"To teach is to learn twice" Added value of peer learning among medical students during COVID-19 Pandemic

Peer Learning Has Double Effects in Clinical Research Education: A Qualitative Study

Background

Peer learning has been recognized for its effectiveness in health professional education. However, its effects on clinical research education are not clear and were explored qualitatively in this study.

Methods

The peer-learning method was implemented in a clinical research education seminar for early-career physicians at a children's and mothers' hospital in 2019. We conducted semistructured interviews with participants about peer-learning experience and qualitatively analyzed verbatim transcripts using Engeström's "activity theory" framework.

Results

From framework analysis, learning processes were extracted mainly in four domains, namely, (a) instrument and its usage: research design and its match with research question, (b) outcome: research result, (c) community: seminar, and (d) division of labor: roles of participants and staff.

Conclusions

In this report of a peer-learning trial in postgraduate clinical research education, the following two pathways of peer-learning effects were abstracted. The indirect pathway was the presentations by experienced participants providing concrete examples of research processes. The direct pathway was the questions from experienced participants to beginners about specific and concrete questions. There were also two points to consider in peer learning in clinical research education: gaps in premise knowledge and beginners' frustration about expected outcomes. We believe that these extracted pathways and points imply the significance and considerations for continuing the peer-learning trial in clinical research education. Future tasks are to promote clinical research education with a view to the learning effects, not only on individuals, but also on groups.

Transition to remote/hybrid learning during the COVID-19 pandemic among Saudi students of the College of Applied Medical Sciences: a cross-sectional study

Background

The novel Coronavirus Disease 2019 (COVID-19) pandemic has presented unparalleled and unique stressors and challenges to the field of applied health sciences education. This study explored how the College of Applied Medical Sciences (COAMS) Saudi students perceive the transition to remote/ hybrid learning during the COVID-19 pandemic.

Methods

A cross-sectional exploratory investigation was carried out during the months of February and March in the year 2023 among 196- COAMS Saudi students, using the 48-item previously developed and validated questionnaire, and with a non-probability convenient sampling technique. Descriptive statistics were generated for participants' demographics, and for each questionnaire item and statistical analysis was performed using chi-square test.

Results

Out of the 283 undergraduates who have enrolled in COAMS, a total of 196 students have agreed to participate in the study with an overall response rate of 69.3%. Over 70% of COAMS students were satisfied and engaged in their on-site coursework. Nevertheless, questionnaire data indicates that their satisfaction and level of engagement diminished following the shift to remote learning. More than 62% of COAMS students were satisfied with their instructors' instructional and assessment strategies during on-site coursework, but such perceptions have decreased with remote instruction. Hybrid learning can be beneficial and effective in improving the performance and learning experience of COAMS students. As compared to female students, COAMS male students were more satisfied with remote learning because it met their needs (p = 0.017).

Conclusion

Remote classrooms have lower attendance and interest than on-site classes. Despite lower satisfaction levels in online courses, hybrid learning was viewed favourably by COAMS students. Higher educational institutions should develop plans to increase student involvement, improve academic integrity, and assess the effect of the pandemic on undergraduate education on a regular basis. By incorporating these measures, educational institutions can enhance and support the remote learning experience for their students.

Observed Interactions, Challenges, and Opportunities in Student-Led, Web-Based Near-Peer Teaching for Medical Students: Interview Study Among Peer Learners and Peer Teachers

BACKGROUND

Near-peer teaching (NPT) is becoming an increasingly popular pedagogical tool in health professions education. Despite the shift in formal medical education from face-to-face teaching toward encompassing web-based learning activities, NPT has not experienced a similar transition. Apart from the few reports on NPT programs hastily converted to web-based learning in light of the COVID-19 pandemic, no studies to date have explored web-based learning in the specific context of NPT.

OBJECTIVE

This qualitative study examined the nature of interactions among peer learners (PLs), peer teachers (PTs), and the learning content in a student-led, web-based NPT program for medical students.

