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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 26  |  Issue : 1  |  Page : 62-67

Views of medical students about online classes started during the COVID-19 pandemic: An online exploratory survey from India


1 Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
2 Department of Psychiatry, SPS Hospitals, Ludhiana, Punjab, India
3 Department of Critical Care, SPS Hospitals, Ludhiana, Punjab, India

Date of Submission28-Feb-2021
Date of Acceptance14-Mar-2021
Date of Web Publication30-Jul-2021

Correspondence Address:
Sandeep Grover
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmhhb.jmhhb_43_21

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  Abstract 


Aim of the Study: To evaluate the views of medical students about online classes started in view of COVID-19 pandemic. Methodology: An online survey was conducted using Survey monkey platform®. A survey link which was sent through the WhatsApp platform® to the MBBS/BDS students across the country. The survey questionnaire evaluated the views about the various aspects of the online classes. Results: A total of 1059 students completed the survey, of which 1033 entries were analyzed. The participants' mean age was 20.8 years with nearly equal male-to-female ratio, majority being MBBS students who were taking part in online classes mostly from home (95.4%), by using smart phones (85%). When asked to compare the experience of online classes with regular in-person classes, a majority of the participants reported having poor attention and concentration, poor retention of knowledge, poor learning of theoretical aspects of subject, poor learning of practical aspects of the subject, poor questions/answers sessions, and only 38.9% and 10.6% rated online theory and online practical classes as 'good' or 'very good,' respectively. The most common advantages of online classes reported by the students were that they do not have to travel (69%) and do not have to dress up (69.9%), while the most commonly reported disadvantages included poor learning of practical aspects (75%), followed by strain on eyes (73.4%) and difficulties with internet connectivity (64.8%). A small proportion of students 'occasionally' or more often indulged in surfing Internet, Chatting on WhatsApp/Telegram/FB Messenger, and using Social Media (Facebook, Instagram, We Chat, Snap Chat, and Telegram) while attending online classes. Conclusions: This study suggests that although various colleges are running online classes, as a substitute for the regular in person classes in view of the need for social distancing, these classes are not well received by the students and are possibly does not fulfilling the desired needs of the students. Further, the present study suggests that students still prefer in-person classes.

Keywords: COVID-19, medical students, online education


How to cite this article:
Grover S, Goyal SK, Sahoo S, Goyal S, Mehra A. Views of medical students about online classes started during the COVID-19 pandemic: An online exploratory survey from India. J Mental Health Hum Behav 2021;26:62-7

How to cite this URL:
Grover S, Goyal SK, Sahoo S, Goyal S, Mehra A. Views of medical students about online classes started during the COVID-19 pandemic: An online exploratory survey from India. J Mental Health Hum Behav [serial online] 2021 [cited 2021 Dec 1];26:62-7. Available from: https://www.jmhhb.org/text.asp?2021/26/1/62/322824




  Introduction Top


To tackle the rapid rise of cases in India and to curb the community spread of ongoing COVID-19 pandemic, National level “Lockdown” was declared starting from midnight of March 25, 2020 and extended across the nation up to May 31, 2020. After this, states were allowed to decide about the lockdown and relaxations depending on the number of cases. While lockdown has several beneficial aspects to control the spread of infection, it caused almost a pause to the educational/teaching activities. In this regard, to resume the teaching curriculum, many educational institutions (schools, colleges, and universities) of all courses started online classes for their students to keep the students busy with academic activities and complete the scheduled curriculum.[1]

Owing to the COVID-19 pandemic,[2] medical curriculum was made online in many medical colleges worldwide and the MBBS (medical stream) and BDS (dental stream) students' classes were taken by faculty members on various online platforms. There have been several concerns on postgraduate training programs in almost all streams[3],[4],[5] and undergraduate practical classes.[6] Small-group clinical skill sessions, flipped classroom models, online practice questions, teleconferencing lectures, procedural simulations in virtual platforms have been encouraged to bridge the educational gaps during the COVID era.[6],[7] Moreover, the postgraduate exit examinations procedures/formats were changed in many colleges/universities, and in some scenarios, online examinations were also conducted.[8],[9]

