Psychometric properties of the environmental factors' questionnaire for undergraduate medical students taking online learning during COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Environmental factors are important for students' learning during online classes, especially during a pandemic, such as COVID-19. This study aimed to validate the environmental factors' questionnaire during online learning. METHODS: A total of 218 undergraduate medical students at the Health Campus, Universiti Sains Malaysia, participated in a cross-sectional study that involved an online survey. Environmental factor scales were assessed with the nine-item lighting, noise, and temperature (LNT) scale and the six-item technology scale. Analysis was performed using confirmatory factor analysis (CFA). RESULTS: The English version of the LNT scale with nine items and three factors showed a good fit to the data, with no item deleted. For LNT, the composite reliability (CR) was 0.81, 0.81, and 0.84, respectively, while the average variance extracted (AVE) was 0.61, 0.59, and 0.6, respectively. The English version of the technology scale, with six items and one factor, also showed a good fit to the data, with no item deleted. The CR was 0.84, and the AVE was 0.51. CONCLUSIONS: The results provide psychometric evidence for environmental questionnaire scales in evaluating the factors associated with online learning among Malaysian university medical students. All items were retained and confirmed to fit the sample data.

Supporting the Transition to Distance Education During the Pandemic and Beyond.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic affected almost every country around the world, and various forms of lockdown or quarantine measures were implemented. The lockdowns forced medical educators to step beyond traditional educational approaches and adopt distance education technologies to maintain continuity in the curriculum. This article presents selected strategies implemented by the Distance Learning Lab (DLL) at the Uniformed Services University of Health Sciences (USU), School of Medicine (SOM), in transitioning their instruction to an emergency distance education format during the COVID-19 pandemic. MATERIALS AND METHODS: When moving programs/courses to a distance education format, it is important to recognize that two primary stakeholders are involved in the process: faculty members and students. Therefore, to be successful in transitioning to distance education, strategies must address the needs of both groups and provide support and resources for both.The DLL used two lenses of adult learning and targeted needs assessment to design faculty and student support during the pandemic. The DLL adopted a learner-centered approach to education, focusing on meeting the faculty members and students where they are. This translated into three specific support strategies for faculty: (1) workshops, (2) individualized support, and (3) just-in-time self-paced support. For students, DLL faculty members conducted orientation sessions and provided just-in-time self-paced support. RESULTS: The DLL has conducted 440 consultations and 120 workshops for faculty members since March 2020, serving 626 faculty members (above 70% of SOM faculty members locally) at USU. In addition, the faculty support website has had 633 visitors and 3,455 pageviews. Feedback comments provided by faculty members have specifically highlighted the personalized approach and the active, participatory elements of the workshops and consultations.Evaluations of the student orientation sessions showed that they felt more confident in using the technologies after the orientation. The biggest increase in confidence levels was seen in the topic areas and technology tools unfamiliar to them. However, even for tools that students were familiar with before the orientation, there was an increase in confidence ratings. CONCLUSION: Post-pandemic, the potential to use distance education remains. It is important to have support units that recognize and cater to the singular needs of medical faculty members and students as they continue to use distance technologies to facilitate student learning.

Instructional media selection principles for online medical education and emerging models for the new normal.

The COVID-19 pandemic, and the resulting need to avoid in-person classes, compelled many faculty members to convert to a completely online instructional format. The literature on selecting media for medical educators, however, provided little assistance for them to make choices that facilitated learning through using alternative online instruction practices. In this study, we addressed the lack of guidance for the use of media to facilitate the effective online medical education. To optimise the transition from face-to-face educational modalities to online learning, we incorporated insights from theories of media synchronicity and learning. We considered the value of existing learning theories in influencing how we could guide entrenched face-to-face educators to online learning practice. Therefore, we employed existing theories and practice to assist in developing an algorithmic approach to guiding these educators. We reassessed the way taxonomies of learning objectives, practice-oriented learning experiences, the social and collaborative features of learning activities, and media synchronicity theory could have augmented face-to-face teaching, and influenced how these could be reconfigured to assist in the transition to online learning. Consequently, we have developed key principles to inform the continuity of design and selection of instructional media in the transition to medical online learning. We have constructed specific criteria for media selection that correspond to the 12 goals of medical learning. We found that the majority of the goals can be more enhanced by synchronous media than asynchronous versions. We discuss the role of instructional media in emergency online medical education as well as emerging models of media selection for the new normal in medical education and future directions for medical education media research.

