Introducing the 4Ps Model of Transitioning to Distance Learning: A convergent mixed methods study conducted during the COVID-19 pandemic.
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SUBMITTER: Otaki F
PROVIDER: S-EPMC8282011 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe pandemic of SARS-CoV-2, which causes COVID-19, has caused disruptions in ongoing clinical trials and is expected to accelerate interest in conducting research studies remotely.ObjectiveA quasi-experimental, mixed methods approach was used to examine the rates of visit completion as well as the opinions and experiences of participants enrolled in an ongoing clinical trial of smoking cessation who were required to change from in-person clinic visits to remote visits using video or telephone conferencing due to the COVID-19 pandemic.MethodsFor quantitative comparisons, we used a quasi-experimental design, comparing a cohort of participants followed during the pandemic (n=23, COVID-19 cohort) to a comparable cohort of participants followed over a similar time period in the calendar years 2018 and 2019 (n=51, pre-COVID-19 cohort) to examine the rates of completion of scheduled visits and biospecimen collection. For the qualitative component, interviews were conducted with participants who experienced the transition from in-person to remote visits.ResultsParticipants in the COVID-19 cohort completed an average of 83.6% of remote clinic visits (95% CI 73.1%-91.2%), which was not significantly different than the in-person completion rate of 89.8% in the pre-COVID-19 cohort. Participants in the COVID-19 cohort returned an average of 93.2% (95% CI 83.5%-98.1%) of saliva specimens for remote clinic visits completed, which was not significantly different than the in-person saliva specimen completion rate of 100% in the pre-COVID-19 cohort. Two broad themes emerged from the qualitative data: (1) the benefits of remote visits and (2) the challenges of remote counseling compared to in-person counseling. Despite limited experience with telehealth prior to this transition, most participants expressed a willingness to engage in remote visits in the future.ConclusionsEven in the context of a rapid transition from in-person to remote visits necessitated by the COVID-19 pandemic, rates of visit completion and return of biospecimens remained high. Participants were generally accepting of the transition. Further research is needed to identify the optimal mix of in-person and remote visits beyond the pandemic context and to better understand how these changes may impact study outcomes.Trial registrationClinicalTrials.gov NCT03262662; https://clinicaltrials.gov/ct2/show/study/NCT03262662.
| S-EPMC8092028 | biostudies-literature
Project description:BackgroundEducational pedagogies were modified during the COVID-19 pandemic to minimise interruption to teaching. One approach has been the distance learning problem-based learning (PBL) tutorial utilising the online peer-to-peer platform. The aim of this study was to compare the performance of students using distance learning PBL tutorials using with that of students utilising the conventional face-to-face approach.MethodsThis retrospective study was conducted in a single academic institution. We compared two groups of fourth-year medical students from the same class: one group used distance learning (DL); the other, the face-to-face (FF) method. We used students' baseline performance at the preceding block for one-to-one propensity score matching. Students utilising the PBL tutorial were given grades by their tutors according to a standardised scoring system encompassing five key areas (score range: 0-10). The main outcome was a student's total score (i.e., the sum of the scores from the five key areas, ranging from 0 to 50).ResultWe matched 62 students in each group. With four tutorials, there were 490 observations, with 245 in each group. The mean total score for the DL group was 37.5 ± 4.6, which was significantly lower than that of the FF group (39.0 ± 4.4, p < 0.001). We noted that students in the DL group had a significantly lower scores for all five areas of proficiency: participation, communication, preparation, critical thinking and group skills.ConclusionFindings of this study revealed that the performance of students utilising the DL PBL tutorials was lower than that of students participating in the conventional FF approach. Further studies are needed to ascertain the underlying cause.
