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Introduction: The problem caused by the COVID-19 pandemic led teachers to use different tools to measure the learning process of students in a socially distanced context. For this reason, during the 2019-20 academic year, the teachers at the Faculty of Pharmacy, University of Alcal, Spain, had to come up against the challenge of establishing a consistent, systematic and rigorous online evaluation system to screen which students had the competences and skills demanded by current regulations. Method(s): A survey was designed using Google forms and addressed, from the Dean's office, to professors and lecturers of the five undergraduate courses, concerning the type of evaluation tools that they were going to use with the students in order to proceed with a sound evaluation, taking into account that data protection regulations had to be respected, rigorously. Result(s): Doubts were raised about integrity and ethics when carrying out the different online evaluation tests. News appeared in the media and social networks about how to know the correct answers in a questionnaire through its source code, by hiring experts who solve the exams, or doing the activities together using the versatility of social networks that allow simultaneous collective interaction, etc. In this survey, in addition to indicating the number of tests to be performed, the teachers informed the authors about the tools available for use: short answer questions, multiple choice tests, essay or interrelated concepts questions with clear evaluation rubrics, reflection on practical cases, open-book exams. Conclusion(s): All teachers learned and adapted quickly to the different assessment tools available on the Blackboard platform according to the characteristics of the course and considered that the pandemic has opened a critical window for innovative technology based-assessment methodologies.
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Objective: Maternal mortality in the United States (US) is rising and many deaths are preventable. We sought to determine the efficacy of virtual simulation training to optimize management of obstetric emergencies within low and moderate volume delivery hospitals that are disproportionately affected by adverse maternal outcomes. Study Design: The educational platform was designed and deployed within urban non-teaching and rural hospitals, with low and moderate delivery volumes, in the US during the COVID-19 pandemic. Self-paced, interactive, online didactics on postpartum hemorrhage and hypertensive disorders of pregnancy were followed by two, 2-hour live virtual simulation trainings and debriefings. In this innovative simulation modality, participants verbalized actions to their co-participants and the simulation faculty as scenarios evolved with images, vitals and videos displayed on a PowerPoint. Participants completed multiple-choice questionnaires and confidence and attitude surveys prior to, immediately after and 3-months post-training. The multiple-choice questions were evidence-based using information from published guidelines and were validated by local experts. Paired t-tests were performed to asses for changes in knowledge and confidence. Result(s): From December 2021 to March 2022, four hospitals received training (Table 1). Participants (n=22) were comprised of nurses (59%), certified nurse midwives (14%) and attending physicians (23%) in Obstetrics, Family Practice or Anesthesiology. The survey response rate was 59%. The mean difference in knowledge and confidence scores significantly improved immediately post-training compared to baseline (P < 0.05 for all, Table 2). This improvement was maintained 3 months following the training. Participants reported their preferred training format was hybrid (43%), virtual (35.7%) or in-person (21.4%). Conclusion(s): Virtual obstetric simulation is feasible and improves knowledge and confidence, which can be retained over time. This educational modality is sustainable, scalable and an accessible format to enhance education and training. [Formula presented] [Formula presented] Copyright © 2022
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Aim: Our study aims at analysing the undergraduate students' perspective of online ophthalmology classes during the Covid 19 pandemic. Settings and Design: The study is a descriptive cross-sectional observational analysis conducted in the month of June 2021 at Medical College, Karnataka, India. Material(s) and Method(s): An online self-completion questionnaire containing 13 questions was sent through Google forms. 346 medical students of third and final year, who have completed or undergoing online ophthalmology classes were included in the study. Most of the questions were semi open question. Link to the questionnaire was sent through the WhatsApp group and was available to them for a period of two weeks. Result(s): The online survey questionnaire was responded by 237 students.166 students (70%) did not have any online learning experience before the pandemic. Majority of the students preferred problem-based learning 92 (27.62%) over other methods. Benefit of reading the study material at own pace was perceived as the prime advantage of online classes. Poor internet connectivity was opted as the major hurdle (170-35%) of the online classes. Multiple choice questions were the most preferred method of online assessment (150 -41.32%). 105 students (44.3%) felt that the ophthalmological clinical skills were learnt better by attending clinical postings. Majority of the students (166-70%) favoured classroom teaching over online classes for fruitful learning. Conclusion(s): The COVID-19 pandemic has introduced newer teaching methods in ophthalmology. Most students, even in the era of the internet showed a preference to classroom teaching and clinical postings for a better learning experience. Copyright © 2022 Ubiquity Press. All rights reserved.
