How medical education survives and evolves during COVID-19: Our experience and future direction

Pharmacy Students' Attitudes Toward Distance Learning After the COVID-19 Pandemic: Cross-Sectional Study From Saudi Arabia

BACKGROUND

Electronic learning refers to the use of assistive tools in offline and distance learning environments. It allows students to access learning tools and materials anytime and anywhere. However, distance learning courses depend on several factors that affect the quality of learning, which consequently affect students' preferences in the settings and tools used to deliver educational materials.

OBJECTIVE

This study aimed to evaluate students' preferences for continuing distance learning after the pandemic and to assess the distance educational environment after the pandemic. It also aimed to identify the factors affecting distance learning and evaluate students' preferences regarding modes of communication with instructors.

METHODS

A web-based survey was used to conduct this cross-sectional study. The target participants of this study were students in the doctor of pharmacy program at Unaizah College of Pharmacy, Qassim, Saudi Arabia. All students enrolled from December 2022 to January 2023 received an invitation with a link to the web-based survey.

RESULTS

The survey was completed by 141 students (58 female students and 83 male students). The research results showed that most students (102/141, 72.3%) did not wish to continue distance education for laboratory courses, and 60.3% (85/141) did not wish to continue taking distance team-based learning after the pandemic. Additionally, 83.7% (118/141) of the students indicated that distance courses were simple. More than half of the participants (79/141, 56%) stated that having a camera on during class negatively impacted their learning, and only 29.1% (41/141) of the students stated that nonvisual communication with their fellow students impacted their learning. A large proportion of students (83/141, 58.9%) reported impairment of social engagement on campus, 44% (62/141) in-person interactions during classes, and 73.7% (104/141) were relieved that their classes were not disrupted.

CONCLUSIONS

Similar to all types of education, distance learning is characterized by advantages and disadvantages, as reported by students. Students felt that the course material was intelligible, and the distance course was uncomplicated. Moreover, they expressed relief that their studies were not disrupted. However, they also reported the loss of face-to-face contact during courses as the most significant drawback of distance learning versus face-to-face learning, followed by a lack of social connection on campus.

Undergraduate Medical Education During the Pandemic: How do Academic Staff Members in Greece and Cyprus Feel About it?

This study used a questionnaire to examine how academic staff members in Greece and Cyprus feel about the changes in undergraduate medical education during the COVID-19 pandemic. In general, e-learning was not considered an adequate way of teaching and was less enjoyable. Participants aged 31-40 years experienced more (P = .001), while staff in higher academic ranks less difficulty (P < .001) in adjustment. There was a small increase in workload, which was higher among respondents researching into COVID-19 (P = .001). During the pandemic, daily screen use >6 h was increased from 28.8% to 57.5%. The majority (74.2%) stated that scientific and educational training opportunities were not affected by the pandemic. In conclusion, the pandemic has induced important changes in undergraduate medical education. This new condition was considered adequate but not pleasant, with younger faculty members being more burdened.

The impact of online education during the Covid-19 pandemic on the professional identity formation of medical students: A systematic scoping review

Evolving individual, contextual, organizational, interactional and sociocultural factors have complicated efforts to shape the professional identity formation (PIF) of medical students or how they feel, act and think as professionals. However, an almost exclusive reliance on online learning during the COVID-19 pandemic offers a unique opportunity to study the elemental structures that shape PIF and the environmental factors nurturing it. We propose two independent Systematic Evidence-Based Approach guided systematic scoping reviews (SSR in SEBA)s to map accounts of online learning environment and netiquette that structure online programs. The data accrued was analysed using the clinically evidenced Krishna-Pisupati Model of Professional Identity Formation (KPM) to study the evolving concepts of professional identity. The results of each SSR in SEBA were evaluated separately with the themes and categories identified in the Split Approach combined to create richer and deeper 'themes/categories' using the Jigsaw Perspective. The 'themes/categories' from each review were combined using the Funnelling Process to create domains that guide the discussion. The 'themes/categories' identified from the 141 included full-text articles in the SSR in SEBA of online programs were the content and effects of online programs. The themes/categories identified from the 26 included articles in the SSR in SEBA of netiquette were guidelines, contributing factors, and implications. The Funnelling Process identified online programs (encapsulating the content, approach, structures and the support mechanisms); their effects; and PIF development that framed the domains guiding the discussion. This SSR in SEBA identifies the fundamental elements behind developing PIF including a structured program within a nurturing environment confined with netiquette-guided boundaries akin to a Community of Practice and the elemental aspect of a socialisation process within online programs. These findings ought to be applicable beyond online training and guide the design, support and assessment of efforts to nurture PIF.

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.

Navigating post COVID-19 education: an investigative study on students' attitude and perception of their new normal learning environment

Background

The incidence and aftermath of the COVID-19 pandemic brought about a drastic change in health professional education around the world. Traditional classrooms made way for online classrooms in order to ensure that learning continued in a safe and secure environment. However, how well health professional students perceived and accepted these changes have not been fully gauged yet. Therefore, this study aims to evaluate the perception of health professional students about their new educational climate.

Methods

A modified and validated Dundee Ready Education Environment Measure (DREEM) questionnaire was used to collect data regarding student perception of their educational environment.

Results

The mean DREEM scores for three time periods were in the accepted positive range of 101 to 150 indicating that most of the students perceived the changes positively. The results indicated that most students preferred blended learning over online learning or face-to-face learning alone. Areas where students were unsatisfied with their learning environment that need improvement were identified by poor item-wise scores.

Conclusion

Strategic remedial measures for these concerns need to be developed to improve the quality of education received by the students. However, the results of our study indicated that most of the students were able to adapt positively to the new education environment due to the change in the circumstances during COVID.

Personal protective equipment and medical students in times of COVID-19: experiences and perspectives from the final clerkship year

BACKGROUND

The availability and correct use of personal protective equipment (PPE) to prevent and control infections plays a critical role in the safety of medical students in clinical placements. This study explored their experiences and perspectives in their final clerkship year with PPE during the COVID-19 pandemic.

METHODS

This qualitative study was based on social constructivism and was conducted in 2021 at the Charité - Universitätsmedizin Berlin. In three online focus group discussions, 15 medical students in their final clerkship year reported their experiences with PPE training and use during the COVID-19 pandemic. Data were recorded, transcribed and analysed based on Kuckartz's approach to content analysis. We drew upon the a priori dimensions of the capability, opportunity, motivation - behaviour (COM-B) model as main categories as well as emergent issues raised by the study participants (subcategories).

RESULTS

In addition to the three main categories of the COM-B model, eleven subcategories were identified through inductive analysis. The study participants reported several factors that hindered the correct use of PPE. In the area of capabilities, these factors were related to learning experience with PPE in terms of both theoretical and practical learning together with later supervision in practice. In the area of opportunities, these factors included the limited availability of some PPE components, a lack of time for PPE instruction and supervision and inappropriate role modelling due to the inconsistent use of PPE by physicians and nursing staff. The area of motivation to use PPE was characterized by an ambivalent fear of infection by the SARS-CoV-2 virus and the prioritization of patient safety, i.e., the need to prevent the transmission of the virus to patients.

CONCLUSIONS

Our study revealed several limitations pertaining to the enabling factors associated with the trainable behaviour "correct use of PPE". The concept of shared responsibility for student safety was used to derive recommendations for future improvement specifically for the medical school as an organization, the teachers and supervisors, and students themselves. This study may guide and stimulate other medical schools and faculties to explore and analyse components of student safety in clinical settings in times of infectious pandemics.

Strengthening E-learning strategies for active learning in crisis situations: a mixed-method study in the COVID-19 pandemic

BACKGROUND

Medical universities are responsible for educating and training healthcare workers. One of the fields significantly impacted by the pandemic is medical education. The aim of this study is to identify strategies for enhancing e-learning for active learning and finding solutions for improving its quality.

