A survey of E-learning methods in nursing and medical education during COVID-19 pandemic in India

Background: COVID-19 pandemic has necessitated mandatory e-learning in medical and nursing education. How far are developing countries like India (with wide socioeconomic and cultural diversity) geared up for this challenge remains unexplored. At this critical juncture, we aim to evaluate if online teaching methods are as feasible, acceptable, and effective as in-class teaching for medical/nursing students. Objectives: The questionnaire captured: (1) practicability/feasibility of online classes, (2) health issues from online classes, (3) current methods for e-teaching, and (4) student attitudes and preferences. Design: Cross-sectional survey. Settings: Population-based study in India. Participants: Nursing and medical undergraduate students (I-IV year). Methodology: The online questionnaire was distributed to 200 medical and nursing colleges across India. Categorical variables were analyzed using chi-square tests. Binary logistic regression was done to analyze factors predicting health issues in students. p < 0.05 was considered significant. Results: Overall, 1541 medical and 684 nursing students completed the survey from 156 cities. The availability of laptop (p < 0.0001), Wi-Fi (p < 0.0001), dedicated room (p < 0.0001), and computer proficiency was more in students of affluent families and those from cities (p < 0.0001). Class duration >4 h/day (p < 0.0001), each class >40 min (p < 0.009) and pre-existing health issues (p < 0.0001) predicted the occurrence headache, eyestrain, anxiety, neck/back pain, and sleep disturbance. Power-point presentation was the most widely (80%) used method of teaching. Only 30% got adequate time to interact with teachers. Only 20.4% felt e-learning can replace conventional teaching. Students preferred: 3?6 classes/day, each class <40 min, 10?20 min break between classes and interactive sessions. Conclusion: There is a need to improve information and communication infrastructure to enhance feasibility of elearning for nursing/medical students in India. There should be guidelines (number of classes/day, length of each class, break between classes, curriculum, etc) to improve the retention capacity in students and reduce health issues. Continuous feedback from teachers and students will be required to make e-learning effective.