Asynchronous, digital teaching in times of COVID-19: a teaching example from general practice

Strategies for Digital Clinical Teaching During the COVID Pandemic: A Scoping Review

Widespread "lockdowns" during the COVID pandemic in 2020-2021 restricted medical students' access to patients. We used a scoping review with exploratory thematic synthesis to examine how reports of digital clinical teaching during the first year of the COVID pandemic could inform digital clinical teaching in the post-pandemic world. We looked at strategies used and outcomes reported, lessons learned about how best to use digital methods for clinical teaching, and learning theories used. The eighty-three articles included in the final review fell into four groups. These were telehealth interventions; virtual case-based teaching; multi-modal virtual rotations; and a small group of "other" strategies. Telehealth reports indicated that COVID has probably accelerated the adoption of telehealth, and these skills will be required in future curricula. Engagement with virtual case-based teaching was problematic. Virtual rotations were particularly valued in specialties that relied on visual interpretation such as radiology and dermatology. For general clinical specialties, digital clinical teaching was not a satisfactory substitute for real clinical exposure because it lacked the complexity of usual clinical practice. Sixty-seven articles reported students' reactions only, and 16 articles reported a change in knowledge or skills. Demands on instructors were considerable. Few studies were theorized and none tested theory, which limited their transferability. While telehealth teaching may be a valuable addition to some curricula, digital clinical teaching is unlikely substantially to replace exposure to real patients outside of specialties that rely on visual interpretation. High demands on instructors suggest little potential for new, scalable digital clinical offerings after COVID.

Medical studies in times of a pandemic - concepts of digital teaching for Orthopaedics and Trauma at german universities

BACKGROUND

Due to the Covid-19 pandemic, on-site classroom teaching became limited at most German medical universities. This caused a sudden demand for digital teaching concepts. How the transfer from classroom to digital teaching or digitally assisted teaching was conducted was decided by each university and/or department individually. As a surgical discipline, Orthopaedics and Trauma have a particular focus on hands-on teaching as well as direct contact to patients. Therefore, specific challenges in designing digital teaching concepts were expected to arise. Aim of this study was to evaluate medical teaching at German universities one year into the pandemic as well as to identify potentials and pitfalls in order to develop possible optimization approaches.

METHODS

A questionnaire with 17 items was designed and sent to the professors in charge of organising the teaching in Orthopaedics and Trauma at each medical university. A differentiation between Orthopaedics and Trauma was not made to allow a general overview. We collected the answers and conducted a qualitative analysis.

RESULTS

We received 24 replies. Each university reported a substantial reduction of their classroom teaching and efforts to transfer their teaching to digital formats. Three sites were able to switch to digital teaching concepts completely, whereas others tried to enable classroom and bedside teaching at least for students of higher edcuational levels. The online platforms used varied depending on the university as well as the format it was supposed to support.

CONCLUSION

One year into the pandemic significant differences concerning the proportions of classroom and digital teaching for Orthopaedics and Trauma can be observed. Simultaneously huge differences in concepts used to create digital teaching are present. Since a complete suspense of classroom teaching was never mandatory, several universities developed hygiene concepts to enable hands-on and bedside teaching. Despite these differences, some similarities were observed: the lack of time and personnel to generate adequate teaching material was reported as the leading challenge by all participants of this study.

Can prompts improve self-explaining an online video lecture? Yes, but do not disturb!

In recent years, COVID-19 policy measures massively affected university teaching. Seeking an effective and viable way to transform their lecture material into asynchronous online settings, many lecturers relied on prerecorded video lectures. Whereas researchers in fact recommend implementing prompts to ensure students process those video lectures sufficiently, open questions about the types of prompts and role of students' engagement remain. We thus conducted an online field experiment with teacher students at a German university (N = 124; 73 female, 49 male). According to the randomly assigned experimental conditions, the online video lecture on topic Cognitive Apprenticeship was supplemented by (A) notes prompts (n = 31), (B) principle-based self-explanation prompts (n = 36), (C) elaboration-based self-explanation prompts (n = 29), and (D) both principle- and elaboration-based self-explanation prompts (n = 28). We found that the lecture fostered learning outcomes about its content regardless of the type of prompt. The type of prompt did induce different types of self-explanations, but had no significant effect on learning outcomes. What indeed positively and significantly affected learning outcomes were the students' self-explanation quality and their persistence (i.e., actual participation in a delayed posttest). Finally, the self-reported number of perceived interruptions negatively affected learning outcomes. Our findings thus provide ecologically valid empirical support for how fruitful it is for students to engage themselves in self-explaining and to avoid interruptions when learning from asynchronous online video lectures.

