Facilitators and barriers to online group work in higher education within health sciences - a scoping review

INTRODUCTION

In health education, group work is essential to prepare students for working in health care and medical teams. Following the widespread adoption of online teaching, group work increasingly takes place in online environments. Although successful group work can provide good learning outcomes, it is unclear what facilitates or hinders online group work in health science education, and to what extent this topic has been addressed. Thus, this scoping review aimed to identify the facilitators and barriers to online group work in higher health education, provide an overview of the scientific literature related to the topic, and identify knowledge gaps in the research.

METHODS

This scoping review was guided by the methodological framework described by Arksey and O'Malley, and reporting is in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR). Eight online databases were searched for scientific articles published between 2012 and 2022. At least two researchers independently screened records and full-text articles and charted data including article characteristics and key information related to the research question. Findings were categorized and summarized based on the Community of Inquiry Framework.

RESULTS

After screening 3671 records and 466 full-text articles, 39 articles met the inclusion criteria. The review revealed smaller group size, consistency in group composition and joint responsibility to be facilitators. Challenges with group communication, scheduling synchronous meetings and technical issues were identified as barriers. Our findings supported the importance of all three elements of the Community of Inquiry Framework: social, cognitive, and teaching presence.

CONCLUSION

This review provides an overview of facilitators and barriers to online group work in health science education. However, there is a need for further investigation of these factors and studies addressing this topic from the teachers' perspective.

E-learning in transfusion medicine: An exploratory qualitative assessment

BACKGROUND AND OBJECTIVES

E-learning programmes are increasingly offered in transfusion medicine (TM) education. The aim of this study was to explore facilitators and barriers to TM e-learning programmes, including assessment of learning outcomes and measures of effectiveness.

MATERIALS AND METHODS

Participants selected from a prior survey and representing a diverse number of international e-learning programmes were invited to participate. A mixed methodology was employed, combining a survey and individual semi-structured one-on-one interviews. Interview data were analysed inductively to explore programme development, evaluation, and facilitators and barriers to implementation.

RESULTS

Fourteen participants representing 13 institutions participated in the survey and 10 were interviewed. The e-learning programmes have been in use for a variable duration between 5 and 16 years. Funding sources varied, including government and institutional support. Learner assessment methods varied and encompassed multiple-choice-questions (n = 12), direct observation (n = 4) and competency assessment (n = 4). Most regional and national blood collection agencies rely on user feedback and short-term learning assessments to evaluate their programmes. Only one respondent indicated an attempt to correlate e-learning with clinical practices. Factors that facilitated programme implementation included support from management and external audits to ensure compliance with regulatory educational and training requirements. Barriers to programme implementation included the allocation of staff time for in-house development, enforcing compliance, keeping educational content up-to-date and gaining access to outcome data for educational providers.

CONCLUSION

There is evidence of considerable diversity in the evaluation of e-learning programmes. Further work is needed to understand the ultimate impact of TM e-learning on transfusion practices and patient outcomes.

The BIORES-21 Survey: Insights Into Remote and Online Education in Biomechanics and Mechanobiology

The COVID-19 pandemic necessitated mainstream adoption of online and remote learning approaches, which were highly advantageous yet challenging in many ways. The online modality, while teaching biomedical engineering-related topics in the areas of biomechanics, mechanobiology, and biomedical sciences, further added to the complexity faced by the faculty and students. Both the benefits and the challenges have not been explored systematically by juxtaposing experiences and reflections of both the faculty and students. Motivated by this need, we designed and conducted a systematic survey named BIORES-21, targeted toward the broader bio-engineering community. Survey responses and our inferences from survey findings cumulatively offer insight into the role of employed teaching/learning technology and challenges associated with student engagement. Survey data also provided insights on what worked and what did not, potential avenues to address some underlying challenges, and key beneficial aspects such as integration of technology and their role in improving remote teaching/learning experiences. Overall, the data presented summarize the key benefits and challenges of online learning that emerged from the experiences during the pandemic, which is valuable for the continuation of online learning techniques as in-person education operations resumed broadly across institutions, and some form of online learning seems likely to sustain and grow in the near future.

Implementation of virtual academic detailing in North America: A qualitative study

RATIONALE

The shift toward virtual academic detailing (AD) was accelerated by the COVID-19 pandemic.

AIMS AND OBJECTIVES

We aimed to examine the role of external, contextual, and intrinsic programme-specific factors in virtual engagement of healthcare providers (HCPs) and delivery of AD.

METHODS

AD groups throughout North America were contacted to participate in semistructured interviews. An interview guide was constructed by adapting the Consolidated Framework for Implementation Research (CFIR). A point of emphasis included strategies AD groups employed for provider engagement while implementing virtual AD programmes. Independent coders conducted qualitative analysis using the framework method.

RESULTS

Fifteen AD groups from Canada (n = 3) and the United States (n = 12) participated. Technological issues and training detailers and HCPs were challenges during the transition to virtual AD visits. Restrictions on in-person activities during the pandemic created difficulties engaging HCPs and fewer AD visits. Continuing education was one strategy to incentivize participation, but credits were often not claimed by HCPs. Groups with established networks and prior experience with virtual AD leveraged connections to mitigate disruptions and continue AD visits. Other facilitators included emphasizing contemporary topics, including opioid education beyond fundamental guidelines. Virtual AD had the additional benefit of expanding geographic reach and flexible scheduling with providers.

CONCLUSIONS

AD groups across North America have shifted to virtual outreach and delivery strategies. This trend toward virtual AD may aid outreach to vulnerable rural communities, improving health equity. More research is needed on the effectiveness of virtual AD and its future implications.

Hidradenitis Suppurativa Online Documents Readability: An Analysis Including 23 European Languages

Purpose

Hidradenitis suppurativa (HS) is a complex disease with the vast burden to patients. The aim of the study was to evaluate readability of online electronic materials dedicated to HS.

Patients and Methods

The terms "hidradenitis suppurativa" and "acne inversa" translated into 23 official European Union languages were searched with Google. For each language, first 50 results were assessed for suitability. Included materials were focused on patient's education, had no barriers and were not advertisements. If both terms generated the same results, duplicated materials were excluded from the analysis. Origin of the article was categorized into non-profit, online-shop, dermatology clinic or pharmaceutical company class. Readability was evaluated with Lix score.

Results

A total of 458 articles in 22 languages were evaluated. The overall mean Lix score was 57 ± 9. This classified included articles as very hard to comprehend. Across all included languages significant differences in Lix score were revealed (P < 0.001). No significant differences across all origin categories and Lix scores were observed (all P > 0.05).

Conclusion

Despite the coverage of HS on the Internet, its complexity made it hard to comprehend. Dermatologist should ensure readable, barrier-free online educational materials. With adequate Google promotion, these would be beneficial for both physicians and patients.

Investigating the impact of remote neuroanatomy education during the COVID-19 pandemic using online examination performance in a National Undergraduate Neuroanatomy Competition

Neuroanatomy is a notoriously challenging subject for medical students to learn. Due to the coronavirus disease-19 (COVID-19) pandemic, anatomical education transitioned to an online format. We assessed student performance in, and attitudes toward, an online neuroanatomy assessment compared to an in-person equivalent, as a marker of the efficacy of remote neuroanatomy education. Participants in the National Undergraduate Neuroanatomy Competition (NUNC) 2021 undertook two online examinations: a neuroanatomically themed multiple-choice question paper and anatomy spotter. Students completed pre- and post-examination questionnaires to gauge their attitudes toward the online competition and prior experience of online anatomical teaching/assessment. To evaluate performance, we compared scores of students who sat the online (2021) and in-person (2017) examinations, using 12 identical neuroradiology questions present in both years. Forty-six percent of NUNC 2021 participants had taken an online anatomy examination in the previous 12 months, but this did not impact examination performance significantly (p > 0.05). There was no significant difference in examination scores between in-person and online examinations using the 12 neuroradiology questions (p = 0.69). Fifty percent of participants found the online format less enjoyable, with 63% citing significantly fewer networking opportunities. The online competition was less stressful for 55% of participants. This study provides some evidence to suggest that student performance is not affected when undertaking online examinations and proposes that online neuroanatomy teaching methods, particularly for neuroradiology, may be equally as effective as in-person approaches within this context. Participants perceived online examinations as less stressful but raised concerns surrounding the networking potential and enjoyment of online events.

Exploring Physical Education Teachers' Intention and Perceived Constraints in Offering Online Lessons Using the Theory of Planned Behavior: A Multi-Country Analysis

Guided by the theory of planned behavior, this study aimed to determine the influence of Physical Education (PE) teachers' attitudes, their perceived behavioral control, and the influence of subjective norms on their intention and constraints (intrapersonal, interpersonal, and structural) to offer a high-quality class based on best practices to deliver PE lessons online during the COVID-19 pandemic. This cross-sectional, multi-country survey study recruited PE teachers from five countries (China, Malaysia, the Philippines, Turkey, and the United States). A total of 928 online questionnaires were used in the analysis. In terms of the overall intention to teach online, our findings showed that American and Filipino teachers had higher levels of intention to continue teaching online. In contrast, Turkish, Malaysian, and Chinese teachers showed a lower interest. Moreover, Malaysian teachers had more intrapersonal constraints while the teachers in the other four countries were not as restrained intrapersonally. The results highlight the significant influence of perceived behavioral control and attitudes on PE teachers' intention to deliver online courses. Constraints to online teaching had a considerably large negative impact on attitudes, subjective norms, and perceived behavioral control. Based on the results, the proposed extension to the theory of planned behavior was an appropriate framework for understanding the behavioral intent of PE teachers.

