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 Table of Contents  
Year : 2022  |  Volume : 14  |  Issue : 2  |  Page : 117-123

Challenges and acceptance of synchronized e-learning for undergraduates during COVID-19 pandemic: Teachers' views from a health school of India

1 Departments of Physiology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India
2 Saheed Laxman Nayak Medical College and Hospital, Koraput, Odisha, India

Date of Submission02-May-2022
Date of Decision09-Jul-2022
Date of Acceptance12-Jul-2022
Date of Web Publication9-Aug-2022

Correspondence Address:
Magna Manjareeka
Department of Physiology, KIMS, KIIT University, Bhubaneswar - 751 024, Odisha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajprhc.ajprhc_41_22

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Background: Synchronized e-learning has been the savior of the educational system during the current COVID-19 pandemic. As this is newly implemented in lockdown, adaptability by the teachers may face challenges. Objectives: We aimed to evaluate the perception and experiences of teachers on online live classes conducted during the pandemic in a health school in the eastern part of India. Materials and Methods: This cross-sectional online survey was conducted after getting the approval of the institutional ethics. The survey was conducted with medical, dental, and nursing teachers. The survey was anonymous. The self-administered questionnaire was distributed among teachers through Google Forms. Results: A total of 130 teachers participated in this survey with a response rate of 63.8%. Among them, 120 (90.2%) were first time taking online classes in their teaching career. Around 78% and 41.5% of the faculties experienced discontinuation of class due to Internet disruption and technical issues, respectively. Around 72.3% of faculties perceived that animations or videos may increase the attention of students. The majority of the teachers (86%) considered the traditional method to be better than online classes and it cannot be a substitute for classroom learning on normal curricular days. Conclusion: Due to sudden implementation and resource limitations, many teachers faced challenges in conducting synchronized e-classes. Teachers considered online classes to be learner-centric one with time and place flexibility. Although online classes are not a substitute for traditional classes can enhance each other in the post-pandemic period.

Keywords: COVID-19, medical colleges, online classes, pandemics, perception, students, teachers

How to cite this article:
Manjareeka M, Kanungo PK, Mishra S, Mondal H, Mishra J. Challenges and acceptance of synchronized e-learning for undergraduates during COVID-19 pandemic: Teachers' views from a health school of India. Asian J Pharm Res Health Care 2022;14:117-23

How to cite this URL:
Manjareeka M, Kanungo PK, Mishra S, Mondal H, Mishra J. Challenges and acceptance of synchronized e-learning for undergraduates during COVID-19 pandemic: Teachers' views from a health school of India. Asian J Pharm Res Health Care [serial online] 2022 [cited 2022 Sep 27];14:117-23. Available from: http://www.ajprhc.com/text.asp?2022/14/2/117/353625

  Introduction Top

The use of technology and electronic devices to enhance learning is known as E-learning.[1] Internet-based learning, online learning, web-based learning, distributed learning, or computer-assisted instructions are also used synonymously and interchangeably for this type of learning.[2] E-learning can be synchronous learning or asynchronous learning. Learning is said to be synchronous when instructions are given to learners face-to-face from the teacher. Participants and instructors interact with each other in real-time. Asynchronous e-learning is when there may be a time gap between the instructions provided and the response of the learners. Participants and instructors do not interact in real time.[3] There have been many e-learning interventions in the medical education such as internet and local area network-based e-learning, nonnetworked computer-based e-learning, digital game-based learning, and psychomotor skills training.[1] Although e-learning is growing at a good pace in medical education in India, still very few eminent institutes practice some of these techniques in training medical undergraduates.[4] These institutes may have used blended techniques for undergraduate teaching but never have used e-learning as a sole way of teaching undergraduates.

Due to the sudden outbreak of coronavirus disease-19 (COVID-19) throughout the world, the lockdown was imposed for proper social distancing in highly populous countries like India.[5] The lockdown has impacted many factors of which education remains to be an important one.[6] Higher education, especially those which require skills and professionalism are highly affected.[7] Uncertainty of lockdown period and re-opening of institutes have forced many institutions to start online classes.

