|ONLINE ONLY ARTICLES - ORIGINAL ARTICLE
|Year : 2022 | Volume
| Issue : 2 | Page : 149
Usage of learning management system to implement online teaching methodology in undergraduate medical students: A cross sectional study
Shivakumar Ajay Kumar1, G Niveditha1, P Seema2, Girish M Bengalorkar1
1 Department of Pharmacology and Community Medicine, ESIC Medical College and PGIMSR, Bengaluru, Karnataka, India
2 Department of Community Medicine, ESIC Medical College and PGIMSR, Bengaluru, Karnataka, India
|Date of Submission||11-May-2022|
|Date of Decision||18-May-2022|
|Date of Acceptance||20-May-2022|
|Date of Web Publication||26-Aug-2022|
Girish M Bengalorkar
ESIC Medical College, Bengaluru - 560 010, Karnataka
Source of Support: None, Conflict of Interest: None
Background: The COVID-19 pandemic caused a temporary roadblock in learning among medical colleges in India as traditional classroom teaching was suspended temporarily. Students and faculty members had to adapt in a short period of time to transition from traditional practices of live classroom lectures to a virtual mode by using learning management system (LMS). Objectives: The present study aims to describe the perceptions of students and faculty members about their experience using the LMS to attend online classes. It also aims to assess the possibility of using the same for postgraduate medical education, particularly in specialties requiring visual aid for learning such as radiology, dermatology, and pathology. Materials and Methods: A cross-sectional survey-based observational study was conducted on 123 MBBS students and 36 faculty members after 6 months of the online teaching using LMS. Responses were collected on their experience with the LMS and assessed using a three-point Likert scale. Results: About 62.6% of the students who participated in the study felt that it was easy to log into the LMS platform. About 58.6% of the students felt that the audio and video quality of the classes on the platform was good. The majority of students (93.5%) felt that the user interface of the LMS was easy to use. Poor Internet connectivity issues accounted for the main cause of interruptions during online classes for 48% of the students. About 88.9% of the faculty members felt that it was easy to log into the LMS to conduct online classes. Around 86.1% of them felt that the audio and video quality was good on the platform. Browsing through the platform during online lectures was easy according to 75% of them. Conclusion: The majority of students and faculty members felt that the user interface and quality of the audiovisual feed of the LMS were very good. The LMS platform made the scheduling of classes, marking attendance, and usage of additional annotation tools convenient. Usage of LMS can supplement the traditional face-to-face lecture classes to enhance learning in medical undergraduate and postgraduate education.
Keywords: Learning management system, COVID-19 pandemic, undergraduate medical education
|How to cite this article:|
Kumar SA, Niveditha G, Seema P, Bengalorkar GM. Usage of learning management system to implement online teaching methodology in undergraduate medical students: A cross sectional study. Clin Dermatol Rev 2022;6:149
|How to cite this URL:|
Kumar SA, Niveditha G, Seema P, Bengalorkar GM. Usage of learning management system to implement online teaching methodology in undergraduate medical students: A cross sectional study. Clin Dermatol Rev [serial online] 2022 [cited 2022 Sep 26];6:149. Available from: https://www.cdriadvlkn.org/text.asp?2022/6/2/149/354761
| Introduction|| |
The COVID-19 pandemic outbreak was declared a Public Health Emergency of International Concern on January 30 by the World Health Organization. The whole world came to a standstill, and doors were shut on most factories, commercial outlets, and educational institutions. As the hospital was flooding with patients suffering from COVID-19 illness, the empty lecture halls of the medical education institutions put a sudden roadblock in terms of imparting medical education to students. With the new competency-based medical education curriculum being followed, the main agenda of the curriculum was to make the process of teaching more learner-centric.
