E-learning and E-modules in medical education-A SOAR analysis using perception of undergraduate students.

BACKGROUND: Application of e-learning and e-modules in medical education has been shown to have a positive impact on learning outcomes among all types of learners, across diverse educational settings. Despite its benefits, e-learning and e-modules has not yet reached its full potential in medical education in India. Objective of this study is to evaluate the perception of undergraduate students regarding e-learning and e-modules using an appreciative inquiry tool SOAR (Strengths, Opportunities, Aspirations, Results) analysis, and to identify the barriers and challenges for the same. METHODS: This longitudinal study was conducted among participants from three consecutive batches (n = 250 x 3) of first-year medical students and two consecutive batches (n = 100 x 2) of first-year dental students. The sample was selected using a purposive sampling method. Two structured and validated questionnaires were developed for this study based on the modified Zhou's Mixed Methods Model; the 'Knowledge, Attitude and Practice' Questionnaire (KAPQ) on e-learning and the feedback questionnaire (FBQ) on e-modules. The questionnaires were administered via MOODLE / hard copy, before and after the implementation of e-modules, respectively. Identified strengths, potential opportunities, probable aspirations and likely results for e-learning and e-modules were tabulated based on the qualitative analysis of perceptions of large number students sampled across three years. RESULTS: Six hundred and ninety students returned both questionnaires representing a response rate of 76.6%. Nine themes were identified in the "Strengths" domain as follows: Regular Update of Knowledge, Innovative Learning, Availability, Knowledge Sharing, Abundance of Information, Accessibility, Source of Knowledge, Creativity, and Increased Engagement. Eleven themes were identified in the "Opportunities" domain as follows: Clinical Skills training, Timesaving, Flexibility, Creativity, Increased engagement, Standardized content, Capacity building for students, Capacity building for faculty, Skills training, and Self-assessment. Thirteen themes were identified under the "Aspirations" domain with the three key themes being "maintaining and building on current strengths", "increasing potential opportunities", and "addressing the barriers and challenges identified in the responses to the KAPQ and FBQ questionnaire". Four themes identified for 'Barriers' were eye strain, distractions, preference for conventional methodologies, and internet connectivity. CONCLUSIONS: The findings of this qualitative study are based on the responses received from first-year medical and dental students of a Private University in Chennai, India. In this population of students, implementation of e-learning as blended learning using structured and interactive e-modules may provide more engagement during learning as well as support self-directed learning (SDL) directly or indirectly. Adoption of blended learning with e-modules as an integral part of curriculum planning may be beneficial for the achievement of Competency-Based Medical Education (CBME) goals in India.

Effect of Bhramari pranayama practice on simple reaction time in healthy adolescents - a randomized control trial.

OBJECTIVES: The improvement in the/reaction time is important, as it is an indicator of cognitive function. Therefore, there is a need, especially for adolescents in the form of techniques or courses that can improve the reaction time. Yoga was found to cause a better improvement in the health of the individuals. The present study intended to show the effects of Bhramari pranayama (Bhr.P) on reaction time in the healthy adolescents. METHODS: Of the 730 potential subjects screened, 520 apparently healthy adolescents randomly assigned to either the Bhr.P group (n-260) or control group (n-260). Bhr.P group practiced the bhramari pranayama for 3 days in a week for 6 months. The Auditory Reaction Time (ART) and the Visual Reaction Time (VRT) were assessed before and after Bhr.P pranayama practice. RESULTS: Bhr.P group shows significant shortening of response time in both VRT (from 267.13 ± 52.65 to 249.87 ± 39.41 ms) and ART (from 237.42 ± 48.12 to 227.91 ± 34.60 ms) after 6 months of Bhr.P practice. In control group subjects, no such significant changes were found (p > 0.05). CONCLUSIONS: Shortening of RT implies an improvement in the information processing and reflexes. This beneficial effect of Bhr.P on reaction time can be used for improving cognitive function in the adolescents for their academic performances.

Effects of yoga breathing practice on heart rate variability in healthy adolescents: a randomized controlled trial.

BACKGROUND: This study was conducted among healthy adolescents to assess the effects of a yoga breathing practice (Bhramari pranayama, Bhr.P) towards cardiac autonomic function using heart rate variability (HRV) parameters. METHODS: Of the 730 eligible subjects screened, 520 healthy adolescents who met the inclusion and exclusion criteria were randomly assigned to either yoga breathing group (n = 260) or control group (n = 260). The yoga breathing group practiced Bhr.P. five days a week for a duration of six months while the control group continued with their daily routine without any intervention. Outcome measures were time and frequency domain of HRV in both groups which were assessed before and after the intervention using Lead II ECG. Linear models were used in the analysis of short term HRV. RESULTS: After 6 months of yoga breathing, the time domain parameters of short term HRV showed significant (P < 0.05) improvement towards the parasympathetic domain. Frequency domain parameters also showed the same direction of changes. In contrast, control group subjects showed a trend towards a sympathetic domain. CONCLUSION: The present study showed a positive shift in cardiac autonomic modulation towards parasympathetic predominance after 6 months of yoga breathing practice among apparently healthy adolescents.