Navigating Medical Education in the COVID-19 Era: Comparative Evaluation of Undergraduate Medical Curriculum Online vs. Hybrid Model
Authors: Jaleel Anila , Iqbal Saleem Perwaiz , Cheema Khalid Mahmood , Iftikhar Sundus , Bashir Zahid 
Published: November 2023

Abstract

Background
The evaluation of undergraduate medical curricula plays a crucial role in ensuring effectiveness and helps in continuous improvement. This study aimed to compare the context, input, process, and output of the first-year MBBS curriculum in the COVID-19 era (2019–20) and during the para-COVID-19 pandemic (2020–21) using online and hybrid teaching models.
Methods
A mixed-method study was conducted at Shalamar Medical and Dental College, Lahore, from April 2022 to April 2023. A committee consisting of medical educationists, administrators, and the first-year chairperson analyzed the curriculum. A questionnaire survey was administered, and focus group discussions (FGDs) were conducted with first-year students from the 2019–2020 and 2020–2021 batches, which were recorded. Various educational resources, including recorded lectures, guidebooks, planners, and question papers, were also analyzed. Additionally, admission merit, module assessments, and professional examination results were compared and correlated. The learning environment was assessed using the questionnaire, and facilities provided during both years were compared.
Results
Qualitative data analysis was performed using NVIVO, while quantitative data was analyzed using SPSS version 23. Contextual analysis revealed the need for online teaching and learning during the COVID-19 pandemic, and the resources provided were deemed adequate. Aggressive faculty training and support from the medical education department and administration were also identified. Regarding input, the student-faculty ratio was 3.8, and adequate resources such as libraries, hostels, canteens, and web resources were provided. The faculty members were knowledgeable and well-trained. The admission merit of the completely online batch was better than that of the hybrid teaching class in 2020–21. The process analysis indicated the successful delivery of sessions through webinars and Zoom. Study guides were provided to students in a timely manner, and assessments were conducted punctually. The papers for modular and professional examinations exhibited acceptable reliability (Cronbach's alpha: 0.6–0.8) with minimal difficulty and a discriminatory index in key subjects. However, students reported instances of cheating during online assessments and expressed concerns about the lack of hands-on psychomotor skills training, as only videos of performance were shown. Proctoring during assessments was also identified as an issue. Product analysis showed that the class of 2020–21 performed better in modular and professional examinations in all subjects (P < 0.01) despite having lower admission merit compared to the 2019–20 batch. Both batches performed well in the subsequent professional examinations. Conclusion: Overall, students appreciated the hybrid model due to the motivating teacher-student interaction it provided. However, faculty members appreciated online teaching strategies and suggested the potential use of blended learning in the future. The administration acknowledged the immediate transition to online teaching by the faculty and their commendable performance. However, they stressed the need for faculty development workshops on blended learning and strengthening the medical education department.