The coronavirus disease 2019 (COVID-19) pandemic has changed medical education; the United Nations Educational, Scientific, and Cultural Organization (UNESCO) announced that 1.2 billion students across the planet have been affected by school and university closures due to the pandemic [1]. Saudi Arabia is one of the many countries that made the unprecedented decision to close schools and universities to contain the spread of the deadly virus as social distancing has been the most effective preventative strategy for COVID-19 pending development of a vaccine, treatment, or both [2].
At King Abdulaziz University, this closure dramatically interrupted medical students’ educational activities and clinical training, prompting the institution to move the course of study online and contemplate new approaches to distance education. Faculty members in the pediatric department shifted from in-person to distance education to facilitate students’ education. However, for many in the department, web video conferencing (WVC) technologies and online education were new and challenging.
The educators had to meet four major online education challenges: demonstrating pedagogical skills in an online classroom, addressing their managerial role, establishing relationships with students, and providing technical support [3, 4]. Despite the challenges, the instructors had to effectively facilitate case-based discussion (CBD) via WVC while maintaining a high-quality, authentic learning experience with high student satisfaction rates.
Distance education and student satisfaction
Distance education is defined as learning activities within formal, informal, or non-formal domains that are facilitated by information and communication technologies to lessen distance, both physically and psychologically, and to increase interactivity and communication among learners, learning sources, and facilitators [5]. Distance education has become the basic global mode of course delivery, and the quality of this delivery is essential.
The five elements in the Sloan quality framework for effective online education are student satisfaction, learning effectiveness, faculty satisfaction, student access, and institutional cost-effectiveness [6]. Furthermore, the root causes of online learning success are motive and leadership, focus on the program, faculty support, students (satisfaction, services, outcome), and growth in student enrolment [7]. Thus, the quality of online learning is highly influenced by teaching rather than technology [7].
A systematic review of randomized controlled trials concluded that digital problem-based learning (DPBL) was potentially more effective in improving knowledge and skills than traditional problem-based learning (PBL) due to greater student interaction and engagement in DPBL [8]. However, the review found mixed data concerning student satisfaction outcomes [8]. Various studies on student satisfaction with online learning have identified the following factors: instructor interaction, communication, active learning, students’ ability to initiate and control their actions in the learning environment, efficient assessment of academic progress, technology, and the learning environment [9, 10].
Video conferencing and student satisfaction
WVC is a synchronous model for interactive voice, video, and data transfer between two or more groups. It enables real-time, two-way video and audio communication as well as content sharing and messaging between instructors and students [11, 12]. Additionally, it allows immediate feedback and supports collaborative learning among students [11, 12]. WVC allows learners and instructors to participate in web-based discussions that are not bound to certain hardware or software, utilizing services such as Zoom, Skype for Business, and GoToMeeting [12]. As technology advances, WVC has become one of the most common tools used for synchronous online teaching [13, 14]. It promotes dynamic collaborative efforts, although it does face challenges with technical issues [12].
The findings on student satisfaction with WVC have been mixed. Dawson showed that synchronous communication increases the sense of classroom community and, therefore, student satisfaction [15]. Additionally, in a study by Dogget, over 90% of students responded favourably to the instructor’s use of WVC and his/her encouragement to ask questions; however, 80% stated that they would have been more comfortable in a conventional classroom setting, and 57% agreed that WVC technology was a barrier to interacting with the instructor [16]. Smith et al. [17] demonstrated that WVC was an effective method for satisfactorily teaching surgical tutorials to medical students. In contrast, Giesbers et al. [19] compared the learning experience of students using discussion forums (DF) versus students using both DF and WVC (which is expected to increase social presence) and found that WVC was not associated with enhanced student learning during their four-year experience with WVC. The only exceptions were the clarification of the module’s goals and tasks [19].
Community of inquiry framework
The community of inquiry (COI) framework constitutes three critical elements of online education—cognitive, teaching, and social presence—as well as the internal dynamic relationships among them [20]. These elements are essential for delivering a successful asynchronous (i.e. not simultaneous) online course and creating an effective educational experience [21]. Presence is defined as a state of alert awareness, receptivity, and connectedness to the mental, emotional, and physical workings of the individual and the group in the context of their learning environments, as well as the ability to respond with a considered and compassionate best next step [22]. The SEEQ questionnaire shares the same concepts as the COI framework (cognitive, teaching, and social presence); questions exploring student learning reflect cognitive presence, questions exploring enthusiasm and organization reflect teaching presence, and questions on group interaction and individual rapport reflect teaching and social presence combined.
The relevance of the COI framework to synchronous (i.e., simultaneous interaction) online learning with WVC technology needs to be further verified. According to Moore, using interactive teleconference media offers the opportunity for dynamic inter-learner dialogue and student engagement, thereby enabling instructors to bridge the psychological and communication distance between instructors and learners and among learners. It also provides the opportunity to develop the cognitive skills of analysis and autonomy [18].
Given the novel exposure to distance education for both students and faculty members. This study aimed to evaluate student satisfaction with the teaching quality of case-based discussion (CBD) sessions conducted through WVC. Furthermore, students’ ongoing feedback about their satisfaction with the teaching quality will substantially impact future curriculum planning and design as further online pediatric courses are implemented.