Neurodiversity and cognitive load in online learning: A focus group study.

It is widely accepted that cognitive load plays a crucial role in online learning. However, despite neurodevelopmental conditions being the largest category of qualifying disabilities in education, and the rise of online learning, there is little understanding of the factors impacting cognitive load in online learning for neurodivergent students and how these factors differ from those affecting neurotypical students. This study used qualitative comparison groups with neurotypical and neurodivergent students to examine their experiences of cognitive load in online learning. A sample of 26 university students (14 neurotypical and 12 neurodivergent) participated in focus group discussions. While neurodivergent students reported many similar experiences of cognitive load in online learning compared to their neurotypical peers-such as confusion in navigating the content and technical issues-some difficulties were more present for neurodivergent students-such as transcripts including mistakes and inaccessible content presentation-creating additional barriers in effectively engaging with the educational content. The results suggest that neurotypical and neurodivergent students experience similar challenges, albeit to differing degrees of intensity, and that more research is needed to explore the relationship between neurodiversity and cognitive load in online learning.

[Virtual training of practical competences in sonography]. / Sonographie als Gegenstand virtuellen Wissenstransfers zum praktischen Kompetenzerwerb.

OBJECTIVE: During the COVID-19 pandemic, a particular challenge in the transition to digital teaching was to teach practical skills such as sonography of the head and neck online. The aim of this study was to validate the digital sonography course for medical students established at the Freiburg University Hospital ENT Department. METHODS: Participants were 178 students of human medicine. The study group simulated the sonography examination at home with a dummy transducer using the Peyton method under the guidance of a tutor via video seminar. In a subsequent learning success check, the results of the students in the online course were compared with those of the control group, who learned sonography in the classroom. RESULTS: Students of the online course achieved comparable results to the classroom group. CONCLUSION: This study shows that practical skills which require extensive equipment such as a sonography machine can be taught to a certain extent digitally or at least in a hybrid form.

Evaluative study of a MOOC on knowledge translation in five French-speaking countries.

Over the past few years, the RENARD research team has observed a sharp increase in the need for knowledge translation (KT) training. Given the high demand, it has been nearly impossible for the team to provide training entirely in person, and so a massive open online course (MOOC) was developed. Its aim is to promote the use and appropriation of the KT process by practitioners, decision-makers, and others in the public sphere. The goal of this study was to evaluate the MOOC by collecting users' opinions, reactions, appropriation, and practice changes. A qualitative research design was used. Data were collected through semi-structured individual interviews (n = 16) with professionals from Canada, France, and three West African countries (Burkina Faso, Mali, and Senegal) who had taken the MOOC. All interviews were subjected to thematic content analysis. The MOOC content was generally appreciated and reused by the respondents. The results revealed one main motive for completing the course: the immediate opportunity to apply their learning in their practice environments. However, most respondents deplored the lack of interaction among learners and expressed the need for coaching with an instructor to deepen the topics covered during the course. The results also revealed connection and accessibility issues linked to the Internet network and unstable access to electricity in West African countries. The study highlights the potential of MOOCs for the acquisition of knowledge and competencies by KT professionals. Several recommendations and avenues of exploration were formulated to optimize and improve future designs of MOOCs on KT.

[Communication training in otorhinolaryngology education : Comparison of an online and a classroom-based training course]. / Vermittlung kommunikativer Kompetenzen in der Lehre der HNO-Heilkunde : Vergleich zwischen einer Online- und Präsenzveranstaltung.

