The number of participants who responded to the survey was 33 faculty members out of the total of 56 (response rate was 59%) and 194 students out of 842 (response rate was 23%). Out of the 14 faculty members invited to participate in the FGDs, 13 attended and actively participated (response rate was 93%). Out of the 10 students invited to participate in the FGDs, 9 attended and actively participated (response rate was 90%).
The results are presented here in three sections as follows:
Section I: Characteristics of Study Participants:
Faculty members from all academic ranks (15.2% full professors, 30.3% associate professors, 30.3% assistant professors, and 24.2% lecturers) represented all the departments of the CMMS-AGU. Also, students represented all years of the medicine program (5.7% second year, 20.6% third year, 24.2% fourth year, 11.3% fifth year, and 38.1% sixth year). First year students were not included as they were still freshmen who just came from high school and they did not experience the two modes of learning (online and face-to-face) at CMMS-AGU.
Section II: Students’ and Faculty Members’ Responses to the Survey:
Paired samples t-test was used to compare the differences of mean scores of responses of faculty members and students regarding both online and face-to-face learning. The results indicate that the mean scores of responses of both faculty members and students were higher for face-to-face learning that for online learning for all the survey items. The differences were statistically significant (p < 0.05) for almost all the items. The lowest scores were reported by the students in the areas related to interaction with other students and teachers, as well as the learning environment and its impact (items 4, 6, 7, 8, 11, and 20) (Table 1).
Table 1: Comparison between Responses of Faculty and Students on Online and Face-to-Face Learning:
Statement
|
Faculty (n=33)
|
Students (n=194)
|
Online
Mean (±SD)
|
Face-to-Face
Mean (±SD)
|
p-value
|
Online
Mean (±SD)
|
Face-to-Face
Mean (±SD)
|
p-value
|
1- Introductions between students and faculty at the beginning of the course create a sense of community
|
3.70 (±1.05)
|
4.73 (±0.52)
|
0.000*
|
3.24 (±1.41)
|
4.08 (±1.05)
|
0.000*
|
2- The instructors facilitate discussions in the sessions
|
4.18 (±0.88)
|
4.61 (±0.70)
|
0.024*
|
3.40 (±1.35)
|
4.14 (±0.95)
|
0.000*
|
3- Students' points of view are respected by their colleagues in the sessions
|
4.03 (±0.81)
|
4.45 (±0.56)
|
0.008*
|
3.70 (±1.32)
|
4.24 (±0.87)
|
0.000*
|
4- Courses create a suitable environment for social interaction between students
|
3.30 (±1.07)
|
4.39 (±0.75)
|
0.000*
|
2.88 (±1.49)
|
4.20 (±0.99)
|
0.000*
|
5- It is comfortable for students to interact in the sessions
|
3.73 (±1.04)
|
4.24 (±0.75)
|
0.036*
|
3.36 (±1.55)
|
3.89 (±1.17)
|
0.002*
|
6- The amount of interaction with other students in the sessions is appropriate
|
3.33 (±0.99)
|
4.30 (±0.73)
|
0.000*
|
2.97 (±1.40)
|
4.01 (±1.04)
|
0.000*
|
7- The quality of interaction with other students in the sessions is appropriate
|
3.39 (±0.90)
|
4.30 (±0.81)
|
0.000*
|
2.95 (±1.41)
|
4.01 (±1.06)
|
0.000*
|
8- Strong social relationships can be built during the courses
|
3.24 (±1.03)
|
4.30 (±0.98)
|
0.000*
|
2.46 (±1.35)
|
4.26 (±1.01)
|
0.000*
|
Social Presence and Interaction
|
3.61 (±0.68)
|
4.42 (±0.60)
|
0.000*
|
3.12 (±1.16)
|
4.10 (±0.80)
|
0.000*
|
9- The students can feel part of a learning community in the courses
|
3.97 (±0.68)
|
4.55 (±0.67)
