Face-to-face or face-to-screen? Undergraduates' opinions and test performance in classroom vs. online learning

B-learning in human anatomy: Comparative analysis of academic achievement between face-to-face and e-learning modalities

INTRODUCTION

In recent years, modern technologies have become established in most educational fields. Thus, e-learning tends to be an integral part of the learner-centered learning process, with the teacher acting as a facilitator. However, the methodologies used to study the impact of e-learning have been varied and imprecise, making comparison and meta-analysis difficult. This study attempts to overcome these obstacles with a large and homogeneous sample to compare (1) the academic outcomes obtained with face-to-face and e-learning in a blended module of human anatomy and (2) the response attempts (response index) of each student in answering questions specific to each learning modality.

MATERIAL AND METHODS

The results of the multiple-choice exams under study were collected. All students (n=1160) were from four consecutive academic years following the same teaching program with a b-learning method: 13 topics were presented face to face by the same lecturers, and six via e-learning with the same online resources. Two variables were compared: (1) the academic grade, based on the score for correct answers and the penalty for incorrect ones, and (2) the response index, based on the number of correct and incorrect answers.

RESULTS

(1) 73.45 % of the examinees passed the test. In the sample as a whole, results were better in face-to-face than in e-learning. In the quartiles ordered by overall academic performance, this superiority was limited to the top half of the higher-performing students. In contrast, lower-scoring students performed better in e-learning. However, these differences were modest (≤ 0.54 points). (2) In proportion, the questions on topics learned face-to-face were the most frequently answered. A strong correlation was observed between the variables in the whole sample and the students with the highest academic scores (first quartile) on the global exam and the questions on topics learned in each modality. In the remaining quartiles, the correlation was also strong in the e-learning content.

CONCLUSIONS

(1) Both modalities included in b-learning are academically effective. (2) Proportionally, students take more risks when answering content questions learned in face-to-face classes, and there is a strong correlation between response attempts and academic grades, especially, on the brightest exams and e-learning content.

Example-based learning in heuristic domains: can using relevant content knowledge support the effective allocation of intrinsic, extraneous, and germane cognitive load?

Introduction

Worked examples support initial skill acquisition. They often show skill application on content knowledge from another, "exemplifying" domain (e.g., argumentation skills have to be applied to some contents). Although learners' focus should remain on the skill, learners need to understand the content knowledge to benefit from worked examples. Previous studies relied on exemplifying domains that are familiar and contain simple topics, to keep learners' focus on skill acquisition.

Aim

We examined whether using a relevant exemplifying domain would allow learners to acquire both skills and content knowledge simultaneously, or whether relevant content distracts from the main learning goal of skill acquisition.

Methods and results

In a training study with 142 psychology students, we used example-based learning materials with an exemplifying domain that was either relevant or irrelevant for participants' course outcomes. We assessed cognitive load, declarative knowledge about skills and course-related content knowledge, and argumentation quality. Incorporating relevant content knowledge in worked examples did not reduce learning outcomes compared to a condition using an irrelevant exemplifying domain.

Discussion

Contrary to previous research, the results suggest that worked examples with a relevant exemplifying domain could possibly be an efficient teaching method for fostering skills and content knowledge simultaneously.

University students' preferences of learning modes post COVID-19-associated lockdowns: In-person, online, and blended

Online teaching accelerated during COVID-19-associated lockdowns. At that time, it was assumed that university students wanted to revert to in-person sessions at the earliest opportunity. However, when in-person sessions were re-introduced, student attendance was not as high as expected. Therefore, we examined students' preferences of learning modes. Students (n = 968) from different UK universities, degree cohorts, study levels and biological sexes were given four learning-mode options: Face-to-face sessions for lectures and tutorials (in-person), Live online sessions for lectures and tutorials (Online-synchronous), Pre-recorded lectures and live online tutorials (Online-mixed-asynchronous-synchronous), and Pre-recorded lectures and face-to-face tutorials (Blended: in-person and online-asynchronous). Students ranked these options as per their preference via an online anonymous survey. Data were analysed using IBM SPSS Statistics 28. Results showed that the most frequently selected 1st and last choices were In-person and Online-synchronous modes, respectively. For the majority, above choices were the same across study levels and biological sex, but across degree cohorts, the 1st choice was either In-person or Blended. Proportion of students selecting In-person mode as their 1st choice (52.2%) was almost equal to the combined proportions of those selecting other learning modes as 1st choices (47.5%). Amongst degree cohorts, In-person mode was least preferred by Language Education students and most preferred by Bioscience and Sports & Exercise Science students. The latter cohort also preferred Online-synchronous mode more than other degree cohorts. Blended mode was preferred more by Language Education, Computer Science and Psychology students but preferred less by Sports & Exercise Science and Pharmacy students, compared to other degree cohorts. Ordinal regression revealed that Sports & Exercise Science students preferred Online-mixed-asynchronous-synchronous mode less than Language Education students. Undergraduates preferred In-person mode more and Online-mixed- asynchronous-synchronous mode less than postgraduates. Preference differences between biological sexes were insignificant. Thus, we identified students' preferences of learning modes and propose that not biological sex, but discipline and study level can predict/influence preferences.

Implementing online learning of Diagnostic Criteria for the Temporomandibular Disorders (DC/TMD) protocol in undergraduate dental education

INTRODUCTION

The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is part of the undergraduate dental curriculum. Online teaching has nowadays become common also in dentistry.

OBJECTIVE

To compare undergraduate students' self-assessed ability and satisfaction with learning DC/TMD Axis I between traditional and online learning and to evaluate the possible gains of online teaching.

MATERIAL AND METHODS

Third-year undergraduate dental students in 2018 (traditional learning, Group 1, n = 43/50) and in 2019 (online learning, Group 2, n = 34/50) at the University of Oulu, Finland evaluated their self-assessed ability and satisfaction with learning DC/TMD clinical examination and diagnostics on a 10-point scale. Additionally, those participating in online courses answered to two open-ended questions; Group 2 (n = 50) and another group from the University of Eastern Finland in 2019 and 2020 (n = 75, Group 3). Total of 105/125 students (84%) responded. Content analysis was used to open-ended responses.

RESULTS

The online course reported significantly higher self-assessed ability in measurements (p = 0.004), identifying referred pain (p = 0.043) and statement for the diagnostics (p = 0.017) and also higher self-assessed satisfaction in measurements (p = 0.046). According to the content analysis, essential gains of online teaching were efficient learning, videos and exercises, and adjustability to own timetable.

CONCLUSION

The online learning course can be considered as a good option for traditional learning of the DC/TMD protocol.

Consensus report of the second European Consensus Workshop on Education in Periodontology

BACKGROUND

The second European Consensus Workshop on Education in Periodontology was commissioned, as a result of the changes in the discipline and the advances in educational methods/technology, to update the 2009 Consensus report of the first European Federation of Periodontology (EFP) Workshop on the same topic that was jointly authored by the Association for Dental Education in Europe.

AIM

To identify and propose changes necessary in periodontal education at three levels, namely undergraduate, specialist and continuing professional development (CPD), with respect to learning outcomes, competencies and methods of learning/training and evaluation.

METHODS

Four working groups (WGs) considered education in periodontology at the undergraduate, specialist and CPD levels, and education methods. Four commissioned position papers, one per WG, summarized the relevant information. Workshop participants gathered at an in-person consensus meeting to discuss the individual reviews, and this consensus report summarizes the conclusions.

RESULTS

The learning outcomes for undergraduate and specialist education in periodontology have been updated, and a proposal for learning outcomes for CPD programmes was made. Learning/teaching/training and evaluation methods were proposed for each level of education, which included face-to-face, virtual and blended learning methods.

CONCLUSION

Developments in oral/dental medicine and in contemporary educational technologies have been translated into updated learning outcomes and learning/teaching/ training/evaluation methods relevant to education in periodontology.

