Effectiveness of early clinical exposure in medical education: Settings and scientific theories - Review

From books to the bedside: post-graduation impact of 'Week On the Wards' on medical education

BACKGROUND

The transition between preclinical and clinical years during medical school has been shown to be challenging. Cooper Medical School of Rowan University (CMSRU) implements one required two-week-long shadowing program for first and one one-week-long shadowing program for second-year medical students called Week On the Wards (WOW). The goal of this study is to ascertain whether students who completed the WOW curriculum found it beneficial over the long-term. Specifically, we want to evaluate alumni's impression of the program's influence on career, specialty choice, professional development, personal development, and confidence.

METHODS

To evaluate our program, we developed, validated, and distributed a survey via email in the autumn of 2023. Our population included alumni from the classes of 2019-2022, irrespective of race and gender. After following steps for survey development, it was validated via focus group using qualitative methods. The survey consisted of 19 questions answerable on a 5-point Likert scale, a "Yes/No/Unsure/Maybe" section, and an optional open-ended response question. Descriptive analysis was done to report the percent responses.

RESULTS

The survey was emailed to 353 alumni, with 72 completed responses returned. Majority of respondents agreed or strongly agreed that the WOW program showcased the importance of teamwork in medicine (80.6%), helped them learn to apply medical knowledge (77.8%), influenced their decision regarding which residency/specialty they chose (72.2%), provided an example of how teamwork in medicine is necessary for patient safety and effective care (66.6%), and increased their confidence in their networking skills (66.6%). Alumni nearly unanimously agreed that the WOW program was a useful part of their medical school education (93.1%) and that it should be continued for future classes (94.4%).

CONCLUSION

Our results highlight the sustained importance of early preclinical exposure to clinical environments in students' future career decisions, in their understanding of the clinical applications of learned preclinical topics, and the importance of teamwork in medicine.

Moderating effect of family structure on the relationship between early clinical exposure and emotional labor of nursing students: a cross-sectional study

BACKGROUND

Emotional labor is an essential component of nursing practice and is important for Generation Z nursing students born from the mid-1990s to early 2010s. They will become the backbone of the nursing workforce but present more emotional regulation problems. Studies on emotional labor are limited to clinical nurses and influencing factors at the individual level. The impacts of external systems on emotional labor of nursing students have not been explored. This study aimed to quantify the relationship between early clinical exposure and emotional labor and test the moderating effect of family structure on the relationship.

METHODS

The cross-sectional study recruited 467 nursing students using convenience sampling from seven colleges and universities in mainland China. An e-survey created on WJX.CN was used to collect data in January 2023. Emotional labor (surface acting and deep acting) was measured with the Emotional Labor scale. Early clinical exposure (exposure or not and times of exposure) and family structure (nuclear family, extended family, and single-parent family) were assessed with self-reported questions. Descriptive statistics and the linear mixed-effects modeling were used to do the analyses.

RESULTS

The mean scores of surface acting and deep acting were 26.66 ± 5.66 and 13.90 ± 2.40, respectively. A significant difference in scores of surface acting was not observed for exposure or not, whereas such a significant difference was found for times of exposure. Nursing students from extended families demonstrated significantly lower scores on surface acting while exposed to clinical practice compared with those from nuclear families. Family structure moderated the relationship between times of exposure and surface acting of nursing students when exposed to clinical practice for one time, but the significance disappeared when the times of exposure increased. No significant findings of early clinical exposure on deep acting were observed.

CONCLUSIONS

Early clinical exposure influenced emotional labor, and students from extended families were more likely to get benefits from early clinical exposure. Studies are needed to help students from nuclear families get comparable benefits on emotional labor as those from extended families, and improve deep acting by early clinical exposure.

