Distance learning in clinical medical education amid COVID-19 pandemic in Jordan: current situation, challenges, and perspectives

Abstract Background As COVID-19 has been declared as a pandemic disease by the WHO on March 11th, 2020, the global incidence of COVID-19 disease increased dramatically. In response to the COVID-19 situation, Jordan announced the emergency state on the 19th of March, followed by the curfew on 21 March. All educational institutions have been closed as well as educational activities including clinical medical education have been suspended on the 15th of March. As a result, Distance E-learning emerged as a new method of teaching to maintain the continuity of medical education during the COVID-19 pandemic related closure of educational institutions. Distance E-Learning is defined as using computer technology to deliver training, including technology-supported learning either online, offline, or both. Before this period, distance learning was not considered in Jordanian universities as a modality for education. This study aims to explore the situation of distance E-learning among medical students during their clinical years and to identify possible challenges, limitations, satisfaction as well as perspectives for this approach to learning. Methods This cross-sectional study is based on a questionnaire that was designed and delivered to medical students in their clinical years. For this study, the estimated sample size (n = 588) is derived from the online Raosoft sample size calculator. Results A total of 652 students have completed the questionnaire, among them, 538 students (82.5%) have participated in distance learning in their medical schools amid COVID-19 pandemic. The overall satisfaction rate in medical distance learning was 26.8%, and it was significantly higher in students with previous experience in distance learning in their medical schools as well as when instructors were actively participating in learning sessions, using multimedia and devoting adequate time for their sessions. The delivery of educational material using synchronous live streaming sessions represented the major modality of teaching and Internet streaming quality and coverage was the main challenge that was reported by 69.1% of students. Conclusion With advances in technologies and social media, distance learning is a new and rapidly growing approach for undergraduate, postgraduate, and health care providers. It may represent an optimal solution to maintain learning processes in exceptional and emergency situations such as COVID-19 pandemic. Technical and infrastructural resources reported as a major challenge for implementing distance learning, so understanding technological, financial, institutional, educators, and student barriers are essential for the successful implementation of distance learning in medical education.

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Premedical Student Exposure to Pharmaceutical Marketing: Too Much, Too Soon?

Family Medicine ◽

10.22454/fammed.2019.360469 ◽

2019 ◽

Vol 51 (9) ◽

pp. 722-727

Author(s):

Toby Keys ◽

Mark H. Ryan ◽

Sharon Dobie ◽

David Satin ◽

David V. Evans

Keyword(s):

Medical Students ◽

Medical School ◽

Health Care Providers ◽

Direct Marketing ◽

Medical Schools ◽

Pharmaceutical Marketing ◽

Care Providers ◽

Clinical Experiences ◽

Premedical Students ◽

Pharmaceutical Representatives

Background and Objectives: Direct pharmaceutical marketing to physicians by pharmaceutical representatives is effective in changing behavior of health care providers, resulting in less evidence-based prescribing. Although much has been written about pharmaceutical marketing exposures among medical students, less is known about direct marketing exposures before students matriculate. This study examined the types of pharmaceutical representative direct marketing exposures for premedical students and where they occurred. Methods: From June to August of 2017, researchers surveyed students who accepted admission to US public medical schools. These prematriculated students completed our survey just prior to matriculation. The survey inquired about whether the students were exposed to pharmaceutical marketing directly from pharmaceutical salespeople, the types of marketing they observed or received, and where these interactions occurred. Results: Survey participants included 911 prematriculated students from 14 of the 188 medical schools invited to participate. Seventy-one percent (646) of the participants received or observed someone receiving pharmaceutical marketing gifts, small meals or snacks, articles, or samples. The two most common contexts for direct pharmaceutical marketing exposures were during shadowing experiences (54%, 346) and during employment (50%, 323). Conclusions: The findings suggest that it may be common for medical students to have interacted directly with pharmaceutical salespeople or observed other health professionals in these interactions before they matriculate in medical school. Because many of these interactions occur during clinical experiences required by institutions for admission, medical schools and premedical associations should consider delivering conflict-of-interest education early in medical school education or before students matriculate.

