It's what you do, not the way you do it - online versus face-to-face small group teaching in first year medical school

Digital learning about patients: An online survey of German medical students investigating learning strategies for family medical video consultations

Objective

Training in video consultations is seldom included in the curriculum for future physicians. Exploration of preferred teaching methods and learning objectives in this context among medical students remains limited. This study addresses this research gap by conducting a survey among medical students in Germany to assess their educational requirements concerning video consultations and patient-centred distance learning.

Methods

This quantitative study employed an online questionnaire designed for German medical students, following the guidelines of the International Association for Health Professions Education. The study primarily focused on discerning the didactic preferences related to patient-centred digital teaching regarding family medical video consultations. We provided a detailed explanation of a concrete learning concept, a family medical synchronous distance learning seminar. Subsequently, we surveyed students to gauge their needs, expectations, and evaluations of this concept. The collected data were subjected to descriptive analysis.

Results

The analysis revealed that students aspire to offer video consulting services to their patients in the future (sample size (n) = 369, median (med) = 68 of 101 Likert scale points, interquartile range (IQR) = 53.75), despite having limited knowledge in this area (n = 353, med = 21, IQR = 33.25). To acquire expertise in telehealth, students favor blended learning models (n = 331, med = 76, IQR = 50). They also recognize the benefits of distance learning, particularly for students with family responsibilities or those who must travel long distances to their learning institutions,. The presented distance seminar concept resonated with them (n = 278, med = 72.5, IQR = 50.5), surpassing five other digital learning models in preference. Furthermore, they expressed a desire for its continued implementation beyond the Coronavirus SARS-CoV-2 pandemic (n = 188, med = 77.5, IQR = 44.75).

Conclusions

The deficiency in medical school education regarding video consultations requires attention. This issue could be resolved by integrating one of the five distance learning concepts outlined in this article.

Transitioning from face-to-face to distance education. Part 2: A qualitative study in the former Yugoslavia during COVID-19

BACKGROUND

Similar to other countries, Departments of Family Medicine in the former Yugoslavia had to transition from face-to-face to distance education during COVID-19.

OBJECTIVES

To elucidate obstacles and facilitators of the transition from face-to-face to distance education.

METHODS

A cross-sectional, multicentre, qualitative study design was used to analyse nine open-ended questions from an online survey using inductive thematic analysis. The questionnaire was distributed to 21 medical schools, inviting them to involve at least two teachers/students/trainees. Data were collected between December 2021 and March 2022.

RESULTS

In 17 medical schools, 23 students, 54 trainees and 40 teachers participated. The following themes were identified: facilitators and barriers of transition, innovations for enhancing distance education, convenience of distance education, classical teaching for better communication, the future of distance education, reaching learning outcomes and experience of online assessment. Innovations referred mainly to new online technologies for interactive education and communication. Distance education allowed for greater flexibility in scheduling and self-directed learning; however, participants felt that classical education allowed better communication and practical learning. Teachers believed knowledge-related learning outcomes could be achieved through distance education but not teaching clinical skills. Participants anticipated a future where a combination of teaching methods is used.

CONCLUSION

The transition to distance education was made possible thanks to its flexible scheduling, innovative tools and possibility of self-directed learning. However, face-to-face education was considered preferable for fostering interpersonal relations and teaching clinical skills. Educators should strive to strike a balance between innovative approaches and the preservation of personal experiences.

Virtual reality against Zoom fatigue? A field study on the teaching and learning experience in interactive video and VR conferencing

Aim

During the COVID-19 pandemic, the absence of in-person teaching was partially compensated for through videoconferencing. However, lecturers complain that students do not participate actively in video-based online seminars. One reason cited for this is Zoom fatigue. Conferences in virtual reality (VR), accessible with and without head-mounted display, represent one potential remedy to this issue. The research to date does not shed any light on the (1.) teaching experience, (2.) student demand, (3.) learning experience (including participation and social presence), and (4.) learning performance (declarative and spatial) associated with VR conferences. The present work will compare these aspects for videoconferencing, independent study, and - in the case of teaching experience - with in-person teaching.

Methods

A compulsory seminar in General Physiology was offered during the 2020/21 winter semester and the 2021 summer semester as part of the Human Medicine program at the Faculty of Medicine at Ulm University. The seminars were offered in three different formats with identical content: (a) VR conference, (b) video conference, and (c) independent study, with students selecting the format of their choice. In the VR conferences, the lecturer taught using a head-mounted display while students participated via PC, laptop, or tablet. The learning experience and learning performance were assessed using questionnaires and a knowledge test. A semi-structured interview was conducted to assess the VR teaching experience.

Results

The lecturer's teaching experience in the VR conferences was similar to in-person teaching. Students predominantly chose independent study and videoconferencing. The latter resulted in worse outcomes with regard to learning experience (including participation and social presence) and spatial learning performance than the VR conferences. Declarative learning performance differed only slightly between teaching formats.

