
The Covid-19 pandemic continues to cause serious physical and mental problems for health professionals, particularly nurses.
To estimate the prevalence of anxiety and insomnia and to evaluate their possible association with family support received by nurses two years after the onset of the pandemic.
In total, the study participants were 404 nurses (335 females and 69 males) with a mean age of 42.88 (SD = 10.9) years and a mean of 17.96 (SD = 12) years working as nurses. Nurses from five tertiary hospitals in Athens constituted the study population who completed the questionnaires State-Trait Anxiety Inventory (STAI), Athens Insomnia Scale (AIS) and Family Support Scale (FSS), in the months of November and December 2021. Regarding demographic and occupational characteristics, gender, age and years of experience as nurses were recorded.
60.1% of the nurses showed abnormal scores in state anxiety, with 46.8% in trait anxiety, and 61.4% showed insomnia. Women showed higher scores on the two subscales of anxiety and the insomnia scale compared to men (p < 0.01 and p < 0.05 respectively), while they showed a lower score on the FSS without statistical significance (p > 0.05). Positive correlations (p < 0.01) were found between the State Anxiety Inventory, Trait Anxiety Inventory and AIS, while all of them showed a high negative correlation with FSS (p < 0.01). Age showed a negative correlation with Trait Anxiety Inventory (p < 0.05). As shown by the mediation analysis, the relationship between state anxiety and insomnia was mediated by trait anxiety, whereas state anxiety appeared to be dependent on family support.
Nurses continue to experience high levels of anxiety and insomnia and feel less supported by their families than in the first year of the pandemic. Insomnia appears to be dependent on state anxiety, with a significant indirect effect of trait anxiety, while family support seems to affect state anxiety.
Citation: Christos Sikaras, Maria Tsironi, Sofia Zyga, Aspasia Panagiotou. Anxiety, insomnia and family support in nurses, two years after the onset of the pandemic crisis[J]. AIMS Public Health, 2023, 10(2): 252-267. doi: 10.3934/publichealth.2023019
[1] | Yosef Mohamed-Azzam Zakout, Fayez Saud Alreshidi, Ruba Mustafa Elsaid, Hussain Gadelkarim Ahmed . The magnitude of COVID-19 related stress, anxiety and depression associated with intense mass media coverage in Saudi Arabia. AIMS Public Health, 2020, 7(3): 664-678. doi: 10.3934/publichealth.2020052 |
[2] | Prasanna Kannan, Jasmin Bhawra, Pinal Patel, Tarun Reddy Katapally . Preserving rural school health during the COVID-19 pandemic: Indigenous citizen scientist perspectives from a qualitative study. AIMS Public Health, 2022, 9(2): 216-236. doi: 10.3934/publichealth.2022016 |
[3] | Pamila Sadeeka Adikari, KGRV Pathirathna, WKWS Kumarawansa, PD Koggalage . Role of MOH as a grassroots public health manager in preparedness and response for COVID-19 pandemic in Sri Lanka. AIMS Public Health, 2020, 7(3): 606-619. doi: 10.3934/publichealth.2020048 |
[4] | Nguyen Tuan Hung, Vu Thu Trang, Trinh Van Tung, Nguyen Xuan Long, Ha Thi Thu, Tran Song Giang, Tran Hoang Thi Diem Ngoc, Vu Thi Thanh Mai, Nguyen Kim Oanh, Nguyen Thi Phuong, Nguyen Hang Nguyet Van, Nguyen Hanh Dung, Pham Tien Nam . COVID-19-related music-video-watching among the Vietnamese population: lessons on health education. AIMS Public Health, 2021, 8(3): 428-438. doi: 10.3934/publichealth.2021033 |
[5] | Sushant K Singh . COVID-19: A master stroke of Nature. AIMS Public Health, 2020, 7(2): 393-402. doi: 10.3934/publichealth.2020033 |
[6] | Srikanth Umakanthan, Anuradha Chauhan, Madan Mohan Gupta, Pradeep Kumar Sahu, Maryann M Bukelo, Vijay Kumar Chattu . COVID-19 pandemic containment in the Caribbean Region: A review of case-management and public health strategies. AIMS Public Health, 2021, 8(4): 665-681. doi: 10.3934/publichealth.2021053 |
[7] | Sukhbir Singh, Manjunath B Govindagoudar, Dhruva Chaudhry, Pawan Kumar Singh, Madan Gopal Vashist . Assessment of knowledge of COVID-19 among health care workers-a questionnaire-based cross-sectional study in a tertiary care hospital of India. AIMS Public Health, 2021, 8(4): 614-623. doi: 10.3934/publichealth.2021049 |
[8] | Safaa Badi, Loai Abdelgadir Babiker, Abdullah Yasseen Aldow, Almigdad Badr Aldeen Abas, Mazen Abdelhafiez Eisa, Mohamed Nour Abu-Ali, Wagass Abdelrhman Abdella, Mohamed Elsir Marzouq, Musaab Ahmed, Abubakr Ali M Omer, Mohamed H Ahmed . Knowledge and attitudes toward COVID-19 vaccination in Sudan: A cross-sectional study. AIMS Public Health, 2023, 10(2): 310-323. doi: 10.3934/publichealth.2023023 |
[9] | Seyedeh Fatemeh Ghafari, Jamileh Mahdizadeh, Ali Valinejadi, Esmaeil Mehraeen, Ali Mohammadpour, Hamid Bouraghi, Mehdi Kahouei . Iranian physicians’ expectations of telemedicine development and implementation infrastructures in teaching hospitals. AIMS Public Health, 2019, 6(4): 514-522. doi: 10.3934/publichealth.2019.4.514 |
[10] | Akari Miyazaki, Naoko Kumada Deguchi, Tomoko Omiya . Difficulties and distress experienced by Japanese public health nurses specializing in quarantine services when dealing with COVID-19: A qualitative study in peri-urban municipality. AIMS Public Health, 2023, 10(2): 235-251. doi: 10.3934/publichealth.2023018 |
The Covid-19 pandemic continues to cause serious physical and mental problems for health professionals, particularly nurses.
To estimate the prevalence of anxiety and insomnia and to evaluate their possible association with family support received by nurses two years after the onset of the pandemic.
In total, the study participants were 404 nurses (335 females and 69 males) with a mean age of 42.88 (SD = 10.9) years and a mean of 17.96 (SD = 12) years working as nurses. Nurses from five tertiary hospitals in Athens constituted the study population who completed the questionnaires State-Trait Anxiety Inventory (STAI), Athens Insomnia Scale (AIS) and Family Support Scale (FSS), in the months of November and December 2021. Regarding demographic and occupational characteristics, gender, age and years of experience as nurses were recorded.
60.1% of the nurses showed abnormal scores in state anxiety, with 46.8% in trait anxiety, and 61.4% showed insomnia. Women showed higher scores on the two subscales of anxiety and the insomnia scale compared to men (p < 0.01 and p < 0.05 respectively), while they showed a lower score on the FSS without statistical significance (p > 0.05). Positive correlations (p < 0.01) were found between the State Anxiety Inventory, Trait Anxiety Inventory and AIS, while all of them showed a high negative correlation with FSS (p < 0.01). Age showed a negative correlation with Trait Anxiety Inventory (p < 0.05). As shown by the mediation analysis, the relationship between state anxiety and insomnia was mediated by trait anxiety, whereas state anxiety appeared to be dependent on family support.
Nurses continue to experience high levels of anxiety and insomnia and feel less supported by their families than in the first year of the pandemic. Insomnia appears to be dependent on state anxiety, with a significant indirect effect of trait anxiety, while family support seems to affect state anxiety.