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Conversational Learning in Medical Education

International Journal of User-Driven Healthcare ◽

10.4018/ijudh.2012040103 ◽

2012 ◽

Vol 2 (2) ◽

pp. 12-23 ◽

Cited By ~ 1

Author(s):

Tamoghna Biswas ◽

Amy Price ◽

Shivika Chandra ◽

Adrija Datta ◽

Rakesh Biswas

Keyword(s):

Medical Education ◽

Medical Students ◽

Health Care Providers ◽

Real Life ◽

Care Providers ◽

Problem Solving Skills ◽

Diagnostic Uncertainty ◽

Conversational Learning ◽

Neurological Problem ◽

Persistent Headache

Traumatic Brain Injury (TBI) survivors frequently experience headaches, often labeled as a psycho-social aftermath of poor adjustment to the reality of decreased brain function, but they may be the result of actual physical sequelae of the TBI. This article illustrates an active experiential learning exercise set in a in a user-driven learning environment using a web interface. Using a conversational learning approach, the discussion was centered around a neurological problem on the topic of chronic persistent headache, which generates a considerable amount of diagnostic uncertainty and interventional dilemma among physicians. The physician members of an online forum shared their viewpoints and insights regarding the topic. By utilizing a blend of experiential and empirical evidence, they collaboratively reached a solution. User-driven learning can serve as a potential learning tool in continuing medical education and also as a valuable educational resource to medical students, helping them develop empathy and real-life problem solving skills. Also, when such conversations involve multiple stakeholders (patients and their relatives, physicians and other health-care providers, medical students, etc.) it can foster a collaborative interface which is the essence of user-driven healthcare.

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How the COVID-19 Pandemic Impacted Medical Education during the Last Year of Medical School: A Class Survey

Life ◽

10.3390/life11040294 ◽

2021 ◽

Vol 11 (4) ◽

pp. 294

Author(s):

Gillian Franklin ◽

Clare Martin ◽

Marc Ruszaj ◽

Maliyat Matin ◽

Akaash Kataria ◽

...

Keyword(s):

United States ◽

Medical Education ◽

Medical Students ◽

United States Of America ◽

Clinical Training ◽

Medical Schools ◽

The United States ◽

Learning Program ◽

Medical Specialties ◽

E Learning

The novel coronavirus disease 2019 (COVID-19) pandemic has changed the medical education platform for students in the United States of America (USA). In that light, medical schools had to rapidly rearrange the dynamics of their educational curricula from the traditional platforms, to incorporate telemedicine. The telemedicine platform is supported in many specialties, allowing students various options to continue their education without interruption during the COVID-19 pandemic, and beyond. Telemedicine platforms are projected to grow exponentially due to the COVID-19 pandemic, allowing a segue for medical schools to modify their curricula by incorporating telemedicine programs. These distant-, e-learning (tele-education) programs align with the recommendations and guidelines for practicing social distancing. In this article, we surveyed fourth-year medical students to better understand their views on multiple aspects of e-learning, and its impact on their medical education during the COVID-19 pandemic. We assessed the medical students’ experiences, satisfaction, insight and knowledge with e-learning, tele-education, telehealth, and their related modalities during COVID-19. We provide an organized overview and analysis of the main factors that influence medical education during the COVID-19 pandemic, while bringing forth the main challenges, limitations, and emerging approaches in the field of telemedicine and its application as it relates to medical education and e-learning across medical specialties. We outline the main themes and ideas that the medical students voiced, as to how their medical education is being impacted by the COVID-19 pandemic and how they will incorporate telemedicine and tele-education in their future career. A cross-sectional, mixed-method survey was developed and distributed via Google Surveys to 181 University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, United States of America, 4th year medical students, in December 2020. Results were compiled and analyzed after a 6-day open period for responses to be submitted. The survey instrument consisted of questions that inquire about the students’ perspectives as it relates to their rapid switch from their traditional method of learning to the on-line version of medical education during the COVID-19 pandemic. A total of 65 students responded to the survey, of which 63 completed the survey. More than half of the students (n = 63, 57%) indicated that both their specialty of interest, and (n = 21, 33%) their sub-internships were impacted by the temporary lockdown, due to the COVID-19 pandemic. Students also indicated that the top three specialties that were affected included surgery, internal medicine and obstetrics and gynecology. When the students were asked if they were satisfied with the use of aquifer for their health care e-learning, only 35% of the students were satisfied. The students expressed that the school’s administration team did a good job in developing the new tele-education curriculum for those in clinical training. In addition, responses indicated that students were open to case-based video learning and readings, when combined with the abbreviated clinical exposure during the make-up “clinical immersions periods” allowed for adequate learning. Overall, the survey responses show that more than half, approximately 54% of the medical students utilized telemedicine platforms during their clerkships that were impacted by COVID-19. The 4th-year medical students did not find tele-education and e-learning to be as effective as traditional medical education that combines in-person didactic classroom instructions and in-person face-to-face in hospital clerkships. Students felt that the telemedicine program that was rapidly set up due to the COVID-19 ‘lockdown’ was fragmented, since it was not a formal integration of a telemedicine E-learning program. Students would have preferred more ‘real’ cases to follow, instead of the ready-made, aquifer type of cases. Telemedicine has significant potential to address many of the challenges facing the medical education environment today. We believe now that people have become comfortable with this method of teaching, that even after the pandemic ends, we will continue to see tele-education used as a platform for medical education.

