Abstract
Background
Prior reviews investigated medical education developments in response to COVID-19, identifying the pivot to remote learning as a key area for future investigation. This review synthesized online learning developments aimed at replacing previously face-to-face ‘classroom’ activities for postgraduate learners.
Methods
Four online databases (CINAHL, Embase, PsychINFO, and PubMed) and MedEdPublish were searched through 21 December 2020. Two authors independently screened titles, abstracts and full texts, performed data extraction, and assessed risk of bias. The PICRAT technology integration framework was applied to examine how teachers integrated and learners engaged with technology. A descriptive synthesis and outcomes were reported. A thematic analysis explored limitations and lessons learned.
Results
Fifty-one publications were included. Fifteen collaborations were featured, including international partnerships and national networks of program directors. Thirty-nine developments described pivots of existing educational offerings online and twelve described new developments. Most interventions included synchronous activities (n Fif5). Virtual engagement was promoted through chat, virtual whiteboards, polling, and breakouts. Teacher’s use of technology largely replaced traditional practice. Student engagement was largely interactive. Underpinning theories were uncommon. Quality assessments revealed moderate to high risk of bias in study reporting and methodology. Forty-five developments assessed reaction; twenty-five attitudes, knowledge or skills; and two behavior. Outcomes were markedly positive. Eighteen publications reported social media or other outcomes, including reach, engagement, and participation. Limitations included loss of social interactions, lack of hands-on experiences, challenges with technology and issues with study design. Lessons learned highlighted the flexibility of online learning, as well as practical advice to optimize the online environment.
Conclusions
This review offers guidance to educators attempting to optimize learning in a post-pandemic world. Future developments would benefit from leveraging collaborations, considering technology integration frameworks, underpinning developments with theory, exploring additional outcomes, and designing and reporting developments in a manner that supports replication.
Acknowledgments
The authors express their gratitude to librarian, Whitney Townsend, for her expertise developing the search strategy and assistance running the database search.
Disclosure statement
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.
Additional information
Notes on contributors
Deena Khamees
Deena Khamees, MD, is an Assistant Professor of Emergency Medicine, McGovern Medical School, University of Texas Health Sciences Center, Houston, Texas, USA.
William Peterson
William Peterson, MD, is a Director of Emergency Medicine Residency Preparatory Course, Assistant Clerkship Director, and an Assistant Professor of Emergency Medicine, Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI.
Madalena Patricio
Madalena Patricio, PhD, is Past-President of the Association for Medical Education in Europe (AMEE), Chair of BEME, and Honorary Professor at the Department of Medical Education at the Faculty of Medicine, University of Lisbon, Portugal.
Teresa Pawlikowska
Teresa Pawlikowska, MB BS, PhD FRCPI, is Foundation Director of The Health Professions Education Centre (HPEC) which is also a BEME International Collaborating Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Carolyn Commissaris
Carolyn Commissaris, MD, is a Clinical Lecturer and Assistant Program Director of Emergency Medicine at the University of Michigan Medical School in Ann Arbor, Michigan, USA.
Andrea Austin
Andrea Austin, MD, is an Associate Physician Diplomate at the University of California, San Diego School of Medicine, La Jolla, California, USA.
Mallory Davis
Mallory Davis, MD is an Emergency Medicine resident at Michigan Medicine, Ann Arbor, Michigan, USA.
Maxwell Spadafore
Maxwell Spadafore, MD is an Emergency Medicine resident at Michigan Medicine, Ann Arbor, Michigan, USA.
Max Griffith
Max Griffith, MD, is an Emergency Medicine resident at Michigan Medicine, Ann Arbor, Michigan, USA.
Ahmad Hider
Ahmad Hider, MPhil, is a second-year medical student at the University of Michigan Medical School, Ann Arbor, Michigan, USA.
Cameron Pawlik
Cameron Pawlik, BS, is a first-year medical student at the University of Michigan Medical School, Ann Arbor, Michigan, USA.
Jennifer Stojan
Jennifer N. Stojan, MD, MHPE, is an Associate Professor of Internal Medicine and Pediatrics at the University of Michigan Medical School in Ann Arbor, Michigan, USA.
Ciaran Grafton-Clarke
Ciaran Grafton-Clarke, MBChB, is a Clinical Education Fellow at University Hospitals of Leicester, UK, and Honorary Fellow at the University of Leicester, UK.
Hussein Uraiby
Hussein Uraiby, MBChB, PGCert, FHEA, is a Specialty Trainee in Histopathology and a Clinical Education Fellow at the University Hospitals of Leicester NHS Trust, UK.
Satid Thammasitboon
Satid Thammasitboon, MD, MHPE, is a Director of the Center for Research, Innovation and Scholarship in Medical Education (CRIS), Co-Director of a BEME International Collaborating Centre, and Associate Professor of Pediatric Critical Care Medicine at Texas Children's Hospital, Houston, Texas, USA.
Morris Gordon
Morris Gordon, MBChB, PHD, MMed, is Cochrane Coordinating Editor, Chair of the BEME Executive Committee, and a Professor of Evidence Synthesis and Systematic Review, University of Central Lancashire, Preston, UK.
Michelle Daniel
Michelle Daniel, MD, MHPE, is Chair of the BEME Review Committee, Associate Editor for Medical Teacher, and Vice Dean for Medical Education and Clinical Professor of Emergency Medicine at the University of California, San Diego School of Medicine, La Jolla, California, USA.