Navigating undergraduate medical education: a comparative evaluation of a fully online versus a hybrid model

Background: The evaluation of undergraduate medical curricula plays a crucial role in ensuring effectiveness and helps in continuous improvement of the learning process. This study aims to compare the effectiveness of online and hybrid teaching models of the first-year MBBS curriculum in the COVID-19 era (2019-20) and the para-COVID-19 pandemic (2020-21).

Study methodology: Mixed methods study with CIPP model was used. Data was collected by administering a survey and focus group discussions (FGDs) with first-year students from the 2019-2020 and 2020-2021 cohorts, faculty and administrators, which were recorded for analysis. Recorded lectures, guidebooks, planners, and question papers were also scrutinized for quality and adequacy. Furthermore, admission merit, module assessments, and professional examination results were compared and correlated. The learning environment was evaluated through the questionnaire (validated and used by Pakistan Medical and Dental council for inspections of medical schools) and the facilities provided in both years were juxtaposed. The study utilized NVIVO for qualitative and SPSS version 23 for quantitative data analysis.

Results: Contextual analysis underscored the critical need for online teaching during the COVID-19 pandemic, with provided resources being deemed sufficient. Notably, the student-faculty ratio stood at 4:1, and essential resources were readily available. The fully online batch outperformed the hybrid teaching class in 2020-21. Process analysis revealed successful session delivery in hybrid and online through webinars and Zoom, accompanied by timely provision of study guides and punctual assessments. Moreover, examination papers demonstrated acceptable reliability (Cronbach's alpha: 0.61) in core subjects. Product analysis indicated that the 2020-21 cohort performed better in modular and professional examinations across all subjects (P < 0.01) despite their lower admission merit compared to the 2019-20 batch.

Conclusions: The study revealed challenges faced during total online teaching, highlighting knowledge and skills gaps in students. While students favored hybrid teaching for interaction, faculty preferred online strategies and suggested blended learning. The administration recognized faculty's swift transition but stressed the need for blended learning workshops and strengthening the medical education department. Recommendations include implementing blended learning strategies, conducting faculty workshops, equipping the medical education department for online teaching, and gathering student feedback after each module to enhance the curriculum.