The pandemic had a role in creating hurdles for learning by medical students for whom the clinical postings and classroom learning were suspended temporarily. Traditional activities such as lectures, practical classes, small group discussions, and self-directed learning activities had to suddenly shift to an eLearning model. Medwhiz, a specialized learning management system (LMS) software was utilized to impart medical education to the students in remote format and help bridge the gap for students to learn during the COVID-19 pandemic. LMS is defined as an automated software that is used to overlook the tracking, administration, and reporting of training events and delivers the learning content very rapidly. In this study, we aim to discuss the perceptions of students and faculty members on the use of LMS in imparting theory classes during the COVID-19 pandemic at a teaching hospital in a South Indian city.
| Methods|| |
This is a cross-sectional observational study that was conducted online at a teaching hospital in a South Indian city on 124 undergraduate MBBS students (1st, 2nd, 3rd, and 4th-year students) and 36 faculty members using a questionnaire. The study was conducted after 6 months of online live classes on the LMS platform during the first wave of the COVID-19 pandemic.
A Google Form-based online questionnaire was shared with the undergraduate medical students and faculty members on their respective e-mail ids and batch WhatsApp groups. The questionnaire consisted of 12 questions that were based on the following domains of the LMS. The students were informed that submitting the responses was voluntary in nature and that complete anonymity would be maintained on receiving the feedback. The ethical clearance was obtained from the Ethics Review Committee at ESIC Medical College.
Ease of login and scheduling of classes
Two questions were based on their experience with ease of logging in and whether the classes started on time as scheduled. The responses were graded using a three-point Likert scale (where 1-difficult, 2-satisfactory, and 3-easy) for the question related to ease of login. An assertive Yes/No response was recorded for the questions on the promptness of classes starting and ending on time. Responses were also recorded to know if they faced any interruptions during the classes.
Audio visual quality and user interface
Students were provided with study material such as notes, videos, and images to provide an added layer to their learning. The importance of images/illustrations from subjects such as radiology, dermatology, and pathology as a visual aid to improve learning cannot be stressed upon enough in the undergraduate curriculum. Questions regarding the quality of material provided, audio and video of live lectures, and the ease of navigating the user interface of the LMS platform were assessed using the three-point Likert scale (1-poor, 2-average, and 3-good).
Impact of additional tools
The LMS platform had the option of accessing the recordings of the lectures, if students had missed the live class due to Internet connection problems. It also had additional features such as the annotation tool and an option to mark the attendance directly on the platform, which was used by the faculty members. Questions related to their provision and usage were also present in the questionnaire and were evaluated using an assertive Yes/No response.
The data set received through the Google questionnaire forms were compiled and analyzed on Microsoft Excel (2010).
A total of 123 students from the teaching hospital participated in this study. The cohort of students comprising the undergraduate batches hails from different towns, villages, and cities of states such as Karnataka, Kerala, Maharashtra, and a few other North Indian states.
According to the data collected, 62.6% of the students felt that it was easy to log into the LMS platform, 32.5% felt that it was satisfactory, and 4.9% of them felt that it was difficult.
The majority (93.5%) of the students felt that the classes scheduled on the platform started on time, whereas 6.5% of them felt that the classes did not start on time. About 58.6% of the students felt that the quality of audio and video of the classes conducted on the platform was good, 26.8% of them felt it was average. Only 8.2% of students felt that the quality of audio and video was poor.
On being asked about the ease of navigating and using the LMS platform, 93.5% of them felt that it was easy, whereas 5.7% found that it was difficult to use the website. One student answered that he/she was unsure about the ease of using it.
To enhance revision of the material being provided and to provide access to lecture videos to students with poor Internet facilities, the classes conducted online were recorded, and stored to be made available again. However, only 25.2% of the students answered that they were provided with the recordings of the classes, whereas 74.8% answered that they were not provided with them.
Interruptions from the Internet and lack of knowledge about navigating the website usually lead to problems with time management, but 90.2% of the students felt that the classes finished on time, whereas 9.7% of the students felt that the classes did not finish on the scheduled time. With students residing in different geographic locations with varying infrastructure and facilities, about 41.5% of students faced the difficulty of interruptions in the online classes. 54.5% did no't feel that there were any interruptions in their learning and around 4.1% were unsure.
