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Table of Contents
VIEWPOINT
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 85-89

Experience from a medical college in Saudi Arabia on undergraduate curriculum management and delivery during COVID-19 pandemic


1 Professor of Medical Education & Physiology, Head of Medical Education Department, College of Medicine, King Saud University, Saudi Arabia
2 Associate professor of ENT, Vice Dean of Academic Affairs, College of Medicine, King Saud University, Saudi Arabia
3 Professor of Urology, Dean, College of Medicine, King Saud University, Saudi Arabia

Date of Submission18-Nov-2020
Date of Decision21-Dec-2020
Date of Acceptance31-Dec-2020
Date of Web Publication13-Apr-2021

Correspondence Address:
Mona Soliman
Head of Medical Education Department, Professor of Physiology and Medical Education, College of Medicine, King Saud University
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jnsm.jnsm_146_20

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  Abstract 


Coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization on March 11, 2020. In response to the pandemic, the Kingdom of Saudi Arabia's Ministry of Education announced the suspension of educational activities. The pandemic has challenged universities worldwide to provide education virtually as an immediate response to prolonged lockdown periods. This article highlights the College of Medicine's experience at King Saud University, Saudi Arabia, in managing undergraduate medical education in response to the pandemic situation. We describe the process of implementing the curriculum's delivery online during the lockdown and the decisions regarding the final assessment for all years. Furthermore, we highlight the steps taken to prepare for the new academic year 2020–2021 as a blended learning approach in light of the COVID-19 situation.

Keywords: Coronavirus disease 2019, distance learning, medical education, online education, teaching


How to cite this article:
Soliman M, Aldhaheri S, Neel KF. Experience from a medical college in Saudi Arabia on undergraduate curriculum management and delivery during COVID-19 pandemic. J Nat Sci Med 2021;4:85-9

How to cite this URL:
Soliman M, Aldhaheri S, Neel KF. Experience from a medical college in Saudi Arabia on undergraduate curriculum management and delivery during COVID-19 pandemic. J Nat Sci Med [serial online] 2021 [cited 2021 May 18];4:85-9. Available from: https://www.jnsmonline.org/text.asp?2021/4/2/85/313645




  Introduction Top


Coronavirus disease 2019 (COVID-19) originated in Wuhan city, China, in November 2019 and was declared a pandemic by the World Health Organization on March 11, 2020. The first case of COVID-19 in Saudi Arabia was detected in a traveler returning on March 2, 2020. As of October 17, Saudi Arabia has reported more than 341,854 cases with 5165 deaths.

In response to the pandemic, governments worldwide undertook highly protective actions to stop the spread of the infection including economic, health, and educational restrictions. Saudi Arabia was among the first to implement early precautionary measures, which helped restrict the virus's spread inside the country. On March 5, the Ministry of Education announced the suspension of all educational activities and an immediate shift to online education. By the end of March, Saudi Arabia announced a complete lockdown.[1] These precautionary measures taken to stop the infection's spread had serious implications and challenged educational institutes worldwide.[2],[3] Medical education was seriously challenged, as teaching and assessment in undergraduate medical colleges included teaching and assessing clinical skills taught onsite.[4],[5] There was a great deal of uncertainty for the upcoming year.[6] This situation challenged the medical colleges worldwide to invent new teaching and assessment methods to provide quality and satisfactory medical education with minimum face-to-face teaching.[2],[7] We aim to present the King Saud University Medical College's experience for the academic year starting in September 2020, both in managing the urgent shift to online medical education during the COVID-19 pandemic and in preparing for undergraduate medical students' teaching and assessment.


  College of Medicine, King Saud University, Saudi Arabia Top


King Saud University is the largest university in Saudi Arabia with 22 colleges. The university has six health colleges: The College of Pharmacy, College of Medicine, College of Dentistry, College of Applied Medical Sciences, College of Nursing, and College of Emergency Medical Services.

The College of Medicine at King Saud University was founded in 1967. The College has 19 academic departments [Table 1]. It was the first medical college in Saudi Arabia and celebrated 50 years of excellence in 2018. The number of newly enrolled undergraduate students is approximately 300/year. The number of postgraduate training programs is 120, with a total enrollment in postgraduate education and residency of 1200. There are four master's programs and 2 PhD programs in the various colleges.
Table 1: King Saud University Medical College Academic Departments

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The College of Medicine's undergraduate curriculum is managed by the Vice Deanship of Academic Affairs and the Medical Education Department. The medical education department was founded in 2010, and since then, they have managed the delivery and development of the curriculum in the College of Medicine. The Medical Education Department has different units including the faculty development unit, e-learning and informatics unit, and masters in medical education unit [Figure 1]. The Medical Education Department played a major role in planning and monitoring the curriculum during the pandemic. In addition, they made certain that the necessary faculty development training was provided to ensure the quality of curriculum development.
Figure 1: Medical education Department units

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The Medical Education Department played a major role in planning and implementing the guidelines to meet the delivery and design of the curriculum during the pandemic. Communication with all the academic bodies delivering the medical curriculum included the academic departments, the Clinical Skills and Simulation Centre (CSSC), the Assessment and Evaluation Centre, and the Student Council. The department also ensured the implementation of the approved plan, monitored the curriculum's delivery, and provided essential training for the staff.


