. These technologies moved to smart transportation systems in the hospital during the COVID-19 Pandemic. Modern manufacturing technologies create digital transformation in manufacturing, optimises the operational processes and enhances productivity.

Online teaching of forensic medicine and pathology during the COVID-19 pandemic: A course evaluation

As the COVID-19 pandemic progressed in early 2020, social distancing rules and ‘lockdowns’ brought face-to-face teaching in universities in the UK, and globally, to a halt, leading to an abrupt move to online teaching and learning.

This article details student feedback to a course on applied forensic medicine and pathology – framed as ‘safeguarding vulnerable patients’ – which was adapted for delivery online in response to restrictions imposed by the pandemic.

That feedback indicated that the adapted online course was well-received and, overall, it compared favourably with pervious iterations of the blended learning course, which had included a substantial face-to-face teaching component. Students remained engaged with the teaching, and they continued to see the relevance of forensic medicine to their future clinical practice.

Impact and perception about distant online medical education (tele-education) on the educational environment during the COVID-19 pandemic: Experiences of medical undergraduate students from India

INTRODUCTION

The impact of online medical education using videoconferencing platforms on the education environment during the present COVID-19 pandemic is not known. The objectives were to evaluate the impact of online teaching using videoconferencing platforms on the education environment, satisfaction, and perception of the medical undergraduate students to online teaching.

METHODS

This prospective observational survey undertaken at a medical college included voluntarily participating medical undergraduate students from first (2nd semester), second (4th semester), and third year MBBS (6th and 8th semesters). The education environment was evaluated using the validated Dundee Ready Education Environment Measure (DREEM). The perception of the students was evaluated using questionnaire with five point Likert scale response.

RESULTS

The response rate in our survey was 77.5% (465 out of 600 students). The mean DREEM score of medical undergraduate students was 132.3 ± 19.8. Domains of DREEM evaluated were students' perception of learning (30.1 ± 6.3), students' perception of teachers (29.7 ± 4.6), students' academic self-perception (21.3 ± 4.9), students' perception of atmosphere (32.5 ± 6.2), and students' social self-perception (18.7 ± 3.5). Two hundred and fifty five students (54.8%) were extremely satisfied and quite satisfied with the online teaching-learning modalities. Two hundred and fifty eight students (55.5%) rated online learning methods to be very useful and quite useful during the lockdown period.

CONCLUSION

The educational environment at our medical college was positive and students had a positive perception and attitude toward the role of the videoconferencing platforms for learning (telemedicine) during the COVID-19 pandemic lockdown.

Impacts of the Covid-19 pandemic on the health of university students

The Covid-19 pandemic caused by the novel Sars-CoV-2 coronavirus, has resulted in millions of deaths and disruption to daily life across the globe. University students have been additionally affected by a sudden move to online learning, the closure of campuses and dramatic societal changes that have upended their experiences of higher education. Here we focus on the physical and mental health consequences of the pandemic for this population sector during 2020, and the interdependencies of these impacts. We survey the challenges for infection control on campuses and for monitoring the disease dynamics in student communities. Finally, we explore the psychological and mental health problems that have been exacerbated by the pandemic and evaluate the underlying factors that are most relevant to students.

Covid-19 Pandemic: Resumption of Orthopedic Care and Medical Education

Covid-19 is a respiratory disease caused by coronavirus 2 (SARS-CoV-2) first identified in Wuhan, China (December 2019). The disease rapidly crossed the barrier of countries, continents and spread globally. Non-pharmaceutical measures such as social distancing, face mask, frequent hand washing and use of sanitizer remained the best available option to prevent the spread of disease. OPD, IPD admissions, elective O. Ts were curtailed. Orthopedic care was only limited to emergency and semi-urgent procedures like necrotizing fasciitis, open fracture, and compartment syndrome. These measures were taken to preserve infrastructure and manpower to manage covid-19 pandemic. The children were thought to have a low susceptibility to covid-19 as compared to an adult. Deferring the patient during pandemic has led to high orthopedic disease burden, morbidity and disease-related sequelae, hence elective care must be resumed with modified hospital infrastructure. Resumption of elective/emergent orthopedic care should be slow, phasic and strategic, much similar to unlocking. Cases must be stratified depending on covid status and severity. Dedicated O.Ts with neutral/negative pressure and HEPA filter for covid positive and suspected patients are to be used. All symptomatic and suspected patients should be investigated for covid-19 by RT-PCR, blood counts and CT scan. Regional anaesthesia should be preferred to General anaesthesia. Power drill/saw/burr/pulse lavage should be minimized to avoid aerosol generation. Postoperatively continuous surveillance and monitoring to be done for covid related symptoms. Medical institutes rapidly shifted to the online mode of education. Blended learning (virtual & physical) and imparting skills have to be continued in post covid phase with equitable distribution of teaching hours to students of different years.

