Coronavirus Disease 2019 (COVID-19) has been ongoing in China since December, 2019. On January 30, 2020, the second meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) declared that the outbreak of COVID-19 constitutes a Public Health Emergency of International Concern (PHEIC). The pandemic raised great concern in China and other countries[2-5]. In order to prevent the spread of COVID-19 at mass gatherings, Ministry of Education of the People's Republic of China adopted countermeasures such as online education to keep medical schools running without suspending classes.
Before the COVID-19 pandemic, China’s higher medical education mostly adopted traditional education model, namely the second-generation education model. However, with the incredible growth of Internet since the 1990s, online education has begun to thrive. In 2009, Khan Academy and flipped class became popular in China, and a number of higher medical education institutions in China have begun to accept or try online education. In 2010, large-scale online courses such as MOOCs had a tremendous impact on China’s higher medical education. At present, there are numerous online platforms of MOOCs, including Coursera, Udacity and edX, the top three world-renowned education platforms as well as domestic platforms such as Chinese university MOOC, XuetangX and Icourses. The proliferation of online education has already been an inevitable trend, and the COVID-19 pandemic facilitate this transformation.
Health professionals for a new century: transforming education to strengthen health systems in an interdependent world published in Lancet proposed an idea of the third-generation educational reform. It focuses on system-based medical education to improve the performance of health systems by adapting core professional competencies to specific contexts, while drawing on global knowledge. With the rapid development of medical science, the traditional teaching methods featuring slow knowledge updating and low teaching efficiency, to some extent, are unable to fully meet the diverse learning needs of medical students. Proposed in 2003, blended learning has become one of the mainstream educational approaches in the medical educational reform. It is a style of education in which students learn via electronic and online media as well as traditional face-to-face teaching, that places an emphasis on empowering students with the skills and knowledge required to make the most of the online material and independent study time, guiding students toward the most meaningful experience possible. E-learning is based on network support. 5G is the abbreviation of the fifth-generation mobile communication technology. 5G network features enhanced mobile broadband (eMBB) coping with the significant increase of data volumes, overall data capacity, and user density, massive machine type communications (mMTC) requiring low power consumption for a huge number of connected devices, ultra-reliable and low latency communications (URLLC) providing safety-critical and mission critical applications. Compared with 4G network, WLANs or Wi-Fi, 5G network guarantees the same consistency in performance with less interference, that is very important for critical machine-to-machine communications, especially where the number of devices is massive.
Team-based learning (TBL) is a structured form of small-group learning that can be scaled up for implementation in large classes. Compared with problem-based learning, it is distinct in its requirement for pre-class preparation, its sequence of in-class individual and team activities, its higher student-teacher ratio, and the way it combines peer learning with immediate feedback and expert clarification. “5+3" pattern is an innovative training pattern in graduate education for a professional degree in clinical medicine. The pattern focuses on innovation in training talent as well as reform of the administrative mechanism. In “5+3" pattern, medical students directly enter the 3 years of pursuing a master 's degree after completing 5 years of preclinical and clinical courses. It narrows the gap between student cultivation and standardized training for residents, and facilitates the tight connection between professional training and occupational qualifications. In accordance with boosting medical educational reform by new technologies, we had tried to apply a new blended teaching model based on online TBL via 5G network (hereinafter referred as blended teaching model) to 50 fourth-year medical students who were receiving the “5+3” pattern courses regarding internal medicine in July, 2019 before the outbreak of COVID-19. As the pandemic was later determined to be PHEIC, medical universities in China closed campuses and shifted to home-based online learning which is not based on TBL via other prevalent forms of wireless internet connection (hereinafter referred as traditional online teaching model) in response to the COVID-19 outbreak. It seems to be another alternative learning approach under PHEIC that conform to the trend of the third-generation educational reform.
In order to find a more suitable method to conduct medical education under PHEIC, we used an online survey tool to make a comparison between the blended teaching mode and the traditional online teaching model. In addition, we tried to discuss the impact of this change will bring towards the indices of students’ competencies we put forward based on six core competencies, that is, professionalism, attitude towards learning, knowledge and learning skills including problem analyzing and solving, teamwork skills, self-directed learning, as well as adaptability and acceptance of the courses.