Dissertation committee:
Ανδρέας Χ. Λάζαρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Αγρογιάνννης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Γ. Καβαντζάς, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεωργία Ελένη Θωμοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ειρήνη Θυμαρά, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σπυρίδων Πουρναράς, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Νάστος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
The doctoral dissertation begins with the General Part and the Introduction section that acquaints the reader with the subject matter. This section reveals that the research was conducted at Medical School of National and Kapodistrian University of Athens during the lockdown period when lectures at all universities in the country had to be delivered online, utilizing the e-learning method. Consequently, given that the pandemic necessitated online teaching irrespective of the number of students, the course's nature, and the faculty's readiness and adaptability to transition to e-learning in terms of personnel capabilities and technological efficacy, it is believed to be crucial to solicit feedback from medical students regarding the education they received through the applied e-learning methods. Furthermore, this research assesses the Pathology e-learning course in terms of students' participation and the dynamics of interaction between them and the professor. It is emphasized that this research does not delve into the content of the lessons but instead focuses on the e-learning process and student feedback.
The next section is a literature review of studies evaluating e-Learning in Pathology courses, which reveals a dearth of research specifically examining e-Pathology courses. This research gap was noted even before the global pandemic. Unlike the majority of medical studies that utilize questionnaires to assess either asynchronous e-learning or blended learning (combining in-person classes with asynchronous e-learning), the present research focuses exclusively on e-learning methods and resources that entirely replaced traditional classroom and laboratory teaching formats.This research is pioneering in nature as it was conducted using e-learning modalities as the exclusive method of delivering education. The primary objective of this research is to evaluate e-learning in the context of Pathology courses.
The section that follows provides definitions of key research terminology. It delves into the analysis of e-learning as a learning method, including its division into synchronous and asynchronous e-learning. Furthermore, it explores the terms "participation" and "interactivity" as integral aspects of modern e-teaching procedures. The section also references the use of videos as tools in asynchronous e-learning, particularly considering the widespread adoption of videotaped e-lessons during the Pathology course's e-semester. Lastly, it addresses the term "students' evaluation of teaching," which remains a topic of keen debate.
Legislative context of E-Learning Implementation at Greek Universities is one more section of the dissertation where we meet all the rules that imposed e-learning as the only teaching method for a long period, the lockdown period, for all kind of schools including Higher Education. Thirty-four Government Gazettes of the Hellenic Republic from March 2020 until July 2021 are referred. According all these legal documents E-learning has to be applied, regardless of the nature and the science that is taught to students, at all Universities. No details about the e-connectivity or the technical readiness of the departments and their personnel were referred, as well.
The "Educational Context of the Research" is the final section of the general part, providing an overview of how the Pathology lesson is traditionally organized and scheduled. It initially describes the standard organization under normal circumstances, without pandemic disruptions, including student division and a variety of lessons. Subsequently, the section outlines the transformation to a pandemic 'edition,' detailing the chosen platform for synchronous e-learning, the types of e-lessons taught, and their duration. It also mentions the number of enrolled students (N=257) in the Pathology course and the approval (429/2021) granted by the Institutional Ethics Committee for this research.
The special part begins with the "Methodology" section, which is divided into two subsections: "Applied E-Learning in the Pathology Course" and "Evaluation of E-Learning in the Pathology Course." In the first subsection, which is further divided into "Synchronous E-Learning in the Pathology Course" and "Asynchronous E-Learning in the Pathology Course," online participation was observed at seven different time points during each of the assessed e-lessons. The data collected led to a quantitative analysis, employing statistical methods to analyze and present the results in numerical form using SPSS software. Patterns of interaction between professors and students were identified and categorized based on content. Furthermore, the section measures the number of views of the recorded e-lessons when all videos were uploaded, with updates occurring every 15 days. Analysis of variance (ANOVA) was used for statistical analysis to determine the significance of the time each video had been uploaded on the virtual course platform. T-tests were also employed to assess the significance of changes in the number of views relative to the time leading up to the examinations.
