Introducing the contextual digital divide: Insights from microscopic anatomy on usage behavior and effectiveness of digital versus face-to-face learning

In recent years, there has been a growing trend toward the digitization of education, highlighting the need to understand how different learning modalities impact medical student outcomes. This study analyzes user behavior among medical students in Microscopic Anatomy, focusing on preferences for digital versus face-to-face guided self-study. A cohort of 684 students participated in Microscopic Anatomy courses, choosing between digital and face-to-face guided self-study sessions. Student participation was systematically tracked, capturing detailed data on the frequency and duration of engagement with each self-study modality. Quantitative measures of academic performance were collected, and user behavior was analyzed to identify trends in learning outcomes. The majority preferred face-to-face sessions, with attendance increasing over the semester. By the end, 78.44% found hands-on engagement with microscopes more effective and engaging than digital alternatives. Students attending in-person sessions achieved superior academic outcomes, with a failure rate of 13.69% compared to 22.04% among nonattendees. Preferences were influenced by direct tutor interactions (61.38%) and peer engagement during free microscopy sessions (74.25%). Additionally, 46.71% reported higher motivation when studying in the histology lecture hall compared to at home. These findings reveal a 'Contextual Digital Divide', where digital learning may not fully meet educational needs in contexts requiring hands-on experiences and direct interaction. Our results highlight the need to reinforce face-to-face teaching in specific contexts to ensure an effective learning experience. Future research should build on these insights to better understand situations where digital methods may fall short of learners' needs.