A proposed model for a comprehensive virtual subinternship in vascular surgery.

OBJECTIVE: In the present study, we sought to understand the challenges, advantages, and applications of a vascular surgery virtual subinternship (VSI) curriculum. METHODS: Our institution hosted 25 students for two 4-week VSI rotations, one in July 2020 and one in August 2020. The students participated in a curriculum centered around the use of Zoom and telephone interactions with residents and faculty. The curriculum included selected readings, surgical videos, group didactics, and one-on-one mentorship. Anonymous pre- and postrotation self-assessments were used to ascertain the students' achievement of the learning objectives and the utility of the educational tools implemented during the rotation. The faculty and resident mentors were also surveyed to assess their experience. RESULTS: With the exception of knot-tying techniques (P = .67), the students reported significant improvement in their understanding of vascular surgery concepts after the virtual elective (P < .05). The highest ranked components of the course were interpersonal, including interaction with faculty, mentorship, and learning the program culture. The lowest ranked components of the course were simulation training and research opportunities. The rating of the utility of aspects of the course were consistent with the ranking of the components, with faculty interaction receiving the highest average rating. The ideal amount of time for daily virtual interaction reported by the students ranged from 3 to 6 hours (median, 4 hours). Overall, most of the mentors were satisfied with the virtual course. However, they reported limited ability to assess the students' personality and fit for the program. The time spent per week by the mentors on the virtual vascular surgery rotation ranged from 2 to 7 hours (median, 4 hours). Of the 17 mentors completing the surveys, 14 reported that having a virtual student was a significant addition to their existing workload. CONCLUSIONS: Overall, our student and mentor feedback was positive. Several challenges inherent to the virtual environment still require refinement. However, the goals of a VSI are distinct and should be explored by training programs. With changes to healthcare in the United States on the horizon and the constraints resulting from the severe acute respiratory syndrome coronavirus 2 pandemic, implementing a virtual away rotation could be an acceptable platform in our adaptations of our recruitment strategies.

Active learning tools improve the learning outcomes, scientific attitude, and critical thinking in higher education: Experiences in an online course during the COVID-19 pandemic.

Active teaching methodologies have been placed as a hope for changing education at different levels, transiting from passive lecture-centered to student-centered learning. With the health measures of social distance, the COVID-19 pandemic forced a strong shift to remote education. With the challenge of delivering quality education through a computer screen, we validated and applied an online course model using active teaching tools for higher education. We incorporated published active-learning strategies into an online construct, with problem-based inquiry and design of inquiry research projects to serve as our core active learning tool. The gains related to students' science learning experiences and their attitudes toward science were assessed by applying questionnaires before, during, and after the course. The course counted on the participation of 83 students, most of them (60.8%) from postgraduate students. Our results show that engagement provided by active learning methods can improve performance both in hard and soft skills. Students' participation seems to be more relevant when activities require the interaction of information, prediction, and reasoning, such as open-ended questions and design of research projects. Therefore, our data show that, in pandemic, active learning tools benefit students and improve their critical thinking and their motivation and positive positioning in science.

Going virtual for research training during the COVID-19 pandemic and beyond: e-SORT IT.

The Structured Operational Research and Training Initiative (SORT IT) model has contributed to building research capacity and has produced evidence for improving public health program performance in countries with limited research capacity. The model involves hands-on mentorship and consists of three modules/weeks. It is recognized to be an innovative research capacity building model. In a world changed by COVID-19, where bringing people together is not viable, an innovative, interactive, web-based, knowledge-transfer platform (e-SORT IT) for virtual implementation of SORT IT modules was created. The platform design imitated the residential course as closely as possible with the same lectures, plenary sessions, and breakout rooms. Despite the challenges, the platform performed well and even though participants and mentors were located in eight different time zones, the course was successful; 90% of participants achieved their milestones and 10 manuscripts were successfully completed. Participant evaluation revealed a satisfaction level that was nearly equivalent to the residential module. However, mentor evaluation indicated a number of shortcomings including capacity building, professional networking, communication, engagement, and contribution by participants, as well as overall module success. In conclusion, COVID-19 stimulated the creation of the e-SORT IT platform that provided a functional alternative to the residential version. Despite the limitations of reduced capacity building and networking, the e-SORT IT platform should be considered a success - it delivered the goods. This is an example of innovation and flexibility, two attributes that are sorely needed to maintain activities during the pandemic and beyond.

Special education for students with autism during the COVID-19 pandemic: "Each day brings new challenges".