Online education for prosthetics and orthotics students in the era of COVID-19 pandemic in Iran: challenges, opportunities, and recommendations.

INTRODUCTION: With the advent of the COVID-19 pandemic, many higher education programs in Iran, including prosthetics and orthotics (P&O), had to shift to the online environment all at once. This unanticipated transition was challenging for the educational system. However, online education is superior in some aspects to conventional methods, and this situation may offer opportunities. This study was carried out from September 2021 to March 2022 to investigate the challenges and opportunities of online education in the P&O sector in Iran based on the opinions of students and faculty members. Relevant recommendations will also be discussed. METHODS: In this qualitative study, semi-structured interviews were conducted in both oral and written formats. Purposive and snowball sampling techniques were used to recruit undergraduate and postgraduate P&O students, as well as P&O faculty members, for this qualitative study. The data gathered from interviews with study participants were analyzed by thematic analysis. RESULTS: Based on the data analysis, many sub-themes of the three main themes were recognized: (1) challenges: technical, socioeconomic, environmental distractors, supervision and evaluation, workload, digital competence, interactions, motivation, sessions-related issues, class time, hands-on and clinical training; (2) opportunities: technological innovations, infrastructure development, flexible learning environment, student-centered learning, availability of contents, time and cost saving, high concentration, more self-confidence; (3) recommendations: technical infrastructure, team dynamics, hybrid courses, time management, awareness. CONCLUSION: Online education of P&O during the era of the COVID-19 pandemic was accompanied by a series of challenges. Technical issues and the gravity of hands-on training in this field were significant challenges. This era, however, provided the opportunity to facilitate the establishment of needed infrastructure and support technological innovations for online education. Considering hybrid (mixed online and on-site) courses was recommended to improve the quality of learning.

Self-efficacy and resilience as predictors of students' academic motivation in online education.

Motivation as a catalyst for human conduct has been associated with lots of variables. However, self-efficacy and resilience as two important components of the individuals' psychological capital have not received enough scientific attention. This gets more significance considering the global COVID-19 pandemic with noticeable psychological consequences for the learners receiving online education. Hence, the current study proceeded to investigate the relationship between students' self-efficacy, resilience, and academic motivation in online education. To this aim, a convenience sample of 120 university students coming from two state universities in south of Iran participated in an online survey. The questionnaires used in the survey included the self-efficacy questionnaire, resilience questionnaire, and academic motivation questionnaire. Pearson correlation and multiple regression statistical methods were applied to analyze the obtained data. The results pointed to a positive relationship between self-efficacy and academic motivation. In addition, those with a higher degree of resilience were found to experience higher academic motivation. Moreover, the results of multiple regression test revealed that self-efficacy and resilience can significantly predict the academic motivation of the students involved in an online mode of education. The research proposes a number of recommendations for developing the learners' level of self-efficacy and resilience through enacting various pedagogical interventions. In this way, a heightened level of academic motivation would enhance EFL learners' learning rate.

Accelerating digital health literacy for the treatment of growth disorders: The impact of a massive open online course.

Background: Growth hormone deficiency (GHD) is a rare disorder characterized by inadequate secretion of growth hormone (GH) from the anterior pituitary gland. One of the challenges in optimizing GH therapy is improving adherence. Using digital interventions may overcome barriers to optimum treatment delivery. Massive open online courses (MOOCs), first introduced in 2008, are courses made available over the internet without charge to a large number of people. Here, we describe a MOOC aiming to improve digital health literacy among healthcare professionals managing patients with GHD. Based on pre- and post-course assessments, we evaluate the improvement in participants' knowledge upon completion of the MOOC. Methods: The MOOC entitled 'Telemedicine: Tools to Support Growth Disorders in a Post-COVID Era' was launched in 2021. It was designed to cover 4 weeks of online learning with an expected commitment of 2 h per week, and with two courses running per year. Learners' knowledge was assessed using pre- and post-course surveys via the FutureLearn platform. Results: Out of 219 learners enrolled in the MOOC, 31 completed both the pre- and post-course assessments. Of the evaluated learners, 74% showed improved scores in the post-course assessment, resulting in a mean score increase of 21.3%. No learner achieved 100% in the pre-course assessment, compared with 12 learners (40%) who achieved 100% in the post-course assessment. The highest score increase comparing the pre- and the post-course assessments was 40%, observed in 16% of learners. There was a statistically significant improvement in post-course assessment scores from 58.1 ± 18.9% to 72.6 ± 22.4% reflecting an improvement of 14.5% (p < 0.0005) compared to the pre-course assessment. Conclusion: This "first-of-its-kind" MOOC can improve digital health literacy in the management of growth disorders. This is a crucial step toward improving the digital capability and confidence of healthcare providers and users, and to prepare them for the technological innovations in the field of growth disorders and growth hormone therapy, with the aim of improving patient care and experience. MOOCs provide an innovative, scalable and ubiquitous solution to train large numbers of healthcare professionals in limited resource settings.

