Coronavirus Disease 2019 (COVID-19) Learning Online: A Flipped Classroom Based on Micro-Learning Combined with Case-Based Learning in Undergraduate Medical Students

Transforming Medical Training Through Online Case-Based Learning: Brief Review

Online case-based learning (CBL) is a pedagogical approach that employs the use of digital platforms and virtual environments to discuss clinical cases with undergraduate medical students. The purpose of the current review is to explore the scope and merits of online case-based learning, development of a plan for designing and implementing online CBL sessions in a medical college for undergraduate medical students. This happens to be an innovative approach as students get an opportunity to discuss and analyze clinical cases by practically applying their theoretical knowledge to clinical practice. Like any teaching-learning method, the effectiveness of online CBL sessions also depends on the efforts taken by educators in the planning stage. As these sessions will be conducted online, the most important consideration is to ensure that students have access to the required technology. As we all know, assessment drives learning, there is a definite need to supplement teaching-learning activities in online CBL sessions with suitable formative assessments. In conclusion, online CBL is an effective pedagogical approach to promote discussion on interesting clinical cases using flexible online platforms. Considering the merits of the method and the fact that technology has become an integral part of medical education delivery, every medical institute must explore its infrastructure to systematically introduce online CBL within the medical curriculum.

Analysing the effectiveness of Just-A-Minute Optometry Clinical Pearls: a micro-learning tool in continuing optometry education

CLINICAL RELEVANCE

Just-A-Minute Clinical Pearls as a microlearning concept may be beneficial in enhancing optometry and ophthalmology practice globally.

BACKGROUND

Medical education often witnesses a gap in effectively translating the learnings into clinical practice, pointing to the complex and traditional teaching methods as hindrances. The present work studied the usefulness and acceptability of Just-A-Minute Optometry Clinical Pearls, a micro-learning tool, among optometrists and ophthalmologists.

METHODS

Just-A-Minute Optometry clinical pearls were developed by the optometry team of LV Prasad Eye Institute and shared (via email) among optometrists and ophthalmologists on a daily basis between June 2021 to May 2022. In the middle of the project, the recipients were invited to participate in an online survey. The variables studied included frequency of checking clinical pearls, simplicity of their content, grasping speed, most used subspeciality pearls, knowledge gain and retention, practice applicability, overall learning experience, and the likelihood of recommending it to a friend.

RESULTS

Among 150 respondents, 103 (68.7%) were ophthalmologists, and 46 (30.7%) were optometrists. The majority were from private (n = 64, 42.7%) and institutional (n = 48, 32%) practices, with 102 (68.4%) having more than five years and 21 (14%) having 2-5 years of experience. About 115 (77%) respondents checked clinical pearls every day, 147 (99%) found the format easy, and 131 (88%) could grasp the content within one minute. They felt that JAM-OCP 'always' enhanced clinical knowledge (n = 108, 72%) and clinical applicability (n = 82, 55%) and helped in knowledge retention (n = 123, 84%). The responses to the clinical application significantly varied (Chi-square tests) among subgroups of education qualification (p < 0.001) and practice types (p < 0.03).

CONCLUSIONS

The Just-A-Minute Optometry Clinical Pearls were beneficial to optometrists and ophthalmologists in their practices. This, as a tele-education tool, supports continuing optometry education across the globe.

Change and challenge: An online course in Medical Biochemistry and Molecular Biology

The development of information technology and portable devices has sparked a revolution in the field of education, facilitating access to diverse educational resources and lifelong learning. In particular, the COVID-19 pandemic has accelerated the transition from face-to-face to distance teaching, which requires online education to be provided worldwide. Biochemistry and Molecular Biology are key basic medical courses in laboratory-based science that cover complicated theories and applications. The balance between traditional and online courses, and the effectiveness of online courses, are fundamental to the teaching quality of Biochemistry and Molecular Biology. In this study, we explored the concepts, designs, and practices of a new blended online course and identified potential challenges. We hope that our experiences will provide new ideas for online teaching and promote teaching reform and the development of Medical Biochemistry and Molecular Biology education.

The effectiveness of the fully online flipped classroom for nursing undergraduates during the COVID-19: Historical control study

AIM

Evaluate the fully online flipped classroom's effects during the pandemic.

DESIGN

A comparative descriptive study with historical control design.

METHODS

In an internal medicine nursing course, the fully online flipped classroom instruction was used with 53 undergraduates in 2020. Their final examinations were compared with the 50 students taught with traditional offline methods in 2019. Online interactions and students' experiences were described. Pass rates in both classes were over 90% (Χ²  = 0.276, p = 0.60), but the median score in 2019 was higher than in 2020 (Z = -2.491, p = 0.01). There were 996 online interactions and 734 valid interactions in total. All 49 students believed the online flipped classroom schedule was reasonable and all but three said it was helpful. However, 19 students (39%) felt traditional teaching is more effective.

CONCLUSIONS

The fully online flipped classroom method was fairly effective during the pandemic. This model also did increase class participation and sufficient faculty-student interactions in remote education. However, fewer students earned outstanding scores, with possible reasons including the online flipped classroom, lack of clinical practice, stress from COVID-19 and the shortened exam time. Overall, the method is worth recommending under public health emergencies like COVID-19, and future research exploring potential concerns about scores is necessary.