Saudi Medical Students' Perspectives on the Radiology Curriculum

Introduction The importance of radiological technology in healthcare is indisputable in diagnosing and treating many diseases, yet undergraduate radiology education globally remains inadequate. Worldwide, students express dissatisfaction with radiology education, underscoring the need for improvement in this aspect. Saudi Arabia's medical system lacks a unified radiology curriculum, necessitating robust curriculum development, which should be addressed by the Council of Deans of Saudi Medical Schools. This study aims to assess Saudi medical students' perceptions of radiology education. Methods This is an observational cross-sectional study conducted in the Kingdom of Saudi Arabia (KSA) among undergraduate medical students from King Faisal University (KFU) and Imam Abdulrahman Bin Faisal University (IAU). The study used an online survey to assess medical students' perspectives regarding the radiology curriculum, the adequacy of the students' exposure to various imaging modalities, and their confidence in evaluating radiological images. Subjective parameters were measured using a four-point Likert scale, and the results are presented as percentages of students. The data were analyzed using Statistical Package for Social Sciences (SPSS) software, version 29 (IBM Corp., Armonk, NY). Results The current paper encompassed 845 participants, revealing a gender distribution of 56.7% (n = 479) female and 43.3% (n = 366) male. Notably, 39.2% (n = 331) and 29.6% (n = 250) aimed for medical and surgical clinician roles, respectively. By contrast, 27.8% (n = 235) expressed uncertainty about their future plans, and only 3.4% (n = 29) intended to pursue radiology as a future career. In evaluating students' perspectives on the radiology curriculum, more than half of the students (59.4%, n = 502) stated that the amount of radiology education included in their curriculum was inadequate, while 35.7% (n = 302) stated that it was just right, and only 4.9% (n = 41) stated that it was too much. A substantially larger proportion of KFU students (65.2%, n = 334) perceived their clinical exposure to be inadequate compared to IAU students (50.5%, n = 168). Furthermore, a larger percentage of IAU students (46.8%, n = 156) reported "just right" exposure levels compared to KFU students (28.5%, n = 146). This disparity is statistically significant (p < 0.001). Our study demonstrated that X-ray imaging is the most encountered modality during clinical rotations, with 87.2% (n = 737) of students reporting exposure, followed by CT scans (75.2%, n = 636). Conclusion The majority of Saudi medical students in the Eastern Province reported an "inadequate" level of exposure to radiology. By identifying shortcomings and inadequacies in the current system, the research may provide a foundation for future improvements, ensuring that medical graduates in the Eastern Province possess the requisite knowledge for competent and safe clinical practice.

Exploring the impact of early exposure and mentorship on the neurosurgery career aspirations of medical students in low- and middle-income countries

Early exposure to neurosurgery has been shown to have a positive influence on students' perceptions and attitudes towards the field of neurosurgery. This review delves into the problems faced by the neurosurgery workforce in LMICs, highlighting the necessity for local and international collaborative strategies and plans to enhance the medical education curriculum, training, and retention of neurosurgeons in their home countries. Mentorship also emerges as a crucial factor in neurosurgical career progress, narrowing the gap between theoretical knowledge and real-world practical skills, and providing guidelines in career pathways. Despite numerous benefits of early exposure and mentorship, limitations such as limited resources, inadequate elective opportunities, and negative cultural influences, hinder students' interest in neurosurgery. However, initiatives such as global outreach programs and collaborations between HICs and LMICs aim to address these challenges and improve access to mentorship and training opportunities and programs. This review recommends the integration of mentorship into career development strategies, establishing well-structured mentorship programs, and strengthening neurosurgery exposure in medical education. By implementing these recommendations, the next generation of neurosurgeons can be better equipped to address the complex challenges in LMICs, ultimately, enhancing easy access to neurosurgical care and strengthening healthcare systems.

Assessing interventional radiology specialty knowledge and perception amongst Tanzanian medical students before and after exposure to an immersive curriculum

AIMS

This study aims to assess the impact that delivering an introductory interventional radiology (IR) lecture series has on the knowledge and perception of the specialty among medical students in a resource-limited setting with, until recently, no IR presence.

MATERIALS AND METHODS

An introductory four-hour lecture series in IR was delivered to third-year medical students in Tanzania. Prior to and following the lecture series, participants completed a 27-item paper-based survey assessing their knowledge and perception of the specialty.

RESULTS

Out of a class of 213, the pre- and post-lecture survey was returned by 148 (69.5%) and 151 (70.9%) respondents, respectively. 94.5% of respondents indicated that they were aware of IR as a specialty. Among respondents, 97.3% expressed interest in having IR lectures integrated into their curriculum, compared to 29.0% that reported having any prior IR training. 27.3% believed their knowledge in IR compared to other specialties was either "good" or "excellent", which improved to 43.3% (p<0.001). Identification that IR physicians consult patients directly, have outpatient clinics, have inpatient beds, and do rounds improved from 55.4% to 81.1% (p<0.001), 49.7% to 60.3% (p=0.066), 48.3% to 66.7% (p=0.001), and 52.0% to 66.2% (p=0.013), respectively.

