Physician-Patient Communication Course: When the Inauguration of a New Israeli Medical School Coincided with COVID-19 Pandemic

Purpose

The curriculum of the Adelson School of Medicine at Ariel University, the newly established sixth medical school in Israel, includes a simulation center-based extended course on physician-patient communication, aiming to help students master the core competency of interpersonal and communication skills. For more than a year following the emergence of the COVID-19 pandemic, the school suspended most face-to-face (F2F) encounters, transforming most teaching activities to remote platforms. The paper outlines the ways we adapted teaching of this course to these circumstances, the reactions of students and mentors to the changes and results of 1st year students' survey.

Methods

During the lockdown in the first year 48 of 70 first-year students participated in a voluntary anonymous online evaluation of the course assessing motivation to become a physician; perceptions, feelings and attitudes towards the communication course, and advantages and disadvantages of online and F2F medical interviews.

Results

46.1% of the responding students reported that the pandemic strengthened their desire to become physicians. 56.3% claimed that they were able to a relatively large extent to empathize with COVID-19 patients who were exposed to the virus; 79.1% viewed their mentors as positive role models of communication skills. The students were able to receive and offer social support to their peers. They evaluated very highly the short instructional videos produced by the faculty.

Conclusion

During the lockdown, the respondents generally indicated positive attitudes towards the communication course, the mentors and the inclusion of physician-patient communication as a topic in medical education. The students and mentors reported many disadvantages and few advantages of remote learning. Yet inevitably remote learning including online-based simulations is a step towards preparations for future practice within virtual medical care and telemedicine. The limitations of this study include the cross-sectional design, small sample size and self-reporting.

Impact of COVID-19 on Mothers Raising Children with Special Needs: Insights from a Survey Study

Home confinement during the COVID-19 outbreak had psychological effects that continue to be explored by researchers. This study investigated factors influencing the mental health of mothers caring for special needs children in Italy's first lockdown. Specifically, we investigated the relationships between emotional states of depression, anxiety, stress, perceived distress related to home confinement, coping strategies, and other contextual variables (such as opportunities for distance learning and remote working) in a group of 68 mothers of children with special needs and 68 matched mothers of typically developing children. Data from an online survey showed no significant difference between the two groups. However, the research revealed that being a remote worker was a significant predictor of reduced stress in mothers of children with special needs, while distance learning was a significant predictor of reduced stress in mothers of typically developing children. In addition, the study found that hyperarousal symptoms were predictive of stress in mothers of children with special needs, while intrusive thoughts and avoidance coping were predictive of stress in mothers of typically developing children. In conclusion, further research is needed to develop effective support and intervention strategies for families with children with special needs and to deeply investigate the impact of flexible work arrangements and social aid on the mental health of mothers in non-emergency settings.

Inequalities in Home Learning and Schools' Remote Teaching Provision during the COVID-19 School Closure in the UK

Millions were affected by COVID-19 school closures, with parents and schools caught unprepared. Education is expected to play a role in creating equal opportunities, so transferring schooling responsibilities to families may have increased learning inequalities generated by family backgrounds. We examined the time students spent on home learning and explored the role of the schools' distance teaching provision in explaining differences traditionally attributed to parental education, eligibility for free school meals, ethnic background and single parenthood. Using the Understanding Society COVID-19 dataset, we found children who received free school meals, single-parent families and children with parents with lower formal education qualifications and Pakistani or Bangladeshi backgrounds spent significantly less time on schoolwork. However, schools' provision of offline and online distance teaching and homework checking significantly increased the time spent on learning and reduced some inequalities, demonstrating the policy relevance of digital preparedness to limit learning loss in school closures.

Are Psychophysiological Wearables Suitable for Comparing Pedagogical Teaching Approaches?

