Medical students' self-directed learning skills during online learning amid the COVID-19 pandemic in a Korean medical school

Dental Students' Satisfaction With Web-Based Learning During the Initial Phase of the COVID-19 Pandemic: Mixed Methods Study

BACKGROUND

The COVID-19 pandemic has precipitated an accelerated shift in education, moving from traditional learning to web-based learning. This transition introduced a notable transactional distance (TD) between the instructors and learners. Although disease control and staff and students' safety are the top priorities during a pandemic, the successful delivery of education is equally crucial. However, the ramifications of this swift transition are particularly critical in the context of dental education. Dental education is inherently practice oriented, necessitating hands-on training and manual skills development, which poses unique challenges to distance learning approaches.

OBJECTIVE

This study aims to examine dental students' web-based learning satisfaction and experience of TD, investigate the predictors of web-based learning satisfaction, and explore the perceptions of students about the advantages and disadvantages of web-based learning.

METHODS

This study explored the factors associated with web-based learning satisfaction using TD theory during the transition to web-based education. Psychological factors that could influence satisfaction were adapted from the health belief model. We conducted a cross-sectional web-based survey of 345 dental students from 2 institutions in South Korea who were enrolled in the spring semester of 2020. Data were collected between July 8 and September 14, 2020. Qualitative analysis was used to examine responses to open-ended questions concerning perceptions of web-based learning.

RESULTS

A multivariate hierarchical linear regression model was used to analyze the effects of student characteristics, TD, and psychological factors (ie, perceived risk of infection and efficacy belief of web-based learning) on web-based learning satisfaction. The average score for web-based learning satisfaction was 3.62 (SD 0.84), just above the midpoint of the possible range (1-5). Self-regulated learning (β=0.08; P=.046), learner-instructor interaction (β=0.08; P=.03), and learner-content interaction (β=0.64; P<.001) were associated with higher levels of satisfaction. Moreover, a significant association was revealed between high efficacy beliefs in web-based learning (β=0.20; P<.001) and satisfaction. Although the learning structure (synchronous vs asynchronous) did not exhibit a significant association with satisfaction, the qualitative analysis results revealed that each structure possesses distinct strengths and weaknesses. The students in synchronous learning (79/345, 22.9%) recognized heightened autonomy in the "learning environment" (19/79, 24%); however, technical issues (28/79, 35%) and reduced concentration (15/79, 19%) were identified as downsides. Conversely, the students in asynchronous settings (266/345, 77.1%) emphasized unlimited access to learning content (74/266, 27.8%) and the flexibility of "learning in preferred time" (69/266, 25.9%). Nevertheless, challenges, such as self-management difficulties (66/266, 24.8%) and limited interactions (55/266, 20.7%), were evident.

CONCLUSIONS

The findings suggest that efforts to minimize TD, facilitating self-regulated learning and interaction among students and instructors, are critical for achieving web-based learning satisfaction. Moreover, establishing a common understanding among students regarding the necessity and efficacy of web-based learning during epidemics could enhance their satisfaction.

Predominant aspects of knowledge and practical skills among medical students with online learning during the COVID-19 pandemic era

BACKGROUND

Social restrictions due to the COVID-19 pandemic have shifted most learning methods into online courses, especially for medical skills education. However, the effects of online courses on medical skill education amongst medical students are still arguable. The study aims to analyse medical students' knowledge, attitude, practice and satisfaction towards medical skills between online and offline courses.

METHOD

We performed a case-control study conducted among 533 medical students with online (as a case group, n = 288) and offline courses (as a control group, n = 245). We evaluated three fundamental medical skills, including history taking [HT], lung physical examination [LPE], and heart physical examination [HPE]. We tested the knowledge and skills among students through theory and practical examinations. Students' attitudes and satisfaction were assessed using a validated questionnaire.

RESULTS

The scores for knowledge and practical skills among the online group were significantly higher (p = 0.016, p = 0.004, respectively). In comparison, the scores for the students' attitudes and satisfaction were substantially lower (p = 0.000, p = 0.003, respectively) compared to the control group. Most of the students in both groups passed the exam (case vs. control = 81.94%; 83.27%, respectively). Males were the only factor associated with a higher rate of passing the examination (OR 0.42, 95% CI [0.27-0.67], p = 0.000).

CONCLUSIONS

Online learning could be an alternative approach on improving student's knowledge and practice towards medical skill especially amidst COVID-19 pandemic, however further consideration on student's attitude and satisfaction are mandatory to achieve appropriate competence as future general practitioner.

Effectiveness of Twitter Threads to Improve Medical Student Electrocardiogram (ECG) Reading-Skills. The TwittUVa-ECG Non-Randomized Pre-Post Study

Introduction

social media is increasingly used in medical education, but its real educational effectiveness is unclear. In this study we assess the effectiveness of Twitter threads (TTS) in improving electrocardiogram (ECG) basic reading skills (ECGBRS).

Materials and Methods

Seven TTS describing ECGBRS were published from October 28, 2021, to November 24, 2021. Tests were used to assess medical students ECGBRS pre and post intervention. All third and sixth-year medical students were invited to participate. Sixty-three students were enrolled (33 third year and 30 sixth year). Nine (14.3%) participants dropped out.

Results

Sixth year medical students had higher ECGBRS at baseline. The number of correct items increased after the Twitter intervention; median correct pre-test items were 20 out of 56, (interquartile range (IQR) 14-23), and median post-test were 29 out of 56, (IQR 21-36) (p < 0.001). The improvement in sixth year students was greater than for third year students; 10 more correct items (IQR 4-14) vs. 7 (IQR 1-14) items (p = 0.045). The more TTS followed, the greater the improvement in ECGBRS (p = 0.004). The QRS axis calculation was the ECG reading skill with the lowest scores. Most medical students were definitely (35%) or very probably (46%) interested in repeating another on-line learning experience and found the TTS extremely (39%) or very (46%) interesting.

Conclusions

The use of specifically designed TTS was associated with improvement in medical students' interpretation of ECGs. The effectiveness of the threads was higher in the final years of medical school when basic skills had already been acquired.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01885-x.

Self-directed learning assessment practices in undergraduate health professions education: a systematic review

PURPOSE

The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education.

METHODS

Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes.

RESULTS

Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001).

CONCLUSIONS

The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.

Self-directed learning: Alternative for traditional classroom learning in undergraduate ophthalmic education during the COVID-19 pandemic in China

In recent years, the COVID-19 pandemic has led to a shift in medical education from traditional face-to-face to online or remote learning, which provided challenges to faculty and students that have traditionally given face-to-face instruction. Self-directed learning (SDL) has gained popularity in undergraduate education such as nursing and adult education. Although the application of SDL in many medical teachings is practical, the application of SDL in undergraduate ophthalmology education has not been well investigated. COVID-19 pandemic led to changes in the learning style of undergraduate medical students to adapt to the shift from traditional classroom learning (TCL) to online or remote learning. Self-directed learning is a process in which individuals take the initiative in diagnosing their learning needs, formulating learning goals, identifying resources for learning, choosing and implementing appropriate learning strategies and evaluating learning outcomes. This study compared students' perspectives and study outcomes of the SDL and TCL to preliminarily investigate the effect of SDL in undergraduate ophthalmology education. The students showed equal perspectives and satisfaction with both learning models. There was no difference in learning outcomes at the end of the study. The students with different interests in ophthalmology had different perspectives on SDL and TCL. Self-directed learning is an essential alternative to traditional classroom learning in undergraduate ophthalmic education during the COVID-19 pandemic in China.