JTUMED653_proof ■ 22 October 2020 ■ 1/7

Journal of Taibah University Medical Sciences (xxxx) xxx(xxx), xxx

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Taibah University
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Journal of Taibah University Medical Sciences 59
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www.sciencedirect.com 62
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Original Article 65
1 66
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3 Experience of e-learning and online assessment during the COVID-19 68
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5 Q1 Q2 pandemic at the College of Medicine, Qassim University 70
6 Q3
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a, b
7 Q43 Q4 Ahmed Elzainy, MD , Abir El Sadik, MD a, b and Waleed Al Abdulmonem, MD c, * 72
8 Q5 73
9 a
Department of Anatomy and Histology, College of Medicine, Qassim University, Buraidah, KSA 74
Q6
10 b
Department of Anatomy and Embryology, College of Medicine, Cairo University, Egypt 75
11 c
Department of Pathology, College of Medicine, Qassim University, KSA 76
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Received 20 June 2020; revised 15 September 2020; accepted 20 September 2020; Available online - - - 78
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18 ‫ﺍﻟﻤﻠﺨﺺ‬ ‫ ﻻﺣﻈﻨﺎ‬.‫ ﺃﻭﺿﺤﺖ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﻓﻮﺍﺋﺪ ﺍﻟﺘﻌﻠﻢ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ ﻭﺍﻟﺘﻘﻴﻴﻢ‬:‫ﺍﻻﺳﺘﻨﺘﺎﺟﺎﺕ‬
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19 ‫ﺎ‬‫ﺍﺭﺗﻔﺎﻋﺎ ﻓﻲ ﺇﻧﺠﺎﺯ ﺍﻟﻄﻼﺏ ﻭﺗﺼﻮﺭﺍ ﻭﺍﻋﺪﺍ ﻷﻋﻀﺎﺀ ﻫﻴﺌﺔ ﺍﻟﺘﺪﺭﻳﺲ ﻭﺗﺤﺴﻨﺎ ﻣﻠﺤﻮﻇ‬
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20 ‫ ﻗﺎﻣﺖ ﺍﻟﻤﺆﺳﺴﺎﺕ ﺍﻷﻛﺎﺩﻳﻤﻴﺔ ﻋﻠﻰ ﺍﻟﻔﻮﺭ‬،١٩-‫ ﺑﻌﺪ ﺟﺎﺋﺤﺔ ﻛﻮﻓﻴﺪ‬:‫ﺃﻫﺪﺍﻑ ﺍﻟﺒﺤﺚ‬ ‫ ﺗﺪﻋﻢ ﻫﺬﻩ ﺍﻟﻨﺘﺎﺋﺞ ﺍﻟﺘﺤﻮﻝ ﻧﺤﻮ ﺍﻟﺘﻨﻔﻴﺬ ﺍﻟﻤﺴﺘﻘﺒﻠﻲ ﻟﻤﺰﻳﺪ ﻣﻦ‬.‫ﻓﻲ ﻣﻬﺎﺭﺍﺗﻬﻢ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺔ‬
85
21 ‫ ﻳﺼﻒ ﺍﻟﻌﻤﻞ ﺍﻟﺤﺎﻟﻲ‬.‫ﺑﺘﺤﻮﻳﻞ ﺟﻤﻴﻊ ﺍﻟﻨﺸﺎﻃﺎﺕ ﺍﻷﻛﺎﺩﻳﻤﻴﺔ ﺇﻟﻰ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻹﻟﻴﻜﺘﺮﻭﻧﻲ‬ .‫ﺍﻟﻤﻘﺮﺭﺍﺕ ﺍﻟﻄﺒﻴﺔ ﺍﻹﻟﻴﻜﺘﺮﻭﻧﻴﺔ‬
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22 ،‫ﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﻟﻤﺘﺰﺍﻣﻨﺔ ﻟﻠﺘﻌﻠﻴﻢ ﺍﻹﻟﻴﻜﺘﺮﻭﻧﻲ ﻭﺍﻟﺘﻘﻴﻴﻢ ﺍﻟﺘﻲ ﺃﺟﺮﻳﺖ ﻓﻲ ﻛﻠﻴﺔ ﺍﻟﻄﺐ‬