Medical education challenges and innovations during COVID-19 pandemic

COVID-19 pandemic has undoubtedly disrupted the well-established, traditional structure of medical education. Τhe new limitations of physical presence have accelerated the development of an online learning environment, comprising both of asynchronous and synchronous distance education, and the introduction of novel ways of student assessment. At the same time, this prolonged crisis had serious implications on the lives of medical students including their psychological well-being and the impact on their academic trajectories. The new reality has, on many occasions, triggered the 'acting up' of medical students as frontline healthcare staff, which has been perceived by many of them as a positive learning and contributing experience, and has led to a variety of responses from the educational institutions. All things considered, the urgency for rapid and novel adaptations to the new circumstances has functioned as a springboard for remarkable innovations in medical education,including the promotion of a more "evidence-based" approach.

Teaching Online during the COVID-19 Pandemic: A Phenomenological Study of Physical Therapist Faculty in Brazil, Cyprus, and The United States

The COVID-19 pandemic led to a global transition from in-person to online instruction leaving many higher education faculty with little time or training for this responsibility. Physical therapist education programs were especially impacted since a large part of the development of skills rely on face-to-face onsite practice. This phenomenological study explored the perceptions of physical therapist educators in three countries—Brazil, Cyprus, and the United States, who transitioned to an entirely virtual medium of teaching during the pandemic. Sixteen faculty participated in 1:1 semi-structured interviews. Trustworthiness of qualitative inquiry was ascertained using triangulation, thick descriptions, and peer reviews. Four major themes emerged from analysis of participants’ interview data: adapting pedagogy in real-time, expected excellence, limitations of the medium, and informing future teaching practice. All participants described teaching during the pandemic as one of the most challenging experiences of their professional careers. Despite available resources, faculty noted challenges in making authentic connections with students, adapting to technological interruptions, assessment of student understanding of content, and managing work-life balance. Despite the challenges, faculty worked collaboratively with peers to innovate new approaches of creating social, cognitive, and teaching presence. Unique opportunities arose from the pandemic to enhance future teaching practice.

Perceptions of undergraduate medical students regarding institutional online teaching-learning programme

BACKGROUND

Medical education all over the country has been forced to shift to e-learning, mainly online classes. In this scenario, the medical education department (MEU) of a teaching hospital under a deemed university felt the need to study the satisfaction and usefulness of these classes, as perceived by the undergraduate medical students.

METHODS

Questionnaire survey was planned. A specially designed questionnaire was created, keeping in mind, the study objectives. It was validated, and a pilot was conducted, for modifications and to calculate sample size. The questionnaire was administered by email as Google Forms. The responses, which included quantitative and qualitative responses, were analysed, and feedback points noted. Percentage level of satisfaction and usefulness was calculated with 95% confidence interval. To test the statistical significance of the association of satisfaction levels amongst students of different Phases, chi square test was used.

RESULTS

On a scale scoring for satisfaction, 53.6% scored moderate, 31% high, and 15.4% low satisfaction. 49.8% of the students were less satisfied about attending classes from home; 15.7% felt it was better. 57.1% of the students found the concept of online learning moderately useful, 31.4% found it minimally useful, 11.5%, highly useful.

CONCLUSIONS

The undergraduate medical students perceived moderate satisfaction and usefulness with the on-going online classes. They expressed the desire to resume routine physical classes, especially for practicals and clinics. Points of improvement of the online teaching-learning programme were also obtained. This study revealed sufficient feedback to be shared with all stakeholders, regarding improvements in the online classes.

Evaluation of undergraduate medical students' preference to human anatomy practical assessment methodology: a comparison between online and traditional methods

PURPOSE

COVID 19 pandemic has brought crucial changes in the field of medical education. Ad mist university examinations in India medical schools have switched to online assessment methods to avoid student gatherings. In this context, we conducted online anatomy practical evaluation and we have aimed at quantifying the students' experience on virtual assessment.

METHODS

A total of 250 first year MBBS students appeared for online anatomy practical examinations. Immediately after the completion of exams electronic feedback about their experience, in questionnaire format was obtained after getting informed consent. Their feedback was analysed and quantified.

RESULTS

Completed feedback forms were submitted by 228 students. More than 50% of students favoured online anatomy spotter examinations. Only 32.8% of students were comfortable with soft parts discussion using images. For image based viva voce 61.4%, 80% & 82% of students responded that the features and orientation of osteology, radiology and embryology images, respectively, were good. For surface marking 55% of the participants preferred online verbal evaluation. Finally, more than 60% of the students preferred the conventional over online assessment methods.