Conclusions

VR conferencing offers lecturers new didactic opportunities and a teaching experience similar to that of in-person teaching. Students prefer time-efficient videoconferencing and independent study, but rate participation and social presence, among other things, higher in VR conferencing. If faculty and students are open to the technology, VR conferencing can promote interactive exchange in online seminars. This subjective assessment is not associated with better declarative learning performance.

Perceived usefulness of open educational resources: Impact of switching to online learning for face-to-face and distance learners

This paper reports a study on the perceived usefulness of university students on open educational resources (OER) in relation to the switch of learning mode to online learning during the COVID-19 pandemic. The participants involved two groups of students, one studying in a face-to-face mode and the other in a distance learning mode. They took part in a survey which was conducted in 2019 before the pandemic (with a total of 912 responses) and 2021 during the pandemic (with a total of 1,018 responses). The results show that both groups of students generally perceived OER to be more useful during the pandemic. The specific types of OER which were perceived as relatively more useful include open online courses and open access textbooks. Face-to-face students showed a higher level of perceived usefulness of OER for preparing tests and examinations, while distance learning students perceived OER as more useful for supplementing course materials. They both concerned about the limitations of OER, especially on accuracy and comprehensiveness. The findings suggest the importance of recognizing the diverse needs of the two groups of students and offering appropriate OER support for them.

An online case-based teaching and assessment program on clinical history-taking skills and reasoning using simulated patients in response to the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has created unprecedented challenges for medical students and educators worldwide. Groups 1, 2 and 3 of year 3, semester 2 medical students at the Royal College of Surgeons in Ireland (n = 275) had only completed 2, 5 and 7 weeks, respectively, of their scheduled 10-week clinical medicine and surgery attachments, prior to the Irish shutdown of all in-person non-essential activities, including medical student education.

METHODS

We developed and delivered an online case-based program, focused on history-taking skills and clinical reasoning, using simulated patients and video technologies. 12 tutorials were delivered over 6 weeks to 35 subgroups of 8 students in line with program learning outcomes. Both simulated patients (n = 36), and tutors (n = 45, from retired clinical professors to newly graduated physicians), were rapidly upskilled in Blackboard Collaborate and Microsoft Teams, and also in the provision of constructive feedback. We evaluated this newly developed program by the following three criteria: student attendance, achieved grades, and student feedback.

RESULTS

Attendance at the 12 tutorials was higher amongst group 1 and 2 students (75 and 73%) by comparison with group 3 students (60%) (p = < 0.001). Of the 273 students that sat the Year 3 Semester 2 online long case assessment, 93% were successful. Despite group 1 students having the least prior clinical experience, results were similar to those of groups 2 and 3 (1st honors, 2nd honors, pass, and fail grades for group 1, 39%, 33%, 23% and 6%; group 2, 34%, 41%, 17% and 8%; group 3, 39%, 25%, 28% and 7%) (p = 0.48). An increased attendance rate at tutorials was associated with higher numbers of honors grades (p = < 0.001). Anonymous feedback from the students demonstrated considerable satisfaction with program: > 85% agreed that the online program was interactive and very educational.

CONCLUSIONS

Use of online video technology, tutors of varied experience, and simulated patients were demonstrated to replicate patient encounters, and to facilitate the development of clinical skills remotely during the COVID-19 pandemic.

Medical student exam performance and perceptions of a COVID-19 pandemic-appropriate pre-clerkship medical physiology and pathophysiology curriculum

BACKGROUND

Medical schools were compelled to abruptly transition pre-clerkship curricula to remote learning formats due to the emergence of the Coronavirus Disease 2019 (COVID-19) pandemic. We evaluated student perceptions of remote learning, exam performance, and utilization of third-party learning resources to assess the implementation of a newly developed pandemic-appropriate physiology curriculum.

METHODS

This was an observational study based on a survey conducted in the Spring of 2021 at the University of California, Irvine, School of Medicine (UCISOM). This study aimed to assess first (MS1) and second year (MS2) medical students' perceptions of satisfaction, support, academic performance, and connectedness before and during the COVID-19 pandemic. The MS1 class began medical school during the first year of the COVID-19 pandemic, whereas the MS2 class did so prior to the start of the pandemic. A survey instrument was developed and validated to identify the impact remote learning had on student self-perceptions of the Medical Physiology and Pathophysiology course. Surveys were distributed to all students and responses were collected on a voluntary basis. Exam scores on a customized National Board of Medical Examiners (NBME) physiology shelf exam were also compared to objectively identify how the remote curriculum during the pandemic impacted academic performance.

