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

Users Online : 51578

AbstractMaterial and MethodsResultsDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

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 : March | Volume : 16 | Issue : 3 | Page : IC01 - IC06 Full Version

Perceptions and Experience of Medical Students Regarding E-learning during COVID-19 Lockdown: A Cross-sectional Study


Published: March 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/54803.16051
Manisha Bhardwaj, Surender Kashyap, Deepak Aggarwal, Rajesh Bhawani

1. Assistant Professor, Department of Pulmonary Medicine, Shri Lal Bahadur Shastri Medical College and Hospital, Mandi, Himachal Pradesh, India. 2. Vice Chancellor, Atal Medical and Research University Campus, Shri Lal Bahadur Medical College and Hospital, Mandi, Himachal Pradesh, India. 3. Associate Professor, Department of Pulmonary Medicine, Government Medical College and Hospital, Chandigarh, Punjab, India. 4. Professor and Head, Department of Internal Medicine, Shri Lal Bahadur Shastri Medical College and Hospital, Mandi, Himachal Pradesh, India.

Correspondence Address :
Dr. Surender Kashyap,
Vice Chancellor, Atal Medical and Research University Campus, Shri Lal Bahadur
Medical College and Hospital, Mandi-175008, Himachal Pradesh, India.
E-mail: surenderkashyap@hotmail.com

Abstract

Introduction: Medical education has been adversely affected during Coronavirus Disease-19 (COVID-19) pandemic. Imparting medical education through e-platforms exclusively was a novel experience both for students and teachers. Even though online classes have been ongoing since almost one and half year, not much data on perception and experience about e-learning among medical students is available from India.

Aim: To evaluate perceptions, experiences and challenges faced by medical students regarding e-learning during lockdown period owing to COVID-19 along with their future preferences.

Materials and Methods: The present study was a questionnaire based cross-sectional survey regarding use of e-learning during COVID-19 pandemic among 340 Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Science Nursing (BSc-NUR) students. It was conducted in the Department of Pulmonary Medicine at Shri Lal Bahadur Shastri Medical College and Hospital Mandi, Himachal Pradesh, India from May 2021 to July 2021. Students perceptions’ of e-learning were assessed using the validated Technology Acceptance Model (TAM) model and responses were measured on 5-point Likert scale. Quantitative data was expressed by mean and standard deviation and significant level of differences between means were tested by Student’s t-test (unpaired). Proportions were compared by Chi-square test or Fisher’s-exact test. A p-value of <0.05 was considered statistically significant.

Results: Out of 400 students, 340 responded of which 225 were females. Of the total 340 students, (n=333; 97.9%) respondents, had an idea of e-learning and more than half (n=188; 55.3%) had used any type of e-learning platform prior to onset of COVID-19. More number of MBBS students had used e-learning than BSc-NUR students (55% v/s 41%; p=0.033). Cell phone was the most common device (n=324; 95.3%) used. The quick sharing of material (n=258; 76%) and flexibility (n=233; 68.5%) were top rated benefits of e-learning. The key disadvantages were suboptimal practical training (n=222; 65.3%) and lack of face-to-face interactions (n=146; 43%). Majority of students voted for traditional learning (n=156; 45.9%) closely followed by blended learning (n=140; 41.2%).

Conclusion: The students had an overall positive attitude towards e-learning and wanted to continue e-learning alongside traditional teaching i.e., blended learning. Exploration of merits and barriers to e-learning during pandemic can act as a guide to implement blended learning in medical curriculum for enhanced teaching/learning experience.

Keywords

Alternative learning, E-platforms, Hybrid learning, Online classes, Pandemic

Coronavirus Disease-2019 (COVID-19), a highly infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), was declared as pandemic by World Health Organisation (WHO) on 31st March, 2020 (1). In view of lack of specific treatment/vaccine for the disease, measures like social distancing, wearing masks and repeated hand washing were implemented worldwide to stop the human to human transmission (2). On similar lines, lockdowns were announced across 107 countries including India that led to closure of all public places including medical institutions across the country which adversely affected teaching and learning activities for a considerably long period (3),(4). In a survey on 440 medical students in 33 United Kingdom (UK) medical schools, it was found that 77.3% respondents had their electives cancelled and 43% of assistant placements were postponed (5).

