The Experience of Using Online Education in a Radiological Academic Department During the Pandemic of Corona Virus COVID-19

Abstract

Purpose

In response to the coronavirus (COVID-19) pandemic, most educational institutions transitioned to online delivery because of the urgent need to avoid spreading the virus. For this study, the emergency transformation to 100% online education in a diagnostic radiology department was evaluated based on student experience and performance.

Methods

One hundred and thirty four radiology students participated in this study. Reflecting on the department's shift to online education, students rated their experience: their general opinions about courses, preferences for online education, their evaluation of the procedures of the implemented plans, and their evaluation of academic components such as exams, lectures, assignments, teamwork, interaction, and compensating for the loss of practical learning.

Results

The results indicate that the students appreciated the online emergency plan. Overall, they preferred online education compared to traditional classes, especially with regard to lectures, exams, teamwork, and interaction. Students agreed that some courses can be delivered online effectively, such as physics and research courses, while others should not. In general, this study demonstrates that radiology courses can be effectively delivered using online distance methods, and this should be a compulsory part of instruction in the future.

Conclusion

This study describes the effects of moving to online education in the field of radiology on both practical and theoretical learning outcomes.

Introduction

In response to the coronavirus (COVID-19) pandemic, most educational institutions transitioned to online delivery (Ahmed et al., 2020; Crawford et al., 2020; Alahmadi & Abdeen, 2021; Hodges et al., 2020; Rose, 2020; Wlodarczyk et al., 2020) because of the urgent need to avoid spreading the virus. The definition of online education in the literature includes courses that deliver 70% to 80% of the content on course syllabi using distance learning methods (Allen & Seaman, 2008; Allen & Seaman, 2014; Allen & Seaman, 2011). However, it should be noted that in this study, 100% of courses and courses were delivered online because of the enforcement of social distancing. Given the scope of this transition, most institutions were not fully prepared and probably struggled in ensuring that learning outcomes were achieved as planned. To examine this suggestion, this paper introduces and discusses the case of transitioning to online education in a radiological department for technologists in the Kingdom of Saudi Arabia.

On the 8th of March 2020, the Ministry of Education in Saudi Arabia announced that schools and universities should stop traditional classes and move to online education. The Diagnostic Radiology Department at King Abdulaziz University responded quickly to this request and initiated a full strategic educational plan that included schedules of exams, required assignments, and methods for delivering virtual classes to the students. This plan was fully organized and included all the elements students needed to finish the semester. The plan also included introductory guidance on the use of different online tools. The plan was delivered to students in one document that covered all courses for easy reference and access.

The department moved to new online class schedules using 2 common platforms: Zoom and Blackboard. An initial challenge was quickly increasing awareness about and successful use of online learning tools. Instructional online lectures, provided by the university or the department, were distributed to the staff and students. The department emphasized the importance of being available to answer student questions and engage in open, direct discussion to its teachers. It has been shown that this kind of openness and engagement has a highly positive impact on student experiences and satisfaction (Wallace, 2003).

Students received regular follow-ups through direct communication to ease their transition and address their psychological situations and fears. In addition, the staff followed up with students on a daily basis regarding the effectiveness lectures and assignments. In terms of achieving learning outcomes, online delivery presented the most difficult challenges to those courses that integrated practice and training in hospitals or the department labs. However, methods to address this challenge included providing videos demonstrating these practical aspects and live case discussions; these methods were especially relevant for courses that involved X-rays, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and hospital case studies.

Through different committees, the department also solved and followed up on issues that students faced with regard to the usage of online tools, internet problems, or general difficulties. Several direct and indirect forms of feedbacks were distributed to the students to gather their opinions and evaluation of the provided services. These feedback mechanisms helped to improve the student experience. Concerning the students’ grades, the Ministry of Education provided clear guidelines on changes in distribution, from 60% for the continuous assessments to 80%, and from 40% for the final exam to 20%. Continuous assessments included new ways of completing assignments such as open book exams and virtual presentations.

The sudden changes in educational delivery impacted student performance, both negatively and positively; it is important to understand these impacts on effective outcomes precisely. As a result, this study aimed to answer these questions: How did the impact of suddenly shifting to online education affect student performance? Can radiology be taught effectively online? Did the administration's procedures improve student experience? Do students prefer a completely online education or online learning as part of their education, covering only some of its steps? To address these questions, the study focused on undergraduate students in radiology and the experiences they faced during the transition in 2020.

Methods

Participants (134 out of 150) were undergraduate students in radiology; respondents were exactly split between male and female. The institutional ethics committee approved the study. A comprehensive, anonymous survey was designed using Google Forms that included simple yes or no questions, preferences, and Likert scale questions. These questions included rating the transition process to online education in relation to the administrative process as well as student experience. Questions were both general (e.g., asking about the clarity of all administrative procedures) and specific (e.g., asking about specific types of courses, such as physics or practical courses).