|
0.000*
|
3.07 (±1.46)
|
4.32 (±0.91)
|
0.000*
|
10- The students can actively exchange ideas in the courses
|
3.94 (±0.97)
|
4.55 (±0.67)
|
0.003*
|
3.08 (±1.44)
|
4.18 (±0.94)
|
0.000*
|
11- The students can develop new skills and knowledge from other members in the courses
|
3.45 (±0.97)
|
4.30 (±0.85)
|
0.000*
|
2.97 (±1.47)
|
4.33 (±0.95)
|
0.000*
|
12- The students can develop problem-solving skills through peer collaboration during sessions
|
3.79 (±0.86)
|
4.45 (±0.71)
|
0.001*
|
3.11 (±1.45)
|
4.26 (±0.94)
|
0.000*
|
13- Collaborative learning in the courses is effective
|
3.76 (±0.66)
|
4.30 (±0.81)
|
0.002*
|
3.10 (±1.43)
|
4.19 (±1.00)
|
0.000*
|
14- Students save time with collaborative learning in the courses
|
3.85 (±0.80)
|
3.91 (±0.98)
|
0.763
|
3.54 (±1.49)
|
3.46 (±1.26)
|
0.658
|
15- Overall, collaborative learning experience in the courses is satisfying
|
3.64 (±0.74)
|
4.21 (±0.74)
|
0.001*
|
3.16 (±1.41)
|
3.93 (±1.12)
|
0.000*
|
Collaborative Learning
|
3.77 (±0.6)
|
4.32 (±0.67)
|
0.000
|
3.15 (±1.29)
|
4.10 (±0.86)
|
0.000*
|
16- Students can learn effectively from the sessions
|
4.06 (±0.70)
|
4.33 (±0.65)
|
0.048*
|
3.29 (±1.51)
|
4.12 (±1.08)
|
0.000*
|
17- Students are stimulated to do additional reading or research on topics discussed in the courses
|
4.00 (±0.79)
|
4.24 (±0.83)
|
0.058
|
3.37 (±1.46)
|
4.02 (±1.12)
|
0.000*
|
18- Discussions assist students in understanding other points of view
|
4.21 (±0.60)
|
4.42 (±0.66)
|
0.090
|
3.41 (±1.41)
|
4.19 (±0.95)
|
0.000*
|
19- The level of learning that takes place in the courses is of high quality
|
3.94 (±0.83)
|
4.30 (±0.81)
|
0.003*
|
3.17 (±1.52)
|
4.09 (±1.09)
|
0.000*
|
20- Learning environment in the sessions is motivating
|
3.76 (±0.83)
|
4.33 (±0.74)
|
0.001*
|
2.85 (±1.57)
|
3.99 (±1.17)
|
0.000*
|
21- Overall, the courses satisfy the students' learning expectations
|
3.70 (±0.81)
|
4.27 (±0.72)
|
0.000*
|
3.08 (±1.54)
|
4.08 (±1.05)
|
0.000*
|
Satisfaction
|
3.90 (±0.78)
|
4.34 (±0.73)
|
0.001*
|
3.19 (±1.51)
|
4.08 (±1.08)
|
0.000*
|
Overall
|
3.76 (±0.89)
|
4.34 (±0.77)
|
0.000*
|
3.15 (±1.47)
|
4.09 (±1.05)
|
0.000*
|
* Statistically Significant
Figure 1 shows the mean scores of responses of faculty members and students in relation to the studied domains (Social Presence and Interaction, Collaborative Learning, and Satisfaction) and the Overall Experience. The mean scores of faculty members are consistently higher than those of students for both online and face-to-face learning. The differences were statistically significant (p < 0.05).
It is clear from the figure that the mean scores for face-to-face learning for both faculty members and students are higher than the mean scores for online learning, indicating that both faculty members and students are more in favor of face-to-face than online learning.
Chi-square test of the preference of the mode of learning revealed a statistically significant difference between the preferences of faculty members and students (p < 0.05). More than half of the students preferred face-to-face mode of learning, while most of the faculty preferred the blended mode of learning. On the other hand, only a small percentage of faculty members preferred online mode of learning compared to one third of the students (Table 2).
Table 2: Comparison of Responses of Faculty Members and Students Regarding Preference of the Mode of Learning:
Mode of Learning
|
Faculty Members
(n=33)
|
Students
(n=194)
|
Chi2
|
Sig.
