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 Table of Contents  
Year : 2021  |  Volume : 35  |  Issue : 2  |  Page : 63-66

A cross-sectional study of online medical education in the COVID-19 era

Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India

Date of Submission17-May-2021
Date of Decision24-Jul-2021
Date of Acceptance04-Aug-2021
Date of Web Publication27-Nov-2021

Correspondence Address:
Anand Pandey
Department of Pediatric Surgery, King George's Medical University, Lucknow - 226 003, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jms.jms_68_21

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Introduction: COVID-19 infection forced many alterations in our daily life, and continuation of classes by online mode is one of them. The effect of online classes on medical students has not been evaluated in our setup. This study was conducted to assess the medical student's perspective on the usefulness of online teaching.
Materials and Methods: A cross-sectional study of undergraduate medical students was conducted through an online link-based Google Form from November 28 to December 3, 2020. Anonymous responses were collected and evaluated. The values are presented in numbers and tables.
Results: A total of 329 datasets were received. Of these, 318 were included, and the remaining 11 were excluded. The smartphone was the most common gadget used for attending online classes (261, 83.7%). In 164 (57.2%) students, the routine lifestyle was grossly affected. The student complained of visual (183, 58.7%) and concentration (168, 53.8%) discomfort. Two hundred and seven (65.7%) students did not found online classes to be as efficient as traditional offline classes; however, 191 (61.2%) students stated that they might be interested in listening to lectures on interesting topics by experts from other reputed institutes.
Conclusion: In the current circumstances, online classes are considered a stopgap measure for the continuation of teaching, but physical classes are preferred in this field. More time may be needed to overcome the problems faced due to the online system.

Keywords: COVID-19, online classes, students, virtual classes

How to cite this article:
Kumar A, Singh G, Pandey A, Rawat J. A cross-sectional study of online medical education in the COVID-19 era. J Med Soc 2021;35:63-6

How to cite this URL:
Kumar A, Singh G, Pandey A, Rawat J. A cross-sectional study of online medical education in the COVID-19 era. J Med Soc [serial online] 2021 [cited 2022 Nov 26];35:63-6. Available from:

  Introduction Top

The COVID-19 pandemic has affected the whole world. This pandemic impacted all aspects of human life, and medical teaching was no exception to it.[1] On March 25, 2020, the Government of India imposed an indefinite nationwide lockdown.[2] Since teaching cannot be stopped indefinitely, and with no signs of flattening of the epidemic curve, as an alternative to physical classes, online classes were gradually started.

As online classes are not a standard teaching method across Indian schools and universities, their effect on the student and the teachers is not apparent. There is limited literature available on online medical classes with student perspectives.[3] This study was conducted to evaluate the medical students' views on the usefulness of online teaching.

  Materials and Methods Top

This survey was a cross-sectional study conducted from November 28 to December 3, 2020, as per STROBE guidelines (STrengthening the Reporting of Observational Studies in Epidemiology, EQUATOR Network). A Google Form containing the study questionnaire was circulated among various medical schools using social media platforms such as WhatsApp and Facebook. The Google Form's link expired after submitting a response to prevent the repetitive response from the same IP address. The investigator, the respondents, and the person analyzing the data were blinded, i.e., triple-blind, to avoid any bias.[4]

The questionnaire was circulated in the WhatsApp groups of the medical students by one of the members. This particular student was instructed to keep our details anonymous from the students' groups. The inclusion criteria included only those undergraduate medical students enrolled in online classes for more than 6 months to ensure adequate exposure to the online medical education system. All other students were excluded from participating in the study. The student who circulated the questionnaire was also excluded from it. Besides, the questionnaires with incomplete information or missing data were also excluded.

Since there was no patient involvement in this study and only anonymous data were collected, so ethical waiver was requested. Participation was voluntary, and consent was taken at the beginning of the survey questionnaire. A friendly reminder was sent to potential respondents to ensure the highest possible response rate. Participants were not aware of the study's aim or outcomes to reduce any possible bias risk.

