Lived experiences of medical students of online learning: lessons for adopting virtual learning in medical education.

BACKGROUND: The COVID 19 lockdown created a shift in medical education from the traditional physical classroom to online learning. OBJECTIVES: To explore the lived experiences of students in various years of medical education attending a medical college in Chennai, India. METHODS: In this qualitative exploration of lived experiences we conducted 4 focus group discussions among students of the four years in the medical college with the help of a checklist. We recorded the interviews, transcribed them and performed a thematic content analysis. RESULTS: There was a gendered impact of the lockdown on the online learning experiences with women students finding it challenging to attend classes balancing their gender roles of performing household chores. Online learning offered some advantages in the form of increased participation and engagement due to the partial anonymity. The greatest disadvantage of online learning was lack of clinical learning experience. The students resorted to fabricating case studies for discussion, which some students found useful and some commented that it can never replace real life clinical discussions. A generational gap between adoption of technology between the senior professors and the students hampered the online learning. Online assessments were challenging, and many students resorted to cheating in these exams. CONCLUSIONS: Though online learning offers several advantages, it has serious limitations in offering the clinical learning experience. While planning adoption of online learning into routine medical education adequate time must be set aside for real life clinical exposure in addition to the online lectures and demonstrations for conceptual understanding.

Understanding University Students during COVID-19: A Longitudinal Mixed-Methods Analysis of Their Experiences of Online Learning, Mental Health, Academic Engagement, and Academic Self-Efficacy.

INTRODUCTION: Research has consistently demonstrated that the COVID-19 pandemic, and resulting sudden shift to online learning (OL), had detrimental impacts on the motivation and mental health of university students. To date however this research has been cross-sectional and quantitative. METHOD: This study employed a mixed-methods design to examine the experiences of students at a large national Australian University both at the outset of the pandemic in 2020 (n = 824) and again 6 months later (n = 254) at the conclusion of their academic year. RESULTS: Key findings from this study highlighted that despite quantitative findings suggesting poorer attitudes toward learning during the pandemic, qualitatively students perceived both positives and negatives to studying online. The qualitative results further highlighted that this experience was not the same for all and suggests the need to reconsider the standard approaches to offering support for students. CONCLUSION: Students reported poor mental health in both time points, but outlined avenues which improved not only their mental health but also their motivation for studying such as increased peer engagement and self-care activities. Students reported that OL negatively impacted on both their engagement with studies and their mental health, highlighting the need for universities to prioritize supporting their students' mental health as much as their development of academic skills.

Peer learning and collaborative placement models in health care: a systematic review and qualitative synthesis of the literature.

AIMS: To summarise the international empirical literature to provide a comprehensive overview of peer learning and collaborative practice placement models in health care and to synthesise their benefits and challenges. BACKGROUND: Practical placements for students are in high demand due to the need for an increased nursing, midwifery and health professional workforce, thus collaborative placement models are an attractive solution to potentially increase placement capacity and enhance the student learning experience. DESIGN: A systematic search of the literature and qualitative data synthesis using the PRISMA checklist and ENTREQ guidelines. REVIEW METHODS: MEDLINE and CINAHL searched in March 2020. Quality appraisal of studies conducted. Collaborative models and empirical findings summarised. Reported benefits, challenges and implementation recommendations synthesised. Two tables developed for data representation. RESULTS: 172 studies were identified by the search strategy. Of these, 47 articles were included for appraisal and synthesis. 30 articles employed qualitative, seven quantitative and ten mixed-methods approaches. Research took place in eight countries. The majority of studies employed focus groups, interviews as well as questionnaire design. The total participant sample was 3462 consisting of students and educators. CONCLUSIONS: This review confirmed that any peer learning is beneficial in supporting students' confidence and team working skills. It is especially helpful when pairing first year with third-year students. The latter can demonstrate their clinical skills and prepare for working in practice. Simultaneously, expert-led learning is important for role modelling and for the recognition of acquired skills. Evidence on the optimal placement experience is inconclusive; however, it can be concluded that any form of collaborative placement model requires careful planning and continuous preparation for staff and students. RELEVANCE TO CLINICAL PRACTICE: Decision makers should consider implementing at least some form of peer learning to assist students with peer support, and ideally work towards a collaborative learning environment.

Dental students' and staff perceptions of the impact of learning environment disruption on their learning and teaching experiences.

