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Impact of COVID-19 pandemic on Medical Education in Saudi

Impact of COVID-19 pandemic on Medical Education in Saudi

Summary of Study

The pandemic of Coronavirus Disease 2019 (COVID-19) has a significant influence on medical education and healthcare institutions. To support the learning objectives during the pandemic, several learning management systems were used. In Saudi Arabia, the majority of colleges adopted the online teaching methods. There is considerable similarity between online and traditional education. While several research have concluded that there are no substantial differences between traditional and e-learning, some have found the opposite. One of the most serious drawbacks of e-learning is the lack of clinical access. In Saudi Arabia, e-learning is not the favored mode of teaching in medical schools. The majority of the students thought of e-learning as an interactive system that allows them to learn.

Background

Coronavirus disease (COVID-19) was discovered in December 2019 in Wuhan, Hubei Province, China-pneumonia-like symptoms characterize the virus. The disease spread rapidly globally, resulting in an outbreak. The World Health Organization (WHO, 2020) declared it a global pandemic on March 11, 2020.1

Since March 25, 2020, over 150 countries have temporarily shut down colleges and educational institutions, affecting more than 80{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of the world’s student population. According to the Saudi Ministry of Education, health authorities have recommended “preventive and precautionary” measures to ensure that students and staff are appropriately protected.2

This has led to a shift in education in most academic faculties, transforming learning from traditional to online. Consequently, colleges provided students with several learning management systems.3 One of the most suggested approaches is scheduled live-online video lectures with interactive discussions using different applications or self-study online recorded lectures.4,5 Virtual clinical experience was another approach to the suspension of clinical clerkship rotation. This idea supports the concern of the Ministry of Health regarding medical students’ exposure to the virus during training as well as their potential to act as spreaders of the virus in the community.6 They were limited patient care and bedside learning opportunities during the pandemic, as doctors and other healthcare workers were required to focus on COVID-19 cases. Hence, students were safe at home, complying with social distance guidelines; they learned about the dynamics of patient interaction by interviewing patients, collaborating with treatment planners, assisting with paperwork, and counselling patients.7

Online and traditional education shares several similarities. Students still have to attend class, learn new topics, submit assignments, and participate in group projects. While many studies have found no significant differences between traditional and e-learning, others have reported opposing results.8 E-learning offers more program choices, compared with traditional face-to-face learning. It is classified as synchronous or asynchronous. Synchronous e-learning allows live interactions between tutors and students, such as live-video conferences and chats.9 Asynchronous e-learning can involve e-mails, recorded videos, etc., where there are time lags between the tutor and their students.9

With traditional classroom education, students are confined to taking courses at specific centers on a fixed schedule. Thus, e-learning helps save up to 60{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of traditional learning time, with the only requirements being an adequate computer, internet connection, and basic computer skills.10,11

In contrast, online classes involved an absence of in-person, face-to-face classroom, or office interactions. For many students and programs, interpersonal communication is crucial. For example, consulting lecturers in person and discussing matters in groups is an essential motivational activity and learning strategy; however, it is not easy to practice medicine online.12–16

Additionally, the on-campus atmosphere and the opportunity to meet many people face-to-face is another motivation for students; moreover, it has an essential impact on student performance and understanding lectures. Nevertheless, in e-learning, online classes depend on personal factors, such as: student’s home environment, socioeconomic factors, and parents’ level of education. Unfortunately, conducive surroundings are not always available to many students.

Another essential factor in students’ comprehension; online teaching can easily create a sense of boredom while listening to a monotonous lecture, devoid of interaction and visual stimulation. This reduces students’ motivation to attend future lectures.17

The perceived benefits of both teaching methods must be thoroughly outlined and assessed to determine which medium generates better student performance. Both approaches are generally beneficial; however, we still need to examine whether one is more superior compared to the other. Hence, this study aimed to measure the effect of online classes on medical students’ comprehension attending campus classes during the COVID-19 pandemic.

Methods

Study Design

We conducted a cross study using an online survey between 2020 and 2021. Data were collected from medical students in their basic and clinical years in the western region of Saudi Arabia using a questionnaire. Questionnaires with incomplete or missing data were excluded from the analysis.

Questionnaire Tool

The survey was adapted from previously validated assessment scales.3,18 The survey involved 45 multiple-choice and multiple-answer questions, including primary demographic data, such as age, gender, academic year, and the name of the school they attended, without recording any identifying data for confidentiality. Additionally, the survey included general questions about the students’ knowledge of e-learning and the status of the technology tools used during the education process. It also had questions to assess the students’ attitude toward the e-learning system as well as their evaluation and suggestions for improving online teaching. Finally, specific questions were asked to appraise the effect of the COVID-19 pandemic on medical students.

