Promoting Pedagogical Resilience: Unveiling the Efficacy of Synchronous Online Lectures Compared to Traditional Methods From the Students' Vantage Point Amidst the COVID-19 Pandemic.

Introduction The COVID-19 pandemic significantly disrupted traditional educational methods, forcing medical institutes to adapt to online classes. Since online teaching was an untested approach in Indian medical education, student feedback was essential. This study compares synchronous online lectures with traditional classroom lectures from the students' perspective. Method The cross-sectional study was conducted on undergraduate medical students across India undergoing synchronous online MBBS classes during the COVID-19 pandemic. After obtaining institutional ethical clearance, five-section questionnaires via Google Forms were circulated on WhatsApp and Facebook. The generated quantitative data were analyzed using descriptive statistics and frequency analysis. Result Out of 341 responses, 64 students did not consent and were excluded, resulting in 277 responses for analysis. The total score for traditional face-to-face lectures was 11.61 out of 15, with a percentage mean score of 77%, highlighting the significant positive influence of instructor presence and a conducive learning environment. In contrast, synchronous online lectures had a total score of 16.01 out of 25, with a percentage mean score of 64.04%, reflecting mixed responses. The Student's t-test analysis underscored the significant advantages of face-to-face interactions and structured learning environments in traditional classroom settings despite the flexibility and independence offered by synchronous online lectures. Conclusion The findings of this study reveal that students have a moderate level of satisfaction with synchronous online lectures, as indicated by a mean score of 64.04%. While these lectures provide flexibility and promote independence, they require students to exhibit higher levels of self-motivation, discipline, and self-directed learning. However, the online format poses challenges for effective communication and technical issues. Addressing the challenges of technology use, teacher training, and student engagement can enhance the effectiveness of online teaching and ensure that it complements traditional teaching methods, ultimately promoting pedagogical resilience in medical education.

The Effects of Implementing Gamification in the Hepatology Curriculum for Medical Students.

Background Gamification, the incorporation of game theory into the curriculum, has been correlated with improved knowledge retention compared to standard didactics. Objective To determine the impact of gamified hepatology modules on medical student knowledge retention and exam performance. Methods We created three web-based, gamified hepatology modules with 15-question pre- and post-tests. Differences in each module's pre- and post-test scores were compared using paired t-tests. Medical school exam scores (total score and hepatology-specific score) in module users versus non-users were compared using independent two-sample t-tests. Results Module completion yielded significant increases in pre- to post-test scores for the jaundice (p=0.002) and anatomy modules (p<0.001). Module users scored 1.2 points higher on the total exam score (p=0.4) and 2 points higher on the hepatology exam score (p=0.31). Post-module survey results revealed higher knowledge retention in hepatology topics, expanded interest in hepatology, and an increased inclination to use web-based learning platforms for future learning experiences. Conclusion Module use led to improved post-test scores in the modules. Module users also had higher hepatology exam and total exam scores, yet, this difference was not statistically significant. Overall, this study suggests that gamification may be beneficial in aiding hepatology knowledge recall.

Utilisation of Learning Analytics to Identify Students at Risk of Poor Academic Performance in Medical Schools.

Introduction Identifying students at risk of failure before they experience difficulties may considerably improve their outcomes. However, identification techniques can be costly, time-intensive, and of unknown efficacy. Medical educators need accessible and cost-effective ways of identifying at-risk students. The aim of this study was to investigate the relationship between student engagement in an online classroom and academic performance given the transition of many courses from in-person to online learning.  Methods A retrospective study was conducted on a group of 235 students from the University of Edinburgh Bachelor of Medicine and Surgery (MBChB) in Year One for eight weeks from the start of term, September 2020. Purposive sampling was used. Data were collected on total test submissions, total discussion board submissions, engagement scores, and overall exam scores. Learning analytics on discussion board engagement were collected for new medical students before they had sat any summative assessment. Tests completed, discussion board posts made, and their total engagement score were correlated with their first summative assessment scores at the end of semester one. Results We found a statistically significant correlation between total test submissions, total discussion board submissions, engagement scores, and overall exam scores, with small-medium effects (r = 0.281, p<0.001) (r = 0.241, p<0.001), and (r = 0.202, p<0.001). Students with more test submissions, total discussion board submissions, and total engagement had a higher overall exam score. There was a statistically significant moderate correlation between total submissions and overall exam scores (r = 0.324, p<0.001). Conclusions Students who had a higher number of submissions were more likely to perform better on assessments. Early engagement correlates with performance. Learning analytics can help identify student underperformance before they undertake any assessment, and this can be done very inexpensively and with minimal staff resources if properly planned.