LAY ABSTRACT: The novel coronavirus (COVID-19) disrupted how special educators provided supports and services for students with autism spectrum disorder. School closures and the related pivoting between learning modalities (i.e. virtual, hybrid, and face-to-face) were difficult for all students, but especially for students with autism, who rely on routine and require individualized instruction. In this study, we surveyed 106 special education teachers, behavior specialists, and speech pathologists who work with autistic students to learn about how they adapted instruction to comply with the complex social distancing rules and changing expectations of the pandemic. Participants reported "making the best out of a bad situation" and "constantly using 'trial & error' to find the best way for our students to eLearn." They emphasized the importance of collaboration with parents, who helped deliver intervention and monitor progress across settings. They made alterations to Individualized Education Programs, by adding individualized contingency learning plans, adjusting service minutes, and sometimes eliminating social goals. Participants were surprised that while students with more intense needs struggled, others actually preferred virtual instruction. This raises concerns for what will happen in the future, when social expectations resume. Despite the overwhelming challenges posed by COVID-19, participants demonstrated remarkable resiliency and an innovative ability to adapt instruction.

A Multicenter Study of Student Engagement and Satisfaction in Online Programs.

BACKGROUND: Students who are more satisfied and engaged in online courses have better learning experiences and outcomes. METHOD: Survey data were collected during a 4-month period in 2019. The research team created a survey to collect demographic information and assess student satisfaction. Student engagement was measured using the 19-item Online Student Engagement Scale. RESULTS: Overall student engagement and satisfaction scores in online programs were moderately high. Generation Z participants and students from PhD programs were the most satisfied and engaged in their programs. CONCLUSION: Students who are more engaged in online coursework are more satisfied and thus are more likely to remain and successfully complete their respective programs. [J Nurs Educ. 2021;60(5):259-264.].

Short-term research projects in cognitive neuroscience for undergraduate students: a contingency plan to maintain quality teaching during COVID-19 pandemic.

The Corona Virus Disease 19 (COVID-19) pandemic has imposed serious restrictions for academic institutions to maintain their research and teaching practical subjects. Universities have implemented adaptive measures to maintain educational activities and achieve the learning objectives for undergraduate and postgraduate students by shifting to online teaching and learning. Although such approaches have enabled delivering the theoretical content of courses during the pandemic, universities have faced serious difficulties in running practicals with actual research experiments and teaching hand-on skills because such activities potentially override the required safety guidelines. Here, we report an adaptive measure, implemented at Monash University, to run home-based studies in cognitive neuroscience and achieve learning objectives, which are normally delivered in face-to-face practicals. We introduce two specifically designed short-term research projects and describe how different aspects of these projects, such as tutorials, experiments, and assessments, were modified to meet the required social distancing. The results of cognitive tests were closely comparable between the laboratory-based and home-based experiments indicating that students followed the guidelines and the required procedures for a reliable data collection. Our assessments of students' performance and feedback indicate that the majority of our educational goals were achieved, while all safety guidelines and distancing requirements were also met.

Anatomy education of medical and dental students during COVID-19 pandemic: a reality check.

PURPOSE: During this forced down-time of COVID-19 pandemic, shift to virtual anatomy education is the solitary solution to support the learning of students. The purpose of this study was to understand the visible and invisible potential challenges being faced by the 1st year medical and dental students while attending digital anatomy classes. METHODS: The present study was conducted on 81st year medical and dental students who were admitted to their respective college in August 2019 and were willing to participate in the study. A multiple choice close-ended questionnaire regarding their opinion on virtual classes was designed and feedback was taken from the students. RESULTS: Majority (65%) of the students agreed that they missed their traditional anatomy learning i.e., dissection courses, face to face lectures and interaction with mentors. The students strongly felt the lack of confidence and difficulty in the topics completed without dissections, models, microscopic slides and other modalities. 83% felt lack of proper gadgets, high-band width and strong internet connections, a potential barrier in their digital learning. Lack of self-motivation was felt by 69% students. CONCLUSIONS: The current situation of anatomy education is not intentional, and is not the long term silver bullet solution for a visual subject like anatomy. Though learners face a lot of challenges, however, a shift to online must be supported at this time of health crisis. As the digital learning may go for indefinite period, the feedback of students may be helpful for relevant and timely modifications in digital anatomy education.

Medical students' perception of the reliability, usefulness and feasibility of unproctored online formative assessment tests.