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Introduction: The COVID-19 (Coronavirus Disease 2019) pandemic is associated with several stressful factors that can negatively affect peoples' sleep quality and mental health. Objective(s): The aim of the current study was to prospectively identify decreased sleep quality and associated risk factors in general population during COVID-19 pandemic. Method(s): We conducted a prospective, observational online study on a Romanian sample of 667 respondents aged >18 years. Sleep quality and quantity was evaluated with Athens Insomnia scale (AIS) and the main concerns associated with the pandemic context were evaluated through a multiple-choice question. Result(s): The data collected identified important evidence regarding the prevalence and intensity of insomnia. The average score for AIS was 6.13 (cut-off point for was set at 8). However, it is worth noting that 179 respondents (26.8%) meet the criteria for insomnia. Of the 8 self-assessment items, daytime sleepiness was the criterion evaluated with the highest average score (1.01), all other items getting subunit values. A low quality of sleep was linearly related with fear of illness/death (p=0.053), fear of illness/death of close people (p=0.032), social isolation (p<0.001), economic impact (p=0.003), losing the job (p<0.001) and social stigma associated with COVID-19 infection (p=0.009). Conclusion(s): More than a qurter of respondes scored above the threshold of 8 at the insomnia scale, while losing the job, social stigma associated with COVID-19 infection and social isolation are the main risk factors for a low quality and quantity of sleep.
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Background and Aims: The presence of a code stroke nurse has been demonstrated to reduce door-to-treatment time. Unprecedented COVID-19 pandemic have halted face-to-face training program, resulting in a hybrid training program development. The aim of this project was to explore the users' experience and effectiveness of a new hybrid program for hyperacute stroke nursing training. Method(s): This hybrid workshop was incorporated virtual learning platforms and traditional in-person learning. Pre-post self-assessment knowledge was evaluated using a 20 multiple choice questions (MCQs) and a 5-point Likert scale. A virtual Objective Structured Clinical Examination (OSCE) was conducted as summative assessment. All faculty and participants completed the course evaluation. Result(s): Six neuroscience Advanced Practice Nurses with no prior experience in stroke activation participated in the training program. There was only a 10% increase in MCQ mean score. Feedback received for MCQs include having plausible distractors and difficult vocabulary. Five participants completed the virtual OSCE with mean score of 80%. Majority would prefer to have more clinical exposure. Overall, there was 39.4% increase of self-assessment on knowledge post workshop. Being able to conduct proper assessment and debrief in safe environment were key positive feedbacks. Conclusion(s): This hybrid workshop enhances nurses' knowledge in code stroke nursing training. Faculty will need to review and improve the MCQ construct. Clinical attachment extension would have created more opportunity to gain clinical knowledge and insight on the stroke activation processes. Overall, hybrid session on hyperacute stroke nursing training is feasible especially in this COVID-19 pandemic.