METHODS

This mixed-method (quantitative-qualitative) research was conducted in 2023 at three selected universities in Mazandaran Province. In the quantitative phase, 507 students participated via stratified random sampling using a standard questionnaire. In the qualitative phase, data were collected through semi-structured interviews with 16 experts until data saturation was achieved. SPSS 21 and MAXQDA 10 software were used for data analysis.

RESULTS

In the multivariate regression analysis, an increase of one point in the dimensions of student-teacher interaction, active time, immediate feedback, and active learning corresponded to an average increase in learning scores of 0.11, 0.17, 0.16, and 1.42 respectively (p≤0.001). After the final analysis in the qualitative phase, four main domains (infrastructure, resources, quantity of education, and quality of education) and 16 sub-domains with 84 items were identified.

CONCLUSIONS

The greatest challenge in e-learning is the interaction and cooperation between students and teachers. The implementation of the identified strategies in this research could provide useful evidence for policymakers and educational administrators to implement interventions aimed at addressing deficiencies and enhancing e-learning.

University students' and educators' perceptions on the use of digital and social media platforms: A sentiment analysis and a multi-country review

Due to Covid-19, an inevitable restructuring of higher education teaching and learning pedagogies ensuring the continuous and effective learning of students is deemed important. Despite such vitality, a prevalent disparity worldwide on the usages and gains of digital and social media integration is still noticeable. Following a Scoping Literature Review and using the Atlas.ti software for a Grounded Theory qualitative analysis, this study aims to ascertain the significance of digital and social media tools during and after the Covid-19 pandemic. The study explains the common challenges and opportunities both students and educators faced in thirty countries. Drawing on the sentiment analysis of these stakeholders, results indicate that despite the acceleration of digital education into a flexible, and student-centered didactic approach, various barriers in effectively fulfilling online learning still exist. Findings also revealed the lack of, and therefore need for, proper teaching and learning material and strategies suitable for digital education.

Differences in medical education before, during, and in the post-peak period of the COVID-19 pandemic-exploring senior medical students' attitudes

BACKGROUND

The burden that COVID-19 has brought to the economy, healthcare systems, and education is unmatched. Public health and social measures were implemented to halt transmission. Thus, social gathering and in-person learning, core aspects of medical education, were interrupted. Studies have documented the detrimental impact students graduating during the pandemic have had on their confidence and skills. However, data comparing pre-pandemic, pandemic, and post-peak students still lack. This study aimed to identify senior medical students' attitudes regarding their education and compare them according to the three previously described periods.

METHODS

In this cross-sectional study, the survey employed was designed based on a previous questionnaire and applied to senior medical students before graduating between January 2018 and June 2022. Answers were collected using a three-point Likert scale and Yes/No questions. Associations between variables were examined using Chi-squared, Fisher's Exact tests, and ANOVA, employing logistic regression to calculate odds ratio (OR) when appropriate.

RESULTS

A total of 679 responses were analyzed. Most students (59%) were women. Up to 383, 241, and 55 senior medical students answered the survey before, during, and in the post-peak period of the COVID-19 pandemic, respectively. There was a staggering decrease in the percentage of students in the post-peak compared to the pre-pandemic period that considered certain factors such as being taught about the doctor-patient relationship (62% vs 75%), practicing teamwork (33% vs 54%), preclinical & clinical subjects (44% vs 63%), and being taught to conduct research (22% vs 32%) as "very useful" to their professional traineeship. There was a significant difference between pre-pandemic, pandemic, and post-peak students when asked if the study curriculum accomplished the goal of training a professional with integrity (89% vs 66% vs 64%, p < 0.001), respectively. In a multivariate analysis graduating during the pandemic (OR 3.92; 95% CI, 2.58-5.94) and in the post-peak period (OR 4.24; 95% CI, 2.23-8.07) were independent factors for the appreciation that the study curriculum did not meet its objective.

CONCLUSIONS

The pandemic has hindered medical education. Students' appreciation of their instruction has deteriorated. Urgent interventions that halt the negative impact on training, ensure readiness for future problems and improve schooling worldwide are needed.

Performance and satisfaction during the E-learning transition in the COVID-19 pandemic among psychiatry course medical students

Background

In the field of medical education, students faced significant challenges during the COVID-19 pandemic. Abrupt alterations were made in the form of preventative precautions. Virtual classes replaced onsite classes, clinical placements were canceled, and social distance interventions prevented face-to-face practical sessions. The present study aimed to assess students' performance and satisfaction before and after the transition of a psychiatry course from onsite to entirely online during the COVID-19 pandemic.

Methods

A retrospective, non-clinical, and non-interventional comparative educational research study included all students registered in the psychiatric course for the academic year 2020 (pre-pandemic/onsite) and 2021 (during the pandemic/online).To assess students' satisfaction, we utilized the National Commission for Academic Accreditation and Assessment (NCAAA) students' satisfaction survey used by the academic quality unit at KSU, College of Medicine.Satisfaction was assessed in six domains: course organization, learning resources, faculty experiences, clinical teaching, practical sessions, and overall satisfaction. The reliability of the questionnaire was measured using Cronbach's alpha test.To assess their performance, students' grades from both periods were obtained from the exam center.

Results

A total of 193 medical students enrolled in the study; 80 received onsite learning and assessment, while another 113 received full online learning and assessment. The students' mean indicators of course satisfaction for the online courses exceeded their corresponding indicators significantly compared to the onsite courses. These indicators included students' satisfaction in terms of course organization, p < 0.001; medical learning resources, p < 0.050; faculty experience, p < 0.050; and overall course, p < 0.050. There were no significant differences regarding satisfaction in both practical sessions, p > 0.050, and clinical teaching, p > 0.050. The students' performance mean was significantly higher in the online (M = 91.76) compared to the onsite courses (M = 88.58) (p < 0.001), and the Cohen's D statistic showed there was a medium level of enhancement in students' overall grades (Cohen's d = 0.41).

Conclusion

Students perceived the switch to online delivery methods very favorably. Students' satisfaction significantly improved regarding the themes of course organization, faculty experience, learning resources, and overall course satisfaction, while a similar level of adequate student satisfaction was maintained in terms of clinical teaching and practical sessions during the transition of the course to e-learning. In addition, the online course was associated with a trend toward higher students' grades. However, the assessment of the achievement of course learning outcomes and the maintenance of this positive impact warrants further investigation.

Online education for prosthetics and orthotics students in the era of COVID-19 pandemic in Iran: challenges, opportunities, and recommendations

INTRODUCTION

With the advent of the COVID-19 pandemic, many higher education programs in Iran, including prosthetics and orthotics (P&O), had to shift to the online environment all at once. This unanticipated transition was challenging for the educational system. However, online education is superior in some aspects to conventional methods, and this situation may offer opportunities. This study was carried out from September 2021 to March 2022 to investigate the challenges and opportunities of online education in the P&O sector in Iran based on the opinions of students and faculty members. Relevant recommendations will also be discussed.

METHODS

In this qualitative study, semi-structured interviews were conducted in both oral and written formats. Purposive and snowball sampling techniques were used to recruit undergraduate and postgraduate P&O students, as well as P&O faculty members, for this qualitative study. The data gathered from interviews with study participants were analyzed by thematic analysis.

RESULTS

Based on the data analysis, many sub-themes of the three main themes were recognized: (1) challenges: technical, socioeconomic, environmental distractors, supervision and evaluation, workload, digital competence, interactions, motivation, sessions-related issues, class time, hands-on and clinical training; (2) opportunities: technological innovations, infrastructure development, flexible learning environment, student-centered learning, availability of contents, time and cost saving, high concentration, more self-confidence; (3) recommendations: technical infrastructure, team dynamics, hybrid courses, time management, awareness.