Medical education has gone online because of the COVID-19 pandemic. Formative assessment is essential to facilitate the learning process in medical education. However, various challenges arise during online assessment, which include reliability, when done without monitoring and practical concerns like Internet connectivity issues. This study was done to assess the medical students' perceptions of the reliability, usefulness, and practical challenges of online tests. One hundred first-year undergraduate medical students taking up online classes and tests in the subject of physiology were enrolled in this study. A questionnaire with items regarding practical challenges, reliability, and usefulness of the online tests, in general, and about different types of online assessment methods, in particular, were sent to the students online. Each item was rated on a five-point Likert scale, and the responses were analyzed anonymously. A large percentage of students used mobile phones (81.4%) to undertake online tests. Although most students (73.2%; P < 0.001) felt that online tests helped them substantially in learning the subject, network connectivity issues were considered to be a matter of serious concern (85.5%, P < 0.001). Among the assessment methods used, viva voce by video conferencing was thought to be most reliable (83%, P < 0.001). Multiple-choice question-based assessment when done online was felt to be more practically feasible with faster feedback than classroom assessment. The results of the study suggest that medical students find online formative assessments helpful for their learning, despite their concerns about reliability and practical challenges.

COVID-19 Impact on Surgical Resident Education and Coping.

BACKGROUND: Healthcare systems and surgical residency training programs have been significantly affected by the novel coronavirus disease 2019 (COVID-19) pandemic. A shelter-in-place and social distancing mandate went into effect in our county on March 16, 2020, considerably altering clinical and educational operations. Along with the suspension of elective procedures, resident academic curricula transitioned to an entirely virtual platform. We aimed to evaluate the impact of these modifications on surgical training and resident concerns about COVID-19. MATERIALS AND METHODS: We surveyed residents and fellows from all eight surgical specialties at our institution regarding their COVID-19 experiences from March to May 2020. Residents completed the survey via a secure Qualtrics link. A total of 38 questions addressed demographic information and perspectives regarding the impact of the COVID-19 pandemic on surgical training, education, and general coping during the pandemic. RESULTS: Of 256 eligible participants across surgical specialties, 146 completed the survey (57.0%). Junior residents comprised 43.6% (n = 61), compared to seniors 37.1% (n = 52) and fellows 19.3% (n = 27). Most participants, 97.9% (n = 138), anticipated being able to complete their academic year on time, and 75.2% (n = 100) perceived virtual learning to be the same as or better than in-person didactic sessions. Participants were most concerned about their ability to have sufficient knowledge and skills to care for patients with COVID-19, and the possibility of exposure to COVID-19. CONCLUSIONS: Although COVID-19 impacted residents' overall teaching and clinical volume, residency programs may identify novel virtual opportunities to meet their educational and research milestones during these challenging times.

Implementation and evaluation of eight virtual surgical electives for medical students during the COVID-19 pandemic.

BACKGROUND: Eight novel virtual surgery electives (VSEs) were developed and implemented in April-May 2020 for medical students forced to continue their education remotely due to COVID-19. METHODS: Each VSE was 1-2 weeks long, contained specialty-specific course objectives, and included a variety of teaching modalities. Students completed a post-course survey to assess changes in their interest and understanding of the specialty. Quantitative methods were employed to analyze the results. RESULTS: Eighty-three students participated in the electives and 67 (80.7%) completed the post-course survey. Forty-six (68.7%) respondents reported "increased" or "greatly increased" interest in the course specialty completed. Survey respondents' post-course understanding of each specialty increased by a statistically significant amount (p-value = <0.0001). CONCLUSION: This initial effort demonstrated that VSEs can be an effective tool for increasing medical students' interest in and understanding of surgical specialties. They should be studied further with more rigorous methods in a larger population.

Identifying factors that influenced wellbeing and learning effectiveness during the sudden transition into eLearning due to the COVID-19 lockdown.

BACKGROUND: The sanitary emergency due to COVID-19 virus obliged people to face up several changes in their everyday life becauseWorld Health Organisation (WHO) guidelines and countries' Health Systems imposed lockdown of activities and social distancing to flatten the infection curve. One of these rapid changes involved students and professors that had to turn the traditional "in presence" classes into online courses facing several problems for educational delivery. OBJECTIVES: This work aimed to investigate the factors that affected both teaching/learning effectiveness and general human comfort and wellbeing after the sudden transition from classrooms to eLearning platforms due to COVID-19 in Italy. METHODS: A workshop, involving students and experts of Human Factors and Ergonomics, has been performed to identify aspects/factors that could influence online learning. Then, from workshop output and literature studies, a survey composed of two questionnaires (one for students and one for teachers) has been developed and spread out among Italian universities students and professors. RESULTS: 700 people answered the questionnaires. Data have been analysed and discussed to define the most important changes due to the new eLearning approach. Absence of interactions with colleagues and the necessity to use several devices were some of the aspects coming out from questionnaires. CONCLUSIONS: The study shows an overview of factors influencing both teaching/learning effectiveness and general human comfort and wellbeing. Results could be considered as a basis for future investigation and optimization about the dependencies and correlations among identified factors and the characteristics of the products/interaction/environment during eLearning courses.