METHODS

A 5-month-long voluntary NPT program to support first- and second-year medical students' biomedical science learning in the undergraduate medical curriculum was designed by 2 senior-year medical students and delivered by 25 PTs with 84 PLs participating. In total, 9 PLs and 3 PTs underwent individual semistructured interviews at the end of the program to explore general NPT experience, reasons for joining NPT, the effectiveness of NPT, the demand and importance of NPT, and the feasibility of incorporating NPT in the formal curriculum. Interview transcripts were analyzed using a thematic analysis approach.

RESULTS

The first general theme focused on the nature of student-student, student-teacher, and student-content interactions. Although PLs were engaged in web-based NPT, there was minimal interaction between students, as most PLs preferred to learn passively and remain anonymous. PLs believed the web-based NPT learning process to be a unidirectional transmission of knowledge from teacher to learner, with the teacher responsible for driving the interactions. This was in sharp contrast to PTs' expectation that both parties shared responsibility for learning in a collaborative effort. The second general theme identified the advantages and disadvantages of delivering NPT on a web platform, which were mainly convenience and teaching skills development and poor interactivity, respectively.

CONCLUSIONS

Student-led, web-based NPT offers a flexible and comfortable means of delivering academic and nonacademic guidance to medical students. However, the web-based mode of delivery presents unique challenges in facilitating meaningful interactions among PLs, PTs, and subject content. A blended learning approach may be best suited for this form of student-led NPT program to optimize its efficacy.

Implementation of a Student-Teacher-Based Blended Curriculum for the Training of Medical Students for Nasopharyngeal Swab and Intramuscular Injection: Mixed Methods Pre-Post and Satisfaction Surveys

BACKGROUND

The COVID-19 pandemic caused a major disruption in the health care sector with increased workload and the need for new staff to assist with screening and vaccination tasks. Within this context, teaching medical students to perform intramuscular injections and nasal swabs could help address workforce needs. Although several recent studies discuss medical students' role and integration in clinical activities during the pandemic, knowledge gaps exist concerning their role and potential benefit in designing and leading teaching activities during this period.

OBJECTIVE

The aim of our study was to prospectively assess the impact in terms of confidence, cognitive knowledge, and perceived satisfaction of a student-teacher-designed educational activity consisting of nasopharyngeal swabs and intramuscular injections for the training of second-year medical students in the Faculty of Medicine, University of Geneva, Switzerland.

METHODS

This was a mixed methods pre-post surveys and satisfaction survey study. Activities were designed using evidence-based teaching methodologies based on the SMART (specific, measurable, achievable, realistic, and timely) criteria. All second-year medical students who did not participate in the activity's old format were recruited unless they explicitly stated that they wanted to opt out. Pre-post activity surveys were designed to assess perception of confidence and cognitive knowledge. An additional survey was designed to assess satisfaction in the mentioned activities. Instructional design was blended with a presession e-learning activity and a 2-hour practice session with simulators.

RESULTS

Between December 13, 2021, and January 25, 2022, a total of 108 second-year medical students were recruited; 82 (75.9%) students participated in the preactivity survey and 73 (67.6%) in the postactivity survey. Students' confidence in performing intramuscular injections and nasal swabs significantly increased on a 5-point Likert scale for both procedures-from 3.31 (SD 1.23) and 3.59 (SD 1.13) before the activity to 4.45 (SD 0.62) and 4.32 (SD 0.76) after the activity (P<.001), respectively. Perceptions of cognitive knowledge acquisition also significantly increased for both activities. For the nasopharyngeal swab, knowledge acquisition concerning indications increased from 2.7 (SD 1.24) to 4.15 (SD 0.83), and for the intramuscular injection, knowledge acquisition concerning indications increased from 2.64 (SD 1.1) to 4.34 (SD 0.65) (P<.001). Knowledge of contraindications for both activities increased from 2.43 (SD 1.1) to 3.71 (SD 1.12) and from 2.49 (SD 1.13) to 4.19 (SD 0.63), respectively (P<.001). High satisfaction rates were reported for both activities.

CONCLUSIONS

Student-teacher-based blended activities for training novice medical students in commonly performed procedural skills seem effective for increasing their confidence and cognitive knowledge and should be further integrated within a medical school curriculum. Blended learning instructional design increases students' satisfaction about clinical competency activities. Future research should elucidate the impact of student-teacher-designed and student-teacher-led educational activities.

