Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : January | Volume : 16 | Issue : 1 | Page : JC01 - JC04 Full Version

Effectiveness of Self-paced and Instructor-led Online Learning: A Study among Phase I Medical Students


Published: January 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/51778.15837
Rose Babu, Biju Bahuleyan, Pallavi Panchu, AV Shilpa, CK Sreeja, Dimple John Manjuran

1. Assistant Professor, Department of Physiology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India. 2. Professor, Department of Physiology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India. 3. Professor, Department of Physiology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India. 4. Associate Professor, Department of Physiology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India. 5. Assistant Professor, Department of Physiology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India. 6. Assistant Professor, Department of Physiology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.

Correspondence Address :
Dr. Rose Babu,
Assistant Professor, Department of Physiology, Jubilee Mission Medical College
and Research Institute, Thrissur, Kerala, India.
E-mail: rosebabu515@gmail.com

Abstract

Introduction: Online teaching is a crucial challenge in the current pandemic situation. Choosing the right modality for teaching and delivering the information in a very effective manner is critical. Self-paced learning is an important modality that moulds the students into adult learners.

Aim: To compare the effectiveness of teaching modalities like self-paced learning and instructor-led live online lecture class based on performance in assessments.

Materials and Methods: A cross-sectional study was conducted on phase I medical students over a period of three months where they were given self-paced learning and online instructor-led lecture sessions. Topics and reading materials for self-paced learning were provided to the participants through Telegram. After one week they were evaluated using objective-based assessments. Instructor-led live online lecture classes also were taken for them through Impartus followed by assessments. Independent t-test was done to assess the difference between the both performances based on the scores attained.

Results: Total of 86 subjects were included in which 54 were females with mean age 18.75 years and 32 males with mean age 18.84 years. After online lecture sessions, 93.02% (n=80) of students came in the high performers group, while only 65.12% (n=56) of students belonged in self-paced learning sessions. There was no significant difference in performance in both modalities between gender (p>0.05).

Conclusion: Instructor-led live online methods are more effective than self-paced learning. Self-paced learning is also important in education as it enhances the quality of adult learning. Implementing e-learning into the current syllabus can be more productive as it augments student teacher interaction.

Keywords

Medical education, Online teaching modality, Self-directed learning

Training of medical students in the current scenario of the Coronavirus Disease-2019 (COVID-19) pandemic is challenging. The compulsion to train without compromise on quality has resulted in the educators exploring different modalities of e-learning. Sudden shift from the traditional teaching modalities to e-learning platforms has been challenging not just for the educator but also for the students. Learning approaches vary for each student and educators are faced with the task of finding a suitable modality which is beneficial for all types of learners. The present medical curriculum of Competency Based Medical Education (CBME) focuses on attaining competencies and skills for critical analysis of new information, linking the new information to what they already know and utilising this information for problem solving (1). Educating a medical student hence involves a multifaceted approach which could be done with ease in the traditional teaching system. In e-learning, all focus is on the content delivered. Segregating the learning content into “must know” and “nice to know” seems to be the prime responsibility of the educators. But the question of how these contents are delivered seems to be evaded by most educators. Some studies have explored into the merits and demerits of online education and the importance of forming an effective method of content delivery (2),(3).

The present scenario of the pandemic has led to the rise of various educational platforms where the content is being delivered using multiple modalities (4),(5). The manner in which the educational content is delivered can create a massive difference in how knowledge is acquired and retained by the learner. Few researchers have explored in discovering the most fruitful method of conveying the information. White LJ et al., have compared face to face lectures and online delivery of content through videos and learning modules and found no difference in students’ performance (6). Root WB and Rehfeldt RA compared on campus lecture and online lectures based on evaluation of quizzes conducted and supported the potential of online lecture. Their study highlighted the importance of implementing online studies into the curriculum (7). The students, are used to the presence of a facilitator in their learning process, we as educators being concerned regarding how they would fare, if the learning process was left to them. The present study was planned based on this backdrop.