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23 ‫ ﻛﻤﺎ ﺩﺭﺳﻨﺎ ﺗﺄﺛﻴﺮ ﺍﻟﺘﻌﻠﻢ ﺍﻹﻟﻴﻜﺘﺮﻭﻧﻲ‬.‫ ﺑﺎﻟﻤﻤﻠﻜﺔ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﺴﻌﻮﺩﻳﺔ‬،‫ﺑﺠﺎﻣﻌﺔ ﺍﻟﻘﺼﻴﻢ‬ ‫؛ ﺍﻟﺘﻌﻠﻢ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ؛ ﺍﻟﺘﻘﻴﻴﻢ ﺍﻹﻟﻴﻜﺘﺮﻭﻧﻲ؛‬١٩-‫ ﺟﺎﺋﺤﺔ ﻛﻮﻓﻴﺪ‬:‫ﺍﻟﻜﻠﻤﺎﺕ ﺍﻟﻤﻔﺘﺎﺣﻴﺔ‬ 88
24 ‫ ﻭﺍﻟﺘﺤﺪﻳﺎﺕ ﺍﻟﺘﻲ ﺗﻮﺍﺟﻪ‬،‫ﻭﺍﻟﺘﻘﻴﻴﻢ ﻋﻠﻰ ﺃﺩﺍﺀ ﺍﻟﻄﻼﺏ ﻭﺃﻋﻀﺎﺀ ﻫﻴﺌﺔ ﺍﻟﺘﺪﺭﻳﺲ‬ ‫ﺍﻟﺘﻌﻠﻢ ﺍﻟﻘﺎﺋﻢ ﻋﻠﻰ ﺣﻞ ﺍﻟﻤﻌﻀﻼﺕ ﻋﺒﺮ ﺍﻹﻧﺘﺮﻧﺖ؛ ﺍﻟﻔﺼﻮﻝ ﺍﻻﻓﺘﺮﺍﺿﻴﺔ‬ 89
25 .‫ﺍﺳﺘﺪﺍﻣﺘﻬﺎ‬ 90
26 Abstract 91
27 ‫ ﻗﻤﻨﺎ ﺑﺮﺻﺪ ﻋﺪﺩ ﻭﻣﺪﺓ‬،‫ ﻓﻲ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﻤﺴﺘﻌﺮﺿﺔ ﺍﻟﻮﺻﻔﻴﺔ‬:‫ﻃﺮﻕ ﺍﻟﺒﺤﺚ‬ 92
28 ‫ ﺗﻢ ﻋﻘﺪ ﺍﻟﺪﻭﺭﺍﺕ‬.١٩-‫ﺍﻷﻧﺸﻄﺔ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﺍﻹﻟﻜﺘﺮﻭﻧﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ ﺃﺛﻨﺎﺀ ﺟﺎﺋﺤﺔ ﻛﻮﻓﻴﺪ‬ Objectives: During the COVID-19 pandemic, academic 93
29 ‫ﺍﻟﺘﺪﺭﻳﺒﻴﺔ ﻟﻺﺟﺮﺍﺀﺍﺕ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻟﻠﻔﺼﻮﻝ ﺍﻻﻓﺘﺮﺍﺿﻴﺔ ﻭﺍﻟﺘﻘﻴﻴﻢ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ ﻟﻠﻤﻌﻠﻤﻴﻦ‬ institutions are promptly shifting all educational activities 94
30 ‫ ﻭﺭﺗﺒﺖ ﻟﺠﻨﺔ ﺍﻟﺘﻘﻴﻴﻢ ﺍﻹﻟﻴﻜﺘﺮﻭﻧﻲ ﺍﻟﻤﻨﺸﺄﺓ ﺣﺪﻳﺜﺎ ﻣﺨﺘﻠﻒ ﺍﻟﺘﻘﻴﻴﻤﺎﺕ‬.‫ﻭﺍﻟﻄﻠﺒﺔ‬ to the e-learning format. The present work describes 95
31 ‫ ﺗﻢ ﻣﻘﺎﺭﻧﺔ ﻣﺘﻮﺳﻂ ﺩﺭﺟﺎﺕ ﻧﻔﺲ ﺍﻟﻄﻠﺒﺔ ﺃﺛﻨﺎﺀ ﺟﻠﺴﺎﺕ ﺍﻟﺘﻌﻠﻢ ﺍﻟﻘﺎﺋﻢ ﻋﻠﻰ‬.‫ﺍﻹﻟﻴﻜﺘﺮﻭﻧﻴﺔ‬ concurrent procedures for online teaching and assessment 96
32 ‫ ﻛﻤﺎ ﺗﻢ ﻋﻤﻞ‬.‫ﺣﻞ ﺍﻟﻤﻌﻀﻼﺕ ﺳﻮﺍﺀ ﻋﻘﺪﺕ ﻭﺟﻬﺎ ﻟﻮﺟﻪ ﺃﻭ ﺗﻢ ﻋﻘﺪﻫﺎ ﺇﻟﻜﺘﺮﻭﻧﻴﺎ‬ performed at the College of Medicine, Qassim University, 97
33 ‫ ﻭﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻷﺳﺒﻮﻋﻴﺔ ﻟﺘﺼﻮﺭ ﺃﻋﻀﺎﺀ ﻫﻴﺌﺔ ﺍﻟﺘﺪﺭﻳﺲ‬،‫ﻭﺗﺤﻠﻴﻞ ﺍﺳﺘﺒﺎﻧﺔ ﺭﺿﺎ ﺍﻟﻄﻼﺏ‬ 98
KSA. We also explored the impact of e-learning and
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.‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺧﺒﺮﺍﺕ ﺟﻠﺴﺔ ﻣﺠﻤﻮﻋﺔ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻦ ﺍﻟﺘﻌﻠﻢ ﺍﻹﻟﻴﻜﺘﺮﻭﻧﻲ‬ assessment on the performance of students and faculty, 99
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and the challenges to their sustainability.
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‫ ﺳﺎﻋﺔ ﺷﻤﻠﺖ‬٩٩٤ ‫ ﻓﺼﻼ ﺍﻓﺘﺮﺍﺿﻴﺔ ﺑﻨﺠﺎﺡ ﻋﻠﻰ ﻣﺪﻯ‬٦٢٠ ‫ ﺗﻢ ﺗﻨﻔﻴﺬ‬:‫ﺍﻟﻨﺘﺎﺋﺞ‬
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‫ ﻭﺍﻟﻨﺪﻭﺍﺕ‬،‫ ﻭﺟﻠﺴﺎﺕ ﺍﻟﺘﻌﻠﻢ ﺍﻟﻘﺎﺋﻢ ﻋﻠﻰ ﺣﻞ ﺍﻟﻤﻌﻀﻼﺕ‬،‫ﺍﻟﻤﺤﺎﺿﺮﺍﺕ ﺍﻟﻨﻈﺮﻳﺔ‬ Methods: In this descriptive cross-sectional study, we
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‫ ﻻﺣﻈﻨﺎ ﺯﻳﺎﺩﺓ ﺫﺍﺕ ﺩﻻﻟﺔ ﺇﺣﺼﺎﺋﻴﺔ ﻓﻲ ﻣﺘﻮﺳﻄﺪﺭﺟﺎﺕ ﺍﻟﻄﺎﻟﺒﺎﺕ‬.‫ﻭﺣﻠﻘﺎﺕ ﺍﻟﻨﻘﺎﺵ‬ recorded the number and duration of different online