Exploring the challenges of virtual internships during the COVID-19 pandemic and their potential influence on the professional identity of health professions students: A view from Qatar University

Introduction

COVID-19 has imposed many shared limitations on medical and health education. Just like other health professions programs at most institutions, the Qatar University health cluster (QU Health) applied a containment approach and shifted all learning online, and onsite training was replaced by virtual internships (VIs) during the first wave of the pandemic. Our study aims to explore the challenges of virtual internships during the COVID-19 pandemic and their influence on the professional identity (PI) of the health cluster students from the College of Medicine, the College of Health Sciences, and the College of Pharmacy at Qatar University.

Methods

A qualitative approach was employed. In total, eight focus groups with students (N = 43) and 14 semi-structured interviews with clinical instructors from all the health cluster colleges were conducted. Transcripts were analyzed following the inductive approach.

Results

The major challenges reported by students were mainly related to the lack of the required skills for navigating the VI, professional and social stressors, the nature of VIs and the quality of learning, technical and environmental issues, and the development of students' professional identity in an alternative internship environment. The challenges relating to the development of professional identity included: limited clinical (practical) experience, a lack of experience in fighting a pandemic, a lack of communication and feedback, and a lack of confidence in meeting the internship's goals. A model was constructed to represent these findings.

Discussion

The findings are important in identifying the inevitable barriers to virtual learning for health professions students and provide a better understanding of how such challenges and different experiences would be affecting the development of their PI. Hence, students, instructors, and policymakers alike should strive to minimize these barriers. Since physical interactions and patient contact are indispensable components of clinical teaching, these extraordinary times demand innovations involving technology and simulation-based teaching. There is a need for more studies that are focused on determining and measuring the short- and long-term effects of the VI on students' PI development.

Towards a sustainable online peer learning model based on student's perspectives

The outbreak of the COVID-19 pandemic has fundamentally shifted learning from the traditional classroom approach to online learning. As such, this study used a revision centre as a case study to develop the factors that contribute to the theoretical framework of online peer learning in the higher education sector due to COVID-19. This study also explores the integrated effects of online peer learning on students and investigates whether advanced information technology creates new opportunities or additional burdens for students in adopting online peer learning environments. Descriptive statistical analysis, factor analysis, and correlation analysis were conducted on survey data gathered from 204 sub-degree students in Hong Kong. The results addressed four main factors developed from 39 variables: enhancement of learning ability, the attitude toward learning, motivation for learning, and interpersonal relationship which were closely associated. The study findings provide strategies and constructive recommendations for educators to develop a new online learning pedagogy, construct sustainable online peer learning, and effectively manage students' online learning to meet the needs for post-COVID online education.

Medical Students' Contribution as a Refining Tool for the Conventional Educational System

One of the most important things that accentuate an institution's greater advancement is its pursuit of change. Student contribution has been advocated for by many well-standing universities and has proven a better approach and a more refined way of an exuberant advancement both academically and personally. This article highlights how such contribution can be administered using novel approaches while preserving the main guidelines for graduating not only health-care providers but also researchers and life-long learners. The new prospect of students as beneficial assets provides an educational institution with valuable creative ideas, eye sights that can detect points of possible reform in the educational system, and another significant voice to the making of future decisions. The faculty has successfully been able to apply certain characteristics-self-independence, new rational scope, practical and tutoring skills-to undergraduates through peer-to-peer learning technique, medical poster presentation skills, and case-based learning manner.

Online or Blended Learning: the COVID-19 Pandemic and First-Year Medical Students' Academic Motivation

The study aimed to investigate the influence of psychological well-being and different study format on the academic motivation of 1st-year medical students during the COVID-19 pandemic. Repeated cross-sectional study carried out in November 2020 (time 1) and March 2021 (time 2). During time 1 (N = 273), all students studied online. In time 2 (N = 159), both students who learned online only (N = 86) and students who were taking (N = 33) or passed offline classes (N = 40) were trained. The mental state of the students was stable overtime of observation. The effect of the level of psychological destruction and quality of life affecting by the COVID-19 pandemic on academic motivation was minimal. The level of academic motivation was higher in time 2; this was especially noticeable among students who underwent blended learning. The mediating role of satisfaction with academic life and college belongingness in the relationship between the learning format and motivation was found. Blended type of education during a pandemic is more favorable for students in terms of their motivation to study. Further epidemiological studies are needed to assess the safety of blended learning. However, we would like to emphasize that no cases of COVID-19 in the blended learning format have been reported.

