1
|
Voss M, Geniets A, Winters N. Strategies for Digital Clinical Teaching During the COVID Pandemic: A Scoping Review. MEDICAL SCIENCE EDUCATOR 2024; 34:219-235. [PMID: 38510387 PMCID: PMC10948717 DOI: 10.1007/s40670-023-01894-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 03/22/2024]
Abstract
Widespread "lockdowns" during the COVID pandemic in 2020-2021 restricted medical students' access to patients. We used a scoping review with exploratory thematic synthesis to examine how reports of digital clinical teaching during the first year of the COVID pandemic could inform digital clinical teaching in the post-pandemic world. We looked at strategies used and outcomes reported, lessons learned about how best to use digital methods for clinical teaching, and learning theories used. The eighty-three articles included in the final review fell into four groups. These were telehealth interventions; virtual case-based teaching; multi-modal virtual rotations; and a small group of "other" strategies. Telehealth reports indicated that COVID has probably accelerated the adoption of telehealth, and these skills will be required in future curricula. Engagement with virtual case-based teaching was problematic. Virtual rotations were particularly valued in specialties that relied on visual interpretation such as radiology and dermatology. For general clinical specialties, digital clinical teaching was not a satisfactory substitute for real clinical exposure because it lacked the complexity of usual clinical practice. Sixty-seven articles reported students' reactions only, and 16 articles reported a change in knowledge or skills. Demands on instructors were considerable. Few studies were theorized and none tested theory, which limited their transferability. While telehealth teaching may be a valuable addition to some curricula, digital clinical teaching is unlikely substantially to replace exposure to real patients outside of specialties that rely on visual interpretation. High demands on instructors suggest little potential for new, scalable digital clinical offerings after COVID.
Collapse
Affiliation(s)
- Miranda Voss
- Department of Education, University of Oxford, Oxford, UK
- Harris Manchester College, Mansfield Road, Oxford, OX1 3TD UK
| | - Anne Geniets
- Department of Education, University of Oxford, Oxford, UK
| | - Niall Winters
- Department of Education, University of Oxford, Oxford, UK
| |
Collapse
|
2
|
Dahmen L, Linke M, Schneider A, Kühl SJ. Medical students in their first consultation: A comparison between a simulated face-to-face and telehealth consultation to train medical consultation skills. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc63. [PMID: 37881523 PMCID: PMC10594035 DOI: 10.3205/zma001645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/07/2023] [Accepted: 07/07/2023] [Indexed: 10/27/2023]
Abstract
Objective A simulated conversation between a physician and a family member, i.e., a medical conversation, was changed from a conventional face-to-face conversation (SS 2019) to a telehealth conversation (SS 2020) due to the COVID-19 pandemic. The medical education conversation is part of the biochemistry seminar "From Genes to Proteins" which second semester human medicine students take. The objective of this study was to analyze to what extent the switch from face-to-face to telehealth conversations affected student satisfaction and motivation. Methodology In the seminar, students study biochemical as well as competency-oriented content, such as how to talk to family members. In the summer semester of 2019, students were trained how to talk to their patients' family members in a traditional conversation setting with the help of lay actors in a classroom format. In the summer semester of 2020, this conversation took place under comparable conditions, but in the form of an online telehealth conversation instead. Student satisfaction and motivation were surveyed by means of an evaluation questionnaire following the seminar in both semesters. Results Both conversation formats achieved a high level of satisfaction from students (school grade A-B). For some evaluation items, such as "realistic conversation simulation", the face-to-face conversation was perceived as more satisfying (Md=5.0, IQR=1.0) than the telehealth conversation (Md=5.0, IQR=2.0). In addition, the face-to-face conversation resulted in higher subjective motivation from students (Md=5.0, IQR=1.0) than that of the telehealth conversation (Md=4.0, IQR=2.0). Conclusion The high student satisfaction and acceptance of both didactic concepts leads to the conclusion that the simulated telehealth conversation is an adequate substitute for the simulation of a traditional face-to-face conversation with regard to the parameters that were studied.