New modes and tools of delivering education were discovered which helped to continue and impart learning in these unprecedented times. E-learning supposedly turned out to be the powerful medium to mitigate gaps in learning (6). Medical universities like Harvard and Yale considered e-learning as a reasonable alternative during pandemic (7). In a quantitative survey, 65.21% healthcare professionals perceived that e-learning played a major role in minimising the impact of pandemic on medical education (8). Research by Dost S et al., on 2721 medical students across 39 medical schools in the UK also pointed out that integration of technology can enhance teaching/learning experience coupled with benefit of flexibility of time and space (9). Ba?czek M et al., echoed similar benefits of e-learning in a study among polish medical students during COVID-19 lockdown (10).

Most of the literature on e-learning during pandemic has been generated from western studies (5),(9),(10). With difference in infrastructural facilities as well as access, knowledge and awareness about these teaching modes, the results from these studies may not be applicable to Indian settings. Hence, this study was conducted to evaluate the experience, perceptions and challenges faced by medical students regarding e-learning during lockdown period owing to COVID-19.

Material and Methods

The present study was a questionnaire-based cross-sectional observational study conducted in the Department of Pulmonary Medicine at Shri Lal Bahadur Shastri Medical College and Hospital (SLBS GMCH), Mandi, Himachal Pradesh, India from May 2021 to July 2021. The confidentiality and anonymity of participants was maintained. The study was approved by Institutional Ethics Committee (IEC) (letter no. 50).

Inclusion criteria: The study population included all students in second year (batch of 120), third year (batch of 100) and final year (batch of 100) undergraduate medical students (MBBS) as well as second year (batch of 40) and third year (batch of 40) BSc-NUR students, who gave consent to participate in this study.

Exclusion criteria: Students in first year of MBBS and BSc NUR who joined the course in 2021 were excluded as they had no experience of online classes. Those students who refused to participate were also excluded. Moreover, survey forms with incomplete information were not included in analysis.

Sample size: A total of 400 students were enrolled in the study. Forty students did not gave consent to participate in the study. In addition, 20 participants provided incomplete information. Therefore, a total of 340 participants were available for final analysis. Similar sample size was taken in previously published studies also (9),(11),(12).

Data Collection Tools

Questionnaire was developed by two investigators (MB and SK) comprising of 30 questions divided into four sections. The proforma included questions regarding perceptions towards e-learning from validated Technology Acceptance Model (TAM) model which was used in previously published studies also (10),(13),(14),(15). Pilot study was done and tested on 20 students (10 MBBS and 10 BSc-NUR) and modifications were done after incorporating suggestions from respondents. The questionnaire was finalised after inputs from senior medical faculty involved in medical education.

The type of questions included were as follows:

Initial three questions were Yes/No type, open ended and Multiple Choice Question (MCQ) type with multiple correct options. Questions 4-7 and 25-28 were MCQ type. Questions from 8-24 and 29 were 5-point Likert scale response type ranging from strongly disagree to strongly agree and last question was open end type. The yes/no type questions were scored as 0 for unattempted, 1 for no and 2 for yes as responses. For MCQ type, unmarked options were scored as 0 and marked options as 1. The questions regarding perceptions were analysed using 5-point Likert scale with scores 1 to 5 ranging from strongly disagrees to strongly agree. Median scores >2.5 indicated acceptance and below 2.5 indicated refusal. The internal validity of questionnaire was calculated by Cronbach’s alpha coefficient which was 0.89. The open questions were largely pertaining to personal, demographic details and relevant information was added in the text. The last question was an open ended type inviting feedback/suggestions from students to improve learning/teaching experience which is elaborated in the results and discussion.

Each student was given a well-structured questionnaire pertaining to his/her experience and perceptions about e-learning during COVID-19 times when campus teaching was suspended for almost a year. The questionnaire was pertaining to four major parameters.

I. Personal information and demographic details (First part).
II. Knowledge and practices of e-learning before and after lockdown period (seven questions). Live classes were suspended in the institution from March 2020 to March 2021 which was taken as lockdown period where teaching activities were conducted primarily through online classes.
III. Students’ perception of e-learning was measured by four sub constructs (15 questions); perceived usefulness, perceived self-efficacy, perceived ease of use, perceived attitude and intention to use. The questions were based on validated TAM model for exploring factors that affect students’ acceptance and use of e-learning as a teaching tool (14).
IV. Experiences of institutional online classes during lockdown period including various facilitating and hindering factors for satisfactory experience and future preferences (eight questions).