Sampling Strategy

A convenience sampling method was used. All medical students in the Western region of Saudi Arabia were invited to participate in the study. The inclusion criteria were clear in the invitation letter and sent along with the survey link. There was no incentive was provided to the participants to be involved in the study. The survey was conducted online using the Google Forms© and was distributed through social media platforms such as: WhatsApp, and Twitter. A total of 922 respondents were included.

Study Outcomes

The primary outcome was measuring the effect of online classes on medical students’ comprehension of attending campus classes during the COVID-19 pandemic. Secondary outcomes included comparing the level of medical students’ morning excitement for attending lectures before and during COVID-19; further, we also assessed medical students’ attendance rate before and during COVID-19 and the effect of students’ limited clinical exposure on their knowledge. A copy of the questionnaire will be found in Supplementary Section.

Statistical Analysis

Descriptive statistics were used to summarize the data and synthesize a report of the variables. The data description includes proportions and frequencies, for continuous variables. The statistical analyses were carried out using S.P.S.S. (version 27).

Results

Demographics Characteristics

Of the 3700 questionnaires, we collected 922 completed online questionnaires from students of 11 medical schools in the western region of Saudi Arabia. Participants were predominantly women; the sample included 693 (75.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) women and 229 (24.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) men; their mean age was 22 (28.3{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) years. Umm AL-Qura University had the highest response rate with 232 responses (25.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}), followed by King Abdulaziz University with 186 responses (20.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) and Taibah University with 112 responses (12.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}). Two (0.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) of those who completed the survey were not included in the western region of Saudi Arabia. A more significant number of respondents included medical students who had finished their fourth year with a response rate of 325 (35.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}), followed by those who completed the fifth year with 310 responses (33.6{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}). Finally, 33 (3.6{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) responses completed by prior-year students or interns were not included in the sample size. For details see Table 1.

Table 1 Demographic Data of the Study Participants

Students’ Experience About e-Learning

Approximately 49.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} students started online classes during the first week of lockdown. The majority of institutions preferred Blackboard and Zoom as video-conferencing platforms for e-learning. A total of 624 (67.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students used Blackboard, whereas 612 (66.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) used Zoom. Microsoft Teams and Webex Meet were less preferred, as 237 (25.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) and 128 (13.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) used Microsoft Teams and Webex Meet, respectively. Overall, 727 (78.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students had five or more online classes per week, 30.3{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of them had live classes (synchronous), 6{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} had recorded classes (asynchronous), and 63.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} had both (synchronous and asynchronous) (see Table 2).

Table 2 Students’ Experience About e-Learning

Effect of COVID-19 on the Medical Education Process and Evaluation of e-Learning

A total of 395 (42.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) had experienced suspension of their education by the faculty, and 529 (57.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) had suspended their clinical training. In addition, 17.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} students suspended their education program by themselves due to social status and personal responsibilities. Thus, 410 (44.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students stated that the COVID-19 pandemic did not affect their career plans and future interests, but 331 (35.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) reported the opposite. Moreover, owing to the lockdown students had more free time than earlier. Overall, 490 (53.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students spent their time resting and relaxing, 456 (49.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) spent time with family, and 386 (41.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) spent their time watching television. However, our study showed that many students invested their time wisely, as 619 (67.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students participated in programs related to medical education. Further, approximately 396 (43{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) participated in medical research activities and 401 (43.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) in volunteering activities; for details (see Tables 3 and S1).

Table 3 Effect of COVID-19 on the Medical Education Process

Student’s Attitude During COVID-19 Pandemic

Regarding students’ attitudes toward e-learning, 391 (42.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students were worried about losing opportunities to apply for specialty training due to the lockdown. Regarding the students’ perspectives on e-learning, the study shows that a majority of students, that is 451 (48.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}), believed that e-learning depends on the comprehensive digital electronic environment displaying educational curriculum through electronic networks. In comparison, 423 (45.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students believed it was an interactive system that provided an opportunity to learn information and telecommunication technology. Moreover, 367 (39.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students believed that e-learning provides digital multimedia content (ie, written text, audio, video, and images). Less than one-third of the students, that is 255 (27.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}), believed that e-learning in the medical field is not less expensive than conventional learning. A total of 248 (26.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students considered e-learning as a type of tele-education, and for 207 (22.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) instant feedback from the instructor was a benefit of online-learning. E-learning has benefits and drawbacks that affect students’ lives differently. Overall, 603 (65.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students agreed e-learning helps save money and energy, that is typically expended during commuting; moreover, they believed it was a more straightforward learning method.

