|Year : 2020 | Volume
| Issue : 2 | Page : 99-104
Principal components analysis of educational resources usage among undergraduate medical students during the COVID-19 pandemic in Southern Haryana, India
Avinash Surana1, Ram Kumar Panika2, Vikas Gupta2, Abhishek Singh3
1 Assistant Director Health, Rajasthan, India
2 Department of Community Medicine, Government Medical College, Shahdol, Madhya Pradesh, India
3 Department of Community Medicine, SHKM Government Medical College, Nalhar, Haryana, India
|Date of Submission||20-May-2020|
|Date of Acceptance||11-Jun-2020|
|Date of Web Publication||10-Sep-2020|
Dr. Vikas Gupta
Department of Community Medicine, Government Medical College, Shahdol, Madhya Pradesh
Source of Support: None, Conflict of Interest: None
Background: The year 2019–2020 has seen worldwide pandemic resulting from COVID-19 which posed the closure of teaching institutions including medical colleges and have put the students in dilemma. Aim: The present study was conducted with the aim to evaluate the accessible and preferable educational resources among medical students during this pandemic phase. Materials and Methods: This web-based cross-sectional study was conducted among 392 undergraduate medical students after obtaining informed consent during April 2020 using a 24-item structured questionnaire with close-ended responses. Existence of clustering within the student's preferred educational resources was investigated using principal components analysis (PCA). Results: The mean age of the study participants was 20.71 ± 1.65 with 51.3% males and 48.7% females. The major response regarding educational resources were online lectures, online teaching videos reading textbook, and written notes. Wilcoxon signed-rank test revealed that preference for online lectures, online teaching videos, interactive online materials, and medical apps were found to be statistically significant for learning when compared to revision (P < 0.05). The clustering was observed along the online and offline differentiation of resources.Conclusion: This novel study has made an attempt to find out the common educational resources used during COVID-19 pandemic and also analysis using PCA was done to find the clustering of educational resources for new learning or revision of skills and knowledge. Given the increasing number of individuals for online educational resources, it is important to develop a body of evidence supporting teaching excellence and providing information about effective teaching tools in online education.
Keywords: Knowledge, learning, online, revision, textbooks, Wilcoxon signed-rank test
|How to cite this article:|
Surana A, Panika RK, Gupta V, Singh A. Principal components analysis of educational resources usage among undergraduate medical students during the COVID-19 pandemic in Southern Haryana, India. J Sci Soc 2020;47:99-104
|How to cite this URL:|
Surana A, Panika RK, Gupta V, Singh A. Principal components analysis of educational resources usage among undergraduate medical students during the COVID-19 pandemic in Southern Haryana, India. J Sci Soc [serial online] 2020 [cited 2020 Sep 19];47:99-104. Available from: http://www.jscisociety.com/text.asp?2020/47/2/99/294796
| Introduction|| |
The year 2019–2020 has seen worldwide pandemic resulting from severe acute respiratory syndrome (SARS) coronavirus 2, also known as COVID-19 which can result in illnesses ranging from the common cold to SARS. COVID-19 is a zoonotic pathogen that can be transmitted through animal-to-human and human-to-human through droplet, feco-oral, and direct contact with an incubation period of 2–14 days., In the past multiple epidemic outbreaks occurred which includes SARS during 2002 resulted in 800 mortality, and Middle East Respiratory Syndrome (MERS)-CoV during 2012 resulted in 860 mortality., Approximately 8 years after the MERS-CoV epidemic, the current outbreak has rapidly spread to most countries and claimed several lives subsequent to its first report in Wuhan, Hubei Province in China in December 2019. On January 30, 2020, the World Health Organization (WHO) has declared COVID-19 as a public health emergency of international concern. Astonishingly, in the 1st week of March, a devastating number of new cases were reported globally, and subsequently on March 11, 2020, the WHO has declared the COVID-19 to be a pandemic. On March 24, 2020, Government of India (GoI) took a strong initiative to contain the spread of this virus and from the March 25, 2020, onward the closure of nearly all offices, industries, hotels, commercial and private establishments, shops, malls, and others was ordered. The closure of educational, research, and coaching institutions was also initiated with no exception to teaching institutes like medical colleges. The closure of medical colleges during pandemic has put the students in dilemma as they will not get that extent of support, guidance, and supervision from their teachers as they were getting on the campus. Furthermore, there will be no face-to-face interaction between student and teacher; the traditional way of teaching methods will be hampered. As of April 22, 2020, more than 2,475,699 cases of COVID-19 have been reported in over 213 countries and territories, resulting in more than and 169,134 deaths, whereas in India, the actives case counted 15,859, 3960 cured, and 652 deaths., However, in the last decade, the