Statistical Analysis

Data was recorded on a Microsoft (MS) excel sheet and analysed using Statistical Package for the Social Sciences (SPSS) trial version 20.0 (Chicago, IL). Quantitative data was expressed by mean and standard deviation and significant level of differences between means were tested by Student’s t-test (unpaired). Proportions were compared by Chi-square test or Fisher’s-exact test. A p-value of <0.05 was considered statistically significant.

Results

Demographic characteristics: Overall response rate was 85% (MBBS= 82.5%; BSc-NUR= 90%). The age of participants ranged from 18 to 25 years. The mean age was 20.5 years. Out of the total 340 participants, 264 were MBBS students, 72 were BSc-NUR students and 1.2% (n=4) students did not specify the course. Females outnumbered males in the ratio of 2:1 (Table/Fig 1). Majority of participants were residents of Himachal Pradesh (n=266) followed by Rajasthan (n-22) and Kerala (n=18). The rest belonged to places as follows: Delhi (n=11), Haryana (n=7), Punjab (n=4), Telangana and Chandigarh (n=2 each), Uttar Pradesh, Uttarakhand, Maharashtra and Tamil Nadu (n=1 each). Four students did not mention their place of residence.

Knowledge about e-learning prior to COVID-19 lockdown: Majority of the participants (n=333, 97.9%) had some level of knowledge about e-learning. Majority of students (n=258; 75.9%) thought that online learning is same as e-learning. Almost half of them (n=188, 55.3%) had used any type of e-learning platform prior to onset of COVID-19. Its use was more common among MBBS than BSc-NUR students (55% v/s 41%; p=0.033). Mobile phone was the most common mode of e-learning (95.3%; n=324) followed by laptop (14.1%; n=48). The question regarding use of devices was a MCQ type and responses were not mutually exclusive (Table/Fig 1).

E-learning during COVID-19 lockdown: Google-meet was the most common online platform (n=300; 88.2%) used for online teaching by the students followed by Zoom (n=213; 62.6%) (MCQ type question). There was no difference in the usage of Google-meet between MBBS students and BSc-NUR students (91.6% v/s 87.5%. p=0.40). The platforms were mainly used for online lectures (n=238; 70%) and online tests (n=206; 60.6%)

Perceptions about e-learning among the students: Perception of students about e-learning was evaluated using 15 questions based on 5-point Likert scale. The responses for each question were calculated and analysed separately. Ability to take tests and submit assignments electronically (mean 3.79), to study at any location (mean 3.78) and ability of interactive communication (3.73) were the top 3 ranked perceptions that influenced the overall perception. Details are given in (Table/Fig 2).

Mean score of the participant’s perception was 3.29±0.65. On statistical terms, 145 (42.6%) subjects had a mean score above 3.40 indicating positive perception for e-learning. Moreover, there was no difference in the mean score between MBBS and BSc-NUR students (MBBS mean score 3.30±0.67 v/s BSc-NUR mean score 3.20±0.53; p=0.18).

Experience of Institutional Online Classes during Lockdown

Advantages and disadvantages: Ability for easy and quick sharing of educational material and flexibility in time and space were among the most common advantages of e-learning perceived by 75.9% (n=258) and 68.5% (n=233) of the participants, respectively. The key disadvantages of e-learning were suboptimal practical training (65.3%, n=222) and lack of face-to-face interactions (43%, n=146). Details are given in (Table/Fig 3).

Challenges faced by the students: Poor internet signal (57.1%, n=194) was the topmost challenge reported by respondents while attending institutional online classes. A 144 (42.4%) of students felt that they had low motivation to use e-platforms while others reported lack of conducive atmosphere at home (55.9%, n=190) and distraction issues while using media apps (63.2%, n=215) which hampered their learning. A significant number of students (49.7%, n=169) reported health issues like headache and fatigue while using digital platforms for duration longer than their usual routine. A 57.1% (n=194) students admitted that they copied assignments and evaluation process was not upto the mark (63%, n=214) which hindered their preparation for future examinations.

