The Impact of Teaching-Learning on Electronic Platforms: A Cross Sectional Survey On Medical Students

Introduction

E-Learning can be defined in several ways. It is a kind of learning process for the students. It helps the students to have a technology assisted learning environment and have flexibility in their studies off-campus. One of the universities named Deaken has used online communication with students since 1981.¹ In the extended methods of teaching and learning process, we can use activities such as lectures, tutorials, workshops or online seminars. Most of the universities worldwide have implemented E-learning as part of education. Although e-learning has been existing for over a decade, not much research was done regarding student satisfaction and motivation on using E-learning.² Currently, technology has modified our tutelage by helping scholars to participate in the teaching-learning process. This study helps us to identify various E-learning methodologies applied as well as to identify the pros and cons of each methodology. This will facilitate the teachers and learners to inculcate best methodology for an excellent outcome of learning among the medical students.

Objectives

• To identify the challenges faced on various E-learning platforms.
• To discuss current trends in E-learning methods.

Student perception on E-learning

As per the research done by Mehandi Vinayak Mahajan et al. and Kalpana R (2018),³ students have a perspective of various benefits they received via E-learning. It also has influenced their performance. Students even opted for platforms wherein faculties describe the classes with interaction and also case scenarios can be shared. These days even the learners are accountable for assimilation and improvement. Now-a-days in developed and developing countries, institutions are adopting webbased classrooms or virtual classrooms. The present generation of students are well aware of technology and are quite adept in its usage. Thus, they find this style of learning agreeable as it allows them to have their own pace.

Motivation of students in E-learning

Recent studies indicate that students via e-learning courses outperform the students attending traditional courses. Usage of technology in studies alone does not contribute to the motivational aspect for students. Thus, we should be aware of what exactly can motivate a student. The motivational aspect is very important for a student since this helps in success and failure of online learning as the personal interaction is very less between the teacher and students. Motivation should be generated within students. Students should be aware of using the online environment. Interaction and collaboration between the students can help to generate motivation. Groups prepared by students will avoid isolation of a student. Students who socialize with peers online are increasing motivation.² Teacher-Learner interaction is the key component in education. Observing learner attention by providing continuous feedback is also creating motivation among students. Students can take up online tasks as assignments or online seminars. The emotions or environment of each student is also an important factor for motivation.

Reflective E-learning

Reflective learning is very important in the learning process since it helps the learner to improve knowledge and thereby enhance the performance. This also helps the teacher to receive feedback on the course provided, understand the learner on specific course and also aids in the improvement of teaching. There are several methods in Learning Management System (LMS)⁴ that can help reflective learning.

Note making: Each student must keep a note or learner log or a diary in which the course/class notes⁵ can be written or marked. On completion of a module or chapter, assignments can be given which will reflect on what the learner understood from the class or a particular course. Daily basis assignments also can be given on the notes made on a daily basis. Submission deadlines for the assignments can be set for students.

Pre-learning activities: Pre-learning activities help the students to be clear about the chapter/course and thereby understand the expectations from completion of a particular course.^6,7 It helps the students to set goals in an organized way. It also helps to reduce the challenges of isolation or confusion of E-learning learning activities should include objectives, important notes, questions to be asked, and duration on course completion.

Active E-learning: Active E-learning makes the student improve cognitive skills such as higher-order thinking, analysis, and evaluation. It helps the student to have their ideas and attitudes towards a specific course.^6,7 This can be achieved by project completion, clinical reasoning/problem-solving. Interaction with the teacher, peer group, and class groups help the student to view a problem from a different perspective. From a student's perspective, this will help them to self-motivate and become self-learners. It helps them with deeper thinking and analytical skills. Students will be able to achieve this only by effective delivery of the course by the instructor/ mentor.