availability of education materials or resources to medical students have expanded rapidly. There is an increased access to the online learning tools and apps with the rapid expansion of mobile technology apart from traditional methods textbooks, tutorials, and lectures., In developed countries, the concept of blended learning is well established and accepted, as it includes both e-learning and traditional learning methods., Moving on the similar path, GoI have suggested teaching schools and institutes to teach the students through various available and accessible online portals. The current need of hour is to find out how medical students learn during this pandemic while institutes are closed, the present study was conducted with an aim to evaluate the accessible and preferable educational resources among medical students during COVID-19 pandemic for acquiring new skills/knowledge; and for revising skills/knowledge. The expected benefits of the present study are that the institute will be aware of student's education priorities and needs, the quality and reliability of educational resources can be further evaluated and the most commonly used tools by students can be developed at the level of institution itself.
| Materials and Methods|| |
Study setting and design
This prospective web-based cross-sectional study was conducted in a Government Medical College, of Southern Haryana, during the 3rd week of April 2020. The college was started in 2013 with getting its first batch of MBBS students and since then there is joining of 100 MBBS students each year, so currently, there were 627 MBBS students (regular batch and additional batch) including interns.
Study population and sample size
The study participants included MBBS students from 1st year to prefinal year with currently having access to the internet and it counted to around 392 eligible students. The purpose of the study was explained and informed written consent was obtained from all the study participants; and anonymity and confidentiality of the participants were maintained.
A 24-item structured questionnaire with close-ended responses was developed which covered the domains of participant's characteristics, educational resources for learning new skills/knowledge and for revising skills/knowledge and; level of satisfactions toward learning and revision educational resources during COVID-19 pandemic. The questionnaire was piloted among a small number (n = 20) of undergraduate students and the average time taken to complete the survey was 10 min. The presentation and validity of the questionnaire were undertaken by 15 randomly selected faculty members for clarity, relevance, and acceptability. Refinements were made as required to facilitate better comprehension and to organize the questions before the final survey was distributed to the study population. The study questionnaire comprised three sections containing 24 items. Section 1 had 4 items that explored the characteristics of participants including age, gender, year of study, and access to smart phone. Section 2 comprised of 9 items and aimed to gather student's educational resources for acquiring new skills and knowledge. Similarly, Section 3 comprised of 9 items and aimed to gather student's educational resources for revising old skills and knowledge. The 9 items included “attending lectures online; reading textbooks; consulting medical literature like journals; watching online teaching videos; online or downloaded question banks; interactive online materials; using medical apps like human anatomy Atlas More Details; making written notes; and attending small group discussions/tutorials” and participants were suggested to respond to each items based on a 7-point Likert scale format (1 = never, 2 = rarely, 3 = occasionally, 4 = sometimes, 5 = often, 6 = mostly, and 7 = always). Section 4 comprise of 2 items and aimed to obtain level of satisfaction among participants toward learning and revision educational resources during COVID-19 pandemic and participants were suggested to respond to each items based on a 5-point Likert scale format (1 = extremely unsatisfactory, 2 = unsatisfactory, 3 = neutral, 4 = satisfactory, and 5 = extremely satisfactory). The questionnaire was developed and distributed using Google forms.
Participation in this survey was voluntary and was not compensated. Informed consent was obtained from each participant prior to participation. Undergraduate students were approached and recruited through social networking websites (Facebook, Twitter, and WhatsApp) and the password-protected survey links were posted on the same. An introductory paragraph outlining the aims and objectives of the study as well as instructions to complete the questionnaire was explained in a session to each year participants over “Zoom Meeting” online portal especially mentioning that all questions were mandatory. Sufficient time was given to participants to read, comprehend, and answer all the questions and the participants could not change the answers after submission of questionnaire. The participants were given a week's time to voluntarily complete the questionnaire and those does not respond back to the questionnaire with in defined time and reminders were declared as drop outs and were not included in the data analysis. The study was performed following the Checklist for Reporting Results of Internet E-Surveys guidelines.