| S-EPMC7928185 | biostudies-literature
Project description:BackgroundThe coronavirus pandemic has exerted significant impacts on primary care, causing rapid digital transformation, exacerbating social isolation, and disrupting medical student and General Practice [GP] trainee education. Here we report on a medical student telephone initiative set-up by a final year GP trainee (the equivalent of a family medicine resident), which aimed to support patients at high risk and vulnerable to the Coronavirus Disease of 2019 [Covid-19]. In addition, it was hoped the project would mitigate a digital divide, enable proactive anticipatory planning, and provide an active learning environment to compensate for the pandemic's impact on medical education.MethodsThirty-three medical students conducted daily telephone conversations with high risk and vulnerable patients as specified by the initial NHSE published lists. They confirmed public health messages, offered details for voluntary support groups, established need for medication delivery, explored levels of digital connectivity, and prompted discussions around end-of-life choices. Students had access to online reflective resources and daily remote debriefing sessions with the GP trainee. A convergent mixed-methods evaluation was subsequently undertaken, using quantitative process and descriptive data and individual qualitative interviews were conducted according to a maximal variation sampling strategy with students, General Practitioners [GPs], and the GP trainee. Inductive thematic analysis was then applied with cross-validation, respondent validation, and rich evidential illustration aiding integrity.ResultsNinety-seven 'high risk' and 781 'vulnerable' calls were made. Individuals were generally aware of public heath information, but some struggled to interpret and apply it within their own lives. Therefore respondents felt students provided additional practical and psychological benefits, particularly with regard to strengthening the links with the community voluntary groups. The project was widely liked by students who reported high levels of skill development and widened awareness, particularly valuing the active learning environment and reflective feedback sessions.ConclusionThis study demonstrates utilization of medical students as wider assets within the primary health care team, with an initiative that enables support for vulnerable patients whilst promoting active medical education. Ongoing integration of students within 'normal' primary health care roles, such as chronic disease or mental health reviews, could provide similar opportunities for supported active and reflective learning.
| S-EPMC7578590 | biostudies-literature
Project description:Background: The onset of the pandemic necessitated abrupt transition to telehealth consultations. Although there is a few tools that gauge the patients' perception about their experiences, none of them are contextualized to an emergency in the Middle East and North Africa region. Accordingly, this study aims at developing and validating a tool to address this gap, and deploying it to assess the patients' perception of telehealth services during COVID-19 in Dubai, United Arab Emirates (UAE). Methods: A convergent mixed methods design was adapted. A random selection of 100 patients from Dubai, UAE were invited to participate. Qualitative and quantitative datasets were collected using a tailor-made survey. The qualitative data, collected through open-ended questions, was analyzed using multi-staged thematic analysis. As for the quantitative data, it captured the patients' extent of satisfaction, and was assessed using SPSS (with a series of descriptive and inferential analyses). The qualitative and quantitative findings were then merged via joint display analysis. Results: Out of the 100 patients that were randomly selected, 94 patients participated in this study. The reliability score of Cronbach's Alpha for the instrument was 98.9%. The percentage of the total average of satisfaction was 80.67%. The Principal Component Analysis showed that 88.1% of the variance can be explained by the instrument (p < 0.001). The qualitative data analysis expanded upon the quantitative findings enabling a better understanding of the patients' perception. Three themes, revolving around the quality of the patient telehealth experiences, surfaced: "Factors that worked to the benefit of the patients," "Factors that the patients were not in favor of," and "Opportunities for improvements as perceived by the patients." Discussion: This study introduced a novel patient satisfaction with telehealth consultation survey contextualized to the COVID-19 times in Dubai, UAE. The participants were quite satisfied with the quality of their experience, however they suggested areas for improvement. Regional healthcare decision-makers can leverage the identified advantages and opportunities for improvement of telehealth. This will enable making informed decisions regarding the continuity of telehealth irrespective of how matters unfold in relation to the pandemic. It will also better prepare the healthcare sector for potential resurgence(s) of COVID-19 and/or the occurrence of other similar emergencies.