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40 ‫ ﻋﻜﺲ ﺃﻛﺜﺮ ﻋﺪﺩ‬.‫ﺃﺛﻨﺎﺀ ﺍﻟﺠﻠﺴﺎﺕ ﺍﻹﻟﻜﺘﺮﻭﻧﻴﺔ ﻟﻠﺘﻌﻠﻢ ﺍﻟﻘﺎﺋﻢ ﻋﻠﻰ ﺣﻞ ﺍﻟﻤﻌﻀﻼﺕ‬ educational activities during the COVID-19 pandemic.
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41 ‫ ﻣﻦ ﻃﻼﺏ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻷﺳﺎﺳﻴﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺃﻋﻀﺎﺀ ﻫﻴﺌﺔ‬٪٥٢.٨٢ ‫ﻣﻤﻜﻦ‬ Training sessions for various procedures of virtual
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42 ‫ﺵ‬ ‫ﺭ‬‫ﻭ‬ ‫ﻭ‬ ‫ﻲ‬ ‫ﻧ‬‫ﻭ‬ ‫ﺮ‬‫ﺘ‬‫ﻜ‬ ‫ﻴ‬‫ﻟ‬ ‫ﻹ‬‫ﺍ‬ ‫ﻢ‬ ‫ﻴ‬‫ﻴ‬‫ﻘ‬ ‫ﺘ‬‫ﻟ‬ ‫ﺍ‬ ‫ﻭ‬ ، ‫ﺔ‬‫ﻴ‬‫ﺿ‬ ‫ﺍ‬ ‫ﺮ‬‫ﺘ‬ ‫ﻓ‬‫ﻻ‬ ‫ﺍ‬ ‫ﻝ‬‫ﻮ‬‫ﺼ‬ ‫ﻔ‬ ‫ﻟ‬ ‫ﺍ‬ ‫ﻩ‬ ‫ﺎ‬‫ﺠ‬ ‫ﺗ‬ ‫ﻲ‬‫ﻟ‬ ‫ﺎ‬ ‫ﻌ‬‫ﻟ‬ ‫ﺍ‬ ‫ﻰ‬ ‫ﺿ‬ ‫ﺮ‬‫ﻟ‬ ‫ﺍ‬ ‫ﺲ‬ ‫ﻳ‬‫ﺭ‬ ‫ﺪ‬ ‫ﺘ‬‫ﻟ‬ ‫ﺍ‬ classrooms and online assessments were organised for Q7
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43 .‫ﺍﻟﻌﻤﻞ ﺍﻹﻟﻜﺘﺮﻭﻧﻴﺔ‬ teachers and students. A newly established e-assessment
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44 committee arranged different online assessments. A 109
45 comparison between the mean problem-based learning 110
46 (PBL) grades of the same students was conducted either 111
* Corresponding address: Department of Pathology, College of
47 face-to-face or online. A student satisfaction survey and Q8Q9 112
Medicine, Qassim University, P.O. Box 6655, Buraidah, 51452,
48 online staff focus group about the online learning expe- 113
KSA
49 riences were conducted, and weekly staff perception re- 114
E-mail: waleedmonem@qumed.edu.sa (W. Al Abdulmonem)
50 ports were prepared. The results obtained were then 115
Peer review under responsibility of Taibah University.
51 analysed. Q10 116
52 117
53 Results: A total of 620 virtual classrooms were success- 118
54 Production and hosting by Elsevier
fully implemented over 994 h including theoretical 119
1658-3612 Ó 2020 Taibah University.
Production and hosting by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/
licenses/by-nc-nd/4.0/). https://doi.org/10.1016/j.jtumed.2020.09.005
Please cite this article as: Elzainy A et al., Experience of e-learning and online assessment during the COVID-19 pandemic at the College of Medicine, Qassim
University, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2020.09.005
 JTUMED653_proof ■ 22 October 2020 ■ 2/7