Online Educational Resources for Youth Living With Type 1 Diabetes Transitioning to Adult Care: An Environmental Scan of Canadian Content

OBJECTIVES

There are many educational resources for adolescents and young adults living with type 1 diabetes; however, it is unknown whether they address the breadth of topics related to transition to adult care. Our aim in this study was to collect educational resources relevant to Canadian youth and assess their quality and comprehensiveness in addressing the knowledge necessary for youth to prepare for interdependent management of their diabetes.

METHODS

We conducted an environmental scan, a systematic assessment and analysis, of online education resources in English and French relevant to Canadian youth living with type 1 diabetes. Resources were screened using an open education resource evaluation grid and relevant resources were mapped to the Readiness for Emerging Adults with Diabetes Diagnosed in Youth, a validated diabetes transition readiness assessment tool.

RESULTS

From 44 different sources, 1,245 resources were identified and, of these, 760 were retained for analysis. The majority were webpages (50.1%) and downloadable PDFs (42.4%), and 12.1% were interactive. Most resources covered Diabetes Knowledge (46.0%), Health Behaviour (23.8%), Insulin and Insulin Pump Management (11.8% and 8.6%, respectively), and Health-care System Navigation (9.7%). Topic areas with the fewest resources were disability accommodations (n=5), sexual health/function (n=4), and locating trustworthy diabetes resources (n=3).

CONCLUSIONS

There are many resources available for those living with type 1 diabetes preparing to transition to adult care, with the majority pertaining to diabetes knowledge and the least for navigation of the health system. Few resources were available on the topics of substance use, sexual health, and reproductive health. An interactive presentation of these resources, as well as a central repository to house these resources, would improve access for youth and diabetes care providers during transition preparation.

Elevated perceived stress in university students due to the COVID-19 pandemic: Potential contributing factors in a propensity-score-matched sample

OBJECTIVE

Onset of the Coronavirus Disease 2019 (COVID) pandemic has increased students' perceived burdens. The current study aimed to examine COVID-related changes and to identify potential factors that contribute to students' stress.

METHOD

Adopting a cross-sectional cohort-study design, we examined perceived stress and depressive and anxiety symptoms with a specific focus on the role of study-related variables such as perceived study-related demands, study-related resources, academic procrastination, and stress-enhancing beliefs. Two cohorts (Npre-COVID  = 2,175; NCOVID  = 959) were recruited at the same university and matched with regard to their propensity score (age, gender, semester).

RESULTS

Compared with the pre-COVID cohort, university students in the COVID cohort reported more perceived stress, more depressive and anxiety symptoms, more academic procrastination due to fear of failure, more stress-enhancing beliefs, more distress due to the housing situation, and more perceived study-related challenges (Cohen's d = 0.15-0.45). A stepwise regression analysis identified depressive symptoms, procrastination due to fear of failure, general self-efficacy, increased study demands, perceived difficulties with self-organized learning, distress due to housing, and stress-enhancing beliefs as predictors of perceived stress in the COVID cohort.

DISCUSSION

Findings suggest that the switch to online-only education increased the study-related burden for students, primarily due to exams being replaced by a greater amount of regular coursework and imposing demands on self-organized learning. Possibly, stress-enhancing beliefs and procrastination due to fear of failure might have been elevated due to less opportunity for social referencing and lack of felt social support by peer students.

CONCLUSION

Experienced increased burden in students during the COVID pandemic was mostly accounted for by a lack of perceived individual resources rather than by an increase in objective study-related demands.

Online teaching experience of the healthcare faculty during the pandemic: A cross sectional analysis

BACKGROUND

COVID-19 pandemic had disrupted the teaching in most of the educational institutes worldwide. It has tested the readiness of educational institutes in their ability to deal with crisis.

OBJECTIVE

This study aimed to determine the perception of health sciences faculty toward online education during the period of pandemic in Pakistan.

METHODS

This cross-sectional research determined the perception using online survey which had been taken from the study conducted by Almahasees et al. Questions related to faculty's perception regarding IT skills, online classes taking more effort than on-campus learning, online platforms having adequate tools to facilitate teaching. Data was analyzed using SPSS. Statistical tests comprised of descriptive statistics and Kruskal-Walli's test.

RESULTS

From a total of 318 participants, there were 234 females and 84 males. A statistically significant association was identified between field of specialization and competency to teach online (p = 0.022). Faculty stated that more efforts were required to teach online (p <  0.001). Most of the tutors reported virtual sessions helped improved the interaction with their students (p <  0.001). Most of the time faculty had to prompt students to complete their assignments on time (p <  0.001). Many of the faculty members disagreed that delivering virtual sessions from home was quite ineffective (p = 0.221) and reported experiencing distractions (p <  0.001).

CONCLUSION

This study showed that online learning proved less effective than face-to-face learning. The main drawback of distance learning was the lack of teacher-student interaction. Online learning promotes student-centered learning and could be applied in situations of crisis like the COVID-19 pandemic.

"From All, To All": Implementing a collaborative online conference to reflect on the daily living of individuals with cerebral palsy

BACKGROUND

Translating knowledge to improve paediatric rehabilitation has become a research area of interest. This study describes the development and evaluation of an online conference that brought together perspectives of individuals with cerebral palsy (CP), families, health care professionals, and researchers to discuss the daily living of individuals with CP.

METHODS

We anchored the development and implementation of the online conference in the action cycle of the Knowledge to Action Framework. To develop the meeting, we included representatives from each stakeholder group in the programme committee. The conference programme was designed having the lifespan perspective of individuals with CP, from birth to adulthood, as its central core, with themes related to daily living (e.g., self-care, mobility, and continuing education). Participants' satisfaction with the conference was assessed using an anonymized online survey sent to all participants.

RESULTS

The conference had 1656 attendees, of whom 675 answered the online satisfaction survey. Most participants rated the structure of the conference (i.e., quality of the technical support, audio and video, and online platform) and discussed topics (i.e., relevance, content, discussion, speakers, and available time) positively.

CONCLUSION

Collaborative conferences that include stakeholders throughout the planning and implementation are a viable, effective knowledge translation strategy that allows for sharing experiences and disseminating knowledge among families and individuals with CP, health care professionals, and researchers.

Cognitive Flexibility's Role in Reducing Academic Stress During the COVID-19 Pandemic

Background

Cognitive flexibility (CF) in the psychological literature has been described as an individual's ability to produce several solutions and retain control in novel situations. Recently, the COVID-19 pandemic appeared to be an ideal scenario that demanded the application of adaptive thinking by students to deal with several challenges of the pandemic.

Aim

This study aimed to assess the role of CF in reducing academic stress among university students due to the sudden and strict implementation of online education during the COVID-19 pandemic.

Methods

This study employed a cross-sectional survey design and data collection was completed during the 2020-2021 academic year. The study sample comprised 328 university students from Saudi Arabia. The online survey method was used, and study tools comprises of reliable and valid psychological measures to assess CF, academic stress, the negative impact of the COVID-19 pandemic, and emotional symptoms. IBMSPSS25 was used for statistical analysis of data. Multiple regression analysis was applied to determine the role of CF in reducing academic stress after controlling for other factors such as gender, age, academic year, negative impact of COVID-19 on daily life, and unpleasant emotional experiences.

Results

CF was significantly decreased the risk of experiencing academic stress (b = ‒0.196, t = ‒3.54; p < 0.001; 95% CI = ‒3.53 to ‒0.11) after controlling for the negative impact of the COVID-19 pandemic on daily life (b = 0.119, t = 2.09; p < 0.05; 95% CI = 0.02-0.63) and emotional repercussions (b = 0.109, t = 1.91; p < 0.05; 95% CI = ‒0.01-0.15).

Conclusion

The current findings suggest that CF could be fostered among university students as a useful mental tool to cope with academic stress during less-structured educational and social circumstances that may impact their daily lives and emotional wellness.

Knowledge of Pre- and Postexposure Prophylaxis for HIV Prevention Among Internal Medicine Residents in the United States

Prescription rates of pre-exposure prophylaxis (PrEP) have remained low among noninfectious disease providers in the United States despite almost a decade since their introduction. For future primary care doctors, residency is the optimal time to build practice patterns around HIV prevention. We assessed baseline knowledge of PrEP in specific pre- and post-exposure prophylaxis content areas among internal medicine trainees who completed the Physician Education and Assessment Center HIV learning module between 2013 to 2020 (N = 12,060). Resident baseline PrEP knowledge was universally low; despite rising awareness of antiretroviral therapy for PrEP in successive years following the nadir of 41% in 2014, still only 56% of residents affirmed this means of HIV prevention by 2020. Knowledge remained limited regardless of academic year, local HIV prevalence, or training program type. Online module completion increased competence across all content areas. There is still a deficit in HIV prevention knowledge across U.S. internal medicine residents, suggesting insufficient education and exposure to HIV-related care.