Assessing the Knowledge and Insight of Medical Students into the Field of Plastic Surgery: A Step Toward Creating Well-Rounded Healthcare Professionals.

Introduction Plastic and reconstructive surgery (PRS) is unique in its versatility; however, there seems to be a lack of familiarity with the breadth of the discipline among healthcare workers and medical students. Methods This is a questionnaire-based, cross-sectional study conducted between June and July 2021, targeting medical students at Kuwait University. The questionnaire examined three domains: demographics, perception, and knowledge of the scope of PRS. Results A total of 465 medical students completed the survey, with most (N=106, 22.8%) being in their final year (seventh year). The majority (N=414, 89%) of students had no previous clinical exposure to PRS. Among the several PRS disciplines, knowledge was highest in the aesthetic discipline (4.1/5). Awareness in the hand (0.82/5) and craniofacial (0.8/5) disciplines were the lowest. Students in their clinical years had a higher overall PRS score when compared to those in their pre-clinical years (10.9 versus 9.1, p<0.0001). Participants who believed that PRS is a rewarding specialty had higher overall scores compared with those who disagreed (10.3 versus 9.5, p=0.055). Participants who believed that PRS is synonymous with cosmetic surgery had a lower overall score (9.3 versus 10.4, p=0.008). Furthermore, participants who would consider a career in PRS had a better understanding of all aspects of the specialty as evidenced by higher overall scores. Conclusion Exposure to the field of PRS improves medical students' insight into the various disciplines of PRS and ultimately influences how the field is perceived. Efforts should be made toward promoting the exposure of medical students to PRS through clinical placements and/or didactic lectures.

A Cross-Sectional Analysis of the Readability of Online Information Regarding Hip Osteoarthritis.

Introduction Osteoarthritis (OA) is an age-related degenerative joint disease. There is a 25% risk of symptomatic hip OA in patients who live up to 85 years of age. It can impair a person's daily activities and increase their reliance on healthcare services. It is primarily managed with education, weight loss and exercise, supplemented with pharmacological interventions. Poor health literacy is associated with negative treatment outcomes and patient dissatisfaction. A literature search found there are no previously published studies examining the readability of online information about hip OA. Objectives To assess the readability of healthcare websites regarding hip OA. Methods The terms "hip pain", "hip osteoarthritis", "hip arthritis", and "hip OA" were searched on Google and Bing. Of 240 websites initially considered, 74 unique websites underwent evaluation using the WebFX online readability software (WebFX®, Harrisburg, USA). Readability was determined using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Reading Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), Coleman-Liau Index (CLI), and Automated Readability Index (ARI). In line with recommended guidelines and previous studies, FRES >65 or a grade level score of sixth grade and under was considered acceptable. Results The average FRES was 56.74±8.18 (range 29.5-79.4). Only nine (12.16%) websites had a FRES score >65. The average FKGL score was 7.62±1.69 (range 4.2-12.9). Only seven (9.46%) websites were written at or below a sixth-grade level according to the FKGL score. The average GFI score was 9.20±2.09 (range 5.6-16.5). Only one (1.35%) website was written at or below a sixth-grade level according to the GFI score. The average SMOG score was 7.29±1.41 (range 5.4-12.0). Only eight (10.81%) websites were written at or below a sixth-grade level according to the SMOG score. The average CLI score was 13.86±1.75 (range 9.6-19.7). All 36 websites were written above a sixth-grade level according to the CLI score. The average ARI score was 6.91±2.06 (range 3.1-14.0). Twenty-eight (37.84%) websites were written at or below a sixth-grade level according to the ARI score. One-sample t-tests showed that FRES (p<0.001, CI -10.2 to -6.37), FKGL (p<0.001, CI 1.23 to 2.01), GFI (p<0.001, CI 2.72 to 3.69), SMOG (p<0.001, CI 0.97 to 1.62), CLI (p<0.001, CI 7.46 to 8.27), and ARI (p<0.001, CI 0.43 to 1.39) scores were significantly different from the accepted standard. One-way analysis of variance (ANOVA) testing of FRES scores (p=0.009) and CLI scores (p=0.009) showed a significant difference between categories. Post hoc testing showed a significant difference between academic and non-profit categories for FRES scores (p=0.010, CI -15.17 to -1.47) and CLI scores (p=0.008, CI 0.35 to 3.29). Conclusions Most websites regarding hip OA are written above recommended reading levels, hence exceeding the comprehension levels of the average patient. Readability of these resources must be improved to improve patient access to online healthcare information which can lead to improved patient understanding of their own condition and treatment outcomes.