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Background: Clinicians need updates on VTE prevention strategies for hospitalized medically ill patients. Aim(s): This study examined whether interactive, case-based, online CME could improve competence and confidence of cardiologists related to prevention of VTE in patients hospitalized with acute infectious disease. Method(s): Educational design included a "test, then teach" approach to elicit cognitive dissonance, with evidence-based feedback provided following each learner response. Educational effect was assessed using a repeated-pair design with pre-/ post-assessment. Three multiple choice questions assessed knowledge/competence, and 1, rated on a Likert-type scale, assessed confidence. A paired samples t-test was conducted on overall average number of correct responses and for confidence rating, and a McNemar's test was conducted at the question level (significance level, p < 0.05). Result(s): 186 cardiologists were included in the analysis. 83% of cardiologists improved their competence related to use of evidence-based antithrombotic strategies for VTE prevention in patients hospitalized with acute infectious disease (p < 0.001), showing a 75% relative change in responses correct from pre-to post. On a question level, further results indicate: 54% improvement 41% reinforcement (p < 0.001) in competence in use of evidence-based antithrombotic strategies for VTE prevention in patients hospitalized with COVID-19;60% improvement and 25% reinforcement (p < 0.001) in competence of the use of evidence-based risk assessment tools to determine need for thromboprophylaxis in patient hospitalized with COVID-19;49% measurable increase in confidence in ability to prevent VTE in patients hospitalized with COVID-19, resulting in 41% who were mostly or very confident after education (p < 0.001). Conclusion(s): This study demonstrates the success of interactive, case-based, online CME at improving competence and confidence of cardiologists related to prevention of VTE in hospitalized patients with acute infectious disease. Case-based education with interactive questions and detailed explanations of best practices should be employed more often to help clinicians apply knowledge and evidence into practice to improve patient management.
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Introduction: The outbreak of covid 19 (corona virus) brought with it so many disruption in several countries around the globe. This disruption caused by the disease forced some adjustment to be made in order for the countries to continue running other crucial parts of the economy with alternatives option. One major sector affected was the education sector as physical learning was barred following the nature of transmission of the disease causing countries to be on lockdown resulting in teachers adopting the online. Material(s) and Method(s): The study aim to measure different variables such as type of online class, experience on online learning before lockdown, number of classes, the interaction of students and teachers, reasons for not attending, advantages and disadvantages of online learning. This is a cross-sectional study curried out employing the most appropriate sampling technique in order to obtain the data from the participants using an online survey obtained from Google platform consisting of 18 questions which are adapted from a previous study. Result(s): Using the multiple choice questions, about 70% of the students are pleased with this method of learning and also prefer this method over the traditional method of teaching. However 59.4% would love for this method to be used together with the traditional method. In order to improve the online learning, majority of the student suggested the lecturer should have a proper technical set up. Conclusion(s): The results shows that the students prefer the distance learning over the traditional and other want it to be incorporated and used together with the traditional method of learning. Copyright © 2022 A. CARBONE Editore. All rights reserved.
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Introduction: Hands of health care workers act as the most common vehicle for the transmission of healthcare associated infections. A good practice of hand hygiene reduces the incidence of these nosocomial infections. There is a dearth of precise data about the awareness of hand hygiene practice amongst Ophthalmologists in India. Aim: To assess the knowledge of hand hygiene amongst the Ophthalmologists and trainees in Uttarakhand and surrounding regions of Northern India. Materials and Methods: This cross-sectional study was conducted by Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India amongst Ophthalmologists attending a three days long annual ophthalmology conference in Uttarakhand in October 2019, after taking due approval from the Ethics Committee of the Institute. All the 150 participants which were included in the study filled the World Health Organisation (WHO) hand hygiene questionnaire comprising of 10 multiple-choice questions. The respondents were asked to tick the most appropriate choices and scores were given out of a maximum score of 25. Mann Whitney test was used for statistical analysis in the study. results: A total of 150 subjects participated in the survey among which 70 were females and 80 were males. Of all, 60% of the participants were practicing surgeons while 60 (40%) were postgraduate students. About 126 (84%) reported having received a formal training on hand hygiene. Hands of the health care workers were reported to be the commonest route of cross transmission of germs between the patients and healthcare facilities. The average total score of the participants in the survey was 16 (64%) and there was no significant difference between the scores of participants based on gender and training. conclusion: The study shows that majority of the Ophthalmologists have formal training and fair knowledge on the basics of hand hygiene, but lacked the in-depth knowledge, which needs to be addressed in order to reduce the incidence of hospital acquired infections.