Does the Cognitive Reflection Test Work with Chinese College Students? Evidence from a Time-Limited Study

The cognitive reflection test (CRT) is an experiment task commonly used in Western countries to test intuitive and analytical thinking styles. However, the validity of this task for Chinese participants has not been explored. Therefore, this study recruited Chinese college students to finish CRT tasks with various experimental designs. To gauge the accuracy of the CRT tasks, 438 Chinese college students first completed online questionnaires. Participants were then invited to participate in an offline laboratory with the same experimental settings. Finally, time pressure was used to strictly control intuition and analytical thinking to explore the performance of Chinese college students on CRT tasks. The results show that of the three experiments, Chinese college students had the highest accuracy in the offline test, and the CRT's intuitive conflict problem still applies to Chinese students under the time-limited condition. This study demonstrates the validity of the CRT in China and proves that time pressure is an effective method for identifying individuals with strong logic ability.

Developing novice analysts' videofluoroscopic swallowing study skills in speech-language pathology: A randomised control trial comparing blended and online training approaches

PURPOSE

This research investigates the relative effectiveness of independent online and blended learning approaches for novice analysts' development of videofluoroscopic swallowing study (VFSS) analytical skills. The secondary aims were to explore the impact of training on decision-making and to describe learners' perspectives of training outcomes.

METHOD

Undergraduate speech-language pathology students (n = 74) who had completed the dysphagia academic curriculum in an undergraduate speech-language pathology program were recruited for a randomised control trial. The ability to identify swallowing impairments in adults was compared pre- and post-training across three conditions: independent online (n = 23), peer-supported (n = 23), and expert-facilitated training (n = 28). The training comprised online VFSS training and practice with a commercially available digital video disc (DVD).

RESULT

The three training approaches were equal in improving novice analysts' identification of impairments on VFSS. Participants' analysis improved pre- to post-training (p = <.001), with no statistical difference amongst training conditions (p = .280). However, the expert facilitation condition resulted in better decision-making skill for novice analysts, as well as higher levels of confidence and greater engagement in the learning.

CONCLUSION

Well-designed independent online methods are appropriate to prepare novice analysts for VFSS analytical training. Expert facilitation and peer-supported environments may have benefits for more advanced skill development and engagement, and should be investigated in future studies.

Listening effort, fatigue, and streamed voice quality during online university courses

Understanding the impact of listening effort (LE) and fatigue has become increasingly crucial in optimizing the learning experience with the growing prevalence of online classrooms as a mode of instruction. The purpose of this study was to investigate the LE, fatigue, and voice quality experienced by students during online and face-to-face class sessions. A total of 110 participants with an average age of 20.76 (range 18-28) comprising first year undergraduate students in Speech and Language Therapy and Audiology programs in Turkey, rated their LE during the 2022-2023 spring semester using the Listening Effort Screening Questionnaire (LESQ) and assessed their fatigue with the Multidimensional Fatigue Inventory (MFI-20). Voice quality of lecturers was assessed using smoothed cepstral peak prominence (CPPS) measurements. Data were collected from both online and face-to-face sessions. The results revealed that participants reported increased LE and fatigue during online sessions compared to face-to-face sessions and the differences were statistically significant. Correlation analysis showed significant relationships (p < 0.05) between audio-video streaming quality and LE-related items in the LESQ, as well as MFI sub-scales and total scores. The findings revealed a relationship between an increased preference for face-to-face classrooms and higher levels of LE and fatigue, emphasizing the significance of these factors in shaping the learning experience. CPPS measurements indicated a dysphonic voice quality during online classroom audio streaming. These findings highlight the challenges of online classes in terms of increased LE, fatigue, and voice quality issues. Understanding these factors is crucial for improving online instruction and student experience.

Does a blended learning implementation package enhance HIV index case testing in Malawi? A protocol for a cluster randomised controlled trial

INTRODUCTION

Index case testing (ICT) is an evidence-based approach that efficiently identifies persons in need of HIV treatment and prevention services. In Malawi, delivery of ICT has faced challenges due to limited technical capacity of healthcare workers (HCWs) and clinical coordination. Digitisation of training and quality improvement processes presents an opportunity to address these challenges. We developed an implementation package that combines digital and face-to-face modalities (blended learning) to strengthen HCWs ICT skills and enhance quality improvement mechanisms. This cluster randomised controlled trial will assess the impact of the blended learning implementation package compared with the standard of care (SOC) on implementation, effectiveness and cost-effectiveness outcomes.

METHODS AND ANALYSIS

The study was conducted in 33 clusters in Machinga and Balaka districts, in Southern Malawi from November 2021 to November 2023. Clusters are randomised in a 2:1 ratio to the SOC versus blended learning implementation package. The SOC is composed of: brief face-to-face HCW ICT training and routine face-to-face facility mentorship for HCWs. The blended learning implementation package consists of blended teaching, role-modelling, practising, and providing feedback, and blended quality improvement processes. The primary implementation outcome is HCW fidelity to ICT over 1 year of follow-up. Primary service uptake outcomes include (a) index clients who participate in ICT, (b) contacts elicited, (c) HIV self-test kits provided for secondary distribution, (d) contacts tested and (e) contacts identified as HIV-positive. Service uptake analyses will use a negative binomial mixed-effects model to account for repeated measures within each cluster. Cost-effectiveness will be assessed through incremental cost-effectiveness ratios examining the incremental cost of each person tested.

ETHICS AND DISSEMINATION

The Malawi National Health Science Research Committee, the University of North Carolina and the Baylor College of Medicine Institutional Review Boards approved the trial. Study findings will be disseminated through peer-reviewed journals and conference presentations.

TRIAL REGISTRATION NUMBER

NCT05343390.

Linking the choice of the class format and preclass learning experiences sheds light on a step further in blended medical education

BACKGROUND

The core principle of HyFlex ('hybrid' and 'flexible') learning is to maintain learning equity under most circumstances. Within a blended framework in precision medical education, how different preferences of synchronous learning environment influence learning process and outcome is limited. We investigated students' preclass online video learning experiences and their choices toward synchronous class formats.

METHODS

This was a mixed-methods study. During the 2021 academic year, all 5th-year medical students who had viewed online video clips presenting core concepts were asked to complete a survey on their preference for future synchronous class format (face-to-face, online, or HyFlex) and asked to provide reflective comments on their self-learning. Anonymous survey data, online records, and summative assessment scores (short-term learning outcomes) were collected. Kruskal - Wallis or Chi-square tests were used to compare differences between groups, and multiple linear regression was managed to select the factors associated with various choices. The students' comments were coded in a descriptive thematic analysis.

RESULTS

Among 152 medical students, 150 responded to the questionnaires, and 109 provided comments. Medical students spent a median of 32 min online, significantly shorter in the face-to-face group than in the online and HyFlex groups. The online group had a lower preclass video completion rate for certain concepts. The choice was not associated with short-term learning outcomes. Student feedback revealed a higher frequency of multiple themes for each student in the face-to-face and HyFlex groups, and these themes fell into the categories of learning efficiency, focus concentration, and course attractiveness.

CONCLUSIONS

Linking the choice of the class format and learning experiences of preclass online videos sheds light on a step further within a blended framework of precision medical education. Supplement of online interactive elements may help secure learning engagement among students choosing 'online only' class format of HyFlex learning.

Effectiveness of flipped classroom in pharmacy education - a meta-analysis

BACKGROUND

Flipped classroom, blended with online and offline learning, was regarded as an effective learning approach in pharmacy education. This meta-analysis was to comprehensively compare the effectiveness of flipped classroom and traditional lecture-based approaches, attempting to generate a unified and firm conclusion of the effectiveness of flipped classroom in pharmacy education.

METHODS

Data were collected from 7 databases, involving Cochrane Library, PubMed, Embase, ScienceDirect, Web of Science, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Literature Service System (SinoMed). The studies were included if they included objective evaluation of students' performance between groups of flipped classroom and traditional approaches. The standardized mean difference (SMD) with a corresponding 95% confidence interval (95% CI) was used as the outcomes for data pooling.