The collected data were tabulated and analyzed using SPSS Statistics for Windows, version 22.0 (IBM Corp. Armonk, NY, USA). All the tests were performed at significance level of 5%. Categorical variables were presented as percentage (%). The difference in preferred education resources and level of satisfaction between learning and revising was assessed by Wilcoxon signed-ranked test and; existence of clustering within the student's preferred educational resources was investigated using principal components analysis (PCA).
| Results|| |
A total of 374 participants were assessed in the study as 18 participants did not respond back to the questionnaire after suggested reminders. The mean age of the study participants was 20.71 ± 1.65 with 51.3% males and 48.7% females. There was near equal representation of participants from each academic year (1st year - 26.2%, 2nd year - 24.6%, 2nd year - 24.3%, and 3rd year - 24.9%) and almost each participant had access to the smart phone (97.9%).
[Figure 1] shows the distribution of study participants responses based on 7-point Likert Scale regarding educational resources utilization for learning new skills and knowledge during college closure due to COVID-19 pandemic and it was observed that online lectures (“always” as 42.8%), reading textbook, online teaching videos, and written notes (“mostly” as 35.0%, 31.3%, and 27.3%, respectively) were the new learning priorities among participants. The “rarely” and “never” used educational resources for new learning were small group discussion (25.9% and 29.7%), medical apps (21.9% and 15.5%), interactive online materials (26.2% and 11.5%), and consulting medical literature (32.1% and 31.3%) among participants.
|Figure 1: Distribution of study participants responses based on 7-point Likert Scale regarding educational resources utilization for learning new skills and knowledge (n = 374)|
Click here to view
[Figure 2] shows the distribution of study participants responses based on 7-point Likert Scale regarding educational resources utilization for revising old skills and knowledge during college closure due to COVID-19 pandemic and it was observed that during revision, resource preference of online lectures was “always” in 21.7% participants, but the revision preference resources were reading textbook, online teaching videos, and written notes (“mostly” as 35.6%, 27.8%, and 31.6%, respectively) among study participants. The “rarely” and “never” used educational resources for revision were small group discussion (23.8% and 30.7%), medical apps (27.0% and 13.4%), interactive online materials (28.3% and 13.4%), and consulting medical literature (34.0% and 27.5%) among participants.
|Figure 2: Distribution of study participants responses based on 7-point Likert Scale regarding educational resources utilization for revising old skills and knowledge (n = 374)|
Click here to view
The frequency of each educational resource usage for new learning and; revision of skills and knowledge among the study participants during college closure due COVID-19 pandemic was compared using Wilcoxon signed-rank test [Table 1] and it was found that preference for online lectures, online teaching videos, interactive online materials, and medical apps were found to be statistically significant for learning when compared to revision (P < 0.05). Similarly, difference in satisfaction levels for learning and revision was found to be statistically significant (P < 0.05) and revision was found to be more satisfactory when compared to new learning during college closure in COVID-19 pandemic [Figure 3].
|Table 1: Comparison of frequency of each educational resource usage for new learning or revision of skills and knowledge among study participants using Wilcoxon signed-rank test (n=374)|
Click here to view
|Figure 3: Comparative distribution of study participants' satisfaction based on 5-point Likert Scale regarding educational resources utilization for new learning and revising old skills and knowledge (n = 374)|
Click here to view
[Table 2] shows the PCA of each educational resource usage for new learning or revision of skills and knowledge among study participants and it was observed that most items were loaded to one of the components and component correlation obtained as “r = 0.333.” The clustering into the components indicates that age, gender, and studying year were having no relation for the educational resources preference during learning and revising. The clustering was also observed along the online and offline differentiation of resources for component 1 (online) and component 2 (offline).
|Table 2: Principal components analysis of each educational resource usage for new learning or revision of skills and knowledge among study participants (n=374)|
Click here to view
| Discussion|| |
The present study is completely novel study as even after exhaustive literature search no study was found which used PCA method to explore the use of educational resources among medical students during closure of colleges due to COVID-19 pandemic and it was found that participants were using plenty of education resources whether online or offline for routine learning or revision. The major response regarding educational resources were online lectures, medical apps, interactive online materials, consulting medical literature, online teaching videos and as well as traditional learning resources such as reading textbook, written notes, and small group discussion. Preference for online lectures, online teaching videos, interactive online materials, and medical apps were found to be statistically significant for learning when compared to revision. Results indicate that the use of reading textbook is the most popular resource. However, traditional or online educational formats, including lecture online and online teaching videos, and written notes remain the most popular resource for learning new knowledge.
