Students' learning behavior in digital education for radiation oncology

Abstract

Purpose: Digitalization of medical education is an important trend in terms of reforming and modernizing the global education environment. It has been long requested by students and politicians. The goal of this study was to assess the student perception of a newly developed digital educational program in radiation oncology (RO) using an interactive e‑book combined with short learnings clips on a YouTube channel combined with periodic videoconferences and a forum for queries.

Methods: We performed five evaluations during and at the end of two terms with multiple-choice and free-text answers. We evaluated student perception of our new digital learning scenario in three semesters: one pre-clinical and two clinical semesters. In addition, we analyzed all comments from the kMED forum, the YouTube channel, or the e‑mail contacts. We analyzed the learning behavior of the students based on access to the videos and the number and quality of the reflective questions answered as well as the results of the final examinations.

Results: The students accepted the offer for asynchronous teaching and mainly learned on weekdays (74% of the videos), but also on weekends (23%) and less on public holidays (4%). The answer quality of the reflective questions was good with over 50% correct answers on the first attempt. Learning to be on one's own authority was very difficult for the students, even in the last clinical semesters of the medical study. Without direct intervention by the teacher, access to the learning material by the students was limited and delayed. Therefore, voluntary interim tests were performed during the first analysis term, which led to an increased number of student accesses to the videos and higher number of answers. Nevertheless, in the first analysis term, the average results in the final exam of the students who did not perform the interim test were below average at 59.1%, and the students who performed the test had better results at 69.5% but this was also not satisfactory. In the second analysis term, we taught with the same digital teaching model but with an additional scheme for learning over the term, 2‑week compulsory intermediate tests, and frequent videoconferences to answer any questions. In this term, we measured a success rate of 93% in the final exam. All annotations were very positive regarding the new educational project. The evaluations showed high acceptance of the new education program. The students stated they would prefer the new education course to be continued in future.

Conclusion: Digital teaching methods make not only the type and quality of teaching transparent, but also the learning behavior of the students. Our analysis has shown that, in addition to the quality of the teaching, the clear structure and specification of the learning content per learning week as well as regular monitoring of what has been learned are of decisive importance for the learning success of the students.

Keywords: Blended learning; Digital learning; E-learning; Interactive E-book; Medical education.

Fig. 1

Response style to the reflective questions of the interactive e‑book during the first analysis term. Dashed line correct answer in the first attempt, dotted line correct answer in the second attempt, solid line correct answer in the third or later attempt, dashed and dotted line student attempts to answer the question but did not get the correct answer

Fig. 2

Accesses to the short videos on the YouTube channel and number of reflective questions answered on prostate cancer per week (9th/10th semester). Dashed line with triangles accesses to the videos during the first analysis term, solid line with squares answers to the reflective questions during the first analysis term, dotted line with circles answers to the reflective questions during the second analysis term. Voluntary interim test between 7th and 8th week during the first analysis term; obligatory interim test between 8th and 9th week during the second analysis term; obligatory e‑exam in week 10 during both analysis terms

Fig. 3

Accesses to the short videos on the YouTube channel per week during the first analysis term (5th/6th semester). Gray area number of all accesses, solid line with circles basic knowledge, dotted line with triangles breast cancer, dashed line with squares lung cancer, glioma, and rectal cancer

Fig. 4

Relative number of reflective questions answered per week during the first analysis term (5th/6th semester). Solid line with circles basic knowledge, dotted line with triangles breast cancer, dashed line with squares lung cancer, glioma, and rectal cancer