One year of digital teaching in psychiatry as a response to the COVID-19 pandemic: Knowledge gain and content evaluation of medical students for two summer semesters in 2020 and 2021

After the beginning of the COVID-19 pandemic in 2020, digital teaching had to be implemented by most universities at short notice and widely replaced classroom teaching. As a consequence, digital teaching further reduced direct social interaction for students. One year after the introduction of digital teaching formats at our university medical center (department of psychiatry and psychotherapy), teaching evaluation of students from summer semesters 2020 and 2021 (SS20, SS21) were compared. The main objective of this study was to objectify whether students evaluate digital teaching less favorably after one year of its implementation. Ratings of 311 medical students on (1) knowledge gain, (2) teaching contents and (3) subjective advantages of digital teaching were analyzed for the two separate cohorts SS20 (n = 175) and SS21 (n = 136). Students also rated their pandemic-related stress level, and if learning progress had been reduced by the pandemic in general. Significant knowledge gain was achieved for all included domains in psychiatry (all p < .001), and did not differ between SS20/SS21. Teaching contents in SS21 were rated worse in six out of eight domains compared to SS20 (p < .001 to .05). Also, subjective advantages of digital teaching vanished in most domains comparing the cohorts of SS21 and SS20 (p < .001 to .05). No differences were found for pandemic-related stress level and subjective learning progress. Limitations include the post-hoc design, possible bias from individual exam grades, and sampling bias. The present study showed that knowledge gain can be considered to be stable one year after the pandemic-related implementation of digital teaching. However, sustainability of this teaching format should be monitored critically: The subject of psychiatry and psychotherapy thrives on direct communication, which can be compromised when using digital formats only. In this light, implementation of more interactive formats in digital teaching is discussed.

Classroom Digital Teaching and College Students' Academic Burnout in the Post COVID-19 Era: A Cross-Sectional Study

The continued development of digital technology and its overuse in teaching and learning in the post-epidemic era have brought about digital health risks, which are associated with academic burnout among college students. This study focused on the relationship between classroom digital teaching and students' academic burnout and designed the Classroom Burnout Inventory (CBI) and the Classroom Burnout Causes Inventory (CBCI) to conduct a cross-sectional survey of 206 Chinese university students. Correlations and regression analyses were conducted between key factors and burnout values through a path model of "Digital teaching-Teaching & learning process-Causes subjects-Burnout". The results of the study show that an inappropriate and excessive use of unintegrated digital teaching and learning technologies in the classroom was positively correlated with academic burnout among college students. Burnout levels and the three manifestations were not correlated with students' gender, grade, and major. In terms of causes, the academic burnout of college students was more correlated with their own personal reasons than with external factors such as teachers, universities, and environments. Integrating digital technology platforms, enhancing teacher leadership in the digital classroom, and strengthening peer support and students' psychological resilience are all meaningful explorations of academic burnout prevention strategies.

Virtual Classrooms and Their Challenge of Interaction-An Evaluation of Chat Activities and Logs in an Online Course about Digital Medicine with Heterogeneous Participants

Learning digital competencies can be successful if the information is also tried out immediately using interactive elements. However, interactive teaching poses a particular challenge, especially in large group formats. Various strategies are used to promote interaction, but there is little known about the results. This article shows different strategies and evaluates their influence on the interaction rate in a large group course over two terms that teaches digital medicine. Log files and participation in surveys as well as participation in chat were quantitatively evaluated. In addition, the chat messages themselves were evaluated qualitatively. For the evaluation, relation to the total number of participants was particularly relevant in order to be able to determine an interaction rate in the individual course sessions. A maximum average interaction rate of 90.97% could be determined over the entire term while the participants wrote an average of 3.96 comments during a session in the chat. In summary, this research could show that interactive elements should be well planned and used at regular intervals in order to reap the benefits.

One year of general practice during the COVID-19 pandemic - presentation and evaluation of digital medical education

BACKGROUND AND TEACHING SITUATION

The SARS-CoV-2 pandemic had a substantial didactic impact on medical teaching. In Erlangen, the lecture "General Practice" was offered asynchronously and digitally in an inverted-classroom concept. Contents were available via a learning platform. The lecture was presented using annotated videos, consolidation materials and control questions. A forum encouraged for discussions and feedback and collected in-depth aspects for a case-based video consultation. The aim of this work is to evaluate and critically examine the digital teaching concept during the SARS-CoV-2 pandemic.