This study describes how wearable devices can be used in elementary schools to compare some aspects of different teaching approaches. Upper arm wearables were used as an objective tool to compare three approaches when teaching science: (i) classical frontal teaching, (ii) embodied (kinesthetic) teaching, and (iii) a distance teaching approach. Using the wearables, the approaches were compared in terms of their impact on students' psychological arousal and perceived well-being. In addition, short-term and long-term knowledge gain and physiological synchronization between teacher and students during the lecture were assessed. A synchronization index was defined to estimate the degree of physiological synchronization. During distance teaching, by means of measurements with wearables, students were significantly less physically active and significantly less psychologically aroused. Embodied teaching allowed significantly higher physical activation than during the other two approaches. The synchronization index for all three teaching approaches was positive with the highest values for distance and frontal teaching. Moreover, knowledge gain immediately after the embodied lessons was higher than after frontal lessons. No significant differences in the long-term knowledge retention between the three different teaching methods were found. This pilot study proved that wearables are a useful tool in research in the field of education and have the potential to contribute to a deeper understanding of the mechanisms involved in learning, even in complex environments such as an elementary school classroom.

The interaction patterns of pandemic-initiated online teaching: How teachers adapted

This study investigated how teachers adjusted their teaching practices for online teaching during the COVID-19 pandemic in Vietnam. In the study, we collected data from ten teachers within the Department of English at a university in Vietnam through semi-structured interviews via Zoom. During the interviews, the participants shared how they organised their teaching activities and addressed challenges in engaging students. To analyse the data, we focused on the variety of interaction patterns (teacher-student, student-student and student-content) in online teaching. The results showed that most of the teachers deployed activities for two main types of interaction: teacher-student, and student-content, but not for student-student interaction. Teachers also reported that they received limited online teacher training and had to learn by themselves how to engage students remotely. While the university tried to support teachers, no consistent online teaching guidelines were provided. The study suggests that higher education institutions should offer training opportunities and provide teachers with clear guidelines for online teaching.

Lab at home: 3D printed and low-cost experiments for thermal engineering and separation processes in COVID-19 time

The SARS-CoV-2 virus pandemic has meant that face-to-face teaching activities have had to be replaced by distance learning. Experimental laboratories have been replaced, in most cases, by the utilization of experimental data or by simulations. In this work, we have designed four laboratory experiments to be conducted by students of thermal engineering and separation processes during confinement by COVID-19 at home, to maintain competence acquisition and learning outcomes. A mixed methodology of the educational models of autonomous learning and cooperative learning has been used in obtaining the experimental data and writing the laboratory report. Installations for thermal engineering have been 3D designed and printed and are aimed at studying the heat transmission by conduction and convection in heat exchangers. This work describes in detail the activities carried out and shares the files used in the 3D printing of the installations. The laboratory experiments of separation processes are focused on the removal of a dye (rhodamine B) from an aqueous solution by liquid-liquid extraction and adsorption. A survey made to the undergraduate students has confirmed that the methodology and installations designed have been satisfactory for their expectations on the acquisition of knowledge and skills in both subjects.

Undergraduate Students' Perceived Stress Levels in Summer Term 2020 - A Comparison to Preceding Academic Terms

The COVID-19 pandemic tremendously affected teaching and learning in both schools and higher education settings. In Germany, university students had to shift from in-person group learning in lectures and seminars to new forms of e-learning and distance teaching. Even before COVID-19, stress was a common experience among university students, and these changes have reinforced students’ stress levels. Based on a sample of n = 110 German university students, this study explores whether students’ perceived stress levels in summer term 2020 differed from their perceived stress levels in preceding academic terms. The results show that students experienced lower levels of stress and higher levels of joy in summer term 2020 compared to preceding academic terms. Despite limitations in the interpretation of these findings, possible explanations, such as changes in academic and non-academic workload or decreased demands in university exams, are discussed.

Emerging from emergency pandemic pedagogy: A survey of anatomical educators in the United Kingdom and Ireland