INTRODUCTION: This project is a qualitative investigation into student and staff experiences of the effect of a major building redevelopment on their Dental School learning and teaching environments. Currently, there is little research exploring the impact of disruptions to the learning environment on students' learning and staff teaching experiences. METHOD: Data were collected in 2016 using an online survey, semi-structured interviews and focus groups with students and staff. Data were analysed using a general inductive approach. RESULTS: Four broad themes emerged as follows: (i) students valued having a space for personal and collaborative work within the Dental School; (ii) both staff and students positioned staff contributions to learning experiences above the role of the physical learning environment; (iii) the majority of staff and students not feel that the physical environment limited their clinical training; and (iv) staff and students were able to adapt to the impact of building redevelopment through resilience and organisation. DISCUSSION: Results of this research have informed the provision of collegial spaces at the School, both as the building redevelopment continues, and in planning for the completed building.

Student Experiences of High-stakes Testing for Progression in One Undergraduate Nursing Program.

Each year, thousands of students throughout the world are required to complete one or more high-stakes tests as a measure of competency in undergraduate nursing education. Currently, the trend in nursing education is to use high-stakes tests to establish program progression policies. However, use of these tests to block student progression is of serious concern. This article describes findings of a pilot study that used a phenomenographic approach to understand senior nursing students' experiences of completing multiple high-stakes tests for successful progression within one undergraduate nursing program. Eighteen graduating senior nursing students participated in the study via individual interviews. Students described a multitude of experiences, organized into five main categories of descriptions: high-stakes tests as a value; high-stakes tests as a stressor; high-stakes tests as a high expectation; high-stakes tests as various inconsistencies; and high-stakes tests affecting the transfer of learning. Student perspectives with high-stakes testing contributed valuable insight lacking in the current nursing education literature. Findings suggested if high-stakes tests are to be used for program progression, it is imperative for nurse educators to convene and explore strategies to support student preparation and success with testing, and develop well-defined structures of teaching and learning for the delivery of course content.

Features of an effective operative dentistry learning environment: students' perceptions and relationship with performance.

OBJECTIVE: Students' perceptions of their learning environment influence the quality of outcomes they achieve. Learning dental operative techniques in a simulated clinic environment is characterised by reciprocal interactions between skills training, staff- and student-related factors. However, few studies have examined how students perceive their operative learning environments and whether there is a relationship between their perceptions and subsequent performance. Therefore, this study aimed to clarify which learning activities and interactions students perceived as supporting their operative skills learning and to examine relationships with their outcomes. METHODS: Longitudinal data about examples of operative laboratory sessions that were perceived as effective or ineffective for learning were collected twice a semester, using written critical incidents and interviews. Emergent themes from these data were identified using thematic analysis. Associations between perceptions of learning effectiveness and performance were analysed using chi-square tests. RESULTS: Students indicated that an effective learning environment involved interactions with tutors and peers. This included tutors arranging group discussions to clarify processes and outcomes, providing demonstrations and constructive feedback. Feedback focused on mistakes, and not improvement, was reported as being ineffective for learning. However, there was no significant association between students' perceptions of the effectiveness of their learning experiences and subsequent performance. CONCLUSIONS: It was clear that learning in an operative technique setting involved various factors related not only to social interactions and observational aspects of learning but also to cognitive, motivational and affective processes. Consistent with studies that have demonstrated complex interactions between students, their learning environment and outcomes, other factors need investigation.

How students taking introductory biology experience the chemistry content.

Student experiences learning chemistry have been well studied in chemistry courses but less so in biology courses. Chemistry concepts are foundational to introductory biology courses, and student experiences learning chemistry concepts may impact their overall course experiences and subsequent student outcomes. In this study, we asked undergraduate students enrolled in introductory biology courses at a public R1 institution an open-response question asking how their experiences learning chemistry topics affected their identities as biologists. We used thematic analysis to identify common ideas in their responses. We found that while almost half of student respondents cited learning chemistry as having positive impacts on their experiences learning biology, students who struggled with chemistry topics were significantly more likely to have negative experiences learning biology. We also found significant relationships between prior chemistry preparation, student background, and the likelihood of students struggling with chemistry and negative experiences learning biology. These findings emphasize the impact of learning specific content on student psychosocial metrics and suggest areas for biology educators to focus on to support learning and alleviate student stress in introductory biology.

Exploring the experiences of sonography students with simulation-based learning: A perspective from South Africa.