METHODOLOGY

Two semester cohorts evaluated the lecture. Overall impression of the lecture, didactic elements, suitability and the desired future lecture format were surveyed quantitatively. Free text answers were evaluated by means of qualitative content synthesis.

RESULTS

In terms of overall impression, the students (N=199) rated the lecture on average as "very good" (M=1.41, SD=.57). Digital methods were perceived as suitable for supporting self-study, and digital usage was rated as unproblematically (M=1.18, SD=.50). Desired future teaching formats were blended learning concepts (79.4%). Organisation, structure and content presentation were highly appreciated. The time for completing the course was perceived critically. The students urged for more practical and consolidating lecture work.

DISCUSSION AND IMPLICATIONS

The results illustrate high acceptance of digital teaching and underline the demand for future blended learning concepts. It is particularly important to better consider the students' time investment and practical relevance of digital self-learning mechanisms.

Virtual inverted classroom to replace in-person radiology lectures at the time of the COVID-19 pandemic - a prospective evaluation and historic comparison

BACKGROUND

In the time of the coronavirus disease 2019 (COVID-19) pandemic, in-person lectures had to be shifted to online learning. This study aimed to evaluate students' and lecturers' perception and effectiveness of a virtual inverted classroom (VIC) concept on clinical radiology in comparison to a historic control.

METHODS

In the winter semester 2020/21, 136 fourth year medical students who completed the clinical radiology VIC during the pandemic, were included in the single centre, prospective study. Results were compared with a historic control that had finished the physical inverted classroom (PIC) in the immediately preceding year. The VIC consisted of an initial phase of self-determined preparation with learning videos and a second interactive phase of clinical case studies alternating between the virtual lecture hall and virtual buzz groups. At the end of the lecture series, students rated the lecture on a scale of 1 (most positive assessment) to 6 (most negative assessment) through an online survey platform. Additionally, they reported their impressions in free-form text. Lecturers were invited to comment on the VIC in a group interview. Main outcomes were final grades and student perception of the VIC.

RESULTS

Students' general impression of VIC was lower than that of PIC (median value of 3 [IQR 4, 2] and 1 [IQR 0, 0], p < 0.001), respectively, p < 0.001). The highest rating was achieved concerning use of the audience response system (median 1 [IQR 1, 0]), and the lowest concerning the buzz groups (median 4 [IQR 5, 3]). Students stated that they would have appreciated more details on reading images, greater focus on plenary case studies, and provision of exam related scripts. Lecturers would have liked better preparation by students, more activity of students, and stronger assistance for group support. Exam grades after VIC were better than after PIC (median 1 [IQR 2, 1] and 2 [IQR 2,1], respectively, p < 0.001).

CONCLUSIONS

Students' overall perception of VIC was satisfactory, although worse than PIC. Final grades improved compared to PIC. Provided an adapted buzz group size and support, VIC may serve as complement in medical education once the pandemic is over.

Impact of Synchronous and Asynchronous Settings of Online Teaching and Learning in Higher Education on Students' Learning Experience During COVID-19

The sudden impact of the COVID-19 pandemic challenged universities to provide students with online teaching and learning settings that were both immediately applicable and supportive of quality learning. This resulted in a broad variety of synchronous and asynchronous online settings of teaching and learning. While some courses balanced both kinds, others offered either predominantly synchronous or asynchronous teaching and learning. In a survey study with students (N=3,056) and teachers (N=396) from a large German university, we explored whether a predominance of synchronous or asynchronous teaching and learning settings in higher education was associated with certain student experiences and outcomes. Additionally, we examined how well these two types of teaching and learning settings support students' basic psychological needs for autonomy, competence, and relatedness proposed by self-determination theory (SDT). Data were collected after the first online semester due to the COVID-19 pandemic. The results imply that from the students' perspective, the teaching methods involved in the two settings of teaching and learning differ with regard to their potential to support social interaction and to support basic psychological needs as proposed by SDT. Students who studied mostly in synchronous settings reported more peer-centered activities such as feedback in comparison to students in mostly asynchronous settings. In contrast, teachers perceived fewer differences between teaching methods in synchronous and asynchronous settings, especially regarding feedback activities. Further, students in mostly synchronous settings reported greater support of their basic psychological needs for competence support and relatedness as well as a greater overall satisfaction with the online term compared to students in mostly asynchronous settings. Across all students, greater fulfillment of psychological needs and higher technology acceptance coincided with outcomes that are more favorable. Implications for the post-pandemic classroom are drawn.

