Online Medical Teaching in China During the COVID-19 Pandemic: Tools, Modalities, and Challenges

Evaluation of the performance of nursing students taught using online and offline learning models in emergency and critical care nursing during the COVID-19 pandemic

AIM

The study investigated the outcomes of employing this hybrid method among nursing students engaged in emergency and critical care curricula during the COVID-19 pandemic.

METHODS

A retrospective study examined nursing students enrolled in the nursing program in China between January 2019 and January 2021. Students were divided into two groups: a study group that engaged in hybrid learning and a control group that participated in traditional classroom learning. Both groups received identical learning materials and credit hours. The study group assessed online learning via a platform with broadcasting features, while offline sessions occurred in the classroom. Post-course, groups were compared in knowledge, skill, and homework performance. The study group provided feedback through a reflective questionnaire to pinpoint areas for improvement in their online learning experience.

RESULTS

The analysis involved 1774 nursing students, with 906 in the study group and 868 int the control group. The study group outperformed in homework, individual, and comprehensive skills. Despite 73.7% of the study group citing distractions from surrounding environment, the majority appreciated online learning (853, 96.8%). Regarding the appropriateness of the course materials, foreign body airway obstruction courses are highly rated (721, 81.8%), while invasive hemodynamic monitoring had the least favorability (149, 16.9%). Additionally, 33.0% (291) favored live broadcasting and interactive video teaching during online classes.

CONCLUSIONS

The hybrid learning model enhances nursing students' performance in emergency and critical care courses. However, optimization is needed for environmental distraction, specific contents, and communication methods in online learning.

COVID-19 drives medical education reform to promote "healthy China 2030" action plan

In June 2019, the Chinese government proposed the Healthy China Action Plan (2019-2030) development strategy, which focuses on disease prevention and health promotion. It is expected that by 2030, the national health literacy level will be significantly improved, premature mortality caused by major chronic diseases will be significantly reduced, the average healthy life expectancy will be greatly improved, and the main health indicators of residents will enter the ranks of high-income countries. Unfortunately, at the end of 2019, COVID-19 began to break out in Wuhan, China, which had a huge impact on China's economy and people's health. A series of problems in China's health care and medical education were exposed in the prevention and treatment of the epidemic. How to reform medical education and build a medical talent training system with Chinese characteristics is the key to achieving China's Health 2030 strategy. This article will explore the direction of medical education reform in China under the background of the "Healthy China 2030" strategy and the post pandemic era.

Profiles of teachers' emotional labour during COVID-19 and the consequences on mental health: A comparison between online and offline teaching

BACKGROUND

Despite increasing attention on emotional labor in teacher well-being research, person-centered studies are relatively scarce, particularly concerning the emotional labor of online teaching during COVID-19 and its effects on teachers' non-work-related mental health.

OBJECTIVE

This study aims to address these gaps by examining emotional labor profiles and their consequences on job satisfaction, depression, and anxiety among Chinese teachers involved in either online or offline teaching during October-December 2022.

METHODS

Two samples of teachers were analyzed altogether: one engaged in online teaching (N=605) and the other in offline teaching (N=394). Latent profile analysis was used to identify emotional labor profiles based on three strategies: surface acting, deep acting, and expression of naturally felt emotions.

RESULTS

A total of four subgroups of emotional workers were identified: natural expressors, actors, flexible regulators, and authentic regulators. Significant differences were found between online and offline teaching, with a higher proportion of actors and fewer flexible regulators in the online condition, suggesting that the screen acts as a barrier to authentic emotional display. Among the four classes, actors scored lowest on job satisfaction and highest on depression and anxiety, whereas authentic regulators were the most adaptive, especially in online settings.

CONCLUSIONS

The findings highlight the impact of online teaching on teachers' emotional labor profiles and mental health, with practical implications for optimizing online teaching environments and supporting teacher well-being.

Evaluating the Effectiveness of an Online Targeted Education Programme on Vascular Surgery Aimed at Early Postgraduate Doctors

Introduction Mind The Bleep (MTB) is a junior doctor-led online education organisation that produces free open-access medical education (FOAMed) resources. This paper describes MTB vascular surgery online education programme. The target audience was early postgraduate doctors completing a rotation in vascular surgery. The aims were to increase participant confidence in basic vascular surgery topics and better prepare them for their role in vascular surgery.  Methods Speakers included foundation doctors, vascular speciality registrars, consultant vascular surgeons, and a vascular nurse specialist. Post-webinar feedback surveys presented as a five-point Likert scale were used to assess the effectiveness of the course. Wilcoxon signed-rank tests were used to analyse the data. Results Over three months, from March to June 2022, nine one-hour targeted education sessions were conducted, with a total of 564 participants. Post-session feedback was obtained from 364 participants (64.6%). There was a significant increase in the participants' level of confidence in the topic seen across all sessions (p <0.05). The participants rated webinars highly in the domains of engagement (mean 4.31), helpfulness of the content (mean 4.50), and interest (mean 4.39). From the cohort, 200 participants provided feedback on whether attending the webinar better prepared them for a vascular surgery rotation, with 66.5% (n = 133) reporting yes.  Conclusion The MTB vascular surgery online education program successfully increased participants' confidence and their preparedness for a role in vascular surgery. As a result, it is a useful adjunct to undergraduate surgical education.