2 A. Elzainy et al.

1 lectures, PBL sessions, seminars, and tutorials. A signif- satisfaction and performance. It also aimed to compare the 66
2 icant increase in the mean PBL grades was observed for scores of male and female students during both face-to-face 67
3 female students during the online sessions. Out of the and online PBL sessions, and to explore the expected chal- 68
4 Q11 basic year students and staff, 58.82% reflected their high lenges of this experience to sustain its future implementation 69
5 satisfaction towards virtual classrooms, online assess- after the COVID-19 pandemic. 70
6 ment, and online workshops. 71
7 Materials and Methods 72
8 73
Conclusion: The present study elaborates on the benefits
9 74
of e-learning and assessment. We observed higher student Study design
10 75
achievements and promising staff perceptions with
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obvious improvement in their technological skills. These
12 This was a descriptive observational study conducted over Q16 77
13 findings support the shift towards future implementation 78
65 days. During this period, four weeks of PBL sessions were
14 of more online medical courses. 79
accomplished for the basic year students.
15 80
16 Keywords: COVID-19; Pandemic; e-Learning; Online 81
Study participants
17 Q12 assessment; Online PBL; Virtual classroom 82
18 83
Ó 2020 Taibah University. The study collected data from all the undergraduate stu-
19 84
Production and hosting by Elsevier Ltd. This is an open dents, involved in this e-learning experience, of preclinical
20 85
21
access article under the CC BY-NC-ND license (http:// phase (n ¼ 425) (male students ¼ 252; female students ¼ 173) 86
22
creativecommons.org/licenses/by-nc-nd/4.0/). and clinical phase (n ¼ 249) (male students ¼ 155; female 87
23 students ¼ 94), and 120 instructors (47 basic and 73 clinical). 88
24 Data of 23 students were not included as they dropped out 89
25 from both the basic and clinical phases. The aim and pro- Q17 90
26 Introduction cedure of the study were clarified to the participating stu- 91
27 dents and staff, and their consents were obtained. Students’ Q18 92
28 The COVID-19 pandemic has led to the global disruption identity will not be disclosed for ethical reasons. The confi- 93
29 of medical education which necessitated working online.1 dentiality of the information obtained was maintained. 94
30 Urgent response to the current situation required an 95
31 increase in medical educators’ awareness towards online Setting 96
32 97
teaching.2 Several researches determined the effectiveness
33 All theoretical activities, including lectures, PBL, tuto- 98
of digital technologies for life-long e-learning and contin-
34 99
uous professional development.3 E-Learning has been rials, and seminar sessions, in College of Medicine at Qassim
35 100
established worldwide in response to the shortage of health University were adapted to the e-learning modality through
36 101
37 Q13 educators and the need to switch into TEAL.4,5 E-learning the Blackboard, version 9.1 (Blackboard, Washington, DC)
102
Q14 has several advantages, such as encouraging students for and Zoom Cloud Meetings. The authors contributed to the Q19
38 103
39 self-directed learning6 and updating the curricula.7 rescheduling of timetables for all these activities. All practical
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40 The College of Medicine at Qassim University, estab- or clinical sessions were postponed. Webinars about virtual 105
41 lished in 2001, adopted the PBL system as an interactive classrooms and online assessments were presented for staff 106
42 educational strategy.8 The college shifted into digitalised and students. An e-assessment committee was established for 107
43 PBL materials for one year, which was a good preparation the first time consisting of thirteen membersdnine basic 108
44 for complete online PBL sessions. Recent technologies scientists and four clinical staff. This committee formulated, 109
45 allowed the progressive innovation of e-learning.9,10 revised, and uploaded the online assessments with their lo- 110
46 Several studies have investigated the benefits of these gistics and evaluated the results using item analysis. 111
47 technologies in medical education, especially the PBL 112
48 system.11,12 Official online platforms, mainly through the Measures 113
49 Blackboard learning management system (LMS) version 114
50 9.1 (Blackboard, Washington, DC), are used in Qassim The educational strategies for the live streaming sessions, 115
51 university to conduct educational sessions including during the COVID-19 pandemic, at the College of Medicine 116
52 lectures, tutorials, PBL sessions, seminar presentations, and at Qassim University included lectures, PBL sessions, tuto- 117
53 open discussion forums. Online formative assessments, 118
rials, and seminar presentations to achieve the course ob-
54 119
through the Blackboard, were also performed. These jectives. Comparisons of the mean PBL marks during control
55 120
assessments reflect the nature of online learning and give (face-to-face) and online (virtual) sessions were done for
56 121
Q15 the students more responsibility for their learning.13 Online male and female students of the first and third years. Second-
57 122
assessment allows the learners to demonstrate their year students were excluded as they started a new block with
58 123
59
capabilities in critical thinking and solving problems, which the shift to e-learning. The students completed an online 124
60 are the key benefits of shifting from traditional teaching to satisfaction survey on their perceptions of the e-learning 125
61 e-learning where the teacher is mainly a facilitator.14 experience, with a 5-point Likert scale. Weekly reports con- 126
62 The present study described the procedures performed to cerning staff perceptions on the effectiveness of live stream- 127
63 facilitate the urgent transition to e-learning and online ing activities were collected with a 3-point Likert scale. 128
64 assessment during the COVID-19 pandemic and to highlight The Cronbach’s alpha test was used for testing the in- 129
65 its expected benefits and impact on student and staff ternal consistency and reliability of the students’ and staff’s 130

