We thank the reader for showing interest in our study. This study was done in December, 2015 - February, 2016 with 9th semester students after completion of topics on cardiovascular system. Methodology was informed to them before recruitment; participation had to be voluntary but those who participated, had to attempt pre-post tests. Reasons for relatively low percentage of students volunteering to participate were time constraints due to pressure of university exams (February-March 2016) and apprehension of pre-post tests. In fact, pre-university exams were held during study period with interruption in discussion for two weeks. Not many students were having smartphones or using WhatsApp at that time compared to now.

Secondly, study was designed as non-comparative trial with the objectives to determine the acceptability and efficacy of WhatsApp as teaching-learning media in promoting problem-solving skills and self-study beyond classroom and not to compare with conventional classroom teaching [1].  Though less than 50% of the volunteer students participated in the discussion, Hawthorne effect can not be ruled out. In order to avoid bias in online teaching and discussion, pre and post test sheets were assessed only after the post-test was over. Design of study was based on Case-based learning (CBL) and students applied their previous knowledge, did self-reading, step-by-step analysis, shared answers with reasoning and resources on WhatsApp. Timely feedback helped them to clear doubts and promoted learning beyond classrooms. There is evidence that CBL links theory to practice, promotes self-directed, collaborative and active learning amongst students which help them to learn better and gain in confidence [2].

Thirdly, reasons for low participation of volunteer students as per their feedback were: difficulty to find time for going through discussion (18.7%), not comfortable in participating on WhatsApp (8.1%) and some had problem of net-connectivity. Discussion used to be at a fast pace during late-night hours as it was not permitted during college timings. Many students would be asleep by that time. Later when they could go through the discussion, it would have moved forward and they kept on trailing behind. Despite this, 94.6% read all the discussion as per their convenience and more than 80% felt they benefitted from it.  Hence, we consider this as strength of our study.

We agree, more studies are required as WhatsApp has potential to be adapted as a teaching-learning media for medical education due to ease of availability and flexibility to participate and/or review and revise content as per one’s convenience.  


REFERENCES

1. Kapoor A, Tiwari V, Kapoor A. Teaching undergraduates beyond the classroom: Use of WhatsApp. Indian Pediatr. 2019;56:967-9.

2. Thistlethwaite JE, Davies D, Ekeocha S,  Kidd JM, MacDougall C, Matthews P,  et al. The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23. Med Teach. 2012;34:e421-44.