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Struggle in the bubble – a prospective study on the effect of remote learning and distance education on confidence in practical surgical skills acquired during COVID-19 | BMC Medical Education

Struggle in the bubble – a prospective study on the effect of remote learning and distance education on confidence in practical surgical skills acquired during COVID-19 | BMC Medical Education

Demographics

A total of 232 out of 244 medical students completed both the baseline and follow-up questionnaire-based surveys, resulting in a response rate of 95{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}. Demographic data was comparable between the two cohorts (Table 1).

Table 1 Baseline comparison of the characteristics of participants belonging to the COV-19 and postCOV- 19 cohorts

Improvement in self-confidence for unit 1

First, it was evaluated whether the respective teaching methods in both cohorts resulted in an improvement in the self-confidence of students regarding their surgical skills. While analyzing unit 1 (sterile working), we found that both the COV-19 (Fig. 2A) and postCOV-19 (Fig. 2B) cohorts showed significant improvement in post-course confidence compared to pre-course confidence. This result was observed for all five subcategories of unit 1 (Table 2).

Fig. 2
figure 2

Self-assessment comparing pre- and post-course confidence of COV-19 and postCOV-19. Spider web graphs displaying the difference between pre- (full line) and post- (dotted line) course self-assessment. Unit 1 (sterile working): A (COV-19) + B (postCOV-19); unit 2 (knot tying and skin suturing): C (COV-19) + D (postCOV-19); unit 3 (history and physical): E (COV-19) + F (postCOV-19). COV-19 = cohort of summer semester 2021 (full COVID-19 restrictions), postCOV-19 = cohort of winter semester 2021/2022 (reduced COVID-19 restrictions)

Table 2 Self-assessment of pre- and post-course confidence of unit 1

Improvement in self-confidence for unit 2

While analyzing unit 2 (knot tying and skin suturing), we observed that both the COV-19 (Fig. 2C) and postCOV-19 (Fig. 2D) cohorts exhibited significant improvement in post-course confidence compared to pre-course confidence. This result was similar for all five subcategories of unit 2 (Table 3).

Table 3 Self-assessment of pre- and post-course confidence of unit 2

Improvement in self-confidence for unit 3

Upon analyzing unit 3 (history and physical), we identified that both, the COV-19 (Fig. 2E) and postCOV-19 (Fig. 2F) cohorts, revealed significant improvement in post-course confidence compared to pre-course confidence. This result was observed for all three subcategories of unit 3 (Table 4).

Table 4 Self-assessment of pre- and post-course confidence of unit 3

Having established that both the traditional interactive face-to-face hands-on courses and the newly developed interactive remote learning courses were able to significantly improve the confidence of medical students regarding basic surgical skills, it was necessary to determine the course that resulted in a higher difference between the pre- and post-course confidence and the subgroup of students that would benefit the most from a particular teaching method. Subgroup analysis was performed based on sex (male/female), age group (19–22 years/23–29 years/≥30 years), and prior surgical experience (with and without prior surgical experience) for evaluating the difference between the pre- and post-course self-assessment (Δ self-assessment).

Subgroup analysis

Sex

The cohorts were first stratified based on the sex (male or female) of the participants, and the subgroup that benefited the most from a particular learning method was determined. For unit 1, the mean Δ self-assessment in the COV-19 cohort was significantly higher in male students (1.96) than in female students (1.44) (p = 0.0003). However, in the postCOV-19 cohort, the mean Δ self-assessment was significantly higher in female students (1.57) compared to male students (1.29) (p = 0.0372) (Fig. 3A).