Overall attitude towards e-learning: Overall, students had a positive attitude towards usage of e-learning. They felt that it was underutilised in medical education and would use it to assist learning in future. Though traditional teaching remained the favourite, a significant number liked the idea of hybrid education or blended learning. However, exclusive online learning was advocated by 30 (8.8%) of the participants only (Table/Fig 4). One question pertaining to use of e-learning in module teaching was dropped from analysis as majority of participants did not attempt the question.

Feedback/Suggestions by students: The last question in the proforma was an open ended question inviting feedback/suggestions to improve online teaching/learning experience and is shown in (Table/Fig 5).

Discussion

Institutional e-learning had to be made mandatory for the first time during the lockdown although it has also been sparingly utilised in medical field, previously. In this study, majority were female students. Similar findings have been reported by others also (10),(15). The reasons could be that all BSc-NUR students were females and more females opted for participation in the survey. The present study showed that majority of students (97.9%) had some knowledge about e-learning. A study by Olum R et al., revealed that the awareness rates were similarly high in Makerere University in Uganda (96%) (16). However, Alqahtani N et al., reported that in a medical school in Saudi Arabia only 62% of students of health sciences had a concept of e-learning (17). More than 90% of students reported use of smartphones in this study probably due to its multipurpose utility. So, it became obvious that new models of e-learning adopted at institutional level should be compatible with smartphones and or laptops.

The advantages reported by students such as quick sharing of educational material, flexibility of time and space corroborated with findings of Buch AC et al., (18). Lack of face-to-face interactions with patients was the major limiting factor observed in this study. Further, e-learning was perceived to be ineffective in acquiring clinical skills. Similar concerns were reported previously also; both before and during COVID-19 pandemic (10),(19),(20),(21). In this survey, students from both courses had an overall positive outlook towards e-learning as a teaching aid which was in line with other studies conducted during lockdown period (15),(22),(23). However, parallel surveys by Abbasi S et al., from Pakistan and Olum R et al., from Uganda reported contradictory results (11),(16). The plausible reasons for difference in perceptions could be uniqueness of medical curriculum (blend of knowledge acquisition and skill training), sense of familiarity and comfort with traditional teaching methods, awareness and availability of gadgets, infrastructure or internet issues especially in developing nations (17),(21),(24).

The present study emphasised that blended learning was popular among medical students and closely followed traditional teaching as future preference. Similar findings were reported in previous studies from India and other countries (10),(13),(18),(21). Also, blended learning has an advantage of face-to-face interaction coupled with benefits of autonomy and flexibility associated with e-learning. Search of literature showed that when compared to exclusive online learning, traditional teaching is preferred over by a wide margin (8),(9),(15). However, a study showed that digital lectures could be a satisfactory substitute to classroom teaching in the subject of anatomy (25). The comparative review of literature from similar studies in medical students during COVID-19 pandemic has been summarised in (Table/Fig 6) (8),(9),(10),(11),(12),(15),(16),(18),(21),(22),(23),(26),(27).

E–learning has a potential to enrich teaching/learning experience in medical field (24). But, inculcation of e-learning in medical curriculum requires meticulous planning and such surveys can help a great deal in identifying areas that need consideration for satisfactory experience. Evidence from literature showed that students echoed similar feedback/suggestions for successful implementation of e-learning (8),(15),(18),(22). Competency Based Medical Education (CBME) which has been introduced in India for undergraduate level of MBBS course can set the stage for necessary changes to make e-learning/blended teaching an established pedagogic tool. It is learner-centered competency based training that allows vertical and horizontal integration of subjects for better understanding. Learning is divided into four domains (knowledge, skill, attitude, and communication) and five levels of competencies (knows, knows how, shows, shows how and performs). It also aims to boost communication skills (28),(29). There is an urgent need to restructure/modify the curriculum to make the e-learning a viable platform even for regular teaching and training sessions in different disciplines of medical sciences. The suggested framework for e-learning in a teaching institution for implementation of CBME is depicted in (Table/Fig 7) (18),(26),(30).