Medical students being adult learners, self-paced learning or Self-Directed Learning (SDL) seems to be a promising approach as each learner can decide the pace of his or her learning (8). A self-paced learning is a type of learning, where a particular amount of work is completed at their own pace without any guidance from the faculty (9). Instructor-led learning is one of the familiar methods of learning in which an instructor or faculty facilitates the teaching session for a group of students. The students are able to have an opportunity to discuss or learn from the faculty during the session itself. Various elements can be incorporated of learning like discussion, hands on training, group activities during the session (10). Hence, the aim of this study was to compare the effectiveness of self-paced learning and instructor-led live online lectures based on the performance of students in assessments.

Material and Methods

This cross-sectional study was conducted among Phase I MBBS students of Jubilee Mission Medical College and Research Institute, in Thrissur, Kerala, India, in the year 2020 for a duration of three months, (April-June, 2020). Convenient sampling method was used and all 100 medical students of Phase I who were willing and gave consent to participate in the study were recruited. This study was approved by the Institutional Ethics Committee (IEC) (27/20/IEC/JMMC&RI). Students were provided with self-paced learning sessions and online lecture sessions for which they were evaluated. Performance of the students in both sessions were analysed.

Inclusion criteria: Phase I MBBS students who were willing to participate in the study.

Exclusion criteria: Students who were not willing to participate or who did not have access to the network connection for participating in online sessions were excluded.

Self-paced Learning

A Telegram group was formed including all 100 students and the faculty. The self-paced learning was conducted in four sessions. For every session, students were given case-based scenarios regarding particular topic and the literature study materials based on the topic, links for reference from other sources were shared in the group. The topics for four self-paced learning sessions were, regulation of body temperature, taste pathway and modalities, blood brain barrier and cerebrospinal fluid. A gap of one week duration was given between each topic. Three days were provided for preparing each topic. Following this, after each session, they were evaluated by giving an objective type assessment (10 multiple choice questions) through google forms. Students were free to clarify their doubts regarding the case and the topic to the respective faculty directly through telegram or whatsapp. The students were notified regarding the assessment well in advance prior to the announcement of topics. After the evaluation, the list of toppers was displayed in the telegram group and they were appreciated by the faculty. This was how they were motivated.

Instructor-led Live Online Lecture Sessions

Live lecture sessions were conducted online through Impartus (an online learning management software). Interaction and active participation of the students were assured throughout the session where faculties used to ask questions to the students, students were free to ask doubts through available services on the platform. Thus, this provided a platform for open discussions and live interaction. Each lecture session lasted till the end of case discussion and the explanation of the topic regarding the case. Approximately the sessions lasted for 1.5 to 2 hours. The live lecture sessions were conducted online, where faculty could observe each student through webcam. At the beginning, the faculty provided a clinical case scenario to the students through a presentation. The students’ participation was monitored throughout the lecture. Cases like spinal cord injuries, Parkinsonism, referred pain, abnormalities in vision were given for lecture sessions.

For example, a 72-year-old man came to the medicine Out Patient Department (OPD), complaining of weakness. On examination, the doctor observed pill rolling tremors, mask like face and cogwheel rigidity. He was walking with mild forward bend posture and short steps”. The students were asked to comment and give justification regarding the diagnosis. This was followed by giving detailed lectures on the topics and the physiology of the systems involved in particular to the case scenario. Students who participated well in class activity were appreciated and bonus points were awarded.

Evaluation: Online lecture and self-paced learning sessions were evaluated by objective type assessments, which was conducted online using google forms. The questions were of cased scenario based type to evoke their higher order thinking. Difficulty indexes of the questions were taken into account. The faculty in the department framed the questions. A total of 15 questions were framed from each topic and each question carried one mark.

The order of the questions was changed using the shuffling option in the platform. The questions were given at 10 am in the morning and they had to submit the answers by evening 10 pm. The students were divided into four groups as high performers (>75%), medium performers (>65-75%), average performers (50-65%) and very low performers (<50%) based on their scores in assessments following self-paced learning and online lecture sessions.