Effectiveness of Online vs. In-Person Periodontal Health Workshops for Public Awareness

Background

Periodontal health is a critical aspect of overall oral health, yet public awareness and education on this topic remain limited. With the increasing prevalence of online health education platforms, it is essential to evaluate the effectiveness of online periodontal health workshops compared with traditional in-person workshops on improving public awareness.

Materials and Methods

Study Design: This randomized controlled trial (RCT) aimed to assess the impact of online and in-person periodontal health workshops on public awareness. Participants (N = 500) were randomly assigned to one of two groups: the online workshop group or the in-person workshop group. Online Workshop: Participants in this group accessed an interactive online periodontal health workshop, consisting of video presentations, animations, and quizzes. The workshop covered topics, such as gum disease prevention, oral hygiene, and the importance of regular dental checkups. In-Person Workshop: Participants in this group attended a traditional in-person periodontal health workshop conducted by dental professionals. The content and duration of this workshop mirrored the online version. Pre- and Postworkshop Assessments: Both groups completed pre-workshop and postworkshop assessments, including a knowledge questionnaire and a self-assessment of oral health habits. Arbitrary scores were assigned to quantify knowledge gain (0-100%).

Results

Participants in the online workshop group showed a mean knowledge gain of 30% (standard deviation (SD) = 5.2), while those in the in-person workshop group exhibited a mean knowledge gain of 35% (SD = 4.7). The self-assessment of oral health habits indicated an improvement in both groups, with 60% of participants reporting better oral hygiene practices.

Conclusion

Both online and in-person periodontal health workshops demonstrated effectiveness in improving public awareness and promoting better oral health habits. Combining both modalities could be an effective strategy for comprehensive public education on periodontal health.

Assessment of the Psychometric Properties of the Online Education Student Satisfaction Scale: A Methodological Study

Background and Purpose: Assessing student satisfaction is essential in evaluating the quality of education. The number of valid and reliable tools that measure students' satisfaction with online education is limited. This methodological study aimed to assess the psychometric properties of the online education student satisfaction scale. Methods: Eleven academicians from the nursing field provided expert opinions on content validity. Separate 25 students evaluated the language clarity of the draft scale. The study sample included 525 third- and fourth-year nursing students. Finally, a group of 30 nursing students different from the sample participated in the test-retest. The study created an item pool based on the recent literature. The researchers calculated the items' content validity rates and the scale's content validity index by taking the experts' opinions. In addition, item-total score correlation analysis, exploratory factor analysis, discrimination analysis, stability test, and internal consistency analysis were performed. Results: An item with a low-correlation value was excluded from the scale. The correlation coefficients of the remained items were between .536 and .811. In the second round of exploratory factor analysis, a five-factor structure emerged that explained 72.1% of the total variance. In addition, item discrimination, stability, and internal consistency test results ensured that the scale was valid and reliable. Conclusions: The online education student satisfaction scale with five subdimensions containing 28 items is a valid and reliable tool. Researchers, educators, and managers may use it to evaluate students' satisfaction with online education.

Sexual counseling for female sexual interest/arousal disorders: a randomized controlled trial based on the "good enough sex" model

BACKGROUND

Female sexual interest/arousal disorder (FSIAD) is the most common female sexual disorder with adverse effects on women's health and interpersonal relationships.

AIM

This survey evaluated the effects of sexual counseling based on the "good enough sex" (GES) model on the sexual health variables of women with FSIAD.

METHODS

A randomized clinical trial with a 1:1 allocation ratio was conducted among 80 women with FSIAD in Iran in 2021. Eligible participants were randomly assigned to group A (women) and group B (couples). Women attended 4 weekly online group sexual counseling sessions based on the GES model, each lasting 120 minutes. In group B, husbands participated in sessions 2 and 3.

OUTCOMES

Women's sexual health parameters-including sexual desire, sexual satisfaction, sexual function, sexual distress, sexual communication, frequency of sexual intercourse, and dysfunctional beliefs-were evaluated before and 3 months after counseling. The significance threshold considered P < .007 due to Bonferroni correction.

RESULTS

After the intervention, all sexual parameters except sexual dysfunctional beliefs showed significant improvement (P < .001) in both groups. During the follow-up period, the average scores for all sexual variables were slightly higher in group B vs group A. The between-group difference was significant only for frequency of sexual intercourse (P < .01).

CLINICAL IMPLICATIONS

This study reaffirms the impact of the GES model as biopsychosocial therapy in managing female sexual problems. Considering men's reluctance to accompany their wives to sex clinics, counseling for women alone can play a significant role in solving sexual problems, especially in the case of FSIAD. Online sexual consultation offers cost and time savings, provides a secure space for discussing sensitive topics, and facilitates group program coordination. It ensures universal access to counseling, thereby addressing gender incompatibility issues. It is a powerful, interactive, and acceptable alternative to in-person visits, providing convenience and confidentiality for clients seeking sexual health support.

STRENGTHS AND LIMITATIONS

The following were among the survey strengths: conducting a randomized controlled trial on women with FSIAD by applying an appropriate model and scales, involving spouses, and evaluating online group sexual counseling. However, the results of this study may not be generalizable to women without partners.

CONCLUSION

The GES model, emphasizing intimacy and sexual dialogue, reduces unrealistic sexual expectations and improves women's sexual desire and overall health. Our results showed that instead of insisting on the physical presence of husbands in counseling sessions, clinicians should emphasize their emotional support and companionship during the treatment process.

Comprehensive Sexual Health Educational Learning Modules for College Students

Sexual health education in the United States continues to be a controversial topic of discussion with no federal regulations. Due to this, the sex education students receive before college varies greatly. Our team discovered that no mandatory, comprehensive sexual health education is required for students once they enter the California State University system. At Cal Poly specifically, it was found that students were engaging in risky sexual behaviors. For example, the 2021 American College Health Association-National College Health Assessment III Fall 2021 Data Report revealed that less than half (42.1%) of students reported regularly using condoms during vaginal sex, and a mere 5.1% of students reported barrier method use during oral sex. To fill in the noticed gaps in our students' sexual health education, our team developed a set of 10 comprehensive sexual health educational learning modules. The modules cover topics ranging from condom use and STIs to pleasure, porn literacy, and having difficult conversations with a partner. This anonymous online resource provides students with easy-to-read written material and engaging graphics. Future research will focus on user engagement and the effect of the resource on sexual health best practices across our campus.

Face-to-face and e-learning during the COVID-19 pandemic: A Pakistani dental undergraduates perspective

BACKGROUND

Globally, educational institutes have been obliged to make a quick transition from traditional face-to-face teaching to e-learning during the coronavirus disease 2019 (COVID-19) pandemic, which has purportedly created various barriers to achieving desired learning outcomes.

OBJECTIVE

The aim of our study was to assess the perceptions of undergraduate dental students regarding online and physical learning in Pakistan.

METHODS

This cross-sectional study was conducted from January to March 2022. The study comprised dental students from 1st to 4th years who were above the age of 18 and of either gender. The Google Forms questionnaire was created to evaluate the quality and efficiency of online and physical learning among dentistry undergraduates.

RESULTS

In a survey of 246 students, 70.3% strongly agreed that they would prefer face-to-face instruction over e-learning. There was a statistically significant difference in the improvement of students' technical skills (p = 0.01), accessibility to instructors (p = 0.01) and classmates (p = 0.02), value of technology (p = 0.03), improvement of oral communication skills (p = 0.01), promotion of hybrid model learning after the pandemic (p = 0.01), and utilization of tutorial services (p = 0.04) between different year of study.

CONCLUSION

Pakistani dental students indicated satisfaction with numerous aspects of e-learning, such as technical skills, accessibility to instructors and classmates, the value of technology, improvement of oral communication skills, promotion of hybrid model learning, and utilization of tutorial services compared to face-to-face education concerning the year of study.

Applied distance learning methods in disaster preparedness: A systematic review

Nowadays, accidents and disasters are one of the most important issues facing humans. Training is an important feature in disasters and distance learning is a suitable method for education in every place and at every time. The aim of this study is to determine distance learning methods in disaster preparedness. This study was conducted to this question: what types of distance learning methods can use in disaster preparedness?". In this study, all published English language papers, with no time limit, were extracted by the end of December 2021 through search in PubMed, Scopus, Google scholar, ISI WOS (Web of Science), and Embase. The primary search used "distance learning", "disaster" and their MeSH terms. Quality appraisal carried out with CASP. Information in the articles including study time, study population, e-learning methods, and type of disasters or emergencies were extracted. Based on the search, 46 studies were carried out between 2002 and 2021. The most studied target group in the studies was health professionals and the content of the courses was attributed to disaster preparedness as well as biological disasters. Regarding e-learning methods, the most used method was 'simulation'. At the time of disasters, including pandemics, disruption in education may be long-term and may require overlapping response and recovery periods. And virtual education during a disaster may be rejected or endorsed by individuals or groups based on cultural, ideological, or prejudicial issues. Distance education can be used for effective disaster education in different phases of the disaster cycle, depending on the available facilities and infrastructure.