RESULTS

A total of 22 studies (28 comparing groups) with 4379 participants were included in the meta-analysis. The risk of bias was relatively high. Results of the analysis revealed that flipped classroom presented significant advantages over traditional approaches in student performance improvement, with no evidence of publication bias. Through subgroup analysis, it showed better outcomes for flipped classrooms over traditional lectures for the other subgroups, including different performance, degree programs.

CONCLUSIONS

Current evidence reveals that the flipped classroom approach in pharmacy education yields a statistical improvement in student learning compared with traditional methods. In the future, instructors should introduce more online technology into classroom and construct an interactive learning environment.

Self-paced online learning to improve knowledge competencies for hypertension among medical students in Uganda: A pre-post study

The growing burden of hypertension (HT) is projected to reach 1.56 billion globally by 2025 and is an increasing public health concern, even for low- and middle-income countries (LMIC) like Uganda, where the prevalence of HT is 31.5%. The objective of this study was to test the effectiveness of a freely available HT online course on knowledge competencies for medical students in Uganda. The online course was developed by a multidisciplinary team at Johns Hopkins University to address HT control in resource-constrained healthcare settings. Students in the 3rd, 4th, and 5th years of medical school were randomly selected to participate in the online course. Pre and post knowledge tests were administered using an online survey system. Of the 201 invited students, 121 (60.2%) completed the study. Significant improvements in mean knowledge scores were evident following the online course completion for Module 1, Fundamentals of HT (21.9±2.5 to 23.7±2.5, p<0.001), and Module 2, Basics of HT Management (14.9±3.3 to 18.5±4.3, p<0.001). No statistically significant differences were evident by gender or school year. Students who took a shorter duration to complete the course had significantly higher mean score improvement between pre- and post-test (mean score improvement 7.0 if <4 weeks, 3.6 if 4-8 weeks, and 3.7 if >8 weeks, p<0.003). Students recognized information on blood pressure measurement (32.2%) and HT management (22.3%) as the most important concept addressed in the course. A self-paced online course, complementing medical school training, improved knowledge on HT burden and management in Uganda.

Creativity, Critical Thinking, Communication, and Collaboration: Assessment, Certification, and Promotion of 21st Century Skills for the Future of Work and Education

This article addresses educational challenges posed by the future of work, examining "21st century skills", their conception, assessment, and valorization. It focuses in particular on key soft skill competencies known as the "4Cs": creativity, critical thinking, collaboration, and communication. In a section on each C, we provide an overview of assessment at the level of individual performance, before focusing on the less common assessment of systemic support for the development of the 4Cs that can be measured at the institutional level (i.e., in schools, universities, professional training programs, etc.). We then present the process of official assessment and certification known as "labelization", suggesting it as a solution both for establishing a publicly trusted assessment of the 4Cs and for promoting their cultural valorization. Next, two variations of the "International Institute for Competency Development's 21st Century Skills Framework" are presented. The first of these comprehensive systems allows for the assessment and labelization of the extent to which development of the 4Cs is supported by a formal educational program or institution. The second assesses informal educational or training experiences, such as playing a game. We discuss the overlap between the 4Cs and the challenges of teaching and institutionalizing them, both of which may be assisted by adopting a dynamic interactionist model of the 4Cs-playfully entitled "Crea-Critical-Collab-ication"-for pedagogical and policy-promotion purposes. We conclude by briefly discussing opportunities presented by future research and new technologies such as artificial intelligence and virtual reality.

Converting a face-to-face neuroanatomy course-based undergraduate research experience (CURE) to an online environment: lessons learned from remote teaching

Previously, we described a course-based undergraduate research experience (CURE) for first-year students that featured a unique approach to brain mapping in a model organism (rat). In response to the COVID-19 pandemic, we adapted this course for an online learning environment, emphasizing image analysis (identifying immunoreactive signal in an immunohistochemical stain, making neuroanatomical distinctions in a cytoarchitectural stain) and translation of image data to the brain atlas. Using a quasiexperimental mixed methods approach, we evaluated aspects of student engagement and perceived gains in student confidence with respect to the nature and process of science and student science identity development. Additionally, we examined the dynamics of mentorship and student connectedness experienced in the online-only context. We found that the majority of students reported positive affective outcomes for the course in domains such as project ownership and project engagement in addition to positive responses toward perceived mentorship received during the course. Unsurprisingly, students expressed frustration in not being able to freely communicate with members of the course in an organic face-to-face environment. Furthermore, we found that students encountered greater difficulty in mastering image software skills causing a delay in producing consistent-quality data maps. From our analysis of the course, we have identified both useful approaches and areas for course improvement in any future iterations of the online research course.NEW & NOTEWORTHY Herein, we describe the process of converting a novel, face-to-face neuroanatomy course-based undergraduate research experience (CURE) to an online-only research setting. We document student affective and skill gains resultant from participating in this course and examine best practices for structuring online CUREs to maximize student learning and success.

Development of generic student engagement scale in higher education: An application on healthcare students

AIM

Student engagement is an important factor to the success of higher education. This study aimed to develop a Generic Student Engagement Scale (GSES) for face-to-face and online learning.

DESIGN

This was a cross-sectional psychometric study.

METHODS

We tested the psychometric properties of GSES in 451 students at the school of nursing and health studies undertaking online and face-to-face learning at a local university in Hong Kong between 2016 and 2018.

RESULTS

Content validity, face validity and test-retest reliability of GSES were satisfactory. The 29-item GSES contains five factors "self-regulated learning," "cognitive strategy use," "experienced emotion," "teacher-student interaction," and "enjoyment of school life" with the good model fit. The GSES is a reliable and valid psychometric instrument to measure student engagement in face-to-face and online learning among undergraduates and higher diploma students. Our results implied that student engagement can be assessed in routine or research by using our instrument.

Semi-flipped classroom-based learning interventions in a traditional curriculum of oral medicine: students' perceptions and teaching achievements

BACKGROUND

In recent years, flipped classes have emerged and become popular in college medical education. However, due to the huge medical learning system and the limited pre-class study time of students, it is difficult to implement in all courses. And then we adopted the semi-flipped classes (SFCs) to evaluate its teaching effect. This study analysed three educational methods that can be used in oral medicine courses: online education, offline education, and semi-flipped classes.

METHODS

We used two surveys to evaluate the three educational methods. In the first survey 46 teachers and 238 undergraduates shared their experience of the live-streaming and traditional offline courses offered in the different oral medicine curricula; we used anonymous questionnaires to evaluate their class experience. In the second survey 94 students shared their experience of the semi-flipped and traditional classrooms. Students who attended the SFCs in the experimental group learned about the oral mucosa disease by themselves using an online video course and then participated in offline interaction with teachers. The evaluation of the above educational methods was conducted using the anonymous questionnaires and final exam assessment.

RESULTS

According to the first survey, teachers and students both agreed that the overall teaching experience and learning effectiveness in offline education are superior to those in online education. According to the second survey, students who participated in the SFCs performed better in the final exam than those who participated in the simple offline classes. Additionally, the survey showed that the new teaching method helped students gain more knowledge and positively influenced their clinical practice.

CONCLUSIONS

Compared with the online and offline educational methods, the SFC showed better results in both the questionnaire and final exam assessment. Hence, the effectiveness of medical education can be improved by adopting a teaching mode that combines online and offline teaching methods. Scientific and logical SFCs designs, along with their effective implementation, would eventually make SFCs an important tool for medical education.

