Restructuring the clinical curriculum at University Medical Center Göttingen: effects of distance teaching on students’ satisfaction and learning outcome

Introduction: In summer term 2020, the clinical phase of the undergraduate medical curriculum at University Medical Center Göttingen was restructured since distance teaching had to be used predominantly due to contact restrictions during the COVID-19 pandemic. This paper investigates the impact of restructuring the clinical curriculum on medical students’ satisfaction and learning outcomes. Methods: In each cohort, the 13-week curriculum was divided into two parts: During the first 9 weeks, factual knowledge was imparted using distance teaching by means of a modified inverted classroom approach. This was followed by a 4-week period of adapted classroom teaching involving both real and virtual patients in order to train students’ practical skills. The evaluation of the 21 clinical modules comprised students’ satisfaction with distance teaching as well as students’ learning outcome. The latter was assessed by means of comparative self-assessment (CSA) gain and the results of the module exams, respectively. Data of summer term 2020 (= distance teaching, DT) were compared with respective data of winter term 2019/20 (= classroom teaching, CT) and analysed for differences and correlations. Results: Response rates of evaluations were 51.3% in CT and 19.3% in DT. There was no significant difference between mean scores in module exams in CT and DT, respectively. However, CSA gain was significantly lower in DT (p=0.047) compared with CT. Further analyses revealed that CSA gain depended on the time point of data collection: CSA gain was lower the more time had passed since the end of a specific module. Moreover, we found positive correlations between CSA gain and students’ satisfaction with various aspects of distance teaching, particularly with “communication between teachers and students” (rho=0.674; p=0.002). Discussion and conclusions: Although some limitations and confounding factors have to be taken into account (such as evaluation response rates, assessment time points, and proportion of familiar items in module exams), the following recommendations can be derived from our findings: 1. A valid assessment of students’ learning outcome by means of exam results requires that as few exam items as possible are familiar to the students. . 2. CSA gain seems to be valid if assessment time points are standardised and not contaminated by students’ learning activities for other modules. . 3. Good communication between teachers and students may contribute to increase students’ satisfaction with distance teaching.