  Preparation for the Teaching of Undergraduate Medical Students at King Saud University for the New Academic Year 2020–2021 Top


The COVID-19 situation created a great deal of uncertainty for health care and education.[2],[6] Medical colleges worldwide questioned the future of medical education as the pandemic progressed.[4] Medical colleges gained experience from the sudden shift to online education in April 2020 due to the pandemic and benefited from this experience when planning and preparing for the new academic year 2020–2021. We learned from different experiences worldwide.[8]

The College of Medicine at King Saud University spent the summer of 2020 preparing for the new academic year and implementing the delivery of the curriculum. The College of Medicine implemented a blended learning strategy to deliver the curriculum. The strategy took into consideration the curriculum's sustainability and stability with the utilization of the rich resources provided by King Saud University and the monitoring of the quality of education. The preparation for the new academic year aimed to bring together the sudden shift to online education, to deliver quality education, and to prepare students for the workplace.


  Electronic Learning Resources at King Saud University Top


The widespread use of electronic services has made significant progress in e-learning since 1980. The faculty is used to terms such as virtual learning and online or web-based learning. E-learning has been increasingly used in medical education worldwide.[9] King Saud University has vibrant e-learning resources and services provided by the deanship of electronic services, which provides online training for the learning management system, blackboard (Bb). The deanship also provides licensing for the use of Bb for all the students and faculty. In addition, the Medical Education Department has training workshops for the use of Bb as part of the faculty development unit. During COVID-19, the Medical Education Department provided a week of hands-on training for the faculty on utilizing the Bb and Zoom platforms in teaching. In addition, the deanship of the e-learning and Medical Education Departments provided several handouts on the use of the Bb and Zoom platforms. The Medical Education Department also provided hotlines for help and support on the use of Bb and Zoom. The maximum utilization of Bb and e-learning resources is among the College of Medicine's strategic plan, and the college has taken strong steps in achieving these goals. This helped a greatly during the pandemic, as Bb's culture had been established before the pandemic, and many staff members had already been trained.


  Strategies for Teaching Undergraduate Curriculum at King Saud University Top


The College of Medicine curriculum at King Saud University is a hybrid, namely, it is system-oriented, problem-based, and student-centered. The curriculum was reformed in 2009 according to the latest international standards in medical education. The curricula were first accredited in 2010 by the Saudi National Commission for Accreditation and were the only curricula to be re-accredited for 7 years (in 2018).

Medical students are taught in a variety of methods including lectures, practical sessions, problem-based learning (PBL), clinical skill sessions, clinical bedside teaching, and work-based teaching in clinics and operating rooms. We will highlight the preparations made for each teaching modality [Figure 2].
Figure 2: Guidelines for the Teaching Methods During COVID-19 in the College of Medicine at King Saud University

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Figure 3: Summary of Academic Arrangements for the College of Medicine at King Saud University during COVID-19

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  Lectures and Tutorials Top


The lectures and tutorial materials were uploaded to the Bb system. The teaching was conducted using a Zoom platform according to the approved new academic year schedules. No changes were made to the content of the curriculum due to the pandemic situation. The only changes made to the teaching methods were in the shift to online education. All medical curriculum lectures were shifted to virtual presentations using the Zoom platform [Figure 2]. King Saud University provided Zoom accounts with all the features requested. The Medical Education Department distributed the Zoom accounts to all courses according to the approved new academic year schedules. The Student Council played an important role in coordinating the arrangements with the students' group leaders. The sheer number of medical students (1600 students in 2020) and faculty was an online logistics challenge that the College of Medicine at King Saud University had to face.

An open webinar was conducted before the beginning of the new academic year for orientating faulty on the steps taken in preparation for the new year [Figure 2]. The dean, vice deans, and Medical Education Department presented the steps for preparing for the new academic year. All the steps were highlighted in a booklet sent to the staff and all the students [Figure 2]. Another open webinar was conducted for medical students. Preparation and communication with students and faculty took a great amount of effort and time. It was done to ensure a smooth start to the new academic year and maintain the stability of the undergraduate medical curriculum's delivery during the pandemic situation.


  Practical Sessions Top


The teaching methods used in the undergraduate curricula at the College of Medicine, King Saud University, include the practical teaching sessions conducted at the College of Medicine laboratories. The practical sessions are taught in the system-oriented, integrated courses of years 1 and 2. The topics are related to the theme of the week. The College of Medicine has an excellent, well-equipped laboratory designed for teaching undergraduate students in diverse subjects that include anatomy, physiology, and pathology. Teaching these practical sessions was one of the challenges with the sudden shift to online education. A practical teaching committee was urgently formed to monitor teaching in practical sessions. The committee videoed the practical sessions and uploaded them on Bb with the Medical Education Department's help. The practical committee included members from the department involved in teaching the practical sessions. The challenge was deciding: what has to be taken on campus? What can be changed or run differently? What can be canceled?

