Online teaching and learning

Background from survey

• The main forms of online education used by the teachers include online seminars and online lectures in real time (synchronous type of teaching) that are used in majority on daily basis or every week. Almost 80% of educators used any of these approaches at least several times a month. Online lectures and seminaries/exercises in real time thus represent the most preferred method among educators, followed by videos with pre-recorded lectures (asynchronous online courses). The educators think the students prefer those two methods and according to students’ answers in our survey it is true. On the other hand, the least frequently used forms of online education mentioned by the teachers were the sound recordings (mp3, podcasts), which were never used or not suitable for more than 70% of educators.
• The question on other approaches used in online education was skipped by almost 90% of educators. Those who answered this question mostly mentioned particular teaching methods used in any or most types of online teaching (online tests, online discussion, e-mail communication, screen sharing, demonstration videos, and breakout rooms). Furthermore, a hybrid teaching was mentioned as preferred type of teaching by 2 teachers (1%).
• The teachers´ most frequently reported problems that occurred during real-time online education relate to internet connection. Most of the teachers and students, however, found no major problems with the synchronous online education process (for details, see the section focused on technical side of online education).

Forms of online education

All types of online learning are primarily delivered online and are accessible via online course modules from the students’ computers, laptops, tablets or smartphones. Basic types of the online courses are the following:

• Synchronous online courses
• Asynchronous online courses
• Hybrid (blended) online courses

All methods have pros and cons and may be more suitable or appropriate for different situations, different subjects and types of course (lectures, exercise modules, practical courses, seminars and projects), and different students (according to their preferred learning style, extraversion or introversion, need of social interactions and time constraints). The brief description of particular types of online education including major advantages and disadvantages follows:

Synchronous online courses

• Synchronous learning environments enable students to participate in a course from a distance in real time. The class is usually a firm, weekly or even daily time commitment that cannot be rescheduled. From this point of view, this type of course resembles the in-present education in many aspects.
• These types of course require the teacher and students to interact online simultaneously mostly through the video chat, less frequently through the text or audio chat. The students thus may participate in real-time discussion, ask any question and get questions immediately answered. They can also participate on quick online surveys or quizzes, be asked by the teacher or classmates, get immediate feedback on their response and obtain opinions from other participants. Similarly, teachers may ask students and assess their understanding of the topic, have a chance to re-explain things which were less understandable for students, and get instant feedback on their lectures. The participation of more students may, however, cause the difficulties to get the individual questions answered, since they compete for attention, similarly to the in-person education.
• The synchronous online class usually takes the form of a live video lecture or an instructor-led discussion. The students may also lead discussions themselves or give presentations to the rest of the class.
• Specific types of activities included in a synchronous course depend on the subject and the program. In clinical subjects, for example, the teachers may pose case studies to students, who then have to negotiate an answer with other classmates (either in smaller groups or together, as a class).
• Similarly to in-present classes, the students may be asked to complete some readings and assignments before the class begins which helps them prepare to participate in the discussion.
• When planning the synchronous online classes, the teachers are recommended to set a dedicated agenda and carefully consider the time-frame and schedule of the lecture. It is also necessary to adjust the learning objectives appropriately to the used teaching method according to the Bloom’s taxonomy.
• In contrast to the in-present education, more frequent switch among different activities, frequent breaks and more interactive approach are recommended to attract and keep students’ attention.
• The synchronous education provides regular contacts not only with teachers, but also with the classmates and may partly substitute the in-person interactions (mainly if they are prohibited e.g. for the epidemiological reasons). Synchronous classes thus provide the interactive environment which is frequently mentioned among the students’ needs regarding online education.
• Less flexibility (inability to reach the content at any time and repeatedly) and set schedule and time frames represent major disadvantages of the synchronous learning. Furthermore, unless the class is recorded, the students have no chance to get back to the previous classes or previous parts of the current lecture, which may also represent a certain disadvantage. All of these disadvantages, however, apply to in-present education as well.
• Another disadvantage of the synchronous learning are its higher technological demands. Especially on real-time video chats, a slow internet can cause lag times where the students (or teachers) might miss the key points or discussions.
• Online lectures and online seminars in real time represent the most frequently used type of online learning and are most preferred by both the teachers and students.
• This type of education is particularly suitable for exercises and practical courses (if they can’t be performed in person) and also for seminars where the active students’ participation and presentation is required. In the latter case, the synchronous online learning helps the students to improve their presentation and communication skills.