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Background: The Coronavirus disease 2019 pandemic led to unprecedented changes to medical education as educators adapted to a world necessitating precautions and social distancing. In response to the pandemic, the Emergency Medicine Residents' Association (EMRA) committees' educational programming in association with the American College of Emergency Physicians 2020 Scientific Assembly (ACEP20), initially scheduled to be held in Dallas, TX, between October 26-29, 2020, transitioned to a fully virtual conference. Escape rooms have become popular recreational activities over the last several years. In-person escape rooms are structured around working in teams to solve a series of puzzles in a fictional scenario that allows participants to "escape" the room upon completion. The teamwork and problem-solving skills utilized in escape rooms lend themselves to use in medical education. The traditional in-person escape room format has previously been applied to toxicology for the purposes of providing engaging toxicology education to emergency medicine (EM) residents. Method(s): The researchers developed and led the first nationwide virtual toxicology escape room during ACEP20 using the Zoom platform. The activities consisted of one web-portal linking to a sequence of four Google Forms multiple-choice question quizzes and four games made on Wordwall.net, a virtual educational activity creator. Six teams of 5 residents and medical students from residency programs across the country registered and participated for a total of 30 participants. Teams were split into Zoom breakout rooms, each moderated by at least one medical toxicologist and/or medical toxicology fellow. A survey was sent to participants to assess their overall experience with the activity. Result(s): Every team completed all eight activities within 45 min. This activity demonstrates the feasibility of a large-scale, realtime competitive virtual escape room to engage participants and deliver toxicology education. The lessons learned from exploring virtual sessions like this one will be valuable tools in the future of medical education. Ten participants completed the survey. 80% of respondents reported that the event increased their interest in toxicology. 90% agreed that the format was easy to navigate, instructions were clear, questions were understandable, and toxicologists were well utilized in the event. Conclusion(s): Toxicology-themed escape rooms have potential as virtual activities to educate EM residents on essential toxicology knowledge. While the small survey response rate limits the generalizability of this data, these initial results are promising and suggest that virtual escape rooms may be a viable option for increasing interest in toxicology among resident physicians.
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Aim: Between January and September 2020 our base hospital recorded zero COVID-19 incidence in breast surgery patients, in 30 days post-op, with stringent admission protocols including 14 days self-isolation, PCR testing, 'green' wards and designated 'green' theatres. However, as the UK entered its third lockdown in January 6th2021 the decision was made to move breast cancer surgery off-site to a 'green hub' 43 miles away. The aim of this study was to assess the impact this had on patients. Method: Patients who had surgery moved off-site were requested to anonymously complete a questionnaire which was either posted or handed to them at follow-up. The questionnaire contained 11 Multiple Choice questions and a comments section. Results: 16 of 19 patients (84.21%) responded to the questionnaire. 16 of 16 (100%) understood the reason for the move. 2 (12.5%) stated that it increased anxiety/stress levels while 3 (18.75%) reported the opposite, and the remainder were neutral. 14 (87.5%) said the move made them feel safer, 1 (6.25%) did not feel safer, with the remaining 1 (6.25%) unsure. 15 (93.75%) felt they received enough information at base and 16 (100%) received sufficient discharge information at the 'green hub'. All 16 (100%) were satisfied with the move off-site but only 15 (93.75%) supported the decision. Conclusions: The responses indicate that the decision to move breast surgery off-site was supported and well understood. And while for a minority of patients this increased pre-operative anxiety/stress levels, it did make the majority feel safer.
