Student Response to Remote-Online Case-Based Learning: A Qualitative Study

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.

Knowledge Attainment and Engagement Among Medical Students: A Comparison of Three Forms of Online Learning

OBJECTIVE

This study compared knowledge attainment and student enjoyment and engagement between clinical case vignette, patient-testimony videos and mixed reality (MR) teaching via the Microsoft HoloLens 2, all delivered remotely to third year medical students. The feasibility of conducting MR teaching on a large scale was also assessed.

SETTING & PARTICIPANTS

Medical students in Year 3 at Imperial College London participated in three online teaching sessions, one in each format. All students were expected to attend these scheduled teaching sessions and to complete the formative assessment. Inclusion of their data used as part of the research trial was optional.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was performance on a formative assessment, which served to compare knowledge attainment between three forms of online learning. Moreover, we aimed to explore student engagement with each form of learning via a questionnaire, and also feasibility of applying MR as a teaching tool on a large scale. Comparisons between performances on the formative assessment between the three groups were investigated using a repeated measures two-way ANOVA. Engagement and enjoyment were also analysed in the same manner.

RESULTS

A total of 252 students participated in the study. Knowledge attainment of students using MR was comparable with the other two methods. Participants reported higher enjoyment and engagement (p<0.001) for the case vignette method, compared with MR and video-based teaching. There was no difference in enjoyment or engagement ratings between MR and the video-based methods.

CONCLUSION

This study demonstrated that the implementation of MR is an effective, acceptable, and feasible way of teaching clinical medicine to undergraduate students on a large scale. However, case-based tutorials were found to be favoured most by students. Future work could further explore the best uses for MR teaching within the medical curriculum.

Digital Entry-Level Education in Physiotherapy: a Commentary to Inform Post-COVID-19 Future Directions

Currently, the coronavirus disease 2019 (COVID-19) severely influences physiotherapy education which is based mostly on face-to-face teaching. Thus, educators have been compelled to adapt their pedagogical approaches moving to digital education. In this commentary, we debate on digital education highlighting its effectiveness, the users' perspectives, and its weakness in the context of physiotherapy teaching aimed at informing post-COVID-19 future directions in this educational field. Existing evidence on digital education produced before COVID-19 supports its implementation into entry-level physiotherapy education. However, some challenges (e.g. social inequality and evaluation of students) threaten its applicability in post-COVID-19 era, calling educators to take appropriate actions.

Pediatric Residency Education During the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic has had profound effects on society and, in particular, on many aspects of medical care. Residency training programs are often integral parts of our medical community and consequently have experienced changes in structure, format, and content. The conversion to virtual or online learning has been nearly universal. Decreases in common pediatric diagnoses such as respiratory syncytial virus and asthma have led to less first-hand experience for residents. Limitations designed to minimize the spread of COVID-19, such as use of personal protective equipment and group size limits, have led to fewer clinic rotations, fewer clinic sessions, and fewer patient experiences. Infections of residents themselves have led to an increase in back-up call system usage and a strain on staffing. Mandatory limits on group gatherings have also impaired camaraderie and the overall well-being of trainees. [Pediatr Ann. 2021;50(12):e509-e514.].

Augmented Reality and Plastic Surgery Training: A Qualitative Study

Background and objective

The coronavirus disease 2019 (COVID-19) pandemic has led to many challenges in face-to-face teaching and training in plastic surgery. However, it has also proved to be an incubator for many technological solutions. Augmented reality (AR) platforms may offer a safe, equitable, and efficient means to provide training in plastic surgery. This study aimed to explore the user's experience of AR as an educational intervention during the COVID-19 pandemic in the United Kingdom (UK).

Materials and methods

The Proximie® AR platform (Proximie Limited, London, UK) has been in use in a UK plastic surgical department for facilitating webinars, visual libraries, and streamed procedures. The experience of a range of trainers and trainees was qualitatively explored through 10 individual interviews. Data-emergent theme analysis was also performed.

Results

AR was well-received in the context of COVID-19 and training in general as a means to enable theatre access, and visual revision, remotely. The potential for its use in remote coaching and telementoring was also discussed. Recommendations were made by the users to optimise the experience both from the trainer and learner perspectives. Data were presented pertaining to the following themes: surgical AR as a substitute for hands-on learning; surgical AR and theoretical learning; considerations specific to streamed procedures using Proximie®; considerations in the use of technology in general.

Conclusion

Harnessing novel technologies in surgical education offers an exciting opportunity, fast-tracked by COVID-19, but applicable beyond it. Though this study includes a small sample size, its findings suggest that AR platforms may offer a uniquely interactive remote educational experience in surgical training. Strategies and suggestions for its use are discussed, as well as broader considerations in using technology in surgical education.