The musculoskeletal problems and psychosocial status of teachers giving online education during the COVID-19 pandemic and preventive telerehabilitation for musculoskeletal problems.

BACKGROUND: Musculoskeletal and psychosocial problems have tended to increase during the COVID-19 pandemic. OBJECTIVE: To evaluate the changes in musculoskeletal problems and psychosocial status of teachers during the COVID-19 pandemic due to online education and to investigate the effects of preventive telerehabilitation applications for musculoskeletal problems. METHODS: Forty teachers who conducted online education during the pandemic volunteered to participate in the study. All assessments were performed via online methods. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), ProFitMap-Neck questionnaire, Oswestry Disability Index (ODI), and Upper Extremity Functional Index (UEFI) were used to evaluate musculoskeletal problems; the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used to evaluate anxiety and depression, respectively; and the Work-Life Balance Scale (WLBS) was used to evaluate how well individuals achieve this balance. Information about before online education, during online education, and after training was obtained with the assessments. After the first assessment, telerehabilitation, which involved presentations and brochures, was applied to 18 participants willing to participate in the training. RESULTS: The ProFitMap, UEFI, and WLBS scores during the online education decreased significantly, while the scores of the CMDQ, ODI, BDI, and BAI during the online education increased significantly compared to the pre-online education scores (p < 0.05). In addition, the total CMDQ, ProFitMap, and ODI scores improved significantly after the training (p < 0.05). CONCLUSION: Musculoskeletal and psychosocial problems increased in teachers during online education. Preventive telerehabilitation methods will be beneficial for individuals who do not have access to face-to-face physiotherapy.

Asynchronous Distance Learning of the National Institutes of Health Stroke Scale During the COVID-19 Pandemic (E-Learning vs Video): Randomized Controlled Trial.

BACKGROUND: The COVID-19 pandemic has considerably altered the regular medical education curriculum while increasing the need for health care professionals. Senior medical students are being incrementally deployed to the front line to address the shortage of certified physicians. These students, some of whom will be fast-tracked as physicians, may lack knowledge regarding the initial management of time-critical emergencies such as stroke. OBJECTIVE: Our aim was to determine whether an e-learning module could improve asynchronous distance knowledge acquisition of the National Institutes of Health Stroke Scale (NIHSS) in senior medical students compared to the traditional didactic video. METHODS: A randomized, data analyst-blinded web-based trial was conducted at the University of Geneva Faculty of Medicine between April and June 2020. Fifth year medical students followed a distance learning path designed to teach the NIHSS. The control group followed the traditional didactic video created by Patrick Lyden, while the e-learning group followed the updated version of a previously tested, highly interactive e-learning module. The main outcome was the score on a 50-question quiz displayed upon completion of the learning material. The difference in the proportion of correct answers for each specific NIHSS item was also assessed. RESULTS: Out of 158 potential participants, 88 started their allocated learning path and 75 completed the trial. Participants who followed the e-learning module performed better than those who followed the video (38 correct answers, 95% CI 37-39, vs 35 correct answers, 95% CI 34-36, P<.001). Participants in the e-learning group scored better on five elements than the video group: key NIHSS concepts (P=.02), the consciousness - global item (P<.001), the facial palsy item (P=.04), the ataxia item (P=.03), and the sensory item (P=.04). CONCLUSIONS: Compared to the traditional didactic video, a highly interactive e-learning module enhances asynchronous distance learning and NIHSS knowledge acquisition in senior medical students.

Online open-book examination of undergraduate medical students - a pilot study of a novel assessment method used during the coronavirus disease 2019 pandemic.

BACKGROUND: The coronavirus disease 2019 pandemic has posed a new challenge for medical educators worldwide. While teaching and learning shifted online, assessment posed a roadblock. A pilot study was performed to check the feasibility and acceptability of online open-book examination. METHODS: A pilot study was carried out on sixth semester (fourth year) students. An online open-book examination was conducted on an ENT topic, and feedback was obtained using a pre-validated questionnaire. Two teachers scored and collated the answers, and the marks were averaged for each candidate. RESULTS: Ninety-eight students appeared for the examination: 21.4 per cent failed and 78.6 per cent passed. Eight students scored above 75 per cent correct. Only 55 students volunteered to give feedback; most agreed that the best advantage of this assessment was that it was stress-free. The disadvantage most complained of was network connectivity issues. CONCLUSION: Online open-book examination has the potential to be the new normal in the present circumstances and beyond.