Learning styles in E-Learning

The style of learning for a student is the way they prefer to learn and this can facilitate efficient learning by which the student can remember and recall what they learned.⁸ Learners are broadly classified into two categories:

Sequential Learners: They prefer to learn the content from the basics and in a step by step manner. They pay attention to smallest detail in the syllabus or curriculum and have an urge to complete even the smallest basic topics or content as mentioned in the syllabus.⁹

Global Learners: They prefer to learn the topic in a wholesome manner and prefer problem-solving. They like to receive the material in bulk and also prefer to jump into the matter or main content in one leap.¹

As per the Visual-Auditory-Kinesthetic (VAK) theory, learners are divided into Vision, Audio, or Tactile contingent based on the senses they acquire, store and recall the data or topic. Visual learners learn efficiently by seeing the materials. These learners would always prefer to share the picture/PPT/tables or diagrams so that they can see and learn. Auditory learners prefer learning by hearing or listening to the audio. For these learners, mere listening to lectures or seminars without seeing helps them to store the information and recall it later. They would always prefer to be part of discussions and interactive sessions. Kinesthetic learners would prefer to learn by performing and via tactile sensation. They feel and study. They would always love perming the practical sessions more to learn and remember.¹⁰ As per Herman et al., an adaptive E-learning system should be created such that it matches the learning style of the student i.e., visual, auditory, and kinesthetic, either globally or sequentially.⁸

E-learning methods for a special population

Special population among the children are the ones who face difficulties in this growing world of technology. Education is a basic human right and everyone must have an equal opportunity. Assistive technology utilizing different equipment, tools, systems, and software can help these students overcome the difficulties. We will have to delve into the innovations made for helping these students such as text-to-voice devices, alternative keyboards, software, etc.¹¹

Special keyboards: Keyboards designed for small hands, special keyboard for the blind, large size keyboards, and specially programmed keyboards are all available. Input devices such as virtual keyboards allow the learners to provide data of other gadgets.

Mouse alternatives: Trackball mouse is very helpful for students with fine motor disabilities, assisting them in proper grasping. These are ergonomically designed. Also, mouse wheels can be used as a precise thumb or finger poker to improve typing efficiency.⁵

Head mouse: Not mentioned anywhere much, it operates based on the movement of the head and helps learners to control the applications.

Touch-sensitive screen: These devices help in giving the input to the system via touch by finger or stylus. For students with motor disabilities, switches and special software can be used together. Students can operate the switches by breath control via inhaling & exhaling tools, the load generated in muscle, change in position of the head, or verbal command. To avoid excess typing, Word Prediction Software can be implemented. Text-speech software reads the text aloud for blind students. Intel Reader & Kurzweil 3000 are some of the most used text to speech software programs. Students with learning or writing disabilities can benefit from it. Text to speech devices even helps the students with speech difficulties, by entering a text which will be reproduced as a human voice. This assists them in interaction and allows them to move past their disabilities.

For a special population of students, the content should be Perceptual, Operable, Understandable and Robust. Students can perceive in the form of text alternatives or enlarged print, Braille, symbol replacements, simple language/ text, etc. Presentation of the content should be loud or spoken in an understandable way. The keyboard should have all the assistive functions accessible for them. Enough time should be given for the delivery of content so that the students can have time to get acquainted. Some of the contents can develop seizures or disturbances which should be avoided. Appropriate navigation tools should be designed to help the students considering their barriers. Contents should be user friendly. MS is not the only software. We should always go with the most updated and the best one suitable for each special student according to their needs.

Challenges faced by students in E-Learning

The challenges faced by the student community is mainly categorized into three forms as follows:¹²

1. Teacher centered challenges
2. Information technology related
3. Teaching and learning environment-related
4. Student community or the audience themselves

Teacher-centered challenges: The instructor is not prepared for the lecture and the way of deliverance does not convey the apt point for the particular class. The slide or content preparation is not concise. Irrelevant images and videos are shown to students. The concepts are not explained well, instead it is done by reading the slides.

Information technology-related: The teacher must be able to learn and perform certain essential troubleshooting that might occur during the sessions. In developing countries like India, we could not expect the student community to have latest technology for multitasking on mobile and laptops. Even broadband connections are not available in many places in India.

Teaching and learning environment related: In India, many students stay in remote areas and villages where the bandwidth or the network will not be as expected by the university or teaching institution. This will affect the overall learning process. Constraints including familial issues such as disputes in family and disturbances from the peer group will reduce the learning efficacy.

Audience issues: If the audience is not properly educated about the usage of the facility, there can be cross-talk during the online session or web session which can hinder the teaching and learning process. The age group involved in the learning process will also affect the e-learning process.