RESULTS

Of 204 students enrolled, 74 responses were analyzed, with 42 MS1 (40% of MS1s) and 32 MS2 (31% of MS2s) responses. Overall, MS1s and MS2s were satisfied with the curriculum they received (95 and 97% respectively) and the school's support of their concerns (86 and 100% respectively). Notably, only 50% of MS1s felt connected to their peers, compared to 94% of MS2s. Lecture attendance and self-perception of their academic performance were similar between both classes. Interestingly, the intra-pandemic class's NBME exam average in 2020 (60.2% ± 8.9, n = 104) was significantly higher than the pre-pandemic class average in 2019 (56.8% ± 11.3, n = 100). Both classes primarily used course materials over third-party learning resources. An additional set of survey questions distributed only to the MS1 class found that the majority of MS1s reported minimal barriers with regards to accessibility, including internet connectivity, study-conducive environments, and balancing family commitments. Overall, pre-clerkship medical students had positive perceptions of the newly developed pandemic-appropriate physiology curriculum.

CONCLUSIONS

Changes to the pre-clerkship physiology curriculum during the COVID-19 pandemic were met with overall satisfaction from the students and an increase in NBME scores. More attention to student connectedness is needed to improve how remote learning can be best optimized into future curricula development.

Evaluation of class participation in non-face-to-face CPR training for medical students

BACKGROUND

Cardiopulmonary resuscitation (CPR) education requires that learners practice key skills to promote mastery. Our aim in this study was to evaluate differences in post-education performance and class participation during CPR training between face-to- face (FF) and non-face-to-face (NFF) learning formats.

METHODS

This was a randomized controlled study of third-year medical students from two university hospital, allocated to either the FF or NFF format for CPR education. The learning scenario addressed single-person CPR, consisting of chest compression only, and excluded breathing. The Kahoot! application was used for NFF. Between-group comparisons for class participation and CPR skills were based on video recordings.

RESULTS

Seventy students participated in our study, with 35 randomly allocated to the FF and NFF groups. There were no between-group differences in terms of age, sex, previous basic life support training, and willingness and confidence in performing CPR. Compared to the FF group, the NFF group demonstrated significant differences during CPR, including fewer calling for assistance and using of defibrillator (p = 0.006), as well as fewer checking for breathing (p = 0.007), and fewer counting during chest compression (p = 0.006). Additionally, < 30% of learners in the NFF group completed rhythm analysis after the last defibrillator shock delivery and resumed immediate chest compression (p < 0.001). All students in both groups passed the post-training assessment.

CONCLUSION

Class participation in NFF learning was lower than that in FF learning. Although the post-education evaluation in the NFF group was not inferior, efforts on promoting active participation in NFF learning are required.

Impact of Non-Face-to-Face Teaching with Passive Training on Personal Protective Equipment Use in Health Science Students: A Randomized Controlled Trial

BACKGROUND

In the COVID-19 era, there was a call for the transformation of higher education. Universities had to combine non-face-to-face teaching with traditional procedures. This study analyzed the effectiveness and perceived satisfaction in a cohort of health sciences students of non-face-to-face teaching with passive training versus face-to-face teaching with active training in the proper donning and doffing of personal protective equipment (PPE) in a clinical simulation scenario.

METHODS

A total of 142 participants were randomized into two groups: (a) non-face-to-face teaching with passive training; (b) face-to-face teaching with active training. The proper protocol for donning and doffing PPE was assessed. Students evaluated their skills before and after training and satisfaction with training received.

RESULTS

Significant differences were observed for the statements "I felt more confident in donning after receiving this training" (p = 0.029) and "I felt more confident in doffing after receiving this training" (p = 0.042) in the face-to-face teaching with active training group compared to the non-face-to-face teaching with passive training group, whose number of tasks violated was significantly higher (p = 0.020). Satisfaction was significantly higher in the face-to-face and active training group (p = 0.004).

CONCLUSIONS

Face-to-face teaching with active training improves effectiveness and satisfaction more than non-face-to-face teaching with passive training for acquiring skills in donning and doffing PPE properly.

A Non-randomized, Quasi-Experimental Comparison of Effects Between an In-person and Online Delivery of a College Mental Health Literacy Curriculum

Mental health literacy (MHL) training is essential in college environments. These programs are commonly delivered in-person via workshops or for-credit courses. Campuses now seek high-quality online options. We compare the effectiveness of a for-credit MHL course against a comparison course, focusing on whether online asynchronous delivery was as effective as in-person synchronous delivery. This quasi-experimental pretest/posttest treatment/comparison study included 1049 participants across five semesters (pre-COVID-19) who were 18 years or older and self-selected enrollment in a Mental Health Awareness and Advocacy (MHAA) course (treatment; n = 474) or a general lifespan development course (comparison; n = 575). Using linear mixed effect modeling, changes in MHL were compared across groups and across online/in-person modalities. Students in the treatment group significantly increased their MHL knowledge (β_Identifying = .49, p < .001; β_Locating = .32, p < .001; β_Responding = .46, p < .001) and self-efficacy (β = .27, p < .001), and treatment effects did not differ across modalities. With increased concern regarding mental health issues of isolated college students during the COVID-19 pandemic, this study supports the efficacy of delivering MHL courses online.