Fig. 3
figure 3

Subgroup analysis comparing pre- and post-course self-assessment (Δ self-assessment). A subgroup (sex: male vs. female) analysis for differences in Δ self-assessment, B) subgroup (age: 19–22 years vs. 23–29 years vs. ≥ 30 years) analysis for differences in Δ self-assessment, C) subgroup (prior surgical experience: with vs. without surgical experience) analysis for differences in Δ self-assessment, D) analysis for differences in Δ self-assessment comparing COV-19 vs. postCOV-19. Data are presented as mean and compared using Student’s t-test or ANOVA. A p-value less than 0.05 was considered statistically significant. Significance is indicated by the following symbols: * p < 0.05, ** p < 0.01, *** p < 0.001, **** p < 0.00001, ns = not significant. COV-19 = cohort of summer semester 2021 (full COVID-19 restrictions), postCOV-19 = cohort of winter semester 2021/2022 (reduced COVID-19 restrictions)

For unit 2, the mean Δ self-assessment in the COV-19 cohort was significantly higher in male students (2.59) compared to female students (2.16) (p < 0.0001), whereas no significant difference between males (1.92) and females (2.01) was observed in the mean Δ self-assessment in the postCOV-19 cohort (p = 0.0813) (Fig. 3A).

Nonetheless, for unit 3, we found that the mean Δ self-assessment was comparable between the female and male groups in both cohorts (Fig. 3A).

Age

The two cohorts were stratified based on age, which resulted in three subgroups: 19–22, 23–29, and ≥ 30 years. For unit 1, we found that the mean Δ self-assessment in the COV-19 cohort was the highest for the participants in the age group of 23–29 years (mean Δ self-assessment = 19–22 years: 1.51; 23–29 years: 1.82; ≥30 years: 1.42). Furthermore, the mean Δ self-assessment was significantly higher in students of ages 23–29 years compared to those in the age group of 19–22 years (p = 0.0234). However, no significant differences in the mean Δ self-assessment were observed between the subgroups 19–22 years and ≥ 30 years (p = 0.8443), as well as the subgroups 23–29 years and ≥ 30 years (p = 0.0761).

By contrast, the mean Δ self-assessment of unit 1 did not vary significantly between different age groups in the postCOV-19 (mean Δ self-assessment = 19–22 years: 1.58; 23–29 years: 1.33; ≥30 years: 1.23) cohort (Fig. 3B).

Considering unit 2, we determined that the youngest (19–22 years) subgroup exhibited the maximum improvement in self-assessment for the COV-19 and post-COV19 cohorts. In the COV-19 cohort, the mean Δ self-assessment was significantly higher in the subgroup with participants aged 19–22 years compared to the subgroup with participants aged 23–29 years (p = 0.0017). However, there was no significant difference between the subgroups with participants aged 19–22 years and ≥ 30 years (p = 0.4096), as well as the subgroups with participants aged 23–29 years and ≥ 30 years (p = 0.5073).

In the postCOV-19 cohort, the mean Δ self-assessment was significantly higher in the subgroup with participants aged 19–22 years compared to the subgroups with participants aged 23–29 years (p = 0.0020) and ≥ 30 years (p = 0.0017). In contrast, there was no significant difference observed between the mean Δ self-assessment of the subgroups with participants aged 23–29 years and ≥ 30 years (p = 0.2499) (Fig. 3B).

Upon analyzing unit 3, the mean Δ self-assessment in the COV-19 cohort was significantly higher in the youngest students (19–22 years) compared to the subgroup with participants aged 23–29 years (p = 0.0061) in COV-19. However, there was no significant difference in the mean Δ self-assessment between the participants aged 19–22 years and ≥ 30 years (p = 0.0934) and 23–29 years and ≥ 30 years (p = 0.9923).

Nonetheless, for unit 3, the mean Δ self-assessment was significantly higher in the subgroup with participants aged ≥30 years compared to subgroups with participants aged 19–22 years (p = 0.0224) and 23–29 years (p = 0.0181) in the postCOV-19 cohort (mean Δ self-assessment = 19–22 years: 1.73; 23–29 years: 1.68; ≥30 years: 2.35). However, no significant difference was noted in the mean Δ self-assessment of subgroups with students aged 19–22 years and 23–29 years (p = 0.9332) in the postCOV-19 cohort (Fig. 3B).