Online medical education using a Facebook peer-to-peer learning platform during the COVID-19 pandemic: a qualitative study exploring learner and tutor acceptability of Facebook as a learning platform.

BACKGROUND: In recent years, higher education institutions have been moving teaching online, accelerated by the pandemic. The Remote Learning Project (RLP), based at the Norwich Medical School (NMS) in the United Kingdom (U.K.), was a peer-to-peer teaching program developed to supplement medical school teaching during the pandemic. The teaching was delivered through Facebook using peer-to-peer teaching. Tutors were final year medical students, teaching medical student learners in lower years. Tutors and learners perception of peer-to-peer online learning delivered through the Facebook Social Media (SoMe) platform was investigated. METHODS: This qualitative study recruited tutor and learner participants from NMS by email, participation in the study was voluntary. Online semi-structured interviews of both tutors and learners in the remote learning project were conducted. The data was analysed using thematic analysis. RESULTS: Seven participants were interviewed. Five themes were identified; education (learning/teaching), productivity, data security, professionalism, and usability of the platform. Learners enjoyed the asynchronous nature of the platform and both learners and tutors enjoyed the peer-to-peer nature of the RLP, including the ability to immediately and easily answer on Facebook comments. Some learners felt distracted on Facebook, whilst others enjoyed the reminders. The mix of social and professional on the platform was met with caution from tutors. Both learners and tutors enjoyed the familiarity of the platform. CONCLUSIONS: The study found that SoMe may be a credible platform to deliver online peer-to-peer teaching. Educators should consider the ergonomics of SoMe platforms when designing online curriculums. Guidelines for educators should be developed to better guide educators on the effective and safe use of SoMe as a learning tool.

Assignment strategies modulate students' academic performance in an online learning environment during the first and second COVID-19 related school closures.

A growing number of studies seek to evaluate the impact of school closures during the ongoing COVID-19 pandemic. While most studies reported severe learning losses in students, some studies found positive effects of school closures on academic performance. However, it is still unclear which factors contribute to the differential effects observed in these studies. In this article, we examine the impact of assignment strategies for problem sets on the academic performance of students (n ≈ 16,000 from grades 4-10 who calculated ≈ 170,000 problem sets) in an online learning environment for mathematics, during the first and second period of pandemic-related school closures in Germany. We observed that, if teachers repeatedly assigned single problem sets (i.e., a small chunk of on average eight mathematical problems) to their class, students' performance increased significantly during both periods of school closures compared to the same periods in the previous year (without school closures). In contrast, our analyses also indicated that, if teachers assigned bundles of problem sets (i.e., large chunks) or when students self-selected problem sets, students' performance did not increase significantly. Moreover, students' performance was generally higher when single problem sets were assigned, compared to the other two assignment types. Taken together, our results imply that teachers' way of assigning problem sets in online learning environments can have a positive effect on students' performance in mathematics.

Association between neighbourhood composition, kindergarten educator-reported distance learning barriers, and return to school concerns during the first wave of the COVID-19 pandemic in Ontario, Canada.