The variables included for assessment were general factors (e.g., pre-COVID attendance in offline classes, proxy in online classes, ease of two-way communication, and the gadgets used for an online class), the impact of online class on student physically (e.g., the effect of routine life on students, formal dress code requirement, visual impact, concentration ability of student), and effectiveness and ease of learning.

The categorical data were analyzed using Numbers software (Apple Inc.), and a description of the responses was performed. Results were displayed only in numbers (n) and percentages. The minimum sample size calculated was 30 according to the flat rule of thumb (the National Council for the Social Studies [NCSS] 12 Statistical Software NCSS, LLC. Kaysville, Utah, USA).

  Results Top

A total of 329 datasets were received. Of these, 318 were included, and the remaining 11 were excluded. The results are presented in [Table 1], [Table 2], [Table 3], [Table 4].
Table 1: Questions regarding general factors in online classes

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Table 2: Question regarding physical impact of online classes

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Table 3: Questions regarding opinion on cost and time factors

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Table 4: Questions regarding utility of online classes

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  Discussion Top

Mobile phones are the most common form of gadgets used for long-distance learning and education, using different applications, which are meant for the specified task of learning.[5] Mobile devices are simple and easy to use, and they are becoming increasingly popular. India's smartphone penetration has increased from 27.7% to 36.7% from 2018 to 2019.[6]

The student attending beyond 70% of traditional classes in the pre-COVID period suggests a regular protocol, which they follow to complete the course. An important undue advantage of online classes noted in this study was logging in but not attending the classes. It may be due to the instructions of India's governing body of medical education, where 75% of attendance (including online classes during the COVID-19 period) is mandatory for becoming eligible to appear in the examinations.[7] Until the students disclose this incident, it would not be easy to monitor this habit. Google and other online platform have introduced the new feature of attendance recording, such as screenshots, posting quiz type questions multiple times with quick submission, generating records of log-in E-mail ids, and names of students, even roll numbers;[8] however, they are not very common as of now.

In online classes, two-way communication is limited. The barriers to effective communication are technical, psychological, social, cultural, and contextual. The technical issue is the first to be encountered; however, it must be resolved with time.[9] These hurdles of communication may lead to the students' lack of attention. The physical class inculcates a habit of specific routine in life, such as getting ready on time and attending the class in a manner deemed appropriate for it. These factors are missing while attending the online classes. It was also evident from our survey, where most students attended the online classes in a casual dress rather than a formal one.

Long screen time causes computer vision syndrome, including eyestrain, headaches, blurred vision, dry eyes, and pain in the neck and shoulders.[10] It has been found that the higher screen time is associated with a variety of health harms for children and young people, such as adiposity, unhealthy diet, depressive symptoms and quality of life, and attention deficit.[11],[12] In the current study, visual and concentration difficulties were also faced by the students.

Since medical education is subsidized in government medical colleges and many students belong to the economically weaker section, paid online classes did not find much appeal, whereas they warmly welcomed the option for the free prerecorded lecture. It is more of a speculation, and more evidence is needed to confirm this observation.

In our survey, the students found online classes less efficient than offline classes, and they preferred offline classes in post-COVID era without continuing the online classes. It may be due to limited interaction, technical difficulty, and an uncomfortable environment. Two similar cross-sectional studies in South East Asia concluded that medical students did not find online classes as effective as the traditional classroom teachings.[13],[14] However, the proponents of online classes believe that there is reduced use of transportation facilities and expenses to attend class, recording of the lecture, self-directed learning, and ease to learn at any time in a day.[15]

The medical fraternity saw a similar health crisis during the severe acute respiratory syndrome outbreak in 2003. During that time, online learning was introduced in medical education in Hong Kong and worked excellently. It was subsequently incorporated into their standard curriculum.[16] It can be presumed that the online classes had already started in medical education. The COVID-19 has just accelerated the wheel of momentum suddenly, and the students were not prepared to be taught by only this mode of teaching.