CONCLUSION

By introducing short lectures on IR-relevant topics, knowledge and perception of IR improved among Tanzanian medical students. Early education and exposure to IR should be prioritized to promote the continued growth of the specialty in this setting.

Exploring Motivating Factors for Pursuing Radiation Oncology: A Comparative Analysis of Medical Students and Residents

Purpose Increasing medical student (MS) interest in radiation oncology (RO) is important to meet the rising demand for radiation oncologists. Understanding the factors that drive MS to pursue RO is crucial. This study compares motivating factors between MS and RO residents to inform interventions to increase recruitment and sustained interest in the specialty. Methods Data from two similar studies investigating factors motivating MS and residents to pursue RO were analyzed. The first study surveyed Canadian RO residents to characterize enablers when applying for RO residency. The second study analyzed application essays from MS applying to an RO studentship. A mixed methods approach was used to compare themes ("career aspects," "prior exposure," and "personal experiences") between the datasets. Results Qualitative analysis demonstrated that both MS and residents identified "career aspects" as the most common theme facilitating interest in RO careers. "Multidisciplinary work" and "direct clinical contact and patient care" were prominent sub-themes. MS emphasized "serious illness and palliative care" and "advanced technology," while residents prioritized RO as a "rewarding career." "Prior exposure," particularly through shadowing/observerships, was more important for MS than residents who valued clinical experiences. Practical career considerations including "mentorship" and "career satisfaction and lifestyle" were significant motivators for residents. Conclusion MS value content-based aspects of RO and emphasize shadowing. In contrast, RO residents prioritize lifestyle-based considerations. These differences highlight the opportunity for intervention throughout medical training to sustain interest in RO and facilitate applications to RO residency programs.

Teaching Moral Courage & Rights-Based Leadership in Medicine: A Cross-Disciplinary Exploration

Clinical medicine's complexities and demands often surpass the scope of formal ethics and leadership training that medical schools and residency programs provide. The discrepancy between medical education and the realities of clinical work may contribute to ethical erosion among learners, namely, medical students and residents. Unlike traditional approaches to teaching professional ethics and leadership in medicine, rights-based (aspirational) pedagogies approach trainees as autonomous moral agents, whose work has moral value to themselves and others, who live with the ethical consequences of their professional choices, and whose work shapes their individual moral character. By incorporating teaching strategies that intentionally build learners' rights-based leadership through the development of moral courage, medical educators may counter important aspects of ethical erosion while promoting learner preparedness, outcomes, and well-being. Military teaching approaches offer a valuable example to medical educators seeking to create structured curricula that foster moral courage to promote rights-based leadership, given the high level of moral and managerial complexity present in both medicine and the military. Through a comparative analysis of professional ethics in the medical and military disciplines, this Observation article explores the validity of applying precedents from military ethics and leadership education to medical training. Through arguments rooted in moral philosophy, military history, and military organizational research, we explore the expansion of rights-based teaching methods within the predominantly traditional and rules-based norms of medical education. In relating these findings to real-life clinical scenarios, we offer six specific, rights-based modifications to medical ethics curricula that have potential to promote morally courageous leadership and counteract the ethical erosion medical students and residents face.

Shaping Perceptions and Inspiring Future Neurosurgeons: The Value of a Hands-On Simulated Aneurysm Clipping Workshops at a Student-Organized Neurosurgical Conference