Furthermore, 365 students (39.6{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) believed that it limits the consequences of social contact and 355 (38.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) thought it causes fewer absences than traditional teaching, whereas 296 (32.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students believed that e-learning caused more absences. A total of 232 (25.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students believed that it resulted higher academic achievement, whereas 230 (24.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) agreed that results in better student interaction in classes. However, as Table 4 shows, 555 (60.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) of students believed the limitation of clinical access was one of the biggest disadvantages of e-learning. Moreover, 466 (50.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students disliked the absence of direct contact with a lecturer in e-learning, whereas 386 (41.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) believed that technical requirements were a disadvantage of e-learning. In contrast, 323 (35{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students did not have a conducive environment in the house during online classes. Approximately one-third (32.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students believed that e-learning courses lower academic achievement; moreover, 160 (17.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) felt that online classes were not safe, whereas 280 (30.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students were unable to adapt to e-learning. Regarding student attendance, 727 (78.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students attended five lectures or more per week, and 376 (40.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students were able to participate in more than 80{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of the classes per week. Moreover, 409 (44.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students attended only 50–80{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of the classes, whereas 137 (14.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) were able to participate in only less than 50{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}. For details see Table 4.

Table 4 Student’s Attitude During COVID-19 Pandemic

Status of Educational Technology Tools During the COVID-19 Pandemic

Table S2 describes the students’ proficiency with using various electronic devices: 108 (11.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) reported themselves as proficient, 171 (18.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) were perfect, 371 (40.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) were good, 228 (24.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) had an acceptable level, and 4.8 (44) had an inadequate level. In medical education, the students’ computers varied between tablets (683 [74.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}]) and smartphones (457 [49.6{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}]). Further, 543 (58.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students used personal computers. Around, 698 (75.7{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) were dependent on the university’s lectures for their study, 619 (67.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) were dependent on self-study and utilized various educational sources, whereas 254 (27.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) attended extra courses provided by private education centers.

E-Learning Improvement

Finally, the students could help assess e-learning, as shown in Table S3. Overall, 518 (56.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students did not want to continue using e-learning on its own in the future, whereas 668 (72.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) wished to use e-learning in combination with traditional learning.

Discussion

The COVID-19 pandemic has resulted in a remarkable shift in education and learning methods. Additionally, some medical colleges have adopted open-book examinations, which have shifted toward an entirely new online teaching and examination system. Therefore, studying the effects of e-learning using several parameters on medical students is imperative e-learning. This study aimed to measure the impact of online classes on medical students’ comprehension of attending campus classes during the COVID-19 pandemic. Moreover, we compared the different changes in medical students’ levels of excitement and rate of attendance in e-learning before and after the pandemic.

According to medical students’ responses, our findings revealed that the advantages of e-learning vary among students. Of the students, 423 (45.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) thought e-learning to be an interactive system that provides a learning opportunity. In contrast, a minimal number of students agreed that they had interactive classes. Consequently, 232 (25.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) believed that it offered high academic achievement. Likewise, in the study conducted by Cicha et al, the majority of participants demonstrated a positive feedback about distance learning.19 In contrast, when asked about the disadvantages, most students believed that the limitations of clinical access were one of the worst disadvantages of e-learning. Moreover, 466 (50.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students disliked the absence of direct contact with the lecturer during classes. In contrast, 323 (35{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students did not have a calm home environment during online classes. Finally, 280 (30.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) could not adapt to their online environment. Compared to our study, similar advantages and disadvantages were found in many reports in the literature.17,19–22

Technology knowledge is one of the most important factors for easy transition and success in e-learning.23–25 In our study, the participants reported the need of technical knowledge was one of the major disadvantages of e-learning.

Based on the previous responses of our survey, we noted that medical students believed that e-learning has far more disadvantages, compared with traditional methods that allow for clinical exposure. These disadvantages are considered critical parameters that facilitate each student’s comprehension and understanding. A total of 302 (32.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) students believed that e-learning lowered academic achievement.

The survey results indicate a change in the attendance rates during the pandemic, compared with those recorded before the pandemic. A total of 376 (40.8{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) of students could attend more than 80{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of classes per week. In contrast, 137 (14.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}) attended less than 50{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of the classes. The underlying reasons behind their absenteeism include poor internet connection, inappropriate class timing, and discomfort with virtual teaching.

Several studies have supported the impact of the COVID-19 pandemic on medical education using different perspectives. A study that took place in United Kingdom has identified the effect of the COVID-19 outbreak on final year medical students’ examinations, electives, and assistantship placements and the subsequent impact on preparedness and confidence. Many students felt less prepared to begin work as doctors. This study shows that disruptions to student assistantships significantly impact preparedness, which results in lowered academic achievement.26

Another study investigated medical students’ perceptions regarding the role of online teaching in facilitating medical education during the COVID-19 pandemic. This study suggests that most students prefer face-to-face teaching.27 This study reported that the cancellation of clinical examinations and the conversion of written examinations into open book ones reduces student engagement, which was in line with the findings of our study.

A few limitations of e-learning mentioned in this study was related to technical issues. Moreover, many teachers are inadequately prepared and face many technical difficulties. The quality of the sessions delivered may have been affected by several factors, such as poor internet connection, family distractions, and the timing of the tutorials, as demonstrated by our results.