Post-Covid Lockdown Assessment of Blended Learning Approach for Distance Education in Ghana: implications for human resource managers and curriculum implementers

This study assessed the blended learning approach for distance education and its implications for human resource managers and curriculum implementers. The study used the descriptive survey design from the quantitative approach. A sample of 552 was drawn from a study population of 2208 postgraduate students pursuing their distance programme countrywide with public universities. Data was collected with a self-developed questionnaire and was analysed with Partial Least Square Structural Equation Modelling (PLS-SEM). It was found that there was a significant relationship between challenges with face-to-face and the usefulness of face-to-face, challenges with online learning intention and the usefulness of online intention (decision to continue or discontinue with online learning as against the traditional face-to-face mode). Also,  there was a significant relationship between the challenges of online intentions and the usefulness of online learning; the usefulness of face-to-face and usefulness of online learning, and the usefulness of online learning and challenges with online learning. It was further found that challenges with both face-to-face sessions and online learning needed to be resolved to ensure successful blended learning for postgraduate distance learners. It was therefore recommended that the human resource managers and curriculum implementors should ensure that the right type of courses are taught on the online platform and the remaining courses are taught using the face-to-face mode. It was further recommended that more postgraduate study centres be opened to reduce challenges associated with face-to-face sessions. Also supports in terms of online tools, internet data and requisite skills should be provided to minimise challenges associated with online learning among postgraduate distance learners.

A comparative study about attitudes towards the efficiency, effectiveness, and atmosphere of offline and online learning among medical students

Background

In recent decades, the mode of education has changed, and online learning via the Internet has gradually entered the medical education system. During the Coronavirus disease 2019 pandemic, online learning rapidly became one of the main learning methods for medical students, this has impacted medical undergraduates and postgraduates to varying degrees; however, currently, little is known about its effectiveness as a learning mode.

Methods

This study included undergraduates and postgraduates in medical schools at some universities in China. The student participants were asked to complete a questionnaire survey in which they self-evaluated the learning effectiveness, learning efficiency, learning atmosphere, and other issues associated with online and offline learning. SPSSAU was used to analyze the acquired data.

Results

Most medical students expressed the view that offline learning was superior to online learning in terms of effectiveness, efficiency, and atmosphere. However, online learning was better in terms of the acquisition of learning resources and flexibility. The attitudes of medical undergraduates and postgraduates participating in this research were largely similar (P>0.05); however, undergraduates placed a higher value on offline learning than postgraduates (P<0.05).

Conclusions

Both online and offline learning have advantages and disadvantages. The differences between undergraduates and postgraduates may be related to subtle differences in the training objectives at these 2 levels of medical education. Combining the advantages of online and offline learning may improve the learning of medical students.

In-Person, Remote, or Hybrid Instruction? A Quality Improvement Assessment of a Six Week Interprofessional Education Pathway Program for Undergraduate Pre-Health Students

There is an emphasis on increasing the diversity of healthcare providers with the goal of reducing health disparities among racial/ethnic minorities. To support this initiative, pathway programs were designed to provide educational and career support to students belonging to racial/ethnic minorities or those who have challenges applying to or entering health professions. As a consequence of the COVID-19 pandemic, pathway programs have assumed various instructional delivery formats (e.g., face to face, virtual, hybrid) with little knowledge on the satisfaction of such methods. The current preliminary study examines whether in person, virtual, or hybrid learning is most effective for underrepresented pre-health undergraduate students who are engaged in a six-week interprofessional health pathway program. Quantitative and qualitative data was collected at one time point towards the end of the program when it was offered in person, virtually, and in hybrid format. Results revealed that the pre-health pathway program received highest satisfaction when presented in a hybrid format and least satisfaction when presented in virtual instruction. Qualitative data suggests that virtual instruction increases feelings of isolation and complicates educational information due to the limitations of virtual streaming. Implications for pathway design are discussed.

Improving social presence in online higher education: Using live virtual classroom to confront learning challenges during COVID-19 pandemic

The COVID-19 pandemic has compelled practically all higher education institutions to adopt online education tools over the previous 2 years. Online education has a huge potential to supplement or take the place of in-person instruction. However, there are certain drawbacks of online learning, such as the absence of classroom environment interaction and the difficulty in keeping track of students' engagement and participation. In this study, a live virtual classroom was developed to aid students in their learning activities. The effectiveness of these live video classes was reported from both students and instructors, as well as the variables promoting their implementation within higher education institutions. One of the more significant findings to emerge from this study is that the instructors found it convenient, as they could readily check course participants understanding by studying their live video lectures. The second major finding was that students felt satisfaction with online learning while asking questions without interfering with the instructor's presentation. Moreover, peers could also provide them with more expertise. However, the teaching process became dynamic, requiring the educator to pay close attention. The course participants also experienced anxiety when they were in front of other people. Additionally, both the instructor and the students need to be highly self-sufficient in technology.

Dental students’ academic performance before and after the Covid-19 pandemic: A retrospective analysis

Delivering quality education to students with fair assessment strategies is a key indicator of an excellent educational institution. The present study explored the impact of the COVID-19 pandemic on the academic performance of dental students in terms of the evaluations/grades awarded to them before and during the pandemic. The targeted groups were dental students, studying in the third year of 2018-2019 and 2020-2021 academic years. The sample size included all male and female students who enrolled and completed the following courses: pre-clinical fixed prosthodontics (SDS333), pre-clinical removal prosthodontics (SDS323), clinical operative dentistry-1 (RDS313), and pre-clinical endodontics (RDS323). Evaluations for students who did not complete the requirements were not included in the statistical analysis. Paired sample statistics were used for comparisons between the different groups at p < 0.05. Results revealed statistically significant differences (p ≤ 0.05) for all the course pairs. It was found that students’ grades for all the courses during the pandemic year were higher compared to the grades before the pandemic. While female students demonstrated the highest mean difference (6.13) before and during the pandemic year for RDS323, males demonstrated the highest mean difference (8.14) for SDS323. However, both male and female students demonstrated the lowest mean difference (0.25 and 2.03, respectively) for SDS333. The grades were higher during the COVID-19 pandemic. Overall, female students achieved higher grades than male students.

Sustaining blended and online learning during the normal and new normal conditions in a Saudi higher education institution: health science students' perspectives

Background

Higher education institutions (HEIs) shifted from in-person attendance to blended and online learning due to the COVID-19 lockdowns.

Objective

This study investigated the students' perception of satisfaction, convenience, engagement, and learning towards blended and online courses conducted before, during, and after the COVID-19 lockdowns.

Methods

A longitudinal study design was adopted to examine the students' perception of online and blended learning courses before, during, and after the COVID-19 lockdowns. The subjects consist of Health science students (N = 130) belonging to two different colleges of a public university and the study period includes three academic years (i.e., six semesters) (2018–2021). A survey tool was developed to collect data from students studying the computer fundamentals course through blended and online learning modes from 2018 to 2021.

Results

Over 95% of students have been satisfied with the course offered through various blended learning formats since 2018. The blended 0.50-course format is the most preferred one for the students; however, the Blended 0.75-course format is highly rated by the students regarding their satisfaction and engagement than other learning formats during the COVID-19 lockdowns. Following adaption after COVID-19, the students reported a high perception of learning towards the course when delivered through 100% online learning mode.

Conclusion

Students' achievement is significantly associated with the learning modes, exam modes, and various student batches. The blended 0.75-course format group shows a higher achievement than the other three-course format groups. Likewise, those students who appeared in their exams online showed higher achievement than those who appeared physically. Further, the students felt equally convenient with Blended 0.75 and 100% online learning course formats. These findings would also help HEIs choose appropriate learning and examination modes while designing courses.

A comparison of virtual and in-person instruction in a physical examination course during the COVID-19 pandemic

OBJECTIVE

To compare virtual and in-person physical examination (PE) learning among chiropractic students.

METHODS

Preexisting assessment data from 69 students enrolled in a Head and Neck PE course were analyzed for this study. The course comprised three 50-minute labs and one 50-minute lecture each week. Students had the option to attend the lab class in person or online. The virtual classroom was broadcasted simultaneously with the in-person class. Relevant class materials, including slides and videos, were available to all students on the learning management system. Student performance was evaluated through 8 weekly quizzes and 2 objective structured clinical examinations (OSCEs). Data for after-school practice and learning for each topic were also collected.