Opportunities for Pedagogical Change in Turkish Medical Education Revealed in the Wake of the COVID-19 Pandemic

Phenomenon: As the first stage of a large-scale educational design research (EDR) study focused on the complex problem of providing authentic experiential "hands-on, minds-in" learning opportunities online during a pandemic or other exigency, we conducted a literature review and we interviewed Turkish academic staff and students about their experiences during the first year of the COVID-19 Pandemic. ApproachWe interviewed faculty members, faculty members of medical education departments, and medical students from both public and private medical schools in Türkiye between October 1 and December 31, 2020. Working in pairs, we analyzed the transcripts of 49 interviews using open qualitative coding methods with satisfactory levels of coefficients of agreement. FindingsWe defined six major themes from the qualitative analysis: 1) Fear and concern were the most common reactions when first encountering the pandemic; 2) Teaching methods during the pandemic were primarily unidirectional from faculty to students. This largely one way transmission of information occurred both synchronously and asynchronously; 3) Technological support during the pandemic shutdowns was found to be challenging for both faculties and students; 4) Evaluation of learning during the pandemic was opportunistic and had questionable rigor; 5) Healthy communication was valued by both faculty and students using an array of different tools including social media; and 6) The pandemic had both negative and positive impacts on the educational processes experienced by students and provided by faculty and resulted in recommendations for new approaches to teaching and learning in the future. Medical students were primarily concerned about the susceptibility to COVID-19 of themselves and others, and how the pandemic would affect their progress toward completing their studies. Faculty were primarily concerned about the capacity of online learning to provide clinical learning opportunities and the difficulties of assessing student clinical skills using online modalities. Medical education specialists were primarily concerned about the quality of educational opportunities offered online. InsightsOur findings were similar to other studies conducted in the USA, China, United Kingdom, and other countries. However, the interviews revealed interest among faculty and medical education specialists for further investigation of experiential or active learning models that could be applied in medical education regardless of whether the delivery mode is face-to-face, online, or most likely, blended. In the next stage of our larger scale EDR study, we will design and construct prototype learning environments that incorporate experiential, active, and authentic learning design principles.

Determining the challenges and opportunities of virtual teaching during the COVID-19 pandemic: a mixed method study in the north of Iran

The aim of this study was to determine the challenges and opportunities of virtual education during the COVID-19 pandemic. This study was conducted in 2022-2023 with a mixed method. During the quantitative phase, we chose 507 students from Mazandaran Province medical universities (both governmental and non-governmental) by stratified random sampling and during the qualitative phase 16 experts were collected by purposive sampling until we reached data saturation. Data collecting tools consisted of questionnaires during the quantitative phase and semi-structured interview during the qualitative phase. Data was analyzed using SPSS21 and MAXQDA10. Mean scores of the total score was 122.28±23.96. We found a significant association between interaction dimension and background variables (P < 0.001). The most important privilege of virtual education is uploading the teaching material in the system so that students can access the material constantly and the most important challenge regarding virtual education is lack of proper network connection and limited bandwidth. Virtual education proved to be a suitable alternate to traditional methods of medical education during the COVID-19 pandemic in theoretical topics, we recommend that educational policymakers would take the necessary actions to provide the requirements and facilities needed to improve the quality of virtual education.

The potential influences of professional identity for undergraduate nursing students during the COVID-19 pandemic: A cross-sectional study

AIM

We aimed to investigate the level of undergraduate nursing students' professional identity (PI) during the COVID-19 pandemic and its potential influences.

METHODS

This cross-sectional study included 742 undergraduate nursing students from Chengdu Medical College. Basic demographics, personal characteristics and PI score were collected. Chi-squared test, one-way analysis of variance, and multivariable logistic regression analysis were used to analyze the data.

RESULTS

In the classes of 2019, 2020, and 2021, the PI score was 96.85 ± 18.26, 105.37 ± 17.46, 106.67 ± 22.08 (P < .001). PI score was the independent predictive factor for both "want to be a nurse" and "willingness to serve during COVID-19 or other pandemics".

CONCLUSIONS

PI contributes greatly to nursing students' willingness to be a nurse and overcome pandemics. The challenge of culturing PI during COVID-19 pandemic revealed the necessity of developing individual management strategies for nursing education.