Students’ mental health is impacted by the COVID-19 pandemic, which may be adversely affected by the lack of interaction with friends and colleagues, leading to an increase in anxiety.18 As mentioned in the same study, the main advantages of online teaching are the time and money saved from the lack of travel, flexibility, and the ability for students to learn at their own pace.27 This is similar to our results.

Another study conducted in Jordan,3 which assessed students’ class experience, lecturers’ interaction, and e-learning advantages and disadvantages. Their results show that the e-learning experience was not favorable for most medical students due to limitations with regard to technology, and that traditional face-to-face teaching method is preferred for various reasonse-learning. Furthermore, the non-direct contact between lecturers and students is a significant obstacle, as students and lecturers have had on-ground interaction during regular lectures prior to COVID-19. Finally, the lack of clinical access to medical students is one of the most significant disadvantages due to the essentiality of patients’ exposure to medical students in clinical years.3 In contrast, their students’ online attendance rate was lower than ours. Thus, the cause of this difference in attendance rates required further investigation.3

Another study evaluated the comparison between face-to-face learning and e-learning modalities in teaching an environmental science course and additionally evaluated factors of gender and class rank.11

The results of this study did not show significant difference in performance between online and traditional classroom students by modality and gender. Further, as there is no significant difference in student performance between the two mediums, higher education institutions may gradually shift away from traditional instruction and implement web-based teaching to capture a larger worldwide audience.

If administered correctly, this shift to web-based teaching could lead to a higher cost efficiency, and higher university revenue.11

Many hospitals have suspended medical student clerkships during COVID-19 pandemic. Unfortunately, in our study, student clerkships in the hospitals were suspended or postponed in about 50{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of participants. This is can be a major defect in their medical education journey and needs to be compensated as soon as applicable (12,J).

Our study had some limitations. First, the design of the study is cross-sectional in nature, some missing data could limit the conclusion of the study. The independent variables were not adjusted for real-life accuracy. Furthermore, students have different skills, abilities, preparation, and familiarity with online instructions. Experienced traditional classroom students who take online-based classes and lectures may lack the technical requirements of e-learning. Therefore, they may not be prepared to use e-learning efficiently, thus leading to lowered scores. Second, some medical schools may have been disproportionately represented with more significant numbers of responses from some schools. Finally, some aspects of our survey depended on students’ memory, which may have influenced their reporting.

Implications and Recommendations

Our study is relevant as it explored a crucial educational topic. Simultaneously, the COVID-19 pandemic has accelerated the widespread use of electronic learning in medical education without pre-preparations. This fast acceleration should be investigated to determine its advantages and disadvantages. The results of this study will help make critical decisions for the future of medical education. Moreover, it would help improve electronic education and adapt it to the needs of medical education and medical students by considering all the benefits. According to the student’s responses, as shown in the results, 72.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} (668) wished to use e-learning in combination with traditional learning. Face-to-face learning is essential to increase the academic achievement of medical students and has higher clinical exposure. Additionally, online-learning helps save time, money, and energy. Additionally, we recommend that medical students should be prepared for online applications and platforms to improve their knowledge and experience.

Future studies are needed to investigate the same topic in the broader field of medical education, including the basic years. Moreover, further examination is necessary to find alternative models of clinical exposure that would be effective in compensation during situations similar to the COVID-19 pandemic. Finally, additional studies are needed to investigate an appropriate and effective way to use e-learning alongside traditional learning.

Conclusion

This study found that advantages of e-learning vary among students. Most of the students thought e-learning to be an interactive system that provides a learning opportunity. In contrast, many of the students believed that there were many disadvantages regarding online teaching methods. These findings has been seen in many reports in the literature recently and indicates that further studies are needed to identify the potential causes.

Ethical Statement and Institutional Review of Board Statement

The study was approved by the Faculty of Medicine at Umm Al-Qura University, Makkah, Saudi Arabia (NO. HAPO-02-K-012-2021-06-696). This study was performed in accordance with the principles stated in the Declaration of Helsinki.

Informed Consent

Informed consent was obtained from all subjects involved in the study.

Disclosure

The authors declare no conflicts of interest.

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Residential Architecture Trends Show Continuing Pandemic Influences

Residential Architecture Trends Show Continuing Pandemic Influences

The most up-to-date trends survey displays that properties are receiving greater. This Next Quarter 2022 review by the American Institute of Architects shows effects described by architectural users all over the nation about what’s taking place in their techniques and markets.

There ended up sq. footage decreases in past years related with downsizing, also referred to as “right-sizing,” but that development has sharply reversed in 2021 and 2022. This dovetails with households pressured to accommodate supplemental loved ones associates house from faculty, out-of-house do the job or nursing households mainly because of Covid, as very well as households being demanded to deal with get the job done from house, at dwelling education and physical accommodation demands.