Based on this, practical sessions have been classified into what must be taught on campus and what can be taught virtually using the Zoom platform. In addition, practical sessions have been classified to be taught virtually using Zoom and to be videoed and uploaded as video demonstrations. The practical sessions have been videoed innovatively and have been uploaded on Bb.


  Problem-Based Learning Top


The College of Medicine's undergraduate curriculum is a hybrid problem-based component, in which students take PBL sessions in a small group every week. With the COVID-19 situation, teaching in PBL sessions has shifted to online education. The principles of learning in PBL focus on student interaction, communication, and teamwork. The College of Medicine shifted its teaching of PBL sessions online, using Zoom accounts for each small group. Break-out rooms were activated to encourage active student participation during the sessions. Orientation and training were conducted for faculty and staff before the beginning of the new academic year.


  Clinical Teaching Top


Medical education worldwide has been challenged with the COVID-19 situation in continuing the education of clinical skills that require soft skills and communication. This is the instruction that is difficult to replace through online education, especially with the need to graduate doctors every year.[10]

The challenge was harder at the beginning of the pandemic, during the complete shutdown. The clinical bedside teaching was replaced by online education in utilizing video demonstrations, case-based discussions on Zoom, and discussions using clinical examination reference videos. The majority of the skills were already taught before the onset of the pandemic and the shutdown in April, as Saudi Arabia's 2020 academic year ended in May. As such, there was not much clinical education left to cover.

The situation was different for the new academic year 2020–2021. The College of Medicine at King Saud University adopted a blended learning strategy, combining online education and face-to-face teaching on campus. In light of that, clinical bedside teaching was carefully reviewed. The decision was made to give the final year 5 students the priority for teaching at King Saud University's Medical City, the training hospital for King Saud University medical students. After taking the required precautionary measures, the students were taught in small groups [Figure 2]. Following the hospital's infection control instructions, only one student at a time, per session, examined a patient.

The students rotated through the inpatient encounter. To enhance the learning experience and meet the desired learning objectives of clinical teaching, further clinical practice was continued at the College of Medicine CSSC. The CSSC at King Saud University is one of the largest clinical skills centers in the region and is equipped with high-quality equipment for teaching clinical skills using mannequins and simulations. In addition, the center provides simulated patients to practice the essential clinical skills of history taking and clinical examination. The CSSC was accredited by the American Heart Association in 2017 and the Society for Simulation in Health care in 2019 (for 5 years).

The clinical bedside teaching for all years was shifted to the CSSC. The challenge was to allocate enough rooms based on the infection control team's recommendation on each room's capacity. In addition, precautionary measures were applied to keep a 2-m distance. According to the precautionary measures and infection control team advice, the students' arrangements and distribution were explained in detail and highlighted in the guidelines sent to all students and staff.

Despite the challenge of planning clinical teaching for the new academic year utilizing alternatives to patient encounters or minimizing them as much as possible, the hope is that the COVID-19 situation will clear up soon and medical students will soon satisfy their learning needs in clinical encounters.[2]

Limitations

Some of the limitations are that we did not have the time to compare different online education options. Further comparison of the different types of online platforms and options for online medical education is needed. Another limitation is that there was no reference to a similar situation, in which we could compare the outcome of conducting online education in our college compared to other colleges. Furthermore, another main limitation was the time needed to implement the changes, which was very short.

One of the lessons learned is that we need to prepare ourselves with a clear plan for such incidents as part of the college's strategic plan. This can help if there is a need for an emergency shift to online education; this needs to be included in the curriculum and the college's strategic plan. Another lesson learned is that, despite the difficulties we faced in medical education, the teaching staff coped with it in a very short period.


  Conclusion Top


The COVID-19 pandemic has challenged educational institutions worldwide. The College of Medicine experience at King Saud University was no exception in managing the online curriculum delivery during the pandemic. Further monitoring of the effectiveness of these management efforts is required. Hopefully, it will open new windows for development and better preparedness for similar situations in future.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Gordon M, Patricio M, Horne L, Muston A, Alston SR, Pammi M, et al. Developments in medical education in response to the COVID-19 pandemic: A rapid BEME systematic review: BEME guide no. 63. Med Teach 2020;42:1202-15.  Back to cited text no. 6
    
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Rose S. Medical student education in the time of COVID-19. JAMA 2020;323:2131-2.  Back to cited text no. 7
    
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Raymond-Hayling O. What lies in the year ahead for medical education? A medical student's perspective during the COVID-19 pandemic. Med Educ Online 2020;25:1781749.  Back to cited text no. 8
    
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Ellaway R, Masters K. AMEE Guide 32: E-learning in medical education Part 1: Learning, teaching and assessment. Med Teach 2008;30:455-73.  Back to cited text no. 9
    
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Zayyan, M. Objective structured clinical examination: The assessment of choice. Oman Med J 2011;26:219-22.  Back to cited text no. 10
    


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Abstract
Introduction
College of Medic...
Preparation for ...
Electronic Learn...
Strategies for T...
Lectures and Tut...
Practical Sessions
Problem-Based Le...
Clinical Teaching
Conclusion
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