Factors influencing college teachers' adoption of live online teaching: a conditional process model of technology acceptance, user satisfaction and privacy concerns

Purpose

In recent times, live online teaching has emerged as a prominent trend in online education. However, teachers are confronted with the challenge of not only acquainting themselves with the associated technologies but also effectively integrating them into their teaching practices. This dual challenge exerts pressure on teachers to adopt live online teaching. This study aims to explore the factors and mechanisms influencing teachers' attitudes and continuance intention toward live online teaching. It covers both intrinsic and extrinsic motivations, as well as both enabling and inhibiting factors, thus providing valuable suggestions for encouraging teachers to engage in live online teaching actively.

Method

This study proposed a conceptual model based on the Technology Acceptance Model, Uses and Gratifications Theory, and Communication Privacy Management Theory. A simple random sampling method was employed to recruit participants from a university in eastern China. With 224 college teachers participating in the study, various analyses, including descriptive analysis, regression analysis, and simple slope analysis, were conducted to explore the factors and mechanisms influencing college teachers' adoption of live online teaching.

Results

The study revealed the following key findings: (a) perceived easy of use had a positive impact on perceived usefulness and user satisfaction; (b) perceived usefulness had a positive effect on user satisfaction; (c) both perceived usefulness and user satisfaction positively influenced teachers' adoption of live online teaching; (d) perceived easy of use did not directly affect teachers' adoption of live online teaching; (e) privacy concerns exhibited a moderated effect on the relationship between perceived easy of use and perceived usefulness, as well as the relationship between perceived easy of use and user satisfaction.

Conclusion

The study reveals a conditional process model elucidating teachers' adoption of live online learning. The model incorporates perceived ease of use as a predictor, perceived usefulness and user satisfaction as two mediators, and private concerns as a moderator. The findings suggest that stakeholders should collaborate closely to enhance the design and development of the live online teaching platforms. Additionally, efforts should be made to support and improve teachers' information literacy, fostering their enthusiasm and facilitating their professional development in live online teaching practice.

Evaluating an online module for sexual violence prevention in a tertiary educational setting: An exploratory study

ISSUE ADDRESSED

Sexual violence is an important public health issue affecting significant numbers of university students across Australia and internationally. In response, online modules have been widely implemented and there is an urgent need to better understand their effectiveness. The aim of this study was to evaluate an online sexual violence prevention and response education module designed for and implemented in one Australian university.

METHODS

We used a mixed-methods approach that included pre/post module completion surveys of key measures relating to sexual consent, being a bystander, and response to disclosures as well as knowledge of resources and support services. We conducted post module completion semi-structured interviews.

RESULTS

Results indicated potential effectiveness of the module on beliefs about sexual consent, confidence intervening when witnessing potentially harmful situations, willingness to report incidents, confidence supporting a peer who discloses an incident, and knowledge of support services. Qualitative results indicated support for the online module as an accessible, private and self-paced tool for sexual violence education. Interactive, relevant and engaging content that can be applied in real-life contexts was noted as key for effectiveness.

CONCLUSIONS

This exploratory study suggests there may be potential for online modules to be effective, as one aspect of universities' sexual violence prevention and response strategies-particularly modules aimed at addressing primary, secondary and tertiary prevention. Further rigorous research is required to strengthen best practice in the development and implementation of online modules as part of whole-of-campus strategies. SO WHAT?: Universities across Australia and internationally are grappling with sexual violence response and prevention in light of high prevalence rates among students. Online modules may be one effective tool when implemented as part of a wider strategy.

Online learning in health professions education. Part 2: Tools and practical application: AMEE Guide No. 163

Part 1 of the AMEE Guide Online learning in health professions education focused on foundational concepts such as theory, methods, and instructional design in online learning. Part 2 builds upon Part 1, introducing technology tools and applications of these foundational concepts by exploring the various levels (from beginner to advanced) of utilisation, while describing how their usage can transform Health Professions Education. This Part covers Learning Management Systems, infographics, podcasting, videos, websites, social media, online discussion forums, simulation, virtual patients, extended and virtual reality. Intertwined are other topics, such as online small group teaching, game-based learning, FOAM, online social and collaboration learning, and virtual care teaching. We end by discussing digital scholarship and emerging technologies. Combined with Part 1, the overall aim of Part 2 is to produce a comprehensive overview to help guide effective use online learning in Health Professions Education.

Online learning in Health Professions Education. Part 1: Teaching and learning in online environments: AMEE Guide No. 161

Online learning in Health Professions Education (HPE) has been evolving over decades, but COVID-19 changed its use abruptly. Technology allowed necessary HPE during COVID-19, but also demonstrated that many HP educators and learners had little knowledge and experience of these complex sociotechnical environments. Due to the educational benefits and flexibility that technology can afford, many higher education experts agree that online learning will continue and evolve long after COVID-19. As HP educators stand at the crossroads of technology integration, it is important that we examine the evidence, theories, advantages/disadvantages, and pedagogically informed design of online learning. This Guide will provide foundational concepts and practical strategies to support HPE educators and institutions toward advancing pedagogically informed use of online HPE. This Guide consists of two parts. The first part will provide an overview of evidence, theories, formats, and educational design in online learning, including contemporary issues and considerations such as learner engagement, faculty development, inclusivity, accessibility, copyright, and privacy. The second part (to be published as a separate Guide) focuses on specific technology tool types with practical examples for implementation and integration of the concepts discussed in Guide 1, and will include digital scholarship, learning analytics, and emerging technologies. In sum, both guides should be read together, as Guide 1 provides the foundation required for the practical application of technology showcased in Guide 2.Please refer to the video abstract for Part 1 of this Guide at https://bit.ly/AMEEGuideOnlineLearning.

The Relationship Between Using Smartphones andText Neck Syndrome in Online Learning Among University Students in Jordan: A Survey Study

BACKGROUND

The use of online learning methods has expanded considerably in many countries since the declaration of COVID-19 as a global pandemic by the World Health Organization. Smartphones are widely used for voice and text messaging, checking emails, and distance learning. The aim of this study was to investigate the relationship between using smartphones and text neck syndrome.

MATERIAL AND METHODS

A cross-sectional study was conducted among university students in Jordan between February and March 2023. All undergraduate students were invited to participate. A self-administered online (Google forms) questionnaire was distributed by posting the link to the questionnaire on students' groups through social media websites such as Facebook, Twitter, and WhatsApp.

RESULTS

A total of 171 students responded to the survey. The participants included 103 (60%) females and 68 (40%) males. Approximately 79% of the participants were less than 22 years old. Almost half of the participants reported pain at neck (54%) and shoulder (51%), while about 61% of participants suffered from upper back pain.

CONCLUSIONS

1. Smartphones are widely becoming essential in educational technology, and more concern should be expended to increase the awareness about optimal and healthy usage of smartphones by restricting usage duration in order to reduce neck and shoulder pain and associated poor functioning in daily living activities. 2. Poor patterns of smartphone use increase the likelihood of neck pain. 3. Neck movement limitations are not associated with age or gender. 4. Students who did not report limitation in neck movement were less likely to have difficulty with reading.

Sleep Quality and Perceived Stress among Health Science Students during Online Education-A Single Institution Study

Recently, online education has been gaining prominence in university life. Our survey aimed to examine sleep quality and perceived stress levels among students at the University of Pécs Faculty of Health Sciences. A cross-sectional, quantitative, descriptive survey was conducted between February and March 2023. The online survey included the Hungarian versions of the internationally validated Athens Insomnia Scale (AIS) and Perceived Stress Scale (PSS). Statistical analysis involved descriptive statistics, independent t-tests, analysis of variance (ANOVA), and Mann-Whitney and Kruskal-Wallis tests (p < 0.05). We analyzed 304 responses, and females dominated (n = 270; 88.8%). Students in a relationship had significantly higher AIS scores (t = -2.470; p = 0.014). Medium average (2.50-3.49) students and those who rarely/never exercise showed significantly higher AIS and PSS (p ≤ 0.05). Students on the phone/watching a series during online education, daily laptop/TV use for more than 2 h, and pre-sleep use of smart devices for more than 60 min also negatively affected AIS and PSS scores (p ≤ 0.05). Nursing, physiotherapy, and radiography students were the most affected regarding insomnia and perceived stress (p ≤ 0.05). Our survey shows that excessive smart device use and lack of exercise are associated with higher stress levels and poorer sleep quality.

