|Year : 2021 | Volume
| Issue : 2 | Page : 248-252
Quality and effectiveness of online medical education during COVID-19 outbreak: Perception of medical students in Delhi NCR region
Pratishtha Potdar1, Jyotsna Sharma2, Uday Kumar Gupta3, Deepika Aggarwal4, Yogesh Yadav5
1 Department of Anatomy, Noida Institute of Medical Science, Noida, Uttar Pradesh, India
2 Department of Pharmacology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
3 Department of Biochemistry, Rama Medical College, Ghaziabad, Uttar Pradesh, India
4 Department of Community Medicine, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
5 Department of Anatomy, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
|Date of Submission||18-Feb-2021|
|Date of Decision||27-Mar-2021|
|Date of Acceptance||16-Apr-2021|
|Date of Web Publication||18-Oct-2021|
Dr. Pratishtha Potdar
Department of Anatomy, Noida Institute of Medical Science, Noida, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Introduction: Necessity is the mother of invention, is not only an English language proverb but it has been proved several times in several ways, and recently it has been proved during this COVID-19 outbreak that online medical education has erupted as one of the inventions during these stressful situations as a necessity. In these difficult situations, universities seek to deliver medical education through various new methods or modalities, to ensure the continuous learning of medical students. Novel ways of online teaching should be considered in new medical curriculum development, as well as methods of delivering lectures and practical skills for medical students. In this pandemic situations, medical faculty administrators also had to improvise to make an adjustment, from the formerly class-based lecture to online lecture. This study aimed to measure the perception of medical students regarding the quality and effectiveness of online medical education during COVID-19 Pandemic. Materials and Methods: This study was held in Santosh Medical College, Ghaziabad, from April 2020 to August 2020. This is a cross-sectional survey done by using an electronic questionnaire which was based on the result of previously conducted lectures, practical, and small group discussions. It is carefully checked for validation and reliability before considering it for a study. Questionnaires were made on Google Forms and then this e-questionnaire was sent via WhatsApp to all of students. All the data were collected, tabulated, and analyzed. Results: Three hundred and ninety-nine number of students responded to the electronic survey conducted via WhatsApp. Students' perception about the effectiveness and quality of medical online education revealed few supportive and few inhibitory factors. Conclusions: Data obtained in this study can be used as a valuable input to judge the effectiveness and utility of the online methodology in the future.
Keywords: COVID-19, information technology, medical education, online teaching, pandemic
|How to cite this article:|
Potdar P, Sharma J, Gupta UK, Aggarwal D, Yadav Y. Quality and effectiveness of online medical education during COVID-19 outbreak: Perception of medical students in Delhi NCR region. J Datta Meghe Inst Med Sci Univ 2021;16:248-52
| Introduction|| |
The COVID-19 outbreak had originally started and restricted in China, then suddenly turned into a global pandemic in a very short time. The number of casualties due to this disease still grows and it forces the government of India to control and stop the transmission. This rapid change of condition has had a serious impact on almost all aspects of our lives, including our education system. Different measures such as social distancing to combat the spread of COVID-19, which mean physical attendance of students and staffs to the campus, are truly prohibited and we had to switch learning from traditional class based into distant one. The main goal is to educate people so that the community can participate according to the government instruction to prevent transmission and eliminate COVID from the society. All of our students were ordered to stay at home and do all of their academic activities without leaving their homes through online learning. Every educational institution adjusted and changed its modalities of delivering education by considering and following COVID-19 preventive measures and distance learning is part of it. Petterson also in his book titled “Learning” stated, “in the future, teachers may be able to communicate with their students in Multi-media distance education classrooms for interactive distance education and training” and this seems true in today's scenario. Actually, the daily routine educational activities consist of a mixture of class-based expert-lecture, tutorials, skill's lab, laboratory work or activity, and also students' group discussion and independent self-studying. From these activities, expert lecture and tutorials were modified to some extent so that both can be done electronically and using the Internet. Lectures have rapidly been developed to be delivered online using various platforms such as Zoom, MS Teams, and Go webinars, with such technologically enhanced approaches require a great level of engagement not only of students but also of teachers as well. During the implementation of online learning, we noticed that several factors might influence, positively or negatively, and interfere with the process. This study aimed to find out what factors (according to the students' perspective) can be supportive (positive) or inhibitory (negative) that can affect the implementation of productive online learning.