Description of Medical Students' Behavioral, Cognitive, and Psychological Engagement with Faculty Online Teaching Styles.

Purpose: The teacher-student dyad is the heart of an institute. A teacher's instructional role significantly influences the student engagement that indirectly measures the institutional outcome. The online transition of medical education changed the milieu of medical education where a virtual link between teacher and student is the only hope for the learner to continue the learning. There were no studies on the relationship between student engagement and teaching styles during online medical education. Patients and Methods: The present study was an online survey-based descriptive study on medical undergraduates from two universities in the United Arab Emirates. Google forms containing consent statements, teaching styles inventory in higher education (TSIHE), and online student engagement questionnaires were emailed to all medical students requesting to participate in the study. Completed survey questionnaires were analyzed descriptively for the degree of student online engagement, and a chi-square test was used to correlate the relation between faculty online instructional methods and students' engagement. Results: A total of 423 of 927 students from two universities participated in the survey. There was no significant perception difference among the students from the two universities regarding their faculty online teaching styles. Thirty-three percent of students at first university and 41% of second university students showed engagement during online classes, which is statistically significant. However, the degree of students' disengagement from both universities was high compared to their engagement for online classes. Both university students' cognitive and behavioral engagement was moderate to strongly correlated with four domains of teaching style. Interestingly, there was no correlation between online faculty instructional methods and students' psychological engagement from both the universities. Conclusion: The present study establishes the relationship between students' cognitive and behavioral engagement and teaching instructional practices. However, there is a need to develop robust evidence on students' psychological engagement and the influencing factors during online and blended contexts.

Satisfaction and attitudes towards online continuous medical education and its impact on clinical practice among physiotherapists.

BACKGROUND: The traditional face-to-face of medical education is gradually being replaced with online education. However, the rate of adoption of online continuing medical education (OCME) as a learning method among practicing clinical physiotherapists (PTs) is unclear. The objectives of this study were to measure the satisfaction with, attitudes towards, and impact of OCME among practicing clinical PTs in Saudi Arabia (SA) and to examine the factors that affect the findings for satisfaction, attitude, and impact towards OCME. METHODS: This cross-sectional survey was conducted between October 2021 and January 2022. PTs employed at various medical facilities and specialties in Saudi Arabia completed an online survey to assess satisfaction with, attitudes towards, and impact of OCME. RESULTS: Of the 127 participants, 48 were female (37.8%), 44.1% were aged between 24 and 30 years. Overall, 57.5% of the respondents were satisfied with OCME compared with conventional face-to-face education, and 45.7% agreed and 18.1% strongly agreed that OCME was more flexible. Further, 52.8% of the respondents thought that OCME programs could supplement traditional face-to-face education. The majority of the participants (63.8%) agreed that participating in OCME programs increased their knowledge, and 55.1% and 51.2% agreed that attending these programs improved patient outcomes and increased their confidence in patient management, respectively. However, only 38.6% agreed that participating in OCME programs enhanced their clinical expertise. The mean satisfaction, attitude, and impact scores differed significantly according to age group, marital status, number of years of practice, and specialty (p < 0.0001). Multiple regression analysis showed that older age was independently associated with better satisfaction and more positive attitudes and impact. Further, having a specialization also seemed to improve the impact of OCME. CONCLUSION: The PTs were satisfied with and had positive attitudes towards OCME, and also found that it had a positive impact on their clinical practice. Thus, existing OCME programs are a good option for expanding the number of PTs proficient in clinical care.