| S-EPMC8669510 | biostudies-literature
Project description:The COVID-19 pandemic poses great challenges to higher education. Universities had to change their infrastructure to full remote teaching and learning environments in a very short time. Lecturers and students were forced to adjust their established routines and concepts of teaching and learning. During the first nationwide lockdown in Germany, we explored students' anticipations regarding the risks and chances of this challenging situation. They were asked about the negative and positive effects of this sudden switch to online university courses and the relevance personally ascribed to each of these expected effects. A sample of 584 students provided 3,839 statements, which were examined by means of qualitative content analysis. While 57.7% of the statements concerned negative effects, 42.3% dealt with positive ones. The range of expected negative and positive effects was wide, but key themes emerged particularly frequently. While the mentioned effects were generally considered to be of high personal relevance, negative effects were rated as significantly more relevant, but with only a small effect size. The relevance of negative effects was considered higher by master students than by bachelor students. Relevance ratings were significantly higher for the first effect mentioned compared with all subsequent effects, indicating an ease-of-retrieval effect, which is relevant from both a methodological and content perspective. The results provide important insights into students' perspectives on remote learning that will be significant beyond the current pandemic, as they can guide sustainable measures by exploiting opportunities and mitigating risks. We discuss practical implications and methodological limitations of the study.
| S-EPMC8439379 | biostudies-literature
Project description: Not available
| S-EPMC9126433 | biostudies-literature
Project description:Clinical reasoning is the cornerstone to healthcare practice and teaching it appropriately is of utmost importance. Yet there is little formal training for clinical supervisors in supervising this reasoning process. Distance education provides interesting opportunities for continuous professional development of healthcare professionals. This mixed methods study aimed at gaining in-depth understanding about whether and how clinical teachers can develop complex pedagogical competencies through participation in a Massive Open Online Course on the supervision of clinical reasoning (MOOC SCR). Participants self-assed their clinical supervision skills before and after partaking in the MOOC SCR through the Maastricht Clinical Teachers Questionnaire. Item scores and the distribution of response proportions before and after participation were compared using paired t-tests and McNemar's tests respectively. In parallel, the evolution of a subset of MOOC participants' pedagogical practice and posture was explored via semi-structured interviews throughout and beyond their MOOC participation using simulated and personal situational recalls. The verbatim were analysed with standard thematic analysis. Quantitative and qualitative findings converged and their integration demonstrated that partaking in the MOOC SCR promoted the development of complex pedagogical competencies and reflexivity with the participants. This was quantitatively evidenced by significantly higher self-assessed supervision skills and corresponding attitudes after completing the MOOC. The qualitative data provided rich descriptions of how this progression in pedagogical practice and posture occurred in the field and how it was shaped by participants' interaction with the MOOC's content and their motivations to progress. Our findings provide evidence for the development of pedagogical skills and corresponding attitudes for the supervision of clinical reasoning through participation in the MOOC SCR and contribute to the literature body on the opportunities that distance learning provides for the development of pedagogical competencies. The extent to which the pedagogical underpinnings of the MOOC contributed to these developments remains to be determined.
| S-EPMC10569352 | biostudies-literature
Project description:BackgroundGiven the extent of the COVID-19 pandemic and uncertainty around the timing of its containment, understanding the experiences and responses of the perinatal population is essential for planning responsive maternity care both during and after the pandemic. The aim of this study was to explore the experiences of pregnant people and their responses to the COVID-19 pandemic, and to identify how health care providers can support this population.MethodsThis was a mixed-methods, descriptive study with cross-sectional and qualitative descriptive components. We conducted the study between Mar. 20 and May 31, 2020, in British Columbia, Canada. Any pregnant person at any gestational age living in BC was eligible to participate. We collected quantitative data using online survey tools, including the Edinburgh Postnatal Depression Scale (EPDS) and the 7-item Generalized Anxiety Disorder questionnaire (GAD-7). We collected qualitative data using open-ended questions to explore people's thoughts, feelings and experiences during the pandemic. Participants were recruited using study posters distributed via prenatal care clinics and classes, LifeLabs and social media across the province. We used thematic and descriptive analyses to analyze the data, and we integrated the qualitative and quantitative findings at the interpretation level.ResultsThe study sample included 96 participants with mean (± standard deviation) maternal and gestational ages of 32 ± 3.92 years and 22.73 ± 8.93 weeks, respectively. Most (93%; n = 89) identified as female. Of the participants, 54% (n = 50) and 35% (n = 34) reported anxiety and depressive symptoms, as measured by the GAD-7 and EPDS, respectively. Overarching themes that emerged from the qualitative data included uncertainty about birth plans and setting, added burden to existing health and social disparities, perceived or projected lack of support or limited support, concerns about early development, and struggle over managing multiple demands. Perceived maternity care needs included mental health support, maintaining prenatal care, frequent and proactive check-ins to build rapport, and recommendations specific to the pandemic.InterpretationWe found that the impact of the COVID-19 pandemic on the pregnant population has been substantial. The findings of this mixed-methods study can be used to help plan informed and evidence-based health care interventions to mitigate adverse effects and support mothers and families.