The COVID-19 pandemic has created a global health care crisis with a range of unprecedented challenges, including a severe impact on the entire education system. Medical and health education has been dramatically affected by the closure of higher education institutions. The effects of the COVID-19 pandemic are ongoing, and there is uncertainty about how long it will last. Considering the need of the situation, Universities across the globe prefer continuing teaching and learning via online mode [1]. Although online learning is not a new concept, it was not mandatory for academic institutions before the pandemic [2]. Medical teachers and students started learning how to equip themselves with technological skills. For some teachers, the immediate shifting from face-to-face to online teaching was a huge challenge, while others with prior experience quickly acclimatized themselves with this new learning mode [3]. Stoehr et al. (2021) found a positive attitude of medical students towards online learning. However, the study revealed a considerable discrepancy between what students demand and the curriculum offers. Thus, it was concluded by the authors that the COVID-19 pandemic might be the long-awaited catalyst for a new “online era” in medical education [4].
Globally, different medical schools were already using the learning management system (LMS) as a platform where the teachers were sharing the content, learning resources, assignments for their students [5],[6]. For both students and teachers, LMS was one of the effective online modes of communication. LMS, during the pandemic, eases the transition to online learning for educators of various medical schools [7].
The success or failure of online learning programs depends on the quality of technological infrastructure, necessary technical skills among teachers and students, access to the internet, and availability of computers, laptops, and required devices by the teachers and students [8],[9]. All medical institutions do not have a well-connected technological support system, and all students do not have equal access. Some students and teachers may not have a home environment conducive to teaching and learning. Along with the technology and IT support, medical teachers need to play a significant role in preparing academic strategy and educational design to deliver online teaching effectively. Some other challenges to online education are students' assessment, lack of interaction, lack of motivation, and time management [10]. To develop an effective online learning program and improve the quality of learning, there is a need to consider these barriers to online learning [11].
In this perspective, we reviewed the evidence of best practices for the medical educators to deliver the curriculum through an online platform. Therefore, the current study aimed to review the best practices for effective online teaching and learning in Medical Education during COVID-19 and beyond. We reviewed the technical aspects of online teaching and educational strategies required for educators to provide quality training during the pandemic and beyond this crisis.
Research questions of the study:
In this review article, the search was focused on the literature on online teaching and learning in the context of medical and allied health sciences education. Medline, PubMed, and Google scholar were search engines where articles relevant to the medical and health profession were selected. This review includes various practices on how online teaching could be more impactful and effective during this COVID-19 situation and even in the future through distance education.
A systematic search was performed using the keywords: COVID-19, online learning, e-learning, blended learning, online teaching, innovative teaching, medical teaching, health profession teaching, web-based teaching, distance teaching and learning, learning outcomes, and online technology, assessment, Asynchronous assessment. The database searches generated a total of 105 articles. The authors read the full articles, discussed how to categorize them, and eventually, 53 articles were selected as relevant to best practices in medical and health profession education. These selected articles were grouped into four major categories—online teaching, technological infrastructure, innovative teaching practice, learning outcomes, and evaluation methods concerning the best practice of teaching and learning.
An understanding of learning theories can assist medical teachers in designing and implementing an effective online learning environment, and it will help them make choices about how to approach their teaching in ways that will best fit the needs of the students. There are three broad theoretical approaches such as behaviourism, cognitivism, and constructivism that have contributed to human learning and might have implications for online learning design [11].
According to behavioural learning theory influenced by Thorndike, Pavlov, and Skinner, learning is an observable change in a learner's behaviour caused by external stimuli. Behaviourists claim that practice or repetition of behaviour strengthens the link between stimuli and response [12]. Ignoring the impact of the cognitive or thinking process of the learner, this theory believes that learning occurs by practice and reinforcement. According to behaviourists, the role of the environment, specifically how stimuli are arranged and presented and how responses are reinforced, is of most importance. Early computer learning systems and programs instructions were designed based on a behaviourist approach to learning. Medical educators should provide feedback to the learner during online teaching as it assists the development of positive behaviour. Cognitive learning theory criticized the idea that learners are passive and simply react to stimuli in the environment [13].
Cognitive learning theory claims that learning is an internal mental phenomenon rather than the external environment involving memory, motivation, perceptions, critical thinking, and reflection [14],[15]. The cognitivist approach develops learners' capacity and skills for effective self-directed learning. According to this approach, the teacher facilitates the learner about “learn how to learn” [16]. Small group, online platforms should be provided to the learners to utilize their cognitive abilities. Also, online Problem Based Learning (PBL) is directly associated with cognitive learning theory where tutor facilitates a small group of learners for self-directed learning. Learners utilize their memories and cognitive abilities and think critically to construct new knowledge. The tutor, as a facilitator, ensures substantial contributions of all the learners in the group in the PBL approach.
Constructivist learning theories argue that learning is an active, contextualized process of constructing knowledge where learners are the learning centre. The constructivists believe that deep learning will occur through the active engagement of learners [17]. Even though constructivism is considered a branch of cognitivism (both focus on mental activity), it distinguishes itself from cognitivism in various ways. Cognitivism places the mind at the centre of the learning process, whereas constructivists believe that the mind filters input from the world to construct knowledge. According to constructivist learning theories, a learner's knowledge is assembled through exploration where his/her direct experiences with the environment are considered critical [18]. In constructivist psychology, learners are given control of learning and reflection. In online teaching, teamwork, collaborative and cooperative learning should be encouraged to facilitate constructivist learning. Assignments and projects should be given to the learners to help them apply and personalize the information. Small group teaching, PBL, and flipped classroom are effective online delivery modes for the learners.
Each school of learning offers benefits and limitations to the design and development of online learning. Medical educators should consider these theories while designing an online learning environment curriculum. Online learning pedagogy, which has been widely introduced during the pandemic, is now considered a crucial component in medical education [19]. A properly planned, structured, and dedicated online teaching curriculum would benefit the students. The current situation might present a unique opportunity for augmenting the quality of medical education to fulfil students' teaching needs [4].
In this section, the results are presented concerning the research questions.
The transition to online teaching has raised questions for the faculty about their capability to deal with the existing technology. Without adequate technical knowledge and skills, medical teachers/instructors may face numerous challenges to resolve technology-related problems during the live Class, impacting students' online learning and access to learning materials [20]. You should know about switching the microphone and camera into mute and unmute mode. Also, you can record and upload lectures for later viewing by students who were unable to attend or had internet or other problems [21]. Therefore, proper training and support services should be facilitated to the faculty to deal with technology efficiently. Students also must go through similar training to utilize the best of online teaching [22]. Initially, while using technology, you may experience some difficulties, but you will be confident using the platform after getting used to it. For example, finding and uploading the course materials, using the chat rooms, initiating, recording the sessions, and other activities will be more accessible for you.
The successful functioning of online teaching depends on the availability of technological infrastructure in hardware and software [23]. The existing infrastructure in the medical schools is not adequate to run the various programs in online mode. Especially in the low-middle-income countries, lack of infrastructure and technology have become an obstacle to effectively implementing online teaching. These technological gaps are variable in different geographical regions where some countries lack the basics such as email internet (wired and wireless). At the same time, some are related to poor quality of the services such as poor/intermittent internet access and limited access to computers or laptops [9]. Network connectivity and bandwidth availability are the key challenges even in developed countries. The technological infrastructure and user-friendliness of the LMS played important roles in the online learning of medical and health professional students.
Few suggestions to address these problems are:
Medical teachers/tutors who prefer to deliver teaching on the campus should be provided good internet connection. Technicians should also be available during live classes to avoid disruption or delay due to any technical issues [24].
In online teaching and learning, clear expectations of what is required from students are critical. As a medical teacher, you should make sure that students know the course's learning outcomes before the Class begins. Furthermore, clearly defined learning outcomes help you to select different teaching activities and identify valid assessment tools to evaluate student's performance [25],[26]. Making learning trajectories explicit and visible for both students and teachers can help promote reflection and potentially enhance the teaching and learning process [27]. Proper alignment of learning outcomes, teaching activities, learning resources, and assessment modes mutually reinforce each other. While framing the learning outcomes, you can use Bloom's lists of action verbs or different authors' extended and revised action verbs [28]. Based on the learning outcomes, you should decide the learning activities and determine the teaching aids to be used in the online Class. Assessment criteria should be designed that meet the specific and measurable learning outcomes. Figure 1 shows the essential components of course alignment for online teaching.