Without any doubt lectures by teachers are indeed essential for deep understanding of the subject, but the experience shared by Biavardi, and López-Ruiz, during college closure in COVID-19 pandemic have shown that power point presentations with audio records or explanatory notes being posted by teachers sometimes have a significant delay, so this unavoidable change of in class lectures to online ones have caused some unease and discomfort for the students. To overcome this, medical schools should continue to focus on delivering high quality lectures for the purpose of students learning and revision.,
In general, there is a fundamental change in the manner of learning and consolidating the new knowledge among medical students due to new media and mobile technology. The reason for such change was cited by Moran et al., Masters et al., and Augustin, that online interactive and mobile learning tools are more engaging than traditional teaching tools, easily accessible and convenient for on-the-go, and learner-centered with crossover entertainment appeal to the gaming generation.,,
During COVID-19 pandemic, universities and colleges though have responded by providing e-learning platforms for their students, a lot still needs to be done especially for the medical students, who are next in line for this fight. Understanding learning and revision educational resource preferences of students is valuable in determining teaching strategies as it decides the student's success or lack of success in particular for each educational resource. Studies by O'Doherty et al., and Creswell, have revealed that when there is mismatch in the preferential educational resources of students and the teaching strategies the direct effect is observed where students tend to not do well, feel uncomfortable, become bored, become inattentive, perform poorly on tests, get discouraged, and ultimately either drop the topic or class., Walsh, and Park et al. have reiterated that student-centered approach needs to be implemented including doubt clearing sessions through online portals, virtual bedside stimulation software, creative conceptualization, and student engagement while keeping in mind the four key pillars as skills, resources, institutional strategies, and support and attitude.,
As teachers are interested in new ways to teach students through online platform, but there is a lack of information about the efficacy of the use of teaching technologies within online education at the graduate level as revealed in studies done by Robinson et al., and Jebraeily et al., Furthermore, Gavali et al., and Varshney, expressed that as there is increase in the count of students for online educational resources, it is important to develop a body of evidence supporting teaching excellence and providing information about effective teaching tools in online education.,
Lim et al. came up few challenges for online education resources and one of them is that it will require both capital resource and manpower as there is very studies revealing the effectiveness of education resources, so the capital resource of setting up a virtual learning environment or simulation laboratory may prove a deterrent to their utilization.
Arandjelovic et al., and Elcin et al. commented that increasing use of “inverted” or “flipped classrooms” within medical education has led to discussion on the potential of online educational resources integration into medical teaching., The shift from class-based lectures to the use of online education and the availability of open access resources pose a teaching challenge with maintaining tradition often being a barrier in adopting online learning approaches by teachers during this COVID-19 pandemic. Brooks et al.'s study outcomes have provided the ways to deal psychological distress being faced by the students due to college closure and staying at home during COVID-19 pandemic.
Perhaps, the best opportunity for universities and college to consider utilizing and enhancing other modes of learning and revision such as online lectures, on line teaching videos, medical apps platforms whereby students will be engaged in an interactive manner during COVID-19 or future pandemics. Ultimately, inclusion of pandemic management training in the medical curriculum will instill the upcoming medical graduates with readiness to respond to future global infectious disease outbreaks or pandemics including COVID-19.
| Conclusion|| |
This novel study has made an attempt to find out the common educational resources used during COVID-19 pandemic and also analysis using PCA was done to find the clustering of educational resources for new learning or revision of skills and knowledge. The study reflected that online lectures, reading textbook, online teaching videos, and written notes were the new learning and revision priorities among participants. The medical apps and other online interactive lectures were often used as educational resource. Given the increasing number of individuals for online educational resources, it is important to develop a body of evidence supporting teaching excellence and providing information about effective teaching tools in online education.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Phan T. Genetic diversity and evolution of SARS-CoV-2. Infect Genet Evol 2020;81:104260.
