Perceptions of e-learning among Tunisian medical students during the COVID-19 pandemic: Strategies for effective implementation in medical education

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Published Mar 2, 2025
https://doi.org/10.62438/tunismed.v103i3.5377
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Vol. 103 No. 3 (2025): Tunis Med Mar 2025

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Meriem Gaddas
Department of Physiology and Functional Explorations, Farhat Hached University Hospital of Sousse, Research Laboratory LR12SP09 "Heart Failure", University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.
Mohamed Ben Dhiab
Department of Forensic Medicine, Farhat Hached University Hospital of Sousse, University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
Imed Latiri
Department of Physiology and Functional Explorations, Farhat Hached University Hospital of Sousse, Research Laboratory LR12SP09 "Heart Failure", University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.
Henda El Gharbi
University of Sousse, Higher Institute of Finance and Taxation Sousse, Sousse, Tunisia
Firas Zouari
University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
Helmi Ben Saad
Department of Physiology and Functional Explorations, Farhat Hached University Hospital of Sousse, Research Laboratory LR12SP09 "Heart Failure", University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.

Abstract

Aims. In Tunisia, during the Coronavirus Disease 19 pandemic, the transition to e-learning was brutal. The aim of this study was to assess undergraduate medical students (UMSs)’ perception of the e-learning experience at the Faculty of Medicine of Sousse, and to derive some determinants of its implementation.


Methods. Eligible participants were all UMSs (n=1397). The data was collected from an email questionnaire distributed in January/March 2021. The questionnaire consisted of 89 items exploring three main parameters: institution role, students’ personal experience, and environment impact.


Results. A total of 419 UMSs responded (30% response rate). Half of the UMSs described this transition as difficult, and three-quarters felt concerned about the credibility of their degrees. Logistical issues negatively affected the transition to e-learning, particularly those related to Internet speed. Understanding difficulty via the screen interface was reported by 40% of UMSs. ‘‘Face-to-face” sessions were described as more conducive to assimilation by 64% of UMSs. As far as “information retrieval” is concerned, 83% of UMSs turned to social networks and adopted Wikipedia as a reference.


Conclusions. In Tunisia, as an example of North African country, the transition to exclusive e-learning has been largely impacted by the drawbacks of limited logistics. This study highlights the multiple facets to be considered in the future for the successful implementation of e-learning in medical education.

Keywords:

COVID-19, E-Learning, Health sciences, Low and middle-income country, Medical student

