The COVID-19 pandemic forced educators to find a balance between providing enriched learning experiences for their students while also adhering to public safety measures. Virtual learning models were utilized as medical schools halted in-person learning for several months during the height of the pandemic in the Spring of 2020 [10].
The field of radiology lends itself well to virtual education [11]. Readouts performed over virtual platforms, didactic lectures given in live and prerecorded formats, and interactive methods such as audience polling and quizzes were successful alternatives when in-person meetings were not possible [12].
In implementing a virtual radiology rotation for medical students in Egypt, we assessed pre-test and post-test data for five different radiology diagnoses. In comparing pre-test and post-test results, the cohort of students performed better on the post-test after completing the virtual rotation, with statistically significant results. In the same fashion, several studies showed the effectiveness of virtual teaching of radiology [2, 13]. In a study from Harvard Medical School, 111 medical students enrolled in a virtual radiology curriculum and were given a final exam at the conclusion of the rotation. The final exam results were compared to those of the final exam taken when the rotation was in-person in prior years, with the final exam scores being similar to those of the in-person rotation. This demonstrates the quality of online education delivery with minimal to no deficiency when compared to in-person learning [13]. In the Egyptian cohort that we assessed, employing a similar comparison model with the performance of students enrolled in an in-person radiology curriculum at Egyptian medical schools pre-COVID-19 pandemic could be useful to assess efficacy for future implementation of online learning.
An overwhelming majority of the participants felt that the virtual program increased their interest in radiology as well as their knowledge of using radiology as a diagnostic tool in medicine. With a larger percentage of participants in the Egyptian cohort being undergraduate medical students at Egyptian medical schools, tailoring the difficulty level of the program to match that of a student was key. This was successful as demonstrated by post-course survey results that the material and topics were “just right” and clinically important.
A number of subjective points were assessed pre- and post-course, including familiarity with radiology best-use practices, identifying gross abnormalities on imaging, and the utility of different imaging modalities in different clinical scenarios. The finding of our results is consistent with other studies and supports the value supplemental radiographic education may provide in improving the competency of clinicians and medical students in their specialty [14,15,16,17].
In addition, using an online educational model also helps reach a greater number of students and gives them access to the same kinds of resources, which offers a robust learning experience and more equal field of opportunities that these students may otherwise not have been able to access [18, 19]. This is shown in other virtual education models that have been implemented in interdisciplinary fields in Egyptian medical schools. In medical schools in Assiut, Egypt, flipped classrooms, virtual small group sessions, and the use of simulation videos to teach procedural clinical skills were implemented. Moreover, students were incorporated in telehealth clinic visits with patients, which is helpful given the dynamic practice of medicine [14].
A large majority of the participants agreed to varying extents that the presence of an internist or surgeon at the educational sessions added value to the program. These results were similar to another study that reported the effectiveness of multidisciplinary approach in incorporating radiology in anatomy education [20, 21]. The approach to patient care and treatment continues to grow in a collaborative model. Introducing radiology at an early stage of medical training may reinforce a superior approach to patient care as future healthcare professionals [22]. In addition, learning the radiographic significance of certain pathological diseases can serve as a proactive way for students to correlate better with clinical presentation.
Overall, employing a multidisciplinary approach to radiology education at the medical student level can successfully be done virtually, both in response to the COVID-19 pandemic as well as to the changing fabric of medicine, with telehealth becoming more popular [18, 23]. Online medical education can reach a wider range of students and their learning can be adequately assessed with a combination of live discussion sessions and testing methods [19, 24].
Limitations
As our study depended on students answering both tests, students who answered only one were not included, thus preventing us from attaining a 100% response rate. However, online surveys are expected to not reach a 100% response rate, and we received an appreciable percentage of an ~ 80% response rate for both pre-test and post-test.