Incorporating House at Household

Additions and transformed spaces are escalating in measurement, perhaps to handle these new demands, and the best need for these enhancements is at the luxury stage. These are also the house owners who probably held back far more cash from journey and summer time camps for their small children for the reason that of Covid these earlier two several years, so had additional revenue (and incentive) to invest in their homes.

Finishing unfinished areas in a residence, which can consist of attics, basements and garages, points to the want for accommodating far more house associates and residence-primarily based responsibilities considering that the pandemic began, like analyze, distant work, little business enterprise startups, and amplified foods planning.

Architects functioning on entry degree and cost-effective households observed decreases in household sizes. This could correlate to creating solution value inflation, persistent supply chain challenges and economical stresses among the this house owner cohort, as effectively as Covid help courses taper off.

Bonus House Decreases

At the exact time, adding bonus space has shockingly trended downward, in spite of the crush for excess housing and more room in present housing. The study reveals a marked decrease in accent dwelling units and other rental area from past year to this 12 months. That way too could correlate to enhanced fees of building these units, as properly as a scarcity in development labor producing the course of action more challenging to start and entire.

Growing old in Put

Reported architectural tasks for adding accessibility within just the household have greater from very last yr to these days, as have accessibility into and out of the household, and total patterns for getting older in spot. This much too could relate to older family associates shifting in during the pandemic to support with childcare or handle their possess requires. It also connects to our getting older inhabitants and escalating costs of incapacity with age. Solitary ground plans also enhanced in acceptance, tying into this accessibility development.

Out of doors Dwelling

There was a slight minimize in outdoor living spaces from 2021 to 2022, and in outbuildings (e.g., pool residences, sheds). Supplied rising temperatures in numerous locations of the state, there are additional architectural houseplans with pools. Outdoor security lighting has also markedly improved, likely tied to countrywide crime development worries.

Company Tendencies

AIA associates claimed record significant job backlogs considering the fact that the study commenced in 2005, the survey studies. These figures have sharply improved since the pandemic began and proceed to steadily climb. Whilst the architects described wholesome organization circumstances throughout the place, all housing sectors noted advancement declines, with to start with time customer/reasonably priced residences viewing the most significant drop.

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Pandemic schooling continues to include home schooling | Education

Pandemic schooling continues to include home schooling | Education

Some dad and mom, skeptical that hybrid education would work perfectly for their small children in the fall of 2020, took the leap and determined they would instruct their youngsters at dwelling by themselves. 

And this year, several in no way returned to university.

Whilst the range of young children remaining house-schooled continues to be rather small, it remains far over the 2019 amount. Preliminary figures from the college yr that just ended demonstrate 4,116 students in kindergarten via 12th quality were property-schooled in Erie and Niagara counties, in accordance to the Condition Training Section. That is about 3{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of the whole enrollment in the two counties.

In the initially year of the Covid-19 pandemic, the number of young children in Erie and Niagara counties who ended up house-schooled nearly doubled from 2019-20 to the next calendar year, from 2,425 to 4,209.

There had been an uptick in property schooling in 2019 when New York Condition cracked down on childhood vaccinations necessary for university and removed the spiritual exemption for some 26,000 college students in the condition.

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Kelly Newton of Amherst took her time in determining whether or not to dwelling-school her then-fifth grader and significant faculty sophomore in 2020, but she did not like how the Williamsville Faculty District was managing remote finding out. As the summertime of 2020 went on, she was a lot more confident her kids would have a much better consequence finding out at property.

“My target originally was for them to go back to general public school,” she mentioned, hoping the college would offer you a absolutely remote option.

But it didn’t, and the kids uncovered at residence.   

“I generally believed we would be in New York until finally my daughter graduated from large university,” Newton said. “I enjoy Buffalo, just not the winters.”

Newton’s partner functions from home, and they understood that with the youngsters discovering at home, they no more time experienced to wait around for graduation to depart town. The family returned to North Carolina final tumble, exactly where they had lived 12 years in the past.

Though dwelling schooling was not the only cause they moved, it played a massive portion.

“It would not have been doable experienced it not been for shifting to house schooling as a result of Covid,” she claimed.

Home schooling ongoing, with less polices than in New York.

“It really is a great deal simpler to do from below,” Newton reported. And she additional that she will not have to worry about her children’s safety and they will not have to acquire section in active shooter drills. 

Niagara Falls Superintendent Mark Laurrie mentioned he thinks some dad and mom property-school for the reason that they are worried about violence in universities. A lot more than 200 college students are getting household-schooled in the Niagara Falls Metropolis Universities, about 25 additional than very last 12 months. It truly is the premier group Laurrie has found in far more than 20 decades as an administrator.

“I believe a large amount of it had to do with Covid fears, some of it has to do with school violence,” Laurrie explained.