Please cite this article as: Elzainy A et al., Experience of e-learning and online assessment during the COVID-19 pandemic at the College of Medicine, Qassim
University, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2020.09.005
 JTUMED653_proof ■ 22 October 2020 ■ 3/7

e-Learning during COVID-19 3

1 Q20 perceptions. Kendall’s tau B, a nonparametric measure of mean PBL marks of the female students of the first and third 66
2 association that exists between two variables, was used to test years than that of the male students of the relevant year in 67
3 the correlation of the items of the students’ survey. both face-to-face and online sessions (Tables 3 and 4). 68
4 An online focus group for the staff, using the Focus- Two hundred and fifty students of the preclinical phase Q23
69
5 GroupIt software (https://www.focusgroupit.com/), was (58.82%) completed the perception survey. Students’ satis- 70
6 performed. The questions were presented in the form of a faction towards the new modality of e-learning and online 71
7 72
SWOT analysis (Figure 1). The group was composed of one assessment was reported (Table 5). The items covered in the
8 73
moderator, one observer, and seven participants (the students’ survey included the following: the success of e-
9 74
supervisors of basic sciences departments and one learning in compensating for the urgent suspension of face-
10 75
radiology staff). The two-hour-long online synchronous to-face teaching during the COVID-19 pandemic, efficiency
11 76
12
focus group discussion was recorded. The analysed data were of instructions announced before the online teaching, staff’s 77
13 reviewed and interpreted by an independent investigator. resistance and experience in e-learning requirements, and 78
14 The data were analysed using the Statistical Package for the effectiveness of online assessment in testing their knowledge 79
15 Social Sciences (SPSS) software, version 21 (IBM Corp., and skills levels. The Cronbach’s alpha test performed for all 80
16 Q21 Armonk, NY). Descriptive statistics (percentages, mean, and items of this survey resulted in an overall score of 0.67. Q24 81
17 standard errors of the mean) were used to describe the Kendall’s tau B was used to test the correlation of these 82
18 quantitative variables with their analysis through paired- items. The correlation coefficient ranged from 0.134 to 0.394. 83
19 samples (to compare the male and female mean PBL Open-ended comments were received from 225 out of 250 84
20 marks) and independent t-tests (to compare the mean marks students (90%), which were classified into two catego- 85
21 of the face-to-face and online PBL sessions). A p-value of riesdone for teaching activities and the other for online 86
22 <0.05 was considered significant. assessment. Eighty-seven per cent (n ¼ 195) of the students Q25 87
23 reflected their enthusiasm towards the e-learning modality: 88
24 Data collection for example, ‘Very amazing; online teaching experience is the 89
25 future of learning’ and ‘Online lectures are super-satisfying’. Q26
90
26 They expressed their satisfaction in having the same staff 91
Weekly reports though the official learning management
27 delivering the lectures for both male and female students. E- 92
systemdBlackboarddregarding the number, duration, and
28 Learning provided a chance for the shy studentsdas they 93
modality of different educational activities including the live
29 94
streaming sessions and students’ attendance rate were could participate freely through online chattingd and
30 95
collected from the course organisers in coordination with the motivated them for verbal discussions: ‘Initially, I was shy
31 96
e-learning unit, phase coordination, and e-assessment com- and shared my opinions during the open discussions only
32 97
mittees. Evaluation of students during their e-learning through chat; by the time I was encouraged to share orally’. Q27
33 98
34 experience was done based on their assessment during the They expressed satisfaction with the rescheduling of educa- 99
35 online PBL sessions. tional activities and their allocated time and duration; for 100
36 example, ‘Modification of the timetable allows more time for 101
37 Results educational and recreational activities, thus allowing to live 102
38 like a normal human’. The students expressed that some of 103
39 Tables 1 and 2 present the details regarding the virtual the staff lacked adequate experience in conducting open 104
40 classrooms, conducted mostly through Blackboard, of the discussions during online teaching. Seventy per cent 105
41 preclinical and clinical phases. They represent the numbers (n ¼ 158) of the students reported that frequent online 106
Q22
42 of e-learning activities successfully implemented. quizzes motivated them to study; for example, ‘Online 107
43
Significant increase in the mean PBL marks of the female quizzes are very helpful to improve my grades’. They 108
44
students of both first and third years was observed during the appreciated the conduction of the mock quiz; for example, 109
45 ‘Mock exam was very helpful for training before the online 110
online sessions than in the face-to-face sessions of the rele-
46 exams’. Electronic assessment ensured fewer errors carried 111
vant year. Additionally, there was a significant increase in the
47 112
48 113
49 114
50 115
51 116
52 117
53 118
54 119
55 120
56 121
57 122
58 123
59 124
60 125
61 126
62 127
63 128
64 129
65 Figure 1: e-Learning and online assessment e- SWOT analysis. 130

Please cite this article as: Elzainy A et al., Experience of e-learning and online assessment during the COVID-19 pandemic at the College of Medicine, Qassim
University, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2020.09.005
 JTUMED653_proof ■ 22 October 2020 ■ 4/7