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December 2019 has become one of the most surprising days in the whole world in light of the flare-up of a most infectious sickness brought about by novel Covid or Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV-2). This study is conducted to assess the benefits of the use of home remedies to prevent the cause of Covid-19 and evaluate the assessment of dietary changes and physical activity in the prevention of Covid-19. A questionnaire-based online survey is conducted using Google forms consisting of multiple-choice questions about home remedies, lifestyle and dietary changes made by the people during this pandemic. These home remedies included using different types of herbal preparations, steam inhalation, physical exercise and OTC medications for prophylaxis. Questions likewise included about being infected by Coronavirus-19(during first wave or second) and their recovery period, additionally collected their viewpoint for changes made, for example how much they are useful in the prevention of the attack and whenever encountered any undesirable impacts. Total responses were 210, among which 121(57.6%) responses were from females and 89(42.4%) from males. 65 people tested Covid positive (42 during the first wave and 23 during the second wave). 118(56.2%) of people think these changes are very beneficial. (Rated 4 and 5 out of 5 points). From our survey, we concluded that different herbal preparations of their composition, which they thought are helpful, and steam inhalations have been used. Rating regarding the use and effectiveness was also found to be average. Further studies are needed to prove and provide clear evidence about adverse and side effects associated with the use of herbal products.
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Background: Cancer patients (pts) were among the first to receive vaccination against SARS-CoV-2 (vac). However, their attitude towards as well as experience with vac remain unclear. Methods: Between 04-11/2021 cancer pts at our university cancer center completed a baseline (BL) and follow-up (FU) questionnaire (Q) containing multiple choice questions and ten eleven-level Likert items ranging from 1 (“totally disagree”) to 11 (“totally agree”). Data was analyzed using Student's t-test or Chi-square test. Results: 219 pts (43% female) completed BLQ (110 FUQ). Mean age was 64 (24-87) years. 82% had solid tumors, 93% were on active therapy (80% chemotherapy). 4% had history of COVID-19. 78% had already received at least one vac at BL, mainly BNT162b2 (91%) or ChAdOx1-S (8%). Only 1% refused vac. Most pts completely agreed to “definitely get vaccinated” (82%) and completely disagreed with “vac is dispensable due to COVID-19 being no serious threat” (82%;more dissent among men, p = 0.037) or “being against vaccination in general” (81%). Self-assessment as member of a risk group (p = 0.03) and fear of COVID-19 (p = 0.002) were more common among women. Every third patient (31%) completely agreed to “being afraid of COVID-19”, every second thinks “SARSCoV-2 infection would be very dangerous” (56%). Only 41% expressed “complete confidence in the vaccine being safe” and 37% “not being afraid of side effects”. Fear of side effects (SE) was more common among women (p = 0.0016), pts with solid tumors (p = 0.05), with GI tumors (p < 0.0001) and below mean age (p = 0.006). The latter expressed less “confidence in the vaccine being safe” (p = 0.0029). At FUQ, most pts (91%) reported their vac to be well tolerated, 44% reported no SE, especially men (p = 0.001) and pts above age average (p = 0.002). Most common SE was local pain at injection site (36%), which was more frequent among women (p = 0.002), younger pts (p = 0.024) and pts with solid tumors (p = 0.04). Other common SE included fatigue (18%) and myalgia (8%). No thromboembolic events occurred. Only 3 pts had their therapy postponed due to SE. Almost all pts felt retrospectively sufficiently informed about vac and possible SE (94%), would have it again (88%) and agree to get it yearly, if recommended (78%). After vac, pts felt safe meeting friends or family (91%) or shopping (62%). Vacation (32%), work (22%), public transport (21%) or sports (19%) were considered less safe (less frequent among men, p < 0.05). Most pts (70%) did not feel that the COVID-19 pandemic negatively influenced their treatment and regarded the hospitals protective measures as adequate (91%). Conclusions: Willingness to get vac is high among cancer pts and vac is well tolerated in this sensitive cohort. However, concerns about vac safety remain an issue. Those as well as gender differences need to be addressed to increase vac rates and tolerability. The present results may help identify pts that benefit from more detailed pre-vac consultation.