Objective  Early exposure to niche specialities, like neurosurgery, is essential to inform decisions about future training in these specialities. This study assesses the impact of a hands-on simulated aneurysm clipping workshop on medical students' and junior doctors' perceptions of neurosurgery at a student-organized neurosurgical conference. Methods  Ninety-six delegates were sampled from a hands-on workshop involving hydrogel three-dimensional printed aneurysms clipping using surgical microscopes. Consultant neurosurgeons facilitated the workshop. Changes in delegates' perceptions of neurosurgery were collected using Likert scale and free-text responses postconference. Results  Postworkshop, 82% of participants reported a positive impact on their perception of neurosurgery. Thematic analysis revealed that delegates valued the hands-on experience, exposure to microsurgery, and interactions with consultant neurosurgeons. Thirty-six of the 96 delegates (37.5%) expressed that the workshop dispelled preconceived fears surrounding neurosurgery and improved understanding of a neurosurgeon's day-to-day tasks. Several delegates initially apprehensive about neurosurgery were now considering it as a career. Conclusion  Hands-on simulated workshops can effectively influence medical students' and junior doctors' perceptions of neurosurgery, providing valuable exposure to the specialty. By providing a valuable and immersive introduction to the specialty, these workshops can help to dispel misconceptions, fears, and apprehensions associated with neurosurgery, allowing them to consider the specialty to a greater degree than before. This study of a one-time workshop cannot effectively establish its long-term impact on said perceptions, however.

Third Year MBBS - Gateway to Clinical Skills Learning

Practising medicine is all about art, skills and knowledge. According to the Tribhuvan University curriculum, the second phase, third year Bachelor of medicine and bachelor of surgery is the beginning of clinical skill learning. After studying integrated basic medical sciences for two years which is more like a conventional method of learning, the third year brings a new experience. It integrates theoretical knowledge in hospital settings by observing the patients, historytaking, examination, learning effective communication skills and empathy.

Keywords

clinical skills; communication; empathy.

Flexner has fallen: Transitions in medical education system across time, a gradual return to pre-Flexnerian state (de-Flexnerization)

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner, his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur. He could say what other reformers could not, due to their links to the medical education community. But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students, the decline in the number and quality of investigator initiated research among clinical researchers, lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis, poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes. The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations. This de-Flexnerization trend and regression to pre-Flexnerian era standards, ideologies, structures, processes, and attitudes, are bound to beget pre-Flexnerian outcomes, for you get what you designed for.

The Current State of Undergraduate Trauma and Orthopedics Training in Saudi Arabia: A Survey-Based Study of Sixth-Year Medical Students' and Interns' Learning Experience and Subjective Clinical Competence

Background and objective Students frequently complain about the lack of practical skill learning and the poor quality of the medical school curriculum. In light of this, the purpose of this study was to assess the learning experience and subjective clinical competence of final-year medical students and interns in the field of orthopedics in Saudi Arabia (SA). Methods A cross-sectional observational descriptive study utilizing an electronically validated survey was conducted, which included the following six main sections: introduction, demographics, self-assessment of competency regarding certain orthopedic skills, clinical experience in orthopedics, orthopedics curriculum assessment, and choice of future career specialty. Results The total number of participants was 794. Among them, 33% (n=160) and 37.1% (180) had attended no "trauma meetings" or "operating room (OR)" sessions respectively, and only 21.9% (n=106) had attended more than five clinics. Subjective competence in history taking was highest (mean: 8.925 ±1.299) among students who had received more than four weeks of orthopedic rotation and attended more than six clinics. The students who had completed more than four weeks of orthopedic rotation and more than six bedside sessions scored the highest in terms of subjective competence in handling orthopedic patients in primary care settings (mean: 8.014 ±1.931). Conclusion The survey indicates that the amount of orthopedic training provided by institutions varies, with some students receiving less training than recommended. However, longer rotations lead to greater perceived orthopedic competence. Students and interns with more exposure to orthopedics through curriculum and elective rotations demonstrated a greater interest in pursuing orthopedics as a future career.

Early clinical exposure in medical education: the experience from Debre Tabor University

BACKGROUND

The idea of early clinical exposure in Ethiopian medical schools is a young concept. Old and newly established universities across the nation are shifting towards incorporation of early clinical exposure (ECE) in their curricula. Debre Tabor University introduced ECE in undergraduate medical education from inception. This study generated evidence on students' experience and academic leaders' reflection on early clinical exposure implementation.

OBJECTIVE

This study was carried out to investigate medical students' perception towards early clinical exposure and its implementation process by instructors in undergraduate medical education at Debre Tabor University.