CONCLUSION

Online education of P&O during the era of the COVID-19 pandemic was accompanied by a series of challenges. Technical issues and the gravity of hands-on training in this field were significant challenges. This era, however, provided the opportunity to facilitate the establishment of needed infrastructure and support technological innovations for online education. Considering hybrid (mixed online and on-site) courses was recommended to improve the quality of learning.

[Instrument validation that measures disruptive education on clinical training]

Background

During the contingency derived from the COVID-19 pandemic, there were no instruments assessing the aspects of clinical training, which is why it is necessary to have a questionnaire that let us know the opinion of medical students about the disruptive education.

Objective

To validate a questionnaire designed to know the opinion of medical students about disruptive education in their clinical training.

Material and methods

Validation cross-sectional study which was developed in three phases: 1) Elaboration of the questionnaire aimed at undergraduate medical students who include clinical science subjects in their curricular program; 2) validation of content by Aiken's V test with 7 expert judges and reliability estimation with Cronbach's alpha coefficient in a pre-sample test with 48 students; 3) analysis of the information through descriptive statistics, where the following results were observed: Aiken's V index of V = 0.816; Cronbach's alpha coefficient = 0.966. A total of 54 items were incorporated in the questionnaire after the pre-sampling test.

Conclusions

We can rely on a valid and reliable instrument that objectively measures disruptive education in the clinical training of medical students.

Online or physical class for histology course: Which one is better?

Background/purpose

The coronavirus disease 2019 gradually slows down. As schools now progressively went back to the physical class, it was essential to think about whether we should go back to the physical course, shift to the online course, or try to combine both.

Materials and methods

One hundred and six students (including 67 medical students, 19 dental students, and 20 students from another department) who took the histology course with both physical and online lectures and the virtual microscopy for the histology laboratory course were enrolled in this study. Students’ acceptance and learning effectiveness were evaluated by a questionnaire-based survey, and their examination scores were compared before and after the online class.

Results

Most students accepted the combined physical and online lectures (81.13%), considered increased interactivities in the physical class (79.25%), and felt comfortable when taking the online class (81.14%). Moreover, most students considered that the online learning was friendly to use (83.02%) and could improve the learning effectiveness (80.19%). The mean examination scores were significantly higher after the online class than before the online class, regardless of different genders and groups of students. Most participants (29.2%) preferred the 60% online learning proportion, followed in a descending order by the 40% online learning (25.5%) and the 80% online learning (14.2%).

Conclusion

Our students can generally accept the combined physical and online lectures for learning the histology course. The academic performances significantly improve after the online class. The hybrid course may become the future trend of learning the histology course.

Differences in perception of online anesthesiology between Thai medical students and teachers during the COVID-19 pandemic

PURPOSE

Traditional anesthesiology learning was disrupted by the coronavirus disease 2019 pandemic and replaced by online learning. Students and teachers did not prepare well for this change. Determining the differences in perceptions can close the gap and develop more effective curricula. Our study aims to compare students' and teachers' perceptions of online anesthesiology learning.

METHODS

We conducted a prospective descriptive study, a cross-sectional survey between July 2020 and January 2021 in the Anesthesiology Department, Faculty of Medicine, Khon Kaen University, Thailand. Our participants were fifth-year medical students and teachers participating in online anesthesiology. We compared the perception of the teaching process, support system, learning outcomes, satisfaction, and preference. Using an online structured questionnaire survey with a 4-point Likert scale to measure the degree of agreement with each item. We analyzed the difference between students' and teachers' perceptions by topic.

RESULTS

We received responses from 174 students and 24 teachers. Students had a significantly higher proportion of positive perceptions than teachers on the teaching process (theoretical teaching, problem-based learning, feedback, and response system), on a support system (technological support, connectivity, and learning materials), on learning outcomes (clinical practice readiness, critical thinking, long-term memory, and enthusiasm), satisfaction score, and online learning preference (p&lt;0.05).

CONCLUSION

Differences in perception were high in many aspects of online anesthesiology learning. This perception gap was particularly evident in the teaching process, support system, and learning outcomes. And Thai students had more preference for online learning than teachers. Strategies to reduce the gap should focus on teachers' training and supporting online learning should be concerned.

The freedom to teach (at the best)

Over the past decades, biomedical education has changed considerably, mostly by the introduction of novel didactic strategies, as well as the addition of technology. As a consequence, the centuries-old lecture-style presentation has come under criticism for providing only a one-directional transfer of information. However, the delivery of traditional lectures has also seen considerable changes such as the use of Microsoft PowerPoint slides which can be projected and serve as lecture handouts to learners. Electronic technologies and the internet now allow for the permanent recording of lectures and the distribution of video recordings to students who are unable or choose not to attend lectures in person. This off-site consumption of lecture presentations can either be synchronous or, if the recorded videos are made available online, asynchronous. At the beginning of the Covid-19 pandemic, most schools were forced to change all lecture-style instruction to an online format. With students returning to classroom teaching, schools, and educators have to make a decision whether to offer online lecture recordings permanently, reintroduce in-person lecture presentations, or compromise on a combination of both. Each solution has its own advantages and disadvantages, some of which are discussed in this article. However, there appears to be no single 'best solution' to serve all learners, educators, and educational needs.

Anxiety among College Students Who Self-Isolated During the Omicron Variant of SARS-CoV-2 in China

We investigated the prevalence of anxiety and its associated risk factors among college students who self-isolated for 30 days during the emergence of the Omicron variant in China. We sampled college students specializing in four academic majors by cluster sampling and conducted questionnaires separately on days 1, 10, 20, and 30 after self-isolation. Anxiety was assessed using the 7-item Generalized Anxiety Disorder Scale (GAD-7) and Self-Rating Anxiety Scale (SAS). An odds ratio (OR) with a 95% confidence interval (CI) was used to estimate the strength of associations. A total of 10231 college students responded to the questionnaire 4 times. More students reported experiencing anxiety as the period of self-isolation approached 30 days. Among the students from four different major disciplines, medical students reported the highest rate of anxiety after 30 days of self-isolation, whereas humanities students exhibited the lowest rate of anxiety. Factor analysis indicated that the main reason for anxiety among all participating students was a delay in course completion. For engineering and medical students, there was an association between anxiety and research project delay. This study reveals the level of anxiety associated with COVID-19 pandemic-related self-isolation in college students and finds that it was aggravated by long-term isolation.

Hawler Medical University students' perceptions of e-learning during the COVID-19 pandemic

BACKGROUND

Protective measures like social distancing and staying home when possible were imposed by the public health authorities to combat the COVID-19 pandemic. Educational institutions which had previously experienced only face-to-face traditional methods of service delivery suffered from huge difficulties in maintaining an effective teaching process. This cross-sectional study investigates the experiences of students of Hawler Medical University (Erbil, Iraqi Kurdistan), exploring their e-learning experience and satisfaction when conventional classroom learning was suspended due to lockdown.

METHODS

A self-administered online questionnaire designed on Google Forms was administered from 14 to 31 March 2020. The main section of the questionnaire asked participants to rate their agreement with statements concerning e-learning satisfaction using a five-point Likert scale, with answers ranging from strongly disagree to strongly agree.

RESULTS

From an initial 1550 participants, 808 ultimately completed the processual stage. The majority of respondents were female, from the College of Medicine, of urban residence, and of an average economic situation. Three-quarters of the respondents had not participated in any online course before, 27.7% did not have the required electronic devices, 43.3% did not have the sufficient computer skills for the e-learning, and 38% thought that the University did not support the use of the e-learning system. During the processual stage, only 24.4% thought that the internet connection was good and helpful, 14.6% easily attended the online sessions, 35.6% thought that teachers have enough time to answer students' questions and concerns, and 18% that the teaching materials contributed to the course objectives and overall learning outcome.