Flipped Classroom With Artificial Intelligence: Educational Effectiveness of Combining Voice-Over Presentations and AI.

BACKGROUND: Most theorists and medical educators agree that a curriculum rich in active learning (AL) strategies, such as a flipped classroom, is superior to passive listening to promote better retention and application of new knowledge. Although AL multimodal teaching strategies have been considered the most effective, including online virtual teaching, voice-over pre-recorded lectures, and, more recently, the addition of artificial intelligence (AI), data on the effectiveness of these methods in medical education is scarce. The present educational research study examined the effectiveness of voice-over-style lectures and AI in facilitating learning outcomes as assessed by test scores after participating in basic science lectures in a medical school setting. METHODS: Participating students were divided equally into two educational strategy groups: slide decks only traditional way (PPT) or PPT plus AI (PPT+AI) platform (edYOU; Los Angeles, CA, USA). The PPT+AI group comprised the PPT with narration and real-time interaction with an AI being personalized, which leverages natural language processing to tailor customized conversations to each student's current knowledge. Students in the two groups were asked to participate in a formative quiz (not reflective of their academic evaluations) to answer questions relevant to voice-over lectures (PPT and PPT+AI). The statistical strategy for conducting quiz item analysis included item difficulty, item discrimination, and point-biserial correlation R. A student's T-test was conducted to compare the two strategies' effectiveness via test scores. A priori, an alpha level of 0.05 was considered significant. RESULTS:  Data are presented as mean ± s.e.m.; Cohen's d. A total of 42 (n=21 in each group) students participated in the study. Students using PPT+AI obtained statistically significant (P <0.043; d = .54) higher quiz scores under challenging questions and less time spent in lectures (54.1 ± 14.3 hrs.) in the PPT+AI group (P <0.001; d = 1.17) compared with the PPT group.  Conclusions: The PPT+AI strategy could be the difference between a pass and a fail, as the PPT+AI strategy is particularly efficient in improving difficult question test scores. At the same time, students may learn the material in less time (efficiency). Research on the application of AI as part of educational strategies for improving satirized test scores, including boards, is warranted. The present study is part of the necessary early steps to better understand the impact of AI as an educational strategy for improving educational outcomes.

Does student evaluation of on-demand video lectures vary with student characteristics? A questionnaire survey of medical students at Tokushima University.

The popularity of online classes in university education has grown rapidly since the COVID-19 outbreak. This study aims to examine the association between the detailed characteristics/various contexts of students and the evaluation of online classes. An online questionnaire survey administered to third- and fourth-grade medical students of Tokushima University in September 2021-with 101 (42.8%) valid responses-showed the respondents' general impressions, comprehension, convenience, and desire for online classes even after the pandemic ends were significantly higher for the on-demand lectures than for simultaneous online classes. Notably, students who did not do other things while watching video lectures (10.9%) rated on-demand lectures as facilitating significantly higher impression, comprehension, and convenience than those who did other things (89.1%). A multivariate analysis revealed that students who did not do anything else while watching, whose waking time changed slightly, who commuted to school for shorter periods, who were not good at morning lectures, and who watched at high speed rated the video lectures highly. Thus, video lectures are appreciated by students who are committed to learning, which is a positive result for the future of on-demand education. J. Med. Invest. 70 : 483-493, August, 2023.