Online dental teaching practices during the COVID-19 pandemic: a cross-sectional online survey from China

Background

Coronavirus disease 2019 (COVID-19) emerged in China in December 2019. The COVID-19 pandemic hindered dental education, as school buildings were closed. Online dental teaching provided an alternative teaching tool for dental education. However, the efficiency of online dental teaching and student preferences for online dental teaching are unclear.

Aim

To investigate the satisfaction with online dental teaching practices among undergraduate dental students and standardized resident physician training students during the COVID-19 pandemic in China.

Methods

A total of 104 undergraduate dental students and 57 standardized resident physician training students from Zhejiang University participated in the study. A 12-item survey was conducted. This investigation included the teaching methods received, frequency of classes, degree of satisfaction, preferred teaching method, whether to participate in a course regarding COVID-19 prevention, and the effects of teaching. The percentages were then calculated and evaluated for each item.

Results

A total of 161 students (104 undergraduate dental students and 57 standardized resident physician training students) participated in this survey. All students had online dental classes during the COVID-19 pandemic. Lecture-based learning (LBL), case-based learning (CBL), problem-based learning (PBL), team-based learning (TBL), and research-based learning (RBL) were selected as teaching methods. Students were more satisfied with LBL and CBL than PBL, RBL, and TBL. The majority of students had more than four classes per week. The most selected protective measures were hand washing, wearing masks, and wearing gloves. A total of 46.6% of students participated in courses on COVID-19. After training, the students consciously chose to wear face shields and protective clothing.

Conclusions

Dental students accepted online dental learning during the COVID-19 pandemic. Students preferred LBL and CBL and were satisfied with the classes. Courses on COVID-19 helped students understand how to prevent COVID-19 transmission in the dental clinic.

Students' perception and learning on case based teaching in anatomy and physiology: An e-learning approach

INTRODUCTION

Case based teaching (CBT) has been accepted as an effective interactive learning strategy. Digital portals allow the students to learn the content at their own pace, explore various resources and finally enable them to discuss within group and build team work approach, which is a prime focus in the health care professional field. The aim of this study was to assess the perception and learning outcome of first year medical students towards CBT using e-learning approach.

METHOD

This is a non-randomized, interventional study on first year undergraduate medical students from 2017-18 batch (43) and 2018-19 batch (41) of Sumandeep Vidyapeeth University. They were divided into a group of 8-10 members, who attended six sessions of case-based teaching via Google group. Learning outcome was analyzed by comparing the students who participated in the sessions and those who did not. Feedback survey questionnaire was analyzed by Mann Whitney ranking test and focus group discussion by thematic analysis for qualitative analysis manually.

RESULT

A p value <0.01 was considered statistically significant for post-test by e-learning tool for CBT. Participants agreed that CBT is a good way to conceptualize applied aspect of basic science, enhance critical thinking, and explore varied resources. Thus, they confirmed that team building approach and leadership qualities for managing the group contributed to better understanding of the course and would be useful to them in near future.

CONCLUSION

Usage of Google group technology for CBT allowed medical students to explore clinical application of basic sciences course from the first year of the program, going beyond the classroom, thus developing self-directed learning and team building approach.

How does video case-based learning influence clinical decision-making by midwifery students? An exploratory study

BACKGROUND

Clinical decision-making skills are essential for providing high-quality patient care. To enhance these skills, many institutions worldwide use case-based learning (CBL) as an educational strategy of pre-clinical training. However, to date, the influence of different learning modalities on students' clinical decision-making processes has not been fully explored. This study aims to explore the influence of video and paper case modalities on the clinical decision-making process of midwifery students during CBL.

METHODS

CBL involving a normal pregnant woman was provided for 45 midwifery students. They were divided into 12 groups; six groups received the video modality, and six groups received the paper modality. Group discussions were video-recorded, and focus groups were conducted after the CBL. Transcripts of the group discussions were analysed in terms of their interaction patterns, and focus groups were thematically analysed based on the three-stage model of clinical decision-making, which includes cue acquisition, interpretation, and evaluation/decision-making.

RESULTS

The students in the video groups paid more attention to psychosocial than biomedical aspects and discussed tailored care for the woman and her family members. They refrained from vaginal examinations and electric fetal heart monitoring. Conversely, the students in the paper groups paid more attention to biomedical than psychosocial aspects and discussed when to perform vaginal examinations and electric fetal heart monitoring.

CONCLUSION

This study clarified that video and paper case modalities have different influences on learners' clinical decision-making processes. Video case learning encourages midwifery students to have a woman- and family-centred holistic perspective of labour and birth care, which leads to careful consideration of the psychosocial aspects. Paper case learning encourages midwifery students to have a healthcare provider-centred biomedical perspective of labour and childbirth care, which leads to thorough biomedical assessment.