Medical and nursing students' satisfaction with e-learning platforms during the COVID-19 pandemic: Initial findings of an experimental project in China

Satisfaction with learning management systems (LMSs) is an essential indicator of students' e-learning experiences and reflects the quality of e-learning. Applying the technology satisfaction model, the present study aimed to investigate medical and nursing students' satisfaction with LMSs and its predictors. We conducted our survey at a medical university located in East China and received a total of 329 effective responses. Structural equation modelling was used to analyse the data. Our findings confirmed that perceived ease of use and perceived usefulness were two direct predictors of medical and nursing students' satisfaction with LMSs. Furthermore, the influence of perceived usefulness on satisfaction was more powerful than that of perceived ease of use. This study also substantiated that computer self-efficacy and perceived ease of use can indirectly impact medical and nursing students' satisfaction with LMSs. Our research effectively links the theoretical hypotheses with empirical findings, highlighting the central role of Computer Self-Efficacy (CSE), perceived ease of use, and perceived usefulness in shaping medical and nursing students' satisfaction with LMSs. Our findings contributed to the understanding of the technology satisfaction model and medical and nursing students' e-learning during the COVID-19 pandemic.

Assessment and evaluation of online education and virtual simulation technology in dental education: a cross-sectional survey

BACKGROUND

The global outbreak of coronavirus disease (COVID-19) has led medical universities in China to conduct online teaching. This study aimed to assess the effectiveness of a blended learning approach that combines online teaching and virtual reality technology in dental education and to evaluate the acceptance of the blended learning approach among dental teachers and students.

METHODS

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed in this study. A total of 157 students' perspectives on online and virtual reality technology education and 54 teachers' opinions on online teaching were collected via questionnaires. Additionally, 101 students in the 2015-year group received the traditional teaching method (TT group), while 97 students in the 2017-year group received blended learning combining online teaching and virtual reality technology (BL group). The graduation examination results of students in the two groups were compared.

RESULTS

The questionnaire results showed that most students were satisfied with the online course and the virtual simulation platform teaching, while teachers held conservative and neutral attitudes toward online teaching. Although the theoretical score of the BL group on the final exam was greater than that of the TT group, there was no significant difference between the two groups (P = 0.805). The skill operation score of the BL group on the final exam was significantly lower than that of the TT group (P = 0.004). The overall score of the BL group was lower than that of the TT group (P = 0.018), but the difference was not statistically significant (P = 0.112).

CONCLUSIONS

The blended learning approach combining online teaching and virtual reality technology plays a positive role in students' learning and is useful and effective in dental education.

Global trends and future directions in online learning for medical students during and after the COVID-19 pandemic: A bibliometric and visualization analysis

This study explores the evolution of online learning research in the context of medical education during and following the COVID-19 pandemic. It aims to understand the principal focus areas, and trends that have emerged in this rapidly evolving landscape. A total of 2751 publications related to online learning were retrieved from the Web of Science Core Collection (WoSCC) from 2020 to 2022. Bibliometric analysis and visualization techniques were employed to comprehensively examine the landscape of online learning research. Publications, co-cited references, and keyword co-occurrence were analyzed to identify patterns and trends in research focus and collaboration networks. The significant surge in research output reveals the academic community's response to the pandemic. Various themes have emerged in online learning research, encompassing online teaching, flipped classrooms, mental health, and blended learning. The evolution trajectory of research has traversed 3 stages, reflecting a shift in research focus from immediate pandemic responses to more refined strategies and interdisciplinary perspectives. Keyword co-occurrence analysis was also conducted to show the effects of the COVID-19 pandemic on the research. The study underscores the global scholarly engagement, collaborative networks, and principal themes that have shaped the field. As medical education adapts to the shifting landscape, the trajectory of online learning research points toward increased learner autonomy, integration of advanced technologies, and interdisciplinary collaboration. This transformative shift promises to reshape medical education, equipping learners and educators with the tools needed to navigate the dynamic realm of modern healthcare education.

Comprehensive qualitative evaluation of the first ever full-time online course for medical students in one middle-income country

The measures to control the COVID-19 pandemic in the academic 2020/2021 included full-time online courses for medical students in Serbia for the first time since the faculty was founded in 1920. The purpose of this study was to examine the attitudes and opinions about the full-time online course among medical students and their teachers. A qualitative study was carried out in the autumn of 2021. In-depth interviews were conducted with 38 participants (27 students in the 4th study year and 11 teachers who teach in the 3rd study year) about their experiences in the past academic year. To select study participants, purposive sampling was employed. The interviews were audio-recorded and transcribed verbatim. Qualitative content analysis was applied. Five topics emerged: 1) Theoretical online learning, 2) Practical online learning, 3) Motivation, 4) Technical aspects of online learning and 5) Evaluation of knowledge. Overall, students' attitudes toward theoretical classes were mostly negative, but the attitudes of teachers were mostly positive. However, the attitudes of both students and teachers toward practical online classes were mostly negative. Students were, in general, less motivated to follow online classes compared to conventional courses, even though the teachers felt that they had to put more effort into making a suitable online course. Most participants considered that the online classes had a negative impact on their knowledge and practical skills, but their academic achievement was not inferior compared to previous years. The full-time online course should include conventional on-site teaching. The relevance of acquiring practical skills is strongly emphasized.