Prior surgical experience

Lastly, the two cohorts were stratified based on prior surgical experience. Students without prior surgical experience showed a significantly higher improvement in their self-assessment of post-course confidence compared to pre-course confidence. This result was found for unit 1 and 2 in the COV-19 (unit 1 = mean Δ self-assessment with surgical experience: 0.58; without surgical experience: 1.74; p < 0.0001; unit 2 = mean Δ self-assessment with surgical experience: 1.65; without surgical experience: 2.14; p < 0.0001) and postCOV-19 cohorts (unit 1 = mean Δ self-assessment with surgical experience: 0.77; without surgical experience: 1.57; p < 0.0001; unit 2 = mean Δ self-assessment with surgical experience: 1.15; without surgical experience: 2.10; p < 0.0001).

However, for unit 3, we observed that the mean Δ self-assessment did not vary significantly between students with and without prior surgical experience in the COV-19 cohort (mean Δ self-assessment with surgical experience: 1.21; without surgical experience: 1.09; p = 0.2242) but was significantly higher for students without surgical experience in the postCOV-19 cohort (mean Δ self-assessment with surgical experience: 1.19; without surgical experience: 1.89; p < 0.0001) (Fig. 3C).

To summarize, the mean Δ self-assessment was the highest in the young (19–22 years) male students without surgical experience in the COV-19 cohort and young (19–22 years) and elderly (≥30 years) female students without surgical experience in the postCOV-19 cohort.

Finally, we compared the mean Δ self-assessment of both cohorts using each unit. Both, the COV-19 (Δ self-assessment: 1.58) and postCOV-19 (Δ self-assessment: 1.46) cohorts showed comparable (p = 0.1485) results for unit 1. For unit 2, the mean Δ self-assessment was significantly (p < 0.0001) higher in the COV-19 cohort (Δ self-assessment: 2.26) compared to the postCOV-19 (Δ self-assessment: 1.98). In contrast, for unit 3, the Δ self-assessment was significantly (p < 0.0001) higher in the postCOV-19 cohort (Δ self-assessment: 1.76) compared to the COV-19 cohort (Δ self-assessment: 1.1) (Fig. 3D).

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Effect of using 5A’s model for lifestyle counseling on psychological symptoms in women with polycystic ovary syndrome: a randomized field trial

Effect of using 5A’s model for lifestyle counseling on psychological symptoms in women with polycystic ovary syndrome: a randomized field trial

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    Effect of educational intervention on improvement of physical activities of middle-aged women | BMC Women’s Health

    Effect of educational intervention on improvement of physical activities of middle-aged women | BMC Women’s Health

    This experimental examine was performed in 2017 on the middle-aged girls referring to Ahwaz health and fitness facilities, Iran. The inclusion conditions ended up as follows: girls of 30–59 years of age, staying equipped to browse and generate, not acquiring persistent health conditions this kind of as cardiovascular or respiratory ailments or these that cause bodily routines to be banned, not owning mobility prohibition (able to move, take part in academic packages, and recommendations for physical routines), absence of being pregnant, absence of particular conditions, absence of a heritage of mishaps resulted in a mental and bodily trouble through the earlier month (traffic accident, death of a family members member, etcetera.), and willingness to take part in the study task. The exclusion requirements involved the reluctance to participate in the research at any time and not attending numerous levels of the analysis (pre-schooling and article-training assessments, and academic sessions).

    In get to identify the sample size and contemplating the confined statistical inhabitants (160 men and women), the subsequent sampling system was regarded as.

    $$n = frac{{left( Z_1 – fracalpha 2 + Z_1 – beta correct)^2 remaining( delta_1^2 + delta_2^2 right)}}left( mu_1 – mu_2 right)^2 $$

    We employed the two-stage cluster sampling strategy. To start with, Ahwaz city was divided into 4 geographical areas with close to equivalent populations of center-aged females. Two facilities (intervention and handle groups) were chosen in just about every location) full 8 centers). Then, each and every middle was referred and based on the inclusion standards, a record of middle-aged women was geared up from among the the house documents in the center, and 20 folks have been selected from a straightforward random choice (in full 160 personal).

    We utilized cluster sampling technique dependent other research [17,18,19,20].

