Comparing Online and Face-to-Face Performance in Scientific Courses: A Retrospective Comparative Gender Study of Year-1 Students.

Purpose: As a result of COVID-19 pandemic, medical education at the Arabian Gulf University was instructed to apply online teaching instead of face-to-face for all phases of teaching at the University. Phase-1 is concerned with basic science courses delivered to year 1 students. We conducted this study to detect if there are any differences in the performance of medical students between online and face-to-face ways of learning. Also, a comparison between male and female performance in scientific courses was carried out in pre and during COVID-19 periods. Methods: The participant were first year students for pre COVID-19 period from 2018 to 2019 and during COVID-19 period from 2020 to 2021. The university used Moodle and Zoom as an online way of teaching. The students' performance in the year 1 (three-semester) -online period of teaching were compared with a three-semester-performance of conventional teaching prior to COVID-19. This is a retrospective study that attempts to shed some light on the efficiency of AGU experience in online learning for year 1 (Phase I) students. This study evaluates the outcome of both, online and face-to-face examinations for scientific courses. Results: The results showed that the mean performance of year one medical students in all basic scientific courses (Phase I) during the coronavirus pandemic was greater than the mean performance before the pandemic with the exception of the Biostatistics course. The results by gender showed that the mean performance of females was better than males across all scientific courses before coronavirus. Also, during the COVID pandemic, the mean performance of females was better than males in all basic science courses. Conclusion: Year -1 students' performance in science courses during the coronavirus period seems better than pre COVID19 era. Females' performance was better than males' in both periods; pre and during COVID -19 periods.

Best Practices of the World Health Organization Collaborating Centres (WHOCCs) in the Eastern Mediterranean Region.

Background: World Health Organization Collaborating Centres (WHOCCs) cooperate with the WHO on a range of strategic areas such as nursing, nutrition, mental health, chronic diseases, education, and health technologies, depending on their speciality areas. As of 2021, WHO has 47 CCs in the Eastern Mediterranean Region (EMR) collaborating on diverse areas. Four CCs in the EMR located in Egypt, Kingdom of Bahrain, Sudan, and Pakistan focus primarily on medical education (ME). Objective: The objective of this review of the literature is to describe the best practices in ME based on published research from the four WHOCCs in EMR. The secondary objective is to classify them based on the level of Kirkpatrick's model (KM) of educational outcomes. Methods: The contributions of WHOCCs are categorised in to five domains namely "Curriculum Development and Course Design", "Student Assessment", "Quality, Accreditation, and Program Evaluation", "Teaching and Learning" and "Innovation in Medical Education". Initial extraction yielded 96 articles for review, while the second level of analysis reduced the number of publications to 37 based on the date of publication within the last 5 years. Numerous best practices in ME emerged from the recently published works of these WHOCCs in the areas of learning and teaching, curriculum development, innovations in medical education, quality, and assessments in medical education. Literature from the WHOCCs on assessment and curriculum design are limited, possibly indicating opportunities for additional research. Conclusion: The researchers conclude that the WHOCCs in the EMR show transformational impact on all principal areas of research and at multiple levels.

Faculty development programmes in medical education in the Eastern Mediterranean Region: a systematic review.

Background: Faculty development is essential for enhancing medical education. The World Health Organization in 2013, promoted faculty development based on moderate quality of evidence and conditional recommendations. Aims: To conduct systematic review of faculty development programmes in medical education in the Eastern Mediterranean Region (EMR), during 2013 to 2020. Methods: A systematic research was conducted in PubMed, Google Scholar, EMBASE and ERIC using appropriate Boolean operators. Articles in English from the EMR, explicitly mentioning "faculty development" in medical education, in the title, abstract or anywhere in the text, during 2013-2020 were included. Results: Two thousand three hundred and forty-seven (2347) articles were retrieved, of which 54 were considered for further analysis based on Kirkpatrick's Model for program evaluation. Articles were grouped into 4 themes: evaluation of new interventions (n = 21), evaluation of already implemented interventions (n = 13), needs assessment (n = 16), and recommendations and guidelines (n = 4). It was revealed that 23 studies addressed level 1 (reaction), while 4 studies addressed level 4 (results) of the Kirkpatrick's Model of program evaluation. Conclusion: Faculty development should be need-based and provide hands-on training. Longitudinal programmes are recommended for maximum benefits.

Evaluation of the Utility of Online Objective Structured Clinical Examination Conducted During the COVID-19 Pandemic.