INTRODUCTION: Simulation-based learning (SBL) is widely used in healthcare education to provide a safe environment for students to practice clinical scenarios without causing patient harm. While established in developed countries, SBL's implementation is new in South Africa; there is a lack of research addressing sonography students' experiences. This study aimed to explore and describe the experiences of Bachelor of Science (BSc) second-year sonography students using SBL for clinical training at a local University of Technology (UoT). METHOD: An exploratory, qualitative and descriptive research study was conducted in 2020, with virtual one-on-one interviews due to COVID-19 restrictions. Eight BSc second-year sonography students, who had undergone SBL in their first year, participated. Data saturation was achieved, and interviews were audio recorded and transcribed verbatim. RESULTS: Thematic analysis revealed three themes: (1) Enhancing preparedness for the clinical environment, (2) Limitations of the tissue-equivalent phantom and (3) Suggestions for improving simulation. While students expressed positive feedback and enjoyment of the simulation tool, they also highlighted limitations, such as unrealistic representations of real patient scanning conditions. CONCLUSION: This study provides valuable insights into sonography students' experiences with SBL. Positive influence of SBL on clinical training was observed. To enhance SBL for future sonography students, consideration for high-fidelity simulators with advanced software is recommended. Funding options to invest in such simulators should be explored by radiography educators to promote more realistic training experiences.

Cadaver Dissection Experience for First-Time Dissectors: a Hypothetical Three-Pronged Approach for Student Preparation.

This systematic review synthesized evidence for the development of a preparatory process for first-time dissectors, geared toward improving cadaver dissection (CD) experiences. Eleven studies focused on pre-CD intervention were selected from a literature search in PubMed, the Education Resources Information Centre (ERIC), Google Scholar, PsycNET, and the Cochrane Library. A three-pronged preparatory process was formulated for first-time dissectors based on the evidence from the review. The process includes (1) background assessment; (2) pre-CD education; and (3) gradual exposure and desensitization. The preparatory process shows some hypothetical potential for decreasing negative CD-related experiences, but it still needs validation before implementation.

"It's Really Hard to Have Your Own Place": The At-Home Experiences of Latina/o/x Undergraduates During COVID-19.

The purpose of this study was to understand the at-home lived experiences of Latina/o/x college students during the COVID-19 pandemic. Using Critical Race Theory as the guiding framework, the authors used storytelling to capture the at-home experiences of 19 Latina/o/x college students during the pandemic. Findings revealed how the pandemic shifted meaning of the home space, increased roles and responsibilities, and increased stress and mental health demands for students.

El propósito de este estudio fue el entender las experiencias vividas en casa por los estudiantes universitarios latina/o/x durante la pandémica de COVID-19. Usando la teoría de Raza Crítica como marco de referencia los autores usaron el cuento para capturar las experiencias en casa de 19 estudiantes universitarios latina/o/x durante la pandémica. Los resultados revelaron cómo la pandémica cambió el significado del espacio de casa, incrementando papeles y responsabilidades, e incrementando la tensión y las demandas de salud mental para los estudiantes.

Nursing students' experiences of a home visiting programme for older adults with multimorbidity (VISITAME project): A phenomenological study.

INTRODUCTION: Nursing students should acquire competence in promoting self-care in older adults with chronic multimorbidity, but opportunities for clinical practice are limited. The implementation of a home visiting programme to community-dwelling older adults with chronic multimorbidity could contribute to nursing students' acquisition of this competence. OBJECTIVE: The aim of our study was to understand the experience of nursing students participating in a home visiting programme to community-dwelling older adults with chronic multimorbidity. DESIGN: Qualitative study based on Gadamer's hermeneutic phenomenology. METHOD: Twenty-two in-depth interviews were conducted with nursing students participating in a home visiting programme. Data were recorded, transcribed and analysed following the procedure developed by Fleming. RESULTS: Three main themes were extracted in the data analysis process: (1) 'living the theory. Experience as a catalyst for learning', (2) 'the home visiting programme as a tool for promoting competence in caring for older adults', and (3) 'when learning sparks interest in working with older adults'. CONCLUSION: The home visiting programme to community-dwelling older adults has an important impact on the personal and professional development of nursing students. The experience of the home visiting programme leads to deep learning that sparks interest in caring for older adults. The implementation of a home visiting programme could be a beneficial strategy for the acquisition of competence to promote health and self-care.

Post Graduate Students' Experiences with Research Ethics: A South African Perspective.

The strict adherence to ethical principles (namely respect for persons, beneficence/non-maleficence and justice) when conducting research involving human participants is the bedrock of research. There has been little research on students' experiences with the research ethics process and how these students incorporate ethical standards into their research work, despite previous research looking into teaching methodologies, curricula, and the educational environment for postgraduate students. The purpose of the study was to investigate postgraduate students' experiences with research ethics during their research project. A sample of 11 participants was used. Through online interviews, this qualitative study, underpinned by the interpretivist paradigm, collected data from postgraduate students from different disciplines and universities in South Africa between June and August 2021. The findings showed different perspectives on the training received in research ethics, and on support and guidance received from supervisors, and the application of research ethics principles in their research projects. Most participants indicated gaps in the teaching and support they received and had not read their university research ethics policies. By focusing on students' experiences in a developing country and different disciplines, the study contributes to the body of knowledge on postgraduate student experiences. Furthermore, the findings suggest that there is need for more research ethics training amongst postgraduate students in South Africa.

