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      Distance learning in clinical medical education amid COVID-19 pandemic in Jordan: current situation, challenges, and perspectives


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          As COVID-19 has been declared as a pandemic disease by the WHO on March 11th, 2020, the global incidence of COVID-19 disease increased dramatically. In response to the COVID-19 situation, Jordan announced the emergency state on the 19th of March, followed by the curfew on 21 March. All educational institutions have been closed as well as educational activities including clinical medical education have been suspended on the 15th of March. As a result, Distance E-learning emerged as a new method of teaching to maintain the continuity of medical education during the COVID-19 pandemic related closure of educational institutions. Distance E-Learning is defined as using computer technology to deliver training, including technology-supported learning either online, offline, or both. Before this period, distance learning was not considered in Jordanian universities as a modality for education. This study aims to explore the situation of distance E-learning among medical students during their clinical years and to identify possible challenges, limitations, satisfaction as well as perspectives for this approach to learning.


          This cross-sectional study is based on a questionnaire that was designed and delivered to medical students in their clinical years. For this study, the estimated sample size ( n = 588) is derived from the online Raosoft sample size calculator.


          A total of 652 students have completed the questionnaire, among them, 538 students (82.5%) have participated in distance learning in their medical schools amid COVID-19 pandemic. The overall satisfaction rate in medical distance learning was 26.8%, and it was significantly higher in students with previous experience in distance learning in their medical schools as well as when instructors were actively participating in learning sessions, using multimedia and devoting adequate time for their sessions. The delivery of educational material using synchronous live streaming sessions represented the major modality of teaching and Internet streaming quality and coverage was the main challenge that was reported by 69.1% of students.


          With advances in technologies and social media, distance learning is a new and rapidly growing approach for undergraduate, postgraduate, and health care providers. It may represent an optimal solution to maintain learning processes in exceptional and emergency situations such as COVID-19 pandemic. Technical and infrastructural resources reported as a major challenge for implementing distance learning, so understanding technological, financial, institutional, educators, and student barriers are essential for the successful implementation of distance learning in medical education.

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          Barriers and solutions to online learning in medical education – an integrative review

          Background The aim of this study is to review the literature on known barriers and solutions that face educators when developing and implementing online learning programs for medical students and postgraduate trainees. Methods An integrative review was conducted over a three-month period by an inter-institutional research team. The search included ScienceDirect, Scopus, BioMedical, PubMed, Medline (EBSCO & Ovid), ERIC, LISA, EBSCO, Google Scholar, ProQuest A&I, ProQuest UK & Ireland, UL Institutional Repository (IR), UCDIR and the All Aboard Report. Search terms included online learning, medical educators, development, barriers, solutions and digital literacy. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed with inclusion/exclusion criteria. A consensus was drawn on which articles were included. Data appraisal was performed using the Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist and NHMRC Appraisal Evidence Matrix. Data extraction was completed using the Cochrane Data Extraction Form and a modified extraction tool. Results Of the 3101 abstracts identified from the search, ten full-text papers met the inclusion criteria. Data extraction was completed on seven papers of high methodological quality and on three lower quality papers. Findings suggest that the key barriers which affect the development and implementation of online learning in medical education include time constraints, poor technical skills, inadequate infrastructure, absence of institutional strategies and support and negative attitudes of all involved. Solutions to these include improved educator skills, incentives and reward for the time involved with development and delivery of online content, improved institutional strategies and support and positive attitude amongst all those involved in the development and delivery of online content. Conclusion This review has identified barriers and solutions amongst medical educators to the implementation of online learning in medical education. Results can be used to inform institutional and educator practice in the development of further online learning. Electronic supplementary material The online version of this article (10.1186/s12909-018-1240-0) contains supplementary material, which is available to authorized users.
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            e-Learning, online learning, and distance learning environments: Are they the same?

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              Three generations of distance education pedagogy

              This paper defines and examines three generations of distance education pedagogy. Unlike earlier classifications of distance education based on the technology used, this analysis focuses on the pedagogy that defines the learning experiences encapsulated in the learning design. The three generations of cognitive-behaviourist, social constructivist, and connectivist pedagogy are examined, using the familiar community of inquiry model (Garrison, Anderson, & Archer, 2000) with its focus on social, cognitive, and teaching presences. Although this typology of pedagogies could also be usefully applied to campus-based education, the need for and practice of openness and explicitness in distance education content and process makes the work especially relevant to distance education designers, teachers, and developers. The article concludes that high-quality distance education exploits all three generations as determined by the learning content, context, and learning expectations.

                Author and article information

                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                2 October 2020
                2 October 2020
                : 20
                : 341
                [1 ]GRID grid.33801.39, ISNI 0000 0004 0528 1681, General and Breast Surgery, Department of General and Special Surgery, Faculty of Medicine, , Hashemite University, ; Irbid-Amman Street, Al Husn, P.O. Box 3, Irbid, 21510 Jordan
                [2 ]GRID grid.14440.35, ISNI 0000 0004 0622 5497, Otorhinolaryngology, Faculty of Medicine, , Yarmouk University, ; Irbid, Jordan
                [3 ]GRID grid.443749.9, ISNI 0000 0004 0623 1491, Community Medicine, Faculty of Medicine, , Al-Balqa Applied University, ; Salt, Jordan
                [4 ]GRID grid.37553.37, ISNI 0000 0001 0097 5797, Transplant and Hepatopancreaticobiliary Surgery, Department of General Surgery, Faculty of Medicine, , Jordan University of Science and Technology, ; Irbid, Jordan
                [5 ]GRID grid.33801.39, ISNI 0000 0004 0528 1681, General and Gastrointestinal Surgery, Department of General and Special Surgery, Faculty of Medicine, , Hashemite University, ; Zarqa, Jordan
                [6 ]GRID grid.440897.6, ISNI 0000 0001 0686 6540, General and Gastrointestinal Surgery, Department of General Surgery, Faculty of Medicine, , Mutah University, ; Mu’tah, Jordan
                [7 ]GRID grid.9670.8, ISNI 0000 0001 2174 4509, Pediatric surgery, Department of general surgery, Faculty of Medicine, , Jordan University, ; Irbid, Jordan
                [8 ]GRID grid.14440.35, ISNI 0000 0004 0622 5497, Yarmouk University, ; Irbid, Jordan
                Author information
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                : 5 June 2020
                : 24 September 2020
                Research Article
                Custom metadata
                © The Author(s) 2020

                covid-19,distance learning,e-learning,medical education
                covid-19, distance learning, e-learning, medical education


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