(p-value)
|
Online
|
1 (3.0%)
|
57 (29.4%)
|
47.8
|
0.000*
|
Face-to-Face
|
12 (36.4%)
|
103 (53.1%)
|
Blended
|
20 (60.6%)
|
34 (17.5%)
|
* Statistically Significant
Section III: Summary of Qualitative Results (FGDs):
Qualitative analysis revealed five interrelated but distinct themes, namely: 1. Transforming the way theoretical teaching sessions are given, 2. Face to face teaching at campus cannot be replaced for some type of education, 3. Interaction in online sessions is limited, 4. Problems and challenges of online examinations, and 5. Technical issues and challenge of online education (Table 3).
Table 3: List of Codes and Categories Forming the Final Themes in the Qualitative Analysis:
Codes
|
Categories
|
Themes
|
- Improving the quality of theoretical lessons.
- Participation in online resources has improved.
- Recorded theoretical teaching sessions are preferred.
- Teaching that should be given online.
- Attending from home is preferred.
- Future is for blended learning.
- Time and effort saved in online learning.
- Online learning complements face-to-face.
- Dressing up and surroundings for online sessions.
|
- Teaching that should be given online.
- Time and effort saved in online learning.
- Recorded theoretical teaching sessions are preferred.
- Improving resource session quality.
|
Theme 1:
Transforming the way theoretical teaching sessions are given.
|
- Face-to-face teaching/learning has its limitations.
- Communication is better built with face-to-face learning.
- Professional (practical) skills training must be given at the campus.
- Direct participation in face-to-face is better than in online.
|
- In-person participation in face-to-face is better than in online.
- Communication is better built with face-to-face learning.
- Clinical training, laboratory and professional (practical) skills, and tutorials must be conducted face-to-face.
|
Theme 2:
Face-to-face teaching at campus cannot be replaced for some types of education.
|
- Quality of presentations in face-to-face teaching.
- Interaction in sessions.
- Student’s presence in the sessions.
- Attending campus is much better.
|
- Interaction in sessions.
- Students’ presence in online sessions.
- Valuing the direct human interactions and socializing.
|
Theme 3:
Interaction in online sessions is limited.
|
- Achievement in assessments.
- Achieving the transparency in online examinations.
- Setting online examinations is challenging.
|
- Challenges of online examination.
- Assessment issues.
|
Theme 4:
Problems and challenges of online examinations.
|
- Initial challenges to going online.
- Technical issues and support required.
|
- Initial problems to go online.
- Support required for technical issues.
|
Theme 5:
Technical issues and challenge of online education.
|
Theme (1): Transforming the way theoretical teaching sessions are given:
Faculty members in the FGDs proposed that at least 30% of the curriculum could be given online post-COVID-19 as it saves a lot of time and effort. Some aspects of the clinically oriented teaching including history taking and case discussions can also be delivered online in the future. For the subjects requiring teaching in a clinical setting or patient exposure, participants clearly indicated that student presence at the campus would be crucial to meet the learning objectives.
“I can confidently say that 30%-40% of the curriculum can be given online”.
“Subjects like Physiology and Biochemistry that can be taught online easily.” (Faculty members – FGD 1)
Students believed that although online teaching was useful, and complemented their learning, they felt that it should be used as a standby plan for face-to-face teaching. The participants agreed that with the shift to online teaching during the COVID-19 pandemic, the students have most sessions recorded so they can watch them multiple times, which gives them time to absorb the ideas in the lecture.
“I do not depend on the videos entirely. I first watch the lectures, and it is good because if you want to study something you can go back and watch it repeatedly until you understand it.” (Student – FGD 2)
The participants also discussed the need to standardize and revamp the quality of the theoretical teaching sessions. The students reported that faculty members have a wide range of teaching approaches in the classroom and there was no one standard that everyone follows.
“Some teachers explain very well and some of them (are just) ok, but I always have to go to watch a video for the complex concepts.” (Student – FGD 2)
Theme (2): Face-to-face teaching at campus cannot be replaced for some types of education:
Most of the participants agreed that online teaching methods may not help achieve the intended learning outcomes compared to face-to-face teaching. A faculty member believed that responding to questions by students is easier during face-to-face teaching. Clinical faculty members confirmed that it was clear that clinical skills are difficult to be imparted online. They believed that the theoretical teaching is only a part of clinical training, while it would require students to be present and practically perform a procedure in front of their tutors to learn a particular clinical skill. Direct feedback on clinical examinations and procedures can only be given when they are conducted face-to-face in front of the tutors.
