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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 10  |  Issue : 1  |  Page : 10-16

A Study on the Advantages and Disadvantages of the Online Teaching Program Conducted in the Department of Anatomy, AIIMS, Raipur – Students' Perspective


1 Post Graduate, Department of Anatomy, AIIMS, Raipur, India
2 Additional Professor and HOD, Department of Anatomy, AIIMS, Raipur, India
3 Senior Resident, Department of Anaesthesiology, AIIMS, Raipur, India
4 Additional Professor, Department of Anatomy, AIIMS, Raipur, India

Date of Submission18-Aug-2020
Date of Decision18-Sep-2020
Date of Acceptance27-Nov-2020
Date of Web Publication27-Jan-2021

Correspondence Address:
Vijay Kumar Konuri
703/5A, AIIMS Complex, Kabir Nagar, Raipur - 492 001, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/NJCA.NJCA_12_20

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  Abstract 


Background: Medical education in India always relied on the traditional classroom method of teaching. The current COVID pandemic brought a situation where online classes have taken precedence over the traditional classroom teaching. Here we attempt to see from the students' perspective whether online classes can replace the traditional classroom teaching. Aims and objectives: We aimed to study the advantages and disadvantages of online learning. Materials and methods: Online live streamed classes using Free Conference Call app were held in the Department of Anatomy, AIIMS Raipur. Live streaming, pre-recorded lecture videos were supplemented by cadaveric dissection videos, assignments etc posted in Google Classroom. Feedback regarding the online classes were obtained from first year undergraduate medical students using Google Forms. Results: A total of 72 students responded to the survey. 57 students used mobile phones to access the classes. 10 students preferred the online classes with chalk and board lecture, 23 students preferred lecture with PowerPoint presentation while the rest preferred online classes with chalk and board lecture followed by PowerPoint presentation. Out of the total (n=72) respondents, majority of them experienced technical issues which hampered their online learning experience. Owing to this reason, 43 students showed preference for pre-recorded videos over online live classes. 41.7% of the students opined that online classes should be included as a part of MBBS anatomy curriculum. Conclusion: Online learning in the form of live classes and recorded videos can be included as a part of routine Anatomy curriculum but it can never be a substitute for interactive face to face classroom learning and practical session.

Keywords: COVID-19, flipped classroom, Free Conference Call, lockdown, neuroanatomy teaching, online teaching


How to cite this article:
John MR, Sharma DK, Poonuraparampil JA, Konuri VK. A Study on the Advantages and Disadvantages of the Online Teaching Program Conducted in the Department of Anatomy, AIIMS, Raipur – Students' Perspective. Natl J Clin Anat 2021;10:10-6

How to cite this URL:
John MR, Sharma DK, Poonuraparampil JA, Konuri VK. A Study on the Advantages and Disadvantages of the Online Teaching Program Conducted in the Department of Anatomy, AIIMS, Raipur – Students' Perspective. Natl J Clin Anat [serial online] 2021 [cited 2021 May 12];10:10-6. Available from: http://www.njca.info/text.asp?2021/10/1/10/308111




  Introduction Top


The current COVID pandemic has come as a jolt in the blue for all nations, and health-care workers are tirelessly fighting against it. This pandemic has brought a whole new aspect to learning for students. E-learning for medical students also has taken a front stage due to the lockdown. Owing to the advancements in technology and the availability of the Internet, online classes are being held by various apps such as Zoom, Google Classroom, Free Conference Call, Telegram, Skype, YouTube, and FaceTime which provide an interactive platform for learning in this extended break.

Prepandemic preview of online learning versus in-pandemic changes/innovations

The traditional classroom method of learning with teacher and student has been practiced since ages. Before the pandemic, regular classroom with teachers and students remained the preferred mode of lecture, but online education too was making a mark in the field of education around the world. Online education calls for skilled instructors who are proficient in the subject as well as in the use of technology. The pedagogical techniques employed by the instructors determine the quality of online education.[1]

Massive open online courses (MOOCs)[2] have been introduced by many universities globally to meet the educational needs of students. These courses have garnered a wide audience due to its accessibility and affordability. Nemer and Neill have opined that Indian students account for the second highest number of people opting for MOOC.[3] MOOCs have not only trained students and faculty in theoretical dogmas but also have enhanced their soft skills and research capabilities.[4] Continuing medical education programs are now conducted online by webinars, podcasts, etc. Medical professionals require regular updates in their respective fields of knowledge, and they can use MOOC in the pursuit of continuing professional development.[5] The Study Webs of Active-Learning for Young Aspiring Minds and the National Programme on Technology Enhanced Learning developed in India are among the many platforms which provide free courses for various disciplines.[6],[7] The advantages of MOOCs are affordability, wider audience, low cost of development, favorable timings, self-pacing, increased creative skills, sharing of ideas, and knowledge. The disadvantages include higher student dropout, reduced return of investment for course developers, and issues with course recognition and certification leading to reduced employability.[4]