The assessment method in medical and health profession education could be administered in an asynchronous mode during the COVID-19 pandemic. Assessment methods such as open-ended short answer questions, problem-based questions, oral exams, and recorded objective structured clinical exams (OSCE) would be appropriate for Use in an asynchronous environment to assess the knowledge and competence of health professional students during COVID-19.
The transition of the curriculum delivery from face-to-face teaching to online learning requires a lot of planning and preparation [29]. Even experienced medical teachers do not enter the Class without proper planning. You must have the answers to the questions, what your students would be able to know or do from the Class (instructional objectives), which area of the curriculum will be covered (content), what are the learning resources (teaching aids), how the content will be covered in the given time (time management), how the content can effectively be delivered (teaching method) and how the effectiveness of the teaching will be known (feedback and evaluation). Prepare a lesson plan for online teaching. Table 1 shows an example of a lesson plan on a few topics in medicine.
Similarly, you have to prepare lesson plans for the courses you are allotted for teaching. It will help you to understand how much you can fit into the session in the allocated time [30]. Once you have the lesson plan, you prepare for the teaching accordingly and make sure that you have all the PPT, images, videos, quizzes, questions available to share during the online teaching.
Course code and name |
Name of the instructor/lecturer/tutor: XXX |
|||
Topic and date | Instructional objectives | Teaching aids | Teaching method | Assessment |
Cell injury and death Date: Duration: |
-Discuss the types of cell death. -List the factors that are associated with cell growth and regeneration |
-PPT -Recorded lectures -Interactive online materials |
-Lecture -Case presentation -PBL |
-Asynchronous clerkship assessment: MCQ format. -Synchronous clerkship assessment: museum specimen case presentations -In-class Online synchronous quiz and polls. -PBL Assessment: case-based study |
Inflammation Date: Duration: |
-Outline the differences between acute and chronic inflammation. -Explain the stages of acute inflammation with an emphasis on the inflammatory cells in each phase. |
-Recorded lectures -Video clippings -Group based resource study -Guest lecture links. |
-Lecture -Video demonstration -PBL |
-Asynchronous clerkship assessment: Histology spotters -Synchronous clerkship assessment: short case discussion -Asynchronous Short answer essay questions -PBL assessment through objective-based presentation |
Neoplasm Date: Duration: |
-Discuss the morphological differences between benign and malignant tumors. -Outline in detail the features of metastasis. |
-PPT -Recorded lectures -Question banks -Interactive online materials |
-Lecture -Case presentation -PBL |
-Asynchronous clerkship assessment: MCQ format. -Synchronous clerkship case presentations -PBL Assessment -Clinical Case reviews |
The transition to an online mode of delivery is not free from challenges, and poor technological infrastructure and network connectivity issues interrupt smooth course content delivery. Thus, you should have a flexible approach in teaching, assuming that at any time, teachers or students may have a problem with internet connectivity during the teaching session [31]. Sometimes, assignments and resources related to the course that teachers post do not work properly [32]–[34].
It would help if you always had plan B ready for all course contents, assignments, and assessments to overcome the technological glitches. For example, if you are delivering a lecture via Blackboard Collaborate and it stops working, the group should use Zoom or any other links without causing any learning delay. Similarly, students should be given extra time to submit their assignments and projects [31]. To make online teaching more effective, medical schools should provide a clear policy guideline that directs what students can do if they cannot submit assignments due to technical issues like electricity failure, poor internet connectivity, software disrupts, and computer system failure.
In a face-to-face class, you can read students' moods their non-verbal communication and engage them in different activities to make an active and interactive classroom session. It is easy for you to motivate the less participatory student by involving them in group discussions. However, it is quite difficult for a teacher to motivate and engage all students in the Class [34]–[39]. To make the online synchronous Class more effective, you can do the following things:
The hybrid online learning model includes synchronous and asynchronous learning. Synchronous learning happens in real-time. However, asynchronous learning happens online without real-time interaction [40]. There are advantages and disadvantages of both learning models. It is crucial to balance and use each one of them equally. Because among the students there may be different types of learners, such as socially active/passive, understand better/bad or do better/bad in a real-time virtual place? Some students might not desire to be at a specific place at a particular time in the videoconferencing, while others may. Some may be active learners getting immediate feedback from the teachers, and some may not. Some others might learn better and thrive if their questions are answered promptly. For some, it may not be necessary. Some students may want to interact with the teacher and receive mentorship, guidance, or support, while others may not. If there is too much asynchronous learning, the student may have difficulty coping with set schedules and fully depreciating their responsibilities. Therefore, among the students, some may prefer synchronous mode, whereas others may be comfortable with asynchronous learning mode. Considering the preference of both synchronous and asynchronous delivery modes would be the best option.
Face-to-face Lab or practical education is crucial in medical education. However, in terms of Anatomy labs, it is possible to demonstrate the cadavers, bones, or models synchronously with the appropriate camera settings and using online platforms. There is feedback obtained by many students that show that practical classes like Anatomy can be taught quite well online and can improve student performance [41]. An advanced 3D anatomy platform can also be used online to assist students in understanding the concept.
Although hands-on cadaver dissection holds a crucial part of Anatomy education, web-based synchronous cadaver dissection online recordings are the method that can be used. Similar studies have demonstrated web-based surgical skill learning sessions, and their skills were comparable to those taught by conventional face-to-face tutorials [42]. Further, online teaching attempts to substitute hands-on education due to pandemics, including demonstrations of practical procedures, remote patient consultation programs, and simulated cases [43].
The success of online learning largely depends on the active participation of all the students in the Class. An online class should be more interactive, and it should create a suitable environment for learning that is active, innovative, and challenging for the students [44]. Rice (2006) found that online teaching strategies make the best Use of the unique potential of the online environment when they are highly interactive [45]. An interactive approach makes the learning process effective and exciting and allows the teachers to assess students' performance spontaneously and non-intrusively. Students may be less active in the large group, and however, it becomes easier for teachers to engage students in the learning process in a small group. Instead of dominating the group, an educator promotes student-centred learning and actively encourages them to participate in the learning session. While using power-point, make sure that students get a chance to express their views and interact with something on every single slide.
To engage students, teachers should ask thought-provoking questions instead of yes/no type questions to think and try to take part in the discussion. Students should be encouraged to ask questions to drive them to be more attentive and active. Similarly, other students should be encouraged to respond to the questions asked by their peers. Teachers must appreciate students who are asking questions or responding to the questions. To improve the students' engagement with online sessions, online teaching should include quizzes and tests for the students, and it will help to analyse how actively students were involved in the learning process.
One of the crucial risks of online education is cheating or unwanted students' behaviour while using online technology [46]. Compared with the traditional classroom settings, teachers have less control over the online Class, and students show the slightest interest in taking in the teaching-learning process [47]. Students' motivation is one of the significant determinants of the quality of learning and success in both face-to-face and virtual learning environments. Both intrinsic or internal and extrinsic or external motivation can drive the students to participate actively in the online learning process. A student's internal motivation largely depends on his/her interest in the topic, self-requirement, self-determination, self-regulation, and autonomy of learning. The external motivation of students is determined by the teacher's behaviour, teaching-learning strategies, and students' engagement [48]. Being a medical teacher, teachers have to consider all these factors and plan the online teaching accordingly. Generate a sense of belongingness among the students and, instead of making a passive learner, involve them in the learning process. Remember and call students by their names, ask provocative questions, encourage them to speak, and appreciate when they attempt to respond. Another effective way to motivate students is to give feedback to the students after each Class's end. Teachers' constructive feedback helps students identify their strengths and weaknesses and motivate them to engage in learning [49]. The teacher should also emphasize peer feedback in the Class because it stimulates active learning [50].