Asynchronous online courses

• Asynchronous learning courses do not take place in real–time.
• Students are provided with content and assignments and are given a time frame to complete course work and/or exams. The assignments usually need to be completed weekly, biweekly or monthly, depending on the type of course.
• Asynchronous online learning allows students to view the content at any time they choose and how many times they wish, and thus they can learn at their own pace. Such flexibility represents the major advantage of this type of course and some students may prefer asynchronous type of education even in the era when the online education is not obligatory.
  • In medical education theory we often use a term directed self-learning, which is one of the aspects of student-centred learning. It means that the teacher provides support and help to the student in the learning process, but the student is responsible for his own learning. In the asynchronous online learning the teacher can use for example an online study guide.
  • The self-learning, however, puts higher demands on self-discipline and time-management of the participating students. Therefore, it is especially important for students attending and asynchronous course to plan their time and effort. It’s highly recommended to reserve some time to accomplish the assignments in the daily schedule and not saving all the assignments to be done at the last minute.
• The content provided to the students may include many types of files e.g. PowerPoint presentations, Excel files, text documents, online interactive textbooks, video files including the video-recordings of the real-time or online lectures, the pre-recorded commented presentations, audio recordings and others.
  • Of those, sharing the pre-recorded presentations or video lectures is particularly suitable for asynchronous courses since it provides many advantages of the synchronous type of education. It also represents one of the most preferred types of online learning among both the students and teachers.
• Interaction during the asynchronous online course usually takes place through discussion boards or blogs. Students may also complete the home assignments in the form of tests or quizzes, which may provide them immediate feedback (not provided here directly by the teacher or classmates in contrast to the synchronous teaching forms).
• However, there also exist methods using peer feedback in the asynchronous learning. Students have to complete a home assignment, for example to film a short video or write a case report. They upload their homework on the internet (depending on the platform that is used) and the teacher or automatically the E-learning platform distribute anonymously the files and a feedback questionnaire. Students give feedback on the homework to their peers via the feedback questionnaire. Later the teacher can also comment on the results.
• Lower level of interactivity and inability to interact with other students and/or teacher directly during the lectures represent major disadvantages of this type of education. Students may miss the instant feedback, mainly in the situations when they don’t fully understand the topic or its particular aspects, or wonder if they are completing an assignment correctly. The students may also feel even more disconnected or disengaged in an asynchronous, online course.
  • To prevent or get over these students’ feelings, the teachers are recommended to respond to all discussion posts from students and support the meaningful interactions among students (e.g. by creating the projects which require cooperation of smaller groups or all the class).
  • It is also recommended to check in the end of the module or before the end of the course how confident the students feel in completing expected learning objectives, in other words to collect feedback. We can use self-evaluation (e.g. Likert scales in combination with open-ended questions). The result can navigate teachers how to evolve the study materials to help the students to reach the learning objectives.
• The asynchronous type of course also usually doesn’t have any positive impact on the students’ presentation and communication skills.
• In general, asynchronous online learning environments are effective for students with time constraints or busy schedules, for those who prefer to learn at their own pace.
• This type of course is also suitable for the introverted students, who may feel intimidated by the in-person or synchronous classes.
• It may also be advantageous if the students live in many different time zones, which makes the use of synchronous type of course complicated.
  • The educators are aware that the time shift may bring some problems, since they mentioned the students with time shift among those being disadvantaged in online education.

Hybrid courses (blended courses)

• Hybrid courses are learning environments that allow for both in-person and online interaction. Typically, hybrid courses meet in person several times during a semester and provide for computer–based communication in between those face-to-face sessions.
• If at least some extent of in-person interaction is allowed, this type of course might be preferred mainly for exercises and seminars. It allows gaining the practical skills in the in- person manner, while the rest of interactions can be performed in the online space.
• This type of education is the most appropriate for clinical subjects, or those which include the training of practical skills (e.g. in labs).
• Another major advantage is keeping at least some in-person social interactions, which may help to decrease the feeling of isolation.
• This type of course may, however, be not available if all the in-person contacts are strictly prohibited (e.g. from the epidemiological reasons)

Suitable form of teaching for different types of courses

Lecture is a form of teaching in which the teacher teaches students the theory. The lecture is typically held once for all students in the subject. Lectures are generally optional and public (thus accessible to non-students). In the online environment, both the synchronous online lectures and asynchronous type of teaching with sharing the video with pre-recorded lectures or commented presentations are applicable for both pre-clinical and clinical lectures.

• If the synchronous online teaching is used for lectures, students can actively participate on the lectures, ask questions or ask the teacher to re-explain some problems in real-time if needed. It’s recommended to record the lecture and share the record with students. This allows them to review the lecture repeatedly, which represents one of the major advantages of this type of teaching.
• In asynchronous online teaching, the presentation, records or other materials are already available online. The students, however, should have the opportunity to ask questions or discuss some aspects of the topic which are not fully understandable from the presentation or which they find of particular interest. The combination of the asynchronous methods with online discussion boards or similar tools is thus highly recommended.

Seminars and practical laboratory or clinical exercises serve to increase student engagement and practice. They are devoted to smaller groups of students. Exercises are generally mandatory and non-public.

• The most suitable approach for seminars and clinical and laboratory exercises are the hybrid (blended) courses, which allow for both in-person and online interaction.
  • Hybrid courses allow gaining the practical skills in the in-person manner, while the rest of interactions can be performed in the online space.
  • This type of course may, however, be not available if all the in-person contacts are strictly prohibited (e.g. for the epidemiological reasons).
• If the blended type of education is not allowed, synchronous type of course is recommended for exercises which include the training and practical demonstration of certain skills and seminaries where the active students’ participation and presentation is required. This type of education provides instant feedback and allows for more interactions in real-time.