The survey also included classifications of positive or negative issues students faced during this transition to online education, students’ opinions about their gained knowledge and understanding, and preferences for different learning modes (e.g., exams, assignments, classes, interactions, team projects, or communication) in online and traditional education in the radiology department. The survey also compared the situation of suddenly shifting to online education with previous traditional classes. All students answered the survey at their own pace and had no difficulty understanding its different parts.

Results

This study aimed at understanding the effects of transferring to online education during the urgent COVID-19 situation, and it was divided into five sections:

The first section focused on evaluating several aspects of the department emergency plan, which included clear guidelines on revised scheduling, classes, and assignments, access to online materials, and grade distribution. Around 70% of the students or above rated aspects of the plan (including facilitation, communication, execution, reassurance, details, and clarity) as Excellent and around 22% as Very Good. Figure 1 summarizes these rates of response.

Figure 1.

In this figure, students were asked to rate different aspects related to the department plan during the transformation from traditional education to online education.

The second section of the study was related to student experience of elements such as exams, presentations, teamwork, interaction, easy access, and understanding during online education, as shown in Figure 2 . The results showed that the majority of students agreed (over 90%) that exams, presentations, teamwork, interaction, easy access, and understanding were effective during their experience of online education.

Figure 2.

In this figure, students were asked to rate different aspects related to their experience using online education in radiology.

The third section collected students’ feedback about different aspects of learning and whether they preferred them to be delivered online or in a traditional setting. The summary of the results in Figure 3 illustrate the following preferences with regard to online delivery: actual classes (35.1%), assignments (68%), exams (69.4%), self-confidence (50.7%), interaction (30.6%), asking questions (38.8%), teamwork (53.7%), presentations (53%), communications (44.8%), follow-up (52%), feedback (51.5%), and environment (47.8%).

Figure 3.

In this figure, students’ preference choices of different aspects in traditional education or online education.

The fourth section of the study included simple yes, no, or maybe questions in several areas, as shown in Figure 4 . In general, students indicated that they preferred online education to be part of their traditional and future education in the field of radiology by a small margin. The majority thought that some courses could not be compensated for using online education, especially courses that have practical aspects. In addition, students mostly agreed that the change to online education would not affect their overall general performances and grades.

Figure 4.

In this figure, several questions related to students’ experiences after finishing from the online education.

The fifth section asked students whether different types of courses could be taught fully or partially online. Most students agreed that physics and research project courses could be taught online, while courses with practical aspects could not be. These results are shown in Figure 5 .

Figure 5.

In this figure, students indicated whether they thought that different radiology courses could be taught using online education.

Discussion

This study examined the experience of transferring to online education in the Diagnostic Radiology Department at King Abdulaziz University. This shift occurred because of the COVID-19 pandemic and the implementation of social distancing in the kingdom. The study aimed to answer these questions: How did the impact of suddenly shifting to online education affect student performance? Can radiology be taught effectively online? Did the administration's procedures improve student experience? Do students prefer a completely online education or online learning as part of their education, covering only some of its steps?

Overall, clarifying the procedures for the remainder of the semester and the continuous communication between the administration of the department and the students helped to achieve excellent results with regard to student performance and experience. The students showed great appreciation for the clarity and execution of the departmental plan, and for the reassurance and facilitation that was provided. These results indicate that the procedures instituted during this transition period were successful. Recent studies have shown that continued communication with students with appropriate action tasks is key to successful online education (Zhang & Chang, 2022; Photopoulos et al., 2023). Communication is especially important when involving students in future procedural decision-making.

Reflecting on the experience of online education, the majority of students agreed that they were very comfortable with having online classes, as seen in Figure 2. Results that support this conclusion include positive responses regarding time management, easy access to classes, understanding the lectures, and ease of asking questions and interacting with their teachers and their colleagues (Figure 2). Previous studies have demonstrated that online courses should be carefully designed and created as well as well-planned (Sun & Chen, 2016; Castro & Tumibay, 2021; Gacs et al., 2020). This level of preparation was not always possible when the situation was enforced during the pandemic and no other options were available, but one of the interesting findings of this study is the highest rating from students for the effectiveness of teamwork. The students strongly agreed that this type of learning was highly appreciated. Previously students probably did not experience effective communication with their colleagues during traditional class situations, and because they were forced into it by the pandemic, they found it valuable. Also, circumstances prevent some students from attending meetings with their colleagues and teachers, and online learning tools can help address this issue. Promoting social presence was another possible explanation for this positive experience: heightened awareness of other individuals through educational interactions (Kehrwald, 2008; Swan et al., 2009).