Over the decades, there has been a growing interest in using digital technologies to support learning and assessment [51]. However, research is lacking about the effectiveness of online assessment. The emergence of COVID-19 has further increased significant opportunities to develop new assessment forms [1]. There is a need to develop online assessment tools in medical education that are capable of assessing the cognitive (knowledge), psychomotor (skills), and affective (behaviour/attitude) domains of medical students. Medical educators should carefully consider the assessment tools, ensuring that they align with the immediate learning outcomes. Some of the basic online modes of assessments are knowledge-based assessment (e.g., Multiple choice questions, extended matching questions), performance-based assessment (e.g., Using virtual OSCE station), and practice-based assessment (e.g., Use of logbook and portfolios and attitude based assessment (teachers' observation in the discussion or presentations, peer-assessment) [52].
Kühbeck et al. conducted a study with a cohort of undergraduate medical students at the Technical University of Munich, where students were given access to an online assessment consisting of 440 MCQs after a four-week teaching Pharmacology. They found that online assessments improved the self-perceived pharmacology competence of medical students. Another study conducted on medical students in India suggests the effectiveness of online MCQs assessment. Students responded that online assessment was easy to operate, reducing malpractices, and noticed that they were exposed to innovative methods of learning, and they received immediate results. Gaytan and McEwen conducted a study on effective online instructional and assessment strategies perceived by faculty and students. They found a variety of effective assessment techniques, as perceived by faculty and students, including weekly assignments with immediate feedback, self-assessments, projects, portfolios, peer evaluation, and quizzes [18],[53]. To evaluate the learning outcomes in anatomy, various assessment modes, including essay-type questions, practical examination, multiple-choice questions examination (MCQE), and spatial MCQE, have been helpful.
Kearns (2012) examined 24 online courses and identified assessment methods that include: written assignments (research papers, case studies, and short essays); online discussion (asynchronous discussion activity performed on a discussion board or blog; fieldwork (students write a report after collecting field data; quizzes and exams (Multiple choice questions, short answer questions; and presentations (students' online presentation) [54]. These modes of assessments are relevant to medical and health professionals if these are correctly used. The open-book examination could be a more compelling online assessment method that allows educators to pose questions that require critical thinking and higher-order cognitive skills [55]. Timely feedback is also a critical component of an online assessment. Students should know their progress through the online assessment, and they should be guided where they need improvement.
Despite the variety of assessment tools available, multiple-choice questions play an integral part in assessing students' learning performance face-to-face and in the online mode of examination.
The COVID-19 crisis has created an opportunity to think about new ways of teaching and learning in medical education. Even after the pandemic, online education will be a significant part of health care delivery. Medical educators must learn from the experience and cultivate competency with technology for future learning needs. Schools should strengthen technical infrastructure, promote continuous faculty development programs, and support indigent students to access digital technology.
The importance of online education in assessing the learning outcomes through various modes is essential for successful academic progress both to teachers and to the students. It will be worthy to study if the anticipated conclusions are achieved after introducing these varying modes and methods to course delivery. The corroboration of benefits, practicality, drawbacks and modifiable drivers of various methods and modes of online education is entailing. If found to be beneficial to the teachers, students and the institution, these methods can be integrated in courses on a long-term basis following the cessation of the pandemic and not just to be limited during the present active COVID-19 period.
[1] |
Yuan K, Zheng YB, Wang YJ, et al. (2022) A systematic review and meta-analysis on prevalence of and risk factors associated with depression, anxiety and insomnia in infectious diseases, including COVID-19: a call to action. Mol Psychiatry 27: 3214-3222. https://doi:10.1038/s41380-022-01638-z ![]() |
[2] |
Tselebis A, Pachi A (2022) Primary Mental Health Care in a New Era. Healthcare 10: 2025. https://doi.org/10.3390/healthcare10102025 ![]() |
[3] |
Sikaras C, Ilias I, Tselebis A, et al. (2021) Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece. AIMS Public Health 9: 94-105. https://doi:10.3934/publichealth.2022008 ![]() |
[4] |
Schmuck J, Hiebel N, Rabe M, et al. (2021) Sense of coherence, social support and religiosity as resources for medical personnel during the COVID-19 pandemic: A web-based survey among 4324 health care workers within the German Network University Medicine. PLoS One 16: e0255211. https://doi:10.1371/journal.pone.0255211 ![]() |
[5] |
Dong ZQ, Ma J, Hao YN, et al. (2020) The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study. Eur Psychiatry 63: e65. https://doi:10.1192/j.eurpsy.2020.59 ![]() |
[6] |
Marvaldi M, Mallet J, Dubertret C, et al. (2021) Anxiety, depression, trauma-related, and sleep disorders among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Neurosci Biobehav Rev 126: 252-264. https://doi.org/10.1016/j.neubiorev.2021.03.024 ![]() |
[7] |
Pappa S, Ntella V, Giannakas T, et al. (2020) Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun 88: 901-907. https://doi.org/10.1016/j.bbi.2020.05.026 ![]() |
[8] |
Perego G, Cugnata F, Brombin C, et al. (2022) The “Healthcare Workers' Wellbeing [Benessere Operatori]” Project: A Longitudinal Evaluation of Psychological Responses of Italian Healthcare Workers during the COVID-19 Pandemic. J Clin Med 11: 2317. https://doi: 10.3390/jcm11092317 ![]() |
[9] |
Varghese A, George G, Kondaguli SV, et al. (2021) Decline in the mental health of nurses across the globe during COVID-19: A systematic review and meta-analysis. J Glob Health 11: 05009. https://doi:10.7189/jogh.11.05009 ![]() |
[10] |
Sarafis P, Rousaki E, Tsounis A, et al. (2016) The impact of occupational stress on nurses' caring behaviors and their health related quality of life. BMC Nurs 27: 56. https://doi.org/10.1186/s12912-016-0178-y ![]() |
[11] |
Sikaras C, Zyga S, Tsironi M, et al. (2023) The Mediating Role of Depression and of State Anxiety οn the Relationship between Trait Anxiety and Fatigue in Nurses during the Pandemic Crisis. Healthcare 11: 367. https://doi.org/10.3390/healthcare11030367 ![]() |