BACKGROUND: Communication skills are among the most important key qualifications of the medical profession. To what extent these can also be acquired online in medical education in otolaryngology is investigated in this study. OBJECTIVE: A voluntary online training for the teaching of communication skills was compared with a corresponding face-to-face format. The question of the extent to which acceptance of the two formats and students' self-assessment of their communicative skills differed was investigated. MATERIALS AND METHODS: In the online training, students were prepared for the topic asynchronously via a video. Thereafter, they were able to conduct consultations with simulation patients online and synchronously. The face-to-face training was comparable in structure and duration and took place in an earlier semester. The acceptance of both seminars was assessed by a questionnaire with 19 items on a five-point Likert scale. Self-assessment of communication skills was measured by a 10-cm visual analog scale pre/post with 16 items. RESULTS: Both formats achieved high acceptance with an average score (M) of 2.08 (standard deviation, SD = 0.54) for the online format and M = 1.97 (SD = 0.48) for the face-to-face event. Students' self-assessments of communication skills showed a twofold increase in the online group (M = 1.54, SD = 0.94) compared to the face-to-face group (M = 0.75, SD = 0.87). CONCLUSION: This study shows that teaching communication skills in the online format was well accepted and resulted in significant changes in students' self-assessment of communication skills.

[Online training for hearing implant surgery : A new approach to otological training. German version]. / Online-Training für Hörimplantatchirurgie : Ein neuer Ansatz in der otologischen Ausbildung.

OBJECTIVE: Education in microsurgery of the ear includes staged training to allow for mastering of the complex microsurgical procedures, particularly in the context of middle ear reconstruction and cochlear implantation. Traditional surgical training includes temporal bone preparations by cadaver dissection and supervised operating room practice. As these on-site trainings are limited, there is a need to broaden education facilities in an on-line format. Therefore, a first basic on-line training for otosurgery was developed. MATERIALS AND METHODS: The system consists of an artificial temporal bone model together with a set of basic surgical instruments and implant dummies. As an essential part of the training kit, a high-resolution camera set is included that allows for connection to a video streaming platform and enables remote supervision of the trainees' surgical steps by experienced otological surgeons. In addition, a pre-learning platform covering temporal bone anatomy and instrumentation and pre-recorded lectures and instructional videos has been developed to allow trainees to review and reinforce their understanding before hands-on practice. RESULTS: Over the three courses held to date, 28 participants with varying levels of prior surgical experience took part in this otological surgical training program. The immediate feedback of the participants was evaluated by means of a questionnaire. On this basis, the high value of the program became apparent and specific areas could by identified where further refinements could lead to an even more robust training experience. CONCLUSION: The presented program of an otosurgical online training allows for basal education in practical exercises on a remote system. In this way, trainees who have no direct access to on-site instruction facilities in ear surgery now have the chance to start their otosurgical training in an educational setting adapted to modern technologies.

Preparedness of Undergraduate Medical Students for Online Learning.

OBJECTIVE: To determine the preparedness of the first-year undergraduate medical students toward online learning. STUDY DESIGN: Descriptive study. Place and Duration of the Study: The study was conducted at the Department of Medical Education, Fazaia Ruth Pfau Medical College, Air University, Karachi, Pakistan, from September to December 2021. METHODOLOGY: The study participants were first-year undergraduate medical students. A pre-validated instrument developed by Lesley University in July 2014 named 'The Prospective Online Student Readiness Questionnaire' was used. Permission was taken via email. The questionnaire has two parts. Section A consists of the demographic characteristics. Section B evaluates the student's readiness for online learning. RESULTS: Data from 81 respondents were collected through an online questionnaire. The results showed that internet self-efficacy, self directed learning, learner control, and learner style have a positive and significant relationship with students' preparedness for e-learning. CONCLUSION: Students are aware of the use of technology. They could be more comfortable working independently at the beginning of the course. Online environment and communication for learning purposes with peers also appear to be weak areas. Students prefer visual aids for learning, and very few enjoy raising their hands in class to answer questions. They are confident in social communications but need more confidence in using online tools for effective online communication and posting questions on online forums during discussions. KEY WORDS: Medical students, Online learning, preparedness, Self-efficacy, Self-directed learning.

Assessment and evaluation of online education and virtual simulation technology in dental education: a cross-sectional survey.