Exploring the cultivation of psychological resilience in medical students from the perspective of doctor-patient relationship

The current medical model has transitioned from the original biomedical treatment model to a bio-psycho-social model, where patients now have higher demands for service awareness. Consequently, doctor-patient relationships have become a crucial aspect of the contemporary medical process. Currently, psychological resilience among medical students in China tends to be at a moderately lower level. Medical students often exhibit poor psychological qualities in handling contradictions in doctor-patient relationships. Moreover, there is a lack of emphasis on the education of corresponding psychological qualities for medical students during the teaching process. This deficiency is highly disadvantageous for medical students in their future management of doctor-patient relationships. The article explores how to cultivate psychological resilience in medical students and enhance their ability to handle conflicts in doctor-patient relationships from the perspective of doctor-patient relationships. The author suggests that schools should place greater emphasis on the psychological resilience of medical students, change teaching methods, incorporate online education to enhance the mentalization level of medical students, and propose an eight-week mindfulness cognitive therapy program to improve psychological resilience. The intervention process should consider establishing positive coping mechanisms, promoting good interpersonal relationships among medical students, and regulating individual negative emotions. Through simulating doctor-patient scenarios, teachers should consciously train the psychological resilience of medical students, improve their cognition and thinking abilities, and accelerate their psychological health recovery.

Online Physiology Practice with Team-Based Learning During the COVID-19 Pandemic

Background

The spread of the coronavirus disease (COVID-19) has significantly affected medical education. In particular, conducting practical training in a face-to-face format has become difficult.

Purpose

To address this problem, online physiology practice combined with team-based learning (TBL) for deep learning of renal physiology was conducted among second-year medical students.

Participants and Methods

The experiment was performed by a group of students, while other students watched online. After the experiment, all students were grouped using breakout rooms. Following a discussion of the data, a clinical case study related to the experiment was conducted using TBL. To examine the effect of online practice in a case study under TBL, the participants completed an anonymous, open-ended, web-based questionnaire after the program, enabling us to compare their expectations and satisfaction. The questionnaire consisted of questions examining students' opinions on the appropriateness of online practice, degree of understanding, ease of asking questions, time efficiency, and the usefulness of case studies using TBL.

Results

There was no change in the number of students who participated in the online practice before and after class. After class, more students considered the level of understanding easier and displayed better on-time efficiency than with regular face-to-face training. However, these questions are difficult to answer.

Conclusion

Online-based physiology practice combined with clinical case studies under TBL helped maintain students' expectations and satisfaction with the training.

Comparative effectiveness study of flipped classroom versus online-only instruction of clinical reasoning for medical students

CONTEXT

Bedside clinical teaching is the backbone of clerkship education. Data-driven methods for supplementing bedside encounters with standardized content from vetted resources are needed.

OBJECTIVE

To compare a flipped-classroom versus an interactive online-only instruction for improving knowledge, skills, self-directed learning (SDL) behaviors, and satisfaction in a medical school clerkship.

METHODS

An IRB-approved prospective study employing a peer-reviewed clinical reasoning curriculum in neurology was conducted; 2nd-4th year medical students rotating through a required clerkship were enrolled. Students were randomized to flipped-classroom (i.e., flipped) or interactive asynchronous online instruction (i.e., online-only), which supplemented existing bedside teaching. Baseline and end-of-course knowledge, skill development, SDL behaviors, satisfaction, and long-term retention were assessed by peer-reviewed clinical reasoning exam, NBME scores, faculty/resident clinical evaluations, non-compulsory assignment completion, end-of-clerkship surveys, and objective structured clinical exam (OSCE).

RESULTS

104 students (49 flipped, 55 online-only) were enrolled. Age, gender, and training level did not differ by group (all p > 0.43); baseline knowledge was higher in the flipped group (p = 0.003). Knowledge-based exam scores did not differ by group even after adjusting for differences in baseline knowledge (2.3-points higher in flipped group, 95%CI -0.4-4.8, p = 0.07). Clinical skills were significantly higher in the flipped group, including examination skills (4.2 ± 0.5 vs. 3.9 ± 0.7, p = 0.03) and future housestaff potential (4.8 ± 0.3 vs 4.5 ± 0.6, p = 0.03). Students in the online-only group were more likely to engage in SDL (42 vs. 12%, p = 0.001) and reported more hours studying (6.1 vs. 3.8 hours, p = 0.03). Satisfaction (p = 0.51) and OSCE scores (p = 0.28) were not different by group.

CONCLUSIONS

In this comparative study of two evidence-based curricular delivery approaches, we observed no difference in knowledge acquired. Greater clinical skills were observed with flipped instruction, while more SDL was observed with online-only instruction. Supplementing bedside teaching with blended instruction that balances live skill development with vetted online resources is optimal for clerkship education.

The status of virtual simulation experiments in medical education in China: based on the national virtual simulation experiment teaching Center (iLAB-X)

BACKGROUND

Virtual simulation experiments have been rapidly applied to medical education curricula in recent years. China constructed a national virtual simulation experimental teaching center (iLAB-X), and this platform covered almost all of the virtual simulation experiment curricula of domestic colleges or universities. We aimed to comprehensively assess the characteristics and usages of virtual simulation experiments in medical education based on iLAB-X.

METHODS

A total of 480 virtual simulation experiment courses had been constructed on iLAB-X (https://www.ilab-x.com/) by December 20, 2022, and the curriculum level, type and design were all searched in this platform. We also conducted an evaluation of curriculum usage and online tests, including the page view, frequency of participation, number of participants, duration of experimental learning and passing rate of the experimental test.

RESULTS

The national and provincial high-quality virtual simulation experiment curricula accounted for 33.5% (161/480) and 35.8% (172/480), respectively. The curricula were mainly set as basic practice experiments (46.5%) and synthetic designing experiments (48.8%). Significantly, forensic medicine (100%), public health and preventive medicine (83%) and basic medical sciences (66%) focused on synthetic design experiments. In terms of usage experiments, the average duration of experimental learning was 25 minutes per course, and the average number of participants was just 1257. The average passing (score ≥60) rate of online tests was 80.6%, but the average rate of score ≥ 85 was only 58.5%. In particular, the average page views, the number of participants, the duration of learning and the test passing rate of clinical medicine were relatively low.

CONCLUSIONS

The curriculum design features, construction level and utilization rate varied in different medical majors. Virtual simulation experiments are particularly underutilized in clinical medicine. There is a long way for virtual simulation experiments to go to become a supplement or alternative for traditional medical education in the future.

Undergraduate Student Perceptions of Pharmacy Entrustable Professional Activities

Introduction: With declining applicant numbers, pharmacy education seeks to effectively communicate the value of the pharmacist on the health care team to attract learners to pharmacy. The American Association of Colleges of Pharmacy (AACP) published entrustable professional activities (EPAs) to outline the expected roles and responsibilities of new pharmacy graduates. However, it is unknown whether these statements resonate with the general public and could potentially attract learners to pharmacy. Description of Innovation: Students in PHAR1001: Orientation to Pharmacy, and online undergraduate course were surveyed using EPA statements. The survey was administered to all students before and after the completion of an undergraduate overview of pharmacy course. Participants were to respond "yes" or "no" to statements assessing the relevance of each EPA to pharmacy practice and the expectation of the activity to occur in all pharmacy practice settings. Findings: A total of 283 students participated in the pre-course survey, with 258 students completing the post-course survey. Pre-course, 11 of the 15 EPA statements had a high level of agreement (>80%) for relevance to practice. The high level of agreement continued in the post-course survey with five EPA statements exhibiting a significant increase in both the relevance and expectation of the role in pharmacy practice. Conclusions: Most students, regardless of prior knowledge of pharmacy, found the EPAs illustrative of pharmacist activities even prior to completing the pharmacy course. Entrustable professional activity statements may be a reasonable means to communicate the value of the pharmacist to the general public.

Computer-aided drug design course for pharmacy major students in Shenyang Pharmaceutical University following the COVID-19 pandemic: Challenges and opportunities

The computer-aided drug design (CADD) course that spans biochemistry, computational chemistry, medicinal chemistry, and other cutting-edge sciences is considered an important course by pharmaceutical universities in China. The course teaches students how drugs bind to protein targets and exert their biological activities using computer tools, and covers the basic principles of drug development and optimization. Due to the lockdown and social distancing measures adopted during the coronavirus disease 2019 (COVID-19) pandemic, the CADD course in Shenyang Pharmaceutical University was briefly suspended. Thereafter, it was taught in the online mode by adopting a novel blended teaching method. Through a questionnaire survey and final report assessment, we found that blended teaching might provide an opportunity to stimulate greater motivation and interest in students as well as improve teaching effectiveness and learning outcomes of the course. This study describes how we conducted the CADD course during the COVID-19 period with the intention of providing a reference for other teachers to conduct similar courses.