Undergraduate students' perceptions of using videoconferencing for EFL learning: Evidence from Tencent Meeting application

This paper examined Chinese undergraduate students' perceptions of using videoconferencing in learning English as a foreign language (EFL) during the COVID-19 pandemic. The data were collected among 348 Chinese university students who attended sixteen-week learning of Integrated English Course through Tencent Meeting, the most widely used videoconferencing application in China. We adopted voluntary response sampling method in this cross-sectional study. Students completed an online survey on "Wenjuanxing", China's biggest online questionnaire distribution platform. A structural equation model (SEM) was constructed and analyses revealed that perceived ease of use and perceived usefulness were significant predictors of students' satisfaction and participation intention. Students' computer self-efficacy had a positive effect on their perceived ease of use, perceived usefulness, and participation intention while their frequency of using videoconferencing did not influence these variables. This study contributes to the existing literature on the acceptance of videoconferencing in the context of EFL learning and offers insights for developing up-to-date videoconferencing teaching strategies.

Application of flipped classroom combined with virtual simulation platform in clinical biochemistry practical course

BACKGROUND

The study explores an innovative teaching mode that integrates Icourse, DingTalk, and online experimental simulation platforms to provide online theoretical and experimental resources for clinical biochemistry practical courses. These platforms, combined with flipped classroom teaching, aim to increase student engagement and benefit in practical courses, ultimately improving the effectiveness of clinical biochemistry practical teaching.

METHODS

In a prospective cohort study, we examined the impact of integrating the Icourse and DingTalk platforms to provide theoretical knowledge resources and clinical cases to 48 medical laboratory science students from the 2019 and 2020 grades. Students were assigned to the experimental group using an overall sampling method, and had access to relevant videos through Icourse before and during class. Using a flipped classroom approach, students actively participated in the design, analysis, and discussion of the experimental technique. For the experimental operation part, students participated in virtual simulation experiments and actual experiments. Overall, the study aimed to evaluate students' theoretical and operational performance after completing the practical course. To collect feedback, we distributed a questionnaire to students in the experimental group. For comparison, we included 42 students from the grades of 2017 and 2018 who received traditional instruction and were evaluated using standard textbooks as the control group.

RESULTS

The experimental group scored significantly higher than the control group on both the theoretical and experimental operational tests (82.45 ± 3.76 vs. 76.36 ± 3.96, P = 0.0126; 92.03 ± 1.62 vs. 81.67 ± 4.19, P < 0.001). The survey revealed that the experimental group preferred the teaching mode that combined the flipped classroom with the virtual simulation platform. This mixed method effectively promoted understanding of basic knowledge (93.8%, 45/48), operative skills (89.6%, 43/48), learning interest (87.5%, 42/48), clinical thinking (85.4%, 41/48), self-learning ability (91.7%, 44/48), and overall satisfaction compared with traditional methods (P < 0.05). This study demonstrates that an innovative teaching approach significantly improves the quality of clinical biochemistry practical courses and promotes students' professional development and self-directed learning habits.

CONCLUSION

Incorporating virtual simulation with flipped classrooms into clinical biochemistry practical teaching is an efficient and well-received alternative to traditional methods.

The status of e-learning, personality traits, and coping styles among medical students during the COVID-19 pandemic: a cross-sectional study

Objective

The objective of this study was to explore the learning preferences and habits of medical students during the pandemic home e-learning, and to investigate the incidence of adverse emotions, optimistic character level and coping style. To explore the influencing factors of adverse emotions.

Methods

A cross-sectional survey was conducted in China from March to June 2022. Medical students were recruited from three universities in China, and a questionnaire survey was conducted. The questionnaires consisted of a "e-learning preferences and habits questionnaire", life orientation test questionnaire (LOT-R), and simple coping style questionnaire (SCSQ). Finally, a total of 492 medical students who met the inclusion and exclusion criteria became the research subjects and completed the survey.

Results

A total of 57.7% believed they experienced no adverse emotions during home e-learning. ① During the COVID-19 pandemic, the score of optimistic personality of medical students was (7.25 ± 1.933), and the score of pessimistic personality was (5.82 ± 2.240). The score of positive coping was (21.75 ± 5.379), and the score of negative coping was (11.75 ± 3.611). ② The occurrence of medical students' adverse emotions during e-learning was influenced by "Whether there is a private, quiet space to study", "Degree of knowledge mastery", "Physical discomfort or not", "Keep a regular schedule or not", "Optimistic personality tendency".

Conclusion

This study demonstrates the during home e-learning, most medical students have their own learning equipment and can meet their learning needs. Their favorite mobile device to use is a mobile phone, and their favorite method of teaching is to provide course playback. More than half of medical students believe that they have some inconvenience in conducting research during home e-learning. With regard to teacher's real-time screen, the largest number of medical students support teachers turning on live screens so that they feel like they are interacting with the teacher. The preference for blended teaching is highest among medical students. In general, medical students were highly adaptive of the newest e-learning approach. Based on the statistic analysis, the factors that "Whether there is a private, quiet space to study", "Degree of knowledge mastery", "Physical discomfort or not", "Keep a regular schedule or not", and "Optimistic personality tendency" may be the influencing factors for the occurrence of adverse emotions.