| S-EPMC9259458 | biostudies-literature
Project description:IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has caused serious public health problems and compromised the health of individuals and communities. This study aimed to evaluate a Distance e-Learning from the perspective of medical students in the Gynecology ward during the COVID-19 Pandemic.Material and methodsThis cross-sectional study was conducted at the Iran University of Medical from the September 2020 to September 2021. The study sample included 130 medical students who participated in distance training courses in the gynecology ward during the COVID-19 pandemic. All medical students were included for the study. Medical students (externs and interns), who received Distance eLearning in the gynecology ward during the study, were included. The self-administered questionnaire was used in this study. Questionnaires was developed through literature review and consultation with gynecology and eLearning experts. Face and content validity was established by eight experts. Internal consistency was assessed with Cronbach's alpha.ResultsThe questionnaire was sent to 170 medical students. Of the 130 respondents 65% were female and 35% were male. There were 57 (43.8%) externs and 73 (56.2) interns. Most students agreed that mobile devices increase their learning and home is the preferred place for participation in DE. Most students (66.9%) either strongly disagreed or disagreed that Distance e-Learning was an appropriate method for learning basic clinical skills.72.3% of respondents strongly disagreed or disagreed that Distance e-Learning provided them an opportunity to practice clinical skills effectively. Most medical students (69.3%) strongly agreed or agreed that Distance e-Learning created more opportunities to apply theoretical knowledge directly to medical practice.DiscussionThe results of the online survey suggest that medical students have found both positive and negative aspects of clinical learning by DEL format in Gynecology ward.
| S-EPMC10038303 | biostudies-literature
Project description:Objectives The COVID-19 pandemic has changed the way people are accessing healthcare. The aim of this study was to examine the impact of COVID-19 on emergency department (ED) attendance for frequent attenders and to explore potential reasons for changes in attendance. Design This convergent parallel mixed methods study comprised two parts. Setting An interrupted time-series analysis evaluated changes in ED presentation rates; interviews investigated reasons for changes for frequent ED users in a culturally and linguistically diverse setting. Participants A total of 4868 patients were included in the time series. A subgroup of 200 patients were interviewed, mean age 66 years (range 23–99). Results Interrupted time-series analysis from 4868 eligible participants showed an instantaneous decrease in weekly ED presentations by 36% (p<0.001), with reduction between 45% and 67% across emergency triage categories. 32% did not know they could leave home to seek care with differences seen in English versus non-English speakers (p<0.001). 35% reported postponing medical care. There was a high fear about the health system becoming overloaded (mean 4.2 (±2) on 6-point scale). Four key themes emerged influencing health-seeking behaviour: fear and/or avoidance of hospital care; use of telehealth for remote assessment; no fear or avoidance of hospital care; not leaving the house for any reason. Conclusions This study demonstrated reduced ED use by a vulnerable population of previously frequent attenders. COVID-19 has resulted in some fear and avoidance of hospitals, but has also offered new opportunity for alternative care through telehealth.
| S-EPMC8718342 | biostudies-literature