Online-rotation in paediatrics - digital live-interaction with children

An online flipped classroom approach improves the physiology score and subsequent course scores of the top-performing students

An online flipped classroom approach achieved the same teaching effect as online live teaching but had a more positive impact on high-achieving students. The positive impact was not only in Physiology but also in subsequent courses where logical thinking prevailed. However, for low-achieving students, the effect of online live teaching was better.

Teaching Clinical Skills Using Online Modality through Modified Peyton's Framework: An Experience from a Medical University in Pakistan

INTRODUCTION

Medical institutions worldwide faced an unprecedented situation during COVID-19 of identifying alternative strategies to sustain the continuum of learning process. This led to several innovations in the traditional medical curriculum. This study explored the effectiveness and feasibility of using the Peyton's framework modified for a virtual platform (Microsoft Teams) for teaching clinical skills to first and second-year medical students at The Aga Khan University, Karachi, Pakistan.

METHODS

In 2020-2021, the modified Peyton's framework was integrated in the clinical skills (CS) curriculum for all first- and second-year students (N=200). For evaluation, a mixed-method design was used, with pre-and post-session questionnaires. Students' satisfaction was obtained through the standard session evaluation tool of the university. For the qualitative arm, to explore the instructors' experiences, purposive sampling was used (n=8) and a focused group discussion (FGD) was conducted. Finally, performance of the students at the end of year summative Objective Structured Clinical Examination (OSCE) was compared with the students of previous year. Quantitative data were analysed using STATA® version 15.1, using paired t-test to compare the differences in OSCE scores in selected CS stations. A p-value of <0.05 was considered significant for all tests. The FGD was transcribed and analysed through manual content analysis.

RESULTS

Nine clinical skills (that included history and examination skills) were taught using the virtual platform. There was a significant improvement in post-session questionnaires in seven of these skills (p value <0.01). Session evaluations showed that most students were satisfied with the learning experience. The instructors showed that the online teaching offered a promising platform for teaching history taking skills. The OSCE scores showed mixed results, with significant improvement in two out of four repeated stations by using paired t-test [abdominal exam (87.33 ± 8.99, <0.001); and precordial examination (88.45 ± 8.36, 0.001)].

CONCLUSIONS

Modifying Peyton's framework to a virtual platform allowed us to sustain the continuum of clinical education during the COVID-19 pandemic. The results support the use of a blended learning environment for teaching clinical skills.

A Review of Virtual Medical Student Rotations During the COVID-19 Pandemic: Their Role, Advantages, Disadvantages, and Future Prospects

The COVID-19 pandemic resulted in the pause of medical clinical rotations. As a result, virtual rotations were implemented. These are a form of remote learning that seeks to mimic the clinical learning environment that students were already accustomed to. This article seeks to review the published literature to explore which specialties adapted this format, what are the advantages and disadvantages observed, determine what were the responsibilities and involvements of students participating in these rotations, how well these rotations substituted for in-person rotations, and to evaluate if there is a continued role for them after, outside of COVID-19. Virtual rotations have been developed in almost every specialty. These rotations have been developed from small centers to large universities, and are widespread throughout the United States, and in other countries as well. These rotations are targeted toward medical students, medical residents, and physician assistants and range in length from one to four weeks. Responsibilities and scope of interaction varied according to rotation; some rotations allowed patient interaction, and observation of procedures and surgeries, whereas some were purely didactic. A mixture of inpatient and outpatient involvements was seen. Advantages included saving money and time, more flexibility, increased diversity, and participation of international medical graduates. Virtual rotations participants have been invited for interviews at the participating institution's residency programs and have matched there. Disadvantages included lack of assessment of practical skills, inability to receive credit, and inability to obtain a letter of recommendation. Virtual rotations have proven to be a good substitute for in-person rotations, with most medical students seeing a need for the rotations in the future. Due to widespread development and acceptance of these rotations, it is likely that these rotations will continue.