Abstract:

Background:
Due to COVID-19 distancing safety measures, medical students were faced with learning through online platforms. Researchers have suggested that in-person social interaction can be a source of social support among medical students and may serve as an outlet for reducing stress. Lack of in-person social interaction (due to learning online) may serve as a barrier to bonding and social support among medical students, leading to distress and isolation. It is unknown what kind of socioemotional impact the different types of learning modalities (online vs face-to-face) may have on medical students during their early years of training.

Objective:
The objective of this study was to explore associations between certain stressors and social presence, social interaction, and collaborative learning in online and face-to-face courses in preclinical osteopathic medical students during course lecture modality transitions prompted by COVID-19 safety protocols.

Methods:
Cross-sectional data were collected Feb-Mar 2021 from preclinical medical students via an anonymous, online survey. The 40-item Medical Student Stressor Questionnaire (MSSQ) was used to evaluate stress. This measure categorizes stressors into six domains: 1) Academic Related Stressors (ARS), 2) Intrapersonal and Interpersonal Related Stressors (IRS), 3) Teaching and Learning-related Stressors (TLRS), 4) Social Related Stressors (SRS), 5) Drive and Desire-related Stressors (DRS), and 6) Group Activities-related Stressors (GARS). The survey included items developed by So and Brush to measure students’ perceived levels of collaborative learning, social presence, and social interaction. Spearman’s rank order correlations were conducted to investigate associations between the 6 subscales of the MSSQ and social presence, social interaction, and collaborative learning in online and face-to-face courses. Data were analyzed using SPSS v.26.

Results:
One hundred preclinical students aged 22-46 years completed the survey. Regarding online learning, Academic Related Stressors (ARS) was correlated with feeling they had no social presence (p =.340), little social interaction (p=.343), and less collaborative learning (p =.313). With face-to-face learning, ARS was correlated with less social interaction (p=.323) and less collaborative learning (p =.253). Teaching and Learning Related Stressors (TLRS) was correlated with Social Presence with Online Classes (p =.256), Social Interaction with Online Classes (p =.369), and Collaborative Learning with Online Classes (p =.273). Social Related Stressors (SRS) was correlated with Social Interaction with Online Classes (p =.250), Collaborative Learning with Online Classes (p =.223), and Collaborative Learning with Face-to-Face Classes (p =.221). Drive and Desire Related Stressors (DRS) was positively correlated with Collaborative Learning with Online Classes only (p =.218).

Conclusion:
Results indicate there may be associations between social presence, social interaction, and collaborative learning in relation to in-person vs. online learning and stressors among medical students. Understanding the nuances in the types of stress may assist medical school administrators in decision-making regarding when in-person and online learning platforms provide an environment that is optimal for medical students’ emotional as well as academic well-being, even post-COVID-19 pandemic. More research is warranted in this evolving area of medical education.

Keywords:

Collaborative learning, social presence, social interaction, online learning, face-to-face learning, medical education, medical students.