[12] |
Thorsteinsson EB, Brown RF, Owens MT (2019) Modeling the Effects of Stress, Anxiety, and Depression on Rumination, Sleep, and Fatigue in a Nonclinical Sample. J Nerv Ment Dis 207: 355-359. https://doi:10.1097/NMD.0000000000000973 ![]() |
[13] |
Zhang C, Yang L, Liu S, et al. (2020) Survey of Insomnia and Related Social Psychological Factors Among Medical Staff Involved in the 2019 Novel Coronavirus Disease Outbreak. Front Psychiatry 11: 306. https://doi:10.3389/fpsyt.2020.00306 ![]() |
[14] |
Morin CM, Rodrigue S, Ivers H (2003) Role of stress, arousal, and coping skills in primary insomnia. Psychosom Med 65: 259-267. https://doi:10.1097/01.psy.0000030391.09558.a3 ![]() |
[15] |
Yazdi Z, Sadeghniiat-Haghighi K, Javadi AR, et al. (2014) Sleep quality and insomnia in nurses with different circadian chronotypes: morningness and eveningness orientation. Work 47: 561-567. https://doi:10.3233/WOR-131664 ![]() |
[16] |
Knap M, Maciąg D, Trzeciak-Bereza E, et al. (2022) Sleep Disturbances and Health Consequences Induced by the Specificity of Nurses' Work. Int J Environ Res Public Health 19: 9802. https://doi:10.3390/ijerph19169802 ![]() |
[17] |
Jahrami H, BaHammam AS, Bragazzi NL, et al. (2021) Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. J Clin Sleep Med 17: 299-313. https://doi:10.5664/jcsm.8930 ![]() |
[18] |
Watson NF, Badr MS, et al. (2015) Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. Sleep 38: 1161-1183. https://doi.org/10.5665/sleep.4886 ![]() |
[19] |
Hu J, Huang Y, Liu J, et al. (2022) COVID-19 Related Stress and Mental Health Outcomes 1 Year After the Peak of the Pandemic Outbreak in China: the Mediating Effect of Resilience and Social Support. Front Psychiatry 13: 828379. https://doi:10.3389/fpsyt.2022.828379 ![]() |
[20] |
Zeng W, Fang Q, Wang C, et al. (2022) Perceived Family Function and Associated Predictors in Nurses: A Cross-Sectional Study. Front Psychiatry 13: 904581. https://doi:10.3389/fpsyt.2022.904581 ![]() |
[21] |
Tselebis A, Lekka D, Sikaras C, et al. (2020) Insomnia, Perceived Stress, and Family Support among Nursing Staff during the Pandemic Crisis. Healthcare 8: 434. https://doi: 10.3390/healthcare8040434 ![]() |
[22] |
Ilias I, Hatzimichelakis E, Souvatzoglou A, et al. (2001) Perception of family support is correlated with glycemic control in Greeks with diabetes mellitus. Psychol Rep 88: 929-930. https://doi:10.2466/pr0.2001.88.3.929 ![]() |
[23] | Sample size calculator & complete guide, 2020. Available from: https://www.qualtrics.com/blog/calculating-sample-size/. |
[24] | Spielberger CD, Gorsuch RL, Lushene PR, et al. Manual for the State–Trait Spielberger Anxiety Inventory (Form Y). (1983).Consulting Psychologists Press. |
[25] |
Fountoulakis KN, Papadopoulou M, Kleanthous S, et al. (2006) Reliability and psychometric properties of the Greek translation of the State-Trait Anxiety Inventory form Y: preliminary data. Ann Gen Psychiatry 5: 2. https://doi.org/10.1186/1744-859X-5-2 ![]() |
[26] |
Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2003) The diagnostic validity of the Athens Insomnia Scale. J Psychosom Res 55: 263-267. https://doi.org/10.1016/s0022-3999(02)00604-9 ![]() |
[27] |
Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2000) Athens Insomnia Scale: Validation of an instrument based on ICD-10 criteria. J Psychosom Res 48: 555-560. https://doi.org/10.1016/s0022-3999(00)00095-7 ![]() |
[28] |
Tselebis A, Anagnostopoulou T, Bratis D, et al. (2011) The 13 item Family Support Scale: Reliability and validity of the Greek translation in a sample of Greek health care professionals. Asia Pac Fam Med 10: 3. https://doi:10.1186/1447-056X-10-3 ![]() |
[29] | Tselebis A, Bratis D, Pachi A, et al. (2013) Chronic obstructive pulmonary disease: sense of coherence and family support versus anxiety and depression. Psychiatriki 24: 109-116. |
[30] |
Chang EC, Chang OD, Martos T, et al. (2017) Family Support as a Moderator of the Relationship Between Loneliness and Suicide Risk in College Students: Having a Supportive Family Matters!. Family J 25: 257-263. https://doi.org/10.1177/1066480717711102 ![]() |
[31] |
Qi T, Hu T, Ge QQ, et al. (2021) COVID-19 pandemic related long-term chronic stress on the prevalence of depression and anxiety in the general population. BMC Psychiatry 21: 380. https://doi:10.1186/s12888-021-03385-x ![]() |
[32] |
Cyr S, Marcil MJ, Houchi C, et al. (2022) Evolution of burnout and psychological distress in healthcare workers during the COVID-19 pandemic: a 1-year observational study. BMC Psychiatry 22: 809. https://doi:10.1186/s12888-022-04457-2 ![]() |
[33] |
Preti E, Di Mattei V, Perego G, et al. (2020) The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence. Curr Psychiatry Rep 22: 43. https://doi:10.1007/s11920-020-01166-z ![]() |
[34] |
Dragioti E, Tsartsalis D, Mentis M, et al. (2022) Impact of the COVID-19 pandemic on the mental health of hospital staff: An umbrella review of 44 meta-analyses. Int J Nurs Stud 131: 104272. https://doi:10.1016/j.ijnurstu.2022.104272 ![]() |
[35] |
Lai J, Ma S, Wang Y, et al. (2020) Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open 3: e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976 ![]() |
[36] |
Morgan R, Tan HL, Oveisi N, et al. (2022) Women healthcare workers' experiences during COVID-19 and other crises: A scoping review. Int J Nurs Stud Adv 4: 100066. https://doi:10.1016/j.ijnsa.2022.100066 ![]() |
[37] |
Li SH, Graham BM (2017) Why are women so vulnerable to anxiety, trauma-related and stress-related disorders? The potential role of sex hormones. Lancet Psychiatry 4: 73-82. https://doi:10.1016/S2215-0366(16)30358-3 ![]() |
[38] |
Morin CM, Jarrin DC (2022) Epidemiology of Insomnia: Prevalence, Course, Risk Factors, and Public Health Burden. Sleep Med Clin 17: 173-191. https://doi:10.1016/j.jsmc.2022.03.003 ![]() |
[39] |
Morin CM, Bjorvatn B, Chung F, et al. (2021) Insomnia, anxiety, and depression during the COVID-19 pandemic: an international collaborative study. Sleep Med 87: 38-45. https://doi:10.1016/j.sleep.2021.07.035 ![]() |
[40] |
Alimoradi Z, Gozal D, Tsang HWH, et al. (2022) Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis. J Sleep Res 31: e13432. https://doi:10.1111/jsr.13432 ![]() |
[41] |
López-Soto PJ, Fabbian F, Cappadona R, et al. (2019) Chronotype, nursing activity, and gender: A systematic review. J Adv Nurs 75: 734-748. https://doi:10.1111/jan.13876 ![]() |
[42] |
Xin J, Zhang Y, Tang Y, et al. (2019) Brain Differences Between Men and Women: Evidence From Deep Learning. Front Neurosci 13: 185. https://doi: 10.3389/fnins.2019.00185 ![]() |
[43] |
AlRasheed MM, Fekih-Romdhane F, Jahrami H, et al. (2022) The prevalence and severity of insomnia symptoms during COVID-19: A global systematic review and individual participant data meta-analysis. Sleep Med 100: 7-23. https://doi:10.1016/j.sleep.2022.06.020 ![]() |
[44] |
Carmel S, Anson O, Levenson A, et al. (1991) Life events, sense of coherence and health: gender differences on the kibbutz. Soc Sci Med 32: 1089-1096. https://doi.org/10.1016/0277-9536(91)90084-p ![]() |