CONCLUSIONS

Hawler Medical students were not well prepared to engage in the e-learning process. The majority experienced internet access and other technical problems in accessing the online sessions. They did not feel that the e-learning process has contributed to the achievement of course objectives and overall learning outcomes.

The nationwide impact of COVID-19 on life support courses. A retrospective evaluation by Resuscitation Council UK

Aim

To determine the impact of the COVID-19 pandemic on Resuscitation Council UK Advanced Life Support (ALS) and Immediate Life Support (ILS) course numbers and outcomes.

Methods

We conducted a before-after study using course data from the Resuscitation Council UK Learning Management System between January 2018 and December 2021, using 23 March 2020 as the cut-off between pre- and post-pandemic periods. Demographics and outcomes were analysed using chi-squared tests and regression models.

Results

There were 90,265 ALS participants (51,464 pre-; 38,801 post-) and 368,140 ILS participants (225,628 pre-; 142,512 post-). There was a sharp decline in participants on ALS/ILS courses due to COVID-19. ALS participant numbers rebounded to exceed pre-pandemic levels, whereas ILS numbers recovered to a lesser degree with increased uptake of e-learning versions. Mean ALS course participants reduced from 20.0 to 14.8 post-pandemic (P < 0.001).Post-pandemic there were small but statistically significant decreases in ALS Cardiac Arrest Simulation Test pass rates (from 82.1 % to 80.1 % (OR = 0.90, 95 % CI = 0.86-0.94, P < 0.001)), ALS MCQ score (from 86.6 % to 86.0 % (mean difference = -0.35, 95 % CI -0.44 to -0.26, P < 0.001)), and overall ALS course results (from 95.2 %to 94.7 %, OR = 0.92, CI = 0.85-0.99, P = 0.023). ILS course outcomes were similar post-pandemic (from 99.4 % to 99.4 %, P = 0.037).

Conclusion

COVID-19 caused a sharp decline in the number of participants on ALS/ILS courses and an accelerated uptake of e-learning versions, with the average ALS course size reducing significantly. The small reduction in performance on ALS courses requires further research to clarify the contributing factors.

COVID-19 Pandemic Affects Children's Education but Opens up a New Learning System in a Romanian Rural Area

(1) Background: In the context of the COVID-19 pandemic, the educational system in Romania faced major challenges. Online knowledge development was necessary and mandatory during this time; (2) Methods: our study included a group of 140 preadolescents and used a phenomenology qualitative method to investigate if the novel online teaching, implemented in a hurry during the pandemic without any previous teacher training, managed to replace face-to-face teaching; (3) Results: The students have expressed their joy for online courses, as long as they are kept interactive. Even though they feel nervous and worried when it comes to evaluation, the students claim they feel capable to learn all of the learning materials. Most of them are pleased by classes and do not get bored during them, feeling constantly motivated to actively participate in dialogue; (4) Discussions: Despite the lack of teaching-method standardization, our learning providers succeeded in accomplishing their tasks during online courses. Even in remote rural areas, they managed to assure the means for these children to access and take part in online courses; (5) Conclusions: our learning system must offer teachers the possibility to emphasize online education using adequate training programs aiming to develop technical and online pedagogical skills.

The impact of the COVID-19 pandemic on undergraduate and postgraduate students: A cross-sectional survey

BACKGROUND

The COVID-19 pandemic has impacted many facets of life. This study focuses on undergraduate and postgraduate students in China to explore how the pandemic has affected health status, daily life, learning situations, graduation-related situations, and their studies or work planning.

METHODS

This study sent online questionnaires to 2,395 participants to investigate the extent to which they were affected by the epidemic in the various aspects mentioned above and to understand what help they tend to get in the face of these effects.

RESULTS

A total of 2,000 valid questionnaires were collected. The physical health of 82.90% of the respondents was affected to varying degrees, with male students, non-medical students, and graduates being more affected than female students, students with medical majors, and non-graduates, respectively. The proportion of students affected by mental health, the total amount of physical exercise, emotional life, and interpersonal communication was 86.35, 88.65, 80.15, and 90.15%, respectively. Compared with medical students and non-graduates, non-medical students and graduates were more affected. In addition, students' learning and graduation conditions have also been affected to a certain extent: 13.07% of students may not be able to graduate on time, and the proportion of postgraduate students' graduations affected was higher than that of undergraduate students.

CONCLUSION

The COVID-19 pandemic has affected the health status of students, their daily lives, learning situations, and so on to varying degrees. We need to pay attention to the issues, provide practical solutions, and provide a basis for better responses to similar epidemics in the future.

Does student evaluation of on-demand video lectures vary with student characteristics? A questionnaire survey of medical students at Tokushima University

The popularity of online classes in university education has grown rapidly since the COVID-19 outbreak. This study aims to examine the association between the detailed characteristics/various contexts of students and the evaluation of online classes. An online questionnaire survey administered to third- and fourth-grade medical students of Tokushima University in September 2021-with 101 (42.8%) valid responses-showed the respondents' general impressions, comprehension, convenience, and desire for online classes even after the pandemic ends were significantly higher for the on-demand lectures than for simultaneous online classes. Notably, students who did not do other things while watching video lectures (10.9%) rated on-demand lectures as facilitating significantly higher impression, comprehension, and convenience than those who did other things (89.1%). A multivariate analysis revealed that students who did not do anything else while watching, whose waking time changed slightly, who commuted to school for shorter periods, who were not good at morning lectures, and who watched at high speed rated the video lectures highly. Thus, video lectures are appreciated by students who are committed to learning, which is a positive result for the future of on-demand education. J. Med. Invest. 70 : 483-493, August, 2023.

Teaching Cellular Architecture: The Global Status of Histology Education

Histology or microanatomy is the science of the structure and function of tissues and organs in metazoic organisms at the cellular level. By definition, histology is dependent on a variety of microscope techniques, usually light or more recently virtual, as well as electron microscopy. Since its inception more than two centuries ago, histology has been an integral component of biomedical education, specifically for medical, dental, and veterinary students. Traditionally, histology has been taught in two sequential phases, first a didactic transfer of information to learners and secondly a laboratory segment in which students develop the skill of analyzing micrographic images. In this chapter, the authors provide an overview of how histology is currently taught in different global regions. This overview also outlines which educational strategies and technologies are used, and how the local and cultural environment influences the histology education of medical and other students in different countries and continents. Also discussed are current trends that change the teaching of this basic science subject.

Impact of COVID-19 on Medical Education: A Narrative Review of Reports from Selected Countries

The COVID-19 pandemic presented unprecedented challenges to medical training worldwide. Many studies examining barriers, such as student safety concerns and technological issues for adaptability to a virtual learning mode, were conducted during social distancing and described the pandemic's impact on medical education. This narrative sought to review how medical schools adapted to the pandemic and to provide a unique analysis of the challenges faced in delivering medical curricula worldwide. A search of the medical education literature yielded articles describing methods employed by medical colleges from locations worldwide. All articles that met search parameters were archived on PubMed. Of 109 manuscripts, 12 describe strategies adopted by 10 countries. They support the discussion of teaching and learning at the pre-clerkship and clerkship levels during the COVID-19 pandemic. Online learning became the method adopted by medical schools worldwide to address hurdles during the pandemic. Access to technology, the internet, and appropriate infrastructure, resulted in solid indicators of medical education success. From the student's perspective, the most significant advantage of this strategy was flexibility. The compiled reports are representative approaches used during the pandemic and may serve as guidelines for medical colleges when strategic change is needed during pre-clerkship and clerkship education. Strategies based on information technology proved successful; however, more equitable access is necessary. It is crucial to consider the complexities of syndemic conditions when adjusting the curriculum in challenging situations such as a pandemic.