Medical, Dental, and Nursing Students' Experience with Virtual Practical Sessions: A Cross-Sectional Study in a Developing Country

Background

The COVID-19 pandemic has disrupted the scope of healthcare education and shifted the teaching methods from on-campus to virtual. The impact of such a shift has rarely been investigated, and limited evidence exists about students' experience in terms of effort made and time spent, especially for laboratory sessions. Assessing students' experiences will provide paramount evidence to fine-tune laboratory virtual learning sessions.

Objective

To assess students' experience of virtual (online) laboratory sessions versus on-campus laboratory sessions, including preference, time spent, the effort made, ability to remember instructions, and preference for future teaching.

Methods

A cross-sectional study was utilized. A Google Forms questionnaire was prepared and sent to medicine, dentistry, and nursing school students registered at Jordan University of Science and Technology (JUST) during the 2019/2020 academic year. Self-reported preference, time spent, efforts made, ability to remember instructions and preference for future teaching were assessed for virtual versus on-campus anatomy, pathology, microbiology, histology, and physiology laboratory sessions.

Results

A total of 455 students participated in this questionnaire. More students in histology (55.2%), pathology (57.4%), and microbiology (55.3%) laboratories, but not anatomy (39.6%) physiology (443.95), reported preferring virtual sessions over on-campus sessions. More students from histology (35.6%) and microbiology (37.0%) reported spending less effort than on-campus sessions. More than half of the participants agreed that virtual laboratory sessions consumed less time than on-campus sessions. Participants reported that they cannot remember the instruction given during virtual teaching compared to on-campus teaching. Differences in students' experiences were detected by gender, major, and year of study.

Conclusion

The COVID-19 pandemic has the potential to change the future of healthcare education, and preparation for future crises is paramount. Effort made, time spent, ability to remember, and preference for virtual education should be considered in terms of gender, major of study, and year. These differences should also be reflected in the planning of virtual sessions for effective implementation.

Importance of clinical parameters for cultivation of critical care thinking by online teaching of critical care medicine

BACKGROUND

The teaching of critical care medicine is a very important task, especially during the COVID-19 pandemic. The understanding of critical care parameters is the foundation and core, which is conducive to the formation of clinical thinking. This study is to evaluate the training effect of teaching of critical care parameters based on an online platform, and explore the teaching methods of critical care medicine that can help to cultivate trainees' clinical thinking and practical ability.

METHODS

Questionnaires were released before and after the training through the official new media platform "Yisheng" application (APP) of China Medical Tribune involving 1109 participants. The trainees who filled in the questionnaire in APP and received training were randomly selected as the investigated population. Statistical description and analysis were carried out using SPSS 20.0 and Excel 2020.

RESULTS

The trainees were mainly attending physicians in tertiary hospitals and above. Among all critical care parameters, trainees paid more attention to critical hemodynamics, respiratory mechanics, severity of illness scoring systems, critical ultrasound, and critical hemofiltration. The degree of satisfaction with the courses was high, especially the course of critical hemodynamics was scored the highest. The trainees believed that the course contents were of great help to clinical work. However, no significant difference was found in the trainees' understanding or cognition of the connotation of the parameters before and after the training.

CONCLUSION

Teaching of critical care parameters based on an online platform is conducive to improving and consolidating the clinical care ability of trainees. However, it is still necessary to strengthen the cultivation of clinical thinking in critical care. In the future, the integration of theory with practice must be strengthened in clinical practice, ultimately achieving the homogeneous diagnosis and treatment of patients with critical illness.

WeChat as a platform for blending problem/case-based learning and paper review methods in undergraduate paediatric orthopaedics internships: a feasibility and effectiveness study

BACKGROUND

Paediatric orthopaedics is a significant and difficult for undergraduate students to master. During the COVID-19 pandemic, we used the WeChat platform to combine the advantages offered by problem-based learning (PBL), case-based learning (CBL) and paper review teaching methods to establish a new blended online teaching model and demonstrated its feasibility and effectiveness.

OBJECTIVE

This study aims to demonstrate the feasibility and effectiveness of a new blended pedagogical method that uses the WeChat platform and combines PBL, CBL and paper review.

METHODS

We enrolled 22 students participating in the Department of Paediatric Orthopaedics. They participated in the WeChat blended pedagogy mode. Their departmental rotation examination scores were compared with those of 23 students who participated in the traditional teaching method. Moreover, an anonymous questionnaire was used to evaluate students' perceptions and experiences.

RESULTS

The total average scores of students who participated in the WeChat blended pedagogy mode and the traditional teaching method were 47.27 and 44.52, respectively. There were no statistically significant differences between the online teaching mode and the traditional teaching method in terms of possessing professional accomplishment, gaining knowledge and promoting interpersonal skills (P = 0.07, P = 0.12 and P = 0.65, respectively). In terms of independent clinical thinking, self-improving capability and improving clinical skills, the scores associated with the WeChat blended pedagogy mode were 8.00, 8.00 and 6.00, whereas those associated with the traditional teaching method were 6.70, 6.87 and 7.48. The overall satisfaction with the WeChat blended pedagogy mode reached 100%. A total of 64%, 86%, 68%, 64% and 59% of students chose very large or large in response to the items concerning professional accomplishment, knowledge absorption, independent clinical thinking skills, English reading and literature exploring capacity, as well as interpersonal skills, respectively. Fifteen participants claimed that the WeChat blended pedagogy mode was less helpful to them with regard to promoting the improvement of their clinical skills. Nine students claimed that the WeChat blended pedagogy mode was time-consuming.