It is critical that academic opinion of pandemic pedagogy is comprehensively quantified in order to inform future practices. Thus, this study examines how anatomists in the United Kingdom (UK) and Republic of Ireland (ROI) perceive the teaching adaptations made in response to COVID-19, and how these adaptations have impacted their experiences teaching, their online work environment and community. Data was collected via a questionnaire from 24 anatomists across 15 universities in the UK (11) and ROI (4). With regards to teaching, 95.6% of academics have upskilled in new technologies to meet the demands of distance teaching. Academics (95.8%) preferred face-to-face delivery of practical sessions. Most universities (80.0%) reported that practical sessions will continue in a new form that ensures social distancing. However, 50.0% of academics are uncertain if these adaptations will improve student learning. Many anatomists believe that the new adaptations may hinder student-student (66.7%) and student-tutor (45.8%) interactions. Regarding assessment, 52.6% of academics preferred traditional methods to online. Remote online assessment was difficult to protect against collusion, but provided time saving opportunities for academics. Finally, in terms of working environment, 83.3% of academics stated that their workload increased; 54.2% preferred working on site rather than remotely and 79.2% think that staff interactions are better when working on site. These results demonstrate a widespread concern amongst anatomists regarding the pandemic-induced adaptations to teaching, assessment and working environment. However, important opportunities were also identified that could ultimately serve to benefit students and educators alike.

Restructuring the clinical curriculum at University Medical Center Göttingen: effects of distance teaching on students' satisfaction and learning outcome

Introduction: In summer term 2020, the clinical phase of the undergraduate medical curriculum at University Medical Center Göttingen was restructured since distance teaching had to be used predominantly due to contact restrictions during the COVID-19 pandemic. This paper investigates the impact of restructuring the clinical curriculum on medical students' satisfaction and learning outcomes. Methods: In each cohort, the 13-week curriculum was divided into two parts: During the first 9 weeks, factual knowledge was imparted using distance teaching by means of a modified inverted classroom approach. This was followed by a 4-week period of adapted classroom teaching involving both real and virtual patients in order to train students' practical skills. The evaluation of the 21 clinical modules comprised students' satisfaction with distance teaching as well as students' learning outcome. The latter was assessed by means of comparative self-assessment (CSA) gain and the results of the module exams, respectively. Data of summer term 2020 (= distance teaching, DT) were compared with respective data of winter term 2019/20 (= classroom teaching, CT) and analysed for differences and correlations. Results: Response rates of evaluations were 51.3% in CT and 19.3% in DT. There was no significant difference between mean scores in module exams in CT and DT, respectively. However, CSA gain was significantly lower in DT (p=0.047) compared with CT. Further analyses revealed that CSA gain depended on the time point of data collection: CSA gain was lower the more time had passed since the end of a specific module. Moreover, we found positive correlations between CSA gain and students' satisfaction with various aspects of distance teaching, particularly with "communication between teachers and students" (rho=0.674; p=0.002). Discussion and conclusions: Although some limitations and confounding factors have to be taken into account (such as evaluation response rates, assessment time points, and proportion of familiar items in module exams), the following recommendations can be derived from our findings: A valid assessment of students' learning outcome by means of exam results requires that as few exam items as possible are familiar to the students. CSA gain seems to be valid if assessment time points are standardised and not contaminated by students' learning activities for other modules. Good communication between teachers and students may contribute to increase students' satisfaction with distance teaching.

Distance teaching of experimental scientific methodology and scientific thinking

Objective: The aim of this project was to convert a traditional face-to-face seminar for the teaching of experimental scientific methodology to remote teaching in a timely manner due to the COVID-19 related restrictions to teaching in presence. Methodology: The main focus of the course was on flow cytometry. Basics were developed in a virtual presence phase. Specific teaching contents were taught by an interactive presentation, which came very close to the user experience of a flow cytometer and interactively illustrated the influence of different experimental conditions on the obtained results. Video sequences of authentic sample acquisitions were integrated into Adobe Captivate^®. These "virtual acquisitions" were not distinguishable from the original procedure. For interpretation of the resulting diagrams, interactions were inserted, which allowed direct comparison of the obtained results. Implementation: A presentation with interactive elements and video sequences was created and used for the virtual presence phases. After publishing on a web server in HTML 5, contents were made available to the students for post-processing of learning contents by self-paced learning with full (interactive) functionality. Conclusion: Contributions elaborated by the students during the course demonstrate a learning outcome comparable to that archieved in the last years in presence mode. While implementation of this solution represented a highly time-consuming process, narrative feedback was consistently positive. Due to the short time available for implementation, no systematic evaluation could be conducted, which represents a clear limitation of this work.