Background: The COVID-19 pandemic led to profound restrictions on the face-to-face learning and assessment in all educational institutions, particularly the medical schools. The College of Medicine and Medical Sciences of the Arabian Gulf University (CMMS-AGU) conducted the final exams, both theoretical and clinical components, for its MD students online. This study was conducted to evaluate the utility of online clinical exams held at CMMS-AGU. Methods: This is a cross-sectional, mixed method study that included samples from final year medical students, examiners, and heads of clinical departments. Data were collected through surveys, structured interviews, documents' review, and calculation of online examination's psychometrics. Descriptive statistics were used. Quantitative data were presented in the form of means and standard deviations. Responses of heads of clinical departments in the structured interview were transcribed and analyzed thematically based on three pre-established themes. Results: Quantitative and qualitative data on the utility (validity, reliability, acceptability, educational impact, and cost and feasibility) of online objective structured clinical examination (OSCE) were collected. Content validity of the online clinical examination was established through high mean scores of content representativeness, which was confirmed by the heads of clinical departments regarding the proper coverage of clinical skills. Criterion validity was established through a high correlation between clinical and theoretical exam results (r = 0.75). Reliability of the exam was established through an acceptable Cronbach's alpha value (0.70 to 0.78) over the four days of the examinations. The examinations were perceived as highly acceptable by both students and examiners. High educational impact was inferred from students' responses and review of documents. The examination was found to be feasible and of reasonable cost. Conclusion: Online OSCE might be a good alternative of conventional clinical assessments in times of crises and impossibility of having in-person contact between students, examiners, and patients. An important major drawback is still present in such initiatives, which is the inability to assess students' physical examination skills.

Perceptions of Medical Students on Distance Learning During the COVID-19 Pandemic: A Cross-Sectional Study from Bahrain.

Purpose: The COVID-19 pandemic resulted in a sudden shift from face-to-face to distance learning. We explored medical students' views of online learning during this pandemic at the Arabian Gulf University in Bahrain. Methods: This was a cross-sectional study of students in years two, three and four (n= 559) using an electronic questionnaire. Data were collected from April 10 to May 5, 2021. The survey included three domains: behavioral, affective, and cognitive. We also analyzed the association between students' perceptions and certain demographic and institutional factors. Results: The number of respondents was 311 (response rate: 55.6%; 27.7% males, 72.3% females). Participants were generally satisfied with distance learning (54.6%), although they had less motivation (46.3%) and required more effort (32.2%). Most students preferred distance learning for theoretical parts, and face-to-face approach for practical components (73.3%). Participants reported that distance learning, improved interaction with instructors and classmates (45.6% and 48.9%, respectively), small group learning (47.6%), independent learning (75.3%) and problem-solving skills (44.7%). The students were comfortable with online assessment (60.1%), and reported improved achievement in written (42.1%) and practical examinations (46%), but not in professional skills grades (21.6%). There was no association between students' perceptions and gender (p= 0.079), year of study (p= 0.28) or attendance of live or recorded sessions (p= 0.904), but there was a positive association with the availability of WiFi (p< 0.01) and attendance of college-organized activities (p< 0.0001). Conclusion: Distance learning was successfully implemented during the COVID-19 pandemic. Students were generally satisfied with distance learning and online assessment, but they had concerns about the clinical skills learning. After the pandemic is over, theoretical components of the curriculum can be delivered using distance learning, whereas hands on elements should be offered face-to-face. However, those curricular reforms will likely need investing in the information technology infrastructure.

Online, Face-to-Face, or Blended Learning? Faculty and Medical Students' Perceptions During the COVID-19 Pandemic: A Mixed-Method Study.

BACKGROUND: COVID-19 pandemic forced educational institutions to adopt online methods which were inevitable to keep continuity of education across all academia after suspension of traditional educational systems. The aim of this study was to explore the experience of faculty and students of online and face-to-face learning, and their preference of the mode of learning after the pandemic. METHODS: This is a mixed-method study. Quantitative data was collected through a survey from 194 medical students and 33 faculty members, while qualitative data was collected through two focus group discussions with 9 students and another two with 13 faculty members. Quantitative variables were presented as means and standard deviations. Paired samples t-test and Chi-square test were used. Thematic analysis of qualitative data was used to code, interpret, and make sense of data. RESULTS: Mean scores of responses of faculty members and students were higher for face-to-face and blended learning compared to online learning in all survey statements with statistically significant differences. More than half of the students (53.1%) preferred the face-to-face mode of learning, while most of the faculty members (60.6%) preferred the blended mode of learning. Qualitative analysis identified five themes, namely: "Transforming the way theoretical teaching sessions are given," "Face-to-face teaching at campus cannot be replaced for some types of education," "Interaction in online sessions is limited," "Problems and challenges of online examinations," and "Technical issues and challenges of online education." It revealed suggestions that at least 30% of the curriculum could be taught online post-COVID-19. Some aspects of clinically oriented teaching including history taking and case discussions can also be delivered online in the future. Faculty members and students reported that dealing with online education was not difficult, although the transition was not smooth. CONCLUSION: Medical students and faculty members were in favor of face-to-face and blended modes of learning. However, they perceived online mode of learning as an acceptable adaptation in theoretical teaching and in some clinically oriented teaching including history taking and clinical case discussions. Although face-to-face education in medicine is irreplaceable, the blended mode of learning remains an acceptable and practical solution for the post-COVID era.

Validation of academic motivation scale among medical students using factor analysis and structural equation modeling: Middle Eastern perspective.