4 A. Elzainy et al.

1 66
2
Table 1: Virtual classrooms for the students of the preclinical phase. 67
3 Students’ Year Live streaming Duration Number of Students Educational Activity 68
4 Bb Zoom (hours) Lecture PBL Seminar 69
5 70
6 First 114 27 231 3634 37 91 13 71
7 Second 108 7 216 3512 31 72 12 72
8 Third 81 34 189 1979 19 84 12 73
Total 303 68 636 9125 87 247 37
9 74
10 Bb: Blackboard. 75
11 76
12 77
13 78
14 Table 2: Virtual classrooms for the students of the clinical phase. 79
15 80
Students’Year Live streaming Duration Number of Students Educational Activity
16 81
17 Bb Zoom (hours) Lecture Tutorial Seminar 82
18 Fourth 82 24 169 3805 79 27 0 83
19 Fifth 99 39 189 5031 159 0 17 84
20 Total 181 63 358 8836 238 27 17 85
21 86
Bb: Blackboard.
22 87
23 88
24 89
25 Table 3: Comparing the mean PBL marks of the first year out by the students while filling out bubbles in their answer Q28 90
26 students. sheets. Lastly, they recommended that some courses could be 91
27 implemented online in the future. Staff satisfaction in virtual 92
PBL sessions First Year Students
28 classrooms was also observed (Tables 6 and 7), which 93
29 Male Female reflected that the live streaming sessions were very effective. 94
30 N 84 56 The online focus group discussion was categorised into 95
31 Control PBL (Face-to-face) 4.41  0.09 4.72  0.07b four themes based on the SWOT analysis. Concerning the 96
32 Online PBL (Virtual classes) 4.54  0.08 4.94  0.02a,c strengths, most of the staff agreed that the new arrangement 97
33 a of educational activities efficiently compensated for the sus- 98
Significant to control female.
34 b pension of face-to-face teaching. They were satisfied with the 99
Significant to control male. Q29
35 c university’s efforts to improve staff awareness regarding 100
Significant to online male (paired and independent t-test).
36 virtual classrooms and online assessment through webinars. 101
Q30
37 102
The majority of them appreciated the tremendous shift to
38 Table 4: Comparing the mean PBL marks of the third year 103
implement online summative assessments; for example,
39 students. 104
‘Online assessment assured the staff about students’
40 105
PBL sessions Third Year Students achievement of learning outcomes’ and ‘Conduction of live
41 106
42 Male Female
oral exams based upon clear standardised checklist was 107
43 highly effective’. The concerns expressed by the participants 108
N 78 59 included some staff’s limited online teaching experience and
44 Q31 109
Control PBL (Face-to-face) 4.39  0.1 4.54  0.09b
45 the insufficient number of IT technicians which interferes 110
Online PBL (Virtual classes) 4.73  0.08 4.88  0.03a,c
46 with proper digitalisation. Regarding the opportunities that 111
a
47 Significant to control female. could be gained, the staff acknowledged the constitution of 112
b
Significant to control male. the e-assessment committee in the focus group; ‘Such com-
48 c 113
Significant to online male (paired and independent t-test). mittee was an urgent requirement to tackle the full
49 114
50 115
51 116
52 Table 5: Students’ survey for e-learning and online assessment. 117
53 118
54 # Question N SA A NAD D SD 119
55 n % n % N % n % n % 120
56 121
1 E-Learning compensated the suspension of face-to-face teaching 250 92 36.8 103 41.2 30 12.0 19 7.6 6 2.4
57 due to the COVID-19 pandemic 122
58 2 Educational activities got enough time during the online teaching 250 75 30.0 97 38.8 43 17.2 25 10.0 10 4.0 123
59 3 Staff have enough experience in e-learning requirements 250 19 7.6 81 32.4 74 29.6 62 24.8 14 5.6 124
60 4 Interaction during online session was satisfactory 250 50 20.0 95 38.0 52 20.8 38 15.2 15 6.0 125
61 5 Announced instructions before quizzes are useful and sufficient 250 96 38.4 91 36.4 31 12.4 20 8.0 12 4.8 126
62 6 Online assessments are effective to test the knowledge level 250 66 26.4 84 33.6 41 16.4 34 13.6 25 10.0 127
63 7 Do you suggest online teaching for some theoretical courses? 250 149 59.6 49 19.6 13 5.2 14 5.6 25 10.0 128
64 129
SA: strongly agree, A: agree, NAD: neither agree nor disagree, D: disagree, SD: strongly disagree.
65 130

Please cite this article as: Elzainy A et al., Experience of e-learning and online assessment during the COVID-19 pandemic at the College of Medicine, Qassim
University, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2020.09.005
 JTUMED653_proof ■ 22 October 2020 ■ 5/7