[45] |
Sriharan A, West KJ, Almost J, et al. (2021) COVID-19-related occupational burnout and moral distress among nurses: a rapid scoping review. Nurs Leadersh 34: 7-19. https://doi:10.12927/cjnl.2021.26459 ![]() |
[46] |
Galanis P, Vraka I, Fragkou D, et al. (2021) Nurses' burnout and associated risk factors during the COVID-19 pandemic: a systematic review and meta-analysis. J Adv Nurs 77: 3286-3302. https://doi:10.1111/jan.14839 ![]() |
[47] |
Italia S, Costa C, Briguglio G, et al. (2021) Quality of Life, Insomnia and Coping Strategies during COVID-19 Pandemic in Hospital Workers. A Cross-Sectional Study. Int J Environ Res Public Health 18: 12466. https://doi:10.3390/ijerph182312466 ![]() |
[48] |
Sahebi A, Abdi K, Moayedi S, et al. (2021) The prevalence of insomnia among health care workers amid the COVID-19 pandemic: An umbrella review of meta-analyses. J Psychosom Res 149: 110597. https://doi:10.1016/j.jpsychores.2021.110597 ![]() |
[49] |
Jahrami H, Haji EA, Saif ZQ, et al. (2022) Sleep Quality Worsens While Perceived Stress Improves in Healthcare Workers over Two Years during the COVID-19 Pandemic: Results of a Longitudinal Study. Healthcare 10: 1588. https://doi:10.3390/healthcare10081588 ![]() |
[50] | Trakada A, Nikolaidis PT, Economou NT, et al. (2022) Comparison of sleep characteristics during the first and second period of restrictive measures due to COVID-19 pandemic in Greece. Eur Rev Med Pharmacol Sci 26: 1382-1387. https://doi:10.26355/eurrev_202202_28131 |
[51] | COVID-19 CORONAVIRUS PANDEMIC, 2023. Available from: https://www.worldometers.info/coronavirus/country/greece/. |
[52] | Health at a Glance: Europe 2020 STATE OF HEALTH IN THE EU CYCLE, 2020. Available from: https://ec.europa.eu/health/system/files/2020-12/2020_healthatglance_rep_en_0.pdf. |
[53] | Zhao Y, Hu B, Liu Q, et al. (2022) Social support and sleep quality in patients with stroke: The mediating roles of depression and anxiety symptoms. Int J Nurs Pract 28: e12939. https://doi:10.1111/ijn.12939 |
[54] | Ye B, Hu J, Im H, et al. (2022) Family Cohesion and Sleep Disturbances During COVID-19: the Mediating Roles of Security and Stress. Int J Ment Health Addict : 1-14. https://doi:10.1007/s11469-022-00753-w |
[55] | Xiao H, Zhang Y, Kong D, et al. (2020) The effects of social support on sleep quality of medical staff treating patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit 26: e923549. https://doi.org/10.12659/MSM.923549 |
[56] |
Bilgiç Ş, Çelikkalp Ü, Mısırlı C (2021) Stress level and sleep quality of nurses during the COVID-19 pandemic. Work 70: 1021-1029. https://doi:10.3233/WOR-210538 ![]() |
[57] |
Bruce HA, Kochunov P, Kvarta MD, et al. (2023) Frontal white matter association with sleep quality and the role of stress. J Sleep Res 32: e13669. https://doi:10.1111/jsr.13669 ![]() |
[58] |
Chan NY, Chan JWY, Li SX, et al. (2021) Non-pharmacological Approaches for Management of Insomnia. Neurotherapeutics 18: 32-43. https://doi:10.1007/s13311-021-01029-2 ![]() |
[59] |
Hertenstein E, Feige B, Gmeiner T, et al. (2019) Insomnia as a predictor of mental disorders: A systematic review and meta-analysis. Sleep Med Rev 43: 96-105. https://doi:10.1016/j.smrv.2018.10.006 ![]() |
[60] |
Meaklim H, Saunders WJ, Byrne ML, et al. (2023) Insomnia is a key risk factor for persistent anxiety and depressive symptoms: A 12-month longitudinal cohort study during the COVID-19 pandemic. J Affect Disord 322: 52-62. https://doi:10.1016/j.jad.2022.11.021 ![]() |
[61] | Acar Sevinc S, Metin S, Balta Basi N, et al. (2022) Anxiety and burnout in anesthetists and intensive care unit nurses during the COVID-19 pandemic: a cross-sectional study. Braz J Anesthesiol 72: 169-175. https://doi:10.1016/j.bjane.2021.07.011 |
[62] |
Roberts NJ, McAloney-Kocaman K, Lippiett K, et al. (2021) Levels of resilience, anxiety and depression in nurses working in respiratory clinical areas during the COVID pandemic. Respir Med 176: 106219. https://doi:10.1016/j.rmed.2020.106219 ![]() |
[63] |
Varma P, Junge M, Meaklim H, et al. (2021) Younger people are more vulnerable to stress, anxiety and depression during COVID-19 pandemic: A global cross-sectional survey. Prog Neuropsychopharmacol Biol Psychiatry 109: 110236. https://doi:10.1016/j.pnpbp.2020.110236 ![]() |
[64] |
Pachi A, Sikaras C, Ilias I, et al. (2022) Burnout, Depression and Sense of Coherence in Nurses during the Pandemic Crisis. Healthcare 10: 134. https://doi:10.3390/healthcare10010134 ![]() |
[65] |
Bratis D, Tselebis A, Sikaras C, et al. (2009) Alexithymia and its association with burnout, depression and family support among Greek nursing staff. Hum Resour Health 7: 72. https://doi:10.1186/1478-4491-7-72 ![]() |
[66] |
Tselebis A, Bratis D, Karkanias A, et al. (2008) Associations on dimensions of burnout and family support for a sample of Greek nurses. Psychol Rep 103: 63-66. https://doi:10.2466/pr0.103.1.63-66 ![]() |
[67] | Lekka D, Pachi A, Tselebis A, et al. (2014) Pain and Anxiety versus Sense of Family Support in Lung Cancer Patients. Pain Res Treat 2014: 312941. https://doi:10.1155/2014/312941 |
[68] |
Noh D, Park S (2022) Mediating Effects of Social Support and Resilience on the Association between COVID-19-Related Stress and Mental Health in Korean Young Adults. Int J Environ Res Public Health 19: 6935. https://doi:10.3390/ijerph19116935 ![]() |
[69] |
Shi LS, Xu RH, Xia Y, et al. (2022) The Impact of COVID-19-Related Work Stress on the Mental Health of Primary Healthcare Workers: The Mediating Effects of Social Support and Resilience. Front Psychol 12: 800183. https://doi:10.3389/fpsyg.2021.800183 ![]() |
[70] |
Mohammed S, Peter E, Killackey T, et al. (2021) The “nurse as hero” discourse in the COVID-19 pandemic: A poststructural discourse analysis. Int J Nurs Stud 117: 103887. https://doi: 10.1016/j.ijnurstu.2021.103887 ![]() |
[71] |
Boulton M, Garnett A, Webster F (2022) A Foucauldian discourse analysis of media reporting on the nurse-as-hero during COVID-19. Nurs Inq 29: e12471. https://doi.org/10.1111/nin.12471 ![]() |
[72] |
Elsayed MEG, El-Abasiri RA, Marzo RR, et al. (2023) Mental health, risk perception, and coping strategies among healthcare workers in Egypt during the COVID-19 pandemic. PLoS One 18: e0282264. https://doi:10.1371/journal.pone.0282264 ![]() |
[73] |
Htay MNN, Marzo RR, Bahari R, et al. (2021) How healthcare workers are coping with mental health challenges during COVID-19 pandemic? - A cross-sectional multi-countries study. Clin Epidemiol Glob Health 11: 100759. https://doi:10.1016/j.cegh.2021.100759 ![]() |
[74] |
Htay MNN, Marzo RR, AlRifai A, et al. (2020) Immediate impact of COVID-19 on mental health and its associated factors among healthcare workers: A global perspective across 31 countries. J Glob Health 10: 020381. https://doi:10.7189/jogh.10.020381 ![]() |
[75] |
Marzo RR, ElSherif M, Abdullah MSAMB, et al. (2022) Demographic and work-related factors associated with burnout, resilience, and quality of life among healthcare workers during the COVID-19 pandemic: A cross sectional study from Malaysia. Front Public Health 10: 1021495. https://doi:10.3389/fpubh.2022.1021495 ![]() |