Leveraging deep learning and big data to enhance computing curriculum for industry-relevant skills: A Norwegian case study.

Computer science graduates face a massive gap between industry-relevant skills and those learned at school. Industry practitioners often counter a huge challenge when moving from academics to industry, requiring a completely different set of skills and knowledge. It is essential to fill the gap between the industry's required skills and those taught at varsities. In this study, we leverage deep learning and big data to propose a framework that maps the required skills with those acquired by computing graduates. Based on the mapping, we recommend enhancing the computing curriculum to match the industry-relevant skills. Our proposed framework consists of four layers: data, embedding, mapping, and a curriculum enhancement layer. Based on the recommendations from the mapping module, we made revisions and modifications to the computing curricula. Finally, we perform a case study of the Norwegian IT jobs market, where we make recommendations for data science and software engineering-related jobs. We argue that by using our proposed methodology and analysis, a significant enhancement in the computing curriculum is possible to help increase employability, student satisfaction, and smart decision-making.

Adaptiveness for Online Learning: Conceptualising 'Online Learning Dexterity' from Higher Education Students' Experiences.

Online learning dexterity, or the ability to effortlessly adapt to online learning situations, has become critical since the COVID-19 pandemic, but its processes are not well-understood. Using grounded theory, this study develops a paradigm model of online learning dexterity from semi-structured interviews with 32 undergraduate and postgraduate students from a university in New Zealand. Through students' online learning experiences during the pandemic from 2020 to 2021, online learning dexterity is found to be how students make online learning 'just as good' as face-to-face learning by creating and adjusting five learning manoeuvres according to developing online learning circumstances. Undergraduates and postgraduates re-use familiar study strategies as deep learning manoeuvres, but undergraduates restrict support-seeking manoeuvres to lecturers. Technical problems with online systems and poor course organisation by lecturers affected learning productivity, resulting in the need for more time optimisation manoeuvres. Social support helped students activate persistence manoeuvres to sustain online class attendance. However, undergraduates had more problems sustaining interest and engagement during class as they were not as proficient with using learning presence manoeuvres as postgraduates enrolled in distance learning programmes. The theoretical and practical significance of online learning dexterity for post-pandemic higher education is discussed.

Learning and assessment strategies to develop specific and transversal competencies for a humanized medical education.

Introduction: Medical education should promote the development of skills and abilities that can be applied to real-world work performance. The aim of this study is to evaluate technical and methodological knowledge, as well as physician-patient communication skills, as one of the most important transversal competencies that a good physician should acquire; all this in a reliable, accurate and objective way. Methods: We present a rubric specifically designed and implemented for the evaluation of specific and transversal competencies in the physiology practical sessions, during the second year of the medical degree. The assessment consists in two evaluation tests: 1) a theoretical test that consists of multiple-choice questions. Students must demonstrate that they have acquired adequate theoretical knowledge (specific competency "to know"); 2) a practical test, in which students are evaluated by the rubric through the simulation of a medical consultation. Thus, demonstrating their ability to execute/apply what they have learned in class (specific competency "to know how to do"). They are also evaluated on the transversal competencies that we call "communication with the patient" (transversal competency "to know how to be there") and "dealing with the patient" (transversal competency "to know how to be"). Results: We evaluated whether there were differences in the grades obtained by students when the transversal competencies were not assessed (academic years 2017-2018 and 2018-2019; n = 289), and when the transversal competencies were assessed by applying the rubric in the academic years 2019-2020, 2021-2022, and 2022-2023 (n = 526). Furthermore, we present a student perception that supports the use of clinical simulation and our rubric as a good method within the competency learning process. Discussion: The acquisition of these competencies, starting from the first courses of undergraduate education, helps to raise the students' awareness in the development of a more humanized medicine, allowing a better response to the patients' needs. Our rubric, which clearly indicate the performance criteria, have become an excellent method to carry out the assessment of competencies, both for students and teachers, since they allow to obtain clear evidence of the level of acquisition and application of knowledge.

The Impact of Special Operations Medics and Corpsmen on Military Medical Student Training: A Qualitative Study.