Introduction: Research to date has established that the COVID-19 pandemic has not impacted everyone equitably. Whether this unequitable impact was seen educationally with regards to educator reported barriers to distance learning, concerns and mental health is less clear. Objective: The objective of this study was to explore the association between the neighbourhood composition of the school and kindergarten educator-reported barriers and concerns regarding children's learning during the first wave of COVID-19 related school closures in Ontario, Canada. Methods: In the spring of 2020, we collected data from Ontario kindergarten educators (n = 2569; 74.2% kindergarten teachers, 25.8% early childhood educators; 97.6% female) using an online survey asking them about their experiences and challenges with online learning during the first round of school closures. We linked the educator responses to 2016 Canadian Census variables based on schools' postal codes. Bivariate correlations and Poisson regression analyses were used to determine if there was an association between neighbourhood composition and educator mental health, and the number of barriers and concerns reported by kindergarten educators. Results: There were no significant findings with educator mental health and school neighbourhood characteristics. Educators who taught at schools in neighbourhoods with lower median income reported a greater number of barriers to online learning (e.g., parents/guardians not submitting assignments/providing updates on their child's learning) and concerns regarding the return to school in the fall of 2020 (e.g., students' readjustment to routines). There were no significant associations with educator reported barriers or concerns and any of the other Census neighbourhood variables (proportion of lone parent families, average household size, proportion of population that do no speak official language, proportion of population that are recent immigrants, or proportion of population ages 0-4). Conclusions: Overall, our study suggests that the neighbourhood composition of the children's school location did not exacerbate the potential negative learning experiences of kindergarten students and educators during the COVID-19 pandemic, although we did find that educators teaching in schools in lower-SES neighbourhoods reported more barriers to online learning during this time. Taken together, our study suggests that remediation efforts should be focused on individual kindergarten children and their families as opposed to school location.

The association between online learning, parents' marital status, and internet addiction among adolescents during the COVID-19 pandemic period: A cross-lagged panel network approach.

INTRODUCTION: Previous research has identified the association between online learning and Internet addiction (IA) and the role of family factors in it. However, few studies have treated IA as a multidimensional mechanism and explored the underlying linkage of online learning, IA, and parental marital status with a cross-lagged network approach. The study aimed to examine the relationship between online learning during the COVID-19 pandemic, Internet addiction (IA), and parental marital status among Chinese adolescents. METHODS: The sample consisted of 2356 adolescents who completed the Internet Addiction Test twice over a four-month period. Four symptom networks and two cross-lagged panel networks were performed. RESULTS: The results showed that adolescents from divorced families had a higher prevalence of IA (27 %) compared to those from non-divorced families (17 %). The strongest cross-lagged association was found between "spending more time online" and "preferring the excitement online". In the divorced group, "school grades suffering" had the highest influence, while in the non-divorced group, "anticipation" had the highest influence. CONCLUSION: This study highlights the relationship between online learning, IA, and parental divorce and suggests that long-term online learning may contribute to IA, and parental divorce may exacerbate problematic Internet use and increase IA levels.

Is online learning during the COVID-19 pandemic associated with increased burnout in medical learners?: A medical school's experience.

INTRODUCTION: The COVID-19 pandemic necessitated a shift to virtual curriculum delivery at Canadian medical schools. At the NOSM University, some learners transitioned to entirely online learning, while others continued in-person, in-clinic learning. This study aimed to show that medical learners who transitioned to exclusively online learning exhibited higher levels of burnout compared to their peers who continued in-person, clinical learning. Analysis of factors that protect against burnout including resilience, mindfulness, and self-compassion exhibited by online and in-person learners at NOSM University during this curriculum shift were also explored. METHODS: As part of a pilot wellness initiative, a cross-sectional online survey-based study of learner wellness was conducted at NOSM University during the 2020-2021 academic year. Seventy-four learners responded. The survey utilized the Maslach Burnout Inventory, the Brief Resilience Scale, Cognitive and Affective Mindfulness Scale-Revised, and the Self-Compassion Scale-Short Form. T-tests were utilized to compare these parameters in those who studied exclusively online and those who continued learning in-person in a clinical setting. RESULTS: Medical learners who engaged in online learning exhibited significantly higher levels of burnout when compared with learners who continued in-person learning in a clinical setting, despite scoring equally on protective factors such as resilience, mindfulness, and self-compassion. CONCLUSION: The results discussed in this paper suggest that the increased time spent in a virtual learning environment during the COVID-19 pandemic might be associated with burnout among exclusively online learners, as compared to learners who were educated in clinical, in-person settings. Further inquiry should investigate causality and any protective factors that could mitigate negative effects of the virtual learning environment.

Student stress and worry related to distance education during the COVID-19 pandemic.

