Student perspective of classroom and distance learning during COVID-19 pandemic in the undergraduate dental study program Universitas Indonesia

The World Health Organization has declared the pandemic of the novel SARS-CoV2 infection early this year and it has now become a major public health challenge worldwide [1]. The infection control and physical distancing measures are crucial to prevent the virus from further spreading and to help control the pandemic situation. The policy of compulsory physical distancing has been implemented in many countries including in Indonesia [2, 3], resulting in nationwide school and university closures. In accordance with this policy, dental academic institutions are compelled to make appropriate and timely modification in order to continue to deliver education and to sustain the continuation of student academic progress. The teaching and learning activities were immediately shifted to a full E-learning.

E-learning is defined as learning that makes use of Information and Communication Technologies (ICTs). The incorporation of technological resources and innovative education strategies has transformed the teaching and learning processes. Previous studies have shown various e-learning and online learning tools that are effective for teaching and learning in the fields of health profession, including dentistry [4,5,6,7,8]. The knowledge gain and performance of the students as a result of E-learning were shown to be equivalent to that of face to face methods [9, 10]. Blended learning is mainly defined as the integration of classroom and distance learning to facilitate an independent, interactive and collaborative learning among students. However, to understand it in a more general perspective, blended learning approach redesign courses that are developed, scheduled and implemented through a combination of physical and virtual learning activities. It was previously reported that blended learning provides better student’s satisfaction, motivation, student engagement and performance [5, 7, 11, 12]. This approach promotes active and self-directed learning and has gained acceptance in dental education as a complementary method to traditional learning.

The undergraduate curriculum of the Faculty of Dentistry Universitas Indonesia adopted Student Centered Active Learning (SCAL) using collaborative learning, question-based learning or Problem-Based Learning (PBL) since 2003. In PBL, students work in groups to construct content knowledge and develop self-directed learning skills. The activities along the steps of the chosen learning methods (group discussions, clarification sessions, the laboratory works and skills lab) were all conducted in classroom learning with online support. The university E-learning management system (LMS) was utilized to facilitate various teaching and learning activities at different academic levels in the undergraduate dental program. The organization of courses, access to resources and additional learning materials are available through LMS to support self-directed learning within an integrated PBL curriculum. During this COVID-19 pandemic, courses delivered in student-centered learning methods were immediately moved to full E-learning. In the first half of semester before the pandemic, group discussions, clarification sessions and interactive lectures were carried out in-campus classroom learning while in the second half of semester, learning activities were delivered in full distance learning employing various online meeting platforms. In order to make the format of discussion sessions stay similar as it had been conducted before the pandemic, every online session was delivered synchronously with the attendance of a facilitator in each group. Students and facilitators’ time spent on setting or accomplishing tasks was similar as in classroom learning.

Despite previous reports on the comparison of classroom and distance learning [4,5,6,7,8,9,10,11], the evaluation on the student-centered active learning approaches that are delivered through blended learning methods compared to full online learning has not been widely available. The majorities of studies on distance learning method reported student perception of virtual learning modules that were integrated with classroom learning. Student feedback could provide important information for the evaluation of distance learning so as to improve future learning strategies. Therefore, the study aimed to analyze student perspective of SCAL delivered through full distance learning compared to the classroom learning in the undergraduate dentistry study program. An online questionnaire was distributed to the undergraduate dental students at the end of semester. We hypothesized students positive outcomes on the acceptance of distance learning as a new learning strategy that was implemented during COVID-19 pandemic condition.

Sampling procedures and participants

This study was performed from May to June 2020. Study participants were the first, second and third-year of undergraduate students of the dentistry study program at the Faculty of Dentistry Universitas Indonesia. The online questionnaire was given at the end of semester. They were strongly encouraged to fill out the questionnaire but their participation remained voluntary. The name and other personal information of the study participants were protected. Dental Research Ethics Committee Faculty of Dentistry Universitas Indonesia approved the study in accordance with the Helsinki Declaration (6/EA/FKGUI/VI/2020). Students were informed about the study and signed consent form.

Learning methods

Before COVID-19 pandemic, learning strategies in the dentistry academic study program (pre-clinical) at the Faculty of Dentistry Universitas Indonesia was student-centered active learning. Collaborative learning (CL) and question-based learning (QBL) approaches were mainly used in the courses of the earlier semesters such as basic oral biology and introduction of health and dental science courses for the first-year dental students. Problem-based Learning (PBL) was mainly used in the courses of the latter semesters such as clinical dental science courses for the second and third-year dental students. The group discussions of these active learning approaches and lectures for clarification were delivered in classroom learning. Each group discussion consisted of 10–13 students and was supervised by 1 facilitator/tutor. Universitas Indonesia web-based education tools (EMAS, Moodle-based learning management system) was used to support various learning activities. Students could access the syllabus, learning objectives of each studied courses as well as scenarios/list of sub-topics or questions, list of references through the EMAS system and this learning approach represents blended learning.

As the COVID-19 pandemic protocol forced the compulsory work and study from home policy, since March 17, 2020, courses with CL, QBL and PBL methods were transferred to full distance learning. Group discussions, clarification lectures and assessments were carried out using various online platforms (Microsoft Teams, Google meets, Zoom and EMAS). Practice class and skills lab courses in which the expected learning outcomes involved various psychomotor skills were either substituted with video simulation, and or live and presented the stages of work online or postponed until the university is ready to be opened for the face-to-face classroom learning.

Questionnaire

The questionnaire was developed to assess [1] the student’s perception of the distance learning method. The response options of the questionnaire items represent 4 Likert-type scales (0 = strongly disagree to 3 = strongly agree), except for questions of the most effective methods for distance learning (six options of the format of online learning) and open questions for the challenges and positive experience during distance learning. Altogether there were 22 statements in four parts: (A) general information on the student’s gender, year of study and GPA; (B) Preference; (C) Effectiveness, and; (D) Learning satisfaction.

Statistical analysis

The internal consistency reliability questionnaire was measured by Cronbach’s alpha. Descriptive statistics were computed and bivariate analyses were performed. Logistic regression analyses were conducted to identify factors associated with the students’ preference towards distance learning. The level of statistical significance was at 0.05.

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