Collapse
Affiliation(s)
- Lena Dahmen
- University of Ulm, Faculty of Medicine, Institute of Biochemistry and Molecular Biology, Ulm, Germany
| | - Maike Linke
- Dresden University of Technology, Carl Gustav Carus Faculty of Medicine, Psychosocial Medicine and Developmental Neurosciences, Dresden, Germany
| | - Achim Schneider
- University of Ulm, Faculty of Medicine, Dean of Studies Office, Ulm, Germany
| | - Susanne J. Kühl
- University of Ulm, Faculty of Medicine, Institute of Biochemistry and Molecular Biology, Ulm, Germany
| |
Collapse
|
3
|
Abdull Mutalib AA, Md Akim A, Jaafar MH. A systematic review of health sciences students' online learning during the COVID-19 pandemic. BMC MEDICAL EDUCATION 2022; 22:524. [PMID: 35786374 PMCID: PMC9251028 DOI: 10.1186/s12909-022-03579-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/16/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND This study aims to analyse the effectiveness of distance learning during the COVID-19 pandemic among undergraduate health sciences students using systematic review. Online learning has been chosen as the best approach to continue offering education in this pandemic era. METHOD The screening process was done using Scopus, ScienceDirect and PubMed based on the eligibility criteria. Out of 1486 studies, 1269 were screened. A total of 64 eligible studies obtained were included in the quantitative analysis. Results were categorized into i) student attitudes (perceptions/satisfactions/engagements), and ii) student learning outcomes, and compared to the Kirkpatrick model. RESULTS Although facing difficulties, 50% of the studies was moderately satisfied with distance learning, while 36% was highly satisfied and 17% dissatisfied. Most studies (26%) reported flexibility in online learning. Internet issues (19%) and low interaction between learners and instructors (19%) were the most prevalent problems mentioned. Online education engages students better than traditional learning. The learning outcome was assessed using two categories: i) academic performance and ii) skill development. Most studies (72%) stated that online learning improves academic performance, 14% reported a drop, and 14% stated no effect, while an increase in clinical skills and communication skills were reported. Kirkpatrick evaluation revealed 80% of the studies obtained was evaluated at level 1 (reaction), 8% at level 2 (learning), 12% at level 3 (behaviour) and none at level 4 (results). CONCLUSION Overall, this systematic review found that the online learning performed better than expected during COVID-19, but the data gained is insufficient to say it is beneficial when compared to other types of teaching approaches.
Collapse
Affiliation(s)
- Abdull Assyaqireen Abdull Mutalib
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Abdah Md Akim
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Mohamad Hasif Jaafar
- Academy of Contemporary Islamic Studies, Universiti Teknologi MARA, 72000, Kuala Pilah, Negeri Sembilan, Malaysia
| |
Collapse
|
4
|
Holzmann-Littig C, Zerban NL, Storm C, Ulhaas L, Pfeiffer M, Kotz A, Wijnen-Meijer M, Keil S, Huber J. One academic year under COVID-19 conditions: two multicenter cross-sectional evaluation studies among medical students in Bavarian medical schools, Germany students' needs, difficulties, and concerns about digital teaching and learning. BMC MEDICAL EDUCATION 2022; 22:450. [PMID: 35681177 PMCID: PMC9183753 DOI: 10.1186/s12909-022-03480-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/20/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND Since March 2020, COVID-19 has created a need for adaptation in many areas of life. This study explores medical students' perspectives on digital teaching under conditions of the COVID-19 pandemic. It focuses on expectations and concerns about digital teaching, the evaluation of specific aspects of teaching, and requests for future teaching. METHODS Six German faculties have joined forces within the Bavarian network for medical education to develop and deploy a common core questionnaire. Cross-sectional surveys were conducted at the end of the summer semester 2020 and winter semester 2020/21. Medical students from different semesters participated in the online survey. Data was analyzed descriptively and/or inferentially. Item differences across semesters were examined using contingency tables and Chi2 tests. Mean values were compared using the independent samples t-test; answer frequencies in retrospective and prospective concerns were compared using contingency tables and Chi2 tests with Yates' correction. RESULTS In the summer semester 2020, 1565 students and in winter semester 2020/21, 1727 students took part in the survey. Students' main prospective concern was lack of social exchange between fellow students (70%), but also with teachers. Second and third most often concerns were a lack of practical training (68%) and lack of integration of on-site digital teaching (50%). Approximately 7% of the students lacked sufficient access to technical equipment.. Approximately 39% of the students lacked a sufficient internet connection for synchronous digital teaching, 17% for asynchronous digital teaching. On-site teaching was the preferred form of teaching (60%), and there was a preference for asynchronous (24%) over synchronous (15%) digital teaching. Teaching recordings (79%) were particularly popular to complement future on-site teaching. CONCLUSIONS The following areas of education under COVID-19 conditions are highly important to medical students: adequacy of information sharing, integration of opportunities for exchange with fellow students and teachers, possibility to perform practical trainings. After the normalization of the pandemic situation, on-site teaching should be supplemented with blended learning concepts such as the inverted classroom model. Percentages of results are rounded averages from summer and winter semesters.