Statistical Analysis

The performance of the assessments was tabulated in a spreadsheet. The normality of the data was checked using Q-Q plot and it was normally distributed. The difference between the performances of students after going through the above teaching modalities was done using Paired t-test. Independent t-test was performed to explore the difference in performances between male and female students. Pearson’s correlation was performed to find the correlation between self-paced learning and online lecture sessions of students. The p-value of <0.05 was taken as significant. The data was analysed using Statistical Package for the Social Sciences (SPSS) software version 20.0.

Results

All phase I MBBS students participated in this study and the data of 14 students were excluded for the study as they missed few assessments. For analysis, the final sample included 54 females (mean age=18.75 years) and 32 males (mean age=18.84 years). After online lecture sessions, 93.02% (n=80) of students came in the high performers group, while only 65.12% (n=56) of students belonged in self-paced learning sessions (Table/Fig 1). The percentage of very low performer students was almost equal after both sessions.

The score attained by the students is exhibited in (Table/Fig 2) and it shows that the score attained after the online lecture session was significantly higher than after the self-paced learning session (p<0.001). This pattern was similar even when compared in males and females separately.

The scores obtained have been compared between female and male students are shown in (Table/Fig 3). It shows no significant difference in both self-paced learning and online lecture sessions (p=0.08 and 0.12, respectively).

The correlation between self-paced learning and online lecture sessions of the students have been illustrated in (Table/Fig 4). (Table/Fig 5) depicts the correlation between two learning methods within gender and shows that male students have a stronger correlation (Pearson’s correlation) (r=0.82) than females (r=0.62).

Discussion

Online training in medical education is the least explored area. The current scenario of the COVID-19 pandemic has opened up areas to examine and explore this method of teaching and learning. The present medical curriculum, CBME, focuses on the attainment of competencies by a medical graduate (1). Online education is challenging to both the students and the faculty in terms of how to deliver the knowledge in an effective way. An effective teaching methodology should be in such a way that the students should be able to process the information and apply that knowledge. Hence, the focus should not be on the content delivery alone but also in the process of how the content is being delivered (11).

The prime focus of the present study was to determine which process of e-learning is beneficial to the students. In this study, self-paced e-learning and instructor-led online lecture was compared based on the performances in the assessments. The primary outcome of the study was that the performances of the students were significantly higher for instructor-led modality than for the self-paced learning method and a greater percentage of students belonged to the high performers group after the instructor-led modality.

A previous study done by Pai KM et al., has found that Self-Directed Learning (SDL) was as effective as a lecture session in acquiring information as there was no significant difference between the mean scores of a group that underwent SDL and the other group that underwent lecture with SDL (12). In this study, the mean score after the online lecture session was significantly higher than after the online self-paced learning session, which shows that the students were able to grasp the information better after the lecture session. When we looked into the difference between the performance in the sessions among females and males students separately, the result was similar and hence, it can be concluded that it has no association with gender.

In the present study, it was found that most of the students (93.02%) belonged to the high performers group after the online instructor-led session whereas only 63.12% of students categorised into this group after the online self-paced learning session. This was contradicting the results shown by Pai KM et al., where there was no difference between the groups in categories like high medium or low (12). There were an equal proportion of students, when looked into the low performer group. In few other studies, the self-instructed group of students outperformed the students in the lecture group comparing the pre and post-test outcomes (13),(14).

When compared between females and male students, there was no significant difference in performance in online self-paced learning and online instructor-led sessions separately this finding was in par with another study done by Premkumar K et al., (15). This states that students in both sexes have equal capacity in comprehending the information even if self-paced. Gyawali S et al., also expressed that there is no significant difference between gender on acceptance of SDL (16).