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Medical education challenges and innovations during COVID-19 pandemic

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2021-140032 ◽

2021 ◽

pp. postgradmedj-2021-140032

Author(s):

Michail Papapanou ◽

Eleni Routsi ◽

Konstantinos Tsamakis ◽

Lampros Fotis ◽

Georgios Marinos ◽

...

Keyword(s):

Medical Education ◽

Medical Students ◽

Student Assessment ◽

Well Being ◽

Educational Institutions ◽

Healthcare Staff ◽

Academic Trajectories ◽

Traditional Structure ◽

Physical Presence ◽

The Impact

COVID-19 pandemic has undoubtedly disrupted the well-established, traditional structure of medical education. Τhe new limitations of physical presence have accelerated the development of an online learning environment, comprising both of asynchronous and synchronous distance education, and the introduction of novel ways of student assessment. At the same time, this prolonged crisis had serious implications on the lives of medical students including their psychological well-being and the impact on their academic trajectories. The new reality has, on many occasions, triggered the ‘acting up’ of medical students as frontline healthcare staff, which has been perceived by many of them as a positive learning and contributing experience, and has led to a variety of responses from the educational institutions. All things considered, the urgency for rapid and novel adaptations to the new circumstances has functioned as a springboard for remarkable innovations in medical education,including the promotion of a more “evidence-based” approach.

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Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools

Journal of Medical Education and Curricular Development ◽

10.1177/23821205211018696 ◽

2021 ◽

Vol 8 ◽

pp. 238212052110186

Author(s):

Lisa M Meeks ◽

Ben Case ◽

Erene Stergiopoulos ◽

Brianna K Evans ◽

Kristina H Petersen

Keyword(s):

Medical Education ◽

Medical Students ◽

Students With Disabilities ◽

Class Size ◽

Medical Schools ◽

Organizational Characteristics ◽

School Level ◽

Student Diversity ◽

Structural Barriers ◽

Disability Disclosure

Introduction: Leaders in medical education have expressed a commitment to increase medical student diversity, including those with disabilities. Despite this commitment there exists a large gap in the number of medical students self-reporting disability in anonymous demographic surveys and those willing to disclose and request accommodations at a school level. Structural elements for disclosing and requesting disability accommodations have been identified as a main barrier for students with disabilities in medical education, yet school-level practices for student disclosure at US-MD programs have not been studied. Methods: In August 2020, a survey seeking to ascertain institutional disability disclosure structure was sent to student affairs deans at LCME fully accredited medical schools. Survey responses were coded according to their alignment with considerations from the AAMC report on disability and analyzed for any associations with the AAMC Organizational Characteristics Database and class size. Results: Disability disclosure structures were collected for 98 of 141 eligible schools (70% response rate). Structures for disability disclosure varied among the 98 respondent schools. Sixty-four (65%) programs maintained a disability disclosure structure in alignment with AAMC considerations; 34 (35%) did not. No statistically significant relationships were identified between disability disclosure structures and AAMC organizational characteristics or class size. Discussion: Thirty-five percent of LCME fully accredited MD program respondents continue to employ structures of disability disclosure that do not align with the considerations offered in the AAMC report. This structural non-alignment has been identified as a major barrier for medical students to accessing accommodations and may disincentivize disability disclosure. Meeting the stated calls for diversity will require schools to consider structural barriers that marginalize students with disabilities and make appropriate adjustments to their services to improve access.