It has been suggested that the online classes/academics have been found to be quite beneficial as these can help in high caliber learning experience, improved attendance and engagement, digitally trackable learning, flexible timings, budget friendly, reduced distractions, and quick assessment.[10],[11] However, there are some negative perceptions about it among the general public and parents, some of which are that these academics are time-consuming, are associated with excessive use of internet data, lack of concentration, less supervision of the teachers, and risk of getting hooked to the Internet. However, some of the negative aspects of online academics include poor social interaction or personal connection between peers and teachers which is quite essential for personality development requires extensive time management skills from students; and many a times, students have increased workload as compared to usual routine teaching classes. The assignments given to the students in these online classes are also required to be submitted through E-mails or in the form of pictures which can be quite tedious to the students and the teachers as they were never used to such teaching technologies before.[12]

Being an entirely new concept, although the essential mode of teaching in the current pandemic situation, there can be several drawbacks and teething issues.

In this regard, as more and more number of MBBS and BDS colleges have started online academics, it is essential to know the viewpoints of the students about online classes. In this background, the current study was planned with an aim to evaluate the views of medical students about online classes started in view of COVID-19 pandemic.


  Methodology Top


It was an online survey conducted by using Survey monkey platform®, through a survey link that was sent through the WhatsApp platform® to the MBBS/BDS students across the country. The survey was conducted during the period of June 6, 2020–June 26, 2020. The participants could respond to the survey link only once by using one device. The participants were requested to forward the link to their colleagues pursing the MBBS/BDS course.

The study was approved by the Institute's Ethics Committee. The survey invitation clearly stated that the participation was voluntary, participants have the right not to participate in the survey and participation in the survey would imply providing informed consent. The survey link also stated clearly that those not willing to participate can ignore the message. Confidential and anonymity was assured in the invitation message.

To be included in the study, the students were required to be pursuing MBBS/BDS, aged >18 years, of either gender, able to read English and providing informed consent to participate. The survey questionnaire was made available in English and consisted of the following instruments: (1) Demographics and personal characteristics: A basic information sheet which included the participant's age, gender, locality, current place of residence, course details, and if their college/institute had been doing online classes since COVID-19 lockdown period and (2) A self-designed Questionnaire – a specially designed questionnaire to evaluate the various aspects of online teachings, the device used for the online classes, any problems faced during classes, perceived advantages and disadvantages along with a comparison to previous mode of usual teaching curriculum.

The IP addresses were verified to rule out duplicate entries.

Descriptive statistics were applied, and the data collected were analyzed using SPSS 16.0 version (SPSS Inc. Released 2007, SPSS for Windows Version 16.0. SPSS Inc., Chicago). The Chi-square test and independent t-test were used to compare for any gender differences in the categorical and continuous variables, respectively.


  Results Top


During the study period, a total of 1059 students completed the survey. However, from the total 1059 participants, 26 participants reported that their colleges were not running any online classes and were excluded. The final sample included in the analysis was 1033. The participants' mean age was 20.8 (standard deviation-1.44) years with nearly equal male-to-female ratio (males-49.2% and females 50.8%). More than half of the participants were from the urban background (58.8%), and this was followed by those from semi-urban (21.8%) and rural (19.5%) locality. Majority (95.4%) of the participants were staying at home during lockdown and small proportions of them were staying at hostel (3.4%) or were staying as paying guest (1.3%). Students from dental (BDS) stream comprised of only 3.1% of the total sample and rest were MBBS students. Majority of the participants were studying in government colleges (45.2%) and this was followed by those studying in government aided colleges (46.7%). Very few (8.1%) students were from private medical/dental colleges.

The participants reported of using more than one device as per their convenience or availability of resources for the online classes. The most common device used was smart phones (85%), followed by laptops (23.2%), desktop (2.4%), tablets (7.1%), and other devices (1.7%) to attend the online classes. Majority (79%) of the participants used personal data pack (79%), followed by personal Wi-Fi (24.9%) and other (6.2%) resources of internet connection to attend the online classes.