Impact of COVID-19 on Academic and Psychological Aspects in Students of Medicine: A Cross-Sectional Study

Background The COVID-19 pandemic has caused a devastating disruption in medical education worldwide. The influence on training, mainly for undergraduate MBBS pupils, has been noteworthy, especially the significant and unexpected shift to online learning. Materials and methods We performed a two-month, cross-sectional study from June to August 2022 at Kasturba Medical College in Mangalore, India. The study participants were second- and third-year MBBS students at Kasturba Medical College. The sample size was 319. We collected data using a pre-structured, validated, printed questionnaire, then coded and entered the data into SPSS Statistics for Windows, version 25.0, for interpretation. Results A total of 319 people took part in the study. Of these, 60.2% were females, 39.4% were males, 71.8% were from the batch of 2019-2020, and the remaining 28.2% were from the batch of 2018-2019. Among the participants, 90 students suffered from COVID-19, including 72.7% (n = 65) from the second year. Twenty-four percent of the population did not contract COVID-19, including 88 from the second year. A total of 153 participants were unsure whether they were infected with COVID-19, including 57.5% from the second year and 42.5% from the third year. The study group's p-value of <0.0001 is statistically significant. On multivariate analysis, 54.5% of the study participants said the pandemic caused a significant disruption to their medical education. A majority of students (51.7%) agreed that the pandemic hampered practical/clinical work; 42.9% of participants somewhat disagreed that the pandemic hampered their interest in pursuing medical education in the future; and 21.9% of students said the pandemic hindered their interest in further studying medicine. Regardless of gender, a majority of the participants (78.1%) felt that online education negatively affected their time management skills and ability to cover the syllabus. Nearly half (46.4%) reported proficiency in using electronic devices. The medical students encountered multiple challenges: approximately 88% indicated that anxiety over the possibility of contracting the disease led to changes in personal behavior and interactions with family and friends. The study also revealed that 71% exhibited anxiety traits, and 11% displayed depressive symptoms, which may have been pre-existing. Furthermore, 77.1% of the participants experienced poor sleep quality, which, according to another study, is a significant predictor of depression and anxiety during COVID-19. Our findings show a significant correlation between undergoing COVID-19 testing and increased anxiety and stress levels among students, most of whom were infected during the pandemic's second wave in India. Conclusion The study has shed light on the effect of the COVID-19 pandemic on MBBS scholars and the students' reactions to this unparalleled situation. This aligns with Sustainable Development Goal 3, which focuses on "good health and well-being." The medical community has been significantly impacted by the pandemic due to its frontline position, and medical students' struggles to thrive academically. The knowledge gained from this study will assist facilitators and students of the medical fraternity in carrying out effective teaching modalities during this pandemic and any future outbreaks.

Mental Health and Contraceptive Knowledge in High Schoolers: Comparing Remote and In-Person Learning during COVID-19

Background and Objectives: In response to the COVID-19 pandemic's effects on education, this study delves into the behavioral, mental health, and sexual education characteristics of high school students during 2020-2021 and 2022-2023. Materials and Methods: We evaluated a variety of factors, including substance use, academic performance, sexual activities, mental health support, pandemic-related anxiety levels, and quality of life indicators using standardized instruments such as the SF-36, GAD-7, and WHOQOL-BREF. Furthermore, we addressed specific questions concerning contraception and sexual education during this period. Results: The questionnaires were filled in by 44 students in 2020-2021 and 41 students in 2022-2023. Significant findings included a noteworthy increase in COVID-19 vaccination rates, from 18.2% in 2020-2021 to 39.0% in 2022-2023 (p = 0.033), enhanced perceptions of mental health support during remote learning, from 7.1% to 20.0% (p = 0.044), and a rise in students partaking in reproductive health discussions from 10.7% to 25.0% (p = 0.046). Additionally, there was a marked decline in anxiety regarding the transition back to in-person learning (p = 0.048). Health surveys, such as the SF-36, signaled improvements in both physical and mental health over the years (p = 0.046 and p = 0.019, respectively), while the GAD-7 scores depicted a considerable reduction in anxiety symptoms (p = 0.038). The WHOQOL-BREF results also highlighted a significant uptick in students' mental well-being in 2022-2023 (p = 0.039). Conclusions: As the COVID-19 pandemic ended, high school students exhibited shifts in behavior, health, and education over four academic years, particularly in areas of contraceptive knowledge and mental health outcomes. The pronounced enhancements in vaccination rates, perceptions of mental health support, participation in health conversations, and overall mental wellness emphasize the adaptability and resilience of students in these tumultuous periods, and a general increase in contraceptive knowledge and quality of life during the end of the pandemic.

Assessment of the factors affecting health profession students' emergency transition during the COVID-19 pandemic: A cross-sectional study

Objective: This study aimed to identify the factors that affected health profession students' emergency transition during the COVID-19 pandemic and to explore strategies that may help students be better prepared for any future health crises. Participants: This study population included 73 students that were originally enrolled in one online section (n = 49) and one face-to-face section (n = 24) of a healthcare administration course before the transition. Methods: The cross-sectional study was conducted and the anonymous survey data were analyzed using SPSS and a Man-Whitney U test. Results: Of the 73 students, 48 completed the survey, with a response rate of 66% (48/73). There was a statistically significant difference in the perceived COVID-19 impact (z=-3.339, p = 0.001) and difficulty transitioning during the pandemic (3-2.142, p = 0.032) between both groups. The top three hindering factors were stress and anxiety, difficulty focusing on studying at home, and time management due to uncertainty. Conclusions: The study findings suggest strategies that may help students with adequate knowledge and capabilities in managing stress, anxiety, and unprecedented challenges in the future.

Effectiveness of Online Faculty Calibration Activities

Purpose Dental hygiene faculty members must be able to provide evidence of skill calibration for clinical evaluation of students. The purpose of this study was to evaluate the effectiveness of online instructional videos compared to in-person sessions for faculty calibration.Methods A randomized crossover pretest/posttest research design was used to evaluate online and in-person faculty calibration activities. Fifteen faculty members from a baccalaureate dental hygiene program were randomly assigned to an AB or BA sequence for calibration sessions on two different instruments. Following a 2-week washout period, the groups switched activity modalities. A pretest, posttest, and retention test, administered 10 weeks following the activity, were administered to determine learning levels and the new and retained knowledge. A 7-point Likert scale questionnaire evaluated the reaction to and impact of the calibration activities. Descriptive statistics analyzed demographic and Likert scale data. Paired samples t-tests were used to analyze the research questions (p≤0.05).Results Online calibration activities yielded higher posttest scores than in-person activities (p=0.01). Findings related to feelings of confidence revealed a greater percentage of participants agreed that online calibration activities increased their ability to evaluate student performance. Findings related to feelings of preparedness supported equal percentages of participants who agreed the online and in-person activities increased their ability to teach dental hygiene instrumentation. There was no significant difference between in-person and online retention test scores (p=0.235).Conclusion Faculty members agreed that both online and in-person calibration activities were an effective use of their time and contributed to greater feelings of confidence and preparedness. However, the online calibration activities seemed to be more effective at increasing calibration on instrumentation. More research is needed to determine additional effective strategies for online calibration of clinical faculty.

A comparison of online and face-to-face modalities in endodontic preclinical education: A retrospective study

PURPOSE

The aim of this study was to evaluate the competency of undergraduate students in following the principles of access cavity preparation and the radiographic quality of root canal filling in maxillary molar teeth in either online or face-to-face education courses during the novel coronavirus disease 2019 (COVID-19) pandemic.

METHODS

A total of 178 extracted maxillary molar teeth that underwent endodontic dental treatment by undergraduate students who completed the endodontic preclinical practice course online or face-to-face during the COVID-19 pandemic were retrospectively analyzed. A visual access cavity examination determined the form, width of the cavity, deroofing of the pulp chamber, and the presence of a perforation. Root canal fillings were examined radiographically on periapical radiographs for length, homogeneity, taper, and the presence of iatrogenic defects. Statistical analysis was performed using the chi-square test.

RESULTS

The incidence of incorrect form, wide cavities, and perforation was statistically higher in the online group than in the face-to-face group (p < 0.05). It was determined that root filling length and homogeneity were more successful in the face-to-face group (p < 0.05). When evaluated for iatrogenic errors, the presence of broken instruments was found to be significantly higher in the online group (p < 0.05). There was no significant difference between the groups in other iatrogenic errors and the taper of the root canal filling (p > 0.05).

CONCLUSION

The students who underwent face-to-face education were more successful in accessing cavity preparation and root canal fillings than the students who undertook online education.

Evaluation and Perception of the Immediate Impact of COVID-19 on Dental Education: An Observational Study

Background The primary aim of the study is to assess how the COVID-19 pandemic has affected dental education for students and teachers, particularly concerning the efficiency of online teaching strategies for both clinical and academic outcomes. Additionally, it also emphasizes psychological behavior like stress and anxiety in the post-pandemic era due to academic pressure. Materials and methods The study included 300 undergraduate dental students from various years of studying and 31 teachers actively teaching in dental college from all nine departments. The questionnaire was created in Google Forms for both students and teachers. The questionnaire contained various aspects of an education system that was adopted post-pandemic. The questions were given to evaluate the opinions of students as well as teachers to understand which method of teaching is preferable for them. Whether it's an online method of teaching or the offline mode, out of which the majority of respondents preferred the offline method of teaching. Result Most of the respondents agreed that the pandemic had affected their academic as well as clinical performance. Online mode of learning was not as effective as face-to-face learning. It did not affect the students clinically but mentally, which made them more anxious and stressed out during their studies and preparation for exams. Teachers too had to face a lot of problems from technical aspects while teaching online which led to mental stress and anxiety. This study re-emphasizes the negative impact of COVID-19 on dental education. It also further highlights the more fundamental changes and improvements that are desperately needed in the education system to adapt and overcome the current pandemic situation and future such events. Conclusion The COVID-19 pandemic has significantly impacted educational institutions, curricula, and clinical practice. Dental students are particularly vulnerable, and online education platforms in India face challenges in regulation. The quality of materials, technical assistance, and expertise in online classes significantly impact teaching and learning experiences. The pandemic has led to concerns about students and staff contracting the disease, creating a skill gap in dental graduates, and loss of clinical exposure, causing more anxiety. To address these concerns, regular, open, and compassionate communication with students is essential. Educational institutions must undergo a transformation to adapt to the pandemic and potential future disasters.