To evaluate the applied e-learning in the Pathology course, a structured questionnaire consisting of 17 items was distributed to enrolled students (N=257). An impressive 80.5% of them voluntarily completed and returned valid questionnaires. A substantial volume of data was collected and categorized. The data analysis was conducted using the open-source program Statistical Processing PSPP v.1.5.1. To validate each questionnaire instrument used in the study, exploratory factor analysis was performed in all cases, employing Principal Component Analysis (PCA) extraction and Varimax rotation. The factor analysis of the Pathology items produced two scales: Pathology E-Class Items and Pathology E-Class Material. The reliability of the scales was measured using Cronbach's alpha. To determine the appropriate analysis test, a normality analysis was conducted using the Kolmogorov–Smirnov test. In the normality analysis, all the p-values were < 0.05, indicating a non-normal sample distribution, thus necessitating the use of non-parametric tests. The non-parametric Kruskal–Wallis test was employed and revealed significant differences among the scales and items in the study. Mean analysis further corroborated and supported the findings obtained through the applied statistical methods.
Therefore, the research adopted methodological triangulation for data collection, utilizing naturalistic observation (online lesson), observation of digital traces of uploaded files (video analytics), and gathering responses from a questionnaire. Additionally, multiple statistical analyses were conducted using SPSS, PSPP, ANOVA, T-tests, and factor analyses.
The "Results" section follows, and it can be noted that the findings are both extensive and intriguing. A statistically significant difference was observed in the mean percentage of student participation among the seven time points of each e-lesson. However, the difference in the mean percentage of students' online participation across the seven assessed e-lessons was not statistically significant. Evidence of interactivity was summarized in a table, and interactions between professors and students were categorized based on their content. It was found that the professor posed questions to students every 2–5 minutes during each synchronous e-lesson and e-tutorial observed. In response to each question, students typically wrote 3–6 answers in the chat. As the number of synchronous e-learning classes increased, students tended to ask more questions, with only a few exceptions. Furthermore, the results indicate that there is a statistically significant difference in the number of views of the videotaped e-lessons during the two-month period leading up to the examinations. Time was identified as a statistically significant factor affecting the impact of an educational video.
The results obtained from the answers on the provided questionnaires indicate that the vast majority of students highly evaluated fifteen out of the seventeen components of the e-learning Pathology questionnaire. The remaining two items, the HIPON platform and the Microlabs e-lessons, received high evaluations from nearly half of the students. Approximately 93% of medical students expressed the opinion that e-learning could be integrated into the medical curriculum alongside traditional classroom lessons. Among them, 62.8% (N = 130) of students responded affirmatively to a great extent, while 30.4% (N = 63) responded to a small extent.Statistically significant differences were identified between the demographic characteristics of the participants (gender, permanent residence, working status) and their assessments of the various e-learning components.
The "Discussion" section follows the "Results" section, and the process of interpretation has been completed. In this section, various aspects such as Participation, Interactivity, Educational Videos, and all items of the questionnaire have been elucidated and interpreted. The discussion section also highlights the consistency of research in the field of e-learning. Particular emphasis has been placed on the Pathology course and its online teaching method, with the aim of enhancing it, especially in situations where e-learning is required for an extended or brief period. It is recommended that the components of e-learning identified in this study, both synchronous and asynchronous, be used both in the adoption of online teaching in medical courses and in related researches of distance education.
In the final section, the "Conclusions" have been presented to ensure clarity and ease of understanding. The e-learning method employed in the Pathology course received overwhelmingly positive feedback from the students. The extensive data collection, voluminous statistical analysis, and the thorough interpretation that ensued rendered the conclusions of this research both unique and highly significant in the realm of medical education and education in a broader context. Moreover, this study sheds light on the quality of the teaching procedures offered by Medical School of National and Kapodistian University of Athens, emphasizing the importance of continuous improvement in educational practices.