The correlation between the two sessions based on the performance of all the students was shown and it exhibited that there was no strong correlation (r=0.66). There was a big cluster in the graph which says that some of the students performed better after both sessions. A group of students performed better after the online instructor-led session but not in the self-paced learning session. This reveals that the dependence on self-paced learning completely for delivering information cannot be advisable. This also depends on the topics involved because some of them require application of knowledge for clinical and practical purposes. Certain topics needed an additional effort and guidance from facilitators as well. Raupach T et al., have found in their study that for delivering information regarding an applied technical procedure like Electrocardiogram (ECG), a clinical skill, near-peer learning is effective (17). This means that the presence of a facilitator is necessary for understanding certain topics, skills, procedures etc. to increase the efficacy in knowledge delivery. In present study, the difficulty index of the topics involved in self-paced learning and instructor-led sessions were the same. However, the ability and capacity in registering the information might be different for the students.

Self-Directed Learning (SDL) serves as a method, where the medical students, who are lifelong learners, gain the ability as self-learners and it has to be implemented in the education system. It is important that they should be updated with the immense development of scientific knowledge (18),(19). The real question is, whether the students are ready for this quick transition from teacher centered learning methods followed in schools to an adult learning set up in colleges. We can mould them and develop their self-learning ability by giving short topics in the first year of medicine rather than assigning a greater number of topics to them through self-paced learning. Hence, it is better to incorporate both types of modalities like instructor-led sessions and self-paced learning in education. The efficacy of SDL is questionable and doubtful which is exhibited from the performance during the assessments. This could be due to the lack of motivation in students during the course of study as they are locked up in their houses due this current situation. The methods to develop motivation in students can be one of the areas to focus on. Summary of different studies that have compared SDL and lecture methods are given in (Table/Fig 6) (12),(13),(14),(20).

In contrast to present findings, a study done by Peine A et al., found that students who belonged to self-instructed (non guided) group and e-learning group performed better than teacher centered groups (20). This could be because in this study, the investigators gave a single topic for a duration of four weeks whereas in present study, several topics were covered in a short time which could have affected the students who were slow learners. Learning a topic by self-paced learning requires more time when compared to a teacher centered learning (21),(22). In India, the duration of medical course is 4.5 years and in Phase I the duration is hardly a year where the entire topics of basic subjects like anatomy, physiology and biochemistry is covered. The students will find it difficult to acquire a vast knowledge in a short period of time. Implementing online self-paced learning only in the current scenario would be not feasible.

A study done by Rafi AM et al., on conventional methods of teaching in medical students based on feedback from them, found that students prefer an online learning platform as a student friendly platform, where the teacher could interact with the students and students were able to participate actively throughout the lecture (5). Therefore, even after the present pandemic situation reverses back to the earlier set up, blended learning or incorporating e-learning into the education system is important. Usage of student friendly e-learning methods can increase student and teacher interaction compared with big classroom lectures. It will be an opportunity for the students who are not open enough to interact with teachers in front of the crowd.

Limitation(s)

The students’ ability in grasping the knowledge is variable. Some students are motivated whereas others are least encouraged in self-paced learning especially in the current situation, being at their comfortable zone as in home environment may not be feasible for few students to get into a learning atmosphere. In this study, all the students could not be included as some of them missed some sessions and the topics assessed were also limited.

Conclusion

Instructor-led method of learning is more fruitful than self-paced learning which was based on the scores attained in the assessments. There was no difference in the scores attained when males and females were compared. Learning difficult topics that require guidance have to be considered and to augment student teacher interaction implementing blended learning could be a better choice. The method of self-paced learning can be started from school level itself, thus can help develop the students’ capability to get self-motivated and self-learn. Building up motivation in students in this current lockdown situation has to be focused on. Further studies have to be done to find out an effective method of delivering the online lecture using the latest technologies in a multicentric set-up that augment their motivation in learning.

Acknowledgement

Authors thank the participants who took part and gave their valuable contributions in the study.

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DOI and Others

DOI: 10.7860/JCDR/2022/51778.15837

Date of Submission: Aug 07, 2021
Date of Peer Review: Oct 11, 2021
Date of Acceptance: Nov 29, 2021
Date of Publishing: Jan 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 11, 2021
• Manual Googling: Nov 16, 2021
• iThenticate Software: Dec 07, 2021 (7%)

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