Students' and Teachers' Perspective on the Implementation of Online Medical Education in China: A Qualitative Study

Students' Perceptions on Online Clinical Learning amid the COVID-19 Pandemic in an Institution of Higher Learning: A Qualitative Inquiry

Institutions of learning have been disrupted globally with serious implications for clinical teaching for students of health professions. The purpose of our study was to explore the perceptions of students towards online clinical teaching during the COVID-19 pandemic at Fatima College of Health Sciences. This was a descriptive qualitative study conducted on a purposive sample of 25 students from 24 June to 30 August 2020. The sample size was determined by data saturation. These were mainly nursing students in their 2nd to the 4th years of study. Students are required to have experiences, of stipulated nature and duration, in various specialty clinical settings throughout the clinical years of their programs. Approval for the study was granted by the Fatima College Research Ethics Committee (approval number: INTSTF010BSN20). The research was conducted according to the requirements of the Declaration of Helsinki. Data were collected through online semistructured questionnaires. Prospective participants were sent a soft copy of the informed consent document, and consent was indicated by clicking an "agree" link on the page that took them to the questionnaire. All participants were informed of their freedom to either participate in the study or not, without any penalty and were assured of their confidentiality. The questionnaires were kept in a password-protected file to which the researchers had sole access. Manual thematic analysis was done following the stages of organisation, familiarisation, transcription, coding, developing a thematic framework, indexing, displaying, and reporting. The major themes identified were the unfamiliar experience, challenges of online clinical learning, and possible solutions. Challenges of online clinical learning are multifaceted and require concerted multidisciplinary efforts to resolve. Nursing institutions, ours included, must develop flexible education systems that will be able to thrive in crisis and other unforeseeable circumstances.

Factors affecting the self-efficacy of medical teachers during a health crisis - a qualitative study on the example of the COVID-19 pandemic

BACKGROUND

The diversity of tasks entrusted to medical teachers with their simultaneous responsibility for the safety of patients and the effective education of future healthcare professionals requires maintaining a skillful balance between their teaching, scientific and clinical activities. Meanwhile, the COVID-19 pandemic disrupted the work of both healthcare facilities and medical universities, forcing already overworked medical teachers to establish a new balance. One's ability to perform effectively in new, ambiguous, or unpredictable situations was described by Albert Bandura as a self-efficacy concept. Consequently, this study aimed to identify factors affecting the self-efficacy of medical teachers and the influence of the COVID-19 pandemic on them.

METHODS

Twenty-five semi-structured interviews with medical teachers were conducted using a flexible thematic guide. They were transcribed and analyzed by two independent researchers (researcher triangulation) with phenomenology as the qualitative approach.

RESULTS

Identified themes demonstrate a process of the evolvement of clinical teachers' self-efficacy in response to the sudden outbreak of the COVID-19 pandemic, namely the decline of self-efficacy in the first phase of the crisis, followed by building task-specific self-efficacy and the development of general self-efficacy.

CONCLUSIONS

The study shows the significance of providing care and support for medical teachers during a health crisis. Crisis management decision-makers at educational and healthcare institutions should consider the different roles of medical teachers and the possibility of overburden associated with the cumulation of the excessive number of patient, didactic, and research duties. Moreover, faculty development initiatives and teamwork should become a vital part of the organizational culture of medical universities. A dedicated tool acknowledging the specificity and context of medical teachers' work seems necessary to quantitatively evaluate their sense of self-efficacy.

"Nothing replaces meeting my students at class": Analysing academics' views regarding distance education

Distance education, also called distance learning, e-learning, and online learning, is a practice of teaching and learning in which teachers and learners are not in a closed class or room in person, but where education takes place through various new-media technologies and all parties (student-teacher, teacher-teacher, student-student) are able to communicate, interact and exchange information and emotions. Being on the agenda of educational science for a long time now and gaining further importance during COVID-19 lockdowns, both advantages (e.g., reducing social anxiety, and a flexible schedule) and disadvantages (lack of social interactivity, and miscommunication) of distance education are highly debated in the related literature. Therefore, this study, through a qualitative method (i.e., a case study design and semi-structured interviews), aims to analyse the opinions and experiences of academics regarding distance education and its applications. The participants consist of 36 lecturers working at 16 different Turkish universities selected by the purposeful sampling method (i.e., typical case sampling). The results suggest that the participants still have doubts about online distance education, and they mention both ups (ease of connection, and cost-effectiveness) and downs (lack of self-motivation, socialization, and the sense of isolation) of it. Nonetheless, none of the academics thinks distance education will replace an in-person learning environment in the near future. Thus, this study presents a general illustration of distance education activities through the views of Turkish academics and gives recommendations for future digital/distance/online learning activities and functionalities.