On further analysis of students who faced the problem of interruptions, it was found that the Internet connectivity issues accounted for the main problem for 48% of the students. The next main issue was related to the software according to 16.3% of the students. Electricity and login credentials were an issue divided equally between 4.8% of the students. Around 30.9% of students who faced the interruptions left this question unanswered.
Out of the 36 faculty members that were part of the study, 7 (19%) were from preclinical subjects, 10 (27%) were from para-clinical subjects, and 20 (54%) were from clinical subjects. The majority of the faculty (88.9%) felt that it was easy to log in to their accounts on the LMS platform to conduct classes online. Around 2.8% of them felt that it was difficult, and 8.3% of them felt that it was satisfactory.
Usage of teaching material and handouts is a very important aspect of classroom teaching and 63.9% of the faculty felt that it was easy to upload study materials such as PowerPoint presentations, 30.6% felt that it was satisfactory, and only 5.6% felt that it was difficult. The quality of the audiovisual feed enhances the user experience and aids in a smooth learning process and the majority of the faculty members (86.1%) felt that the audio and video quality of the platform to be good, and only 13.9% of them felt that it was average.
Regarding questions on the ease of browsing through this platform, 75% of the faculty members found that it was easy to browse through along with their presentations, 19.4% felt that it was satisfactory, and 5.6% felt that it was difficult. When asked about the benefits of the annotation tool in the presentations, 83.4% agreed that it was beneficial, 5.6% disagreed, and around 11.1% answered that they did no't know.
With respect to marking attendance, 80.5% of the faculty members felt that it was easy to mark the attendance online on the LMS, 13% felt that it was satisfactory, and 2.8% felt that it was very difficult.
According to 94.4% of the faculty, they could finish the class in the scheduled time but 5.6% felt otherwise. Interruptions during online classes are quite common, but 72.2% of them felt there were no interruptions during the class, and only 27.8% felt that there were interruptions observed during the class.
| Discussion|| |
The COVID-19 pandemic caused a temporary transition from traditional classroom teaching to an online teaching methodology, which was quite new for undergraduate students and faculty members of medical colleges in India. It also brought along a new challenge for educators to move into an unknown territory of a virtual model of teaching. The impact of the pandemic was such that most educational institutions had to learn and adapt new methods to prevent a pause in learning for students. Most medical colleges in the country welcomed the possibility of continuing the curriculum in a virtual mode, but it was marred with new challenges every step of the way. The current study enables us to better understand the usage of LMS in enhancing medical education to produce competent and skillful doctors during challenging times.
The usage of LMS platform in medical education was unheard of until the COVID-19 pandemic. Due to the advanced software technology, it posed a challenge for students and faculty members alike. Capacity-building programs were organized to train students and faculty members to use the LMS platform to its maximum potential. The goal of the training was to enhance their learning and to simulate a classroom experience virtually. New log-in credentials were created for teachers and students and sent individually on their e-mail ids. Faculty members were also trained on how to use the annotation tool during teaching, marking the attendance of students. They were also taught to organize assignments, formative assessments, and skill certification exercises on the platform.
In a study conducted on medical students by Vishwanathan et al., 55% of the students out of 465 felt that they were satisfied with online classes. There is also evidence to show that effective time management can be achieved by using eLearning methodologies.
A pilot study conducted on final year medical students being taught the Otolaryngology-head-and-neck surgery curriculum showed that interactive eLearning can be a valuable tool as it allows readily accessible and flexible on-demand learning.
Although we did not include feedback from postgraduate students, studies have also shown the importance of imparting knowledge through e-learning to resident trainees. In a large systematic review conducted on 6750 students from medical, para-medical, and allied specialties, it was concluded that eLearning is possibly superior to traditional forms of learning due to the convenience and flexibility of schedules, along with adequate teacher–student interaction compared to conventional meeting platforms such as Zoom and Google meet. LMS platforms help to organize the academic content, attendance marking system, and an academic evaluation system for students and teachers and hence is very different from Zoom and Google Meet which help to organize meetings for a large group of people (although still limited to a certain number for basic plans)., The implementation of LMS is no small task. Along with the necessary workforce, it requires creativity and adaptability by all parties involved to achieve the necessary outcomes.