    Instructional intervention

    The intervention method was executed for a 2-month period of time for the intervention group. It consisted of 4 confront-to-experience consultation classes, just about every for 15 minutes in a month, and 4 follow-up sessions (months 5- 8) right after the session periods for the intervention team. The 1st session session included the completion of a questionnaire for each individual person to determine their wellbeing position. Then, the researcher, with the aid of a teaching heart expert and a physical schooling instructor, shipped a speech on physical exercise and highlighted its importance, and furnished a foundation for getting ready the members to improve in purchase to do actual physical things to do. The second session associated a team dialogue in between the participants in the examine and expressing their views on whether bodily exercise was beneficial or not, so that every single participant would access a selection-generating equilibrium and perceived self-efficacy. In the celebration of a hole in the choice of just about every participant, the researcher and the psychologist of the centre defined and suggested them on how to increase their will. The participants were being also guided to define their plans to have actual physical things to do and specify their direction. In the third session session, the researcher evaluated the stages of the participants’ contemplating and planning to alter by displaying instructional movies. The fourth session targeted on reaching the plans of the past a few periods. For the duration of the weeks 5-8, the researcher reviewed the extent of the participants’ development in actual physical exercise and re-evaluated the level of their functions as well as the phase of improve. The researcher also encouraged them and tried to find out the explanations for their failure. At the conclude of the 8th 7 days, the researcher completed the questionnaire on the level of physical activity and the stages of adjust for the intervention and handle teams. It should really be observed that after the finish of the intervention, the control group was given some sports and health pamphlets.

    The details selection equipment in this analyze were being a checklist of the women’s demographic information and facts (like their career, spouse’s task, education, spouse’s schooling and revenue) and the regular questionnaire on bodily activity. The questionnaire consisted of two parts. The to start with portion was based on the modify constructions of the participants’ actual physical functions. This section comprised of 7 sections: planning to alter (issues 1-5), conclusion-making stability [6,7,8,9,10], perceived self-efficacy [11,12,13,14,15], pre-thinking [16,17,18,19,20], thinking [21,22,23,24], planning [25,26,27,28], observe [29,30,31,32] and servicing [33,34,35,36]. The pre-considering stage is the phase in which men and women are inactive and do not intend to start out standard physical functions in the subsequent six months. The stage of wondering is the a single in which people are inactive and are about to get started typical physical things to do in the subsequent six months. At the preparing phase, the persons have irregular bodily things to do and do them fewer than 3 moments a week and 30 minutes each and every time. The exercise phase is the one particular in which the men and women have regular bodily functions for much less than 6 months. At the servicing stage, the men and women regularly workout for more than six months. The next element of the questionnaire was the brief type of the Worldwide Actual physical Activity Questionnaire, which determined the physical activities of the research samples per 7 days dependent on Fulfilled-min/7 days. Metabolic Equivalent of Activity (Fulfilled) is a device utilized to estimate electricity intake in bodily things to do. If an individual’s Met is equal to just one, it implies s/he is inactive. In case the Achieved is larger than 1 and significantly less than a few, there is small level of bodily action. If the Fulfilled is better than or equivalent to 3 and a lot less than six, the depth of bodily action is moderate, and if the Fulfilled is better than 6, the intensity of actual physical activity is superior. To determine the depth of actions, the Satisfied worth of each exercise is multiplied by the time invested in a single working day or in just a 7 days. This questionnaire was translated by gurus and its Cronbach’s alpha coefficient was .72{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} based on a pilot research [15]. The Kappa coefficient on the validity of the phases of modify questionnaire was also obtained to be 76 by Ghahremani et al. in a research aimed at boosting actual physical functions [16].

    This examine was permitted by the Ethics Committee of Shiraz College of Health-related Sciences. To describe the info, necessarily mean, typical deviation and frequency have been made use of. Apart from, to ascertain the degree of regularity amongst the research samples in the two the intervention and manage groups, the variables these types of as age, instruction amount, marital position, spot of home, spouse’s education and learning, spouse’s profession and sort of housing were employed. The Chi-sq. exam was also used. To look at the influence of schooling, the Impartial T-test check and paired T-take a look at were applied as well. The data assessment was performed employing the SPSS 19 software package and the importance level was viewed as to be .05 in all tests.