Newer methods such as the flipped model/inverted classroom models[8],[9] have been developed, where out-of-class activities are followed by face-to-face classroom activities. This type of learning method focuses on the student rather than the teacher. The classroom activities include discussions, group activities, projects, presentations, microlectures, case studies, gaming, guest lectures, student assignments, and many more.[10] Videos, online modules, PowerPoint presentations, audio lectures, tutorials, etc., are included in the out-of-classroom activities. Although there are several advantages to this model such as improved student outcome, increased interaction, and improved skills, there are some disadvantages to it such as increased burden on the students as well as teachers and limited access to technology.

In addition to the above mentioned methods, e-books, webinars, podcasts, blogs, etc., have been used as educational tools by several instructors.[1] Although these methods have been implemented by many institutes, traditional classroom and clinical training always took precedence over online leaning in medical education.

Ferrel and Ryan,[11] Sandhu and de Wolf,[12] and Edigin et al.[13] described how the COVID-19 pandemic has affected the medical education all over the world. Face-to-face classrooms have been replaced by online live or prerecorded classes. Medical students' clinical rotations which include case presentations to impart skills and training to medical students have been canceled. Resident doctors, however, continued with their clinical work. Exposure of training doctors to medical conferences enhancing their academic skill and personal development has also suffered a setback. Undergraduate, postgraduate, and licensing examinations have been canceled. Newer assessment methods such as open book examinations and online live examinations are being practiced. Students and faculty are now forced to adapt to a new system of education which might be temporary or may be the new normal.

The current pandemic has forced the medical fraternity to use the online platform for medical education and clinical training. Pather et al.[14] studied anatomy teaching methods during this pandemic period from 10 universities in Australia and New Zealand. The cadaveric dissection was suspended owing to lockdown. Most of the colleges resorted to online live lecture classes or prerecorded lectures prepared before the pandemic. Online lectures were supported with other digital resources such as three-dimensional (3D) virtual dissection classes and cadaveric dissection videos. Similar strategies for anatomy teaching have been adopted in the United Kingdom and the Republic of Ireland as described by Longhurst et al.[15] They performed a strengths, weaknesses, opportunities, and threats analysis of the newer system in place. The strengths include the utilization of already available online resources and development of newer ones for teaching and assessment. Lack of cadaveric dissection classes and practical classes and student academic assessment issues are few of the weaknesses. This pandemic has offered an opportunity for exploring newer methods of learning like blended learning and working with other professional expertise worldwide. The threats include the reduced involvement of students and the varied student teacher interaction.

Online classes – the Indian scenario

Online classes have revolutionized learning and teaching with minimal requirements that included a smartphone or laptop with Internet connection. Shah[16] in 2005 has mentioned his experience of using telemedicine in India to reach people in rural areas. He weighed the merits and demerits of online education and suggested that blended learning can be an option for Indian students.

The success of any program can be attributed to the availability of technology and resources to both the teacher and the student. As per data released by the Telephone Regulatory Authority of India, total Internet subscriber (per 100 population) is 52.08 in the last quarter of 2019. The urban subscriber (per 100 population) is 104.25 while it is 27.57 (per 100 population) in the rural areas revealing a huge discrepancy between the two.[17] Furthermore, the smartphone penetration rate in India is lower than that of a developed nation like the USA.[18] The question to be raised here is whether online learning further increases the disparity between medical students from rural and urban locations. Medical students, in general, may be able to afford a smartphone or a laptop, but network issues and other technical issues will still be faced by them during live-streamed classes.

A survey of 77 postgraduate pediatric residents was conducted during this in-pandemic period by Agarwal and Kaushik regarding online classes using Zoom platform.[19] The students were satisfied by the online training imparted and suggested for implementation of online classes in postgraduate curriculum.[19] Another aspect to be researched, especially at this in-pandemic period, is the improvement in the self-directed learning skills of medical students in India.[20]

Anatomy as a subject requires students to have a 3D visualization of the human body to aid their learning. An attempt is made here to review the feedbacks of 1st-year undergraduate medical students located in various parts of India taking online classes via Free Conference Call app. Their preferences as well as the issues faced while having online live-streamed classes are being discussed here.