Collapse
Affiliation(s)
- Christopher Holzmann-Littig
- TUM Medical Education Center, Faculty of Medicine, Technical University of Munich, Munich, Germany.
- Department of Nephrology, University Hospital rechts der Isar, Faculty of Medicine, Technical University of Munich, Munich, Germany.
| | - Nina L Zerban
- Institute of Medical Teaching and Medical Education Research, University Hospital of Würzburg, Würzburg, Germany
- Simulated Patient Program, Faculty of Medicine, Julius-Maximilians-Universität of Würzburg, Würzburg, Germany
| | - Clara Storm
- Institute for Medical Education, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Lilian Ulhaas
- Faculty of Medicine, Dean's Office and Department of Medical Education Augsburg DEMEDA, Augsburg University, Augsburg, Germany
| | - Mona Pfeiffer
- Institute for Medical Education, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Alexander Kotz
- Faculty of Medicine, Office of the Dean for Student Affairs, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Stephanie Keil
- Faculty of Medicine, Dean's Office, University of Regensburg, Regensburg, Germany
| | - Johanna Huber
- Institute for Medical Education, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| |
Collapse
|
5
|
Schwär M, Ullmann-Moskovits J, Farquharson M, Sennekamp M. The sudden switch to online communication training after 10 years in the classroom - comparing the evaluation results of a course on doctor-patient communication. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc22. [PMID: 35692358 PMCID: PMC9174076 DOI: 10.3205/zma001543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/10/2021] [Accepted: 01/24/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of the study was to find out whether it is possible to successfully convert a communication course for around 400 students to a blended-learning format (asynchronous theoretical course/synchronous digital practical course). The main focus thereby was on assessing subjective learning progress and the extent to which the importance of communication and doctor-patient communication can be conveyed online. The study is based on the results of an evaluation of the opinions of both the students and the lecturers that participated in the course. METHODS The students, who were in their fourth preclinical semester in 2020, were asked to fill in a self-assessment sheet at the beginning of the course, and following its completion. The feedback provided by the lecturers was also assessed. In order to compare the results and identify possible discrepancies, the corresponding self-assessment and evaluation results for the past 10 years (stemming from traditional classroom courses) were also taken into account. RESULTS Participants in the online courses reported distinct subjective learning progress, and greater progress than was reported for traditional courses in previous years. The suitability of the online format was viewed critically by both students and lecturers, while the course atmosphere was seen positively. The relevance of doctor-patient communication was assessed particularly highly in the online format. CONCLUSION Based on the results of the evaluation, the experience gained from the blended-learning format will be included into future iterations of the communication course at Goethe University Frankfurt. The results have shown that doctor-patient communication can be learned well online. This format can therefore be recommended for new learning concepts in the future.
Collapse
Affiliation(s)
- Miriam Schwär
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt am Main, Germany
| | | | - Maria Farquharson
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt am Main, Germany
| | - Monika Sennekamp
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt am Main, Germany
| |
Collapse
|