BACKGROUND: The global outbreak of coronavirus disease (COVID-19) has led medical universities in China to conduct online teaching. This study aimed to assess the effectiveness of a blended learning approach that combines online teaching and virtual reality technology in dental education and to evaluate the acceptance of the blended learning approach among dental teachers and students. METHODS: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed in this study. A total of 157 students' perspectives on online and virtual reality technology education and 54 teachers' opinions on online teaching were collected via questionnaires. Additionally, 101 students in the 2015-year group received the traditional teaching method (TT group), while 97 students in the 2017-year group received blended learning combining online teaching and virtual reality technology (BL group). The graduation examination results of students in the two groups were compared. RESULTS: The questionnaire results showed that most students were satisfied with the online course and the virtual simulation platform teaching, while teachers held conservative and neutral attitudes toward online teaching. Although the theoretical score of the BL group on the final exam was greater than that of the TT group, there was no significant difference between the two groups (P = 0.805). The skill operation score of the BL group on the final exam was significantly lower than that of the TT group (P = 0.004). The overall score of the BL group was lower than that of the TT group (P = 0.018), but the difference was not statistically significant (P = 0.112). CONCLUSIONS: The blended learning approach combining online teaching and virtual reality technology plays a positive role in students' learning and is useful and effective in dental education.

Developing and piloting an online course on osteoporosis using a multidisciplinary multi-institute approach- a cross-sectional qualitative study.

INTRODUCTION: Postgraduate medical trainees (PGs) in developing nations face various educational hurdles due to limited access to quality resources and training facilities. This study aimed to assess the effectiveness of e-learning, particularly Massive Open Online Courses (MOOCs), within postgraduate medical education. It involved the development of a customized online course focused on osteoporosis for PGs and an examination of their perspectives and preferences concerning online learning methods like Virtual Learning Environment (VLE) platforms. METHODS: The study was conducted from January 2018 to December 2020. A multi-institutional, multidisciplinary team was assembled to design an osteoporosis course on the VLE platform. PGs (n = 9) from diverse disciplines and institutions were selected with informed consent. Focus group discussions (FGDs) among these PGs identified their preferences for the online course, which subsequently guided the development of the MOOC. The modular MOOC comprised recorded micro-lectures, flashcards, videos, case challenges, and expert interviews. The educational impact of the VLE was assessed using pre- and post-module tests among the participants, and their perceptions of the PGs and course facilitators were gathered via an online survey. RESULTS: The study identified the involvement of PGs in the course design process as beneficial, as it allowed for content customization and boosted their motivation for peer-to-peer learning. During the FGDs, PGs expressed a strong preference for flexible learning formats, particularly short downloadable presentations, and micro-lectures. They also identified challenges related to technology, institutional support, and internet connectivity. In the subsequently customized MOOC course, 66% of PGs (n = 6) attempted the pre-test, achieving a mean score of 43.8%. Following the VLE module, all PGs (n = 9) successfully passed the end-of-module test, averaging a score of 96%, highlighting its impact on learning. The majority (n = 8, 88.9%) agreed that the course content could be applied in clinical practice, and 66.7% (n = 6) expressed extreme satisfaction with the learning objectives and content. Participants favoured end-of-module assessments and the use of best-choice questions for evaluation. CONCLUSION: This study highlights the importance of virtual learning, particularly MOOCs, in addressing the educational challenges faced by developing nations. It emphasizes the need for tailored online courses that cater to the preferences and requirements of PGs. The findings suggest that MOOCs can foster collaboration, networking, and opportunities for professional development, and interdisciplinary collaboration among faculty members can be a key strength in course development. This research provides valuable insights for educators, institutions, and e-learning developers seeking to enhance their teaching methodologies and establish accessible educational environments in the digital age.

Factors affecting medical students' satisfaction with online learning: a regression analysis of a survey.