He reported a tiny quantity of moms and dads could choose to household-university since they are skeptical that schools do not instruct crucial race principle.

Laurrie explained he thinks some mom and dad in Niagara Falls went to residence education this year due to the fact the district did not provide a standard distant studying option.

“It truly is their proper,” he stated. “Even although I consider to communicate them out of it, I you should not fight them.”

Just about 170 college students in the Iroquois Central School District realized at residence for the 2020-21 university yr, with the selection dropping to 146 this 12 months.

Iroquois Superintendent Douglas Scofield famous that college students started the school calendar year sporting face masks, and then the mask mandate was lifted in late wintertime. He thinks mom and dad decided to carry on household education for the rest of the school calendar year.

“I assume individuals were uncertain of what the point out would mandate for faculties and they just held their children exactly where they were being,” Scofield explained.

Some parents have already arrive in to sign up their small children for future calendar year, he explained.

“There is certainly no explanation for them to make a determination nowadays,” he said. “They can make a determination in August.”

Lots of rural faculty districts observed a bigger share of learners picking out to dwelling-faculty. In North Collins Central, approximately 70 kids uncovered at house this faculty yr, even though 548 attended college in individual. 

The district has been adhering to the uptick, Superintendent Scott Taylor claimed. 

“I hope that degrees off or arrives back,” Taylor explained.  

“Ultimately, it is a family’s alternative in conditions of factors why they do it, and I respect that,” he mentioned. “I could be biased, thinking North Collins, it really is a fantastic area to be and get a wonderful schooling.”

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A systematic review of health sciences students’ online learning during the COVID-19 pandemic | BMC Medical Education

A systematic review of health sciences students’ online learning during the COVID-19 pandemic | BMC Medical Education

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    Online education and the mental health of faculty during the COVID-19 pandemic in Japan

    Online education and the mental health of faculty during the COVID-19 pandemic in Japan

    The doing the job natural environment of college faculty improved speedily for the duration of the COVID-19 pandemic. School associates were being questioned to change from in-individual instruction to instructing lessons on the web in a pretty short interval of time, as portion of endeavours to stop the spread of the COVID-19 pandemic15. From this backdrop, this examine investigated the mental overall health of Japanese school customers who taught lessons on-line for the duration of the COVID-19 pandemic, to discover hazard variables for bad mental health and fitness and reduce the development of psychological ailment in the future. Even though other reports have examined the mental wellbeing of college students all through the COVID-19 pandemic3,10,11,12, rather couple scientific studies have centered on the psychological well being of school associates in universities. Accordingly, our review contributes to the literature by furnishing new conclusions on the matter.

    Initial, we investigated the true problem of the faculty’s psychological overall health prior to the COVID-19 pandemic. Even just before the outbreak of the pandemic, it had been noted that school members in universities have weak mental overall health as opposed to customers of other professions18. We used the WHO-5 to measure the psychological health and fitness of faculty customers and then calculated the proportion of school at threat of psychological ailment (total WHO-5 score < 13). The results revealed that 15.3{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of faculty members had been at risk of developing a mental illness, even before the COVID-19 pandemic. Another investigation of mental health among Japanese faculty reports that 10.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of faculty members were at risk for mental illness prior to the pandemic33. Compared to this result, the at-risk group was larger in our sample. Lee et al.34 also used the WHO-5 to assess the mental health risks of various occupations. They reported that 13.2{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of management/professionals were at risk of developing mental illnesses. In the context of their findings, the proportion of faculty members at the risk of developing a mental illness is comparatively high, thus demonstrating that the mental health of faculty members in universities is inherently worse than that of workers in the management/professional field. Lee et al.34 also reported that the proportion of office workers at the risk of mental illness was 12.9{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf}. Thus, the proportion of faculty members at the risk of developing mental illness exceeded that of office workers. It is quantitatively evident that the mental health of faculty members in universities had been worse than that of workers in other occupations, even before the COVID-19 pandemic.

    Next, we focused on the WHO-5 scores of faculty members before and during the COVID-19 pandemic, which revealed that the mental health of faculty members worsened during the pandemic. The proportion at risk of mental illness was 15.3{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} before the COVID-19 pandemic, but nearly doubled to 33.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} during that period. We speculated that this large increase was due to lifestyle and work-related changes, including remote work, a lack of face-to-face communication, and the shift to online instruction in a very short period of time. In particular, the sudden transition to teaching classes online involved a very heavy workload, accompanied by unforeseen financial and time costs35.