| Materials and Methods|| |
This survey is a cross-sectional study conducted in Delhi and NCR region of India, from the month of April 2020 to the month of August 2020. Ethical approval was obtained from the Institutional Ethical Committee. An online teaching program was started in our universities and other medical colleges in Delhi and NCR regions from April 2020. Didactic lectures, practical, and small group discussions, etc., were conducted every day as per routine teaching schedule. Zoom Platform, MS Team, Google Classroom, Dhoot app, Go to webinar, etc., were different platforms used for this online education during lockdown and different phases of unlocking of COVID-19. A questionnaire was conceptualized and designed on Google Form about the perceptions of medical students regarding the quality and effectiveness of online medical education during COVID-19. The survey consists of demographic profile and questions related to quality and effectiveness of online teaching, Internet accessibility, and supportive and inhibitory factors. After completion of 4 months of online teaching, this e-questionnaire was distributed to the students using social media platforms, i.e., WhatsApp. All the participants agreed to participate after a brief informed consent stated in the opening of the e-questionnaire. The responses were then validated and analyzed on a Microsoft Excel sheet.
| Results|| |
The MBBS students participated in this survey from April to August 2020. A total of 391 students responded to the survey and submit a completed e-questionnaire. All of our respondents' representatives of students are from the first year/freshmen student to the final year students with details number based on 1st/2nd/3rd/4th/5th/6th semester insequences are as follows 68/98/32/48/20/51/14 (in percentage as follows 17.6/25.4/8.3/12.4/5.2/13.2/3.6) most of our respondents were first year, second year, and final year students. Various observations are as follows.
[Table 1] shows that out of 391 responses of students, 75.7% are using mobile phones most commonly, 15.9% are using laptop, and 6.6 are using iPad. [Table 1] shows that connectivity to Internet during online lecture conducted was as follows: out of 391 respondents, 48.8% are using cellular data only, 17.1% are using WIFI only, and 34.0% are using a combination of cellular data and WIFI. Some of the students rely more on cellular data without having any backup (e.g., WIFI), it means that they were very dependent on certainty and continuity of cellular phone signal.
[Graph 1] shows demographic characteristics of our respondents based on gender, 47.6% were male and 52.4% were female with a mean age of 21 years. In our study, 71.1% of students are from Uttar Pradesh, 15.1% from Delhi, and 13.8% from other states. Almost 84.2% are from urban region and 15.8% from rural region. Two hundred and ninety-six students are using mobile phones and 191 out of 391 are using cellular data.
[Graph 2] shows that most of our students 221 (58.3%) out of 391 used headphones for online classes, 213 students used Microsoft Team app for online classes, and 177 used WhatsApp for coordinating classes. This also shows that WhatsApp is most commonly used for coordinating classes followed by the Microsoft Team app. Out of 391 responses, 76.3% responses used WhatsApp, Microsoft Team app: 43.8%, then Zoom app: 28.65%, and Google Classroom: 25.3%. In our study, it is also observed that the Microsoft Team app is used most commonly for uploading classes: 79.5%, WhatsApp: 30.7%, Google Classroom: 13.3%. Youtube: 11.8%, live class with instructions: 84.6%, uploaded video class: 17.3%, uploaded presentation: 38%, and uploading reading material: 23.8%.