“For surgical skills, like suturing, how can you teach this to students online? I can only give them the basic theoretical background online, but for the actual act and performance, you need to touch the patients or models physically.” (Faculty member – FGD 1)
Similarly, faculty members and students unambiguously identified problems with the problem-based tutorial sessions conducted online, as they believed that these sessions are best conducted face-to-face with direct interaction between students with each other and students with their teachers. Apart from the claim that the problem-based tutorial sessions are useful face-to-face, the students believed that they are also more enjoyable because sitting physically with colleagues gives an opportunity to students to get to know and meet with their friends.
“When it comes to the online tutorial sessions, I do not feel that it is that interactive or focused. I present and then I can go do something else away from the computer.” (Student – FGD 2)
Theme (3): Interaction in online sessions is limited:
Students’ perceptions of quality of theoretical teaching sessions they used to have face-to-face in the classrooms before the shift to the online mode during the pandemic showed that they value more interaction.
“Using the pen and the smart screens and drawing on the white board in the classroom make the interaction very much better, valuable, and helpful and help us understand better.” (Faculty member – FGD 1)
Faculty members and students discussed how valuable was interaction out of the classroom and that they missed talking to their peers since online teaching was implemented during the COVID-19 pandemic. Being present in the campus helps students interact with other students and build relationships that are difficult to be built online.
“We used to meet and spend good time together, and personally, I used to study in the library with my friends. I see everyone studying and that encourages me to study as well.” (Student – FDG 2)
Faculty members believed that nurturing communication skills in medical undergraduate students through physical interaction is crucial for them to be prepared to face patients in the future.
“Medical students are not supposed to just acquire knowledge in online sessions, but they also need to learn communication skills through direct (face-to-face) interaction with their colleagues and teachers. They need that … they will face people and interact with patients.” (Faculty member – FGD 1)
Theme (4): Problems and challenges of online examinations:
Faculty members were concerned about the quality of the examinations held online and whether the online examinations can properly assess students’ knowledge. The first concern about examinations was whether the student knowledge has improved as reflected by the inflated marks they get in online examinations. Faculty members believed that students were securing about most of the marks in their multiple-choice question-based examinations because these were much easier compared to on campus examinations conducted before. Another participant informed that almost one third of the students could secure full marks, which has never happened before. Participants justified the inflated results by the fact that the online examinations do not contain supply-type questions in which students used to lose marks. A faculty member believed that the inflated marks could also have resulted from the online assessment of some clinical skills, in which students received higher marks.
“I do not believe that whatever the quality of the multiple-choice exams we prepare we can be confident that the real achievement of the learning outcomes by the students is guaranteed. Other question types and assessment methods are always needed.” (Faculty member – FGD 1)
Students were concerned about the online examinations as they appeared to be dissatisfied with the time allocated for completing them, which is shorter than in the normal conditions where the exams are on campus and proctored. Another issue they identified was that they were not able to go back to a previous question to correct it whenever needed, a feature that was adjusted in the online examinations platform to prevent or reduce cheating possibilities.
“In an exam, we were given 40 questions in one hour, so we have to give each question one and a half minutes, which was not sufficient for answering some complex questions.” (Student – FGD 1)
Theme (5): Technical issues and challenge of online education:
Communication technology issues were listed, by both the faculty members and students alike, as one of the main challenges of online education that took place in response to the sudden shift from face-to-face to online education. Initially, faculty members were recording their lectures through adding voice to the PowerPoint slides and sharing the recording with the students through cloud sharing platforms. Faculty members termed this initial interaction with students as “not actually virtual teaching” but rather a teaching based only on “recordings”. Challenges of recordings included issues with the length and quality of videos and voice as well as inability of the students to ask questions. Shortly, faculty members started to conduct synchronous live sessions with their students, where they could interact with them and could answer their questions and provide further instructions whenever needed. The important issue that popped up at that stage was the unstable internet speed that affected the live streaming of educational sessions. Faculty members and students reported that dealing with online education was not difficult, although the transition was not smooth.
“I always make sure my students can hear me before I go on and on in the session. It is important to guarantee every single student is following instruction.” (Faculty member – FGD 1)