CONCLUSIONS

Our study verified the feasibility and effectiveness of the WeChat blended pedagogy mode for undergraduate paediatric orthopaedics internships.

TRIAL REGISTRATION

Retrospectively registered.

Experience of Online Learning from COVID-19: Preparing for the Future of Digital Transformation in Education

COVID-19 has affected traditional instructional activities. Home-based isolation and restrictive movement measures have forced most learning activities to move from an offline to an online environment. Multiple studies have also demonstrated that teaching with virtual tools during the COVID-19 pandemic is always ineffective. This study examines the different characteristics and challenges that virtual tools brought to online education in the pre-pandemic and pandemic era, with the aim of providing experience of how virtual tools supported purely online learning during a health crisis. By searching keywords in public databases and review publications, this study tries to summarize the major topics related to the research theme. These topics are the characteristics of learning supported by technologies in pre-pandemic and pandemic era, the challenges that education systems have faced during the COVID-19 pandemic. This study also compares the functions, advantages and limitations of typical virtual tools, which has rarely been done in previous studies. This study tries to present the features of virtual tools that support online learning and the challenges regarding real-life risk scenarios, and tries to provide educational institutions with a distinct perspective for efficient teaching and learning in future potential health crises.

Development and Evaluation of a Massive Open Online Course on Healthcare Redesign: A Novel Method for Engaging Healthcare Workers in Quality Improvement

Healthcare workers are under increasing pressure to use limited resources more efficiently and improve patient outcomes. Healthcare redesign, a quality improvement methodology derived from the automotive industry, is a proven means of achieving these goals. Continuing Professional Development (CPD) opportunities for nurses seeking to build their capacity for healthcare redesign often come in the form of university courses, which can be costly and prohibitively time-consuming. We developed a Massive Open Online Course (MOOC) with a view to increasing the number of healthcare workers undertaking CPD in healthcare redesign and subsequently using these principles in their workplaces. The aim of the current study is to describe the development of our MOOC and its initial feedback from users. Materials and Methods: The theoretical and practical components of an existing postgraduate award course unit were made fit for purpose by being arranged into six weekly modules, before being transposed to an established learning management platform for MOOCs. Related quizzes, videos and interactive activities were then developed and included in each of these modules. Peer review of this content was completed by subject matter and teaching and learning experts prior to the MOOC being launched. Results: After running for nine months, 578 participants had enrolled in the MOOC, of whom 118 (20%) had followed through to completion. Participants were overwhelmingly from Australia (89%) and identified as female (78%). Preliminary feedback obtained from participants was positive, with 81% of respondents agreeing that they were satisfied with their experience, and 82% intending to apply their knowledge in practice. Conclusions: The MOOC has addressed a learning need by providing a brief and free form of education; learning from its development will help others seeking similar educational solutions. Initial feedback suggests the MOOC has been well-received and is likely to be translated into practice.

A moodle course to substitute resuscitation teaching in a medical curriculum during the COVID-19 pandemic: A prospective pilot study

Background

Face-to-face medical education was restricted during the COVID-19 pandemic, leading to alternative teaching methods. Moodle^® (Modular Object-Oriented Dynamic Learning Environment) - an online course format - has not yet been sufficiently evaluated for its feasibility and effectiveness in teaching cardiopulmonary resuscitation.

Methods

Medical students in the eighth semester took part in a Moodle^® course teaching basic life support, the ABCDE-approach, airway management, and advanced life support. The content was presented using digital background information and interactive videos. A multiple-choice test was conducted at the beginning and at the end of the course. Subjective ratings were included as well.

Results

Out of 594 students, who were enrolled in the online course, 531 could be included in this study. The median percentage of correctly answered multiple-choice test questions increased after completing the course [78.9%, interquartile range (IQR) 69.3-86.8 vs. 97.4%, IQR 92.1-100, p < 0.001]. There was no gender difference in the median percentage of correctly answered questions before (female: 79.8%, IQR 70.2-86.8, male: 78.1%, IQR 68.4-86.8, p = 0.412) or after (female: 97.4%, IQR 92.1-100, male: 96.5%, IQR 92.6-100, p = 0.233) the course. On a 5-point Likert scale, 78.7% of students self-reported ≥4 when asked for a subjective increase in knowledge. Noteworthy, on a 10-point Likert scale, male students self-reported their higher confidence in performing CPR [female 6 (5-7), male 7 (6-8), p < 0.001].