RESULTS

Our results indicated that OSCE and weekly quiz scores were positively correlated with in-person class attendance (p = .000, r = .619 and p = .000, r = .488, respectively). Participants were broken down into 2 groups: (1) higher than 50% attendance rates and (2) 50% or lower attendance rates. The mean OSCE (p = .000) and quiz scores (p = .001) for group 1 (49.41 ± .72 and 22.48 ± 1.06) were significantly higher than those for group 2 (48.13 ± 1.30 and 21.22 ± 1.29). By contrast, the mean number of videos watched was lower for group 1 compared with group 2 (3.23 ± 2.61 vs 5.70 ± 3.35, p = .011). There were no significant differences in the number of practices between the 2 groups (p = .18).

CONCLUSION

Students who participated in in-person PE learning outperformed those in virtual learning in this study.

Strategies adopted by undergraduate teaching assistants in physiology and biophysics education during the COVID-19 pandemic

The COVID-19 pandemic affected almost all aspects of our lives, including the education sector and the way of teaching and learning. In March 2020, health authorities in Brazil imposed social isolation and the interruption of on-site activities in schools and universities. In this context, the Federal University of Minas Gerais (UFMG), one of the largest universities in Brazil and Latin America, developed an emergency remote learning (ERL) plan that allowed the return of classes in an online format and supported students to obtain access to equipment and internet network. Within this new perspective, the Undergraduate Teaching Assistant (UTA) program of the Department of Physiology and Biophysics (DFIB) explored strategies to minimize the impact of the absence of face-to-face classes. Using different available tools in online platforms and social media such as Microsoft Teams, YouTube animated video classes, and Instagram, the UTA program assisted >500 undergraduate students and strongly supported professors during ERL. In just over a year, our video classes on YouTube Channel reached ∼40,000 views. Most of the students reported that their questions were fully and quickly solved by the UTA program. Collectively, our results indicate that the strategies implemented by the UTA program helped the undergraduate students and professors to adapt to a remote learning format.

“Effects of the COVID-19 pandemic on university students’ physical health, mental health and learning, a cross-sectional study including 917 students from eight universities in Germany”

The COVID-19 pandemic has severely affected physical and mental health. Since its commencement in 2020, social distancing has become the “new normal”. Temporary lockdowns and distance learning have disproportionately affected young adults, including university students. To identify effects of the pandemic on university students’ physical and mental health and learning, this empirical study included eight universities in Heidelberg, Mannheim and Ludwigshafen. Data was collected in May and June 2020. The self-administered survey was filled by 1,246 university students. 917 students completed the survey in full. 80.6% were bachelor students (n = 738), the mean semester was 3.8 and mean age was 23.1 years. 51.8% (n = 472) were female students and 47.4% (n = 432) male students. 38.5% (n = 352) stated a deterioration in physical health and 53.1% (n = 485) in mental health. From 0 to 10, students rated mean levels of stress highest due to social distancing (5.6), spending most time at home (5.0) and e-learning (4.5). Compared to male students, female students’ mental health worsened significantly (58.7% vs. 46.8%). A logistic regression analysis identified gender having a significant effect on university students’ stress levels: males seemed to have a lower risk of moderate to high levels of stress compared to females (odds ratio = 0.698; 95% CI = 0.515 to 0.945). Age, city of university and semester did not show a significant effect. The results are important to both regional and international audiences as university students face similar physical and mental health challenges due to the pandemic and its public health measures. Low-threshold initiatives are needed to mitigate the effects of the pandemic. These may include measures to reinforce students’ locus of control, sense of belonging, relaxation and mindfulness as well as (online) counselling services. Gender-specific differences must be taken into account.

A Study on the Online-Offline and Blended Learning Methods

The education sector is witnessing a paradigm shift with the rapid and ongoing technological advancements. The online, offline, and blended modes of learning continue to evolve with time. The purpose of this survey is to collect students’ responses to understand their perspectives on the different modes of learning. The advantages, challenges, and requirements for conducting classes through online, offline, and blended learning methods are discussed. A questionnaire was designed, and a survey was conducted among undergraduate engineering students. The questions are carefully planned to understand the choice of students while selecting different modes of learning, various activities and tools, and the reasons for their preferences. 654 students took part in the survey and shared their feedback. The advantages and disadvantages of online and offline learning are presented. A chi-square test was conducted, and the association between the two questions is shown to be significant. Suggestions for enhancing teaching and learning based on the findings of the survey help faculty members to plan the teaching methodology to suit the requirements of students.

Stress Predictors in Nursing Students during the COVID-19 Pandemic Confinement

Background:

The COVID-19 pandemic has largely impacted nursing education. Owing to the element of confinement, emergency education fostered conflicts between problems and their solutions, leading to higher stress among students.

Objective:

The aim of the study was to identify the determinants of perceived stress in nursing students during confinement due to the COVID-19 pandemic.

Methods:

This multicentric, quantitative, and cross-sectional study employed the multiple linear regression model. The study was conducted at seven nursing graduate schools in the Iberian Peninsula, with 1,058 nursing graduate students in confinement. An online questionnaire was administered to nursing students between April 23 rd and May 02 nd , 2020. According to socio-demographic data, COVID-19 experience, satisfaction with learning strategies, and coping strategies ( Brief COPE scale ) of the nursing students, the model was developed with the Perceived Stress Scale as the explained variable.

Results:

Stress is predictable in the form of greater coping-avoidance (b = 2.415; p < .001) when a family member is infected (b = -2.354; p = .005) and in younger students (b = -.104; p = .002). It tends to be lower with higher coping-reflective (b = -2.365; p < .001) and when the students have a more favourable self-perceived life (b = -1.206; p < .001). Furthermore, the stress has been found to be higher in Portuguese students (b = -1.532; p < .001) and women (b = 2.276; p < .001) than their Spain and male counterparts, respectively. Among variables related to academics, perceived stress is higher when the students are dissatisfied with the time spent on the computer (b = 1.938) and with the evaluation methods (b = 1.448).

Conclusion:

Personal factors and the ease of mobilisation of the proposed training strategies affect the students’ ability to deal with stress. Emergency education should consider stress predictors so that the students can adapt to training better.

A systematic review of health sciences students' online learning during the COVID-19 pandemic

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.

Face to face or blended learning? A case study: Teacher training in the pedagogical use of ICT

We are experiencing a transitional period in education: from the traditional, face to face teaching model to new teaching and learning models that apply modern pedagogical approaches, utilize technological achievements and respond to current social needs. For a number of reasons including the recent pandemic covid-19 situation, technology enhanced distance learning, seems to gain ground against traditional face to face teaching and in fact, in a sharp way. Acknowledging that changes in education need time, research and careful steps in order to be successfully applied and established at large scale, in this paper we attempt to compare face to face ("traditional") teacher training with teacher training through a blended learning approach/ model. The latest combines characteristics of both face to face and distance learning models. The case study is based on a large-scale in-service teacher training initiative which has been taking place in Greece for over a decade to train teachers in the utilization and application of digital technologies in the teaching practice (i.e. B-Level ICT Teacher Training). The B-Level ICT Teacher Training was initially based exclusively on face to face teaching but it was later adapted to a specially designed blended learning model which combined both face to face and synchronous distance sessions, accompanied by asynchronous activities and supported by specific e-learning platforms and tools. The comparison refers to the effectiveness of the two models/ approaches, as it derives from teacher trainees' performance, especially in the framework of the certification procedure that takes place through nationwide, independent exams that follow the training and assesses the relevant knowledge and skills acquired. Research findings point out better performances of a small or marginal scale for the teachers of various specialties who participated in blended learning teacher training programs compared to those who participated in traditional teacher training programs. Actually, it is shown that blended learning model trainees i) feel more comfortable to participate in the exams for the certification of knowledge and skills acquired, ii) have some better success rate and iii) get a bit higher grades in these exams. Thus, it can be argued that learning outcomes of the blended learning application in this teacher training initiative, overstep those of the "traditional" model in a small scale and with some slight differentiations among teacher specialties.