[76] |
Kamberi F, Sinaj E, Jaho J, et al. (2021) Impact of COVID-19 pandemic on mental health, risk perception and coping strategies among health care workers in Albania - evidence that needs attention. Clin Epidemiol Glob Health 12: 100824. https://doi:10.1016/j.cegh.2021.100824 ![]() |
1. | Jennifer L. Bueche, Jennifer M.K. Jensen, Kelly Martin, Emily Riddle, Kim S. Stote, Distance Education in Nutrition and Dietetics Education over the Past 30 Years: A Narrative Review, 2022, 22122672, 10.1016/j.jand.2022.11.006 | |
2. | Nichola McLarnon, Maggie Hutchings, Veronica O'Carroll, Lisa-Christin Wetzlmair, Sharron Blumenthal, Louise Boyle, Alla El-Awaisi, Jane Greaves, Vikki Park, Alison Power, Rethinking assessment for interprofessional learning during COVID-19: steering a middle course, 2022, 30, 0969-4900, 572, 10.12968/bjom.2022.30.10.572 | |
3. | Eeshika Chatterjee, Talha Khan, Laura S Renzi, Earlan J Charles, Kesava Mandalaneni, A Bibliometric Analysis of COVID-19 Scientific Literature From the English-Speaking Caribbean, 2022, 2168-8184, 10.7759/cureus.30958 | |
4. | Barbara Duffy, Roisin Tully, Alice V. Stanton, An online case-based teaching and assessment program on clinical history-taking skills and reasoning using simulated patients in response to the COVID-19 pandemic, 2023, 23, 1472-6920, 10.1186/s12909-022-03950-2 | |
5. | So Won Kim, Eun Joo Choi, Yun Jeong Lee, Effects of Blended Learning on Pharmacy Student Learning Satisfaction and Learning Platform Preferences in a Team-based Learning Pharmacy Experiential Course: A Pilot Study, 2023, 33, 1226-6051, 202, 10.24304/kjcp.2023.33.3.202 | |
6. | Mona Abubakr Bawazeer, Saima Aamir, Fatmah Othman, Reem Alkahtani, Students engagement using polls in virtual sessions of physiology, pathology, and pharmacology at King Saud bin Abdulaziz University for Health Sciences during COVID-19 pandemic: a cross-sectional study, 2023, 23, 1472-6920, 10.1186/s12909-023-04253-w | |
7. | Helena Vallo Hult, Christian Master Östlund, Paul Pålsson, Katarina Jood, Designing for digital transformation of residency education – a post-pandemic pedagogical response, 2023, 23, 1472-6920, 10.1186/s12909-023-04390-2 | |
8. | Amanda K. Burbage, Peggy Gesing, Dyrell Ashley, Protocol for applying the Learning Environment Diversity, Equity, and Inclusion tool to asynchronous health professions courses, 2023, 5, 26663740, 100277, 10.1016/j.ijedro.2023.100277 | |
9. | Tamara Kliot, Adrian Holloway, Katherine Spillman, Julianne Moss, Natalie Louise Davis, Abebech Ayalew, Adnan Bhutta, Yayehyirad Mekonnen Ejigu, Remote Didactic Education Effectively Increases Cardiac Critical Care Nursing Staff Knowledge in Low-Resource Settings, 2024, 15, 2150-1351, 74, 10.1177/21501351231186419 | |
10. | Chevy van Dorresteijn, Monique Meij, Natalie Pareja Roblin, Frank Cornelissen, Joke Voogt, Monique Volman, Teaching strategies to facilitate social and cognitive processes in online learning environments, 2024, 19, 1554-480X, 421, 10.1080/1554480X.2024.2379790 | |
11. | Midori Matthew, Daryl Bainbridge, Valerie Bishop, Christina Sinding, Samantha Winemaker, Frances Kilbertus, Katherine Kortes-Miller, Hsien Seow, Implementing palliative care education into primary care practice: a qualitative case study of the CAPACITI pilot program, 2023, 22, 1472-684X, 10.1186/s12904-023-01265-7 | |
12. | Jeffrey P. Durney, Katie M. Catalano, D. Marlowe Miller, Amy J. Starmer, Kate Humphrey, Catherine Perron, Anne M. Stack, Improving Safety through a Virtual Learning Collaborative, 2024, 9, 2472-0054, e740, 10.1097/pq9.0000000000000740 | |
13. | Lotte Timmermans, Peter Decat, Veerle Foulon, Ann Van Hecke, Mieke Vermandere, Birgitte Schoenmakers, Transforming healthcare: A pilot study to improve primary healthcare professionals’ self-management support behaviour through blended learning, 2024, 24, 1472-6920, 10.1186/s12909-024-05799-z | |
14. | Sreenivasulu Reddy Mogali, Olivia Ng, Jia Xin Tan, Thu Htet San, Kian Bee Ng, Voice‐over anatomy lectures created by AI‐voice cloning technology: A descriptive article, 2024, 1935-9772, 10.1002/ase.2524 | |
15. | Dympna Tuohy, Pauline Boland, Patrick Stark, Lana Cook, Tara Anderson, Heather E. Barry, Matt Birch, Christine Brown-Wilson, Emma Cunningham, James McMahon, Margaret Graham, Geoffrey M. Curran, Gary Mitchell, Jill Murphy, Audrey Tierney, Alice Coffey, Digital education about delirium for health care professional students: a mixed methods systematic review, 2024, 24, 1472-6920, 10.1186/s12909-024-05725-3 | |
16. | Nicole DeVaul, Melissa A. Carroll, Kirsten M. Brown, Creative Solutions for a Condensed Anatomy Course, 2024, 1941-9430, 10.1097/JPA.0000000000000604 | |
17. | Marie K. Norman, Carla Spagnoletti, Chelsea Proulx, Isabel Crevasse, Natalie Vazquez, Thomas R. Radomski, The Case for Instructional Teams in the New Era of Online Medical Education, 2023, 33, 2156-8650, 1231, 10.1007/s40670-023-01850-8 | |
18. | Elena Marques-Sule, Juan Luis Sánchez-González, Juan J. Carrasco, Sofía Pérez-Alenda, Trinidad Sentandreu-Mañó, Noemí Moreno-Segura, Natalia Cezón-Serrano, Regina Ruiz de Viñaspre-Hernández, Raúl Juárez-Vela, Elena Muñoz-Gómez, Effectiveness of a blended learning intervention in cardiac physiotherapy. A randomized controlled trial, 2023, 11, 2296-2565, 10.3389/fpubh.2023.1145892 | |
19. | Dawn E. Havrda, Andrew J. Crannage, Angela L. Bingham, Kristen M. Cook, Susan E. Hamblin, Andie E. Lloyd, J. Russell May, Jessica R. Merlo, Kaely G. Miller, Christina A. Spivey, Best practices in online/distance pharmacy practice course didactic instruction, 2024, 7, 2574-9870, 670, 10.1002/jac5.1983 | |
20. | Minglong Li, Mengyang Zhao, Xiaoyang Sun, Hailian Qiu, Aimin Deng, Which combination of teaching methods lead to high level of effectiveness in offline-online mixed teaching? A configuration analysis based on fsQCA, 2023, 33, 14738376, 100459, 10.1016/j.jhlste.2023.100459 | |
21. | Constance A. Lightner, Carin A. Lightner-Laws, A new day in higher ed: HyFlex Universities, 2024, 1049-4820, 1, 10.1080/10494820.2024.2312932 | |
22. | Eshwar Rajesh, Sudharshini Subramaniam, Priya Pasupathy, Tharini Suresh, Vijayaprasad Gopichandran, Lived experiences of medical students of online learning: lessons for adopting virtual learning in medical education, 2024, 24, 1472-6920, 10.1186/s12909-024-05953-7 | |
23. | Bikash Barua, Umma Nusrat Urme, Assessing the online teaching readiness of faculty member, 2023, 2397-7604, 10.1108/JRIT-10-2022-0070 | |
24. | Milena Kovačević, Nevena Ivanović, Ana Protić, Danijela Milenković, Zoran Mandinić, Dragana Puzović, Miloš Bajčetić, Dušan Popadić, Jelena Parojčić, Anđelija Malenović, Health sciences students' perspectives on online teaching and learning: Extending the implications beyond the COVID‐19 pandemic, 2024, 59, 0141-8211, 10.1111/ejed.12660 | |
25. | Xin Zhao, Fangxia Pan, Xiaowei Ma, Syed Ali Raza, Xiaoxiao Zhou, New challenges in mitigating climate change: Digital teaching for the sustainable development and innovation, 2023, 9, 24058440, e22829, 10.1016/j.heliyon.2023.e22829 | |