Limitation(s)

Feedback from teachers regarding use of e-learning during COVID-19 pandemic was not taken in the study. It could have provided a comprehensive analysis of the issue. Further, deficiency in infrastructure and technical support including internet availability could have affected perceptions of students regarding use of e-learning as teaching aid. More surveys with larger sample involving students from other disciplines such as dentistry, physiotherapy, laboratory technology etc., can help in better understanding of scope of e-learning in various disciplines of medical sciences.

Conclusion

E-learning became a popular pedagogical tool to minimise gaps in learning during COVID-19 pandemic. It allows quick sharing of information and gives the advantage of flexibility of time and space. However, students missed face-to-face interactions and felt that practical training was compromised. The students had an overall positive attitude towards e-learning and wanted to continue e-learning alongside traditional teaching i.e., blended learning. It is high time that concrete steps are taken to formally incorporate e-learning in medical curriculum for enriched teaching/learning experience.

References

1.
COVID 19 Strategy Update- 14 April 2020 [Internet]. [cited 2021 Aug 1]. Available from: https://www.who.int/publications/i/item/covid-19-strategy-update---14-april-2020.
2.
Lau H, Khosrawipour V, Kocbach P, Mikolajczyk A, Schubert J, Bania JKT. The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China. J Travel Med. 2020;27(3):taaa037. [crossref] [PubMed]
3.
Gupta R, Pal SK, Pandey G. A comprehensive analysis of COVID-19 outbreak situation in India. medRxiv. 2020;2020.04.08.20058347. [crossref]
4.
Education: From Disruption to Recovery [Internet]. [cited 2021 Aug 1]. Available from: https://en.unesco.org/covid19/educationresponse.
5.
Choi B, Jegatheeswaran L, Minocha A, Alhilani M, Nakhoul M, Mutengesa E. The impact of the COVID-19 pandemic on final year medical students in the United Kingdom: A national survey. BMC Med Educ. 2020;20(1):01-11. [crossref] [PubMed]
6.
Giliyaru S, Hegde G, Gajjala S, Vemuri O, Azzopardi C, Hurley P. COVID-19 pandemic and medical education. Indian J Med Sci. 2021;73(1):64-65. [crossref] [PubMed]
7.
COVID-19-Moving Classes Online, Other Updates- Covid-19 Information [Internet]. [cited 2021 Aug 1]. Available from: https://www.harvard.edu/coronavirus/covid-19-moving-classes-online-other-updates/.
8.
Syed S, Rastogi A, Bansal A, Kumar A, Jindal A, Prakash A, et al. Future of e-learning in medical education-perception, readiness, and challenges in a developing country. Front Educ. 2021;6:598309. [crossref]
9.
Dost S, Hossain A, Shehab M, Abdelwahed A, Al-Nusair L. Perceptions of medical students towards online teaching during the COVID-19 pandemic: A national cross-sectional survey of 2721 UK medical students. BMJ Open. 2020;10(11):e042378. [crossref] [PubMed]
10.
Baczek M, Zagańczyk-Baczek M, Szpringer M, Jaroszyński A, Wozakowska-Kaplon B. Students’ perception of online learning during the COVID-19 pandemic: A survey study of Polish medical students. Medicine (Baltimore). 2021;100(7):e24821. [crossref] [PubMed]
11.
Abbasi S, Ayoob T, Malik A, Memon SI. Perceptions of students regarding e-learning during COVID-19 at a private medical college. Pakistan J Med Sci. 2020;36(COVID19-S4):S57-61. [crossref]
12.
Gismalla MDA, Mohamed MS, Ibrahim OSO, Elhassan MMA, Mohamed MNE. Medical students’ perception towards e-learning during COVID 19 pandemic in a high burden developing country. BMC Med Educ. 2021;21(1):377. [crossref] [PubMed]
13.
Khan MA, Vivek, Nabi MK, Khojah M, Tahir M. Students’ perception towards e-learning during COVID-19 pandemic in India: An empirical study. Sustain. 2021;13(1):1-14. [crossref]
14.