Conclusion

The Moodle^® course led to a significant increase in theoretical knowledge. It proved to be a feasible substitute for face-to-face courses - both objectively and subjectively.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Hot topics and frontier evolution in college flipped classrooms based on mapping knowledge domains

With the outbreak of COVID-19 and the development of online teaching, the online flipping teaching mode has attracted increasing attention. Systematic analysis of the research status and development trend of the flipped classrooms is significant for guiding the improvement of the quality of online flipped teaching. This study used the metrology software CiteSpace to draw a scientific knowledge map of relevant research in the web of science database from 2013 to 2021. It performed visual analysis of research authors, research institutions and countries, keyword clustering, keywords co-occurrence, and keyword time zone distribution. The results showed that: (1) The flipped classrooms research has attracted increasing attention from the social and educational circles, however, the relationship between relevant research authors, institutions, and countries is not close enough, and there is little cooperation. We need to strengthen cooperation further and realize the sharing of high-quality resources; (2) Based on keyword co-occurrence cluster analysis, this study identified three hot topics, namely, preparation before class, classroom activities and consolidation after class; (3) According to the keyword time zone map, this study divided three frontier evolution trends: exploration period, adaptation period, and growth period; (4) Finally, with the spread of novel coronavirus, it is suggested to promote the online flipped classroom teaching mode, and put forward reasonable suggestions from the perspective of teachers, students and researchers, and look forward to the future digital development direction of the flipped classroom.

Online-Offline Teaching for Bio-Pharmaceutical Students During the COVID-19 Pandemic: The Case Study of Advanced Mathematics in Application-Oriented Universities of China

Background

With the development of the COVID-19 pandemic, the importance of online teaching is becoming more and more prominent, especially for the basic advanced mathematics majoring in bio-pharmaceutical in colleges. However, the only online teaching model loses efficiency when facing the undergraduates in application-oriented universities.

Purpose

How to improve the teaching quality of advanced mathematics has always been a concern because the mathematical abilities of students in application-oriented universities are not ideal. In this article, we develop a blending online-offline teaching model that combined online teaching and offline outcome-based education (OBE), as an alternative to traditional offline education.

Methodology

The comparative analysis experiment is carried out to the two classes of undergraduates. The control group and the experimental group are, respectively, the 2020 class students and the 2021 class students majoring in bio-pharmaceutical. The experimental group students receive the combined teaching method, while the control group students receive the traditional offline education.

Results

(1) From the comparative analysis, we can find that the students under the online-offline teaching model are more differentiated than those under the traditional offline education model. (2) The online-offline teaching model equipped with “case study + knowledge point + applications” process has achieved a good teaching effect in the author's university.

Conclusion

The proposed teaching model can well stimulate students' interest in advanced mathematics learning and resonate with students through actual cases, thereby arousing students' autonomous learning drive and allowing them to apply what they have learned to professional fields.

Medical Students and Faculty Perceptions About Online Learning During COVID-19 Pandemic: Alfaisal University Experience

Background and Objectives

Off-campus online learning methods abruptly increased and gained popularity during the COVID-19 pandemic. Previous studies have highlighted the limitations of online learning mode; however, further studies on the experiences of medical students are needed. This study aimed to investigate the preclinical medical students and faculty members' experiences with online education and learning.

Subjects and Methods

In this cross-sectional study, data were collected using convenience sampling. Two hundred nine students and 13 faculty members who participated in the online courses offered during the spring semester of 2019–2020 completed an online questionnaire. A 30-item questionnaire for the students and a 25-item questionnaire for the faculty were used in this cross-sectional study.

Results

Overall, 30% of the student sample was satisfied; importantly, high-achieving students (GPA > 3.5) were less satisfied (25 vs. 32%; p = 0.006). Satisfaction was also low (35%) for student-faculty interaction opportunities. About half of the student sample agreed that small-group interactive sessions would improve learning (53%). The most favored course format was the blended mode (43%), followed by traditional (40%) and online modes (17%). Six out of 13 (46%) faculty members were satisfied with their online experiences. Most of them found virtual teaching applications convenient (77%). Conversely, few faculty members agreed to interact effectively (54%), while 69% favored a blended format.

Conclusions

The level of satisfaction in fully online courses offered during the COVID-19 pandemic remained low, especially among high-achieving students. Both students and faculty favored the blended format for future purposes. Small group active-learning strategies and web-based interactive tools may facilitate engagement and student-faculty interactions.

E-Learning during COVID-19: perspectives and experiences of the faculty and students

BACKGROUND

Aimed to corroborate students' and faculty's experiences with e-learning during the current pandemic.

METHODS

A cross-sectional study was conducted from February to June 2020. Seven surveys were distributed electronically to all undergraduate students and the faculty (4 to students and 3 to teachers) at the Southern Medical University (China). Descriptive statistics and t-tests were used to analyze the data. Statistical significance was set at p < .05.