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Self-Assessment of Problem Solving Disposition in Medical Students

Journal of Biomedical Education ◽

10.1155/2014/161204 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6

Author(s):

Silvia Lizett Olivares-Olivares ◽

Mildred Vanessa López-Cabrera

Keyword(s):

Health Care ◽

Medical Education ◽

Medical Students ◽

Problem Solving ◽

Medical Schools ◽

Self Assessment ◽

Competency Based Education ◽

Competency Based ◽

Future Demands ◽

Disposition Model

Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 experts in medical education and applied to 135 registered students on the sixth year of the M.D. Physician Surgeon program at a private medical school. Cronbach’s alpha indicated an internal consistency of 0.751. The findings suggest that selected items have both homogeneity and validity. The factor analysis resulted in components that were associated with three problem-solving subcategories. The students’ perceptions are higher in the pattern recognition and application of general strategies for problem solving subcategories of the Problem solving disposition model.

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Abstract P163: Accuracy to Diagnose Cardiac Arrest and Quickness to Start Chest Compression in Different BLS Algorithms; a Comparative Study

Circulation ◽

10.1161/circ.118.suppl_18.s_1480-c ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Tomoko Tamura ◽

Koichi Tanigawa ◽

Shinji Kusunoki ◽

Takuma Sadamori ◽

Tadatsugu Otani ◽

...

Keyword(s):

Cardiac Arrest ◽

Medical Students ◽

Health Care Providers ◽

Chest Compression ◽

Loss Of Consciousness ◽

Care Providers ◽

Clinical Experiences ◽

European Resuscitation Council ◽

The Subject ◽

Erc Guidelines

Background; BLS algorithms for health care providers or experience personnel recommended by AHA, European Resuscitation Council (ERC), and Japanese Resuscitation Council (JPN) differ with respect to the sequence of assessment and procedures. The differences may affect accuracy to diagnose cardiac arrest and quickness to start chest compression. We compared BLS algorithms recommended by these organizations with respect to accuracy of respiratory/circulatory assessment, and quickness to start chest compression using a computed manikin model. Methods; Thirty three subjects (16 physicians and 17 medical students) were enrolled. The Sim-Man (Laerdal) was used to develop 2 scenarios (no pulse/no breathing, with pulse 60/min and breathing 10/min). The three algorithms and 2 scenarios were randomly assigned to the subject, and the accuracy to diagnose cardiac arrest and the time from confirmation of loss of consciousness to starting chest compression were evaluated. Results; The rates of incorrect assessment of respiratory/circulatory status were AHA;9.8% (13 out of 132), ERC;9.1%(12 out of 132) and JPN;6.8%(9 out of 132)(n.s. among algorithms). When the results were analyzed with respect to clinical experiences of the subjects, i.e. physicians vs. medical students, significant differences were found between the groups: AHA;17.2% (11 out of 64), ERC;15.6% (10 out of 64), JPN;12.5% (8 out of 64) in students, whereas AHA;2.9% (2 out of 68), ERC;2.9% (2 out of 68), JPN;1.5% (1 out of 68) in physicians* (* p<0.05 vs. students). The time to starting chest compression were AHA;27.8±5.1 sec, ERC;18.6±3.2** sec, JPN;23.7±4.2 sec (**p<0.05 vs. AHA and JPN), and no significant differences were found between physicians and students. Conclusions; No differences were found in accuracy of respiratory and circulatory assessment among the algorithms, although it may be influenced by clinical experiences of evaluators. The BLS algorithm starting CPR from chest compression such as ERC guidelines may reduce the time of no-flow status in cardiac arrest.

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Assessing the current state of medical education on cannabis in Canada: Preliminary findings from Quebec

Paediatrics & Child Health ◽

10.1093/pch/pxaa015 ◽

2020 ◽

Vol 25 (Supplement_1) ◽

pp. S29-S33

Author(s):

Laurent Elkrief ◽

Julien Belliveau ◽

Tara D’Ignazio ◽

Philippe Simard ◽

Didier Jutras-Aswad

Keyword(s):

Medical Education ◽

Medical Students ◽

Medical School ◽

Medical Schools ◽

School Curriculum ◽

Medical Curricula ◽

Comfort Levels ◽

Current State ◽

Low Levels ◽

Current Curriculum

Abstract The legalization of recreational cannabis across Canada has revealed the importance of medical education on cannabis-related topics. A recent study has indicated that Canadian physicians report a significant gap in current versus desired knowledge regarding the therapeutic use of cannabis. However, the state of education on cannabis has never been studied in Canadian medical schools. This article presents the preliminary findings of a survey conducted to understand the perceptions of Quebec’s medical students regarding cannabis-related teachings in their current curriculum. Overall, students reported very low to low levels of exposure to, knowledge of, and comfort levels with cannabis-related subjects. The majority of students reported that they felt that their medical curricula did not prepare them to face cannabis-related issues in their future practices. Strategies need to be developed for improving medical school curriculum regarding cannabis-related issues. These findings provide potential key strategies to improve curricula.