BACKGROUND: Medical education requires the implementation of different teaching methods and strategies for future doctors to achieve broad learning objectives. This wide range of methods and strategies includes the use of Information Technologies. For a long time, there was a call for a change in medical education for blending new teaching approaches to lessen medical students' class time. The COVID-19 pandemic then sped up the transition to the new way of medical education and classroom lectures were quickly moved to a virtual environment. We expect that these changes will continue, and online learning will be one of the main teaching strategies in medical education. Therefore, educational experiences during the COVID-19 pandemic will improve our understanding of online learning and will help to develop blended medical school curricula in the future. For this reason, we aimed to determine students' overall satisfaction with their online learning experience and to define the main factors affecting students' satisfaction with their online learning program at Cerrahpasa Medical Faculty. METHODS: A cross-sectional survey study was conducted to determine medical students' overall satisfaction with online learning methods and to identify factors associated with positive and negative satisfaction levels. A questionnaire, consisting of 24 questions to collect demographic characteristics, factors associated with online education experience and overall satisfaction levels was developed and distributed to 1600 medical students. Multivariable linear regression analysis was used to determine the factors associated with positive and negative satisfaction levels. RESULTS: Regression analysis showed that being familiar with online teaching techniques (ß = 0.19, 95% CI [0.07, 0.30], faculty members' higher online teaching skill levels (ß = 0.42, 95% CI [0.32, 0.51], interactive online teaching approaches (ß = 0.54, 95% CI [0.41, 0.67], having a personal workspace (ß = 0.43, 95% CI [0.19, 0.67], and a self-reported longer attention span (ß = 0.75, 95% CI [0.57, 0.92] were associated with higher overall satisfaction with online learning. The occurrence of technical problems (ß = -0.19, 95% CI [-0.26, -0.12] was associated with lower overall satisfaction. CONCLUSIONS: Higher online teaching skills of faculty members, use of interactive approaches, students' familiarity with online teaching techniques, provision of a personal workspace, and self-reported longer attention spans positively contributed to higher levels of student satisfaction with online learning. Considering the increasing significance of online educational methods, our study identified key components that affect students' level of satisfaction. This information might contribute to the development of online educational programs in the future.

Social networking website increases efficacy and engagement in a distance learning course about oral lesions.

PURPOSE: Distance learning appears to be an attractive approach to continuing education courses, but one barrier is maintaining learner engagement throughout the course. The primary aim of this research was to evaluate the operational efficacy of a private Facebook™ group (FG) in serving as a support mechanism for distance learning courses, and its impact on three fundamental dimensions: the attrition rates of participants who did not complete the course (commonly referred to as dropout rates), the rates of course completion and approval, and the overall performance of the participants. METHODS: The participants of this quasi-experimental study comprised 159 dental students and 565 dentists enrolled in an e-learning course on oral mucosal lesion diagnosis. Prior to the initiation of the course, all participants were provided with the option to join a private FG. Within this group, moderators shared motivational messages and provided reminders concerning deadlines. Moreover, participants had the opportunity to engage in interactive discussions pertaining to topics related to the course. The course itself followed a self-guided format, employing the flipped-classroom methodology, spanning a total of 50 instructional hours. In order to assess the effectiveness of the course, participants were presented with photographs illustrating 30 oral lesions and were asked to propose diagnostic hypotheses both before and after the educational intervention (pre-tests and post-tests). RESULTS: Dentists who participated in the FG exhibited a significantly lower rate of discontinuation. As for dental students, their involvement in the group was positively associated with better performance, as determined by the percentage of accurate diagnostic hypotheses (a minimum of 70% correct responses was required for their approval in the course). CONCLUSIONS: Facebook™ demonstrates promise as a supplementary pedagogical tool in distance education courses. The interactive nature of the platform has the potential to alleviate the inherent challenges of remote learning.

Online learning in health professions education. Part 2: Tools and practical application: AMEE Guide No. 163.

Part 1 of the AMEE Guide Online learning in health professions education focused on foundational concepts such as theory, methods, and instructional design in online learning. Part 2 builds upon Part 1, introducing technology tools and applications of these foundational concepts by exploring the various levels (from beginner to advanced) of utilisation, while describing how their usage can transform Health Professions Education. This Part covers Learning Management Systems, infographics, podcasting, videos, websites, social media, online discussion forums, simulation, virtual patients, extended and virtual reality. Intertwined are other topics, such as online small group teaching, game-based learning, FOAM, online social and collaboration learning, and virtual care teaching. We end by discussing digital scholarship and emerging technologies. Combined with Part 1, the overall aim of Part 2 is to produce a comprehensive overview to help guide effective use online learning in Health Professions Education.