    In addition, we hypothesized that the dramatic decline observed in the mental health of many faculty members could be attributed to four risk factors: the number of classes taught online, the time needed to prepare for those classes, challenges related to the technology needed to conduct classes online, and the level of satisfaction with support services provided by the university. Our results suggest that two of these were significant risk factors for the poor mental health among faculty members. The first risk factor was related to technology. Faculty members who reported having difficulty using the required technology were more susceptible to poorer mental health. The second risk factor was the level of satisfaction with the university support services. Faculty members who reported higher levels of satisfaction with university support services maintained good mental health despite the unforeseen shift in the mode of instruction. When faculty members first began teaching their classes online, many of them were not familiar with the online conferencing software, lacked the required equipment (e.g., webcams, high-quality microphones), and received limited, if any, training on online content delivery36. Furthermore, the lack of relevant IT skills and experience made it difficult for these individuals to adapt to teaching classes online17. Faculty members who lacked IT skills had to redesign their courses and learn IT skills simultaneously. In this situation, it is speculated that faculty members who had difficulty in using IT felt a substantial burden and decline in their mental health.

    In addition, the results revealed that the amount of satisfaction with university support services for online teaching was related to good mental health. To reduce difficulty in using IT, it is important to ensure that the working environment of the faculty satisfies the needs of the faculty who must use unfamiliar technology to teach classes online37. According to Wang and Li37, the needs of the faculty broadly refer to the support that universities must provide for faculty members to effectively use new technology (organizational level) and the technology that helps them meet the objectives of their job (technological level). It also involves assistance from their colleagues, which helps them effectively use technology at work (people level). The administrative support services for online teaching satisfied all the requirements listed above. For example, the university provided social support such as consultations with university IT staff, who explained how to use the software and equipment needed for online instruction, as well as technical support such as providing equipment and writing manuals for some software. Satisfaction with this comprehensive support provided by the university might have reduced the faculty members’ difficulty in using IT, and consequently, improved their mental health.

    Our results also showed that both the number of classes taught online and class preparation time were weak predictors of mental health among faculty during the COVID-19 pandemic, as compared to challenges related to the technology needed to conduct classes online. This result suggests that the psychological burden of dealing with unfamiliar technology, rather than the workload resulting from online classes, including the long preparation time, had a substantially negative effect on the mental health of faculty members.

    The workload for faculty members can be broadly divided into three categories: teaching, research, and service. Faculty members are required to strike an appropriate balance between the three. According to Zey-Ferrell and Baker38, faculty members recognize that teaching is the main component of their work. Their study investigated 503 faculty members, and found that although 92.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} had strong expectations from themselves about teaching, such ideal self-expectations were incongruent with what they actually did. Furthermore, there are a few serious stressors for faculty members, including heavy workloads and anxiety related to securing funding for their research, but the most serious was excessively high self-expectations39,40. Taking these findings into consideration, it is possible that during the COVID-19 pandemic, faculty members placed high expectations on themselves, aiming to provide high-quality lessons online and had to simultaneously deal with the unfamiliar technology needed to conduct classes online. Such circumstances can be reasonably expected to cause stress, which leads to poor mental health.

    In Japan, some university classes were held in person after the lockdown was lifted. However, many courses continue to be conducted online. Some faculty members consider the shift to online teaching to be a positive challenge or at least useful for developing certain competencies17. A previous study also revealed that online classes can be useful, effective, and have a positive influence on student performance41. Furthermore, with online classes, faculty members and students do not need to spend time and money to commute, and there is less drain on university resources. This leads to benefits such as conserving the time and energy of the faculty and saving university resources42. Based on these findings, we assume that online classes will become a normal part of university education, and that faculty members will therefore continue to teach classes online to some extent. Accordingly, universities will need to provide both technical and social support to reduce faculty members’ difficulty in using IT and maintain their mental health.

    We established the effect of teaching classes online during the COVID-19 pandemic on the mental health of faculty members in universities, but there were some limitations to our research, related to sampling and measurement. As sampling issue, we first acknowledge that the number of participants in our study was quite limited, and included only Japanese faculty members. The extent of the COVID-19 infection and government countermeasures differ across countries. In addition, the utilization of online services to deliver course instructions in the setting of higher education varied according to country, before the COVID-19 pandemic. Therefore, the results may not be generalizable to other countries. Furthermore, depending on the major (e.g., medical science and nursing science), some practical subjects may have been more difficult than others to adapt to online instruction. This study investigated a Japanese university specializing in social science therefore, the results may not be generalizable to other institutions of higher education. Accordingly, we need to widen the scope of participants to include faculty members from various departments and institutions in more countries in future research. Finally, due to missing data, we could not investigate gender differences. The switch to online education and remote work may have affected women and men differently. For example, previous research suggests that during COVID-19, women carried a heavier load in the provision of childcare43. Therefore, future research should look deeper into gender differences in mental health among academic staff during the pandemic.