CONCLUSIONS

The inclination of students' preference for traditional anatomy examination methods mandates adequate training of both students and teachers for virtual examination. The superiority of conventional anatomy practical examination methods is unbiased but pandemic situations warrant adequate preparedness. In the future the anatomy teaching and evaluation methodology in Indian medical schools have to be drastically reviewed in equivalence with global digitalization.

Medical Education and E-Learning During COVID-19 Pandemic: Awareness, Attitudes, Preferences, and Barriers Among Undergraduate Medicine and Nursing Students at Makerere University, Uganda

Given the dearth need for healthcare workers in the control of the ongoing COVID-19 pandemic, e-learning has been adopted in many settings to hasten the continuation of medical training. However, there is a paucity of data in low resource settings on the plausibility of online learning platforms to support medical education. We aimed to assess the awareness, attitudes, preferences, and challenges to e-learning among Bachelor of Medicine and Bachelor of Surgery (MBChB) and Bachelor of Nursing (B.NUR) students at Makerere University, Uganda. An online cross-sectional study was conducted between July and August 2020. Current MBChB and B.NUR students aged 18 years or older constituted the study population. Using Google forms, a web-based questionnaire was administered through the Makerere University mailing list and WhatsApp messenger. The questionnaire was developed using validated questions from previously published studies. Overall, 221 participants responded (response rate = 61%). Of the 214 valid responses, 195 (92.1%) were Ugandans, 123 (57.5% were male, and 165 (77.1%) were pursuing the MB ChB program. The median age was 23 (18 to 40) years. Ownership of computers, smartphones, and email addresses were at 131 (61.2%), 203 (94.9%), and 208 (97.2%), respectively. However, only 57 (26.6%) respondents had access to high or very high quality internet access. Awareness and self-reported usage of e-learning (MUELE) platforms were high among 206 (96.3%) and 177 (82.7%) respondents, respectively. However, over 50% lacked skills in using the Makerere University e-learning (MUELE) platform. About half (n = 104, 49%) of the students believed that e-learning reduces the quality of knowledge attained and is not an efficient method of teaching. Monthly income (P = .006), internet connectivity quality (P < .001), computer ownership (P = .015) and frequency of usage of academic websites or applications (P = .006) significantly affected attitudes towards e-learning. Moreover, internet costs and poor internet connectivity were the most important barriers to e-learning reported by 199 (93%) and 179 (84%) students, respectively. Sensitization and training of students and faculty on e-learning and use of existing learning platforms are important to improve the attitude and use of e-learning. Blended online and use of offline downloadable learning materials would overcome the challenges related to the variable quality of internet access in the country.

A Randomized, Crossover Pilot Study of a Novel Web-Based/Mobile Platform for Collaborative Small Group Practice in Therapeutic Reasoning

BACKGROUND AND PURPOSE

Therapeutic reasoning-the mental process of making judgments and decisions about treatment-is developed through acquisition of knowledge and application in actual or simulated experiences. Health professions education frequently uses collaborative small group work to practice therapeutic reasoning. This pilot study compared the impact of a web-based/mobile tool for collaborative case work and discussion to usual practice on student perceptions and performance on questions designed to test therapeutic knowledge and reasoning.

METHODS

In a therapeutics course that includes case-based workshops, student teams of 3 to 4 were randomly assigned to usual workshop preparation (group SOAP sheet) or preparation using the Practice Improvement using Virtual Online Training (PIVOT) platform. PIVOT was also used in the workshop to review the case and student responses. The next week, groups crossed over to the other condition. Students rated favorability with the preparatory and in-workshop experiences and provided comments about the PIVOT platform via a survey. Student performance on examination items related to the 2 workshop topics was compared.

RESULTS

One hundred and eleven students (94%) completed post-workshop surveys after both workshops. The majority of students (57%) preferred using the PIVOT platform for workshop collaboration. Favorability ratings for the in-workshop experience did not change significantly from first to second study week, regardless of sequence of exposure. There was no relationship between examination item scores and the workshop platform the students were exposed to for that content (P = .29). Student responses highlighted the efficiency of working independently before collaborating as a group and the ability to see other students' thought processes as valuable aspects of PIVOT. Students expressed frustration with the PIVOT user interface and the lack of anonymity when discussing their answers in the workshop.

CONCLUSION

A web-based/mobile platform for student team collaboration on therapeutic reasoning cases discussed in small group settings yielded favorable ratings, examination performance comparable to standard approaches, and was preferred by a majority of students. During the rapid shift to substantial online learning for the COVID-19 pandemic, virtual collaboration tools like PIVOT may help health professions teachers to better support groups working virtually on scaffolded therapeutic reasoning tasks.