When the students were asked to compare the experience of online classes with regular classes on different aspects, most of them reported the online classes to be less comfortable and less satisfactory. A majority of the participants reported having poor attention and concentration, poor retention of knowledge, poor learning of theoretical aspects of subject, poor learning of practical aspects of the subject, and poor questions/answers sessions [Table 1].
Table 1: Overall rating of online class on various aspects by the students (n=1033)

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Further, when the students were asked to rate their experience of regular classes and online classes, it was seen that significantly higher proportion of the participants rated in person theory (68.9%) and practical classes (67.6%) as “good” or “very good.” However, on the similar questions for online classes, only 38.9% and 10.6% rated online theory and online practical classes, respectively, as “good'” or “very good” [Table 2].
Table 2: How would you rate the quality of the following based on your experience in the college in which you are pursuing the course

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When the opinion of the students about the advantages and disadvantages of online classes was evaluated, the most common advantages reported by the students were that they do not have to travel (69%) and do not have to dress up (69.9%). Other advantages of online classes reported by one-fourth to one-third of the participants included flexibility of multitasking, no need to meet others, can hide the video and escape from getting viewed/scrutinized by teachers, can go back to the recording again, lesser number of classes than the usual classes at college and less time duration of the online class compared to usual class [Table 3]. Other aspects such as these being cost-effective, lack of cancellation, lack of bullying, ability to view the recording on will, and minimal or no home task given were considered to be the advantages by less than one-fourth of the participants.
Table 3: Advantages and disadvantages of online classes as reported by students

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In terms of disadvantages, the most commonly reported disadvantages included poor learning of practical aspects (75%), followed by strain on eyes (73.4%) and difficulties with internet connectivity (64.8%), poor interaction with peers (54.5%), boring (46.6%), poor learning (46.3%), feeling of detachment (40.4%), feeling overburdened with daily online classes (39.5%), social isolation (38.9%), difficulty in writing or noting down main points/preparing notes (38.8%), and loneliness (36.4%) [Table 3].

When the students were asked to choose the format for future classes (online vis-à -vis in-person or combined), only 8% opined for only online classes, whereas 30% opined for in person classes and about half (47.9%) suggested for a mix of online and in-person classes with more of in-person classes [Table 3].

When asked about indulgence in different activities while attending the online classes, it is evident that a proportion of students “occasionally” or more often (i.e., often or always) indulged in surfing internet, Chatting on WhatsApp/Telegram/FB Messenger, and using Social Media (Facebook, Instagram, We Chat, Snap Chat, and Telegram) [Table 4]. When the gender differences in indulgence in various activities were evaluated, it was seen that compared to females, higher proportion of males more often indulged in surfing internet (<0.001***), playing games on the mobile/tablet/laptop/PC (0.029)*, and watching pornography (<0.001***).
Table 4: Self-reported indulgence in the different activities while attending the online classes

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  Discussion Top


The present study was aimed at evaluating the views of medical students about online classes. The web-based survey had 1033 medical students from the different parts of the country. As at present, there is limited data on this subject, it is difficult to compare the findings of the present study with the existing literature. Hence, we would try to discuss the possible implications of the findings of the present study.

This study suggests that students mostly used smart phones with personal data packs to access the online classes, and majority stayed at their homes due to lockdown following the onset of the pandemic. The use of smart phone devices to attend the online classes, being the most common device can be understood from various perspectives. First, is the lack of availability of proper equipment, i.e., laptop or desktop. Second, this can be understood from the perspective of convenience. Using the smart phone, the students could assess the classes anywhere, which may be possible with the use of desktop, or to a certain extent, with the laptop. The use of smart phones for online classes can have demerits of severe strain on the eyes.

The present study suggests that, compared to the regular classes, the participants reported the online classes to be less comfortable and less satisfactory. A majority reported having poor attention and concentration, poor retention of knowledge, poor learning of theoretical aspects of subject, poor learning of practical aspects of the subject, and poor questions/answers sessions. In addition, only about two-fifth of the participants considered online theory and only 10% of the participants considered online practical classes as “good” or “very good” and majority favored for in-person classes. This lower level of rating of online classes could be due to multiple factors, such as the issues with the devices used for attending the classes, connectivity issues, difficulty in adjusting to this new mode of learning, and organization of the classes by the teachers in the way which may not be acceptable to the students. Considering this way of online teaching to be an innovative way of teaching and many students might not be habituated to such way of teaching, it can be expected to have problems related to satisfaction and learning as in-person regular classes. These findings suggest that, possibly at this moment, both the students and teachers are not very much geared up for the exclusive online classes. These findings also provide preliminary evidence to suggest that online classes may not be able to replace the in person classes in near future. In the present study, the participants reported poor learning of both theoretical and practical aspects of the subject which can be understood as an in-person theoretical class have a personal touch between the teacher and student and an in-person practical class has an add on advantage of hands-on skill practice which lacks in online classes.[13] Moreover, studies evaluating faculty members opinion on online classes have reported that they were unable to teach practical modalities of clinical work and inability to assess students' understanding during online lectures.[13]