Adapting to a Pandemic: Web-Based Residency Training and Script Concordance Testing in Emergency Medicine During COVID-19.

OBJECTIVE: The coronavirus disease (COVID-19) pandemic necessitated alternative methods to ensure the continuity of medical education. Our study explores the efficacy and acceptability of a digital continuous medical education initiative for medical residents during this challenging period. METHODS: From September to December 2020, 47 out of 60 enrolled trainee doctors participated in this innovative digital Continuous Medical Education (CME) approach. We utilized the Script Concordance Test to bolster clinical reasoning skills. Three simulation scenarios, namely Advanced Trauma Life Support (ATLS), Advanced Life Support (ALS), and European Paediatric Life Support (EPLS), were transformed into interactive online sessions via Zoom™. Participant feedback was also collected through a survey. RESULTS: Consistent Script Concordance Testing (SCT) scores among participants indicated the effectiveness of the online training module. Feedback suggested a broad acceptance of this novel training approach. However, discrepancies observed between formative SCT scores, and summative Multiple-Choice Questions (MCQ) assessments highlighted areas for potential refinement. CONCLUSIONS: Our findings showcase the resilience and adaptability of medical education amidst challenges like the global pandemic. The success of methodologies such as SCT, endorsed by prestigious bodies like the European Resuscitation Council and the American Heart Association, suggests their potential in preparing health care professionals for emergent situations. This research offers valuable insights for shaping future online CME strategies.

The Learning Experience of Romanian Medical Students During the Online Teaching Imposed by the COVID-19 Pandemic.

Introduction: The COVID-19 pandemic has disrupted many aspects of society, including medical education. In response to the pandemic, Romanian medical schools and universities have turned to online learning as a means of continuing instruction while maintaining social distancing protocols. While online learning in medical education was utilized prior to the pandemic, its widespread adoption has brought both challenges and opportunities to the field. The purpose of this study was to assess medical students' perception towards implementing E-learning during COVID 19 pandemic. Material and Methods: This cross-sectional multicentric study comprised 611 medical students from several medical university centers from Romania. A self-developed questionnaire was online applied between January and March 2021 and used for the evaluation and analysis of perceived changes in teaching before and during the COVID-19 pandemic. Results: Most students (n = 71.5%) considered that the pandemic had an overall negative impact on their professional development. A significant negative correlation (p < 0.01, for all), was observed between during COVID-19 pandemic and the level of medical training, motivation to learn, and level of self-confidence. Conclusion: The shift to online learning during the pandemic decreased the psychological and professional development of medical students, resulting in a low perception of self-confidence, motivation, and practical involvement. However, there are many benefits brought by the use of electronic technologies for medical education both in Romania and in the world. These benefits should be systematically evaluated, and effective strategies should be developed to permanently improve the e-learning methods of these students.

Effect of the COVID-19 Pandemic on Medical Students at the University of Jeddah, Saudi Arabia.

Background This study aims to identify the coronavirus disease 2019 (COVID-19) pandemic impact on the academic, financial, psychological, and hygienic aspects of medical students at the University of Jeddah. Methodology Three hundred fifty medical students from the University of Jeddah were sent an online questionnaire using a simple consecutive type of sampling for this cross-sectional study. Students from the preclinical and clinical years were included. The survey consisted of 39 items: four questions were for the demographic domain, 14 items were for the academic domain, another 14 were for hygienic, psychological, and financial aspects, and seven items assessed the effect on elective. A P-value of less than 0.05 was regarded as significant during the statistical analysis, which was conducted using Statistical Package for Social Sciences (SPSS) version 25 (IBM Corp., Armonk, NY, USA). Results There were 333 responses, 174 (52.3%) of them were males. The commonest age group was 21-23 years (n=237, 71.2%). Most of the participants were living in Jeddah (n=307, 92.2%). The majority (54%, n=180) agreed or strongly agreed that "Fluctuations in lecture timing is one of the downsides of online teaching" and "The hands-on experience has suffered greatly" and 42% (n=140) strongly agreed on "Technical issues like poor WiFi connection and lack of computer or mobile devices make online teaching difficult". One hundred five (31.5%) of the participants had an elective during the pandemic, of which 41 (39%) did not have it in training centers. In terms of the mental aspect, 154 (46.2%) students were impacted by the COVID-19 pandemic, and 111 (72.1% of them) developed anxiety or depression. Social media (n=150, 45%) was the most preferable source of information during the pandemic.". Conclusion The COVID-19 pandemic affected the academic advancement of medical students, particularly during the years of their clinical training at the University of Jeddah. Our findings also showed that the COVID-19 pandemic had an impact on the students' financial, hygienic, and mental health, which led to increased depression and concern about visiting hospitals and providing care for patients, which ultimately prevented them from acquiring the necessary clinical skills.