Mlekus L, Bentler D, Paruzel A, Kato-Beiderwieden AL, Maier GW. How to raise technology acceptance: User experience characteristics as technology-inherent determinants. Grup Interaktion Organ Zeitschrift fur Angew Organ. 2020;51(3):273-83. [crossref]
15.
Gupta S, Dabas A, Swarnim S, Mishra D. Medical education during COVID-19 associated lockdown: Faculty and students’ perspective. Med J Armed Forces India. 2021;77(Suppl 1):S79-84. [crossref] [PubMed]
16.
Olum R, Atulinda L, Kigozi E, Nassozi DR, Mulekwa A, Bongomin F, et al. Medical education and E-Learning during COVID-19 pandemic: Awareness, attitudes, preferences, and barriers among undergraduate medicine and nursing students at Makerere University, Uganda. J Med Educ Curric Dev. 2020;7:2302120520973212. [crossref] [PubMed]
17.
Alqahtani N, Innab A, Bahari G. Virtual education during COVID-19: Exploring factors associated with E-Learning satisfaction among Saudi nursing students. Nurse Educ. 2021;46(2):E18-22. [crossref] [PubMed]
18.
Buch AC, Rathod H, Kamble R. E-learning: The scenario during COVID-19 Pandemic. J Med Educ. 2020;19(2):e107227. [crossref]
19.
Caroro RA, Jomuad MT, Lumasag JM. Effectiveness of online learning system as a supplemental pedagogical tool. J Multidiscip Stud. 2013;2(1):2350-7020. [crossref]
20.
Vitoria L, Mislinawati M, Nurmasyitah N. Students’ perceptions on the implementation of e-learning: Helpful or unhelpful? J Phy Conf Ser. 2018;1088 012058. [crossref]
21.
Abbasi MS, Ahmed N, Sajjad B, Alshahrani A, Saeed S, Sarfaraz S, et al. E-Learning perception and satisfaction among health sciences students amid the COVID-19 pandemic. Work. 2020;67(3):549-56. [crossref] [PubMed]
22.
Alsaywid B, Lytras MD, Abuzenada M, Lytra H, Sultan L, Badawoud H, et al. Effectiveness and preparedness of institutions’ E-Learning methods during the COVID-19 pandemic for residents’ medical training in Saudi Arabia: A pilot study. Front Public Heal. 2021;9:707833. [crossref] [PubMed]
23.
Puljak L, Čivljak M, Haramina A, Mališa S, Čavić D, Klinec D, et al. Attitudes and concerns of undergraduate university health sciences students in Croatia regarding complete switch to e-learning during COVID-19 pandemic: A survey. BMC Med Educ. 2020;20(1):416. [crossref] [PubMed]
24.
Dhir SK, Verma D, Batta M, Mishra D. E-learning in medical education in India. Indian Pediatr. 2017;54(10):871-77. [crossref] [PubMed]
25.
Singh A, Min AKK. Digital lectures for learning gross anatomy: A study of their efficacy. Korean J Med Educ. 2017;29(1):27-32. [crossref] [PubMed]
26.
Alsoufi A, Alsuyihili A, Msherghi A, Elhadi A, Atiyah H, Ashini A, et al. Impact of the COVID-19 pandemic on medical education: Medical students’ knowledge, attitudes, and practices regarding electronic learning. PLoS One. 2020;15(11):e0242905. [crossref] [PubMed]
27.
Essilfie AA, Hurley ET, Strauss EJ, Alaia MJ. Resident, fellow, and attending perception of E-Learning during the COVID-19 pandemic and implications on future orthopaedic education. J Am Acad Orthop Surg. 2020;28(19):e860-64. [crossref] [PubMed]
28.
Bhardwaj M, Kashyap S, Aggarwal D. The impact of COVID-19 on medical education: An indian perspective. Int J Anatomy, Radiology Surg. 2021;10(4):AM01-04. [crossref]
29.
Basheer A. Competency-based medical education in India: Are we ready? J Curr Res Sci Med. 2019;5(1):01-03. [crossref]
30.
National Medical Commission. Module on Online Learning and Assessment. New Delhi. 2020;1-57.

DOI and Others

DOI: 10.7860/JCDR/2022/54803.16051

Date of Submission: Jan 07, 2022
Date of Peer Review: Jan 24, 2022
Date of Acceptance: Feb 08, 2022
Date of Publishing: Mar 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. No

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 12, 2022
• Manual Googling: Feb 07, 2022
• iThenticate Software: Feb 11, 2022 (19%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com