[Table 2] shows students' response on the quality of lecture which is good for 37.3%, average for 52.9%, and poor for 8.7%. The content of online lecture was responded relevant by 85% of 391 students' responses and slightly irrelevant by 12.4%. Interaction during online lecture with students is 48.7% sometime, often in 33%, and very often in 12.4%. [Table 2] also shows that MCQ type is a common mode of assessment in this COVID-19. Most of the assignments are given via Google Form: 29.3%, MS team: 24.3%, Mail 21.9%, and WhatsApp 17.6%. Moreover, the feedback of assignment is given mostly through WhatsApp 42.7%, 25.5% through mail, and 20.7% through Google Classroom.
| Discussion|| |
The coronavirus disease pandemic has had a worldwide impact on the health-care systems, population, and global economy. Spread of the virus has resulted in far-reaching consequences such as closure of schools, colleges, and universities and had a great effect on mental well-being of population and compelled us for use of innovative methods to deliver education and to ensure that students continue to receive meaningful teaching with the use of different modalities.
Imparting education has become much more challenging and complexed during this COVID-19 pandemic, especially medical education where distance learning has never been a standard teaching modality. Changes that may be seen are relatively minor as compared to global pandemics, but they have a huge potential to drastically change the carrier path of many students.
This cross-sectional, questionnaire-based study shows how COVID-19 pandemic has changed and forced the lecturers, staffs, and students, to make so many adjustments to make online learning as best as possible. The data on Internet connectivity also informed us about the possibility of challenges of online implementation of education, especially at the higher level of medical education, worldwide.,, Implementation of online lectures in medical college actually gives an opportunity to modify or react positively to fulfill the goal of education.,
Online medical education delivery was started by COVID but shaped by the learned faculty and young future doctors who are actually the backbone of the shifted education during COVID pandemic with their profound knowledge of Information Technology and Gadgets. Basic strength to fight during these odd times comes from the lecturers who fulfilled the responsibilities of delivering this online education to the medical students., This difficult time shifted us from classic classroom-based interaction to different modalities of learning which can be done anytime or anywhere. With online classes, the lecturer and also the students can stay at home, relax, and enjoying the discussion which is held at the exact appointed time/hour. Even though 68.5% of students did not support the idea of online teaching over classroom teaching, 185 numbers of students support the advantages of online teaching in the form of recording of content and time flexibility associated with online lectures. As this online learning can be done at home, and every member of the group does not necessarily have to leave their home means that the costs for transportation, bus/train ticket, meals, can be reduced to almost negligible. Online learning to some extent supports fully the idea of social distancing, and might prevent contact and transmission, at the same time, it reduces the burden of global economy. There are positive effects of integrating Information Technology and mobile devices with teaching and learning on students' learning performance, as we can see during the implementation of online learning due to COVID pandemic.
Nowadays, artificial intelligence driven by machine learning algorithms are superior tools that could play a key role by defining the way medicine will be practiced in the future, and there is no better time to start than right now. With progression of education delivery, the video conferencing methods can also be applied to other types of routine clinical procedures as well as simulated learning methods to encourage everyone to put their best effort to make this online teaching–learning method better. Several supportive responses were received in view of online educations like the feasibility of recording information which students can use for future references, flexibility of class timings, and convenience of continuation of class. Factors considered to be inhibitory are connectivity-related problems, geographical limitations which may lead to hampered telecommunication signals. Out of 391 responded, 63 (14.6%) were faced problem related to headphones, 84 (19.5%) power related, no right place related to 75 (17.4%), noise-related problems related to 158 (36.7%), microphone related to 98 (22.7%), and difficulty in taking responsibility related to 112 (26.7%). This study showed us that there are 68.5% of students who are not agree to online classes and only 13.8% are agree to it and online practical classes are also not agreed by 88.0% and only 4.1% agreed, as shown by a study done by Daroendo et al.
These limitations also become a challenge to us, especially to the online implementation of our education, which rely 100% on IT connectivity so that these great challenges become the opportunity. Even though this is subjective, but direct human interaction is still and always much more beneficial and quite needed in the area of education, especially in medicine. In general, this is a limitation for IT advancement, because even though IT can do barely almost everything in our lives, but still it cannot replace human touch and humanity. Humanity belongs to living humans, and not machines (no matter how advance and sophisticated the machine). This is a challenge to the administrators to improve, or to insert more humanistic approach to the implementation of online teaching.