Online Education in Allergy and Immunology: An Update to Conferences Online in Allergy (COLA).

PURPOSE OF REVIEW: Online resources have become an essential component of medical education. We describe here our long standing but unique approach to providing online education in the specialty of allergy and immunology and its impact.  RECENT FINDINGS: In this article, we report the process and updates to our online conferencing curriculum known as Conferences Online in Allergy (COLA). The program was developed at Children's Mercy Kansas City almost two decades ago for the utilization of fellows in training, as well as practicing allergists. Since its inception viewership has continued to grow. COLA has served as a significant resource for both the new and practicing allergists. With rapidly continuing advancements in medical knowledge and technology, coupled with the aftereffects of a pandemic and remote learning, COLA will continue to play a significant role in allergy and immunology medical education.

Readability of Online Hand and Upper Extremity Patient Resources.

Background Online patient resources regarding hand and upper extremity topics published by professional societies are written at a level that exceeds that of the average reader. Methodology Online patient resources focused on hand and upper extremity topics published by the American Society for Surgery of the Hand (ASSH), the American Association for Hand Surgery (AAHS), and the American Academy of Orthopaedic Surgeons (AAOS) were reviewed. The reading material from each topic page was analyzed using the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) formulas. The reading level (FKGL) of each topic page was compared against an eighth-grade reading level, which corresponds to the average US reading level. Results A total of 170 online patient resources were reviewed, including 84 from the ASSH, 74 from the AAOS, and 12 from the AAHS. Overall, the mean FKGL was 9.1, and the mean FRE was 57.3. Overall, 50% of all hand and upper extremity online resources were written at or below an eighth-grade reading level. Pairwise testing revealed topic pages written by the ASSH had lower FKGL compared to those written by the AAHS (p = 0.046). Conclusions Online patient resources focused on hand and upper extremity topics are, on average, written at a level that exceeds the ability of the average reader. Comparisons between organizations showed a statistical, but not clinical, difference in readability measures. An emphasis on improving readability should be maintained as professional organizations continue to develop their online patient resources.

Physician Assistant Students' Perception of Online Didactic Education: A Cross-Sectional Study.

PURPOSE: This study describes physician assistant students' perception toward online didactic education and highlights relationships between student characteristics and their preference for online learning. METHODS: A previously validated survey questionnaire was administered online to physician assistant students enrolled in traditional, in-person training programs across the United States. The survey consisted of five Likert-scale statements measuring perceptions of online learning and was rated on a seven-point Likert scale. Students also reported their age, gender, history of taking an online course, and preferred learning style. Mean scores were reported for agreement with each Likert-scale statement; Pearson correlation coefficients, one-way ANOVA with post hoc Tukey tests, and independent samples t-tests were used to determine relationships between student characteristics and their preference for online learning. RESULTS: A total of 391 completed surveys met the inclusion criteria for the study and were used in data analysis. The average age of respondents was 25.98 years, 81.1% (n = 317) were female, 96.2%, (n = 376) reported taking an online course previously, and preferred learning styles were reported as 36.1% (n = 141) visual, 7.7% (n = 30) auditory, 15.6% (n = 61) reading/writing, and 40.7% (n = 159) kinesthetic. Nearly a quarter of respondents indicated they preferred online courses, particularly students with a preferred learning style of reading/writing. No relationships were observed between age, gender, or history of taking an online course and preference for online education. CONCLUSION: Most physician assistant students prefer in-person learning. However, a substantial number prefer online learning, and a significant number of these students reported a preferred learning style of reading/writing. More research is necessary to give educational institutions the ability to make data-driven, student-centered program development decisions. However, data in this study indicate a need for continued development of online/hybrid physician assistant programs to better align with current student preferences.

