Medical Students' Perceptions and an Anatomy Teacher's Personal Experience Using an e‐Learning Platform for Tutorials During the Covid‐19 Crisis

Abstract

To the Editor, Anatomical Sciences Education: The Covid-19 crisis has caused devastation around the world, where face-to-face (F2F) teaching in universities has been abandoned and anatomy education courses shifted to the virtual mode (Evans et al., 2020; Ravi, 2020). In fact, e-learning platforms have become increasingly popular in teaching practices in tertiary institutions, in particular health professional education (Lewis et al., 2014), and mainly ascribed to observed learning benefits through verbal, visual, and auditory stimulations (Selim, 2007; Jelonek, 2015). E-learning is a way of teaching supported by digital technologies as underlined by the definition that e-learning is “the use of new multimedia technologies and the internet to improve the quality of learning by facilitating access to resources and services, as well as remote exchange and collaboration” (Alonso et al., 2005). Due to the institution of a partial lockdown or what has been termed as a “circuit breaker” to curb the spread of Covid-19 in Singapore, we take the example of a medical school in Singapore where Anatomy is taught to first year medical students by didactic lectures and prosection sessions to large groups of students (approximately 280 medical students for lectures and 100 students per group for prosection practical sessions) and tutorials to small groups of students (around 18 medical students). Steps have been taken to use e-learning platforms to reduce F2F interactions. Anatomy lectures were delivered using e-learning strategies such as webcast from the previous year and/or recording of narrated lecture slides using PowerPoint presentation, as well as Zoom video conferencing platform for conducting interactive large and small group classes. This letter outlines the tutor's and students' perceptions and challenges encountered while conducting an Anatomy e-tutorial for 2 hours using Zoom (a video conferencing tool), scheduled at the end of head and neck region teaching block. Students were first notified of the e-tutorial using the Zoom platform via email so that everyone can access the session via the given link. The e-tutorial was conducted on head and neck topics that included pharynx, larynx and ear. To facilitate the e-tutorial session, PowerPoint slides were shared in real time with all the students. Both tutor and students had engaging discussions and students were able to clarify any doubts regarding understanding of the material. The 18 students in the group used the Zoom platform on their laptops, desktops, tablets, and smartphone to access the tutorial session, supporting the use of the flexibility of this platform for supporting teaching and learning in distance education, whether it is for one-to-one, one-to-many, and/or many-to-many sessions (CITR, 2019). After the e-tutorial, students received a questionnaire designed to evaluate their opinions about Zoom platform on a five-point Likert scales. The two statements in the questionnaire were: (1) I am satisfied with the understanding and learning of anatomy using Zoom; and (2) Please provide one way in which Zoom can be enhanced further to maximize learning in anatomy (an open-ended question). Although Zoom has basic annotation tools that a teacher can use to guide students around a visual display or explain a concept, students may be unable to visualize the pointer if using shared screen indicating the structure of interest by the tutor. Another challenge faced is that it is not easy to perceive the images that is, 3D relations of the structures which are necessary in learning anatomy during the e-tutorial. A number of students have reflected on the need for more interaction in the e-tutorial using Zoom platform like using Poll Everywhere (PollEv). An emerging platform used to facilitate small group teaching is the numerous audience response software that has been made available which allows for tutor–student interaction, such as PollEv, Slido, Glisser, Crowdpurr, OMBEA, Pigeonhole Live, TurningPoint, Bravura, Crowd Connected, MeetingPulse, and many others (Bay et al., 2020). Overall, both students and tutor were positive about the e-tutorial using Zoom platform. The present study has highlighted that Zoom can be adopted as a useful and effective teaching tool for conducting e-tutorials in anatomy, although a limitation is the small sample size. E-learning platforms can be enhanced further to maximize students learning by including interactions using PollEV and quizzes. To date, there has been no study reported on Anatomy e-tutorial using the Zoom platform from a medical educator's perspective although there are reports on barriers which students face and solutions for improving engagement with online learning (Muilenburg and Berge, 2005; Gormley et al., 2009; O’Doherty et al., 2018). Further studies should be conducted to assess the effectiveness of various e-learning strategies for conducting tutorials, which could open a new vista for Anatomy education. It is thus clear that implementation of effective and successful online learning and inclusion of digitally enabled resources, can provide a range of other positive outcomes including developing a learning environment that caters for students with different pace of learning and those that require multiple learning channels, as well as facilitating opportunities for deeper learning (Ozer et al., 2017; Guy et al., 2018; Evans et al., 2020). On the flip side, e-learning has been observed to result in loss of integrated “hands-on” experiences with impacts on workload, traditional roles, pedagogy, and personal educational philosophies of anatomy teachers (Pather et al., 2020). Still, medical educators should continue to engage with e-learning even post-Covid-19, in an effort to come up with innovative approaches to train medical students as new educational methods are always appreciated by students and have the potential to provide better engagement compared with traditional didacticism (Huynh, 2017). Progressive implementation of computer-based learning methods have been deemed crucial for continuing medical education reforms, providing new challenges, and opportunities for anatomical sciences educators (Trelease, 2016).

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