e-Learning during COVID-19 5

1 skills efficiently. Murphy19 recently reported that most 66

2
Table 6: Staff satisfaction in virtual classrooms of the pre- 67
medical schools suspended the clinical settings during the Q34
3 clinical phase. 68
COVID-19 pandemic. This could be overcome by using
4 Students’ Number of Very Somewhat Not virtual-reality simulators.20,21 69
5 Year educational Effective Effective Effective Unfortunately, most of the students were unsatisfied with 70
6 activities 71
N % N % N % how some staff members practiced e-learning. A previous
7 72
First 141 118 83.69 22 15.60 1 0.71 study performed in a similar culturedUnited Arab Emir-
8 73
Second 115 104 90.43 9 7.83 2 1.74 atesdobserved that the teachers felt worried about the shift
9 74
Third 115 100 86.96 14 12.17 1 0.87 into a new educational strategy. Psychological assurance was
10 75
Total 371 322 86.79 45 12.13 4 1.08 recommended to encourage them to deal with the unknown
11 76
12
consequences. Multiple webinars about proper virtual 77
13 classrooms and peer sharing of experiences between the staff 78
14 members solved this problem. Goh et al.18 claimed that live 79
15 Table 7: Staff satisfaction in virtual classrooms of the clinical streaming applications will improve the technological skills 80
16 phase. of the educators. PIVOT MedEd22 appreciated the free e- 81
17 learning webinars for health professional educators 82
Students’ Number of Very Somewhat Not
18 Year educational Effective Effective Effective
worldwide and the national coordination between medical 83
19 activities schools in sharing such training courses. Successful 84
20 N % N % N % collaborative online learning demanded the support of IT 85
21 Fourth 106 89 83.96 15 14.15 2 1.89 technicians, as previously reported.16,23 The Cronbach’s 86
22 Fifth 138 133 96.38 5 3.62 0 0.00 alpha test implied that the survey tool had a good level of 87
23 Total 244 222 90.98 20 8.20 2 0.82 internal consistency and reliability for both the students’ 88
24 survey and staff’s overall satisfaction in the live streaming 89
25 experience. The correlation coefficient indicated that the 90
26 items in the students’ survey were well correlated. 91
27 responsibility for online assessments’. They reflected the 92
However, the application of Kendall’s tau B test on the
28 improvement of their expertise towards the novel pedagog- 93
staff perception was non-feasible since it measures the as-
29 ical e-learning techniques and their enthusiasm to construct 94
sociation between two variables, unlike the current study
30 online courses; for example, ‘Adoption of electronic courses 95
which focused on the staff perception on the effectiveness of
31 allows better arrangement of educational activities and gives 96
virtual classrooms.
32 more chances for students’ self-directing learning’. Two staff 97
The higher achievement level detected in the mean marks
33 members reported the inconvenience of some students in 98
34
of online PBL compared with face-to-face sessions could be 99
taking the online quizzes, especially during the initial period,
35 attributed to the easier access to the explanation of the 100
Q32 while the others specifically talked about those who live in
36 phenomena. The students’ assessment during the PBL ses- 101
distant rural areas with insufficient internet coverage. Four
37 sions in this work was based upon their commitment, team 102
staff members emphasised the limited capabilities of the
38 spirit, interaction with peers and tutors, presentation skills, 103
official version of Blackboard, particularly in conducting the
39 and ability for brain storming and analysing the phenomena. 104
morning sessions.
40 The students’ assessment during the PBL sessions was based 105
41 upon their performance during the session rather than their 106
Discussion
42 achievements through other summative assessment methods 107
43 such as multiple choice questions which are associated with 108
44 Advanced technologies emerged during the COVID-19 higher chances of cheating.24 Q35 109
45 pandemic to sustain world productivity. The Horizon 2020 These findings are in agreement with the previous study25 110
46 Teaching and Learning report highlighted the role of advanced which observed that online PBL enhanced critical thinking 111
47 technology in medical education. The present study represents and fulfilled the intended learning objectives. Therefore, 112
48 the major change in the educational culture. E-learning was online PBL could enhance the metacognitive skills, ability 113
49 highly beneficial for competent educators as it decreased the to solve problems, and team working. Collaborative 114
50 needs for in-class attendance.15 In agreement with McCoy interaction in the online environment helped enhance peer 115
51 et al.,16 students and staff reflected that live streaming sharing.26 After the SARS epidemic, one medical school in 116
52 lectures efficiently compensated the suspension of face-to- 117
China adopted online PBL as an educational strategy for
53 face teaching and provided more chances for open discus- 118
the subsequent years.1 The higher PBL scores in female
54 sions. Nomination of the same staff to virtually present each 119
students could be attributed to the difference in the style of
55 topic for both male and female students encouraged more peer 120
56
thinking, learning, and capabilities of problem-solving.27 121
Q33 sharing and competition among the students. The rescheduled Makonye28 detected that female students have more ability
57 122
educational activities were more convenient to the students, as for knowledge perception and reflection of their own ideas,
58 123
reflected in their attendance. Recent technologies resolved the and a higher competitive attitude. Additionally, this gender
59 124
lack of physical attendance and increased learning effective- variation in PBL scores could be due to a higher
60 125
ness.17,18 The Horizon 2020 report highlighted the effectiveness commitment of female students in attending different
61 126
62
of online teaching in overcoming the restrictions such as educational activities.29 However, Ajai and Imoko30 127
63 shortage of venues for large group lectures. However, one of observed equal performance of male and female students in 128
64 the main challenges of e-learning, as reflected in the current PBL sessions, and recommended further studies to examine Q36 129
65 work, is in teaching the psychomotor, practical, and clinical the underlining causes. 130

Please cite this article as: Elzainy A et al., Experience of e-learning and online assessment during the COVID-19 pandemic at the College of Medicine, Qassim
University, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2020.09.005
 JTUMED653_proof ■ 22 October 2020 ■ 6/7