Online live classrooms have several advantages which have been highlighted by many researchers. The downside, as perceived, lies in the technical issues and other minor issues which could hamper the smooth functioning of these live classes, especially in the Indian scenario.

NB- The terminology “in-pandemic” is perhaps being used for the first time to describe the current time of COVID-19 pandemic as opposed to pre or post pandemic.


  Materials and Methods Top


Online live-streamed neuroanatomy classes were held in the Department of Anatomy, AIIMS, Raipur, for first professional MBBS students using Free Conference Call app. The different methods adopted by the faculty while taking online live classes were (a) traditional chalk and board lecture, (b) lecture with Microsoft PowerPoint presentation, and (c) traditional chalk and board lecture followed by Microsoft PowerPoint presentation. Some topics were taught using prerecorded videos also. Online assignments and discussions were conducted using Google Classroom. Videos of cadaveric dissections performed in the department were shared in Google Classroom. Feedback from 1st-year MBBS students regarding the online live-streamed classes were taken using Google Forms (Appendix). Personal details of the participants were not collected. Clearance for the study was obtained from the Research Committee and Institute Ethics Committee of AIIMS, Raipur (Proposal no. AIIMSSRPR/IEC/2019/273). Out of the 100 students, 72 students gave feedback, and these were analyzed, and the following results were obtained.


  Results Top


Out of the total respondents (n = 72), 57 (79.2%) students used mobile phones, 11 (15.3%) students used laptops, and the rest of them used tablets for accessing the Free Conference Call app. 98.6% reported using the app for the first time. Fifty-seven (79.2%) students used mobile Internet connection, 7 (9.7%) students used Wi-Fi network, while 8 (11.1%) students used both mobile internet and Wi-Fi network [Table 1].
Table 1: General Information regarding app use

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Majority of the students experienced frequent technical issues which could have made them prefer a PowerPoint presentation to supplement the class [Figure 1] and [Figure 2] and [Table 2].
Figure 1: Pie chart representation of students response to interruptions during 1 hour online class

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Figure 2: Students' responses to teaching methods

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Table 2: Technical issues (n=72)

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Among the 72 students, 51 (70.8%) students preferred the traditional face-to-face classroom over the online classes. Furthermore, 43 (59.7%) students favored prerecorded classes which did not have the issue of technical glitches while only 6 (8.3%) students preferred the online live classes. Ten students preferred the online classes with chalk and board lecture, 23 students preferred lecture with PowerPoint presentation, while the rest preferred online classes with chalk and board lecture followed by PowerPoint presentation [Table 3] and [Figure 3].
Figure 3: Students' response to different mode of teaching

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Table 3: Student's preferences

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41.7% of the students strongly agreed that online classes should be included as a part of MBBS anatomy curriculum while 48.6% of the students disagreed on the matter while the rest of the students opined that online classes may be included as part of the curriculum.

Even though students were attending online classes from their own homes, due to technical and nontechnical issues, only 51 (70.8%) of the total (n = 72) students actually attended all the classes.

The questions and the students' responses are given below. The questions and the answers were tabulated in [Table 1] and [Table 3].


  Discussion Top


Teaching underwent several changes, and the sudden lockdown situation due to COVID-19 has forced all medical institutes to implement online teaching modules. AIIMS, Raipur, also was forced to redesign its teaching methods and so the Anatomy Department had started online classes with the help of Free Conference Call app, WhatsApp group, and Google Classroom platform. Lockdown happened in the mid of neuroanatomy course, so the second half of this course went online.

Classes were taken in the department as virtual lectures (without students) in front of the laptop. These lectures were broadcast through Free Conference Call app in Google classroom. Some faculty had posted few PowerPoints. Some dissections of head and neck were done by the faculty but posting them online met with difficulties because of the size of the videos.

These classes were received well by the students, in spite of several students (87.5%) having technical difficulties. The most common difficulties faced by the students were because of internet bandwidth. Several students residing in remote areas have no access to good internet connection. The classes were received well by the students and they liked them, as they felt difficulty in reading text books without prior classes. Hence, many intricate details of neuroanatomy were discussed in these classes.