COVID-19 and lockdown schooling: how digital learning environments influence semantic structures and sustainability knowledge

Promoting sustainable lifestyles through Education for Sustainable Development (ESD) is part of the UN's Agenda 2030. Earlier empirical studies proved direct interactions with and in natural environments to be effective ESD methods. Pandemic-related lockdowns rendered such courses nearly impossible, which raised concerns about achieving the Sustainable Development Goals (SDGs) in general. To evaluate what young learners know about the concept sustainability so far and how it can be taught effectively online, we designed an online learning module tackling sustainability issues and compared it with data from an on-site intervention module for Bavarian 5th graders (~ 10 years old). Cognitive learning as well as attitudinal preferences of 288 learners were monitored in a pretest-posttest design. The learning module comprised two sections: One about botany, plant characteristics, and plant families; the other about the advantages and disadvantages of traditional as well as sustainable farming methods. The customized cognitive test and semantic differentials for sustainability and environmental protection produced three major findings: (1) A digital learning environment successfully and significantly increased sustainability knowledge (2) Learners clearly distinguished the concepts Sustainability and Environmental Protection (3) There is no direct correlation between semantic differential scores and learning outcome.

Student Survey Results of a Virtual Medical Student Course Developed as a Platform for Neurosurgical Education During the Coronavirus Disease 2019 Pandemic

Background

Before the coronavirus disease 2019 (COVID-19) pandemic, medical students training in neurosurgery relied on external subinternships at institutions nationwide for immersive educational experiences and to increase their odds of matching. However, external rotations for the 2020–2021 cycle were suspended given concerns of spreading COVID-19. Our objective was to provide foundational neurosurgical knowledge expected of interns, bootcamp-style instruction in basic procedures, and preinterview networking opportunities for students in an accessible, virtual format.

Methods

The virtual neurosurgery course consisted of 16 biweekly 1-hour seminars over a 2-month period. Participants completed comprehensive precourse and postcourse surveys assessing their backgrounds, confidence in diverse neurosurgical concepts, and opinions of the qualities of the seminars. Responses from students completing both precourse and postcourse surveys were included.

Results

An average of 82 students participated live in each weekly lecture (range, 41–150). Thirty-two participants completed both surveys. On a 1–10 scale self-assessing baseline confidence in neurosurgical concepts, participants were most confident in neuroendocrinology (6.79 ± 0.31) and least confident in spine oncology (4.24 ± 0.44), with an average of 5.05 ± 0.32 across all topics. Quality ratings for all seminars were favorable. The mean postcourse confidence was 7.79 ± 0.19, representing an improvement of 3.13 ± 0.38 (P < 0.0001).

Conclusions

Feedback on seminar quality and improvements in confidence in neurosurgical topics suggest that an interactive virtual course may be an effective means of improving students' foundational neurosurgical knowledge and providing networking opportunities before application cycles. Comparison with in-person rotations when these are reestablished may help define roles for these tools.

An Imperative for the National Public Health School in Burkina Faso to Promote the Use of Information and Communication Technologies in Education During the COVID-19 Pandemic: Critical Analysis

BACKGROUND

Several studies have reported the positive impact of information and communication technologies (ICTs) on academic performance and outcomes. Although some equipment is available, the ICTs for education at the National Public Health School (NPHS) of Burkina Faso have many shortcomings. These shortcomings were clearly revealed during the search for responses to the crisis caused by the COVID-19 pandemic. Indeed, to curb the spread of COVID-19, some measures were taken, such as closure of educational institutions. This resulted in a 2.5-month suspension of educational activities. Despite its willingness, the NPHS was unable to use ICTs to continue teaching during the closure period of educational institutions.

OBJECTIVE

In this paper, we aim to propose practical solutions to promote ICT use in teaching at the NPHS by analyzing the weaknesses and challenges related to its use.

METHODS

We conducted a critical analysis based on information from the gray literature of NPHS. This critical analysis was preceded by a review of systematic reviews on barriers and facilitating factors to using ICTs in higher education and a systematic review of ICT use during the COVID-19 pandemic in higher education. An ICT integration model and a clustering of ICT integration factors guided the analysis.

RESULTS

The weaknesses and challenges identified relate to the infrastructure and equipment for the use of ICTs in pedagogical situations in face-to-face and distance learning; training of actors, namely the teachers and students; availability of qualified resource persons and adequate and specific financial resources; motivation of teachers; and stage of use of ICTs.

CONCLUSIONS

To promote the use of ICTs in teaching at the NPHS, actions must be performed to strengthen the infrastructure and equipment, human resources, the skills of actors and the motivation of teachers in the pedagogical use of ICTs.