26. | Nelson César Santisteban Salazar, Mirtha Yvis Santisteban Salazar, Adaptation Plan to the Virtual Modality in the Nursing Career of a University in Northeastern Peru, 2024, 18, 1981-982X, e05966, 10.24857/rgsa.v18n6-099 | |
27. | 2023, 10.12794/metadc2257391 | |
28. | Pratik S. Awale, Astha Kumar, Nandkishor J. Bankar, Jagdish Makade, Yogesh Kale, 2024, 3188, 0094-243X, 100032, 10.1063/5.0240379 | |
29. | Jianwei Dong, Kailea Q. Manning, Chih-Hsuan Wang, The influence of adjustment, mental health and motivation on graduate student learning strategies during COVID-19, 2024, 4, 2731-4537, 10.1007/s44202-024-00314-3 | |
30. | Claudio Intimayta-Escalante, Rubí Plasencia-Dueñas, Janeth N. Nuñez-Lupaca, Kevin Flores-Lovon, Nancy Ramirez-Bernuy, Giancarlo Pares-Ballasco, Natalia Barrientos-Odias, Ronald Castillo-Blanco, Adaptación, validación e invarianza factorial de una escala para evaluar la calidad de los cursos virtuales desarrollados para estudiantes peruanos de ciencias de la salud durante la pandemia por la COVID-19, 2025, 26, 15751813, 101008, 10.1016/j.edumed.2024.101008 | |
31. | Ayako Mori, Izumi Kato, Katsuya Narumi, Yoh Takekuma, Shuhei Ishikawa, Hitoshi Kashiwagi, Yuki Sato, Mitsuru Sugawara, Masaki Kobayashi, Impact of Eye Contact on Communication during Online Medication Counseling: An Analysis Using the Roter Interaction Analysis System, 2025, 48, 0918-6158, 17, 10.1248/bpb.b24-00489 | |
32. | Larissa Pagels, Oskar Schindler, Kerstin Luedtke, Overview of styles, content, learning effects and attitudes of students towards digitally enhanced physiotherapy education – a scoping review, 2025, 25, 1472-6920, 10.1186/s12909-025-06750-6 | |
33. | Megan Smith-Uffen, Shilpa Jyothi Kumar, Oren Levine, Daryl Bainbridge, Jeff Myers, Leah Steinberg, Nadia Incardona, Maggie Civak, Hsien Seow, A mixed methods pilot study of a serious illness communication training curriculum among medical residents, 2025, 19, 2632-3524, 10.1177/26323524251326949 | |
34. | Beth Frates, Kenny Kusnadi, Tracie McCargo, Teaching Assistants: Essential Members of the Teaching Team, 2025, 1559-8276, 10.1177/15598276251328635 | |
35. | Mustapha Abdelouahed, Dana Yateem, Chadi Amzil, Ilyas Aribi, El Hassan Abdelwahed, Salim Fredericks, Integrating artificial intelligence into public health education and healthcare: insights from the COVID-19 and monkeypox crises for future pandemic readiness, 2025, 10, 2504-284X, 10.3389/feduc.2025.1518909 | |
36. | Tracie McCargo, Irena Matanovic, Case Brabham, Mina McBride, Beth Frates, 2025, Chapter 20, 978-3-031-82887-4, 411, 10.1007/978-3-031-82888-1_20 | |
37. | 2024, 10.12794/metadc2415892 | |
38. | Hsien Seow, Daryl Bainbridge, Samantha Winemaker, Jeff Myers, Kathy Kortes-Miller, Frances Kilbertus, Oren Levine, Nadia Incardona, Leah Steinberg, Gregory Pond, Denise Marshall, Kelli Stajduhar, Jose Pereira, Does Facilitated Palliative Care Education Improve Patient Identification? A Cluster Randomized Controlled Trial of Primary Care Providers in the CAPACITI Training Program, 2025, 1096-6218, 10.1089/jpm.2024.0453 | |
39. | Casey P. Schukow, Timothy Craig Allen, A New Generation of Pathologists: Addressing Modern Curriculum and Educational Scholarship for Pathology Educators and Trainees After the End of the COVID-19 Pandemic, 2025, 149, 1543-2165, 578, 10.5858/arpa.2024-0114-RA | |
40. | Marija J. Rowane, Kevin A. Thomas, Travis M. Smith, Mark A. Terrel, Michael P. Rowane, Robert W. Hostoffer, Scholar 12 longitudinal outcomes: osteopathic research development application to facilitate scholarly activity during the pandemic and beyond, 2025, 2702-3648, 10.1515/jom-2025-0041 | |
41. | Timothy K. Fincher, Abby J. Weldon, Charles R. Breese, Melissa A. Burmeister, Examination of the utility of an algebra-based interview day math assessment to predict academic outcomes in an accelerated pharmacy curricula; A retrospective observational cohort study, 2025, 17, 18771297, 102409, 10.1016/j.cptl.2025.102409 |
Course code and name |
Name of the instructor/lecturer/tutor: XXX |
|||
Topic and date | Instructional objectives | Teaching aids | Teaching method | Assessment |
Cell injury and death Date: Duration: |
-Discuss the types of cell death. -List the factors that are associated with cell growth and regeneration |
-PPT -Recorded lectures -Interactive online materials |
-Lecture -Case presentation -PBL |
-Asynchronous clerkship assessment: MCQ format. -Synchronous clerkship assessment: museum specimen case presentations -In-class Online synchronous quiz and polls. -PBL Assessment: case-based study |
Inflammation Date: Duration: |
-Outline the differences between acute and chronic inflammation. -Explain the stages of acute inflammation with an emphasis on the inflammatory cells in each phase. |
-Recorded lectures -Video clippings -Group based resource study -Guest lecture links. |
-Lecture -Video demonstration -PBL |
-Asynchronous clerkship assessment: Histology spotters -Synchronous clerkship assessment: short case discussion -Asynchronous Short answer essay questions -PBL assessment through objective-based presentation |
Neoplasm Date: Duration: |
-Discuss the morphological differences between benign and malignant tumors. -Outline in detail the features of metastasis. |
-PPT -Recorded lectures -Question banks -Interactive online materials |
-Lecture -Case presentation -PBL |
-Asynchronous clerkship assessment: MCQ format. -Synchronous clerkship case presentations -PBL Assessment -Clinical Case reviews |
Course code and name |
Name of the instructor/lecturer/tutor: XXX |
|||
Topic and date | Instructional objectives | Teaching aids | Teaching method | Assessment |
Cell injury and death Date: Duration: |
-Discuss the types of cell death. -List the factors that are associated with cell growth and regeneration |
-PPT -Recorded lectures -Interactive online materials |
-Lecture -Case presentation -PBL |
-Asynchronous clerkship assessment: MCQ format. -Synchronous clerkship assessment: museum specimen case presentations -In-class Online synchronous quiz and polls. -PBL Assessment: case-based study |
Inflammation Date: Duration: |
-Outline the differences between acute and chronic inflammation. -Explain the stages of acute inflammation with an emphasis on the inflammatory cells in each phase. |
-Recorded lectures -Video clippings -Group based resource study -Guest lecture links. |
-Lecture -Video demonstration -PBL |
-Asynchronous clerkship assessment: Histology spotters -Synchronous clerkship assessment: short case discussion -Asynchronous Short answer essay questions -PBL assessment through objective-based presentation |
Neoplasm Date: Duration: |
-Discuss the morphological differences between benign and malignant tumors. -Outline in detail the features of metastasis. |
-PPT -Recorded lectures -Question banks -Interactive online materials |
-Lecture -Case presentation -PBL |
-Asynchronous clerkship assessment: MCQ format. -Synchronous clerkship case presentations -PBL Assessment -Clinical Case reviews |