Meet the Metaorganism: A web-based learning app for undergraduate and graduate biology students

Meet the Metaorganism is a web-based learning app that combines three fundamental biological concepts (coevolution, community dynamics, and immune system) with latest scientific findings using the metaorganism as a central case study. In a transdisciplinary team of scientists, information designers, programmers, science communicators, and educators, we conceptualized and developed the app according to the latest didactic and scientific findings and aimed at setting new standards in visual design, digital knowledge transfer, and online education. A content management system allows continuous integration of new findings, which enables us to expand the app with the dynamics of the research field. Students can thus gain a close insight and connection to current research, and at the same time learn that knowledge is not static but grows dynamically. Especially in the realm of the easily accessible metaorganism research, visualization plays an essential role to keep complex processes understandable and memorable. Meet the Metaorganism is freely available online and can be accessed here: www.metaorganism.app.

Effectiveness of online sexual education based on the extended PLISSIT model on sexual function and sexual satisfaction in women undergoing breast cancer treatment

BACKGROUND

Despite therapeutic interventions having increased the survival rate of women with breast cancer, sexual dysfunction occurs in cancer survivors due to treatment. The aim of this study is to determine the effect of online sexual education, based on the Ex-PLISSIT model on sexual function and satisfaction, on women undergoing breast cancer treatment.

MATERIALS AND METHODS

The present study was a quasi-experimental and interventional control study. It was conducted with a pretest-posttest design between April and July 2022 in Isfahan, Iran. The participants were divided into an intervention (n = 40) and a control group (n = 40). The intervention group received sexual education based on the Ex-PLISSIT model that consisted of four levels of intervention, namely, permission (P), limited information (LI), specific suggestions (SS), and intensive therapy (IT), presented in four sessions. The Female Sexual Function Index (FSFI) and Larson's Sexual Satisfaction Questionnaire were used to measure the sexual function and sexual satisfaction of the participants. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 21. P values below 0.05 were considered statistically significant.

RESULTS

The results showed that the mean of sexual satisfaction and function scores in the intervention group significantly increased after intervention. Moreover, the results showed a statistically significant difference in the mean of sexual satisfaction scores between the intervention and control groups after intervention (P = 0.020). Although there was a difference between the mean of sexual function scores in the intervention and control groups after the intervention, the t-test showed no statistically significant difference (P = 0.176).

CONCLUSIONS

According to the results of the study, sexual education based on the Ex-PLISSIT model could effectively enhance sexual satisfaction of women undergoing breast cancer treatment. It seems that this model can help health care providers evaluate the sexual needs of the patients and provide appropriate suggestions in order to decrease sexual problems.

Use of Massive Online Open Courses (MOOCs) model in virtual education development in first macro-region universities of medical sciences in countrywide territorial planning

BACKGROUND

Massive online open cources (MOOCs) are a new chapter in the topic of teaching-learning in higher education, which have been able to acquire a significant and valuable position in higher education and prestigious universities worldwide in line with the advancement of technology. The present study was conducted pursuing the goal to investigating the effect of use of MOOCs in the development of virtual education in universities of medical sciences in the first macro-region of countrywide territorial planning.

MATERIALS AND METHODS

This research is based on a mixed method and practical in terms of purpose, and it was carried out in 2021 and 2022 in first macro-region of countrywide regional planning Medical Sciences Universities. The data of the qualitative section were converted into a questionnaire using the method of qualitative content analysis in a purposeful and semi-structured interview with 24 experts in the field of virtual education who had sufficient experience in the field of MOOC courses. The statistical population of the quantitative section is 1938 faculty members of the first macro-region of countrywide regional planning, of which 324 were selected by stratified random sampling. Its validity was calculated by Lawshe and Waltz-Bausell method by R software, and the reliability was calculated using Cronbach's alpha method with SPSS-21.

RESULTS

Universities are facing challenges in structural, managerial, cultural, social, technological, and evaluation dimensions, and the current situation of using MOOCs in them is not appropriate.

CONCLUSION

Besides, the analysis of the optimal situation of using MOOCs in these universities indicates that technological, structural, managerial, evaluation, educational, and personal dimensions are the most important in the effect of using MOOCs on the development of virtual education.

Assessment of the Early Detection of Anosmia and Ageusia Symptoms in COVID-19 on Twitter: Retrospective Study

BACKGROUND

During the unprecedented COVID-19 pandemic, social media has been extensively used to amplify the spread of information and to express personal health-related experiences regarding symptoms, including anosmia and ageusia, 2 symptoms that have been reported later than other symptoms.

OBJECTIVE

Our objective is to investigate to what extent Twitter users reported anosmia and ageusia symptoms in their tweets and if they connected them to COVID-19, to evaluate whether these symptoms could have been identified as COVID-19 symptoms earlier using Twitter rather than the official notice.

METHODS

We collected French tweets posted between January 1, 2020, and March 31, 2020, containing anosmia- or ageusia-related keywords. Symptoms were detected using fuzzy matching. The analysis consisted of 3 parts. First, we compared the coverage of anosmia and ageusia symptoms in Twitter and in traditional media to determine if the association between COVID-19 and anosmia or ageusia could have been identified earlier through Twitter. Second, we conducted a manual analysis of anosmia- and ageusia-related tweets to obtain quantitative and qualitative insights regarding their nature and to assess when the first associations between COVID-19 and these symptoms were established. We randomly annotated tweets from 2 periods: the early stage and the rapid spread stage of the epidemic. For each tweet, each symptom was annotated regarding 3 modalities: symptom (yes or no), associated with COVID-19 (yes, no, or unknown), and whether it was experienced by someone (yes, no, or unknown). Third, to evaluate if there was a global increase of tweets mentioning anosmia or ageusia in early 2020, corresponding to the beginning of the COVID-19 epidemic, we compared the tweets reporting experienced anosmia or ageusia between the first periods of 2019 and 2020.

RESULTS

In total, 832 (respectively 12,544) tweets containing anosmia (respectively ageusia) related keywords were extracted over the analysis period in 2020. The comparison to traditional media showed a strong correlation without any lag, which suggests an important reactivity of Twitter but no earlier detection on Twitter. The annotation of tweets from 2020 showed that tweets correlating anosmia or ageusia with COVID-19 could be found a few days before the official announcement. However, no association could be found during the first stage of the pandemic. Information about the temporality of symptoms and the psychological impact of these symptoms could be found in the tweets. The comparison between early 2020 and early 2019 showed no difference regarding the volumes of tweets.

CONCLUSIONS

Based on our analysis of French tweets, associations between COVID-19 and anosmia or ageusia by web users could have been found on Twitter just a few days before the official announcement but not during the early stage of the pandemic. Patients share qualitative information on Twitter regarding anosmia or ageusia symptoms that could be of interest for future analyses.

Student perceptions of the impact of quality matters essential standards in an animal physiology course

As online learning becomes increasingly popular in higher education, the quality of courses that utilize this modality is becoming a focus of inquiry. Quality Matters (QM) is a leading quality assurance organization that reviews online and hybrid (partially online, partially in-person) courses for standards of pedagogy and instructional design and certifies courses that sufficiently meet these standards. In this study, we examine student perceptions of course quality in a hybrid three-credit-hour animal science course that has been certified by QM. The class met twice a week for 1.25 h with one class period online and one in person. It consisted of 11 modules, each of which included learning content, learning activities, and assessments. Upon completion, 46 of 114 students completed a survey in which they rated the course on each of the 21 QM essential standards (Fifth edition). Descriptive analysis revealed that for 19 of the 21 specific review standards, 75% to 91% of students agreed or strongly agreed that the course reflected the best practice described in the standard. For the other two standards, over half of students (72%, 63%) agreed or strongly agreed that best practices were reflected in course design. Another way to examine the data is to collapse specific review standards into eight general review categories as specified by QM; the collapsed data revealed that 75% to 88% of students agreed or strongly agreed that the course design reflected the eight general course design standards. The percentage of students disagreeing that the course reflected each best practice was 11% or lower. Cronbach analysis to examine the internal consistency of the QM questionnaire (0.96), indicated instrument reliability and stability. A principal component analysis of the data conducted to further examine features and patterns of student responses revealed four primary factors that students rated highly (learning objectives, learner interaction and engagement, accessibility and usability, and clarity) that explained 78% of the data variance. This study demonstrates that the high quality of course design and delivery in a QM-certified course is clear to students. and provides justification for the investment in high-quality online and hybrid course design. In the future, we plan to compare student perceptions of course quality in a course that has not been QM-certified with one that has, as well as the impact of those revisions on student outcomes.