The lasting footprint of COVID-19 on surgical education: A resident and attending perspective on the global pandemic.

BACKGROUND: The COVID-19 pandemic has impacted surgical training nationwide. Our former curricula will likely not return, and training will need to adapt, so we are able to graduate residents of the same caliber as prior to the pandemic. METHODS: A survey evaluating perceptions of changes made in surgical training was conducted on surgery residents and attendings. RESULTS: Disaster medicine training has become more relevant and 85% residents and 75% attendings agreed it should be incorporated into the curriculum. Safety of family was the most significant concern of residents. Virtual curriculum was perceived to be acceptable by 82% residents and only 22% attendings (p < 0.01). Residents (37%) were less concerned than attendings (61%) of falling behind on their overall training (p = 0.04). Both groups agreed operative skills would be adversely affected (56%vs72%; p = 0.37). CONCLUSIONS: To maintain an effective surgical curriculum, programs will need to implement new educational components to better prepare residents to become surgeons of the future.

Evaluation of undergraduate medical students' preference to human anatomy practical assessment methodology: a comparison between online and traditional methods.

PURPOSE: COVID 19 pandemic has brought crucial changes in the field of medical education. Ad mist university examinations in India medical schools have switched to online assessment methods to avoid student gatherings. In this context, we conducted online anatomy practical evaluation and we have aimed at quantifying the students' experience on virtual assessment. METHODS: A total of 250 first year MBBS students appeared for online anatomy practical examinations. Immediately after the completion of exams electronic feedback about their experience, in questionnaire format was obtained after getting informed consent. Their feedback was analysed and quantified. RESULTS: Completed feedback forms were submitted by 228 students. More than 50% of students favoured online anatomy spotter examinations. Only 32.8% of students were comfortable with soft parts discussion using images. For image based viva voce 61.4%, 80% & 82% of students responded that the features and orientation of osteology, radiology and embryology images, respectively, were good. For surface marking 55% of the participants preferred online verbal evaluation. Finally, more than 60% of the students preferred the conventional over online assessment methods. CONCLUSIONS: The inclination of students' preference for traditional anatomy examination methods mandates adequate training of both students and teachers for virtual examination. The superiority of conventional anatomy practical examination methods is unbiased but pandemic situations warrant adequate preparedness. In the future the anatomy teaching and evaluation methodology in Indian medical schools have to be drastically reviewed in equivalence with global digitalization.

Retrospective investigation of organization and examination results of the state examination in restorative dentistry, endodontology and periodontology under simulated conditions in times of Covid-19 compared to standard conditions when treating patients.

Objective: Primary outcome of this retrospective study was the comparison of state examination results under simulated treatment conditions in times of Covid-19 versus patient treatment under non-pandemic conditions. Additionally, correlation analysis was performed between students' self- and examiners' assessment of the treatment results. Methods: Within 4 hours, 22 examinees each had to place a multi-surface adhesive anterior and posterior restoration, performed an endodontic treatment on a maxillary premolar and a periodontal debridement of one quadrant. All treatments were performed on a model fixed in a phantom head. Compliance with the prescribed hygiene and social distancing guidelines and self-assessment of the practical performance was part of the practical examination as well. One examiner per examination part evaluated anonymously the final results. The historical control was based on the exam results of a cohort from 2019. Mean values (standard deviation), non-parametric correlations (Spearman's Rho) and group comparisons (Mann-Whitney) were calculated for statistical analysis. Results: Examination results under simulated treatment conditions were significantly worse (p<0.05) than in the cohort that took their state exam in patients, with exception of the endodontic partial exam. The overall scores in restorative dentistry and periodontology of both groups, which include a structured theoretical examination, did not differ. The majority of the candidates rated their performance worse than the examiners, and there was no correlation between self- and third-party assessment. Conclusion: In the comparison of two years, a simulated practical examination without patients in restorative dentistry, endodontics and periodontology resulted in matchable results compared with an examination on patients. Equal conditions for the candidates resulting in better comparability and avoidance of ethical dilemmas of patient treatment under examination conditions could also be arguments towards a state examination under phantom conditions in the future.