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al
. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579:270-3.
Zhong NS, Zheng BJ, Li YM, Poon LLM, Xie ZH, Chan KH, et al
. Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, People's Republic of China, in February, 2003. Lancet 2003;362:1353-8.
Eurosurveillance Editorial Team. Note from the editors: World Health Organization declares novel coronavirus (2019-nCoV) sixth public health emergency of international concern. Euro Surveill 2020;25:200131e.
Ministry of Home Affairs. Guidelines on The Measures to be Taken by Ministries/Department of Government of India, State/Union Territory Governments and State/Union Territory Authorities for the Containment of COVID-19 Epidemic in the Country. Available from: http://126.96.36.199/WriteReadData/userfiles/Guidelines.pdf
. [Last accessed on 2020 Apr 22].
Davies BS, Rafique J, Vincent TR, Fairclough J, Packer MH, Vincent R, et al
. Mobile medical education (MoMEd) - how mobile information resources contribute to learning for undergraduate clinical students – A mixed methods study. BMC Med Educ 2012;12:1.
Grasso MA, Yen MJ, Mintz ML. Survey of handheld computing among medical students. Comput Methods Prog Biomed 2006;82:196-202.
Ruiz JG, Mintzer MJ, Leipzig RM. The impact of E-learning in medical education. Acad Med 2006;81:207-12.
Gaebel M, Kupriyanova V, Morais R, Colucci E. E-learning in European Higher Education Institutions: Results of a Mapping Survey Conducted in October-December 2013. Brussels: European University Association Publications; 2014.
Biavardi NG. Being an Italian medical student during the Covid-19 outbreak. Int J Med Stud 2020;8:49-50.
López-Ruiz E. Studying medicine in Barcelona during the COVID-19 pandemic. Int J Med Stud 2020;8:60-1.
Moran J, Briscoe G, Peglow S. Current technology in advancing medical education: Perspectives for learning and providing care. Acad Psychiatry 2018;42:796-9.
Masters K, Ellaway RH, Topps D, Archibald D, Hogue RJ. Mobile technologies in medical education: AMEE Guide No. 105. Med Teach 2016;38:537-49.
Augustin M. How to learn effectively in medical school: Test yourself, learn actively, and repeat in intervals. Yale J Biol Med 2014;87:207-12.
O'Doherty D, Dromey M, Lougheed J, Hannigan A, Last J, McGrath D. Barriers and solutions to online learning in medical education: An integrative review. BMC Med Educ 2018;18:130.
Creswell J. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. Thousand Oaks, California: Sage Publications; 2009.
Walsh K. Online assessment in medical education-current trends and future directions. Malawi Med J 2015;27:71-2.
Park CL, Crocker C, Nussey J, Springate J, Hutchings D. Evaluation of a teaching tool-Wiki-in online graduate education. J Inf Syst Edu 2010;21:313-21.
Robinson T, Cronin T, Ibrahim H, Jinks M, Molitor T, Newman J, et al
. Smartphone use and acceptability among clinical medical students: A questionnaire-based study. J Med Syst 2013;37:9936.
Jebraeily M, Fazlollahi ZZ, Rahimi B. The most common smartphone applications used by medical students and barriers of using them. Acta Inform Med 2017;25:232-5.
Gavali MY, Khismatrao DS, Gavali YV, Patil KB. Smartphone, the new learning aid amongst medical students. J Clin Diagn Res 2017;11:JC05-8.
Varshney U. Mobile health: Four emerging themes of research. Decis Support Syst 2014;66:20-35.
Lim EC, Oh VM, Koh DR, Seet RC. The challenges of continuing medical education in a pandemic era. Ann Acad Med Singapore 2009;38:724-6.
Arandjelovic A, Arandjelovic K, Dwyer K, Shaw C. COVID-19: Considerations for medical education during a pandemic. MedEdPublish 2020;9:87.
Elcin M, Onan A, Odabasi O, Saylam M, Ilhan H, Kockaya PD, et al
. Developing a simulation-based training program for the prehospital professionals and students on the management of Middle East respiratory syndrome. Simul Healthc 2016;11:394-403.
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al
. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet 2020;395:912-20.
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]