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Introduction The COVID-19 pandemic has forced healthcare professionals (HCPs) to rapidly alter their delivery of outpatient services. Perceived benefits include reducing unnecessary travel and waiting times. However, as one of the geographically largest training regions in the UK, we aimed to determine satisfaction levels amongst gastroenterology HCPs with the 'new normal'. Methods Satisfaction surveys were disseminated electronically across 13 acute trusts in the South West between June and August 2021. These consisted of multiple choice questions and Likert 5-scale ranking questions, ranging from 'strongly agree' to 'strongly disagree'. Virtual clinics were defined as telephone or video consultations. Results 64 HCPs from 7 trusts responded (52% consultants;23% registrars;19% nurse specialists;6% dieticians). 80% had performed phone consultations and 23% were providing video consultations. 94% of participants stated face-to-face (F2F) consultations remained their preferred mode of clinic, whilst video consultation was the least favoured for new patients. For follow-up patients, the most favoured combination was phone and F2F consultations, followed by solely F2F consultations. Less than a third of respondents strongly agreed that they would be comfortable using a computer for video consultation (32%), compared to over half when using phone instead (53%). 47% of HCPs stated virtual clinics were now the default clinic mode in their trust. The majority of respondents found it difficult to develop a rapport with remote consultations, with only 19% respondents stating this was not an issue. There was equipoise about whether time efficiency improved with virtual consultations, though 60% of respondents agreed or strongly agreed that virtually delivered clinics can reduce clinic non-attendance. Two thirds of respondents did not have a local process to identify patients who would not benefit from virtual clinics, whilst over three quarters did not have technical support to troubleshoot issues during virtual clinics (78%). Only five respondents (8%) thought it was straightforward to include an interpreter on a virtual consultation and 70.3% had difficulties including relatives on virtual calls. Conclusions Gastroenterology departments in the South West continue to adapt to delivery of virtual clinics, through a predominantly telephone format. There is consensus that followup patients do not routinely need to F2F appointments, but new patients should primarily be seen F2F. Departments should have clear protocols to identify patients that will not benefit from virtual consultations. Finally, robust strategies are required to accommodate patients whose first language is not English to ensure they are not disproportionately disadvantaged.
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Introduction The COVID-19 pandemic has forced patients to rapidly adjust to virtual consultations in outpatients. A perceived benefit is reducing unnecessary travel. However, there is a paucity of literature describing acceptability of virtual consultations to gastroenterology patients. Methods In collaboration with the Patient Experience team, satisfaction surveys were disseminated in Gastroenterology and Hepatology clinics at Bristol Royal Infirmary electronically via SurveyMonkey® and paper format between June and August 2021. These consisted of multiple choice questions and Likert 5-scale ranking questions, ranging from 'strongly agree' to 'strongly disagree'. Virtual clinics were defined as telephone or video consultations. Data was collected on patient demographic, travel method, satisfaction with virtual clinics, and preferences for service delivery. Results 100 patients completed the survey (27% aged 55- 64yrs;21% aged 65-74 years). 50%, 27% and 23% of patients were from hepatology clinic, inflammatory bowel disease clinic and general gastroenterology clinic respectively. 84% were follow-up patients. 56% of patients normally drove to appointments, with a further 30% taking public transport. 23% of patients were travelling over 10 miles to attend appointments. 38% of patients were in full-time employment of which 63.1% had to take annual leave to attend appointments (n=24/38). 82% of patients owned a laptop of which 19.5% (n=16/82) disagreed or strongly disagreed with feeling comfortable using their computer for an online appointment. Face-to-face (F2F) consultation was the preferred mode of appointments in almost half of patients (49%), followed by a mix of F2F and telephone consultations (19%). 54% of patients agreed or strongly agreed that clinicians could address their concerns virtually, with only 16% disagreeing or strongly disagreeing with this. 65% of patients agreed or strongly agreed they felt comfortable sharing personal information during a virtual consultation, with 14% of patients disagreeing or strongly disagreeing with this. 80% of patients stated they would want to receive bad news in a F2F consultations. Conclusions Virtual consultations appear to be acceptable rather than preferable to gastroenterology patients. F2F consultations remain the overall preference, particularly when receiving bad news. Virtual consultations can provide flexibility in service delivery. This is important given almost two thirds of patients in full time employment had to take annual leave to attend an appointment. Furthermore, as services consider their carbon footprint, with half of patients driving to their appointments in Bristol, virtual consultations offer a genuine opportunity to provide a greener service.