The gross anatomy course: SARS-CoV-2 pandemic-related effects on students' learning, interest in peer-teaching, and students' perception of its importance

The COVID-19 pandemic required adjustments and limitations in university teaching, thereby challenging teaching concepts in anatomy requiring in-person contact, including the gross anatomy course. Therefore, the present study investigates the impact of COVID-19-associated adjustments on students' perception of the gross anatomy course's importance and quality, students' preferred learning setting and outcome, and their motivation to involve themselves in academic activities, including becoming a future peer-teacher of the course. Using paper-based questionnaires in Ulm, Germany, 397 (response rate: 82.3%) students of the winter term of 2020/2021 were surveyed using quantitative and qualitative items, which were compared with cohorts prior to the pandemic. Students reported a higher global rating on course quality during COVID-19 (pre-COVID-19: 5.3 ± 0.9, during-COVID-19: 5.6 ± 0.7, p < 0.001; 1 = very bad, 6 = very good). Students' perceived importance of the gross anatomy course showed a small but significant increase (pre-COVID-19: 4.2 ± 0.6, during-COVID-19: 4.3 ± 0.6, p < 0.001; 1 = strongly disagree, 6 = strongly agree). Students' motivation to apply as a peer-teacher remained stable, nevertheless, they reported less interest in transferring their knowledge to junior students. Finally, students reported that they spent significantly more learning time alone and their examination grades remained unchanged during the pandemic. Astonishingly, despite radical changes of the teaching environment due to COVID-19, students appreciate the offered teaching and highly valued the gross anatomy course.

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.

Impact of COVID-19 on medical education in different income countries: a scoping review of the literature

The COVID-19 pandemic has disrupted medical education worldwide. Universities were forced to rapidly adapt to the evolving situation and develop methods of delivering curricula and assessments online. The purpose of this scoping review was to assess the impact of COVID-19 on medical education and investigate how this effect varies in different income countries. The methodology adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. Key terms were searched in six electronic databases. Inclusion criteria included studies describing the effect of COVID-19 on undergraduate medical education in university and clinical settings, studies published post 1 December 2019 and studies published in English. A modified Johanna Briggs Institute data charting tool was used to extract data concerning study characteristics and outcomes. The initial search returned 298 articles. Following duplicate removal and article screening, 33 studies were included. The literature indicated that the pandemic had a negative effect on medical student education worldwide, in both high-income countries (HICs) and low- and middle-income countries (LMICs). A range of factors impacted students and educators, including new curriculum and assessment design, reduced patient contact, use of new technology and lack of infrastructure. However, LMICs encountered more arduous barriers such as lack of access to information technology infrastructure and support from national governments. COVID-19 has impeded medical education worldwide. Future research is needed to address barriers to providing medical education during a pandemic. LMICs need particular support as they have fewer resources and face greater challenges regarding this matter.

Assessing relational coordination and its impact on perceived mental health of students, teachers and staff in a clinical skills program during the COVID-19 pandemic

BACKGROUND

The global spread of the COVID-19 virus caused unprecedented interruptions in medical education. This paper evaluates Relational Coordination (RC): communicating and relating for task integration; between the distinct stakeholders responsible for scheduling,delivering and receiving clinical teaching in the wake of the pandemic.

METHODOLOGY

Using a cross-sectional design, the level of Relational Coordination was assessed between twelve groups within a Clinical Skills Program at a Medical School in the United Arab Emirates. It also measures three relevant mental health factors: namely, Job satisfaction, Work Engagement, and Burnout.

RESULTS

Overall, RC scores were moderate (3.65 out of 5.00). Controlling for participants' position, RC was found to positively and significantly increase both job satisfaction (β = 1.10, p < 0.001) and work engagement (β = 0.78, p < 0.01)., Additionally, RC was significantly associated with lower burnout (β = -0.56, p = 0.05). Fifty percent of participants experienced high job satisfaction, with a mean score of 5.0 out of 7.0, while 73% reported being enthusiastic about their job, with a mean score of 6.0 out of 7.0. About a third of participants (27%) reported feeling burnout.

CONCLUSIONS

During times of disruption and crisis, medical education can benefit from higher levels of relational coordination. Our study shows the significant impact of relational coordination on mental health measures like job satisfaction and work engagement. To achieve the full potential and benefits of excellent levels of relational coordination in this program, we recommend six interventions focusing on improving communication, work processes, regular meetings, education innovations, capacity building, and the establishment of coaching and counseling programs for students and faculty.

Anatomy education beyond the Covid-19 pandemic: A changing pedagogy

The coronavirus disease 2019 (Covid-19) pandemic has induced multifaceted changes in anatomical education. There has been a significant increase in the employment of digital technologies coupled with the upskilling of educators' capacity and altered attitudes toward the digitalization process. While challenges remain, learners have demonstrated capabilities to adapt to digital delivery, engagement and assessment. With alternative and innovative teaching and learning strategies having been trialed and implemented for almost two years, the key question now is what the pedagogy will be for anatomy education beyond the pandemic. Here we discuss some of the changes in anatomy education that have taken place as a result of the Covid-19 pandemic and importantly present some outlooks for evidence-based anatomy pedagogy as the world enters the post-pandemic phase and beyond. The authors conclude that the anatomy discipline is ready to further modernize and has the opportunity to use digital technologies to evolve and enhance anatomy education to ensure students are provided with the learning experience which will prepare them best for the future.

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.

Evolving strategies in whirlwind mode: The changing face of anatomy education during Covid-19 pandemic

The Covid-19 pandemic stipulated adoption of unfamiliar strategies for delivering anatomy education in online mode. The factors which determine education strategies are variable across geographical regions. It was perceived that an overview of education strategies around the globe would be useful for anatomists. Hence this narrative review was undertaken to collate observations from different geographical regions pertaining to education strategies adopted during the pandemic. Data relevant to the topic of study were extracted from 12 articles that were selected from an initial pool of 317 articles based on search criteria set for the review. Subtle differences in core education strategies implied that baseline response from anatomists was similar across regions. It was evident that online digital tools were key elements of education strategies adopted by educators for delivering online anatomy classes across the globe. Interestingly, a considerable gap in terms of number and variety of online tools used for anatomy education (those requiring commercial purchase) was noted between economically developed and developing regions. This may have an impact on learning outcome for students and may even lead to variations in anatomical knowledge by regions. It was observed that offline human dissection sessions were incorporated into online practical classes in one region as positive cases showed a declining trend. This positive development is worth emulating elsewhere based on cautious assessment of prevailing situation. From a broad perspective timely introduction of education strategies ensured delivery of anatomy education during the pandemic and gave an evolved outlook to the fabric of anatomy education.

Changes in Daily Life, Physical Activity, GAD, Depression, and Personal Hygiene of Adolescents in South Korea Due to the COVID-19

This study used raw data obtained from the Adolescents’ Health Behavior Survey by government-affiliated agency open data. A total of 109,796 students were sampled. A comparative analysis was performed based on the year 2020 and when the COVID-19 pandemic occurred, in which we analyzed changes in adolescents’ depression and panic anxiety perception and dietary habits, physical factors, physical activity, and handwashing habits. There was no weight control in the second year compared to the first year of the COVID-19 pandemic, and obesity also increased. The continuation of the non-contact situation caused by COVID-19 led to a worsening of subjective health awareness, and the experience of generalized anxiety disorder, depression, sadness and hopelessness, and suicidal thoughts and attempts increased. The frequency of washing hands with soap before meals and after using the toilet at school or at home was reduced. As a result of this analysis, we believe that there needs to be a system of support in place to address the academic gaps and deficiencies in learning caused by COVID-19, and that psychological and emotional support needs to be strengthened at this time, as well as the issues to be supported after the end of the non-contact situation.

Medical education in post-pandemic times: Online or offline mode of learning?

