Changing Methods of Education During a Pandemic: Questionnaire Survey about Examinations for Nuclear Medicine Technology at Educational Institutions in Japan

DISCUSSION

In this study, we investigated the lecture format with respect to teaching nuclear medicine technology before examinations at Japanese educational institutions during COVID-19. We also examined novel efforts to ensure the quality of conventional educational approaches and measures to achieve infection control.

We found that the methods adopted by the surveyed institutions changed significantly as a result of the pandemic. In the first semester of 2020, none of the institutions undertook face-to-face lectures: they switched to such formats as remote or hybrid lectures. The spread of COVID-19 caused the Japanese government to declare a state of emergency during April and May 2020. As a result, Japan’s residents were asked to avoid unnecessary outings and maintain social distance (9).

In the first semester of 2020, remote and hybrid lecture formats were introduced toward controlling the infection. We observed that educational institutions with few students in classes tended to opt for remote lectures. Accordingly, the small class sizes meant that students could communicate and interact with lecturers remotely. In that way, lecturers were able to assess the learning levels of each student, which supported the remote lecture strategy.

Institutions with many students in each class provided remote and video-on-demand lectures, which meant that students did not have attend in person. To prevent clustering in the case of large classes, the studied institutions adopted a lecture format such that students did not come into close contact with one another.

By contrast, most of the educational institutions with classes of 51–100 students offered hybrid lectures. With the hybrid format, students who wished to take lectures remotely were able to do so, reducing the number attending face-to-face lectures. That format allowed lecturers to monitor students’ understanding and satisfaction and teach accordingly. The hybrid format allowed adequate measures against infection.

In the first semester of 2020, the face-to-face format was the most frequently applied method for conducting regular examinations. However, some institutions that used remote lectures in the first semester adopted various test formats to prevent infection. Some institutions conducted testing remotely. Among the comments received from institutions that conducted remote testing were comments indicating that such tests did not allow confirmation that students were relying solely on their academic ability. When taking such tests, students showed their own face on the computer monitor. However, it would have been possible to browse study materials and cheat in such a way that it could not be seen on the monitor. Remote testing can prevent students from being infected, but the biggest disadvantage is that it cannot exclude such fraudulent activities. We received many comments stating that face-to-face testing was the best approach.

In the second semester of 2020, the number of institutions offering face-to-face lectures increased significantly. The reason for the increase was that COVID-19 infection control had begun to be established. Around March of 2020, the Prime Minister’s Office of Japan announced that the “Three Cs” should be avoided: closed spaces, crowd places, and close-contact settings. The notification was introduced because of the increased risk of COVID-19 infection (1,10). Educational institutions that considered face-to-face lectures more effective could conduct teaching in that manner while avoiding the Three Cs. With face-to-face lectures, it is necessary to implement adequate infection control measures throughout the university. In the first half of 2020, there was no way of providing lectures while avoiding the Three Cs. Therefore, no educational institutions gave face-to-face lectures in the first semester.

In the second semester of 2020, the face-to-face format for regular examinations had also increased markedly. In that semester, the institutions had become accustomed to face-to-face infection control. Accordingly, regular examinations were often held in face-to-face format. But some institutions continued with remote or other examination formats because of the infection risk.

Regular examinations are essential for assessing student comprehension. In the regular examination for the lecture held in the second semester, infection control measures were taken, and face-to-face methods were adopted by many educational institutions. However, it cannot be denied that there is a risk of infection. Therefore, we would like to examine the methods used by some educational institutions in the regular examinations in the first semester of 2020. Some educational institutions have adopted the face-to-face-plus-reports format for regular examinations. By adopting this method, it is possible to reduce the risk of infection and evaluate the level of understanding of students in a short time. In the future, we would like to incorporate this type of regular examination into our lectures.

In the free description portion of the questionnaire, we received many comments related to methods of infection control. All institutions that held face-to-face lectures took thorough infection control measures. Many comments related to remote lectures addressed methods of improving student understanding. Unlike face-to-face lectures, the remote format does not permit real-time evaluation of students’ comprehension and satisfaction. Further, with the remote format, the lecturer is not physically present; the comments therefore indicated concern about the decline in concentration level with such teaching. This finding has been reported in previous studies (1). Accordingly, lecturers at institutions that conducted remote lectures devised methods that could obtain the same level of student understanding and satisfaction as did the face-to-face format.

The free descriptions of hybrid lectures included methods of reducing the number of class days. Lecturers wished to have direct contact with students to determine whether they understood the lecture content. Thus, institutions provided hybrid lectures and devised ways to reduce the number of attendance days.

Regarding video-on-demand lectures, the free descriptions mentioned ways of improving student understanding. Few institutions offered video-on-demand. However, there were comments about its merits because it allows multiple reviews of a lecture. It was evident from the free description that educational methods have changed completely to prevent COVID-19 infection. Each institution offered ways to prevent infection and improve understanding.

In the questionnaire, we asked about the optimal lecture format for COVID-19. Evidently, there were no clear differences in a comparison of face-to-face, remote, and hybrid lectures in terms of educational suitability; each institution held different views in this regard. All the institutions made efforts to prevent infection and improve understanding: they believed it was possible to teach in a way that ensured the quality of conventional education in any lecture format.

We investigated various lecture formats and initiatives undertaken by educational institutions under COVID-19. COVID-19 has completely changed all institutions, and they have moved away from conventional education. All the institutions we examined had addressed new educational challenges as a result of COVID-19. We wish to share these initiatives and methods adopted, thereby contributing to the promotion of medical education in society—even during a pandemic. In 2021 and 2022, we will continue to give the same lectures as in 2020. Now, mutant strains of COVID-19 are also prevalent, and lectures are given with strict infection control measures. If education policy in Japan changes in the future as a result of COVID-19, it will be necessary to prepare for such changes using the findings of this study.

Finally, we would like to talk about future prospects. It is unclear whether the new initiatives and lecture formats in COVID-19 investigated here will be used permanently. We would like to continue this survey to see what kinds of changes will be brought about in the future. In addition, we would like to investigate changes in student attitude ratings and satisfaction levels and student board examination scores in lectures at each educational institution. Each educational institution may make a difference by instituting these changes. In previous research, remote lectures were found to give students the same level of satisfaction and understanding as the conventional face-to-face lectures (1). Therefore, we believe that by designing lectures that satisfy students in any lecture format, we can provide lectures with a high degree of understanding and satisfaction in any lecture format. Moreover, regarding employment, the chances of getting hands-on training with radiation equipment are decreasing at all educational institutions to prevent infection, and many students are worried about whether they will be able to do their jobs well after finding employment. We would also like to investigate changes in methods of hands-on training that have resulted from COVID-19.