Psychological issues: Regular classroom teaching will provide greater support as the teacher communicates with the students and the facial expression and non-verbal communication helps to understand the psychological issues. But this is lacking in online or e-learning which needs to be emphasized by the teachers during their lecturing. This can be rectified by adding a mentorship program even in e-learning.¹³

Materials and Methods

To determine the perception of students regarding the current education system, a sample survey was conducted among 113 medical students. Survey questions were shared to 113 medical students. Survey was conducted with the aid of Google forms which is also an electronic mode. Survey questionnaire included both close ended and open ended questions. All 113 participant responses were analyzed and results were obtained. This short survey was conducted to analyze the feedback of students on learning through electronic platforms.

A total of 17 items were included which were divided into six sections (ANNEXURE 1). Additionally, the participants were encouraged to provide demographic data including Email ID and name.

The sections include:

• Knowledge on Internet
• Motivation
• Learning style
• Reflective E-Learning
• Satisfaction

Results

As per the survey, 88% of the students agreed that they use the internet and online-based technologies quite often. Among all the students who responded, approximately 77% of the students agreed to train on the E-learning applications as well as online platforms. This states that the learners are well aware of the technologies and but require certain training on the usage of the internet for learning purposes. About 81% of the students who participated in the survey agreed that E-learning is useful. Approximately 81% agreed E-learning is motivational and 75% stated that E-learning is beneficial for enhancing the existing knowledge. It was noticed that 87% of the students found interactive sessions in E-learning to be helpful. For 91% of the learners, course content shared via E-learning platforms was beneficial and 88% were satisfied with the content of the course material shared. Among all the commonly used internet platforms, about 96% of the students were satisfied with Google classroom, and 89% were satisfied with E-mails for content sharing. About 83% of learners agreed for live webinars and 73% opted for WhatsApp. 87% of students were satisfied with the E-assessment and 95% were satisfied with the guidance received. Around 90% of students were satisfied with flashcards & online quiz and 88% were satisfied with proficiency of the faculties. 83% of the students found e-learning cost-effective and 72% were satisfied with the pace of learning.

Students have also reported the challenges such as network /data accessibility, technical issues while using the gadgets. Despite all these challenges, the overall satisfaction of the students while using the E-learning tools on different platforms was found to be 90%.

Students were satisfied with sharing the contents via Emails and WhatsApp. Live webinars were also chosen by the students as an effective medium for teaching and their prospect was not about a monotonous E-learning session, indeed about having interactive sessions, quizzing, flashcards, etc. which helps them to be motivated, improving their knowledge and performance.

Discussion

Learners perceive E-learning as a beneficial tool in the current world since it helps them to access the course contents, improve the pace of learning, and to enhance the knowledge. As per the results obtained from the survey, the challenges they face in E-learning are the technical issues as well as the speed of internet. Also, concern arises about the learner’s accessibility to the internet and technology in certain remote areas of the world since the survey included international students. We should also incorporate some of the advanced technologies to provide suitable alternatives for differently-abled students. Financial barrier is one of the major challenges faced by the differently-abled population in achieving education via E learning. Thus, we must explore more cost-effective means of technologies for these populations.Education is important and every individual has a right for education. In this fast growing world of technology, we should not forget our learners who represent the future of our nations.

Conclusion

Identifying the challenges and implementing appropriate tools and user-friendly platforms can scale up E-learning to next level. Accessibility to technology is one major drawback faced by our students. Removing these barriers can motivate the students and enhance learning. For future, E-learning is one of the developing as well as the most used method of teaching.

Conflicts of interest

The authors do not have any conflict of interest to declare.

Ethical Approval

No treatment procedure or experimental procedure was performed on a human. Hence ethical approval was not essential for the study.

Statement of informed consent

We have mentioned in our introduction statement of the survey about voluntary acceptance by the students for participating in the survey. We stated that the details will be revealed as and when required. Only participants who agree to this statement are allowed to participate.

Data Repository Address:

https://osf.io/29k4j/?view_only=b302a5e6298b454ca3c452fe4b52d0cc

Acknowledgments

I thank Almighty God and I take this opportunity to express my heartfelt gratitude to my Family for their all-time support and encouragement. I express my profound gratitude towards my institution for providing the necessary opportunities for my study. I am extremely grateful to all my contributors and co-authors who gave me support throughout this project. Though words are not enough to express the sense of gratitude towards everyone who helped directly or indirectly, have made a humble attempt to do so and guided me throughout my study