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Indian Pediatr 2019;56:
967-969 |
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Teaching Undergraduates Beyond the Classroom: Use of WhatsApp
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Anil Kapoor 1,
Vibhav Tiwari1
and Anju Kapoor2*
From Departments of 1Medicine and 2Pediatrics,
People’s College of Medical Sciences and Research Center, Bhopal, Madhya
Pradesh; India.
Email:
[email protected]
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WhatsApp is a popular platform for
social interaction. We used it as an e-learning platform for medical
education. We discussed five clinical cases on a WhatsApp group with
undergraduates; it increased their knowledge in the subject
significantly (P<0.001). Participants accepted it well and
perceived that it has improved their problem solving skill and
stimulated them for self-study.
Keywords: E-Learning, Medical
education, Social media.
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W
ith the easy availability of smartphones and
internet facility, medical students are spending significant time on it.
E-learning can be imparted by these smartphones through various
mechanisms which have potential to increase collaboration,
problem-solving and networking among students. It allows them to share
images, data and participate in blogs or video-conferencing [1].
WhatsApp, a social media app is being used frequently for communication
and sharing resources in medical field [2]. It can be a useful tool to
develop a virtual learning community when meeting face- to-face is not
possible [3]. Medical Council of India (MCI) has emphasized on the use
of technology in the new competency-based undergraduate curriculum for
the Indian medical graduate [4].
This study was done to determine the acceptability
and efficacy of WhatsApp as teaching-learning media in promoting
problem-solving skills and self-study among medical undergraduates.
We conducted this educational intervention study on
ninth semester undergraduate medical students over a period of three
months (December 2015 - February 2016) after Institutional Ethics
Committee’s approval and informed consent from participants. Out of 124
students, 40 students who were already using WhatsApp with their own
data pack volunteered to participate, in response to an announcement in
the classroom. A WhatsApp group was created by two participating
students including two faculties as administrator. Case scenarios from
cardio-vascular system (valvular heart disease, arrhythmia,
hypertension, heart failure, coronary artery disease) were written,
reviewed and revised by co-faculty before being posted on WhatsApp for
discussion.
Each case was discussed over 5-7 days by posting a
case scenario followed by some trigger questions (Box 1)
for making and analyzing differential diagnosis, interpretation of
relevant investigations and management plan with reasoning. Laboratory
reports, X-rays and ECGs were shared maintaining anonymity of
patients. Students were advised to go through books and other resources,
if needed. They responded to questions with reasoning, sometimes backed
by relevant resources and/or raised their doubts. Right answers were
appreciated; cues, feedback and correct answers were provided to address
doubts and wrong answers. Discussion was done during evening and night
time on working days and throughout the day on holidays. ‘Active
participation’ was considered if participants responded to questions or
asked queries on WhatsApp. Feedback was taken using a structured paper
proforma, filled individually by each participant, regarding their
perception on use of WhatsApp and their overall satisfaction with this
experience.
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Box 1 Examples of Questions Asked to
Promote Reasoning / Problem Solving Skills*
• What are the possible differential
diagnoses?
• Give points in favour and against each
diagnosis at this point of time.
• Out of all differential diagnoses, which
one is most likely and why?
• What more information will you like to know
about history and examination to reach the final diagnosis?
• What investigation will you like to order
at this point of time? And why?
• Based on this new information, what could
be the cause of deterioration in this patient? What do you think
about this new development in the case?
In addition, relevant questions were asked to elicit the
‘Why’ and ‘How’ during the discussion as per the need.
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Gain in knowledge was assessed by pre-post test
scores using same set of 15 Multiple Choice Questions (MCQs) on paper
before and 2 weeks after the end of WhatsApp discussion. Each MCQ
carried one mark with no negative marking. After confirming normal
distribution of data by Kolmogorov-Smirnov Test, pre- and post-test
scores were compared using paired t-test. All messages from
students and faculty were extracted from the WhatsApp group and analyzed
for frequency and content.
Three students did not complete the post-test, hence
data analysis was done for 37 participants (M:F = 1.6:1). Difference
between mean (SD) score of pre-test and post-test [5.05 (1.9) vs.
7.92 (2.6)] was statistically significant (P<0.001). Range of
marks improved from 1-11 (pre-test) to 3-13 (post-test). Out of total
629 messages, faculty posted 266 messages. Only 19 (51.3%) students,
participated in the discussion and posted 363 messages ranging from 8-74
per student (Table I). Overall satisfaction reported to
this experience was - Very good (32.4%), Good (43.3%) and Satisfactory
(24.3%).
TABLE I Frequency and Content of Responses by Students and Faculty
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Content of the messages |
No.(%)
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Student messages (N = 363) |
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Answered questions without reasoning |
139 (38.3) |
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Answered questions with reasoning |
154 (42.4) |
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Raised queries
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43 (11.8) |
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Shared resource material |
17 (4.7) |
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Posted agreement
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10 (2.8) |
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Faculty messages (N = 266) |
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Case scenarios posted
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5 (1.9) |
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X-rays and ECGs shared (5 each) |
10 (3.8) |
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Questions asked
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119 (44.7) |
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Cues given to address doubts
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58 (21.8) |
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Provided feedback / answers |
74 (27.8) |
Analysis of participants’ feedback on Likert scale
showed that whole discussion was read by 94.6% students. They felt that
they got sensitized for their mistakes during interpretation of clinical
findings (89.2%); felt discussion helped them to analyze the case and
make differential diagnosis with appropriate reasoning (81.1%). Learning
was fun by the new method (86.5%), though 18.7% had difficulty in
finding time to go through the discussion.
In response to open-ended questions on this
experience, they commented i>"approach to cases was made easy;
discussion full of brainstorming and excitement; different viewpoints
improved thought process; it worked on curiosity quotient; discussions
can be followed up anytime, anywhere as per convenience and can also be
revised anytime; learning not bound to classroom teaching; mindful
learning experience; good for introverts." They also reported about
time constraints, fast-paced discussion during night hours, and a
compulsion to check the messages again and again till their query was
solved.
Utility and feasibility of WhatsApp in
teaching-learning for medical graduates and post-graduate students has
also been reported earlier [5,6]. Students enjoyed and liked anytime,
anywhere learning using WhatsApp and it helped them to clear doubts with
improvement in knowledge [5]. WhatsApp has also been used by clinicians
for exchange of patients’ condition and reports, therefore saving time
in decision making and executing treatment [7,8]. It helped nursing
students also for integrating theory and clinical practice [9]. However,
it failed to enhance academic performance of Saudi medical students
[10].
Limitations of present study include small number of
participants and case scenarios limited only to one medical specialty.
To conclude, WhatsApp was well-accepted as
teaching-learning media by undergraduates. There is a need for larger
studies exploring the various components of the learning domains which
may be learned through this modality.
Contributors: Anil K: conceptualized and
developed the study, drafted the initial manuscript, did literature
search, data collection, data analysis, revised the manuscript. VT:
data collection, literature search, reviewed the manuscript. Anju K:
data analysis, literature search, initial drafting of manuscript,
reviewed the manuscript. All authors approved the final manuscript.
Funding: None; Competing interest: None
stated.
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