Generation Z nursing students’ online learning experiences during COVID-19 epidemic: A qualitative study

In early 2022, the coronavirus disease 2019 (COVID-19) continued to spread quickly globally and broke out in some metropolitan areas. To stop the spread of infection, all colleges and universities were shifted to a closed model, and higher education was transformed into online learning (OL). These transitions posed numerous challenges for Generation Z students, especially those in the nursing profession that featured face-to-face practice courses. This study aimed to explore and understand the experiences of OL among Generation Z nursing students during COVID-19 epidemic. This qualitative phenomenological research design applied a purposive sampling approach to enroll 14 Generation Z nursing students from a college. Data were collected and analyzed using in-depth, semi-structured interviews and Colaizzi seven-step method. The analysis demonstrated four themes and eleven subthemes: challenges encountered during OL, advantages perceived during OL, experience of loneliness and stress, and developing resilience during OL. This study concluded that the sudden shift in learning styles presents challenges to Generation Z nursing students. Despite the adversity, the students showed tremendous resilience and endurance. During the pandemic, educators should provide support measures based on the characteristics of Generation Z to improve the effectiveness of OL and respond positively to stress.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

The mediating role of general academic emotions in burnout and procrastination among Chinese medical undergraduates during the COVID-19 pandemic: A cross-sectional study

Background

Academic procrastination has become more prevalent during the COVID-19 pandemic due to teaching/learning changes. This phenomenon induces academic burnout, which is already serious among medical students. However, the academic emotion, which is the factor most vulnerable to changes in the academic environment, is still unknown. Therefore, the current study aimed to investigate the mediating role of general academic emotions in procrastination and burnout among Chinese medical students during the COVID-19 pandemic.

Methods

This cross-sectional study enrolled 995 medical students from China Medical University. We applied the Chinese version of the Maslach Burnout Inventory Student Survey (MBI-SS), the Aitken Procrastination Inventory (API) and the General Academic Emotion Questionnaire for College Students (GAEQ) to evaluate the variables of interest. We examined the mediation effects of GAEs by hierarchical linear regression analysis.

Results

Correlation analyses showed a significant positive correlation between procrastination and burnout. Procrastination and burnout positively and negatively correlated with negative academic emotions, respectively. Hierarchical linear regression analyses showed that procrastination had positive associations with negative academic emotions, while it had negative associations with positive academic emotions. The contributions (as mediators) of GAEs to burnout and procrastination were 21.16% (NAEs), 29.75% (PAEs), 54.25% (NDEs) and 23.69% (PDEs).

Conclusions

The results indicate that academic emotions had mediating effects on procrastination and burnout. Medical students' worries about the uncertainty of the learning environment may have exacerbated academic burnout. Targeted improvements in the teaching environment to communicate encouragement and reduce anxiety and helplessness among medical undergraduates for implementing medical education while preventing and controlling the infection.

Health professions faculty’s perceptions of online teaching and learning during the COVID-19 pandemic

The global societal impact of the COVID-19 pandemic is incalculable with profound social suffering, deep economic hardships and enforced closure of schools, businesses, and higher learning institutions through the imposition of lockdown and social distancing in mitigation of the spread of the SARS-Cov-2 infection. Institutions have had to hastily migrate teaching, learning and assessment to online domains, at times with ill-prepared academics, students and institutions and with unwelcome and disorienting consequences. Our study surveyed perspectives of faculty at the University of Zimbabwe Faculty of Medicine and Health Sciences (UZFMHS) towards the hastily adopted online teaching, learning and assessment implemented in response to the mitigation of the COVID-19 pandemic. Twenty nine (29) faculty in all the major disciplines and career hierarchy. There were mixed responses regarding the use of this modality for teaching, learning and assessment: training before online teaching, learning and assessment, advantages and disadvantages, cost effectiveness, effectiveness for teaching, learning and assessment, effect on student feedback, disruptions from internet connectivity issues, interaction with students, suitability for practical training, and barriers to online teaching, learning and assessment. These results would enable the UZFMHS develop institutional and personalised approaches that would enable execution of online teaching, learning and assessment under the current and post COVID-19 pandemic.

Application of problem-based learning combined with a virtual simulation training platform in clinical biochemistry teaching during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has had a great impact on the traditional teaching mode (Lecture-based Learning, LBL) and laboratory teaching. To address this challenge, the researchers conducted online Problem-based learning (PBL) teaching and virtual simulation laboratory teaching through DingTalk, and evaluated the effectiveness of this method in teaching clinical biochemistry.

METHODS

With the method of cluster sampling, the researchers randomly selected 60 students from two classes of the Class 2019 as the experimental group for this prospective experimental study. The theory class was taught online PBL through DingTalk, and experimental lectures were given by virtual simulation. After the experimental teaching, students were assessed for theory and operation. Self-administered questionnaires were administered through DingTalk. 65 students from our 2018 medical laboratory class were randomly selected as the control group, and offline LBL and traditional experimental teaching methods were used. Examination results were obtained through teaching portfolios.