METHOD

A cross-sectional survey design that combines quantitative and qualitative methods was conducted in 2021. We asked fifth year medical students (42) to complete a self-administered questionnaire on 5-point Likert scale. The data were supplemented by semi-structured interview with 6 purposively selected academic leaders on the factors that facilitate or impede early clinical exposure implementation. The quantitative data were entered and analyzed using SPSS 20 to compute frequency, median and interquartile range. The qualitative data were analyzed thematically.

RESULTS

The study findings suggest that early clinical exposure (ECE) has a positive impact on the development of students' professional knowledge, problem-solving skills, motivation, active learning, and community orientation. Specifically, 64.3% of the surveyed students believed that ECE was effective in constructing their professional knowledge, while 52.4% felt that it improved their problem-solving skills and facilitated constructive/active learning. Additionally, 57.1% of students reported that ECE improved their motivation and 50% noted that it facilitated community orientation. The study also identified several barriers to the implementation of ECE, with the heavy workload being the most commonly mentioned (78.6%). Other challenges included a loose linkage between academic and healthcare institutions (59.5%) and a lack of orientation on the implementation process (35.7%). Academic leaders reflected that ECE was beneficial in familiarizing students with the clinical environment, but staff commitment was crucial for its successful implementation. The study also found that heavy workload, lack of assessment dedicated to ECE on the curriculum, and poorly oriented staff about the program impeded its implementation.

CONCLUSION AND RECOMMENDATIONS

The findings of this study suggest that early clinical exposure was beneficial learning method. Teachers' commitment to their roles with adequate preparation, and the contribution of curriculum in providing the learning objective and cases for each session were factors that facilitate effective implementation of ECE. Heavy workload and poor orientation about the program could impede ECE implementation.

Developing a module for early clinical exposure: Experience of five years

BACKGROUND

Preclinical students often fail to appreciate the clinical relevance of basic sciences during the first year of undergraduate medical training, leading them to lose interest in the subject, and preventing them from achieving the desired goals. In order to rectify this gap in the curriculum, Medical Council of India (MCI) in 2011 published a document announcing curricular strategies including Early Clinical Exposure (ECE) to effectively modify the Indian system of education. Lack of proper guidance prevented many institutions from implementing ECE. Since our institution had run a similar program of "Clinical Observership" as early as 2001, we were able to implement ECE in an efficient way.

MATERIALS AND METHODS

Early clinical exposure was implemented as a structured program, with the participation of 10 clinical departments since 2013. Feedback from the students, soon after ECE and also from the batch of CRRIs, who had undergone this program while they were preclinical students amply support the effectiveness of ECE in its contents and methods of implementation. Manual content analysis was performed on open comments. After reading the responses, they were broken down to meaning units, and these were then condensed. The condensed meaning units were labeled with codes. The codes were grouped into categories. Themes were derived from the categories.

RESULTS

Out of the 70 CRRIs, 52 responded to the questionnaire. All the CRRIs except one said that ECE was very helpful during their clinical postings and internship period. They suggested that the number of hours of posting should be increased and also reiterated the fact that a greater number of clinical departments could be included in the program. Though the beneficial effects were felt in all the domains of learning, the most remarkable impact was felt in the affective domain, wherein changes are not easy to come by.

DISCUSSION

Recently, National Medical Council has come out with plans of including ECE in the syllabus with strict time schedule. It is felt that the faculty will find our experience of running the program for the past five years helpful in implementing this program, for the fullest benefit of the preclinical students.

Role of a medical student neuro-society organized neurosurgical conference: The Glasgow neuro experience

Background

Entering neurosurgical training in the United Kingdom demands extensive prior commitment and achievement, despite little to no exposure to the specialty in medical school. Conferences run by student "neuro-societies" offer a means to bridge this gap. This paper describes one student-led neuro-society's experience of curating a 1-day national neurosurgical conference supported by our neurosurgical department.

Methods

A pre-and post-conference survey was distributed to attendees to ascertain baseline opinions and conference impact using a five-point Likert Scale, and free text questions explored medical students' opinions of neurosurgery and neurosurgical training. The conference offered four lectures and three workshops; the latter provided practical skills and networking opportunities. There were also 11 posters displayed throughout the day.

Results

47 medical students participated in our study. Post-conference, participants were more likely to understand what a neurosurgical career involves and how to secure training. They also reported increased knowledge about neurosurgery research, electives, audits, and project opportunities. Respondents enjoyed the workshops provided and suggested the inclusion of more female speakers in future.