Operation Gunpowder is a high-fidelity military medical field practicum conducted by the Uniformed Services University of Health Sciences, Bethesda, MD. During this multi-day combat simulation, Special Operations Medics and Corpsmen teach military medical students how to treat patients in an austere, resource-limited environment. To investigate the effectiveness of this teaching model, our research team used a qualitative phenomenological design to explore medical students' experiences being taught by Special Operations Medics and Corpsmen during Operation Gunpowder. We found two themes regarding the medical students' personal and professional development: an increased understanding of medics' skills and capabilities and the realization of their future roles as educators and leaders. Our study suggests that the use of Special Operations Corpsmen and Medics in medical student training is a valuable model for both military and civilian medical education and training.

Identifying Factors That Influence Student Perceptions of Stress in Biology Courses with Online Learning Modalities.

Students in higher education encounter many factors both inside (academic) and outside (nonacademic) classrooms that can influence their perceptions of stress in their biology courses. These can include course learning modalities, coursework, grades, as well as time management outside of class. It is unknown what stressors are perceived by students enrolled in biology courses-especially in online learning modalities. Therefore, our mixed method study aims to investigate the extent to which online course modalities influence students' perception of stress, as well as identify academic and nonacademic factors that influence students' perceptions of stress in biology courses. Student survey data (n = 240) was collected in the Fall 2020 semester while many courses were held online due to the COVID-19 pandemic. Our qualitative and quantitative analyses indicated three major findings: First, 70% of students specifically indicated that online-learning modalities increased their stress levels. Our second major finding is that 70% of students indicated the size of class workloads-work both in and out of class-is too much, which especially impacts students with caretaking and work responsibilities. Finally, over 85% of students indicated that exams were a major source of stress, specifically, a third of the students reported the time to complete the exam and exam material as sources of stress. This work is the first to identify stressors in online biology courses, and these analyses will inform future pedagogy, curriculum, and policies to mitigate students' stress as instructors continue to explore online learning pedagogy.

Race, gender, and ethnicity differences of nursing students' experiences during the COVID-19 pandemic.

BACKGROUND: The coronavirosus disease caused physical, mental, and social stress to humans; however, the human impact was not balanced and proportionately distributed to all people; especially nurses. This study explored nursing students' lives affected by the pandemic. PURPOSE: The purpose of this study was to investigate the effects of COVID-19 and the pandemic on students' experiences across different races, genders, and ethnicities. METHOD: This cross-sectional study sought to investigate significant differences in reported experiences of nursing students during the COVID-19 pandemic based upon race, gender, and ethnicity classifications. A survey was developed to collect the data. RESULTS: A national sample of 616 student responses was analyzed. Significant differences were found in the pairwise comparisons. The differences found among the diverse student classifications revealed variations in survey responses to classes moved to on-line, interactions with peers, COVID-19 testing, fear/anxiety, and test performance. CONCLUSION: The research adds knowledge about nursing students' experiences during the pandemic; especially unrepresented students from diverse backgrounds. The findings from this study suggested nursing students reacted differently based on race, ethnicity, and gender.

An exploration of instructors' and students' perspectives on remote delivery of courses during the COVID-19 pandemic.

The world-wide pivot to remote learning due to the exogenous shocks of COVID-19 across educational institutions has presented unique challenges and opportunities. This study documents the lived experiences of instructors and students and recommends emerging pathways for teaching and learning strategies post-pandemic. Seventy-one instructors and 122 students completed online surveys containing closed and open-ended questions. Quantitative and qualitative analyses were conducted, including frequencies, chi-square tests, Welch Two-Samples t-tests, and thematic analyses. The results demonstrated that with effective online tools, remote learning could replicate key components of content delivery, activities, assessments, and virtual proctored exams. However, instructors and students did not want in-person learning to disappear and recommended flexibility by combining learning opportunities in in-person, online, and asynchronous course deliveries according to personal preferences. The paper concludes with future directions and how the findings influenced our planning for Fall 2021 delivery. The video abstract for this article is available at https://www.youtube.com/watch?v=F48KBg_d8AE.

Quality of effort in college activities and learning gains: A case study in China.

This study investigated the mechanism between Chinese undergraduates' quality of effort in college activities and learning gains, using the Chinese College Student Experiences Questionnaire (CCSEQ). 2,990 undergraduates were recruited at a case Chinese university. Gender, grade, and type of high school differences were found in Chinese undergraduates' quality of effort in college activities and learning gains. Compared with data from American Norms, Chinese undergraduates have less interaction with teachers, lower classroom participation, and lower intellectual skills gains. Quality of effort in college activities contributed more to learning gains than demographics, with different influences based on the types of college activities. This research verifies the applicability of the CSEQ in the Chinese context and reveals the characteristics of the learning experiences of Chinese undergraduates and the underlying reasons. Recommendations for programme designers, university faculty, and undergraduates themselves were suggested.