E-learning in medical education: a perspective of pre-clinical medical students from a lower-middle income country.

Background: Many of the educational institutions in developed countries have shifted to online learning. While transition from traditional to electronic learning (e-learning) has remained a great challenge in low-middle income countries, where limited resources for teaching and learning are important factors. Medical education involves not only lecturing but also deep understanding through laboratories and patient exposure. The debate about the effectiveness of e-learning in medical education is still in contradiction due to its limitations. This cross-sectional survey was conducted to assess pre-clinical undergraduate medical students' perception of their first online learning in a lower-middle income country.

Methodology: The survey was conducted among the students who had participated in online learning during COVID-19 for at least a year. A total of 824 preclinical medical students who completed the survey from public and private medical universities in Sindh, Pakistan were included in the study. We used a validated online-based questionnaire, distributed through E-mail and social media platforms to assess the perception of students regarding their first online learning experience.

Results: The response rate of the survey was 87.9%. The mean age of students was 20.7 ± 3.8 years. 392/824 (47%) were males and 57% were females. Our study indicated that 613/824 (75%) of students were experiencing online learning for the very first time while 631/824 (77%) were facing technical issues like internet accessibility and lack of IT-related skills. 381/824 (46%) were not satisfied with the institute's readiness for online teaching. However, 79% (654/824) of participants were of the idea that traditional learning is more effective in developing their practical skills as compared to e-learning. Of note, 668/824 (81%) showed overall dissatisfaction with e-learning.

Conclusion: Based on our study findings, we concluded that most students have a negative perception of e-learning. Difficulty in connectivity, electricity issues, less interaction with colleagues and teachers, and issues with the structure of online courses were the most frequently reported problems by the students.