Dependence of learning outcomes in flipped and lecture classrooms on review questions: A randomized controlled trial and observational study

PURPOSE

The effects of class structure (i.e., lecture vs. flipped) and repeated review on: 1) exam scores and 2) student perceptions of learning were compared in a prospective randomized controlled trial (Study 1) and a retrospective cohort study (Study 2).

METHODS

In Study 1, 42 second year students in a Doctor of Physical Therapy program were randomized to either a lecture or flipped section of a neurobiology class. Both sections incorporated repeated review. In Study 2, exam scores were retrospectively compared between two cohorts: a lecture cohort without repeated review (n = 42) and a flipped cohort with repeated review (n = 46). In both studies, outcomes of interest were exam scores and student surveys.

RESULTS

In Study 1, students in the lecture and flipped sections had similar exam averages (lecture = 76.7 ± 17%, flipped = 77.5 ± 17%, p = 0.73). Repeated review significantly improved exam scores by 12.0 percentage points (95% CI: 8.0 to 16.0 percentage points) in the lecture section and 10.8 percentage points (95% CI: 6.9 to 14.8 percentage points) in the flipped section. The flipped section reported higher levels of satisfaction and perceived learning. In Study 2, the flipped cohort had significantly higher exam scores than the lecture cohort (lecture = 70.2 ± 6.9%, flipped = 83.4 ± 7.7%, p < 0.0001). Student satisfaction and perceived learning were similar in both cohorts.

CONCLUSION

Exam scores improve with review questions and quizzes provided in a class, both in a lecture or flipped classroom.

Design principles for fully online flipped learning in health professions education: a systematic review of research during the COVID-19 pandemic

BACKGROUND

During the COVID-19 pandemic, some instructors transitioned their courses into a fully online environment by adopting flipped learning. In this context, this review examined the challenges to fully online flipped learning and identified useful course-design elements for practicing this instructional approach in health professions education.

METHODS

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for selecting relevant articles. Thirty-three empirical studies (with 32 unique interventions) published between 2020 and 2021 (i.e., the first 2 years of the pandemic) were selected for analysis.

RESULTS

When the instructors in the reviewed studies designed and implemented their online flipped courses, numerous challenges emerged, which could be broadly categorized into student-related challenges (e.g., unfamiliarity with online flipped learning; N = 5), faculty challenges (e.g., increased workload; N = 8), and operational challenges (e.g., students' technical problems; N = 9). Nevertheless, we identified various useful elements for online flipped learning practice and organized them based on the following components of the Revised Community of Inquiry (RCoI) framework: cognitive presence (e.g., application of knowledge/skills; N = 12), social presence (e.g., peer interaction; N = 11), teaching presence (e.g., instructors' real-time demonstration/facilitation; N = 17), and learner presence (e.g., care and emotional support; N = 4).

CONCLUSIONS

Based on the findings from the review and the RCoI framework, we developed nine principles for the effective practice of online flipped learning. These principles appear crucial for sustaining quality health professions education in a fully online flipped learning environment.

Microlearning in Diverse Contexts: A Bibliometric Analysis

In recent years, publications on microlearning have substantially increased, as this topic has received extensive attention from scholars in the instructional design and technology discipline. To better characterize and understand microlearning, there is a need for comprehensive bibliometrics assessments of the literature on microlearning. To this end, this bibliometric study collected 208 relevant publications on microlearning from the Scopus database, published in diverse contexts. Using quantitative topic modeling and qualitative content analysis methods, we identified four major themes in these publications, namely: (1) design of microlearning; (2) implementation of microlearning as an instructional method strategy and an intervention; (3) evaluation of microlearning; and (4) the utilization of mobile devices for microlearning. Based on the study findings, we discuss the significance of the study and provide implications for research and practice, particularly in fostering rigorous inquiry on the topic of microlearning, expanding the context of research to include K-12 settings, and focusing on mobile-based microlearning.

Shift to emergency remote preclinical medical education amidst the Covid-19 pandemic: A single-institution study

The Covid-19 pandemic disrupted medical education, shifting it towards emergency remote delivery. This cross-sectional study aimed to assess the impact of the pandemic on preclinical medical education and identify predictors of the virtual learning experience and perceived stress. An anonymous survey was delivered electronically to the students of the authors' medical school that attended either histology or pathology. This survey contained two scales, the virtual learning experience (VLE) and the perceived stress scale-10 (PSS-10). A total of 173/255 (68%) responded, showing a positive perception towards the remote delivery of both courses. An exploratory factor analysis was performed on the VLE scale items and four new dimensions were formed: "course quality and learning outcomes", "student motivation", virtual against F2F learning", and "virtual laboratory sessions". The following significant predictors of enhanced VLE, in at least one dimension, were identified: female gender, pathology course, final examination grade >80%, lower perceived stress levels, studying in home country, and holding of another degree before medical school. In addition, the following predictors were significantly associated with higher levels of student perceived stress: female gender, pathology course, studying away from home, and suboptimal internet connection. Notably, the quality of internet connection was significantly associated with the students' final examination performance. Concerning the best mode for future delivery of both courses, most students proposed a blended, rather than an entirely on-campus or online approach. In conclusion, despite its problems, a high-quality remote preclinical medical education was possible in the authors' school and offered tremendous opportunities for future improvement.