When asking students about their preferences regarding lectures, exams, teamwork, and assignments, a simple majority of students showed appreciation for using online methods rather than being on campus. Their freedom in performing these tasks could be an explanation for these preferences. Also, previous studies have shown that interactivity, collaboration, and the online learning community have a positive impact on relationships and interactions between peers and teachers, available support, and connectivity within one single comfortable environment (Sun & Chen, 2016; Yuan & Kim, 2014). Engagement between students and the content of their courses has also been shown to be greater compared to traditional learning modes (Hodges et al., 2020). Completing online exams from home, for example, received positive responses from students. Reasons for this preference could include reducing the stress associated with taking exams in-person, allowing students to use resources when taking exams, and a higher comfort-level with the types of questions utilized in online assessments (e.g., multiple choice questions). With regard to student preference for online learning, another important factor is the fact that most materials are electronically distributed, which helps students easily gain access to them and engage with learning platforms (Kim & Bonk, 2006).

Previous research supports the findings of this study and demonstrates that online education can be as effective as traditional education (Kim & Bonk, 2006; Pallavi et al., 2022; Greenhow et al., 2022). The use of advanced electronic and educational tools such as learning management systems, email, and other communication platforms that have friendly interactive sites has also increased the quality of the delivered courses (Tallent-Runnels et al., 2006).

Despite the generally positive evaluation of online learning reflected in this study, students preferred communication, the environment, asking questions, and making presentations in traditional classes. One explanation for these preferences could be related to the actual live feedback that occurs during traditional classes, as well as the presence of body language. Students also identified what they most missed during this transition: meeting their friends, teachers, and being in the department labs, as well as student activities. These results reflect the loss of the actual feeling of getting direct feedback from teachers and peers. Along these lines, the departmental labs were rated as the most missed part of the educational experience, probably because of the importance of actual practice and simulations in performing radiological procedures. At the time of the transition to online learning, the department labs utilized 7 devices including x-ray, computed tomography, ultrasound, and fluoroscopy. Using these devices was important for achieving greater outcomes in courses. Although watching videos and case discussions replaced these practical aspects, students agreed that these methods were not sufficient, indicating that the practical and training aspects of the courses could not be replaced and taught with distance learning.

In addition, students thought that the most difficult issues they faced during online education were comprehension, exams, increased loads of assignments, and general changes in education. Of course, the general sudden changes also had a psychological impact because students were not prepared for this transformation. When asked about the issues that most affected their psychological situation, students most often identified missing their general routines, worrying about their future, and being forced to stay home because of the pandemic. However, students still believed that continuing their education helped to decrease the stress by keeping them occupied.

In general, students in this study did not think that this transition would affect their grades, which indicates that the department was successful in containing and managing this situation. In addition, the department allowed multiple forms of engagement with online education using different platforms. Multiple forms of engagement have been shown to enhance student experience and assist with motivation (Lee, 2017). Moreover, students believed in general that only theoretical physics and research courses could be effective online, while other training and practice-based courses could not be taught online, even if supplemented by additional online resources.

Overall, online delivery is an important tool that should be integrated into contemporary education. One of its important benefits is lowering the costs of education, which would have a great impact on the economy (Allen & Seaman, 2008; Allen & Seaman, 2014). However, online education should be more strategically planned in the future to measure accurately its impacts on achieving the desired learning outcomes (Allen & Seaman, 2011). This shift forced by the pandemic to online education will greatly motivate the growth of its usage and applications. It is clearly possible to integrate online education in radiology education; however, this is only true for theoretical courses.

Future research should focus on longitudinal effects of online education for medical and radiological students, especially in relation to the replacement of hands-on training with the high tech of virtual interactive classes. In future work it would be interesting to compare different sets of students who graduated from the same department via distance learning and traditional learning. In addition, as illustrated in recent studies, additional learning tools for effective radiology education have been shown to be extremely useful in terms of self-improvement and education (Chen et al., 2022; Ogolodom et al., 2022; McCarthy & Uppot, 2019).

Conclusion

In this study, the experience and the impacts of transferring to online education in the Diagnostic Radiology Department at King Abdulaziz University were investigated based on students’ experiences. The study showed that the students appreciated the clear emergency plan that was put into action. The students overall preferred the experience of online education compared to traditional classes especially with regard to lectures, exams, teamwork, and interaction. Students agreed that some courses could be delivered using online education such as physics and research courses, though there were limitations in teaching training and practice online. As a result, radiology courses in the department could ideally be delivered partially using online distance methods, and this should be a compulsory part of its instruction in the future.