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Anwar A, Mansoor H, Faisal D, Khan HS. E-Learning amid the COVID-19 lockdown: standpoint of medical and dental undergraduates. Pak J Med Sci. 2021;37(1):217-22.
  2. Sani I, Hamza Y, Chedid Y, Amalendran J, Hamza N. Understanding the consequence of COVID-19 on undergraduate medical education: Medical students' perspective. Ann Med Surg. 2020;58:117-9.
  3. UNESCO. Education: from school closure to recovery. Link: https://en.unesco.org/covid19/educationresponse (Last visit: November 18, 2024).
  4. Shahzad A, Hassan R, Aremu AY, Hussain A, Lodhi RN. Effects of COVID-19 in E-learning on higher education institution students: the group comparison between male and female. Qual Quant. 2021;55(3):805-26.
  5. Alfani F, Dhrif D, Molini V, Pavelesku D, Ranzani M. Living standards of tunisian households in the midst of the COVID-19 Pandemic. Policy research working paper; No. 9581. © World Bank, Washington, DC. 2021. Links: http://hdl.handle.net/10986/35289 (Last visit: November 18, 2024).
  6. Amnesty international. Tunisian authorities must accelerate fair access to vaccines, as Covid-19 cases soar. July 15, 2021. Link: https://www.amnesty.org/en/latest/news/2021/07/tunisia-must-accelerate-fair-access-to-vaccines-as-covid19-cases-soar/ (Last visit: November 18, 2024).
  7. WHO. Coronavirus (COVID-19) emergency dashboard, Tunisia situation. Link: https://covid19.who.int/region/emro/country/tn (Last visit: November 18, 2024).
  8. Worldometer. Reported cases and deaths by country or territory. Link: https://www.worldometers.info/coronavirus/#countries (Last visit: November 18, 2024).
  9. SICAD. COVID-19 - Press release from the Presidency of the Tunisian government. Link: http://www.sicad.gov.tn/Fr/Avis-et-Communiques_6_12_D646 (Last visit: November 18, 2024).
  10. DCAF Tunisia. Government Decree No. 2020-156 of March 22, 2020, determining the essential needs and requirements necessary to ensure the continuity of the operation of vital services, as part of the implementation of total containment measures. Link: https://legislation-securite.tn/law/104752 (Last visit: November 18, 2024).
  11. DCAF Tunisia. Government Decree No. 2020-208 of May 2, 2020, setting targeted containment requirements. Link: https://legislation-securite.tn/fr/law/104808 (Last visit: November 18, 2024).
  12. DCAF Tunisia. Government Decree No. 2021-49 of January 15, 2021, laying down exceptional provisions for the work of State agents, local authorities, public administrative establishments, authorities, public establishments and public companies. Link: https://legislation-securite.tn/fr/law/104947 (Last visit: November 18, 2024).
  13. Abbasi MS, Ahmed N, Sajjad B, et al. E-Learning perception and satisfaction among health sciences students amid the COVID-19 pandemic. Work. 2020;67(3):549-56.
  14. Elshami W, Taha MH, Abuzaid M, Saravanan C, Al Kawas S, Abdalla ME. Satisfaction with online learning in the new normal: perspective of students and faculty at medical and health sciences colleges. Med Educ Online. 2021;26(1):1920090.
  15. Puljak L, Civljak M, Haramina A, et al. Attitudes and concerns of undergraduate university health sciences students in Croatia regarding complete switch to e-learning during COVID-19 pandemic: a survey. BMC Med Educ. 2020;20(1):416.
  16. Alsoufi A, Alsuyihili A, Msherghi A, et al. Impact of the COVID-19 pandemic on medical education: Medical students' knowledge, attitudes, and practices regarding electronic learning. PLoS One. 2020;15(11):e0242905.
  17. Likert R. A Technique for the measurement of attitude. Arch Psychol. 1932;140:1-55.
  18. Raosoft I. Raosoft, sample size calculator. Link: http://www.raosoft.com/samplesize.html (Last visit: November 18, 2024).
  19. WHO. eLearning for undergraduate health professional education. A systematic review informing a radical transformation of health workforce development. 2015. Link: https://www.who.int/publications-detail-redirect/9789241508261 (Last visit: November 18, 2024).
  20. 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(1):130.
  21. Childs S, Blenkinsopp E, Hall A, Walton G. Effective e-learning for health professionals and students--barriers and their solutions. A systematic review of the literature--findings from the HeXL project. Health Info Libr J. 2005;22 Suppl 2:20-32.
  22. Ackerman DS, Gross BL. How many choices are good? Measurement of the effects of course choice on perceptions of a marketing option. J Mark Educ. 2006;28(1):69-80.
  23. Dost S, Hossain A, Shehab M, Abdelwahed A, Al-Nusair L. Perceptions of medical students towards online teaching during the COVID-19 pandemic: a national cross-sectional survey of 2721 UK medical students. BMJ open. 2020;10(11):e042378.
  24. Rhim HC, Han H. Teaching online: foundational concepts of online learning and practical guidelines. Korean J Med Educ. Sep 2020;32(3):175-83.
  25. Royal K, Hedgpeth MW, Flammer K. Exploring shyness among veterinary medical students: Implications for mental and social wellness. Vet Sci. 2018;5(2).
  26. Yawson DE, Yamoah FA. Understanding satisfaction essentials of E-learning in higher education: A multi-generational cohort perspective. Heliyon. 2020;6(11):e05519.
  27. Morawo A, Sun C, Lowden M. Enhancing engagement during live virtual learning using interactive quizzes. Med Educ. 2020;54(12):1188.
  28. Chandrasinghe PC, Siriwardana RC, Kumarage SK, et al. A novel structure for online surgical undergraduate teaching during the COVID-19 pandemic. BMC Med Educ. 2020;20(1):324.
  29. Gallo G, Sturiale A, De Simone V, Mayol J. Epistemic networks on Twitter: A new way to learn. J Invest Surg. 2021;34(5):536-544.
  30. Hollinderbaumer A, Hartz T, Uckert F. Education 2.0 -- how has social media and Web 2.0 been integrated into medical education? A systematical literature review. GMS Z Med Ausbild. 2013;30(1):Doc14.
  31. Rigamonti L, Dolci A, Galetta F, et al. Social media and e-learning use among European exercise science students. Health Promot Int. 2020;35(3):470-7.
  32. 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.
  33. Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934.
  34. Pedrosa AL, Bitencourt L, Froes ACF, et al. Emotional, Behavioral, and psychological impact of the COVID-19 pandemic. Front Psychol. 2020;11:566212.
  35. Meo SA, Abukhalaf AA, Alomar AA, Sattar K, Klonoff DC. COVID-19 pandemic: impact of quarantine on medical students' mental wellbeing and learning behaviors. Pak J Med Sci. 2020;36(COVID19-S4):S43-S48.
  36. Seifman MA, Fuzzard SK, To H, Nestel D. COVID-19 impact on junior doctor education and training: a scoping review. Postgrad Med J. 2022;98(1160):466-76.
  37. Mahase E. Covid-19: medical students to be employed by NHS as part of epidemic response. BMJ. 2020;368:m1156.
  38. Artino AR, Jr., La Rochelle JS, Dezee KJ, Gehlbach H. Developing questionnaires for educational research: AMEE Guide No. 87. Med Teach. 2014;36(6):463-74.
  39. Braun V, Clarke V, Boulton E, Davey L, McEvoy C. The online survey as a qualitative research tool. Int J Soc Res Methodol. 2021/11/02 2020;24(6):641-54.
  40. Dergaa I, Saad HB. Artificial intelligence and promoting open access in academic publishing. Tunis Med. 2023;101(6):533-6.
  41. Dergaa I, Zakhama L, Dziri C, Saad HB. Enhancing scholarly discourse in the age of artificial intelligence: A guided approach to effective peer review process. Tunis Med. 2023;101(10):721-6.