Medical Education and E-Learning During COVID-19 Pandemic: Awareness, Attitudes, Preferences, and Barriers Among Undergraduate Medicine and Nursing Students at Makerere University, Uganda

Abstract

Given the dearth need for healthcare workers in the control of the ongoing COVID-19 pandemic, e-learning has been adopted in many settings to hasten the continuation of medical training. However, there is a paucity of data in low resource settings on the plausibility of online learning platforms to support medical education. We aimed to assess the awareness, attitudes, preferences, and challenges to e-learning among Bachelor of Medicine and Bachelor of Surgery (MBChB) and Bachelor of Nursing (B.NUR) students at Makerere University, Uganda. An online cross-sectional study was conducted between July and August 2020. Current MBChB and B.NUR students aged 18 years or older constituted the study population. Using Google forms, a web-based questionnaire was administered through the Makerere University mailing list and WhatsApp messenger. The questionnaire was developed using validated questions from previously published studies. Overall, 221 participants responded (response rate = 61%). Of the 214 valid responses, 195 (92.1%) were Ugandans, 123 (57.5% were male, and 165 (77.1%) were pursuing the MB ChB program. The median age was 23 (18 to 40) years. Ownership of computers, smartphones, and email addresses were at 131 (61.2%), 203 (94.9%), and 208 (97.2%), respectively. However, only 57 (26.6%) respondents had access to high or very high quality internet access. Awareness and self-reported usage of e-learning (MUELE) platforms were high among 206 (96.3%) and 177 (82.7%) respondents, respectively. However, over 50% lacked skills in using the Makerere University e-learning (MUELE) platform. About half (n = 104, 49%) of the students believed that e-learning reduces the quality of knowledge attained and is not an efficient method of teaching. Monthly income (P = .006), internet connectivity quality (P < .001), computer ownership (P = .015) and frequency of usage of academic websites or applications (P = .006) significantly affected attitudes towards e-learning. Moreover, internet costs and poor internet connectivity were the most important barriers to e-learning reported by 199 (93%) and 179 (84%) students, respectively. Sensitization and training of students and faculty on e-learning and use of existing learning platforms are important to improve the attitude and use of e-learning. Blended online and use of offline downloadable learning materials would overcome the challenges related to the variable quality of internet access in the country.

Keywords: COVID-19; Medical education; Uganda; attitudes; challenges; e-learning; medicine and nursing students.