    As for measurement issues, mental health before the pandemic was reported retrospectively, so memory biases could have affected participants’ evaluations, rendering them unreliable. Even so, retrospectively evaluated average well-being in our study was similar to that reported in previous studies employing the Japanese version of WHO-544, therefore retrospection might not have critically affected participants’ evaluations. In addition, because we measured difficulty in using IT devices and satisfaction with university support services with one item each, our results should be interpreted with caution. To provide a more detailed image of the problems causing poor mental health among faculty teaching online, validated scales measuring different aspects of university support (e.g. technical vs social support) and IT difficulty (e.g. lack of expertise in using IT vs stress produced by technical problems, etc.), alongside longitudinal assessments of well-being should be used in future research.

    Our research focused on the first year of the COVID-19 pandemic, during which most faculty members in universities were required to shift to teaching their classes online. Accordingly, these faculty members had to adapt their lessons for online instruction in a very short period of time. In fact, many faculty members were required to set up equipment and learn the necessary IT skills, and in many cases, redesign the content of their lessons in just a month. Accordingly, they might have felt overloaded. More than a year after the outbreak, the work of adapting lessons for online instruction is mostly complete, and thus, the burden on the faculty may be less severe in the future. This change might ultimately have a positive effect on the mental health of faculty members. Regardless, the results of this study demonstrate the need to continuously monitor the mental health of faculty members who must teach classes online in universities.

    This study has focused on the mental health of university faculty, but our findings may possibly be applicable to other occupations as well. The COVID-19 pandemic has been found to cause psychological stress for people working in various occupations, with new work-styles such as telework and remote work being identified as the primary cause of such stress45. In addition, it has been shown that during the COVID-19 pandemic utilizing IT has become more important and the need to use IT has become more frequent in comparison to pre-pandemic times46. This situation of work-styles changing due to the pandemic and mental health worsening due to increased use of IT may be viewed as similar to the situation experienced by university faculty. Therefore, the findings of this study may possibly be applied to other occupations as well, in order to explain the cause of the deterioration of mental health from the perspective of degree of familiarity with IT use and satisfaction with company support, thus clarifying the kind of support that companies must offer to promote the continuation of telework.

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    The pandemic pushed an exodus from public schools

    The pandemic pushed an exodus from public schools

    COVID-19 has wreaked havoc on practically each aspect of America’s community educational facilities and now moms and dads are pulling their children out of the method all collectively.

    Why it issues: With university funding immediately tied to enrollment, gurus alert that the decline in learners might have further repercussions, with some faculties most likely pressured to near entirely.

    By the quantities: Districts in the country with the most distant courses shed 4.4{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of their college students, in contrast to a 1.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} fall for people who held university in particular person, in accordance to a countrywide study by the American Enterprise Institute and the College or university Crisis Initiative at Davidson Higher education.

    • New York observed the most significant drop in enrollment statewide from 2020 to 2022, with virtually 6{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} drop.
    • Enrollment in New York City’s general public schools, the country’s greatest university district, dropped by 9.5{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} more than two years, the Washington Submit experiences.
    • General public university enrollment in California for the initial time in two many years fell below six million this academic yr, for every statewide details.

    Driving the information: “This college 12 months has had continued uncertainty for mothers and fathers: ‘Will my child be capable to go to college and have security in their finding out ecosystem?'” Thomas Dee, a professor at the Stanford Graduate Faculty of Instruction, mentioned.

    • “A probable rationalization for the sustained or even accelerated enrollment loss is mom and dad on the lookout for safe harbor for their young children, seeking for some continuity as a result of this,” Dee explained.
    • The uncertainty of education pushed some moms and dads to deliver their youngsters to non-public or parochial schools, when other individuals opted for dwelling-education.
    • Other mothers and fathers delayed their baby beginning kindergarten, Dee stated. The AEI study observed that kindergarten enrollment in the most distant districts was hit the most difficult, losing 8.1{e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} of young children enrolling.

    The major image: AEI said that districts that available in-person understanding were more very likely to experience an enrollment rebound than those people that stayed digital.

    Between the strains: Dee sounded the alarm on those college students who are not accounted for in statewide enrollment details.

    • In California, for occasion, community school enrollment over the previous two several years dropped by 271,000, while private college enrollment amplified by only about 12,000 learners.
    • Some of the discrepancy in the information may be attributed to college students who switched to an choice method of discovering, these kinds of as homeschooling, and have been not counted by the point out, Dee mentioned.
    • “But the other concern is some youngsters might just be truant and if that’s so, these are probable to be our most educationally vulnerable,” he claimed.
    • “From my point of view, that is one particular of the significant unanswered concerns, … what do we know about young ones who might have fallen as a result of the cracks in the technique?”

    The base line: The drop in general public school enrollment is possible to continue on, at least for as extended as the pandemic persists, Dee stated.

    • “You can find going to be ongoing wellness uncertainty and I feel mothers and fathers are heading to be anxious about irrespective of whether general public educational facilities can deliver a secure studying natural environment for the young children,” Dee stated.
    • “For the organizing horizon that most faculty districts have, this is the new regular.”

    Go further: Instructor burnout leaves colleges scrambling