Background and Objective

With the advent of the COVID-19 pandemic, face-to-face training was suspended considering social-distancing norms. The training needs of the healthcare workers (HCWs) were being met by the online mode. Initially, the use of the online mode was limited but was eventually popularized with increased use. This would have led to a change in the perception toward the online mode. However, the use of online learning has financial and temporal obstacles. With this objective, a study was conducted among the HCWs to assess the perception, satisfaction, and preference associated with the modes of learning.

Methods

A cross-sectional study was conducted from February to April 2021 among the HCWs. An online link to the survey was circulated among the HCWs who attended online or/and offline training. The questionnaire had 38 questions assessing the sociodemographic details, perception, satisfaction level, and preferences of the participants. Univariable and multivariate logistic regression were performed using SPSS v-22.

Results

A total of 1,113 responses were received with the mean age of 33.17 ± 8.13 years and approximately 63% of the participants were females. Approximately 54% perceived the online mode of learning as a better mode of learning. Also, 67% preferred and 80.5% recommended the online mode whereas mean satisfaction was found to be more for the offline mode as compared to the online mode.

Interpretation and Conclusions

The study concludes that the online mode of learning is the most preferred and recommended mode among the HCWs, whereas there is more dissatisfaction with respect to the online mode. The study also emphasizes that the instructors need to improve the practical knowledge of the learners by integrating technical modalities.

A systematic review of health sciences students' online learning during the COVID-19 pandemic

BACKGROUND

This study aims to analyse the effectiveness of distance learning during the COVID-19 pandemic among undergraduate health sciences students using systematic review. Online learning has been chosen as the best approach to continue offering education in this pandemic era.

METHOD

The screening process was done using Scopus, ScienceDirect and PubMed based on the eligibility criteria. Out of 1486 studies, 1269 were screened. A total of 64 eligible studies obtained were included in the quantitative analysis. Results were categorized into i) student attitudes (perceptions/satisfactions/engagements), and ii) student learning outcomes, and compared to the Kirkpatrick model.

RESULTS

Although facing difficulties, 50% of the studies was moderately satisfied with distance learning, while 36% was highly satisfied and 17% dissatisfied. Most studies (26%) reported flexibility in online learning. Internet issues (19%) and low interaction between learners and instructors (19%) were the most prevalent problems mentioned. Online education engages students better than traditional learning. The learning outcome was assessed using two categories: i) academic performance and ii) skill development. Most studies (72%) stated that online learning improves academic performance, 14% reported a drop, and 14% stated no effect, while an increase in clinical skills and communication skills were reported. Kirkpatrick evaluation revealed 80% of the studies obtained was evaluated at level 1 (reaction), 8% at level 2 (learning), 12% at level 3 (behaviour) and none at level 4 (results).

CONCLUSION

Overall, this systematic review found that the online learning performed better than expected during COVID-19, but the data gained is insufficient to say it is beneficial when compared to other types of teaching approaches.

Using clinical history taking chatbot mobile app for clinical bedside teachings - A prospective case control study

Introduction

A novel chatbot mobile app for training of undergraduate medical students' clinical history taking skills was developed in 2021. Students were able to take clinical history from the virtual patient for bedside teaching. A case-control study was conducted to evaluate the effectiveness of learning with chatbot mobile app, versus conventional bedside teachings with real patients.

Methods

132 final year medical students were randomized into two groups - Conventional bedside teaching with clinical history taken from a real patient, and Bedside teaching with clinical history taken from the Chatbot. Independent blinded assessment of students' history taking skills was conducted. Students' performance were assessed by standardized marking scheme.

Results

Median age was 23 years old (Range 21-30 years old). There were 62 female and 70 male students.64 students were randomized into conventional group while 68 students were randomized into the chatbot group. Baseline demographic data were comparable between the two groups.Blinded assessment of students' performance in clinical history taking were comparable between the conventional group and chatbot group (p > 0.05).

Conclusion

With the promising results we have demonstrated in this study, we believe training of history taking skills by chatbot will be a feasible alternative to conventional bedside teaching.

Impact of medical school responses during the COVID-19 pandemic on student satisfaction: a nationwide survey of US medical students

PURPOSE

Medical schools have faced various challenges in preparing their clinical students for the frontlines of a pandemic. This study investigated medical students' satisfaction with their institutions during the coronavirus disease 2019 (COVID-19) pandemic with the intention of guiding educators in future public health crises.

METHODS

In this cross-sectional study surveying students in clinical rotations, the primary outcome was overall satisfaction regarding medical schools' responses to the pandemic, and the four secondary outcomes were school communication, exposure to COVID-19, availability of personal protective equipment, and access to COVID-19 testing.

RESULTS

The survey was distributed to ten medical schools, of which 430 students responded for a response rate of 13.0%. While most students were satisfied (61.9%, n=266) with their schools' response, more than one in five (21.9%, n=94) were dissatisfied. Among the four secondary outcomes, communication with students was most predictive of overall satisfaction.

CONCLUSION

In future crises, schools can best improve student satisfaction by prioritizing timely communication.

E-Learning during COVID-19: perspectives and experiences of the faculty and students

BACKGROUND

Aimed to corroborate students' and faculty's experiences with e-learning during the current pandemic.

METHODS

A cross-sectional study was conducted from February to June 2020. Seven surveys were distributed electronically to all undergraduate students and the faculty (4 to students and 3 to teachers) at the Southern Medical University (China). Descriptive statistics and t-tests were used to analyze the data. Statistical significance was set at p < .05.

RESULTS

Most students had some exposure to e-learning prior to the all e-learning regiment, contrasted with close to 90% of teachers having no or very limited experience. Students' perceptions of the most helpful e-learning activities did not change significantly overall (Week 3 vs. Week 9). Approaching 60% of students (Week 9) did find online discussion/Q&A/forum helpful, an increase from less than 30% (Week 3). Among teachers, gaps emerged (Week 9) between e-teaching activities used and their perceived effectiveness. Despite pre-recorded lectures being the most frequently used method, the least gap was associated with live-stream lectures-the least used. Over time, teacher's perceived effectiveness of e-teaching vs. in-person teaching did not differ significantly overall. When the results among students (Week 7) and teachers (Week 9) were corroborated, a slightly higher percentage of teachers viewed online teaching to be less effective than in-person teaching and a slightly higher percentage of teachers viewed online teaching as far less effective. For preferred learning modes after the resumption of in-person learning, students' preferences did not differ significantly overall (Week 3 vs. week 9). Surveys conducted in Week 9 found that a slightly higher percentage of students (~ 70%) than teachers (~ 60%) preferred some forms of hybrid learning and a lower percentage of students preferred face-to-face learning only. Approximately three quarters of teachers responded that at least 50% of course materials could be mastered by students on their own.

CONCLUSIONS

Overall, the perceived effectiveness of e-learning among students and teachers has not changed significantly over time. Nor have students' preferences shifted significantly for various learning modes after the in-person learning resumed. However, informative directional trends have emerged. Our research illustrates empirically the need to corroborate students' and instructors' experiences over time to inform more holistic improvements of e-learning.

Medical teachers' experience of emergency remote teaching during the COVID-19 pandemic: a cross-institutional study

BACKGROUND

The COVID-19 pandemic and the consequent social distancing measures caused unprecedented disruption for medical and healthcare education. This study examined medical teachers' experience with emergency remote teaching during the pandemic and their acceptance of online teaching after the pandemic.

METHODS

In this sequential mixed methods study, online surveys were disseminated to teachers (n = 139) at two Asia-Pacific medical schools to evaluate their experience with emergency remote teaching during the pandemic. Subsequently, in-depth interviews were conducted with teachers from both institutions (n = 13). Each interviewee was classified into an adopter category based on Rogers' Diffusion of Innovations Theory. Interview transcripts were analyzed thematically, and the descriptive themes were mapped to broader themes partly based on the Technology Acceptance Model and these included: (i) perceived usefulness of online teaching, (ii) perceived ease of delivering online teaching, (iii) experience with institutional support and (iv) acceptance of online teaching after the pandemic.