Musculoskeletal Pain and Non-Classroom Teaching in Times of the COVID-19 Pandemic: Analysis of the Impact on Students from Two Spanish Universities

The lockdown, due to the coronavirus, has led to a change in lifestyle and physical activity in Spanish university students. The objective of this study was to analyze the prevalence of musculoskeletal pain and changes in physical activity and self-perceived stress in the student bodies of two Spanish Universities during the lockdown. A cross-sectional study was carried out in a sample of 1198 students (70.6% women). The main instruments used for measuring were the Standardized Kuorinka Modified Nordic Questionnaire and the Perceived stress scale (the questionnaire regarding the practice of physical activity). A reduction in the prevalence of musculoskeletal pain (p < 0.001) was identified in the sample of men and women, an increase (12.5%) in the frequency of carrying out physical activity from moderate to frequent, and the preference for strength training (15.1%), especially among women, was identified. All of this may be taken into account by health institutions when implementing measures to encourage physical activity in both suitable amounts and types, which improves the quality of life of the students.

The Distance Teaching Practice of Combined Mode of Massive Open Online Course Micro-Video for Interns in Emergency Department During the COVID-19 Epidemic Period

Objective: To observe and analyze the application effect of the combined mode of Massive Open Online Course (MOOC) micro-video during the COVID-19 epidemic period in the distance teaching practice of interns in the emergency department. Materials and Methods: The subjects of this study were 60 trainee nurses who conducted emergency nursing practice in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 1 to February 29, 2020. At the time of the COVID-19 outbreak in Wuhan, they were divided into two groups: (1) the experimental group (combined mode of MOOC micro-video) and (2) the control group (traditional theory teaching combined with clinical practice teaching). The differences of theoretical and practical examination scores and teaching satisfaction between the two groups were compared. Results: There was no significant difference in theoretical, practical, and total examination scores between the two groups, but in terms of teaching satisfaction, the overall satisfaction, the degree of easy understanding, the evaluation of teachers and learning results in the experimental group were higher than those in the control group, with statistical difference (p < 0.05). Conclusion: Compared with the traditional teaching methods, the effect of combined mode of MOOC micro-video in emergency nursing practice is the same as that of traditional teaching methods, but the satisfaction is higher, so it is more suitable to be used in nursing practice during the COVID-19 epidemic period, so as to effectively reduce the cross-infection between doctors, nurses, and teaching staff.

Providing an Academic APPE Elective via Videoconference Between Off-campus Faculty and Students

Objective. To describe students' experiences and learning outcomes of an academic advanced pharmacy practice experience (APPE) elective provided via videoconference. Faculty preceptor and experiential administration's perspectives also are described. Methods. This 5-week APPE was developed using backward design and delivered starting in 2015 via videoconferencing, with the faculty preceptor and students physically located in different locations throughout the state. After the APPE, students completed a retrospective survey comparing their perspectives and learning outcomes before and after the rotation. They also provided feedback on the experience. Students completed the standard APPE evaluation. Faculty preceptor's self-reflections and experiential administration's perspectives were documented. Results. Six students completed this unique APPE over three academic years. After the rotation, five students (83%) stated that their interest in a full-time academic career increased, while one student's (17%) interest stayed the same. All students stated there was "no hindrance" with this rotation being conducted via videoconference or with the geographical distance between the faculty preceptor and them. Student ratings of nine learning outcomes increased after completing the APPE, demonstrating their perception of their knowledge improved in all topic areas. Conclusion. Students, the faculty preceptor, and experiential administration deemed this videoconference academic APPE effective and successful. This experience affords students, without regard for physical location, the opportunity to pursue interests in academia, adds to the variety of APPEs offered by the school, and allows students to learn about careers in academic pharmacy, an area of growing need in the pharmacy profession.

World Wide Web for Crystallography

Some characteristics of the World Wide Web (WWW) and its Virtual Library (W3VL) are described. Aspects of the setting up, maintenance, future development and objectives of the World Wide Web Virtual Library: Crystallography are detailed. An overview of the successful use of WWW in the organisation of two crystallographic conferences and one entirely electronic conference is given. A revolution in scientific publication is under way with the introduction of WWW and CD-ROM technologies and a few of the points important to crystallography are touched upon. An application to distance teaching in crystallography is described. There is no mention of WWW applications to crystallographic databases in this paper as others at the Workshop have adequately described their work.