The present study is one of the first from Southeast Asia, where evaluation of online classes for undergraduate medical students has been conducted. The study has attempted to focus on the students' perspective. Since the responses were from more than one medical college of this part, it may be a possibility that the results may be generalized to the undergraduate medical community. The limitation of this study is the total number of responses that we received. Despite having received 329 responses, it is limited when compared to the total number of students. However, it was the best we got at that time. The possibility of bias in responding to the questionnaire cannot be ruled out. To avoid it, we opted for a triple-blind study. Still, the persistence of bias may be there.

  Conclusion Top

In the current circumstances, online classes are considered as a stopgap measure for the continuation of teaching, but physical classes are preferred in this field as of now. More time may be needed to overcome the problems faced due to the online system.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Pattanshetti VM, Pattanshetti SV. The impact of COVID-19 on medical education in India. J Sci Soc 2020;47:1-2.  Back to cited text no. 1
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Saha J, Barman B, Chouhan P. Lockdown for COVID-19 and its impact on community mobility in India: An analysis of the COVID-19 Community Mobility Reports, 2020. Child Youth Serv Rev 2020;116:105160.  Back to cited text no. 2
Yang Y, Cornelius LF. Students' perceptions towards the quality of online education: A qualitative approach. Assoc Educ Commun Technol 2004;27:861-77.  Back to cited text no. 3
Park K. Principles of epidemiology and epidemiologic methods. In: Park K, editor. Park's Text Book of Preventive and Social Medicine. 23rd ed. Jabalpur, India: Bhanot Publishers; 2015. p. 53-131.  Back to cited text no. 4
Yilmaz O. E-Learning: Students input for using mobile devices in science instructional settings. Edu Learn 2016;5:182-92.  Back to cited text no. 5
List of countRIES BY SMARTPHONE Penetration. (From Wikipedia). Available from: [Last accessed on 2021 Mar 10].  Back to cited text no. 6
Medical Council of India Regulation on Graduate Medical Educations; 1997. Available from: [Last accessed on 2021 Mar 10].  Back to cited text no. 7
Khan AM, Patra S. Bloom of online teaching in the era of COVID 19 pandemic: Boon or Bane for medical education. Natl J Med Allied Sci 2020;9:1-5.  Back to cited text no. 8
Berge ZL. Barriers to communication in distance education. Turk Online J Distance Educ 2013;14:374-88.  Back to cited text no. 9
Sheppard AL, Wolffsohn JS. Digital eye strain: Prevalence, measurement and amelioration. BMJ Open Ophthalmol 2018;3:e000146.  Back to cited text no. 10
Stiglic N, Viner RM. Effects of screentime on the health and well-being of children and adolescents: A systematic review of reviews. BMJ Open 2019;9:e023191.  Back to cited text no. 11
Montagni I, Guichard E, Kurth T. Association of screen time with self-perceived attention problems and hyperactivity levels in French students: A cross-sectional study. BMJ Open 2016;6:e009089.  Back to cited text no. 12
Nepal S, Atreya A, Menezes RG, Joshi RR. Students' perspective on online medical education amidst the COVID-19 pandemic in Nepal. J Nepal Health Res Counc 2020;18:551-5.  Back to cited text no. 13
Abbasi S, Ayoob T, Malik A, Memon SI. Perceptions of students regarding E-learning during COVID-19 at a private medical college. Pak J Med Sci 2020;36:S57-61.  Back to cited text no. 14
Mukhtar K, Javed K, Arooj M, Sethi A. Advantages, limitations and Recommendations for online learning during COVID-19 pandemic era. Pak J Med Sci 2020;36:S27-31.  Back to cited text no. 15
Patil NG, Chan Y, Yan H. SARS and its effect on medical education in Hong Kong. Med Educ 2003;37:1127-8.  Back to cited text no. 16


  [Table 1], [Table 2], [Table 3], [Table 4]


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