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Assessment of knowledge and attitude about emergency contraception: a cross sectional study among medical students in North India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174059 ◽

2017 ◽

Vol 6 (9) ◽

pp. 4042

Author(s):

Rajiv Kumar Gupta ◽

Parveen Singh ◽

Rashmi Kumari ◽

Bhavna Langer ◽

Pawan Sharma ◽

...

Keyword(s):

Medical Students ◽

Sexual Intercourse ◽

Health Care Providers ◽

Emergency Contraception ◽

Early Years ◽

North India ◽

Care Providers ◽

Cross Sectional ◽

Unprotected Sexual Intercourse ◽

Knowledge And Attitude

Background: Emergency contraception (EC) which is the only method indicated after the unprotected sexual intercourse prevents unintended pregnancies and its harmful consequences like unsafe abortion or unintended child delivery. Since medical students are the future medical professional and would be the main channel to provide preventive, promotive and curative services to the population at large, their knowledge and attitude towards EC is an important context in the overall health scenario of India. The study aimed to assess the knowledge and attitudes of medical students towards use of EC.Methods: This cross sectional questionnaire based study was conducted among 2nd professional MBBS students in a Government Medical College in North India. The self administered questionnaire intended to seek information on knowledge and attitude of the students. The data so collected was expressed in percentages and Chi square test was used as test of significance.Results: All the respondents had heard of EC with mass media as the main source of information. More than 90% of the respondents knew about the indications for use of EC as well as the timing of the use of EC. Female respondents had better knowledge about composition of EC as well mechanism of action (p<0.05). More than 90% would recommend EC in case of unprotected sexual intercourse and 83.5% had positive attitude towards EC.Conclusions: Although knowledge about EC was good on certain parameters, yet lack of in depth knowledge among future health care providers is a cause of concern. So, attention be given to special issues relating to EC from early years of medical education till internship.

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Virtual Reality Module Depicting Catheter-Associated Urinary Tract Infection as Educational Tool to Reduce Antibiotic Resistant Hospital-Acquired Bacterial Infections

University of the Future: Re-Imagining Research and Higher Education ◽

10.29117/quarfe.2020.0250 ◽

2020 ◽

Author(s):

Yosra M Mekki ◽

Mohamed M Mekki ◽

Mohamed Hamammi ◽

Susu Zughaier

Keyword(s):

Medical Education ◽

Virtual Reality ◽

Antibiotic Resistance ◽

Learning Outcomes ◽

Health Care Providers ◽

Resistant Bacteria ◽

Educational Tool ◽

Care Providers ◽

Antibiotic Resistant ◽

Hospital Acquired

Introduction: Virtual reality (VR) and augmented reality (AR) are used as simulation models in student-patient interactive medical education and shown to enhance learning outcomes. The rise in global burden of infectious diseases and antibiotic resistance world-wide prompt immediate action to combat this emerging threat. Catheter associated urinary infections (CAUTI) are the leading cause of hospital-acquired infections. The aim of this research is to develop a virtual reality (VR) based educational tool depicting the process of CAUTI caused by antibiotic resistant bacteria. The VR-CAUTI module is designed to provide insights to health care providers and community which help in reducing the burden of antibiotic resistant infections. Material and methods: The VRCAUTI module is designed using tools including Blender, Cinema4D and Unity to create a scientifically accurate first-person interactive movie. The users are launched inside a human bladder that needs to be drained. They can witness the insertion of a medical catheter into the bladder to drain the urine. Bacteria adhere to the catheter to establish colonization and infection. An interaction between antibiotic molecules and bacteria in the biofilm is observed later. After designing the 3D models, a highlight of the interaction between models, taken from the storyboard, is used to determine the necessary animation. Moreover, dialogue that facilitates the understanding of infections and antibiotic resistance is recorded. This is followed by the assembly of the module on Unity, and enrichments such as lights and orientation. Results and conclusion: This VRCAUTI module is the proof-of-concept for designing detailed VR based scientifically very accurate medical simulation that could be used in medical education to maximize learning outcomes. VR based modules that have the potential to transform and revolutionize learning experience and render medical education compatible with the IoT in the current 4th industrial revolution.

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