ABSTRACT
Introduction: In-class engagement enhances learning and can be measured using observational tools. As the COVID-19 pandemic shifted teaching online, we modified a tool to measure the engagement of instructors and students, comparing in-person with online teaching and different class types. Methods: Video recordings of in-person and online teachings of six identical topics each were evaluated using our ‘In-class Engagement Measure’ (IEM). There were three topics each of case-based learning (CBL) and lecture-based instruction (LLC). Student IEM scores were: (1) no response, (2) answers when directly questioned, (3) answers spontaneously, (4) questions spontaneously, (5) initiates group discussions. Instructor IEM scores were: (1) addressing passive listeners, (2) asking ≥1 students, (3) initiates discussions, (4) monitors small group discussion, (5) monitoring whole class discussions. Results: Twelve video recorded sessions were analysed. For instructors, there were no significant differences in percentage time of no engagement or IEM scores when comparing in-person with online teaching. For students, there was a significantly higher percentage time of no engagement for the online teaching of two topics. For class type, there was overall less percentage time of no engagement and higher IEM scores for CBL than LLC. Conclusion: Our modified IEM tool demonstrated that instructors’ engagement remained similar, but students’ engagement reduced with online teaching. Additionally, more in-class engagement was observed in CBL. “Presenteeism”, where learners were online but disengaged was common. More effort is needed to engage students during online teaching. © 2022 TAPS. All rights reserved.
ABSTRACT
Objective: To describe the neurological disorders associated with COVID-19 in Singapore. Background: Various neurological disorders have been reported in COVID-19 patients. Postulated mechanisms include hypercoagulopathy, dysimmunity, inflammation and direct viral invasion. The incidence and relationship to SARS-CoV-2, considering the confounding effect of a surge in COVID-19 cases on healthcare systems, are unclear. Design/Methods: This was a prospective, nation-wide, multi-centre, cohort study of patients with microbiologically-confirmed COVID-19 referred for any neurological complaints With in 3 months of infection. Neurological diagnoses and relationship to COVID-19 were made by consensus guided by contemporaneous published case definitions. Results: Between March-July 2020, 47,572 patients [median age 34 (1-102) years, 98% males] were diagnosed with COVID-19 in Singapore. Of 90 patients referred for neurological disorders, 39 [median age 41 (27-73) years, 97% males] were deemed related to COVID-19 and categorised as: i) Central nervous system syndromes - 3 encephalitis, 1 acute disseminated encephalomyelitis;ii) Cerebrovascular disorders - 19 acute ischemic stroke/transient ischemic attack (AIS/TIA), 4 cerebral venous thrombosis (CVT) and 2 intracerebral haemorrhage;iii) Peripheral nervous system - 7 mono/polyneuropathy;iv) Autonomic nervous system - 4 limited dysautonomia. Fifty-one other patients had pre/co-existent neurological conditions (headache, seizure, mononeuropathies and functional neurological disorders) unrelated to COVID-19. Encephalitis is delayed, occurring in critical COVID-19, while CVT and dysautonomia occurred relatively early and largely in mild infections. AIS/TIA was variable in onset;remarkably 63.2% had asymptomatic COVID-19. CVT was more frequent than expected and occurred in patients with mild/asymptomatic COVID-19. The pathophysiology of COVID-19 neurology appeared to be dysimmunity and/or prothrombotic tendency. There were no neurological complications in all 81 paediatric COVID-19 cases. Conclusions: COVID-19 neurology has a wide spectrum of dysimmune-thrombotic disorders. The relatively few cases recorded was probably because our outbreak affected mainly healthy young men with mild/asymptomatic COVID-19 and the pandemic did not unduly affect the Singapore healthcare system.