The COVID-19 pandemic has brought the unprecedented universities’s facilities closure, it affected millions of students worldwide. The sudden transformation in the teaching and learning activities into virtual modalities was carried out in order to continue the academic courses while avoiding people gathering and the potential risk of the spread of infection. The present study documented the student perspective of student-centered active learning delivered through full distance learning since March 17, 2020 and compared to the classroom learning in the undergraduate dentistry study program. Full distance learning whereby group discussions were carried out synchronously through the online communication platforms is a new learning method that has not been previously implemented in our dental school. This study was the first to compare the student perceptions on both types of learning methods related to the preference, effectiveness and learning satisfaction reported during the COVID-19 pandemic condition.
The survey demonstrated 44.2% students preferred distance learning over classroom learning. This result was lower than other studies comparing online and traditional learning methods which reported higher preference toward e-learning compared to traditional classroom methods [5, 13, 14]. Student’s attitude and acceptance toward e-learning has been shown to be more positive and favorable. However, in these studies the virtual learning modules were integrated with classroom learning, while in the present study, the distance learning was delivered in full online. It was previously reported that full online learning offers a sense of unreality and it largely depends on the students commitment to the courses . Bridges and colleagues suggested the integration of learning technologies with face-to-face teaching to support access to digital resources and to enhance the visualization . Blended PBL structured similarly as traditional PBL while offering the ability to use online communication tools and online environment to share materials. These differences in the learning methods and the new learning strategy experienced by our dental students might explain the lower percentage of students preferred full distance learning observed in this study.
In this study, the preference on learning methods was influenced by the year of study. Among students who preferred distance learning, the percentage of freshman students was significantly higher than the seniors. Similarly, studies conducted by Sritongthaworn et al. (2006) and Teo at al (2011) reported that younger students tend to adapt to e-learning [17, 18]. One of the factors that contribute to this finding might be related to the curriculum implemented at the time of this study. Senior dental students learned more clinical dental science courses which involve both theory and procedural knowledge and skills. Essentially such courses require laboratory skill sessions to enhance the understanding of the learned subjects. As the execution of dental laboratory works and practical was postponed due to the university closure, this resulted in the lack of motoric skills experiences, less chance of direct consultation with the instructors and less practical assignments that were normally served as the reinforcement to the theory class. While the curriculum of first-year dental students studied more basic dental science courses which are mostly conceptual theories so that the content knowledge acquisition could still be re-enforced by laboratory activities based on online tutorial and exercises in form of video or photographs. It is well comprehended that dental education can not be carried on the same way as medical education. The reason of this difference is that the dental students requires adequate physical setting and psychomotor skills, even since in the academic years, and that could not be replaced by distance learning strategy as being conducted during the pandemic .
Beside the necessary preparedness of students in distance learning methods, other factors such as personality types may influence student preference for e-learning than classroom learning [19,20,21]. As the personality regulates how individuals perceive, make judgements and react in certain situations. The acceptance of students for e-learning is commonly associated with self regulation character. Self regulatory behavior includes the ability to set goals, effective time management, problem solving capacity, and awareness of time to seek advice from instructors [20,21,22]. On top of self regulatory behavior, constraint of self efficacy, e-learning motivation, and high task value are other factors which strengthen the blended/online learning preference [21, 22]. It is interesting to note that despite the lower percentage of distance learning preference observed in this study, students agreed that distance learning could motivate them to prepare the learning materials before group discussion.
Logistic regression analysis confirmed efficiency has the highest odds ratio in relation to preference towards distance learning. Moreover, students recognized there was more time to study and to review study material in distance learning. Such results are in line with previous studies which has been demonstrated that distance learning offers higher flexibility of place of study process, saving time and cost since commuting from and to campus is no longer needed . Well designed distance learning gives more time for students to access more topics and unlimited information. Such advantage suits the learning process of medical and dental students in recent decades since they have to digest increased loads of new and kept updated topics .
Apart from its obvious advantages, distance learning also brings some disadvantages. Increased chances of distraction, complicated technology, limited social interaction, and increased difficulty to stay in contact with instructors are several conditions that might interfere with the success of distance learning . The present study showed more students felt lower learning satisfaction and more difficult communication either with instructors or with peer students in doing distance learning. Internal factors challenges of student readiness to distance learning, time management and difficulty to stay focused for long online learning duration were reported. Besides the students internal factor as mentioned above, other categories of distance learning barriers were also present in the time and environment when this study was conducted. The performance of instructors in charge in the distance learning process of this study were varied in their interactive pedagogy ability, uplifting spirit, and confidence toward utilization of innovative learning. Self efficacy character is importantly demanded not only from students but also from instructors. The quality of teaching is very important in stimulating students’ satisfaction. Special attention to communicate with students is essential since lack of personal contact may affect the development of trust [22, 23]. Peer to peer communication and interaction in a group discussion are not often feasible in the virtual learning method. The barriers associated with infra-structure were obviously also encountered by the students complaining about unstable internet connection and extra financial burden for internet quota. Moreover, stress experienced by one-third of the participants of the study might have an impact on student perspective toward learning method. Recent study also reported students concerned on the issues of economic slowdown, potential academic delay and changes in daily life and these were associated with the level of anxiety of the college student in China during this pandemic time .
The present study demonstrated important findings that are essential for the improvement and development of learning strategies in the future. However, this study had some limitations. First, the generalizability of the study was limited by the use of data from a single university. Second, although students were encouraged to take part in this study, their participation was voluntary. The response rate of 84.3% was below the 90% response rate that was initially targeted. The number of non-respondents may therefore have undermined the power of the study and the potential response bias can not be completely ruled out . The results of the study must therefore be interpreted with caution. Third, the study focused on the preclinical students as its respondents, while the more challenging adaptation in learning strategy in dentistry during the pandemic is critically faced by the clinical students in the profession program. Forth, the questionnaire used in this study only measured student perception. It was unclear how student academic performance was affected by distance learning strategy, whether there were any difficulties encountered by students in understanding course learning outcomes, particularly for senior-year students who received clinical dental science courses and have lower preference toward distance learning. Previously, it was reported a weak correlation between the student perception of learning with the actual gain of knowledge . Student perception may not reflect student understanding of course learning outcomes. Therefore, assessing the impact of distance learning on student academic performance is as crucial for the evaluation of curriculum transformation. This should be further investigated. Despite these limitations, the results of this study offer valuable information on the current perspectives of dental students with regard to full distance learning methods implemented during the COVID-19 pandemic. As student acceptance of learning method play an important role in creating an effective learning environment [27, 28]. Due to the uncertainty in this COVID-19 pandemic time, whereby the situation is still changes, it is essential to design the learning method that is most suited to current situation and to have appropriate plan once it is permissible for classroom teaching to resume its activities, taken into consideration all the necessary protocols for safety and health protection .