INTRODUCTION: The Coronavirus Disease 2019 (COVID-19) pandemic has caused considerable stress and anxiety in the general population, especially among students. The objective of this study was to determine the stress and anxiety levels among medical rehabilitation students induced by distance education during the COVID-19 pandemic. METHODOLOGY: The sample for this prospective cross-sectional study included 96 students pursuing the medical rehabilitation undergraduate degree at the Faculty of Medicine, University of Novi Sad, Serbia. All respondents took part in an online survey created on the Google Forms platform and accessed via the Facebook social network. The questionnaire included a sociodemographic section, the perceived stress scale (PSS), and the worry about online learning scale (WOLS). All data were analyzed using the IBM SPSS version 25. RESULTS: The study involved 96 students with an average age of 21.97 ± 1.55 years, 72.9% of whom were female. The total stress reported by the students during the COVID-19 pandemic was higher in females than in males (21.75 [SD = 7.50] vs. 17.84 [SD = 8.58]; p < 0.05). Younger students were more susceptible to experiencing stress during the pandemic (rho = -0.217, p < 0.05). Moreover, 57.3% of students suffered from moderate stress, while the WOLS scores indicated that distance education induced a high level of discomfort in this cohort (3.8 [IQR = 1.6]). CONCLUSIONS: Medical rehabilitation students showed a moderate level of stress and a high level of concern about distance education. This stress was more prevalent among younger students and females.

The irreplaceable role of medical massive open online courses in China during the COVID-19 pandemic.

BACKGROUND: Massive open online courses (MOOCs) have become innovative open-learning approach in medical education. This study aimed to evaluate the dynamic changes in the construction and application of medical MOOCs before and after the coronavirus disease 2019 (COVID-19) pandemic in China. METHODS: The dynamic changes of usages about medical MOOCs before and after 2020 were mainly searched on the Smart Education of China Higher Education platform, and the detailed learning profiles and outcome indicators were further analyzed using 40 national first-class medical MOOCs from 'zhihuishu' platform. RESULTS: A total of 2,405 medical MOOCs were exported from the Smart Education of China Higher Education platform, of which 1,313 (54.6%) were launched since 2020. The total and average numbers of participants of 141 national first-class medical MOOCs peaked during the initial spread of COVID-19 in 2020. We further analyzed the dynamic usage of MOOCs from 2018 to 2022 based on 40 national first-class medical MOOCs launched on the 'Zhihuishu' platform. The findings revealed that the number of registered learners (3,240 versus 2,654), questions and answers (27,005 versus 5,116) and students taking the final examination (2,782 versus 1,995) per semester were significantly higher since 2020 compared to these before 2020. Especially, the number of registered learners, registered schools, questions and answers, and students participating in online discussion, taking the unit quiz, taking final examinations and passing final examinations all peaked in the 2020 spring-summer semester. Pearson's correlation analysis found that the number of questions and answers and the number of learners who participated in online discussion were both positively correlated with the number of students who passed the final examination, and the correlation was especially strong since 2020. Moreover, the number of publications on medical MOOC research has soared since 2020 and has maintained a continuous upward trend. CONCLUSIONS: High-quality medical MOOCs have been launched rapidly since the COVID-19 pandemic in China. The number of participants and online interactions of medical MOOCs peaked during the initial spread of COVID-19 in 2020. MOOCs are reliable and valid digital sources that facilitate medical higher education and play irreplaceable roles in emergency management.

Online teaching of undergraduates in pathology during COVID-19 pandemic: An opportunity to grab or dismiss?

Introduction: Covid 19 pandemic has brought human life one on one with the pace of growth. The indispensable lockdown and social distancing norms have posed challenges to continue education in various fields. Distance learning via online teaching has emerged as a savior in the pandemic. In the current scenario, it is very important to keep learners in the loop and obtain feedback from students at the end of online teaching, for understanding its strength and weaknesses which will eventually assist in developing strategies to improve its quality. We intend to share our experience with the online teaching. Materials and Methods: The study was conducted from March 2020 to Feb 2021, which includes 8 months of online teaching classes and practicals, one online examination (mid term exam), and 1 offline examination (final professional exam). The marks obtained by the students who attended online classes (batch II) in 2020-21 session was compared with previous batch i.e 2019-20 (batch I). Also the marks obtained by batch I during online exam (mid-term exam) were compared with their marks during offline exam (final professional exam). Results: Batch II scored higher marks than batch I in theory and practical (p-value < 0.05). However, the marks of viva for both batches were equitable. Conclusions: We feel that the online teaching is a reasonable alternative to conventional teaching in the current scenario.