Informing and inspiring worldwide action against marine litter - The impact of the Massive Open Online Course (MOOC) on Marine Litter.

Marine litter and plastic pollution are growing environmental problems that require sustainable actions from a wide range of stakeholders. To achieve effective solutions, stakeholders need good knowledge and opportunities for active engagement. To encourage leadership and provide these opportunities, we have developed an action-, and change-oriented Massive Open Online Course (MOOC) on Marine Litter. After five years of running the MOOC, we assessed the impact of the MOOC through an online questionnaire among participants. The results showed significant impact and global reach. Respondents from all over the world reported that they used the information of the MOOC in their careers, volunteer work and personal lives. The results underscore the importance of environmental education to inform and inspire stakeholders. Educational activities should respond to participants' motivations by using activating learning forms and illustrative examples. The MOOC inspired participants to take informed action, engage others, expand their networks, and create real change.

The change of the COVID-19 pandemic on medical education in Korea: a national survey of medical schools.

PURPOSE: This study aims to investigate how medical schools in Korea managed their academic affairs and student support in response to the coronavirus disease 2019 (COVID-19) pandemic and their plans for the post-COVID-19 era. METHODS: An online survey was conducted, and a link to a questionnaire was distributed to all the administrators of the 40 medical schools in Korea. The final analysis data involved responses from 33 medical schools and 1,342 students. Frequency analysis, cross-tabulation analysis, Fisher's exact test, and one-way analysis of variance were applied for statistical analysis. RESULTS: Regarding instruction methods, most medical schools in Korea transitioned from in-person learning to video-on-demand learning (51.5%) and real-time online learning (42.4%). Among the school leaders, 36.4% planned to continue offering online classes combined with in-person classes beyond the end of the pandemic. Among the students, the online class concentration and participation score was 3.0 points or lower, but the class understanding score was 3.6 points, above a moderate level. CONCLUSION: Students cited the shorter times needed to attend school and being able to take classes repeatedly as advantages of online classes, and over one-third of medical schools intended to continue with a hybrid of in-person and online learning even after the COVID-19 pandemic restrictions end.

Aprendizaje en investigación clínica: experiencia de enseñanza híbrida con estudiantes de medicina / Learning in Clinical Research: Hybrid Teaching Experience with Medical Students

Introducción: la pandemia de COVID-19 indujo un cambio en nuestro sistema de salud y de educación. Los programas formativos también tuvieron que adaptarse y exigieron un cambio rápido. Objetivos: describir una experiencia educativa de enseñanza virtual/híbrida en investigación clínica, entre docentes del Servicio de Clínica de un hospital universitario y estudiantes de Medicina de una institución privada, que participaron del Programa ESIN (EStudiantes en INvestigación). Metodología: los contenidos y las estrategias educativas incluyeron las clases teóricas audiograbadas o videograbadas (asincrónicas y autoadministradas), el aprendizaje basado en proyectos, los talleres prácticos (encuentros sincrónicos virtuales y grupales), mediante la adopción de modelos de aprendizaje como el aula invertida, y la tutoría individual entre docente-estudiante. Los datos se recopilaron mediante la observación en contextos académicos, y basándonos en elementos de encuestas anónimas de satisfacción, previo consentimiento informado de los participantes. Resultados: participaron 14 estudiantes, 6 durante el año 2021 y 8 durante 2022. Todas mujeres y estudiantes de medicina (50% de cuarto año, 35% de sexto año y 15% de quinto año). Las técnicas implementadas favorecieron la participación y promovieron el aprendizaje activo, basado en proyectos. Mencionaron aspectos positivos como el enfoque académico práctico, la disponibilidad del equipo docente para atender cualquier duda, el tiempo y el entusiasmo por enseñar y fomentar la participación. Los videos teóricos resultaron útiles como herramientas de repaso, y los encuentros grupales fueron especialmente valorados, si bien los encuentros individuales fueron destacados como ayuda y apoyo previo a los congresos científicos. En general, manifestaron que fue una experiencia enriquecedora que demostró que se puede lograr lo que se creía imposible. Todas participaron activamente de al menos un congreso científico, y el 50% resultó coautora de una publicación académica. Conclusión: los estudiantes asumieron compromisos y responsabilidades, e incorporaron competencias y habilidades en la implementación y en la difusión de los proyectos. Esta experiencia educativa facilitó que el tiempo de clase pudiera optimizarse para intercambio, discusión y dudas. Los recursos producidos, las actividades desarrolladas y los contenidos abordados quedan disponibles a nivel institución. (AU)

