Success and Satisfaction with Virtual Hematology Curriculum Implemented in Response to COVID-19
Authors: Gunesch Ali Noel , McClellan Kristen , Meyers Gabrielle , Shereck Evan 
Published: November 2021

Abstract
Introduction: In response to the COVID-19 pandemic, the Oregon Health and Science University Blood & Host Defense medical school pre-clinical block was reformatted to a completely online curriculum. In previous years, the curriculum consisted of traditional 1-hour lectures from Monday to Wednesday, with small group review sessions on Thursday prior to weekly assessments on Friday. Changes for the virtual curriculum included shortened, pre-recorded lectures divided into modules by topic, with follow-up questions to test comprehension in real-time. These were followed by live, 1-hour Q&A sessions each day. Weekly, 2-3-hour case-based review sessions were also held virtually in real-time. We aimed to study student performance in this new curriculum, and to learn about the satisfaction of both students and instructors with these changes.
Methods: To measure performance, class testing averages across graded components were compared to previous years. To measure satisfaction, first-year medical students and course instructors were polled via anonymous, voluntary Qualtrics® surveys after course completion. Answers were given on a 5-point Likert scale. Students were also asked to answer four free-response questions.
Results: Class testing averages were similar to previous years across all graded components of the curriculum. Following remediation, the pass rate for the course was 100%. Fifty eight out of 150 students completed the satisfaction survey, a response rate of 39%. Most students found pre-recorded lectures and weekly live review sessions "useful" or "very useful," but responses were more varied for daily Q&A sessions. Most students either "somewhat preferred" or "greatly preferred" the module-based format over hour-long lectures and indicated they would like a similar format in future virtual blocks. Themes from qualitative questions included a preference for virtual curriculum for its increased flexibility. A small subset of students described a preference for in-person lecture due to increased engagement. Thirteen out of 31 instructors completed the survey, for a response rate of 42%. Six of the respondents indicated that they would prefer the traditional version of the curriculum for the following year, while 5 selected the new virtual-only format. Twelve instructors completed Likert-scale questions comparing the two curriculums. There was no statistically significant difference in satisfaction with lecture format, time and effort to prepare lectures, amount of interaction with students, and overall teaching experience. However, there was a significant increase in dissatisfaction with the quality of student interaction and student engagement with the new virtual curriculum.
Conclusions: Students successfully learned in the new, virtual curriculum as demonstrated by summative assessments. Trends that emerged from student feedback included a preference for module-based format over hour-long lectures, and pre-recorded lectures over live sessions. Most respondents enjoyed the weekly live review sessions, but were mixed regarding daily live Q&A sessions. We suspect this mixed feedback for the daily reviews was due to constraints on the schedule and the necessity of viewing all modules each morning prior to the session. From the perspective of instructors, there was perhaps unsurprisingly decreased satisfaction with student engagement in the virtual setting. However, overall, there was no meaningful difference in preference regarding lecture format. When combining this with the diverse needs and preferences of medical students, future versions of the course should consider incorporating more virtual elements.

Disclosures
No relevant conflicts of interest to declare.