With regard to the advantages of online classes, there are reports of both teachers and students reporting online modalities to be encouraging, student-centeredness, students can learn asynchronously at any time in a day by going back to the recorded sessions and the classes helped in maintaining the continuity of education.[13],[14],[15] In the present study too, a significant proportion of the participants reported advantages of online classes as lack of requirement to get ready and travel to college, flexibility of multitasking, no need to meet others, escaping from viewed/scrutinised by teachers, ability to go back to the recorded classes, lower number and shorter duration of classes compared to usual class as some of the advantages of the online classes. These advantages reported by the study participants are quite broad and hence provide insight to the perception of the students about the convenience of the online classes and possible difficulties they face in attending the routine in-person regular classes. The findings of the present study also suggest that there is a need to look into the issues of cancellation of regular classes, and bullying faced by the students. At present, in most of the institutes, the regular classes are not recorded; hence, students have no option of going back to the classes. In addition to asking the students to attend the online classes, having an option to record the classes, which can be assessed by the students at their ease can possibly help in better learning. Further, suppose the regular classes are available in the recorded format. In that case, these can take away the pressure from the students of preparing notes while attending the classes and possibly can also help in the reduction of cancellation of classes. If a teacher is not available for the class, then this repository of the online classes may be played for the students, which may be better than a cancelled class.

The participants also recognized disadvantages of the online classes in the form of poor learning of practical aspects, strain on eyes, difficulties with internet connectivity, poor interaction with peers, boring, poor learning, feeling of detachment, feeling overburdened with daily online classes, social isolation, difficulty in writing or noting down main points/preparing notes, and loneliness. Few studies which evaluated students from Chinese university during COVID-19 pandemic have shown that about half of the students felt that the teaching objectives were not fully attained, they had difficulty in “focus and restraint, had issues related to unstable network speed, noisy environment at home and lack of professional equipment.[14],[15] Findings of the present study also support the same. Taken together, these findings possibly suggest that online teaching cannot replace the in-person regular classes because of various issues. In India, in many households, the availability of space for online classes, without any disturbance for few hours itself, can be a problem, especially when there are more than one child in the household and if they have classes of different streams same time.

The present study also suggests that while attending the online classes, a significant proportion of students often get distracted and indulge in different activities such as surfing Internet, Chatting on WhatsApp/Telegram/Facebook Messenger, and using Social Media (Face book, Instagram, We Chat, Snap Chat, and Telegram). These behaviors were more often seen in males when compared to females. Previous surveys that have also looked at the distraction while attending the online classes have also come up with similar findings.[13],[14] These findings possibly reflect that, attending online classes probably does not give that kind of structure as is present in real classroom, absence of the teacher in reality and an option of switching off the video possibly provides an avenue to the students to indulge in these activities. Other factors, such as lack of supervision by the parents and poor teaching quality could also contribute to the same.

The present study further suggests that the majority of the participants preferred in-person classes or a system with majority of the classes being in-person with a small proportion of online classes. Previous studies have not looked at this aspect. However, our findings suggest that current generation is at present not prepared for the exclusive online education.

The present study has certain limitations, which needs to be kept in mind while interpreting the findings. First, it was a web-based survey with a cross-sectional study design, was limited to those having access/received the link. The study findings must be interpreted in light of the fact that the responses were limited to the questions asked and there could be many other factors, which were not tapped in the study. However, despite these limitations, the study can be regarded as the first of its kind to explore the various aspects of online teachings from the students' perspectives during COVID-19 pandemic.


  Conclusions Top


The present study provides some insights into the online classes that have been started in view of the COVID-19 pandemic. The study suggests that although various colleges are running online classes, as a substitute for the in-person classes in view of the need for social distancing, these classes are not well received by the students and are possibly not fulfilling the students' desired needs. Possibly, our system at present is not prepared for the online classes. Further, the present study suggests that students still prefer in-person classes. Accordingly, even after the pandemic, while deciding about the mode of education, we need to consider the importance of the in-person classes, and the system should not exclusively or predominantly rely on online classes for teaching.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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