Introduction: the COVID-19 pandemic brought about a change in our health and education system. Training programs also had to adapt and required rapid change. Objectives: to describe an educational experience of virtual/hybrid teaching in clinical research between teachers of the Clinical Service of a university hospital and medical students of a private institution who participated in the ESIN Program (Students in Research). Methodology: the contents and educational strategies included audio or videotaped lectures (asynchronous and self-administered), project-based learning, practical workshops (virtual and group synchronous meetings) by adopting learning models such as the inverted classroom, and individual tutoring between teacher and student. We gathered the data through observation in academic contexts and based on elements of anonymous satisfaction surveys, with prior informed consent of participants. Results: fourteen students participated, six in 2021 and eight in 2022. All were women and medical students (50% fourth year, 35% sixth year, and 15% fifth year). The techniques implemented favored participation and promoted active, project-based learning. They mentioned positive aspects such as the practical academic approach, the availability of the teaching team for any doubts, the time and enthusiasm for teaching, and encouraging participation. The theory videos were a valuable review tool, and team meetings received high praise even if the one-on-one meetings received much attention as help and support before the scientific congresses. In general, they stated that it was an enriching experience that showed that you can achieve what you thought impossible. All of them actively participated in at least one scientific congress, and 50% were co-authors of an academic publication. Conclusion: the students assumed commitments and responsibilities and incorporated competencies and skills in project implementation and dissemination. This educational experience helped to optimize class time for exchange, discussion, and doubts. The resources produced, the activities developed, and the contents addressed are now available at the institutional level. (AU)

Relationship between academic success, distance education learning environments, and its related factors among medical sciences students: a cross-sectional study.

BACKGROUND: Academic success is among the most important criteria for determining students' competence. Hence, one of the concerns of education system researchers has always been investigating its associated factors. Therefore, this study aimed to determine the relationship between academic success, distance education learning environments, and its related factors among Shahroud University of Medical Sciences students. METHODS: This cross-sectional study was conducted on 208 medical sciences students who completed at least two online and two in-person academic semesters. Participants were selected through the convenience sampling method and filled out three questionnaires, including the demographic information form, the Academic Success Inventory for College Students, and the Distance Education Learning Environments Survey. Finally, the data were analyzed using descriptive statistics and inferential tests (t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression). RESULTS: In this study, students reported moderate levels of academic success (107.81 ± 10.72). Moreover, they assessed their distance education learning environment as the positive points were more than the negative points (74.10 ± 14.89). Distance education learning environment (ß = 0.233 and P < 0.001) and field satisfaction (ß = 9.797 and P = 0.001) were also mentioned as factors related to students' academic success. CONCLUSION: According to the present results, it is suggested to improve the learning environment of distance education and increase students' satisfaction to enhance their academic outcomes such as academic success.

Effective interactive engagement strategies for MOOC forum discussion: A self-efficacy perspective.