Methods for Facial Expression Recognition with Applications in Challenging Situations

In the last few years, a great deal of interesting research has been achieved on automatic facial emotion recognition (FER). FER has been used in a number of ways to make human-machine interactions better, including human center computing and the new trends of emotional artificial intelligence (EAI). Researchers in the EAI field aim to make computers better at predicting and analyzing the facial expressions and behavior of human under different scenarios and cases. Deep learning has had the greatest influence on such a field since neural networks have evolved significantly in recent years, and accordingly, different architectures are being developed to solve more and more difficult problems. This article will address the latest advances in computational intelligence-related automated emotion recognition using recent deep learning models. We show that both deep learning-based FER and models that use architecture-related methods, such as databases, can collaborate well in delivering highly accurate results.

Effect of an endodontic e-learning application on students' performance during their first root canal treatment on real patients: a pilot study

BACKGROUND

E-learning has found its way into dental teaching in general and endodontic teaching in particular. The present study aimed to implement a newly developed multimedia learning application and assess its effect on students' first root canal treatment on real patients. With the COVID-19 outbreak, the application's performance was investigated during the pandemic.

METHODS

A total of 138 students in the initial clinical endodontic course participated in this study. The control group (n = 49) followed the traditional curriculum, including practice on artificial teeth and face-to-face teaching events. In addition to the traditional curriculum, test group 1 (n = 54) had access to an endodontic e-learning application containing videos demonstrating artificial teeth and patient cases. With the COVID-19 outbreak, test group 2 (n = 35) had no face-to-face teaching; however, endodontic patient treatments were included. The quality of students' first root canal treatment on real patients was compared using performance and radiographic assessment items. Statistical analysis was done using Kruskal-Wallis and chi-squared tests. Test groups received a questionnaire to assess the learning application. Test group 2 also completed a COVID-19-specific survey to measure students' perceptions of how the pandemic affected their endodontic education.

RESULTS

The results of endodontic treatments were significantly better for test group 1 (P < 0.001) and 2 (P < 0.001) than for the control group. Likewise, there were significantly fewer treatment errors in test group 1 (P < 0.001) and 2 (P < 0.001). No significant differences were found between test groups 1 and 2. Students of the test groups positively evaluated the e-learning application. Students of test group 2 expressed their fear of negative impacts on their course performance.

CONCLUSION

The e-learning application was well-received and seemed to improve endodontic education. The results imply that the quality of education may be maintained by implementing e-learning to compensate for face-to-face teaching. As no difference was found between online and face-to-face teaching, students' and lecturers' concerns that endodontic education is suffering because of the pandemic may be eased.

The impact of assessment and feedback practice on the student learning experiences in higher education

Sound knowledge of the learning process and connectedness of assessment in higher education is imperative. Assessment is essential for both learners and teachers to ensure, and to provide evidence, that learning outcomes/objectives against set competency levels have been achieved for the chosen programme of the study. However, many coming into higher education are often unaware of the rules of the game. In this perspective, we will highlight the reasons why assessment is important, how assessment and feedback affect students' learning process and why the process of assessment can often affect students' mental well-being. We will appraise the different methods of assessment with a specific example (Objective Structured Clinical Examination, OSCE) and highlight why it is important that we adopt a holistic approach towards fostering assessment know-how and student well-being.

The Design and Evaluation of Online Interactive Learning in an Undergraduate Nutrition Course

Understanding factors that promote student engagement with online learning environments is important for benchmarking and improving the quality of teaching in a digital era. This study aimed to describe the online interactive content created for delivery of an undergraduate nutrition course and to evaluate student engagement with the online interactive content. We collected online questionnaire data in 2018 and 2019 from two cohorts of students enrolled in a Deakin University undergraduate nutrition unit. Two-sample unpaired t-tests were used to examine differences in participant engagement with online topic guides between static text-based and interactive content. A total of 89 participants (19-56 years) were included. Sixty four of students reported always/usually reading static text-based topic guides most weeks and 64% perceived them as moderately/highly effective. While 60% of participants reported reading the online interactive topic guides most weeks and 93% perceived them as moderate/highly effective. Most participants indicated the interactive topic guides were more effective than static text-based topic guides they experienced in other courses (76%). Hours dedicated to the online interactive topic guide were higher (6.4 SD 2.9 vs. 1.7 SD 1.7 h; P < 0.001) as was the rating of how engaging the topic guides were (7.2 SD 1.6 vs. 6.7 SD 2.5; P = 0.008). These findings suggest that interactive content is more engaging. However, this content may not be accessible to all students, and so familiarization and training prior to engaging in an interactive online unit may be needed.

Online, Face-to-Face, or Blended Learning? Faculty and Medical Students' Perceptions During the COVID-19 Pandemic: A Mixed-Method Study

BACKGROUND

COVID-19 pandemic forced educational institutions to adopt online methods which were inevitable to keep continuity of education across all academia after suspension of traditional educational systems. The aim of this study was to explore the experience of faculty and students of online and face-to-face learning, and their preference of the mode of learning after the pandemic.

METHODS

This is a mixed-method study. Quantitative data was collected through a survey from 194 medical students and 33 faculty members, while qualitative data was collected through two focus group discussions with 9 students and another two with 13 faculty members. Quantitative variables were presented as means and standard deviations. Paired samples t-test and Chi-square test were used. Thematic analysis of qualitative data was used to code, interpret, and make sense of data.

RESULTS

Mean scores of responses of faculty members and students were higher for face-to-face and blended learning compared to online learning in all survey statements with statistically significant differences. More than half of the students (53.1%) preferred the face-to-face mode of learning, while most of the faculty members (60.6%) preferred the blended mode of learning. Qualitative analysis identified five themes, namely: "Transforming the way theoretical teaching sessions are given," "Face-to-face teaching at campus cannot be replaced for some types of education," "Interaction in online sessions is limited," "Problems and challenges of online examinations," and "Technical issues and challenges of online education." It revealed suggestions that at least 30% of the curriculum could be taught online post-COVID-19. Some aspects of clinically oriented teaching including history taking and case discussions can also be delivered online in the future. Faculty members and students reported that dealing with online education was not difficult, although the transition was not smooth.

CONCLUSION

Medical students and faculty members were in favor of face-to-face and blended modes of learning. However, they perceived online mode of learning as an acceptable adaptation in theoretical teaching and in some clinically oriented teaching including history taking and clinical case discussions. Although face-to-face education in medicine is irreplaceable, the blended mode of learning remains an acceptable and practical solution for the post-COVID era.

Highly Engaged Video-Watching Pattern in Asynchronous Online Pharmacology Course in Pre-clinical 4th-Year Medical Students Was Associated With a Good Self-Expectation, Understanding, and Performance

Background

Online video-based learning is more common in higher education. Investigating students' viewing behaviors while watching online video lectures is essential for instructors to understand their learning status so that the course content, structure, and media selection can be improved continuously. The current study identified the engagement level of the learners based on their online video-watching behaviors, and tested the correlation between the engagement level and learning outcome.

Methods

The action logs of watching online video lectures in 2020 Spring Pharmacology of the 4th-year medical students of the 6-year course and their feedbacks by questionnaires after each exam during the semester were provided anonymously. The data were analyzed and visualized for an efficient way to comprehend and interpret. To define the student's engagement level in his or her video-based learning journey, three viewing criteria, “Completion,” “Pausing,” and “Repeated watching” were identified. We evaluated the association between the engagement level and the students' learning outcomes, including their learning satisfaction, knowledge acquisition progresses based on assessment results, and the grades measured by the instructors.

