Five-year review of an international clinical research-training program

Figures & data

Figure 1 Number of students per year and number of countries where they came from (2008–2012).

Table 1 Student characteristics in 2012 and distribution of participants per site

Variables	n	%
Highest degree
Bachelor	52	15.9
Master	36	11.01
Medical doctor	180	55.05
PhD	59	18.04
Time since graduation
Mean (SD)	8.00	7.62
Median (IQR)	5.00	3–10
Number of national peer-review publications
Mean (SD)	4.38	16.03
Median (IQR)	0	0–2.5
Number of international peer-review publications
Mean (SD)	4.14	13.22
Median (IQR)	0	0–3
Number of approved grants
Mean (SD)	0.80	3.53
Median (IQR)	0	0
Statistical background
Beginner	100	30.49
Intermediate	208	63.41
Advanced	20	6.10
Computer expertise
Beginner	31	9.42
Intermediate	139	42.25
Advanced	159	48.33
Number of previous distance learning courses
0	197	59.88
1–2	99	30.09
3 or more	33	10.03
Use email, phone, text	301	91.49
Download software without help	295	89.67
Sites
Adobe	64	19.45
Boston	29	8.81
Brazil	140	42.55
Peru	14	4.26
Russia	12	3.65
Colombia	9	2.74
Ecuador	15	4.56
Portugal	23	6.99
Chile	7	2.13
Germany	10	3.04
South Korea	6	1.82

Abbreviations: SD, standard deviation; IQR, interquartile range.

Table 2 Major challenges faced in distance-learning courses

Major challenges

• Student engagement and motivation

• Impact of heterogeneous audience on learning

• Learning in large groups

• Enhancing group learning and social presence

• Dropouts

• Quality control

• Course management

Table 3 Methods to enhance motivation and engagement and their use in our course

Methods	Discussion and appropriateness for our course	Already used in our course?
Use of videos	Short videos with special assignments might motivate and refocus students.	No
Case studies involving role-playing	One possibility is to set up a mock journal and have students assume the role of authors, other editors, reviewers, etc. This role-playing can be done during lectures or even in the forum.	Yes
Asking students to come up with assignments for them during the break	This would increase student’s engagement, as they would be choosing something relevant for them; however, this also requires a level of independence and maturity from students.	No
Use of metacognition-teaching techniques	Explore students’ feelings about exams by asking them 1 day before the exam how prepared they feel, and after the exam what the major difficulties were and how their performance was.	No
Providing tips from past students who performed well in the course	Section on the website with tips from past students.	Yes
Constantly asking participants to answer questions	Quizzes during lectures to increase engagement and motivation.	Yes
Acknowledgments in the introduction forum	Students are asked to introduce themselves at the beginning of the course. However, not all students receive responses, which might be a negative factor. TAs could acknowledge all the introductions in the first forum to start developing a relationship between TAs and students.	Yes
Students’ expectations	Although we have been asking students to post their expectations at the beginning of the course, we should map them systematically through an entrance survey.	Yes
Team charter	To increase participation and interaction, we could ask students how they want to work together. Though not all the methods will be accepted, they could be adapted to improve the team’s work.	No
Naming a team	Naming a team (or the group) might be one initial activity to bring the group together.	No
Group discussion – nonparticipating students	Having a series of group discussions that focus on how the group will handle or bring back a nonparticipating student. Mapping the reasons of nonparticipation in a continuous process may be interesting, since reasons for nonparticipation may change during the course.	No
Real-life examples	Connect the course to everyday life by using more real-life examples.	Yes
Students’ questions	Ask students to post questions every week, and have participants discuss their questions. The unsolved questions or the most voted questions could be presented to the class to be resolved. If the questions are still unsolved, they can be answered by the staff/TA in the following 3 days after the class.	No
Specific tasks	Give different tasks for each group to improve collaboration and motivation across students.	No
Promoting intergroup collaboration	Each week, we could assign two groups to work together and vary this across the course to improve the interaction.	Yes
Use of simulation games	Simulation games using novel technological methods, like simple statistical games.	No
Using different methods to show information	Using a variety of methods, such as visual, kinesthetic, auditory stimulation, may enhance learning.	No
Understanding students’ characteristics	Understanding student characteristics better (competitive, collaborative, avoidant, participant, dependent, independent) may help to develop some specific interventions.	No
Selectively use breaks, settling time, and physical exercises	Because our lecture lasts 3 hours, this may be helpful to increase engagement.	Yes
Team competition	Divide learners into teams and having teams against teams in a “course-completion competition”.	No

Abbreviation: TAs, teaching assistants.

Figure 2 Countries from where students attended the course in 2012.

Table 4 Factors to be considered in the redesign of a collaborative learning program

Factors	Redesign
Students’ engagement and motivation	Introduce new methods to enhance motivation in the synchronous and asynchronous discussions.
Impact of heterogeneous audience on learning	Promote more interaction to decrease cultural barriers. Identify individual factors through the initial course survey.
Learning in large groups	Design a system to moderate questions during lectures. Break up small groups and use other interactive Adobe Connect tools. Promote on-site discussion during the class in addition to the virtual space. Tailor the course to specific demands of the audience.
Enhancing group learning	Describe the process of collaborative learning during presentation of the course. Add in an initial questionnaire on group work. Have a good system to grade student participation in group projects, and choose groups by shared common interests so as to make the group project more meaningful to the participants. Encourage networking and collaborative research partnerships.
Enhancing social presence	Identify characteristics that may increase social presence in the initial course survey. Encourage response to forum and feedback from TAs. Develop a better rubric for forum participation to motivate participation and social presence. For instance, grade students based on triggering events, exploration, integration, and resolution. Create a space to communicate on topics not directly related to the course content.
Dropouts	Avoid cognitive overload (prepare students better for the statistical module). Understand main motivation of students to take the course in the initial survey. Ensure presenting information to account for all learning styles (auditory, kinesthetic, tactile, and visual).
Quality control	Adapt questionnaire from Mitton et al.^Citation42 Provide easy and constant technical support.
Course management	Manage appropriate time, define clear roles and responsibilities for course staff. Constantly assess management structure. Arrange workshops for TAs to prepare them for the course.

Abbreviation: TAs, teaching assistants.

MittonCAdairCEMcKenzieEPattenSBWaye PerryBKnowledge transfer and exchange: review and synthesis of the literatureMilbank Q200785472976818070335

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