Instructional media selection principles for online medical education and emerging models for the new normal.

The COVID-19 pandemic, and the resulting need to avoid in-person classes, compelled many faculty members to convert to a completely online instructional format. The literature on selecting media for medical educators, however, provided little assistance for them to make choices that facilitated learning through using alternative online instruction practices. In this study, we addressed the lack of guidance for the use of media to facilitate the effective online medical education. To optimise the transition from face-to-face educational modalities to online learning, we incorporated insights from theories of media synchronicity and learning. We considered the value of existing learning theories in influencing how we could guide entrenched face-to-face educators to online learning practice. Therefore, we employed existing theories and practice to assist in developing an algorithmic approach to guiding these educators. We reassessed the way taxonomies of learning objectives, practice-oriented learning experiences, the social and collaborative features of learning activities, and media synchronicity theory could have augmented face-to-face teaching, and influenced how these could be reconfigured to assist in the transition to online learning. Consequently, we have developed key principles to inform the continuity of design and selection of instructional media in the transition to medical online learning. We have constructed specific criteria for media selection that correspond to the 12 goals of medical learning. We found that the majority of the goals can be more enhanced by synchronous media than asynchronous versions. We discuss the role of instructional media in emergency online medical education as well as emerging models of media selection for the new normal in medical education and future directions for medical education media research.

Accuracy and Utility of Internet Image Search as a Learning Tool for Retinal Pathology.

Purpose Ophthalmology residency training heavily relies on visual and pattern recognition-based learning. In parallel with traditional reference texts, online internet search via Google Image Search (GIS) is commonly used and offers an accessible fund of reference images for ophthalmology trainees seeking rapid exposure to images of retinal pathology. However, the accuracy and quality of this tool within this context is unknown. We aim to evaluate the accuracy and quality of GIS images of selected retinal pathologies. Methods A cross-sectional study was performed of GIS of 15 common and 15 rare retinal diseases drawn from the American Academy of Ophthalmology residency textbook series. A total of 300 evaluable image results were assessed for accuracy of images and image source accountability in consultation with a vitreoretinal surgeon. Results A total of 377 images were reviewed with 77 excluded prior to final analysis. A total of 288 (96%) search results accurately portrayed the retinal disease being searched, whereas 12 (4%) were of an erroneous diagnosis. More images of common retinal diseases were from patient education Web sites than were images of rare diseases ( p < 0.01). Significantly more images of rare retinal diseases were found in peer-reviewed sources ( p = 0.01). Conclusions GIS search results yielded a modest level of accuracy for the purposes of ophthalmic education. Despite the ease and rapidity of accessing multimodal retinal imaging examples, this tool may best be suited as a supplementary resource for learning among residents due to limited accuracy, lack of sufficient supporting information, and the source Web site's focus on patient education.

Surveying and Modelling 21st Century Online Learning Patterns of Medical Students.

Medical education in the 21st century is shifting more toward online learning because of extensive application of information and communication technology (ICT). We surveyed medical students' 21st century online learning experiences and modeled the interrelations among relevant dimensions of 21st century online learning. Based on the general themes proposed by multiple 21st century learning frameworks and current medical education emphases, a seven-factor instrument was developed for surveying 364 medical students' learning process, thinking process, and basic science-related clinical ability. The associations among the seven factors and the structural relationships of how online learning practices and thinking processes affected basic science-related clinical ability were explored. The developed instrument was validated and possessed good reliability. The seven dimensions were interrelated. Specifically, meaningful learning with ICT was positively associated with other learning practices. The learning practices were positively associated with the thinking processes and the thinking processes were positively associated with students' basic science-related clinical ability. Our findings suggested that students engaged in active and collaborative learning with technology would employ higher-order thinking and perceived better basic science-related clinical ability. The findings support engaging medical students with 21st century learning practices to strengthen students' self-perception of clinical ability.