Results

The graphs and the charts demonstrate whether the students allocated enough time to finish the video lectures (completion), paused for a while, then resumed the video (pausing), or replayed the specific sections of video content (repeated watching). The engagement level with video lectures, evaluated by pre-defined thresholds for “Completion,” “Pausing,” and “Repeated watching” had a positive correlation with the learning outcomes.

Conclusions

We suggested that an engagement dashboard containing real-time visualized information on students' online video-watching behaviors can be developed to help instructors to monitor students' learning progress and improve teaching in a timely fashion. It can also help each student to re-feel the stimulation of peers, prompt self-monitoring, improve their learning attitudes and disciplines for better learning outcomes. This innovative way of assessing student's engagement during online video-based learning can also be used for quality assurance purposes.

A Nationwide Virtual Research Education Program for Medical Students in Pakistan: Methodological Framework, Feasibility Testing, and Outcomes

Introduction: Equipping young medical trainees with fundamental research skills can be a promising strategy to address the need for professionals who can understand and responsibly communicate evolving scientific evidence during a pandemic. Despite an ardent interest to partake in research, most educational institutions in Pakistan and other low-middle income countries have not yet adopted a comprehensive strategy for research skills education. The authors aimed to design and assess the feasibility of implementing the first nation-wide virtual research workshop for medical students in Pakistan.

Methods: The course “Beginners Guide to Research,” designed as a nation-wide virtual research workshop series, was conducted for medical students across Pakistan in June 2020. Four interactive live workshops took place online on alternate days from June 22nd, 2020, to June 27th, 2020, each lasting 1–2 h. Outcomes included: (i) reach, (ii) efficacy as indexed by pre-post change in score pertaining to knowledge and application of research and (iii) self-rated perceptions about understanding of research on a Likert scale.

Results: 3,862 participants enrolled from 41 cities and 123 institutions. Enrolled participants belonged to the following provinces: Sindh (n = 1,852, 48.0%), Punjab (n = 1,767, 45.8%), Khyber Pakhtunkhwa (n = 109, 2.8%), Azad Jammu and Kashmir (n = 84, 2.2%) Balochistan (n = 42, 1.1%). We also saw a few registrations from international students (n = 8, 0.2%). Mean (SD) age of enrolled medical students was 21.1 (2.1) years, 2,453 (63.5%) participants were female and 2,394 (62.0%) were from private-sector medical colleges. Two thousand ninety-three participants participants filled out all four pre-test and post-test forms. The total median knowledge score improved from 39.7 to 60.3% with the highest improvements in concepts of research bioethics and literature search (p < 0.001) with greater change for females compared to males (+20.6 vs. +16.2%, p < 0.001) and private institutions compared to public ones (+16.2 vs. +22.1%, p < 0.001).

Conclusion: The overwhelming enrollment and significant improvement in learning outcomes (>50% of baseline) indicate feasibility of a medical student-led research course during a pandemic, highlighting its role in catering to the research needs in the LMICs.

Exploring Inequalities in the Social, Spatial and Material Practices of Teaching and Learning in Pandemic Times

This article conceptualises higher education as a complex and dynamic set of entangled social, spatial and material practices — enacted, adapted and contested across spaces and technologies as these interact with diverse learners, teachers, curricula and contexts. Using modes of enquiry that start from this inherent complexity and intersecting these with contemporary disability and education studies, I ask how some of the normative social and spatial practices of higher education are being surfaced by the pandemic. Rather than framing Covid-19 as a massive shift from ‘normal’ (face-to-face) to ‘abnormal’ (virtual) delivery modes, I propose that its impact both continues and alters assumptions about what constitutes ‘proper’ university education, and both perpetuates and disrupts what is ‘noticed’, valued and supported in conventional teaching and learning processes. To do this, I will focus on two themes in current HE practices in the UK, as examples of what such an approach can open-up to view. This starts from the already existing tensions, complexities and contradictions as to what should constitute appropriate teacher and student behaviours and settings, and how this ‘normality’ is often being perceived as being lost because of the pandemic. By engaging with existing literature about longer-term patterns of inequalities in access and inclusion across physical and virtual HE learning environments, I hope to show some underlying problems in how student competency is being evidenced in virtual as compared to physical space and some ways the pandemic has exposed the unevenness of diverse student and staff relationships to space, time and technologies and the differential impacts on their educational experiences.

Student Self-perception on Digital Literacy in STEM Blended Learning Environments

As students transition into tertiary blended learning environments, their digital literacy in terms of technical capabilities have potential to impact on their access to digital resources. The first foundational year of STEM degrees includes compulsory courses across a broad range of scientific areas, each of which incorporates online technology in a discipline-specific manner. Given the diversity of online resources that STEM students need to access across their first-year coursework, this study applies learning analytical methods to determine whether students' perceived level of digital literacy has an effect on their navigation of learning management systems (LMS) and overall academic performance. The frequency and nature of LMS interactivity were examined across four first-year STEM courses offered in the same semester at a single institution, using a K-means cluster analysis to group student responses. It was observed that high achieving students accessed LMS resources more frequently than mid or low-achieving students across all four STEM courses. Students' perceived level of digital literacy was collected via survey (n = 282), and students were sorted high (n = 106) and low-level (n = 176) of perceived digital literacy-HDL and LDL, respectively. HDL students were not consistently found in the high-achieving academic group and did not perform better in their overall grade when compared to LDL students. LDL students were observed to perform better in specific online assessment tasks, which may be attributed to their increased frequency of LMS interactivity. These findings highlight the delicate balance between students' perceived level of digital literacy, motivation for engaging with online learning environments, and academic performance.

Race and the Ivory Tower: An Antiracism Exercise for an Undergraduate Neuroscience Classroom

This article details an antiracism exercise completed in an introductory undergraduate neuroscience class. Students completed an online pre-class multimedia module entitled "Race and the Ivory Tower" covering racism in science and medicine, the neuroscience behind bias, and the impact of race and racism on health outcomes. The module included two videos, one podcast, and a peer-reviewed journal article, alongside several optional additional resources written for both academic and lay audiences. After completing the module, students participated in an open-ended online discussion followed by an anonymous survey to elicit feedback on the exercise. As a continuation of the antiracism exercise, students researched and reported on the work of a Black or nonwhite Hispanic/Latino scientist for a final project later in the semester. Sixty-eight of 69 students participated in the discussion, and the majority discussed the neuroscience of bias and public health effects of racism. Most students also discussed the importance of the module contents or further questions that they would explore. Sixty of 69 students answered the anonymous survey, where most students reported a better understanding of racism after interacting with the content. Additionally, most students felt better prepared to discuss racism in science and medicine and more able to identify unconscious bias. Finally, students reported that they enjoyed the module contents and online discussion. Overall, this exercise effectively introduced students to the ongoing challenge of racism in science and medicine through both scientific and sociological lenses. Students recognized the collective importance of the content, which was our goal as they represent the future leaders in neuroscience and medicine and should be equipped to address leading issues within their field.

A Comparison of the Effectiveness of Online Instructional Strategies Optimized With Smart Interactive Tools Versus Traditional Teaching for Postgraduate Students

To solve the problem that lack of interaction in online courses affects motivation and effectiveness of students' learning, smart interactive tools were introduced into the online Neurobiology course. This study aimed to evaluate the students' satisfaction with online teaching mode and assess the academically higher and lower performing students' learning effectiveness in the online course optimized with smart interactive tools compared to face-to-face learning. Descriptive statistics and independent t-tests were used to describe student samples and determine the differences in students' satisfaction and performance. Reflections of students' satisfaction revealed that about 65.8% were satisfied with the learning involvement and about 60.5% were satisfied with the class interaction. Almost two-thirds of the class agreed that the smart interactive tools applied in the online course could help them attain their learning goals better. Among all the smart interactive functions, the class quiz was the most effective one in helping students grasp the main points of the course. No significant differences were found between the two teaching modes in the overall and academically higher or lower performing students' final exam average scores. Compared to each band score of such two teaching modes, no one failed to pass the final exam in the online course, however, three lower-performing students who were taught in the traditional course failed. This study suggested that optimized online teaching with smart interactive tools could produce the same learning effectiveness for the academically lower-performing students as for the higher-performing students. Meanwhile, the instructors could know the learning status in which each student was and perform personalized guidance and improve exam passing rate accordingly.