IMPACT OF DISTANCE EDUCATION ON STUDENTS' HEALTH.

OBJECTIVE: The aim: Studying the impact of distance learning on students' health. PATIENTS AND METHODS: Materials and methods: Special research methods and medical-statistical method. Domestic and foreign students were subject of the study during the online form of education, in connection with Covid-19, poll was made using Google Forms. RESULTS: Results: 333 students participated in the study (22.3% - domestic and 77.7% - foreign students). It was established that 88.3% of foreign and 40.5% of domestic students did not suffer from COVID-19 in the past. The overwhelming majority of respondents (86.5% domestic and 85.1% foreign) noted anxiety and concern for their health. 59.4% of domestic and 63.4% of foreign students noted the deterioration of their mental health and increased anxiety during distance learning. Depressive conditions were experienced by 49.3% of foreigners and 52.0% of domestic respondents. The respondents noticed the negative impact of distance learning on their daily routines, namely sleep, nutrition and active recreation, etc. The most frequent complaints were back pain, headaches, and visual impairment. Students noticed that during online classes their academic performance decreases. CONCLUSION: Conclusions: The transition to online education had a negative impact on the physical and mental health of students, which was manifested in the presence and growth of anxiety and depression, a lack of live communication, sleep and eating disorders, reduced physical activity, the appearance of headaches and back pain, vision problems, attention disorders, and a decline in academic performance.

Readiness, barriers, and attitude of students towards online medical education amidst COVID-19 pandemic: A study among medical students of Ebonyi State University Abakaliki, Nigeria.

INTRODUCTION: The COVID-19 pandemic caused massive disruption to medical education in Nigeria, necessitating the call for online medical education in the country. This study assessed the readiness, barriers, and attitude of medical students of Ebonyi State University Abakaliki, Nigeria, to online medical education. METHODS: A cross-sectional study design was employed. All matriculated medical students of the university participated in the study. Information was obtained using a pre-tested, semi-structured questionnaire which was self-administered. Good attitude towards information and communication technology (ICT) based medical education was determined by the proportion of respondents correctly answering 60% of nine variables. Readiness for online classes was determined by the proportion of students who preferred either a combination of physical and online lectures or only online medical education amidst the COVID-19 pandemic. Chi-square test and multivariate analysis using binary logistic regression analysis were used in the study. A p-value of <0.05 determined the level of statistical significance. RESULTS: Four hundred and forty-three students participated in the study (response rate; 73.3%). The mean age of the students was 23.0±3.2 years. The majority of the respondents, 52.4%, were males. The students' most preferred sources for studying before the COVID-19 pandemic included textbooks, 55.1% and lecture notes, 19.0%. The commonly visited websites included Google, 75.2%, WhatsApp, 70.0% and YouTube, 59.1%. Less than half, 41.1%, have a functional laptop. The majority, 96.4%, have a functioning email address, while 33.2% participated in a webinar during the COVID-19 pandemic. Though 59.2% had a good attitude towards online medical education, only 56.0% expressed readiness for online medical education. The major barriers to online medical education included poor internet connectivity, 27.1%, poor e-learning infrastructure, 12.9% and students not having laptops, 8.6%. Predictors of readiness for online medical education included previous participation in a webinar, AOR = 2.1, (95%CI: 1.3-3.2) and having a good attitude towards IT-based medical education, AOR = 3.5, (95%CI: 2.3-5.2). CONCLUSIONS: The majority of the students showed readiness for online medical education. Lessons from COVID-19 pandemic necessitate the initiation of online medical education. University authorities should ensure that every enrolled medical student owns or have access to a dedicated laptop through a university-mediated arrangement. Adequate attention should be given to the development of e-learning infrastructure, including steady internet services within the confines of the university.

Evaluating the optimised font size and viewing time of online learning in young children: a multicentre cross-sectional study.