During the first wave of the COVID-19 pandemic, the LMS platform was used for the first time at this government teaching hospital in a South Indian city. The faculty members were instructed to use the personal computer available in the medical college, with an average Internet speed of 100 Mb/sec and the LMS platform was accessed on the Chrome web application. The features of the LMS were such that students of respective academic years would get regularly notified about the classes scheduled in the day, along with easy access for entry into the virtual classroom. The platform provided a way to incorporate synchronous as well as asynchronous classes for the students. The students were given the opportunity to access the live recordings of the lectures at a later time if they could not join the live class due to issues such as poor Internet connectivity, lack of access to the required infrastructure, and electronic gadgets (laptops, tablets, and smartphones).
Notices regarding the upcoming formative and internal assessments would get published on the platform in a timely manner. Along with conducting live synchronous classes online, the educators also had the opportunity to upload PowerPoint presentations and lecture notes on the platform. The platform had the facility to maintain an e-logbook by the students for the skill-based practical classes which were conducted virtually. Assignments which were required to be completed could be uploaded to the platform for easy evaluation by the teachers.
The biggest advantage of implementing both synchronous and asynchronous teaching methodologies through LMS was the flexibility of time frames it offered to the students and educators.,,, However, the onus would be on the student to be disciplined enough to still complete the course material at their convenience., The overall response from the students and educators remained positive after using the LMS platform to learn and teach, respectively.
The use of LMS enables the implementation of a curriculum that can be tailored according to the needs of the students using it, and all the academic content can be accessed under the same platform. Many studies have already shown the use of LMS in postgraduate medical teaching as well as in implementing complex teaching concepts such as spiral curricula, which can change the way young children learn concepts at school.,,,
From the present study, it was observed that the majority of the students found it easy to navigate through the LMS and had minor issues logging in to their accounts. The most important hurdles faced by them were related to Internet connectivity and infrastructure-related problems. The student and faculty felt that the software interface they used was very user-friendly. The faculty members also responded positively for the additional tools such as the annotation tool, attendance marking system, and provision of recorded classes for students who have missed the live lectures. It is also important to understand the need for having capacity-building programs for the educators to be updated with the current developments to adequately implement what is asked of them in the current online teaching methodologies.,
A study conducted at the University of Bern, Switzerland showed that implementation of LMS in a psychiatry core clerkship for young medical students showed that it had a positive effect on the satisfaction of student learning and also enhances self-regulated learning activities. There was also a study conducted in Saudi Arabia Medical School where they implemented online teaching for elective clinical postings in dermatology. The dermatology modules contained images, quizzes, PowerPoint presentations, and case-based learning in the form of visual aid for learning. The feedback received from the students and faculty after the completion of the module was very positive. The same methods can be used to study the effectiveness of using LMS platform to enhance building the effectiveness of clinical postings in areas with low patient load and lack of infrastructure. The system can also pave the way to accommodate more international students (exchange programs) who can interact and experience a new health-care system from different parts of the world without the hassle of the financial burden of traveling.
These findings show that eLearning using LMS platforms can easily complement, if not be integrated into the current traditional systems in medical colleges across the country. This is also a system that can be very useful during times of need such as consequent waves of the COVID-19 pandemic or other health-care-related emergencies.
| Conclusion|| |
The majority of students and faculty members felt that the user interface and quality of the audiovisual feed of the LMS were very good. The platform made the scheduling of classes, marking attendance, and usage of additional annotation tools convenient for the faculty members. The majority of the users felt that the LMS helped them continue their medical education without being physically present in the colleges.
