By Mark Stephens, MD, Pennsylvania State University
In the past 6 weeks, nearly 30,000 medical students1 have shifted to online learning. With relatively little warning or time for preparations, students, faculty, and administrators scrambled to create platforms, structures, and processes in an attempt to keep students moving in a positive direction along their continuum of medical education. One of the more popular online video platforms (Zoom) saw an increase in traffic from 10 million encounters in December of 2019 to over 200 million in March of 2020.2
Prior to the pandemic, a survey indicated 9 of 10 educators preferred not to teach online.3 The current environment, however, leaves us with few other sustainable options. As necessity has often been said to be the mother of invention, here are a few tips that I have found helpful to establish and sustain a positive environment for learning during COVID-19.
In pandemic times or not, communication is central to success in any human endeavor. What most people crave is information. Establishing clear lines of communication for the succinct delivery of essential information is foundational. Elucidate clear rules of engagement for video conferencing (eg, cameras on, no sidebar conversations, time limit to individual sessions, etc). Clarify expectations for any required activities. Regular communication through preferred contact mechanisms (email, text, video conferencing), helps to clarify expectations and provides structure for instructional activities.
From the student perspective, assessment often drives learning. Students and faculty are often conditioned to either learn for the test or teach to the test. The online environment offers a valuable opportunity to alter this sadly time-honored paradigm. Many institutions across the globe have moved to pass-fail grading4 and increased use of self-assessment5 for the immediate future. By deemphasizing high-stakes exams, students and faculty are presented with the opportunity to more fully engage in cocreated, personalized learning experiences. Students must still be held accountable, and all course standards must be sufficiently met to ensure fairness and appropriate attribution of course credit.
Familiarity breeds contempt. There is an increasing recognition of the epiphenomenon of Zoom fatigue.6 To avoid this, thoughtfully mixing content and process can help to keep students engaged and material fresh. Assigned small-group activities in breakout rooms work well. Rotating the composition of students within the breakouts and guest faculty mixes things up as well. Thoughtful use of embedded chat features and the regular use of formative quizzes helps to keep students engaged. Altering class length can help to avoid cognitive overload—shorter is always better if/when students get the work done.
Thoughtful preparation helps to avoid most problems. Plan for technical failures (eg, students can phone in to sessions if bandwidth precludes video engagement). Plan for unintended consequences (eg, students and faculty will have issues come up that prevent them being able to participate—have a plan for both). Keep to a regular schedule, avoid surprises, and keep sessions secure. Using password protection reduces the risk of unintended Zoom bombing.7
Managing cognitive load is always important. It is also very challenging. Avoid the temptation to get through everything. Content coverage is less important than process curation and community building. Allow opportunities for regular breaks.
- Association of American Medical Colleges. Results of the 2018 Medical School Enrollment Survey. Washington, DC: AAMC; July 2019. https://store.aamc.org/downloadable/download/sample/sample_id/287/. Accessed April 27, 2020.
- A Message to Our Users. Zoom Blog. https://blog.zoom.us/wordpress/2020/04/01/a-message-to-our-users/. Accessed April 27, 2020.
- Darby F. How to Be a Better Online Teacher: Advice Guide. The Chronicle of Higher Education. https://www.chronicle.com/interactives/advice-online-teaching. Accessed April 27, 2020.
- Moody J. What to Know About Pass-Fail Classes in College. US News & World Report. https://www.usnews.com/education/best-colleges/articles/coronavirus-prompts-colleges-to-offer-pass-fail-classes-what-to-know. Publised April 3, 2020. Accessed April 27, 2020.
- UNESCO. Exams and Assessments in COVID-19 Crisis: Fairness at the Centre. https://en.unesco.org/news/exams-and-assessments-covid-19-crisis-fairness-centre. Published April 4, 2020. Accessed April 27, 2020.
- Degges-White S. Zoom Fatigue: Don't Let Video Meetings Zap Your Energy. Psychology Today. https://www.psychologytoday.com/us/blog/lifetime-connections/202004/zoom-fatigue-dont-let-video-meetings-zap-your-energy. Published April 4, 2020. Accessed April 27, 2020.
- Morris DZ. Zoom meetings keep getting hacked. Here’s how to prevent ‘Zoom bombing’ on your video chats. Fortune.https://fortune.com/2020/04/02/zoom-bombing-what-is-meeting-hacked-how-to-prevent-vulnerability-is-zoom-safe-video-chats/. Published April 2, 2020. Accessed April 27, 2020.