Webcam-based eye-tracking to measure visual expertise of medical students during online histology training

Objectives

Visual expertise is essential for image-based tasks that rely on visual cues, such as in radiology or histology. Studies suggest that eye movements are related to visual expertise and can be measured by near-infrared eye-tracking. With the popularity of device-embedded webcam eye-tracking technology, cost-effective use in educational contexts has recently become amenable. This study investigated the feasibility of such methodology in a curricular online-only histology course during the 2021 summer term.

Methods

At two timepoints (t1 and t2), third-semester medical students were asked to diagnose a series of histological slides while their eye movements were recorded. Students' eye metrics, performance and behavioral measures were analyzed using variance analyses and multiple regression models.

Results

First, webcam-eye tracking provided eye movement data with satisfactory quality (mean accuracy=115.7 px±31.1). Second, the eye movement metrics reflected the students' proficiency in finding relevant image sections (fixation count on relevant areas=6.96±1.56 vs. irrelevant areas=4.50±1.25). Third, students' eye movement metrics successfully predicted their performance (R2adj=0.39, p<0.001).

Conclusion

This study supports the use of webcam-eye-tracking expanding the range of educational tools available in the (digital) classroom. As the students' interest in using the webcam eye-tracking was high, possible areas of implementation will be discussed.

Biobank Education for Future Physicians: Training Medical Students Through Student Research Association Networks

Research biobanks have become crucial collaborators in a variety of basic and clinical research projects with comprehensive biological sample collection and associated data storage. Medical students, who are the most important stakeholders of biobanks as future physicians, need to be trained in biobanking; however, there is no consensus on how to include it in formal education. This study aimed to determine and increase awareness among medical students regarding biobanks through peer training organized online by medical student research association networks. Volunteer medical or graduate students were trained by biobank professionals at the Izmir Biomedicine and Genome Center (IBG) biobank for 6-9 months. Then, a biobank event was planned by these trainees, the Ege Scientific Research Team (ESRT), and IBG-Biobank with the support of The Biobanking and BioMolecular Resources Research Infrastructure (BBMRI) Turkey. The study reached students of 46 different medical faculties. Before the event, students' level of knowledge about biobanks was identified using a pre-event questionnaire (n = 239). Following 2 days (4 main sessions) of online events, a post-event questionnaire was administered to event participants (n = 110) and 80.9% of them answered (n = 89). The pre-event survey revealed that only 34.3% of the medical students had heard of the term "Biobank" in Turkey. After the event, medical students were significantly more enthusiastic about putting effort into biobanking and using and sharing stored biobank samples of their patients compared with the pre-event (p < 0.0001). Moreover, 92% of the students stated that they would consider attending an advanced course in biobanking. In conclusion, the current study demonstrates that extracurricular courses with peer learning methods coordinated with medical student associations can be valuable in increasing future physicians' awareness and knowledge of biobanking.

Students' perceptions on how e-learning platforms in universities should be improved to increase the quality of educational services

The Covid-19 pandemic has made a strong mark on the education system globally. Universities have been compelled to take urgent measures to provide young people with access to education, leading them to invest significant resources in building their own e-learning platforms. Because they were created and implemented in a relatively short time, certain e-learning platforms presented several issues, underscoring the need for improvement. This paper aims to identify students' perceptions of how e-learning platforms should be refined in order to increase the quality of online educational services. The research involved a sample of 114 students enrolled in the University of Medicine and Pharmacy Carol Davila in Bucharest. Data collection was conducted using an online questionnaire, and data analysis was performed using the IBM SPSS software. The results indicated that there is room for improvement in the quality of the services offered. To achieve this, further steps should focus on the interface of the online platforms, optimizing the presentation of educational materials, and refining the communication between teachers and students. Furthermore, other online tools (e.g., blogs, forums, or mobile applications) should be incorporated within these platforms, in order to facilitate the integrative distribution of information.

Assessing the Readability of Online Patient Education Materials in Obstetrics and Gynecology Using Traditional Measures: Comparative Analysis and Limitations

BACKGROUND

Patient education materials (PEMs) can be vital sources of information for the general population. However, despite American Medical Association (AMA) and National Institutes of Health (NIH) recommendations to make PEMs easier to read for patients with low health literacy, they often do not adhere to these recommendations. The readability of online PEMs in the obstetrics and gynecology (OB/GYN) field, in particular, has not been thoroughly investigated.

OBJECTIVE

The study sampled online OB/GYN PEMs and aimed to examine (1) agreeability across traditional readability measures (TRMs), (2) adherence of online PEMs to AMA and NIH recommendations, and (3) whether the readability level of online PEMs varied by web-based source and medical topic. This study is not a scoping review, rather, it focused on scoring the readability of OB/GYN PEMs using the traditional measures to add empirical evidence to the literature.

METHODS

A total of 1576 online OB/GYN PEMs were collected via 3 major search engines. In total 93 were excluded due to shorter content (less than 100 words), yielding 1483 PEMs for analysis. Each PEM was scored by 4 TRMs, including Flesch-Kincaid grade level, Gunning fog index, Simple Measure of Gobbledygook, and the Dale-Chall. The PEMs were categorized based on publication source and medical topic by 2 research team members. The readability scores of the categories were compared statistically.

RESULTS

Results indicated that the 4 TRMs did not agree with each other, leading to the use of an averaged readability (composite) score for comparison. The composite scores across all online PEMs were not normally distributed and had a median at the 11th grade. Governmental PEMs were the easiest to read amongst source categorizations and PEMs about menstruation were the most difficult to read. However, the differences in the readability scores among the sources and the topics were small.

CONCLUSIONS

This study found that online OB/GYN PEMs did not meet the AMA and NIH readability recommendations and would be difficult to read and comprehend for patients with low health literacy. Both findings connected well to the literature. This study highlights the need to improve the readability of OB/GYN PEMs to help patients make informed decisions. Research has been done to create more sophisticated readability measures for medical and health documents. Once validated, these tools need to be used by web-based content creators of health education materials.

Burnout and motivation to study medicine among students during the COVID-19 pandemic

Aim

To investigate medical students' burnout and motivation levels in each of the six years of their studies during the COVID-19 pandemic and identify independent predictors of burnout and motivation.

Methods

An anonymous cross-sectional survey was sent to the students of all six years within our school. Burnout was measured with the adapted Oldenburg Burnout Inventory questionnaire (OLBI-S) and motivation with the updated Strength of Motivation for Medical School (SMMS-R) questionnaire. Univariate analysis was performed with the Kruskal-Wallis test and Spearman's correlation, while multivariable analysis with linear regression models.

Results

A total of 333 medical students (52% of student body) responded. Higher burnout levels correlated with lower motivation to study medicine (rho = -0.30, p < 0.001). Burnout levels differed between the six years of medical studies, peaking in years two and four whereas being the lowest in year one (p = 0.01). Motivation levels differed significantly as well, peaking in years one and four whereas being the lowest in years five and six (p = 0.012). In the multivariable linear regression models, being a female (b = 2.22, p = 0.016), studying in the fourth year vs. first year (b = 2.54, p = 0.049), having a perceived beginner/intermediate vs. advanced/expert technology level (b = 2.05, p = 0.032) and a perceived poor school support system (b = 6.35, p < 0.001) were independently associated with higher burnout levels. Furthermore, studying in the fifth year vs. first year (b = -5.17, p = 0.019) and a perceived poor school support system (b = -3.09, p = 0.01) were independently associated with a reduced motivation to study medicine.

Conclusion

Our study highlighted potential areas for intervention to decrease the rate of burnout and low motivation among medical students. However, further research is needed to unravel the full effect of the pandemic on medical students.

'Hold the course(s)!' - a qualitative interview study of the impact of pandemic-triggered contact restrictions on online instruction in community-based family medicine teaching

The COVID-19 pandemic has been identified as a catalyst for the digitalization of medical education. Less is known about the specific impact of the pandemic on decentralized, community-based education, such as in General Practitioner practices. The aim of this study is to understand the impact of the digital transformation process, triggered by the COVID-19 pandemic. As, family medicine courses involve both university-based and community-based teaching, this study focuses the mode and quality of instruction and instructors in family medicine teaching. A qualitative interview study was conducted. The participants (N = 12) of a multi-perspective Quality Circle in family medicine teaching were interviewed twice: first, in 2019, about digitalization in family medicine teaching in Tübingen, Germany, not yet aware of the global changes and local transformation that would take place shortly thereafter. Second, in a follow-up interview in 2020 about the transition process and digitalization following the impact of contact restrictions during the pandemic. Grounded Theory was used as a qualitative research approach to analyze the complex processes surrounding this transformation. By analyzing the interviews with various stakeholders of community and university-based teaching, a model for the digital transformation process of family medicine teaching at the University of Tübingen in response to an external stimulus (the pandemic) was developed. It involves six chronological steps: "The calm before the storm," "The storm hits," "All hands on deck," "Adrift," "Reset course," and "The silver lining." This model seeks to understand the process of digital transformation and its impact on the teaching institution (medical faculty of the University of Tübingen, Institute for General Practice and Interprofessional Health Care) and instructors from an integrated perspective and thereby critically revisits prior concepts and opinions on the digitalization of medical teaching. Insights gained are presented as key messages.