RESULTS

Our participants described accounts of successes with their emergency remote teaching and difficulties they experienced. In general, most participants found it difficult to deliver clinical skills teaching remotely and manage large groups of students in synchronous online classes. With regards to institutional support, teachers with lower technological literacy required just-in-time technical support, while teachers who were innovative in their online teaching practices found that IT support alone could not fully address their needs. It was also found that teachers' acceptance of online teaching after the pandemic was influenced by their belief about the usefulness of online teaching.

CONCLUSIONS

This study demonstrated that our participants managed to adapt to emergency remote teaching during this pandemic, and it also identified a myriad of drivers and blockers to online teaching adoption for medical teachers. It highlights the need for institutes to better support their teaching staff with diverse needs in their online teaching.

A New Normal: Assessment Outcomes and Recommendations for Virtual Versus In-Person Curricula in Post-COVID-19 Times

INTRODUCTION

COVID-19 response efforts that began in March 2020 prompted an urgent need to transition medical education from an in-person to a virtual format. Our aim is to provide evaluation of a virtual platform for a fully integrated curriculum to provide future guidance in teaching methods.

MATERIALS AND METHODS

We used summative assessments and course evaluations from pre- and post-transition from in-person to virtual delivery of educational content to measure the impacts of this transition on student performance and perceptions. Additionally, we surveyed students about their in-person versus online educational preferences.

RESULTS

There were no statistically significant differences in student knowledge acquisition as assessed by weighted averages of summative assessments when comparing an in-person to a virtual educational platform. While the transition to virtual learning was initially well-received by students, our studied cohorts gave lower scores for the overall learning experience after prolonged virtual learning (p < 0.001). Students had a strong preference that anatomy and other group sessions should be delivered in-person. There was no strong preference whether other learning modalities should be given in-person or virtually.

CONCLUSIONS

Although student knowledge acquisition remained stable on a virtual platform, the student learning experience varied. We recommend that when returning to a new normal after COVID-19 restrictions are lifted, sessions that require 3-dimensional or group learning should remain in-person, while other educational activities may be offered on a virtual platform and that, whenever virtual learning is employed, attention be paid to ensuring ongoing social and academic engagement between learners and faculty.

Burnout of Faculty Members of Medical Schools in Korea

BACKGROUND

There is no national survey on medical school faculty members' burnout in Korea. This study aimed to investigate burnout levels and explore possible factors related to burnout among faculty members of Korean medical schools.

METHODS

An anonymous online questionnaire was distributed to 40 Korean medical schools from October 2020 to December 2020. Burnout was measured by a modified and revalidated version of the Maslach Burnout Inventory-Human Service Survey.

RESULTS

A total of 996 faculty members participated in the survey. Of them, 855 answered the burnout questions, and 829 completed all the questions in the questionnaire. A significant number of faculty members showed a high level of burnout in each sub-dimension: 34% in emotional exhaustion, 66.3% in depersonalization, and 92.4% in reduced personal accomplishment. A total of 31.5% of faculty members revealed a high level of burnout in two sub-dimensions, while 30.5% revealed a high level of burnout in all three sub-dimensions. Woman faculty members or those younger than 40 reported significantly higher emotional exhaustion and depersonalization. Long working hours (≥ 80 hours/week) showed the highest reduced personal accomplishment scores (F = 4.023, P = 0.018). The most significant stressor or burnout source was "excessive regulation by the government or university." The research was the most exasperating task, but the education was the least stressful.

CONCLUSION

This first nationwide study alerts that a significant number of faculty members in Korean medical schools seem to suffer from a high level of burnout. Further studies are necessary for identifying the burnout rate, related factors, and strategies to overcome physician burnout.

Online learning developments in undergraduate medical education in response to the COVID-19 pandemic: A BEME systematic review: BEME Guide No. 69

BACKGROUND

The COVID-19 pandemic spurred an abrupt transition away from in-person educational activities. This systematic review investigated the pivot to online learning for nonclinical undergraduate medical education (UGME) activities and explored descriptions of educational offerings deployed, their impact, and lessons learned.

METHODS

The authors systematically searched four online databases and conducted a manual electronic search of MedEdPublish up to December 21, 2020. Two authors independently screened titles, abstracts and full texts, performed data extraction and assessed risk of bias. A third author resolved discrepancies. Findings were reported in accordance with the STORIES (STructured apprOach to the Reporting in healthcare education of Evidence Synthesis) statement and BEME guidance.

RESULTS

Fifty-six articles were included. The majority (n = 41) described the rapid transition of existing offerings to online formats, whereas fewer (n = 15) described novel activities. The majority (n = 27) included a combination of synchronous and asynchronous components. Didactics (n = 40) and small groups (n = 26) were the most common instructional methods. Teachers largely integrated technology to replace and amplify rather than transform learning, though learner engagement was often interactive. Thematic analysis revealed unique challenges of online learning, as well as exemplary practices. The quality of study designs and reporting was modest, with underpinning theory at highest risk of bias. Virtually all studies (n = 54) assessed reaction/satisfaction, fewer than half (n = 23) assessed changes in attitudes, knowledge or skills, and none assessed behavioral, organizational or patient outcomes.

CONCLUSIONS

UGME educators successfully transitioned face-to-face instructional methods online and implemented novel solutions during the COVID-19 pandemic. Although technology's potential to transform teaching is not yet fully realized, the use of synchronous and asynchronous formats encouraged virtual engagement, while offering flexible, self-directed learning. As we transition from emergency remote learning to a post-pandemic world, educators must underpin new developments with theory, report additional outcomes and provide details that support replication.

Impact of sepsis education for healthcare professionals and students on learner and patient outcomes: A systematic review

BACKGROUND

Sepsis is an important global healthcare problem that is a key challenge faced by healthcare professionals face worldwide. One key effort aimed at reducing the global burden of sepsis is educating healthcare professionals about early identification and management of sepsis.

AIM

To provide a comprehensive evaluation of sepsis education among healthcare professionals and students.

METHODS

Six databases (PubMed, CINAHL, Embase, MEDLINE, Cochrane Central Register of Controlled Trials, and Scopus) were searched. We included studies that described and evaluated any form of education or training on sepsis delivered to healthcare professionals and students. Study outcomes were summarised according to the adapted Kirkpatrick model of training evaluation.

RESULTS

Thirty-two studies were included in the review. The learning contents were reported to be in accordance with the Surviving Sepsis Campaign guidelines. Seven studies included the topic of interprofessional teamwork and communication in their sepsis education content. Most educational programs were effective and reported positive effects on immediate knowledge outcomes. Interventions that were delivered through an active learning approach such as simulation and game-based learning generally produced greater gains than didactic teaching. Improvements in patient care processes and patient outcomes were associated with the concomitant existence or implementation of a hospital sepsis care bundle.

CONCLUSION

Incorporating active learning strategies into sepsis education interventions has the potential to improve learners' long-term outcomes. In addition, sepsis education and protocol-based sepsis care bundle act in synergy to augment greater improvements in care processes and patient benefits.

Evaluation of views and perceptions of the medical faculty students about distance anatomy education during the COVID-19 pandemic

Purpose

This study aimed to investigate the students’ opinions about the distance anatomy education given in our faculty at the COVID-19 pandemic and present our department’s experiences.

Methods

An online questionnaire designed for medical faculty students. The questionnaire was applied to 355 volunteer medical faculty students. The questionnaire consisted of demographics, five-point Likert items, and open-ended questions. The questionnaire was applied between August and September 2020. Distance anatomy education activities were evaluated during March and July 2020.

Results

Results showed face-to-face theoretical anatomy education was found to be more effective than distance anatomy education conducted with recorded lecture videos. Even though the positive aspects of distance anatomy education stand out in topics, such as time management, it has been stated that cadaver and laboratory education has been disrupted. Most of the students agreed that they spent more time on supplementary resources during distance anatomy education.