COVID-19 Campus Closures in the United States: American Student Perceptions of Forced Transition to Remote Learning

As colleges and universities rapidly closed due to COVID-19, students and faculty were faced with unique challenges. The pandemic forced the cancellation of all campus activities, both extra-curricular and program-focused, such as student teaching experiences and nursing clinical rotations. Additionally, instructors were forced to rethink content delivery as coursework was quickly moved online and administered remotely via virtual platforms. Students were impacted as university level programs underwent a major paradigm shift within a matter of days or weeks. This study examined perspectives of undergraduate and graduate students regarding their experiences with rapid conversion from on-ground, in-person courses to remote instruction during the spring 2020 semester. The researchers employed a QUAN-QUAL descriptive mixed methods design. Using questionnaires and semi-structured interviews, the researchers examined general perspectives on in-person learning before the pandemic; initial perceptions about remote learning; and perceptions of the students about effort, engagement, needs, and ethical behavior as they engaged in totally remote learning. Results, analyzed using SPSS (QUAN) and inter-coder agreement (QUAL), indicated that initially students were engaged and satisfied with their in-person instruction, but became less satisfied and engaged during remote instruction. Undergraduate students experienced feelings of increased frustration, decreased accountability and engagement during remote learning, and turned to collaboration to earn points as they finished the semester.

Effectiveness of Virtual Medical Teaching During the COVID-19 Crisis: Systematic Review

BACKGROUND

In December 2019, COVID-19 emerged and rapidly spread worldwide. Transmission of SARS-CoV-2, the virus that causes COVID-19, is high; as a result, countries worldwide have imposed rigorous public health measures, such as quarantine. This has involved the suspension of medical school classes globally. Medical school attachments are vital to aid the progression of students' confidence and competencies as future physicians. Since the outbreak of COVID-19, medical schools have sought ways to replace medical placements with virtual clinical teaching.

OBJECTIVE

The objective of this study was to review the advantages and disadvantages of virtual medical teaching for medical students during the COVID-19 pandemic based on the current emerging literature.

METHODS

A brief qualitative review based on the application and effectiveness of virtual teaching during the COVID-19 pandemic was conducted by referencing keywords, including medical student virtual teaching COVID-19, virtual undergraduate medical education, and virtual medical education COVID-19, in the electronic databases of PubMed and Google Scholar. A total of 201 articles were found, of which 34 were included in the study. Manual searches of the reference lists of the included articles yielded 5 additional articles. The findings were tabulated and assessed under the following headings: summary of virtual teaching offered, strengths of virtual teaching, and weaknesses of virtual teaching.

RESULTS

The strengths of virtual teaching included the variety of web-based resources available. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Open-access teaching with medical experts has enabled students to remain abreast of the latest medical advancements and to reclaim knowledge lost by the suspension of university classes and clinical attachments. Peer mentoring has been proven to be a valuable tool for medical students with aims of increasing knowledge and providing psychological support. Weaknesses of virtual teaching included technical challenges, confidentiality issues, reduced student engagement, and loss of assessments. The mental well-being of students was found to be negatively affected during the pandemic. Inequalities of virtual teaching services worldwide were also noted to cause differences in medical education.

CONCLUSIONS

In the unprecedented times of the COVID-19 pandemic, medical schools have a duty to provide ongoing education to medical students. The continuation of teaching is crucial to enable the graduation of future physicians into society. The evidence suggests that virtual teaching is effective, and institutions are working to further develop these resources to improve student engagement and interactivity. Moving forward, medical faculties must adopt a more holistic approach to student education and consider the mental impact of COVID-19 on students as well as improve the security and technology of virtual platforms.