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Factors That Enhance and Hinder the Retention and Transfer of Online Pre-Clinical Skills Training to Facilitate Blended Learning [Response to Letter]
Authors Enoch LC , Abraham RM, Singaram VS
Received 5 October 2023
Accepted for publication 12 October 2023
Published 20 October 2023 Volume 2023:14 Pages 1183—1184
LC Enoch,* RM Abraham,* VS Singaram*
School of Clinical Medicine, Clinical and Professional Practice, College of Health Sciences, University of Kwazulu-Natal, Durban, South Africa
*These authors contributed equally to this work
Correspondence: LC Enoch, Email [email protected]
View the original paper by Dr Enoch and colleagues
This is in response to the Letter to the Editor
Dear editor
Thank you for the opportunity to respond to the correspondence received regarding our paper (Enoch et al, 2023). We appreciate the engagement of the correspondents with our paper and value their insights based on their experiences with virtual learning. We aim to address their concerns and offer clarification where necessary.
Selection bias:
Our paper was based on the adapted teaching strategies that were introduced in our institution during the disrupted learning context of the COVID-19 pandemic. The student cohort involved in our study had unique exposure: onsite teaching in their first year (2019), purely online instruction in their second year (2020) due to the COVID-19 lockdown, and a blend of both in their third year (2021) capped with an onsite clinical readiness session. This cohort’s diverse learning experiences, spanning onsite, online, and blended methods, positioned them uniquely to evaluate the different teaching approaches. For a comparative analysis, we benchmarked the 2021 3rd year cohort’s performance against the 2019 3rd year cohort, taught onsite pre-COVID. This comparison, using formative and summative Objective Structured Clinical Examinations (OSCEs), sought to minimise the sampling bias linked to pre-existing knowledge affecting the 2021 group’s performance.1
Institutional characteristics
Two of the major factors stated in Botma et al’s2 framework regarding transfer of learning involves the design of learning and institutional support. Both of these aspects were examined in our questionnaires, probing students’ and tutors’ perceptions of the adjusted teaching design. Our study revealed significant improvements in three domains of clinical skills after implementing the revised online teaching strategies, stressing the importance of considering these modifications in diverse settings.
Sebbani et al’s study further states that traditional lecture designs typically do not translate well to the online classrooms3 and that adaptations must be made based on student characteristics and environmental/workplace factors. As mentioned above, the qualitative responses by our study participants followed the assessment of their competency during formative and summative OSCEs. Therefore, to replicate this study in other settings, these factors must be considered and applied. The adaptations to the online clinical skills curriculum at our institution are outlined in a previous study by Enoch et al.1
Use of a 6-point Likert scale:
Our mixed-method approach, which combined closed and open-ended questions, enabled participants to articulate their responses in their own words, capturing their holistic experience of the blended curriculum.
A 6-point Likert scale allows a higher trend of discrimination for psychological tests4 as opposed to “knowledge” based tests of a topic. A statistician guided our questionnaire’s development and the subsequent data analysis.
While the pandemic necessitated several single-center studies, we concur with the correspondents about the value of multi-center studies and believe they could now provide richer insights for blended learning in medical education.
Disclosure
The authors report no conflict of interest in this communication.
References
1. Enoch LC, Abraham RM, Singaram VS. A comparative analysis of the impact of online, blended, and face-to-face learning on medical students’ clinical competency in the affective, cognitive, and psychomotor domains. BMC Med Educ. 2022;22(1):753. doi:10.1186/s12909-022-03777-x
2. Botma Y, Van Rensburg GH, Coetzee IM, Heyns T. A conceptual framework for educational design at modular level to promote transfer of learning. Innov Educ Teach Int. 2015;52(5):499–509. doi:10.1080/14703297.2013.866051
3. Sebbani M, Adarmouch L, Mansouri A, et al. Implementation of online teaching in medical education: lessons learned from students’ perspectives during the health crisis in Marrakesh, Morocco. Educ Res Int. 2021;2021:e5547821. doi:10.1155/2021/5547821
4. Chomeya R. Quality of psychology test between likert scale 5 and 6 points. J Soc Sci. 2010;6(3):399–403. doi:10.3844/jssp.2010.399.403
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