BACKGROUND: Demanding careers like medicine requires a lot of motivation and the Academic Motivation Scale (AMS) developed by Vallerand et al. (1992) is an instrument to measure motivation. This study evaluated the validity and reliability of AMS among medical students in the Middle East. MATERIALS AND METHODS: This was a methodological research utilizing a convenient sampling technique. AMS scale comprising 28 items subdivided into seven subscales was administered to 900 students (281 students returned the filled AMS). Data were analyzed using the descriptive statistics, one-way ANOVA, and t-tests. Exploratory factor analysis and Cronbach's alpha were used to evaluate the validity and reliability of the scale, respectively. RESULTS: There was a statistically significant difference between both genders in overall scores (P = 0.015*), two subscales, namely "Identified Regulation" (P =0.017*) and "Stimulating Experience" (P = 0.015*), with females showing higher value. Second-year students (n = 91) had significantly higher score (10.9 ± 4.1) for "Amotivation" (P =.001*) and first-year students (n = 48) had significantly higher score (16.2 ± 3.0) for "Achievement" subscale (P =.014*). P < 0.05 was considered statistically significant with 95% confidence interval. No statistically significant difference was observed between the groups based on nationality or age. Bartlett's test of sphericity was significant (Chi-square: 2988.010; df = 278; P < 0.001). Kaiser-Meyer-Olkin was 0.890. Principal component analysis with varimax rotation extracted seven factors corresponding to the original items of AMS questionnaire. All subscales correlated positively except "amotivation." Structural equation modeling revealed the relation between observed and unobserved variables. DISCUSSION: This study demonstrated that AMS is valid and reliable for application among Middle East medical students, without needing any modification. AMS has widespread application in medical education as it impacts learning outcomes. CONCLUSION: This study demonstrated that AMS is valid and reliable for application among the Middle East students without needing any modification.

A toolbox for conducting an online OSCE.

This toolbox highlights the lessons learned and the tools used to run the online OSCE at the College of Medicine and Medical Sciences, Arabian Gulf University (CMMS-AGU) using Zoom™ï¸. The examiners considered the examination to be valid in assessing all clinical skills except for psychomotor skills and students found it to be highly acceptable. We describe three phases. Planning and preparation phase in which situation analysis, aligning stakeholders, mobilizing resources, creating a shared vision, and ownership of the exam project take place. For successful implementation of examinations, detailed plans are needed including manpower, timings, number of stations and detailed description of the steps of the examination process. We provide a set of guiding questions for proper decision making related to online clinical exams. Implementation Phase in which piloting is very useful to apply improvements to the original plan and to outline the needed capacity building of the participating staff. We give a detailed description of the guiding documents, means of communication and features of ZOOM that were used. Evaluation phase we provide a guide for evaluating the process and outcome, including a list of key performance indicators.

The Curriculum at the College of Medicine and Medical Sciences at Arabian Gulf University: A Way Forward to Meet the Future Medical Education Needs.

Arabian Gulf University (AGU) follows a curriculum based on Problem Based Learning (PBL). PBL is a learner-centered approach that empowers students for life-long learning. Students are taught through problems that are designed based on global health problems customized to the local needs. The classroom teaching is complemented through adjunct programs like community health activities and professional skills program. Medical education aims to meet the changing needs of society. Demographics, disease epidemiology and healthcare needs of the gulf countries have changed over 38 years since the inception of AGU. To keep pace with the changing demands, it is imperative that the curriculum is reviewed in the light of advances in technology and newer techniques of medical education.In the present article the curriculum at AGU is reviewed based on the predictors for future medical education and alternative teaching methods that can be integrated to optimize the student outputs are explored.

Evaluation of Curricular Adaptations Using Digital Transformation in a Medical School in Arabian Gulf during the COVID-19 Pandemic.

BACKGROUND: Several institutions adopted innovative approaches to ensure continued learning for their students during the COVID-19 pandemic. All curricular innovations should undergo curriculum evaluation; hence, the objective of this paper was to share the salient features of evaluation using faculty and student's feedback on curricular adaptations implemented through digital transformation in a Medical School in Arabian Gulf during the COVID-19 pandemic, using a structured questionnaire. METHODOLOGY: After getting informed consent, feedback about acceptability and limitations regarding various aspects of curricular adaptations was obtained from students and faculty, using a structured and validated questionnaire. The response rate from faculty and students was 90% and 60%, respectively. The qualitative responses were analyzed using thematic analysis. RESULTS: About 97% agreed that Modular Object-Oriented Dynamic Learning Environment, ZOOM, and Examsoft platforms were effective for curriculum delivery and assessment. 85% agreed that they were able to maintain online interactivity and 92% conveyed their willingness to continue to use these digital innovations even after the end of pandemic. "Lack of interactivity," "missed clinical training," "live sessions were more engaging than recorded ones" were the prominent themes emerged out of thematic analysis. All faculty and students expressed concern over the lack of clinical training involving real patients. All of them expressed appreciation to the university and faculty for their enormous efforts. CONCLUSION: Innovative ways should be considered to start clinical teaching with real patients, during pandemic. The learning outcomes of digital learning should be validated across all institutions. New indicators related to "digital learning" should be considered for accreditation of medical schools.