OBJECTIVES: Near viewing distance (VD) and longer viewing times are associated with myopia. This study aimed to identify the font size and viewing time that guarantee the appropriate VD and pixels per degree (PPD) for children's online learning. DESIGN: This cross-sectional study comprised two experiments. In experiment A, participants read text in five font sizes on three backlit displays (a personal computer, a smartphone and a tablet), an E-ink display and paper for 5 min per font size. In experiment B, participants watched videos for 30 min on three backlit displays. SETTING: The Peking University People's Hospital in Beijing (China) and the School of Ophthalmology and Optometry, Wenzhou Medical University (Zhejiang Province, China). PARTICIPANTS: Thirty-five participants completed experiment A. Ten of them participated in experiment B. PRIMARY AND SECONDARY OUTCOME MEASURES: VDs were measured by Clouclip. The corresponding PPD was calculated. RESULTS: In experiment A, font size and display type significantly affected VD (F(4840)=149.44, p<0.001, ES (Effect size)=0.77; F(4840), p<0.001, ES=0.37). VDs were >33 cm for all five font sizes on the PC, the tablet and paper and for 18-pt on the smartphone and 16-pt on E-ink. PPD for 16-pt on the PC, 14-pt on the tablet and all five font sizes on the phone were >60. In experiment B, VD increased over the four previous 5 min periods but decreased slightly on tablets and PCs in the fifth 5 min period. PPD was >60. CONCLUSION: Children demonstrated different VDs and PPDs based on font size and display type. To ensure a 33 cm VD and 60 PPD, the minimum font size for online reading should be 18-pt on smartphones, 16-pt on PCs and E-ink, 10.5-pt on tablets and 9-pt on paper. More attention should be given to children's VD with continuous video viewing of more than 25 min. TRIAL REGISTRATION NUMBER: ChiCTR2100049584.

Impact of asynchronous virtual learning on student well-being and success.

INTRODUCTION: As the world has rapidly changed during the COVID-19 pandemic, doctor of pharmacy (PharmD) students' overall well-being has been prioritized. This study aimed to evaluate PharmD students' well-being and perceived academic engagement when moved involuntarily to a majority asynchronous and virtual curriculum during the 2020-2021 academic year in response to the COVID-19 pandemic. Additionally, this study aimed to assess demographic predictors relating student well-being and academic engagement. METHODS: A survey administered via Qualtrics (SAP) was sent to three cohorts of professional students (Classes of 2022 to 2024) enrolled in the PharmD program at The Ohio State University College of Pharmacy. These cohorts were engaged in a primarily asynchronous and virtual curriculum due to COVID-19. RESULTS: Although students displayed mixed results on how asynchronous learning affected their well-being, students replied that they would want to continue learning via a hybrid model (53.3%) or completely asynchronous (24%), while 17.3% wanted primarily synchronous and 5.3% did not reply. CONCLUSIONS: Our results indicated that aspects of the majority asynchronous and virtual learning environment were favored by students. Through student responses, our faculty and staff can take into consideration students' opinions when making future changes to the curriculum. We provided this data for others to consider when evaluating well-being and engagement with a virtual and asynchronous curriculum.

Examination of Musculoskeletal System Disorders and Ergonomic Conditions in the Work Environment of Academics Providing Distance Education During the COVID-19 Pandemic: Controlled Study.

BACKGROUND This study aimed to evaluate whether the incidence rate of musculoskeletal system disorders changed owing to the increase in the time spent on the computer by academics who did or did not provide distance education during the COVID-19 pandemic. MATERIAL AND METHODS The Cornell Musculoskeletal Discomfort Questionnaire was used to assess musculoskeletal discomfort experienced in the past 1 week. In addition, the Occupational Safety and Health Administration (OSHA) Computer Workstations Evaluation Checklist was used to assess the ergonomic structure of the work environment. The questionnaire assessed musculoskeletal system disorders and collected demographic characteristics. RESULTS The study group included 184 (101 male, 83 female) academics who provided distance education, whereas the control group included 82 (44 male, 38 female) academics who did not provide distance education. The mean ages of academics in the study group and control group were 37.46±7.34 and 41.26±10.06 years, respectively. Although computer-based work environment ergonomics were similar (P>0.05) in both groups during the pandemic, the incidence rate of musculoskeletal disorders was significantly high in the study group (P<0.001). These disorders were mostly seen in the neck, back, and waist regions (P<0.001). CONCLUSIONS The results suggested that the incidence rate of musculoskeletal disorders increased in academics who provided distance education during the COVID-19 pandemic.