Conclusion

Neurosurgical conferences organized by student neuro-societies successfully address the gap between a lack of neurosurgery exposure and a competitive training selection. These events give medical students an initial understanding of a neurosurgical career through lectures and practical workshops; attendees also gain insight into attaining relevant achievements and have an opportunity to present research. Student neuro-society-organized conferences have the potential to be adopted internationally and used as a tool to educate on a global level and greatly aid medical students who are aspiring neurosurgeons.

Developing Medical Student Competencies, Clinical Skills, and Self-Efficacy With an Emergency Medical Responder Certification Course

Introduction

Previous studies have claimed gap year clinical experiences before medical school matriculation increase student self-efficacy and clinical confidence. At the University of Central Florida College of Medicine, 41 first-year medical students participated in a new certification course to become emergency medical responders before beginning their coursework. This study describes the results of a follow-up study that aims to investigate the impact the course had on student competency, self-efficacy, and clinical efficacy and if the course would prepare students similarly to previous clinical experience.

Methods

First-year medical students completed a 30-question survey consisting of a Likert scale and free-response questions. Questions were based on the Accreditation Council for Graduate Medical Education core competencies: medical knowledge, practice-based learning and improvement, systems-based practice, patient care, professionalism, and interpersonal and communication skills. Questions on the perceived benefit of the emergency medical responder course and previous clinical experiences were also included. Responses were separated based on participation in the emergency medical responder course and prior clinical experience. Two-tail Welch’s t-tests were performed on the data to determine significance.

Results

Of 98 responses: 20.4% (20/98) of participants of the emergency medical responder course had previous clinical experience, 21.5% (21/98) of participants of the course had no clinical experience, 26.5% (26/98) did not participate in the course but had previous clinical experience, and 31.6% (31/98) did not participate in the course nor had previous clinical experience. Students with previous clinical experience reported the emergency medical responder course improved both their patient care skills and performance in courses that emphasized patient interviewing and physical exams. Students with clinical experience had significantly higher medical knowledge (p < 0.1) and professionalism (p < 0.1) Likert scores. Eighty-seven percent of students agreed the course had a positive impact on their patient care skills.

Conclusion

Larger sample size is needed to make stronger conclusions; however, the responses show the emergency medical responder course had a positive subjective impact on students with previous medical experience. Previous clinical experience leads to the most positive subjective reporting of competencies such as medical knowledge and professionalism. Early clinical exposure, such as an emergency medical responder certification course, may improve self-efficacy and patient care skills for medical students with no previous clinical experience.

Perception of e-learning in medical students and faculty during COVID time: A study based on a questionnaire-based survey

BACKGROUND

With the emergence of COVID, we are forced to use e-learning in form of arranging online classes for students. Medical educators all over the world are conducting online classes for students. This study aimed to evaluate the perception of online learning among MBBS students and teachers through a questionnaire-based survey.

MATERIALS AND METHODS

A cross-sectional study was done in the AIIMS, Bhopal. The study was based on questionnaire (online Google form) response received from 43 number of faculty and 156 number of students.

STATISTICAL ANALYSIS USED

Chi-square test and unpaired t-test were used for statistical analysis using statistical software Systac 13.2.

RESULTS

Handling software, technical issues, and lack of face-to-face interaction were more significant problems in students compared to faculty. The desire for the social site which causes disturbances in learning was a significant problem in the students compared to faculty. Giving and taking assessment problem was reported by 60% and 63.8% of faculty and students, respectively (P = 0.67). Both groups preferred the Google Classroom platform (P = 0.16). Students (65.3%) preferred audiovisual recording, while faculty (72%) preferred PowerPoint with narration. PowerPoint presentation without narration was the least preferred (10.8%). Both groups stressed the importance of training (P = 0.17) and infrastructure development (P = 0.85). Students, as well as faculty, strongly discouraged e-learning for practical/clinical teaching.

CONCLUSIONS

Students, as well as faculty, have mixed reactions toward e-learning. Most importantly affected in the present scenario is practical/clinical teaching and assessment. Every attempt needs to be done to strengthen infrastructure and impart training to students and faculty.