Secondary school students' perception of the online teaching experience during COVID-19: The impact on mental wellbeing and specific learning difficulties

Background

Student engagement and concentration is critical for successful learning. Due to the COVID‐19 pandemic, there has been a dramatic increase in the use of online learning which may affect engagement and concentration, particularly for those students with specific learning difficulties.

Aims

Students would show lower scores on all the measures of student experience when judging these during online learning versus learning within the classroom.

This negative impact of online learning on concentration, engagement, perceived learning, and self‐worth compared to classroom education would be more significant for those with specific learning difficulties.

The drop in student experience scores due to online learning would be associated with poorer mental well‐being.

Sample

Four hundred seven pupils aged 11–18 years at a secondary education school in Wales.

Methods

A retrospective online survey comparing pupils’ normal classroom experience to learning online during the first national lockdown in the United Kingdom (March–July 2020).

Results

Pupils’ learning experiences (concentration, engagement, ability to learn, and self‐worth from learning) were significantly lower for online learning compared to the classroom learning. These differences were more marked in students with specific learning difficulties. Perceived ability to learn and engage during classroom and online learning were also associated with mental well‐being.

Conclusions

The move to online learning appears to have affected students’ ability to concentrate and engage in their schoolwork and appears to have reduced their ability to learn and get self‐worth from their work. These decreases are associated with a decrease in mental well‐being. The effects appear to be exacerbated in some students with specific learning difficulties.

Current Scope of Online Ophthalmology Education and Curriculum Impact Due to COVID-19

Objective Abrupt changes in ophthalmology education caused by the COVID-19 pandemic have resulted in novel online curriculum development. The aims of this study were to identify (1) the scope of online curricula implemented both prior to and during the COVID-19 pandemic; (2) perception of educators on these online modalities; and (3) early lessons from online implementation that may guide future curricular planning.

Methods Implementation of online curricula was evaluated by using a national online survey of Ophthalmology Directors of Medical Student Education (DMSE) via Qualtrics software.

Participants Medical Student Educators of the Association of University Professors of Ophthalmology (AUPO) were surveyed.

Results Fifty responses were collected, representing a 64.9% response rate. Prior to the COVID-19 pandemic, 44% of institutions had no online components in their courses, but 78.3% of institutions reported increasing online components in response to the pandemic. Required courses were significantly associated both with having implemented online components before the pandemic and implementing online-only versions of these courses in response to the pandemic. The three most popular modalities used for online teaching were lectures, interactive cases, and problem-based learning, with a median satisfaction of 4.0, 4.32, and 4.35, (out of five) respectively. The least popular modalities used were online teaching of physical exam skills and telemedicine, both with a median satisfaction of 2.5. Median overall educator satisfaction with online teaching was four (out of five). The most common weakness related to online teaching was the lack of effective physical exam skills training.

Conclusion Our data demonstrate that most institutions successfully shifted their ophthalmology curriculum to a virtual and online version in response to the COVID-19 pandemic. DMSEs adapted quickly, transitioning in-person clinical courses, and extracurricular activities to online formats. Overall, educator satisfaction with online curricula was high. Integration of online curricula provides the opportunity to enrich institutional curriculums and overcome limitations imposed by decreasing curriculum time. This study reveals an early window into the utilization, strengths, and weaknesses of online ophthalmology education, which can serve as a guiding point to enhance ophthalmology curriculum development.

The Use of a Formative Pedagogy Lens to Enhance and Maintain Virtual Supervisory Relationships: Appreciative Inquiry and Critical Review

BACKGROUND

Virtual supervisory relationships provide an infrastructure for flexible learning, global accessibility, and outreach, connecting individuals worldwide. The surge in web-based educational activities in recent years provides an opportunity to understand the attributes of an effective supervisor-student or mentor-student relationship.

OBJECTIVE

The aim of this study is to compare the published literature (through a critical review) with our collective experiences (using small-scale appreciative inquiry [AI]) in an effort to structure and identify the dilemmas and opportunities for virtual supervisory and mentoring relationships, both in terms of stakeholder attributes and skills as well as providing instructional recommendations to enhance virtual learning.

METHODS

A critical review of the literature was conducted followed by an AI of reflections by the authors. The AI questions were derived from the 4D AI framework.

RESULTS

Despite the multitude of differences between face-to-face and web-based supervision and mentoring, four key dilemmas seem to influence the experiences of stakeholders involved in virtual learning: informal discourses and approachability of mentors; effective virtual communication strategies; authenticity, trust, and work ethics; and sense of self and cultural considerations.

CONCLUSIONS

Virtual mentorship or supervision can be as equally rewarding as an in-person relationship. However, its successful implementation requires active acknowledgment of learners' needs and careful consideration to develop effective and mutually beneficial student-educator relationships.

Students' Perspectives and Achievements toward Online Teaching of Medicinal Chemistry Courses at Pharmacy School in Thailand During the COVID-19 Pandemic

This communication was to share the efforts made in developing the fully online courses in medicinal chemistry during the educational disruption due to the coronavirus disease 2019 (COVID-19) pandemic. In the academic year 2020, the online course was implemented for the first time at the Faculty of Pharmacy, Silpakorn University, Thailand. Various online teaching strategies were integrated, raising the question of whether the developed online courses would deliver similar learning outcomes to the traditional classroom. At the end of each semester, the teaching assessment report was conducted and evaluated in 4 parts: part 1, evaluation of lecturer; part 2, student's self-evaluation; part 3, learning outcome development after studying the course; part 4, appropriateness of class environment and equipment. Overall, student responses toward parts 1-3 in the online class were as satisfactory as those in the previous on-site class. Lower scores toward part 4 were observed in the online class. In addition, student performance in terms of grade distributions between the on-site and online classes was different. On-site students earned the highest proportion of A grades, whereas online students earned a higher proportion of B+'s to F's. While the pandemic persists and the need for online courses remains, we hope that this communication will provide some educational insight and strategies to help in the ongoing efforts to adapt and establish more successful online courses.

Effect of COVID-19 on training and mental health of oral medicine residents in North America

Objective

The objective of this study was to assess resident and faculty perception of the effect of the coronavirus disease 2019 pandemic on the training experience, education, and psychological well-being of oral medicine (OM) residents.

Study Design

An anonymous 16-item online questionnaire was e-mailed to faculty and residents of all Commission on Dental Accreditation–accredited OM residency programs in North America. Survey questions asked about the pandemic's effect on resident educational, clinical, and research activities and the well-being of the residents. Survey data were collected using Qualtrics XM.

Results

Forty participants (52.5% residents and 47.5% faculty members) responded to the survey. Regarding the effect on clinical activities, 67.5% reported 50% or less reduction in patient volume seen by residents at its worst during the pandemic. With respect to educational activities, most reported a complete switch of didactic training (85.3%), academic examinations (60%), and off-site resident rotations (45%) to a virtual platform. Research activities were affected the most; 55% reported complete cessation for some time. Thirty-three percent perceived a negative effect, 18% perceived no effect, 11% perceived a positive effect, and 38% were unsure regarding the effect of coronavirus disease 2019 on resident morale. Despite the interruptions in the clinical, research, and educational activities, 62.5% expected on-time resident graduation.

Conclusion

Despite constraints due to the pandemic, OM residency programs successfully continued clinical activities, didactic training, and research productivity through virtual means and a hybrid delivery care model while supporting their residents’ morale.