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Introduction As more specialists become dual accredited in internal medicine, non-gastroenterology specialists have greater exposure to gastroenterology patients over the course of their training, especially via the acute take. Simultaneously, the COVID pandemic has meant most regular local teaching has moved online with varying quality. This project aimed to evaluate 1) whether a standardised protocol can be used to successfully deliver large scale digital gastroenterology teaching that 2) is non-inferior when compared with traditional face to face teaching. Methods Teaching was delivered to internal medical trainees on the acute management of ulcerative colitis and chronic liver disease. Two sessions were delivered a year apart, initially regionally, and then nationally. This was delivered via Zoom, using a standardised protocol based on guidelines to ensure consistency, with live-polled multiple-choice questions to encourage interaction. Each session was followed by Q&A related to that topic. Feedback was taken after each session. Outcome measures analysed were: number in attendance, whether viewers would recommend this teaching to others, whether they thought it ran smoothly, and how they felt about it when compared with face-to-face teaching as measured on a Likert scale. Given the subjective nature of our hypotheses, we accept that these are surrogate markers. Results 171 trainees attended the initial regional teaching session and 469 the subsequent session. Following the first session, 98.9% of trainees would recommend the teaching to others, rising to 99.7% after the second session. 99% and 99.5% respectively agreed or strongly agreed with the statement the initial session ran smoothly, while 84.5% and 88.8% agreed or strongly agreed that digital teaching was as effective as face to face. The benefits of digital teaching were no travel (90%) ability to watch later (86%), whereas the downsides were loss of social interaction (60%) and harder to get study leave (39%). Conclusions Gastroenterology teaching for non-specialists can be delivered successfully at a large scale using a standardised protocol for digital teaching. The vast majority of trainees felt that digital sessions were as effective as face-to-face teaching with a lack of travel and flexibility on viewing time the main reported benefits.
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Introduction: In 2020, the COVID-19 pandemic required the UA RKKCOP Self-Care Therapeutics course, taught traditionally as an oncampus flipped classroom design, to be offered as an online course. Research Question or Hypothesis: Student performance on exams will be similar regardless of students attending a flipped classroom on campus versus online, via web-conferencing. Study Design: Retrospective comparison between an on-campus and online flipped classroom Self Care Therapeutics course. Methods: Exam performance was compared for the 2019 in-person attending cohort and the 2020 online attending cohort. Course design was similar between the two cohorts, with each completing assigned pre-reading, an associated quiz, in-class small group discussions and inclass large group faculty-led debrief. For small group discussions, the oncampus cohort selected their own group members while the online cohort was randomly placed into different groups for each class. Three examinations were administered consisting of 33 multiple choice questions. Descriptive statistics and a two tailed Mann-Whitney U test was used to compare student performance between the on-campus and online attendance cohorts. A significance level of 0.05 was used. Results: There were 243 students included in the analysis (58% female, 42% male). Minimal differences between the exam averages were observed for all 3 exams with statistically significant differences observed in performance for exam 1 only (exam 1 = 0.04±0.11, p=0.02;exam 2 = 0.03±0.09, p=0.11;exam 3 = 0±0.09, p=0.95). The correlation in scores between different exams appeared the same for both years. There was a moderate positive correlation between scores on exams 1, 2, and 3. Conclusion: Based on examination results, content in a flipped classroom design may have been as effectively delivered online as it was in person. Further research using data from multiple courses or from the same cohort, randomized, is needed to improve the external validity of these findings.