The way we protect the students by implementing online teaching, as the government's instruction, also give us not only challenge but opportunity as well. We have to give our best effort all the time, to make sure that the delivery of education to our students is continuously controlled and quality is maintained.
| Conclusions|| |
The coronavirus pandemic has seen the introduction of novel methods of delivering education to medical students. People are working hard to control the spread of the virus, and to find effective treatments and vaccination. The negative impact of the pandemic is expected to persist for a long time, especially as the behavior and pathophysiology of the virus are not yet well understood. Another wave of the pandemic over the winter is still a possibility. Therefore, both immediate and long-term measures should be put in place to tackle the serious difficulties faced by medical education and health services over the coming months and beyond. These measures should be based on the principles of shared responsibility at personal, local, and national levels, in addition to providing alternative education and learning opportunities, and serious consideration of transforming existing methods of medical education and learning. Our study on the effect of COVID on our student's education revealed some supportive but also inhibitory factors. These factors can be challenging but, on the other hand, to our knowledge as an opportunity to improve our medical education delivery system. Students should be provided with clear course instruction and other services in an online format to support academic continuity. Faculty administrators should develop and improvise on strategies for increasing and ensuring higher levels of adaptation in and during online distance teaching/learning.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ahmed H, Allaf M, Elghazaly H. COVID-19 and medical education. Lancet Infect Dis 2020;20:777-8.
Kay D, Pasarica M. Using technology to increase student (and faculty satisfaction with) engagement in medical education. Adv Physiol Educ 2019;43:408-13.
Petterson R. Distance education. In: Learning. Sweden: Tulinge; 2019. p. 54.
Miller DG, Pierson L, Doernberg S. The role of medical students during the COVID-19 pandemic. Ann Intern Med 2020;173:145-6.
Stowell JR, Bennett D. Effects of online testing on student exam performance and test anxiety. J Educ Comput Res 2010;42:161-71.
Rose S. Medical student education in the time of COVID-19. JAMA 2020;323:2131-2.
Sahu P. Closure of universities due to coronavirus disease 2019 (COVID-19): Impact on education and mental health of students and academic staff. Cureus 2020;12:e7541.
Zayapragassarazan Z. COVID-19: Strategies for online engagement of remote learners. F1000 Res 2020;9:246.
Kolachalama VK, Garg PS. Machine learning and medical education. NPJ Digit Med 2018;1:54.
Poh SG, Sandars J. A vision of the use of technology in medical education after the COVID-19 pandemic. MedEdPublish. 2020;9:72-5.
Moszkowicz D, Duboc H, Dubertret C, Roux D, Bretagnol F. Daily medical education for confined students during COVID-19 pandemic: A simple videoconference solution. Clin Anat 2020;33:927-92.
Hopkins L, Hampton BS, Abbott JF, Buery-Joyner SD, Craig LB, Dalrymple JL, et al.
To the point: Medical education, technology, and the millennial learner. Am J Obstet Gynecol 2018;218:188-92.
Plochocki JH. Several ways generation Z may shape the medical school landscape. J Med Educ Curric Dev 2019;6:2382120519884325.
Chick RC, Clifton GT, Peace KM, Propper BW, Hale DF, Alseidi AA, et al.
Using technology to maintain the education of residents during the COVID-19 pandemic. J Surg Educ 2020;77:729-32.
Almarzooq ZI, Lopes M, Kochar A. Virtual learning during the COVID-19 pandemic: A disruptive technology in graduate medical education. J Am Coll Cardiol 2020;75:2635-8.
Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al.
School closure and management practices during coronavirus outbreaks including COVID-19: A rapid systematic review. Lancet Child Adolesc Health 2020;4:397-404.
Daroedono E, Siagian FE, Alfarabi M, Cing JM, Arodes ES, Sirait RH, et al
. The impact of COVID-19 on medical education: Our students perception on the practice of long distance learning. Int J Community Med Public Health 2020;7:2790-6.
Bauchner H, Sharfstein J. A bold response to the COVID-19 pandemic: Medical students, national service, and public health. JAMA 2020;323:1790-1.
[Table 1], [Table 2]