The satisfaction levels of the students were high as they understood the urgency and the situational pressures [Figure 4]. Students felt (41.7%) that the online method of teaching, which could be extended to flipped classroom models, should be continued even if the lockdown ends. Students also strongly felt (48.6%) that the online method of teaching could not replace the traditional method of direct face-to-face teaching. Students felt that during the course of online classes, they lost the human and personal touch of the teachers.
Figure 4: Students' rating to online classes

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Gaur et al.[21] had opined that novel and authentic assessment strategies are required for the students to develop a set of graduate attributes or “soft skills” and to demonstrate understanding and application of the relevant basic science knowledge required for clinical phase.

Liang et al.[22] discussed the various ways in which the COVID-19 crisis has affected medical education in Singapore and suggested exploration of pertinent practical and creative solutions from their previous experience with the SARS outbreak in 2003 as well as the current ongoing COVID-19 crisis.

Iqbal et al.[23] concluded that Telegram app offers more functionalities and fewer potential drawbacks than many other applications such as Zoom or Google Meet.

Khalil et al.[24] from Saudi Arabia had analyzed their experiences and summarized that almost three-fourth of the participants (72%, n = 43) resided within the city (Unaizah) where their medical college campus was located. During the analysis, subthemes were identified by them and were classified under four major themes. The four core themes included the following: (1) educational impact, (2) time management, (3) challenges encountered, and (4) preferences for future application.

Rajab et al.[25] reported that 57.9% of the faculty, 42% of master's students, and 37.4% of medical students reported having little or no experience of online teaching before the pandemic.

Rafi et al.[26] had made a study with certain questions for future planning of online classes. SHe has addressed issues of duration of online classes, requirement of online classes after the regular classes starts, need of online practical classes, reusability of online material and role of college and university in conducting online classes.

The ubiquitous presence of modern technology has served as silver lining even during pandemic.[27]


  Conclusion Top


Online classes worked well in the present scenario of sudden lockdown due to COVID pandemic. However, they have their own drawbacks to be used in a regular scenario. In general times, online classes can be used as a supplement to live face-to-face classes. Proper technical equipment should be procured and kept ready to handle such exigencies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


  Appendix- Questionnaire Top


Feedback form-Online Neuroanatomy classes

Feedback regarding the online live neuroanatomy classes taken using free conference call app.

General info regarding app use

  1. What kind of internet connection do you use to access the app? * Mobile internet / WiFi / Broadband / Other ____
  2. Is this your first time using this app? * Yes / No
  3. How do you access the app? * Mobile / Tablet / Laptop
  4. How do you attend the classes? *Alone / With a friend / As a group


  5. Technical issues

  6. What technical issues have you faced while using the app? * (Check all that apply)


    1. Network issues
    2. Video not clear
    3. Audio not clear
    4. Host server down
    5. session ends abruptly
    6. None of the above
    7. Other _____


  7. How frequently have you faced a technical issue over a 1 hour class *(Check all that apply)


    1. 1 time
    2. 2 times
    3. 3 times
    4. > 3 times
    5. Never


  8. In an average class of one hour duration how long have you been able to attend without any interruption [technical issues]? * Less than 30 minutes / more than 30 minutes
  9. What other issues have you faced? *(Check all that apply)


    1. Handwriting not clear on board
    2. Chalk colour not clear for figures
    3. Timing not favourable
    4. Unable to follow class after technical issue
    5. None of the above
    6. Other ___


  10. What are the disadvantages of online live streamed classes? *(Check all that apply)


    1. Timing
    2. Concepts not clear
    3. Doubts not cleared immediately
    4. Unable to follow classes due to technical issues
    5. Not interactive
    6. None of the above
    7. Other ___


  11. What are its advantages ? * (Check all that apply)


    1. Favourable timing
    2. Comfort of home
    3. Simultaneous use of other learning aids
    4. None of the above
    5. Other ___


  12. What method of teaching do you prefer for online live classroom using app? *


    1. Lecture with chalk and board
    2. Lecture with powerpoint presentation
    3. Lecture with chalk and board followed by ppt


  13. Which classroom experience did you find better? * (Check all that apply)


    1. Regular face to face classes
    2. Online live classroom
    3. Recorded video


  14. Do you think e-learning [online live lectures, recorded videos] should be a part of MBBS anatomy curriculum? * Yes / No / May be


  15. Rating and suggestions

  16. Have you attended all the neuroanatomy online classes? * a. Yes b. No
  17. Kindly give a rating on your online class experience using the free conference call app * Excellent / Good / Average / Bad / Very bad
  18. Kindly give in any suggestions for improvement




 
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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