Crash Course in Orthopaedics: Development and Evaluation of a 12-Week Online Trauma and Orthopaedics Teaching Program for Medical Students During the COVID-19 Pandemic.

Introduction The COVID-19 pandemic caused significant disruption in clinical placements of medical students in the United Kingdom (UK), including trauma and orthopaedic surgery (T&O) rotations. Based on the British Orthopaedic Association (BOA) undergraduate syllabus, a 12-week online teaching program was designed to supplement T&O teaching for medical students across the UK while lockdown and social-distancing restrictions were in place. This study aims to describe the process of designing an online teaching program, evaluate the effectiveness of online education, explore medical student perceptions of the virtual learning environment, and report the lessons learned from this 12-week online program. Methods The "Crash Course in Orthopaedics" consisted of 12 webinars, with topics covering a range of acute and chronic T&O conditions, and was delivered through the online platform Zoom. Attendees were invited to complete a post-course questionnaire retrospectively and the results were used in this study. Qualitative data was assessed using thematic analysis. Quantitative data were presented as descriptive statistics.  Results The webinar series was attended by approximately 5150 participants, with the largest demographic group being clinical medical students (49%). Results from the survey revealed three broad themes which were: 1). Interactivity: question + answer (Q+A), multiple choice questions (MCQs), online tools 2). Content: case examples, orthopaedic examinations, objective structure clinical examination (OSCE) tips  3). Accessibility: slides, recordings, duration of the session. Our study found that the online teaching program improved students' clinical knowledge of T&O and they found learning through interactive methods such as polls, the chat function on zoom, and case-based discussions to be most useful. Also, from the results of this study, a guide on "How to Run a Successful Webinar Series for Medical Students" was developed. Conclusion Online webinars effectively supplement T&O teaching and experience for medical students whose T&O placements were disrupted during the COVID-19 pandemic. The results will be a helpful guide to those planning medical education webinars in the future.

Piloting a Graduate Medical Education Point-of-Care Ultrasound Curriculum.

Objective As point-of-care ultrasound (POCUS) use grows, training in graduate medical education (GME) is increasingly needed. We piloted a multispecialty GME POCUS curriculum and assessed feasibility, knowledge, and comfort with performing POCUS exams. Methods Residents were selected from the following residency programs: internal medicine, family medicine, emergency medicine, and a combined internal medicine/pediatrics program. Didactics occurred through an online curriculum that consisted of five modules: physics and machine operation, cardiac, lung, soft tissue, and extended focused sonography in trauma applications. Residents completed a pre- and post-curriculum questionnaire, as well as knowledge assessments before and after each module. One-hour hands-on training sessions were held for each module. Differences between pre- and post-participation questionnaire responses were analyzed using the Wilcoxon rank sum. Results Of the 24 residents selected, 21 (86%) were post-graduate year two or three, and 16 (65%) were from the internal medicine program. Eighteen (67%) residents reported limited prior POCUS experience. All pre- to post-knowledge assessment scores increased (p<0.05). Statistically significant increases pre- to post-curriculum were found for frequency of POCUS use (p = 0.003), comfort in using POCUS for assessing for abdominal aortic aneurysm, soft tissue abscess detection, undifferentiated hypotension and dyspnea, cardiac arrest and heart failure (p<0.025); and competency in machine use, acquiring and interpreting images and incorporating POCUS into clinical practice (p<0.001). All participants felt the skills learned during this curriculum were essential to their future practice. Conclusions In this pilot, we found using a combination of online and hands-on training to be feasible, with improvement in residents' knowledge, comfort, and use of POCUS.