This was a descriptive cross-sectional faculty based study, where 358 medical students were involved from two universities, Alzaiem Alazhari and Khartoum and results were analyzed by SPSS with the aim of studying the perception of medical students towards virtual learning during COVID-19 pandemic in Khartoum state.
The response rate of faculty of medicine at university of Khartoum was 81%, compared to 19% of faculty of medicine at Alzaiem Alazhari university with 69.6% females, and 30.4% males respondents .The low response rate of Alzaiem Alazhari university was assumed to be due to the semester examinations which were synchronous with the data collection time.
Noticeably 37.2% of the total respondents were from fifth year clinical students. This study revealed that the average number of hours that have been spent on virtual learning before and during the COVID-19 pandemic were statistically significant (p < 0.05) (Fig. 1A), with average of 1.9 hour per day before the pandemic and average was more than 3 hours per day during the pandemic.
The average hours that have been spent specifically during the pandemic by both preclinical and clinical students were statistically significant (P < 0.01) (Fig. 1B, Fig. 1C ) as well, with clinical students spending less hours than the preclinical because clinical skills must be demonstrated at hospitals or health facilities level where practical sessions are made, and this is consistent with a study conducted in the UK in 2020.(9)
Moreover, this study did not find a significant difference between the average hours that have been spent by preclinical and clinical students before the COVID-19 pandemic (P > 0.819) (Fig. 1B), and the majority of the students(83.5%), cited online teaching platforms (online videos like YouTube), as one of the most attractive methods of the virtual learning.
Additionally, students who had a previous experience with virtual learning before the COVID-19 pandemic, had a high perception of virtual learning during the pandemic and this is consistent with a study made in China (10) which revealed the same results this may explain why the students though that why virtual learning did not replace traditional learning successfully also the majority of the students thought that clinical skills cannot be learnt via online learning (Fig. 2A & Fig. 2B).
The results also revealed that students want more engaging online teaching sessions like live lectures via quizzes and polls rather than pre-recorded non-interactive videos or lectures, because this will enhance the participants' participation and create more interactions between the facilitators and the students, (mean score of 3.74) (table 2) (11, 12).
These were remarkable findings for those in Sudan, because it showed that virtual learning has a lot of benefits like; time and cost saving, no need to travel, flexible and feasible to study at any time, etc.
The strong association of clinical medical students' high perception towards face to face learning was interesting, but not surprising because those clinical skills cannot be learnt without performing them on actual patients and being supervised and directed by seniors and professional doctors.
Generally, it seems that because of the mean score (2.57) (table 2) for "being well qualified for your career in the future", the medical students were concerned that virtual learning may negatively impact their professionalism and trust in their future career.
Consistent with a study made in Poland which revealed that students were less active during online lectures compared to traditional classes (13) and this could be explained by the loss of the psychological effect of the schools' environment because studying from home means you are related to other habits and thus the human brain procrastinate the learning and makes the other home habits a priority (14, 15). It was also noticed that the majority of the written examinations have not been affected while the majority of the clinical examinations have been postponed and this is due to the social distancing forced by the pandemic.
These findings provided support for the conceptual premise that virtual learning has not fully replaced the traditional face to face method of teaching. (Mean score of 2.45).The most obvious finding that studying the whole time at home without getting any sun exposure or body movements could lead to vitamin D deficiency in the long term, hence leading to depression as they are related, (16, 17). However, more research on this topic is needed.