LMS can aid in conducting remote clinical case-based learning and tutorial classes which can supplement the current traditional face-to-face lecture classes in medical education institutions. Using the same can also provide the opportunity to share visual aids such as gross/histopathological images, illustrations, pictograms, and radiographs during lectures to enhance learning in specialties such as radiology, pathology, and dermatology. The technological advancements in imparting medical education with the help of various LMS platforms since the first wave of the COVID-19 pandemic will continue to be beneficial in the future for undergraduate/postgraduate medical education and international exchange program students.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Back DA, Behringer F, Haberstroh N, Ehlers JP, Sostmann K, Peters H. Learning management system and e-learning tools: An experience of medical students' usage and expectations. Int J Med Educ 2016;7:267-73.
Vishwanathan K, Patel GM, Patel DJ. Impact and perception about distant online medical education (tele-education) on the educational environment during the COVID-19 pandemic: Experiences of medical undergraduate students from India. J Family Med Prim Care 2021;10:2216-24. [Full text]
Chin RY, Tjahjono R, Rutledge MJ, Lambert T, Deboever N. The evaluation of e-learning resources as an adjunct to otolaryngology teaching: A pilot study. BMC Med Educ 2019;19:181.
Agrawal S, Maurya AK, Shrivastava K, Kumar S, Pant MC, Mishra SK. Training the trainees in radiation oncology with telemedicine as a tool in a developing country: A two-year audit. Int J Telemed Appl 2011;2011:230670.
George PP, Papachristou N, Belisario JM, Wang W, Wark PA, Cotic Z, et al.
Online eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction. J Glob Health 2014;4:010406.
Padhi KS, Balmuchu G, Acharya PS, Singh SR, Murali A. The perspectives of educators and learners on e-learning: A cross-sectional descriptive study in a medical school. Adv Med Educ Pract 2021;12:1059-66.
Ellaway R, Masters K. AMEE Guide 32: E-Learning in medical education Part 1: Learning, teaching and assessment. Med Teach 2008;30:455-73.
Chopra J, Rani A, Chopra S, Manik P, Singh RR. Transition from physical to virtual classroom amidst COVID-19 crisis: Analyzing students' perspective to drive improvement in the current online teaching methodology. J Educ Health Promot 2021;10:241.
Choules AP. The use of elearning in medical education: A review of the current situation. Postgrad Med J 2007;83:212-6.
Khan SZ, Subhani G, Fatima R, Fatima H. E-learning in medical education – A crosssectional study in a medical college. J Med Sci Clin Res 2018;6:604-7.
SS Kadam, P Wani, S Akhade. E-learning for medical education in India: A review. J Forensic Med Sci Law 2015;24:1-6.
Holley KA, Taylor BJ. Undergraduate student socialization and learning in an online professional curriculum. Innov Higher Educ 2009;33:257-69.
Howland J, Moore J. Student perceptions as distance learners in Internet-based courses. Dis Educ 2002;23:183-95.
Schlorhaufer C, Behrends M, Diekhaus G, Keberle M, Weidemann J. Implementation of a web-based, interactive polytrauma tutorial in computed tomography for radiology residents: How we do it. Eur J Radiol 2012;81:3942-6.
Dua A, Sudan R, Desai SS. Improvement in American Board of Surgery in-training examination performance with a multidisciplinary surgeon-directed integrated learning platform. J Surg Educ 2014;71:689-93.
Masters K, Gibbs T. The spiral curriculum: Implications for online learning. BMC Med Educ 2007;7:52.
Nimavat N, Singh S, Fichadiya N, Sharma P, Patel N, Kumar M, et al.
Online medical education in India – Different challenges and probable solutions in the age of COVID-19. Adv Med Educ Pract 2021;12:237-43.
Pinilla S, Cantisani A, Klöppel S, Strik W, Nissen C, Huwendiek S. Curriculum development with the implementation of an open-source learning management system for training early clinical students: An educational design research study. Adv Med Educ Pract 2021;12:53-61.
Kaliyadan F, ElZorkany K, Al Wadani F. An Online dermatology teaching module for undergraduate medical students amidst the COVID-19 pandemic: An experience and suggestions for the future. Indian Dermatol Online J 2020;11:944-7. [Full text]