RESULTS

Most students had some exposure to e-learning prior to the all e-learning regiment, contrasted with close to 90% of teachers having no or very limited experience. Students' perceptions of the most helpful e-learning activities did not change significantly overall (Week 3 vs. Week 9). Approaching 60% of students (Week 9) did find online discussion/Q&A/forum helpful, an increase from less than 30% (Week 3). Among teachers, gaps emerged (Week 9) between e-teaching activities used and their perceived effectiveness. Despite pre-recorded lectures being the most frequently used method, the least gap was associated with live-stream lectures-the least used. Over time, teacher's perceived effectiveness of e-teaching vs. in-person teaching did not differ significantly overall. When the results among students (Week 7) and teachers (Week 9) were corroborated, a slightly higher percentage of teachers viewed online teaching to be less effective than in-person teaching and a slightly higher percentage of teachers viewed online teaching as far less effective. For preferred learning modes after the resumption of in-person learning, students' preferences did not differ significantly overall (Week 3 vs. week 9). Surveys conducted in Week 9 found that a slightly higher percentage of students (~ 70%) than teachers (~ 60%) preferred some forms of hybrid learning and a lower percentage of students preferred face-to-face learning only. Approximately three quarters of teachers responded that at least 50% of course materials could be mastered by students on their own.

CONCLUSIONS

Overall, the perceived effectiveness of e-learning among students and teachers has not changed significantly over time. Nor have students' preferences shifted significantly for various learning modes after the in-person learning resumed. However, informative directional trends have emerged. Our research illustrates empirically the need to corroborate students' and instructors' experiences over time to inform more holistic improvements of e-learning.

Deciphering Learning Motivation in Open Distance Learning towards Sustainable Medical Education

Open distance learning has become a new norm in medical education since the COVID-19 pandemic. The abrupt shift from conventional medical education to fully virtual learning deserves a reflection on how it affected the learning motivation among medical students. Hence, this study aimed to investigate the effect of open distance learning on their learning motivation during this pandemic period, with suggestions to improve through reflections and recommendations. This qualitative study involved 152 medical students undertaking the Doctor of Medicine program in Universiti Kebangsaan Malaysia, Malaysia, during the COVID-19 pandemic. All data were collected through a validated questionnaire. We found that medical students portrayed intrinsic motivation—mainly self-motivation, self-discipline, and self-adaptation—in open distance learning during the pandemic period. Feedback from medical students also showed that they advocated a better internet connection, innovative teaching, and learning, as well as new appropriate assessment methods and strengthening of the learning management system for a sustainable open distance learning outcome. Hence, medical educators should be creative in making use of open distance learning as an attractive complementary platform in medical education to ensure life-long learning.

Enhancement of Online Education to the Teaching Paradigm: Taking Academic Medical Postgraduate Cultivation as an Example

Background

The COVID-19 pandemic posed enormous challenges to postgraduate teaching in 2020. Large-scale and continuous online teaching explorations were introduced to cope with this difficult situation, which incidentally shifted the paradigm of postgraduate teaching.

Purpose

A review of the online teaching of local medical schools for postgraduates was performed to identify the success factors in realizing the practice.

Methods

We retrieved medical postgraduate online teaching publications mainly from the local database, the China National Knowledge Infrastructure (CNKI), via the keywords stated below and then performed a retrospective analysis.

Results

We analyzed key success factors in improving online learning engagement that were considered exclusive to offline classroom teaching, including emotional interaction, the immediacy of communication, and enthusiasm for participation. With these positive effects, the integration of online and offline teaching advantages is beneficial for the initiative of academic medical postgraduates and promotes the construction and development of medical postgraduate education.

Conclusion

Online education can overcome the limitations of time, space, and teaching frequency, with great advantages in terms of flexibility and mobility over traditional classroom teaching. It can effectively cope with difficulties in the education of academic medical postgraduates in challenging times. In the post-pandemic era, blended online and offline teaching approaches continue and will become the new normal pedagogy for the training of medical postgraduate students.

The Use of Blended Teaching in Higher Medical Education during the Pandemic Era

OBJECTIVE

This study aims to compare the effect of blended teaching and traditional teaching in higher medical education during the pandemic era.

METHODS

Taking the teaching of neurology as an example, 293 Yangzhou University Clinical Medicine 2016 undergraduate students were selected as the research subjects, and were randomly divided into 2 groups a blended teaching group (n = 148) and a traditional teaching group (n = 145), and received blended teaching and traditional teaching, respectively. The blended teaching was based on a Massive Open Online Course, problem-based learning, and case-based learning and supplemented by Tencent video conferences, QQ messaging groups, and other auxiliary teaching tools. At the end of the course, the teaching effect and satisfaction rate were evaluated through theory assessment, practical skills assessment, and an anonymous questionnaire survey.

RESULTS

There were significant differences in theoretical achievements (81.83 ± 6.23 vs 76.79 ± 6.87, P < 0.001) and practical skill achievements (84.74 ± 6.50 vs 78.48 ± 6.53, P < 0.001). In addition, significant differences in all aspects of satisfaction rate were observed between the two groups (all P < 0.001).

CONCLUSION

Blended teaching is beneficial to students' learning and stimulates their enthusiasm, cultivates clinical thinking ability, and improves teaching quality. Thus, it has played a positive role in the reform of higher medical teaching during the pandemic era.