Conclusion

The COVID-19 pandemic has provided an unexpected experimental environment. The demand for a blended method, which consists of distance (supported by video recordings) theoretical anatomy education and face-to-face practical anatomy education for the post-pandemic period comes to the fore. Distance anatomy education brings some problems with it due to its nature, and it is essential to seek unique solutions to them. Evaluating the perceptions of the parties will play an essential role in solving the problems of distance anatomy education and in the formation of future anatomy education styles.

Medical students’ satisfaction level with e-learning during the COVID-19 pandemic and its related factors: a systematic review

PURPOSE

This review investigated medical students’ satisfaction level with e-learning during the coronavirus disease 2019 (COVID-19) pandemic and its related factors.

METHODS

A comprehensive systematic search was performed of international literature databases, including Scopus, PubMed, Web of Science, and Persian databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as “Distance learning,” “Distance education,” “Online learning,” “Online education,” and “COVID-19” from the earliest date to July 10, 2022. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool).

RESULTS

A total of 15,473 medical science students were enrolled in 24 studies. The level of satisfaction with e-learning during the COVID-19 pandemic among medical science students was 51.8%. Factors such as age, gender, clinical year, experience with e-learning before COVID-19, level of study, adaptation content of course materials, interactivity, understanding of the content, active participation of the instructor in the discussion, multimedia use in teaching sessions, adequate time dedicated to the e-learning, stress perception, and convenience had significant relationships with the satisfaction of medical students with e-learning during the COVID-19 pandemic.

CONCLUSION

Therefore, due to the inevitability of online education and e-learning, it is suggested that educational managers and policymakers choose the best online education method for medical students by examining various studies in this field to increase their satisfaction with e-learning.

Perceptions, satisfactions, and performance of undergraduate students during Covid-19 emergency remote teaching

Due to the Covid-19 pandemic, the education system worldwide faced sudden and unforeseen challenges. Many academic institutions closed their doors, forcing both educators and students to transition to Emergency Remote Teaching (ERT) for the remainder of the semester. This transition eliminated hands-on experiences, increased workload, and altered curricula. However, these aspects, as well as students' perceptions, study habits, and performance in response to ERT remain poorly documented. This contribution describes changes in the curriculum of an undergraduate cadaver-based laboratory, and explores students' performance, self-perceived learning, and overall satisfaction during this educational crisis. Online content delivery for this course included both asynchronous instruction and synchronous discussion sessions. While formative assessments remained the same, online spotter examinations included short answer, multiple choice, multiple answer, ordering, and true and false questions. Despite examination grades improving 20% during ERT, students reported lower levels of learning, confidence, and engagement with the course materials when compared to the face-to-face portion of the class. The most prevalent challenges identified by students were those related to the loss of access to cadaver-based learning, including difficulty identifying and visualizing structures in three dimensions, and the loss of context and sensorial cues. Flexibility in taking examinations and learning the material at their own pace were recognized as positive outcomes of the ERT transition. While the resulting student perceptions and performances are unsurprising, they offer insight into the challenges of fostering a productive learning environment in a future threatened by epidemic outbreak and economic uncertainty.

Pre-medical students' perceptions of educational environment and their subjective happiness: a comparative study before and after the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic necessarily changed pre-medical students' educational environment into an online format-and students' subjective happiness (SH) is highly impacted by their educational environment. This study investigates changes in pre-medical students' perceptions of their educational environment and their SH before and after the pandemic, as well as explores the predictors related to their SH.

METHODS

The Korean version of the Dundee Ready Educational Environment Measure (DREEM) questionnaire and single-item measures of SH and professional identity (PI) were used. The t-test was employed to analyze the differences of the SH, PI, and DREEM subscales scores before and after the onset of COVID-19. Cohen's d was used as effect size and correlations between SH and different subscales of DREEM were analyzed using Pearson's correlation. The multiple regression analysis was performed to reveal associations between predictors and SH.

RESULTS

A total of 399 pre-medical students completed the survey both before and after the COVID-19 pandemic. The DREEM scores and all subscales scores significantly increased but each presents a different effect size. Students' Perceptions of Learning (SPL: Cohen's d = 0.97), Students' Perceptions of Teaching (SPT: Cohen's d = 1.13), and Students' Perceptions of Atmosphere (SPA: Cohen's d = 0.89) have large effect sizes. Students' Academic Self-Perceptions (SASP: Cohen's d = 0.66) have a medium effect size and Students' Social Self-Perceptions (SSSP: Cohen's d = 0.40) have a small effect size. In contrast, no significant change was noted in the SH and PI. Both PI and SSSP impacted SH before COVID-19, but after the pandemic, SH was impacted by SPL, SPA, and SSSP.

CONCLUSIONS

Students' overall perception of their educational environment was more positive after the onset of COVID-19, but their social self-perceptions improved the least. Additionally, SSSP is the only predictor of SH both before and after the pandemic. The findings of this study suggest that educational institutions must pay attention to students' social relationships when trying to improve their educational environment. Furthermore, so as to increase students' SH, development of both educational environment and PI is essential.

Perception of medical education by learners and teachers during the COVID-19 pandemic: a cross-sectional survey of online teaching

COVID-19 lockdowns have deeply impacted teaching programs. Online teaching has suddenly become the main form of medical education, a form that may be used as long as the pandemic continues. We aimed at analyzing how online teaching was perceived by both teachers and learners to help determine how to adapt curricula in the next few years. An anonymous cross-sectional survey of medical students, pediatric residents, neonatal fellows, and their respective teachers was conducted between June and August 2020 to assess feelings about quality, attendance, equivalence, and sustainability of online teaching programs. 146 Students and 26 teachers completed the survey. 89% of students agreed that the offered online teaching was an appropriate way of teaching during the pandemic. Less than half of learners and teachers felt they have received or provided a training of an equivalent level and quality as in usual courses. About one-third thought that this online teaching should continue after the crisis ends. Medical school students had significantly more mixed opinions on online teaching than residents and fellows did. Attendance of learners significantly improved with synchronous online classes (p < 0.001), and among more advanced learners (p < 0.002). Our study is the first of this kind to assess simultaneously the feelings of learners at different levels (medical students, residents, and fellows) and their respective teachers of pediatric on programs taught online. It showed that online programs were perceived as appropriate ways of teaching during the COVID pandemic. Further studies are, however, needed to assess the efficacy of such teaching methods on medical skills and communication capabilities.

COVID-19 Pandemic and E-Learning Satisfaction in Medical and Non-Medical Student: A Systematic Review and Meta-Analysis

BACKGROUND

The COVID-19 pandemic has led to a rapid shift in student education style from face-to-face to electronic learning. Since the education satisfaction index is considered as a measure of the quality of educational services, therefore, this study aimed to assess E-Learning Satisfaction (ELS) in medical and non-medical students during COVID-19 pandemic.

METHODS

Articles that had been published from 22 Dec 2019 to 4 Jan 2021 were identified through searching databases including PubMed, Scopus, Elsevier, Google Scholar, Web of Science and Iranian Scientific Information Database (SID), Health.barakatkns, IranDoc, Civilica and MagIran using the following keywords: "Distance learning", "Virtual learning", "E-Learning", "Satisfaction", "COVID 19". We systematically reviewed all studies that reported ELS. In this study, meta-analysis was used to estimate the pooled ELS.

RESULTS

Overall, 184 records were identified by the electronic search, of which 24 relevant studies were included in meta-analysis. The pooled ELS in medical, non-medical and overall were 58.1% (50.5%-65.7%), 70.1% (66.8%-73.5%) and 63.8% (58.9%-68.8%) respectively.

CONCLUSION

According to our results and lower ELS in medical students in comparison with non-medical students, designing new E-Learning methods for medical students has been suggested.