This mixed methods sequential explanatory study identified and explained the features of engagement strategies for MOOC forum discussion that help low-achieving students make significant progress. Triangulated data were collected from MOOC learners' (n = 335) scores in two reading assessments, their posts to the embedded online discussion forum, and their self-reflection learning journals. Based on learning progress between pre- and post-assessment tasks, MOOC learners are divided into three groups: 1) little, 2) moderate, and 3) significant progress. According to a statistical analysis of the quantified posts, surprisingly, the low-scoring students from the pre-test who demonstrated significant progress later engaged in significantly fewer peer-peer and peer-teacher interactions in the online discussion forum. Guided by self-efficacy literature, the reflective journals of these learners suggested that 1) learner-content interactions may help them advance learning and obtain new information and linguistic knowledge from the peer-made learning materials in the discussion forum; 2) they did not share and exchange ideas and answers with their peers. Instead, they prefer learning from others' discussions and wish to get quick feedback and suggestions on their contributions to the discussion forum; and 3) peer-peer and peer-teacher interactions were proposed as two solutions to regulate their online learning experience as they lack self-discipline and time-management skills. Implications include teachers' continuous support to encourage low-achieving students to learn peer-generated content and quick feedback on their contributions to the discussion forum.

Transitioning from face-to-face to distance education. Part 2: A qualitative study in the former Yugoslavia during COVID-19.

BACKGROUND: Similar to other countries, Departments of Family Medicine in the former Yugoslavia had to transition from face-to-face to distance education during COVID-19. OBJECTIVES: To elucidate obstacles and facilitators of the transition from face-to-face to distance education. METHODS: A cross-sectional, multicentre, qualitative study design was used to analyse nine open-ended questions from an online survey using inductive thematic analysis. The questionnaire was distributed to 21 medical schools, inviting them to involve at least two teachers/students/trainees. Data were collected between December 2021 and March 2022. RESULTS: In 17 medical schools, 23 students, 54 trainees and 40 teachers participated. The following themes were identified: facilitators and barriers of transition, innovations for enhancing distance education, convenience of distance education, classical teaching for better communication, the future of distance education, reaching learning outcomes and experience of online assessment. Innovations referred mainly to new online technologies for interactive education and communication. Distance education allowed for greater flexibility in scheduling and self-directed learning; however, participants felt that classical education allowed better communication and practical learning. Teachers believed knowledge-related learning outcomes could be achieved through distance education but not teaching clinical skills. Participants anticipated a future where a combination of teaching methods is used. CONCLUSION: The transition to distance education was made possible thanks to its flexible scheduling, innovative tools and possibility of self-directed learning. However, face-to-face education was considered preferable for fostering interpersonal relations and teaching clinical skills. Educators should strive to strike a balance between innovative approaches and the preservation of personal experiences.

Participants found that distance education offers many possibilities, mainly self-directed, flexible learning.Participants felt that face-to-face education remains invaluable since it facilitates communication and the development of practical skills.A balance between new technologies and personal encounters was believed to be best.

University MOOC should be added with farmer interested sections and provide individualized service to adapt to farmer training.

Vegetables represent an important agricultural industry in China. New farmers and new technologies for vegetable production have emerged in recent years, which makes farmer training very necessary. On the other hand, massive open online courses (MOOCs) are currently widely used in universities. The purpose of this study is to investigate the importance of different sections of a university MOOC focused on olericulture to farmers with different demographic characteristics and provide a basis to improve university MOOCs for farmer training. The survey results suggest that the age, education level, gender, farmer scale, facility type and profit of farmer learners are important factors determining evaluations of the importance of different MOOC sections, indicating that services customized to different farmer populations are necessary. Among different sections of MOOC "Olericulture", farmers with younger age, higher education, larger farm, more advanced facility and more profit were more interesting in sections include cultural, social and theoretical knowledge, and less interesting in practical skill sections. Based on the survey, eight new sections including one marketing subsection (new agricultural supplies and market news), one social subsection (laws and regulations), two practical subsections (practice videos, photos and videos from other farms), and three comprehensive subsections (discussion of practical issues, mechanization, and smart olericulture) were added to the original MOOC, and the results indicate that this improvement is efficient in enhancing the importance evaluations and profits of all farmer learners, especially among those with high education levels.