6 A. Elzainy et al.

1 Validity and reliability of assessment should be established strategy with great educational potentials, after the WHO’s 66
2 to ensure students’ achievement of the learning objectives.14 declaration of the COVID-19 pandemic. This successful 67
3 The ability to solve any technical obstacle met during the digital learning environment was observed in terms of stu- 68
4 online mock exam helped the e-assessment committee to dent and staff satisfaction, achievement, and improvement of 69
5 manage the subsequent exams appropriately.25 Results of technological educational skills. 70
6 the online assessments and their item analysis represented 71
7 Recommendations 72
evidence-based high-quality evaluation. This perception was
8 73
supported by Jawaid et al.31 and Bandele et al.32 who reported
9 74
that students expressed a more positive attitude towards The present study recommends a sustained monitoring
10 75
online exams. Similar findings were also observed by Martin and updating of the e-learning resources, particularly the
11 76
12
et al.33 who emphasised that ideal assessment was based official LMS, and availability of sufficient number of infor- 77
13 upon optimal evaluation strategies. The online tests were mation technology personnel. Multiple webinars and work- 78
14 revised by the e-assessment committee, in coordination with shops suggested increasing the student and staff awareness of 79
15 the supervisors of the relevant departments, to estimate online teaching and assessment via improving the current Q39 80
16 sufficient time for each exam. Redistribution of students’ faculty development program. Furthermore, the adoption of 81
17 grades towards more objective assessment strategies such as teaching through complete and partially online courses, and 82
18 PBL, seminar presentations, and oral assessments was kept a total shift from physical attendance for PBL sessions to 83
19 in consideration. This minimised the subjectivity of grading, online ones are encouraged in the future. 84
20 as expressed in the feedback gained from the focus group, 85
21 and discrepancy in students’ grades, in agreement with Availability of data and material 86
22 Ozden et al.34. The procedures implemented during the 87
23 online exams to minimise the chance of cheating and 88
24
All data are available from the corresponding author 89
unauthorised collaboration with peers included scheduling
25 upon reasonable request. 90
of brief exams of not more than 30 min with a timer set for
26 Q37 the whole exam and also for each individual question. 91
27 Source of funding 92
Formulation of a considerable number of scenario-based
28 questions was implemented focusing on higher-order critical 93
29
thinking, following the Bloom’s taxonomy.35 Questions and Researchers would like to thank the Deanship of Scien- 94
30 tific Research, Qassim University for funding the publication 95
answer choices were randomised; each question was
31 of this project. 96
presented on a separate page with forced completion of Q40
32 97
these questionsdstudents were not allowed to return to the
33 Conflict of interest 98
34
previously-submitted questionsdin agreement with Fonta- 99
35 nillas et al.36. A backup version of the questions with the same 100
36 difficulty index was prepared for those students who The authors have no conflict of interest to declare. 101
37 experienced technical difficulties during submission. The 102
38 answers were not displayed to the students until the Ethical approval 103
39 examiner’s permission was obtained and all participants had 104
40 Q38 completed answering. Ethical approval was taken from the ethical committee of 105
41 The potential use of TEAL in medical educationdthe Qassim University. 106
42 future learning eradis expected after the resolution of the 107
43 COVID-19 pandemic. Analysis of the benefits of e-learning in Consent 108
44 the present study could help the decision-makers of educa- 109
45 tional policies and committees of curriculum reform to 110
Written informed consents were obtained from all the
46 implement them in the future. Goh and Sandars11 pointed out participants.
111
47 that the medical educators worldwide, being deeply involved 112
48 in the current tremendous shift towards e-learning, have to 113
49
Authors contributions 114
adapt to the current major educational challenges.
50 Appropriate e-learning resources should be available to 115
51
guarantee the implementation of these enormous changes. WAA conceived and designed the study, conducted 116
52
More use of technological tools will enable the medical research, provided research materials, and collected and 117
53
schools to establish the active process of e-learning.37 The organised the data. AE and AES analysed and interpreted 118
54 the data. All authors wrote the initial and final drafts of the 119
Horizon 2020 report focused on ‘learning engineering’ such
55 article, and provided logistic support. All authors have crit- 120
56
as the virtual reality simulators to facilitate the rapid 121
development of teaching and learning. Online courses form ically reviewed and approved the final draft and are
57 responsible for the content and similarity index of the 122
58 one of the key success factors to achieve the program 123
learning outcomes of medical graduates. manuscript.
59 124
60 Acknowledgment 125
Q41
61 Conclusion 126
62 127
The authors would like to acknowledge the College of
63 The current work explored the benefits of the shift to- 128
Medicine, Qassim University for the generous facilitation of
64 wards e-learning and online assessment, which is a promising 129
the required learning resources.
65 130

Please cite this article as: Elzainy A et al., Experience of e-learning and online assessment during the COVID-19 pandemic at the College of Medicine, Qassim
University, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2020.09.005
 JTUMED653_proof ■ 22 October 2020 ■ 7/7

e-Learning during COVID-19 7

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Please cite this article as: Elzainy A et al., Experience of e-learning and online assessment during the COVID-19 pandemic at the College of Medicine, Qassim
University, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2020.09.005