RESULTS

The experimental group had significantly better examination scores in theoretical knowledge and experimental operational skills than the control group (87.45 ± 5.91 vs. 83.52 ± 9.94, P = 0.0095; 87.08 ± 12.42 vs. 80.18 ± 14.04, P = 0.0044). The results of the questionnaire survey revealed that the experimental group was more receptive to the DingTalk-PBL teaching method and virtual simulation laboratory teaching. Moreover, this hybrid teaching method was more effective in promoting basic knowledge understanding (95.0%, 57/60), facilitating the mastery of operational skills (93.3, 56/60), cultivating interest in learning (96.7%, 58/60), training clinical thinking (95.0%, 57/60), improving communication skills (95.0%, 57/60), and enhancing self-learning ability (91.7%, 55/60) and was more satisfying than traditional teaching method (all P < 0.05).

CONCLUSION

The DingTalk-based PBL method combined with virtual simulation experiments was an effective and acceptable teaching strategy during the pandemic compared with the traditional teaching method.

Impact of COVID-19 pandemic on medical students: a scoping review protocol

INTRODUCTION

The COVID-19 pandemic has spread globally and has been reported in every known country. The effects can be felt in universities and schools, shifting their learning to online platforms. However, medical schools bear the burden of protecting students and ensuring the continuation of the education process. The rapid transition to online learning, coupled with the lack of preparation from the educational system, leads to stresses that affect students' academic performance, mental health and social life. Nevertheless, no review tried to synthesise the complete picture of the pandemic's effects. Therefore, this scoping review aims to identify and explore the available literature on the effects or impacts of the pandemic on medical students without limiting it to specific dimensions.

METHODS

This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and the Joanna Briggs Institute manual for evidence synthesis. We examine articles reporting data from any country. However, only articles written in English will be included. For studies to be included, they must report any form of impact on medical students, qualitatively or quantitatively. Furthermore, the impact must occur within the context of the COVID-19 pandemic. Searches will be done on Medline, EMBASE, ERIC, the Cochrane Library, CINAHL and PsycInfo. After data extraction, we will narratively synthesise the data and explore the types of impacts COVID-19 has on medical students.

ETHICS AND DISSEMINATION

No formal ethical approval is required. The scoping review will be published in peer-reviewed journals and as conference presentations and summaries, wherever appropriate.

A single-center, cross-sectional study of cross-professional faculties' perception to virtual class under different scenarios: A stepwise approach

BACKGROUND

Virtual teaching in medical education is rising with the increased need caused by the recent pandemic. However, evaluations of the perception of clinical teachers across professions for setting a virtual class in different teaching scenarios are limited. This study aims to identify cross-professional clinical teachers' perception of virtual classes and the acceptability of the virtual class-specific checklist for setting a virtual class.

METHODS

We conducted a cross-sectional study to investigate clinical teachers' need to set and teach a virtual class and then designed a virtual class-specific checklist with five essential steps and a related training program in July 2021. After the training, 186 participants were randomly enrolled in October 2021 to evaluate their perceptions about setting virtual classes and the acceptability of the virtual class-specific checklist using an online assessment questionnaire.

RESULTS

In our institution, the number of faculty-led virtual classes has recently been on the increase. Our study revealed that most teachers agreed that virtual classes could break space and time limitations, but that the Internet environment could affect the fluency of the virtual class. They further agreed that the essential five steps in the checklist should vary depending on the type of teaching scenario. Most clinical teachers, with the exception of those who teach in the operating room, considered the operating room as the most difficult scenario for setting virtual classes.

CONCLUSION

Faculty training for setting virtual classes is essential, and the essential virtual class-specific five steps are suitable for different teachers and teaching scenarios. However, the virtual class-specific checklist should be further adjusted according to the limitations caused by emerging innovative virtual teaching technology.

Postgraduate student perceptions of face-to-face and distance education in orthodontics: A cross-sectional qualitative study

Objective:

To investigate postgraduate student perceptions of face-to-face and distance education on a three-year programme in orthodontics.

Design:

Cross-sectional qualitative study.

Setting:

UCL Eastman Dental Institute, London.

Participants:

A total of 25 current postgraduate orthodontic students in the first, second and third years of training were included in this study.

Methods:

Postgraduate student perceptions were obtained by conducting online focus groups on Zoom Video Communications Inc. A focus group topic guide was developed, and a facilitator was trained to host the focus groups. There were separate focus groups for each year group, with a maximum of five participants in each group. The focus groups were audio recorded and transcribed verbatim. The transcripts were assessed by all members of the research team and analysed using a thematic content analysis, with a framework approach to identify themes and subthemes regarding perceptions of distance and face-to-face education.

Results:

A total of 25 students participated. Six key themes were identified relating to student perceptions of face-to-face and distance education: (1) social support network; (2) technology; (3) learning experience; (4) education environment; (5) interpersonal interactions; and (6) effective teaching/learning. There were perceived benefits and drawbacks for both modes of teaching delivery. In particular, students highlighted the importance of reliable technology, peer support and accessibility of educational resources for their academic learning. Students favoured a blended approach to learning where practical skills were taught in person and some theoretical aspects taught remotely.

Conclusion:

The results aid the understanding of how educational tools and digital technology can enrich the student academic experience. The results provide important information for the future development and delivery of orthodontic postgraduate education.