Table 1. Dimension and individual item mean scores of student readiness to engage in remote learning

** highest score in the dimension

*lowest score in the dimension

IV. DISCUSSION

This study aimed to identify medical students’ readiness for remote learning across five dimensions and to identify factors associated with their readiness during the early months of the COVID-19 online learning transition period. Although there is significant resumption of usual activities post-COVID-19 pandemic, many of the online and self-directed components of learning are likely to remain as the way forward in the medical curriculum. Therefore, we feel that this study still has relevance currently.  

All mean scores of the subscales Technology Availability (TA), Technology Skills (TS), Technology Usage (TU), Computer and Internet Efficacy (CIE) and Self-directed Learning (SDL), were above 3 on a scale of 1 to 4. The mean scores in our study were much higher and have less deviation than Adams et al’s study conducted in a similar setting before the COVID-19 pandemic, in which the five dimensions scored lower than 3.00, with SDL scoring the lowest mean in the other study at 1.25+1.55 (Adams et al., 2018). Adams et al’s study also did not show much difference when comparing between medicine, social science, science and engineering students (Adams et al., 2018), indicating that readiness for online learning was much lower overall pre-COVID-19.

Despite the increase compared to Adams et al’s study, SDL still scored the lowest in our study out of the five dimensions. An implication of this is that universities need to help learners transition from facilitator/ instructor-driven learning models to self-directed learning models. This can be done by making training in ‘learning to learn’ (L2L) an essential component of student support. In our setting, this training should address items which scored lowest in SDL as these indicate areas of struggle for students; [SDL3] and [SDL5]. It is also possible that some facilitators are not aware of what SDL is, therefore facilitators can also benefit from training for SDL methods.  

Our study demonstrated significantly higher readiness for remote learning among male students in comparison to female students in the domains of SDL and CIE. While some studies indicate no gender differences in e-Learning readiness, other studies also report gender differences such as males having more positive attitudes toward online learning; males being more ready for online learning (Adams et al., 2018) and males using more learning strategies and having better technical skills than females (Alghamdi et al., 2020).  In the CIE domain, males scored higher in the items [CIE2] and [CIE3] which are both related to communication through a virtual platform. This resulted in males scoring higher in the CIE domain in general. The gender disparity in remote learning readiness needs to be addressed as female students are increasingly the majority (and therefore primary stakeholders) in medical schools worldwide. 

The mean score of clinical students was significantly higher than pre-clinical students only in the Technology Availability domain with clinical students reporting better hardware and infrastructure access compared to pre-clinical students. It is likely that as the learners progress through a course, they become more aware of the technological requirements of the course and invest in better devices and internet access. It is also possible that the students’ socioeconomic status at the beginning of their course may not have been good, for example if they were awaiting scholarships to be processed, which subsequently became available later in their course of study. This may have then enabled the students to purchase better hardware and infrastructure further on in their course, during the clinical years. However, this financial aspect was not included our study. It is still worth considering future programs early in the course, where there could be subsidies for students to purchase necessary technological equipment for their studies.  

A. Limitations and Recommendations

One limitation of this study was that it looked at remote learning in general and did not look at clinical elements such as using online simulated patients for history taking classes, or procedural skills videos. The study also only looked at student perspectives, and not faculty perspectives to get a complete picture of the online learning experiences. Future studies should explore student readiness for clinical online learning as this would be a struggle for students even if the transition was under normal circumstances (Vaughan, 2007).  The perspectives of faculty members on readiness to move towards online learning also need to be explored. The strength of this study was that it used a previously validated questionnaire which allowed some comparison on students’ remote learning readiness with pre-COVID-19 studies.  

V. CONCLUSION

In conclusion, the study explored medical undergraduates’ remote learning readiness in a public medical school in Malaysia during the COVID-19 pandemic. In general, students were found to be ready for remote learning. However, the lowest scores were for the domain of self-directed learning and computer and internet efficacy. Based on our findings, we feel that support for student readiness in transition from instructor-driven learning models to self-directed learning models is crucial and requires attention by institutions of higher learning. Exploring methods to improve self-directed learning and increase availability of technology and conducting sessions to improve computer and internet efficacy can be considered in the early stages of pre-clinical years to ensure equitable access for all students.  There should also be efforts to train the educators to develop online learning activities which incorporate the socio-relational aspects of learning into the remote learning experience. 

Notes on Contributors

Kit Mun, Tan is the first author and person who initiated the study, contributed to the design of the study, data collection and analysis, writing and approval of the final version of the manuscript.

Chan Choong, Foong contributed to the design of study, data collection and analysis, writing and approval of the final version of the manuscript.

Donnie, Adams is the creator of the original Blended Learning Readiness Questionnaire (BLREQ) and contributed to the design of the study, data collection and analysis, writing and approval of the final version of the manuscript.

Wei Han, Hong contributed to the design of the study, data collection and analysis, writing and approval of the final version of the manuscript.

Yew Kong, Lee contributed to the design of the study, data collection and analysis, writing and approval of the final version of the manuscript.

Vinod, Pallath is the corresponding author and contributed to the design of the study, data collection and analysis, writing and approval of the final version of the manuscript. 

Ethical Approval

This study received ethical approval from the Universiti Malaya Ethics Review Committee with the approval number of UM.TNC2/UMREC-889.

Data Availability

Research data of this study are available at https://doi.org/10.6084/m9.figshare.21443100.

Readers may access the anonymised data freely with the above URL. Kindly contact the authors for permission if you wish to use the data for a subsequent study or collaboration.  

Acknowledgement

We would like to acknowledge and express gratitude to the undergraduate medical students who took the time to participate in this study.  

Funding

There was no external funding for this study.

Declaration of Interest

All the authors do not have a conflict of interest to declare.  

References

Adams, D., Sumintono, B., Mohamed, A., & Mohamad Noor, N. S. (2018). E-learning readiness among students of diverse backgrounds in a leading Malaysian higher education institution. Malaysian Journal of Learning and Instruction, 15(2), 227-256. https://doi.org/10.32890/mjli2018.15.2.9

Alghamdi, A., Karpinski, A. C., Lepp, A., & Barkley, J. (2020). Online and face-to-face classroom multitasking and academic performance: Moderated mediation with self-efficacy for self-regulated learning and gender. Computers in Human Behavior, 102, 214-222. https://doi.org/10.1016/j.chb.2019.08.018

Chen, J., Zhou, J., Wang, Y., Qi, G., Xia, C., Mo, G., & Zhang, Z. (2020). Blended learning in basic medical laboratory courses improves medical students’ abilities in self-learning, understanding, and problem solving. Advances in Physiology Education, 44(1), 9-14.

Vaughan, N. (2007). Perspectives on blended learning in higher education. International Journal on E-Learning, 6(1), 81-94. https://www.learntechlib.org/primary/p/6310/

*Associate Professor Dr Vinod Pallath
Medical Education Research and Development Unit,
Faculty of Medicine, Universiti Malaya,
50603 Kuala Lumpur
Email: vinodpallath@um.edu.my