Our university is one among the reputed universities of India, where students' education and holistic development are given importance to and always act swiftly to initiate activities in favor of students. The online classes were going on in our institute since the onset of lockdown in March 2020. Although in our university, the use of technology in teaching and learning is widespread, the faculty of our institute practiced the use of nonnetworked and computer-based e-learning (use of PowerPoint presentations), Internet, and local area network-based e-learning (animations, videos, and study materials) along with traditional teaching. However, the complete lockdown has prompted the faculty of the institute to solely depend on teaching the students through video conferencing applications. Both synchronized and asynchronized e-learning techniques have been adopted by the faculty of all disciplines. Several previous studies have been published regarding the perception, attitude, and challenges of online classes among students during this pandemic lockdown period.[8],[9],[10] However, there is a scarcity of report regarding the perception, attitude, and challenges faced by medical and paramedical teachers.[11]

With this context, this study was planned to assess the perception and experiences of teaching faculty of medical, dental, and nursing colleges regarding the undergraduate online classes. The knowledge gained from this study would help to understand the current scenario regarding the challenges faced by the teachers to deliver online classes and their perception on the teaching–learning in distance online classes. This would help for further planning and implementation of faculty development programs for a smooth operation of e-learning.

  Materials and Methods Top

Type and settings

This cross-sectional survey was conducted by the Department of Physiology and Medical Education Unit of a health school of a reputed University of Eastern India. After obtaining the approval of the institutional ethics (KIIT/KIMS/IEC/132/2020 dated June 12, 2020) this survey was conducted with adult research participants. All of them agreed to the online informed consent form and then participated in the survey. This was an anonymous survey and the identity of the participants or E-mail addresses were not collected.

Participants and recruitment

Medical and paramedical teachers who were conducting online classes were included in this survey as a convenience sample. There is a total of 20 major disciplines which teach MBBS students, 9 exclusive disciplines which teach BDS students, and 5 exclusive disciplines which teach nursing students. We included teachers of all these three courses. Faculties who did not take any online classes during the lockdown were excluded from the study. The total strength of faculty members in all the three institutes who were involved in online teaching during the lockdown counted to be 204, of which 117, 52, and 35 are from medical, dental, and nursing schools, respectively.

The survey questionnaire

We designed a questionnaire for this study. As a part of the questionnaire content validation process, we invited four faculty members from medical colleges and two faculties from dental and nursing colleges, respectively, to pilot-test the initial survey questionnaire. The survey was modified based on their feedback before being shared with everyone. The responses from faculties who were involved in the content validation of the questionnaire were not taken into consideration in the study data. The questionnaire had 34 questions with various types of response options. The items (i.e., questions) in the questionnaire were about the experiences and perception of online classes.

Data collection

We created an online version of the questionnaire on Google Forms. There was a statement for consent and faculty who responded to the Google form were considered to have consented to the study. The link to the Google form questionnaire was sent through the faculty group mail by the first author. The link was also shared with all heads of the departments to be shared in the departmental WhatsApp groups. The link was open for 2 weeks for receiving responses from the faculty members. The principal investigator sent follow-up reminders to faculty members intermittently within these 2 weeks.

Statistical analysis

The data were analyzed using 15.1, Stata Corp, Texas, USA. Data were expressed in number and percentage. Chi-square test and binomial test were conducted to observe the association between the various factors with the usefulness of online classes and excellent rating of online classes. Spearman's correlation coefficient (rho) was calculated between two categorical variables. Statistical significance was considered at 5%.

  Results Top

The questionnaire link was shared with a total of 204 faculties and we got 130 responses with a response rate of 63.8%. As all of the questions were made compulsory, there was no incomplete submission and we analyzed the data of 130 respondents. The responses from medical, dental, and nursing faculty were 75 (64.1%), 26 (50%), and 29 (82.9%), respectively. The mean age of the faculty was 39.19 ± 9.22 years. The average teaching experience was 8.84 ± 6.42 years. Among the respondents, 120 (90.2%) were taking online classes for the first time in their teaching career.

For conducting online classes most of the faculties used laptops/desktops (83.8%) and mobile data (63%) as the Internet connection. Major challenges in online classes were internet disruption (77.7%), technical issues due to device/app used (41.5%), student annotations (49.2%), and time consumption for online class preparation (25.4%) [Table 1]. However, around 44% of faculties opined time consumption for online class preparation was similar to traditional class preparation.
Table 1: Resource used and challenges faced by teachers in conducting synchronized e-classes for undergraduate students

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Various opinions such as mode of knowledge sharing, sharing of animated videos, sharing of study materials before class, the conduct of internal assessment, and receiving feedback of class from students were noted by faculties in content fulfillment. About 72.3% of faculties thought that sharing animations/videos increased the attention of students and 70% opined increased student interaction during class if study materials are provided before class. Most faculties (73%) took feedback from students regarding the online classes [Table 2].
Table 2: Content fulfillment in synchronized e-classes for undergraduate students

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Faculties adapted to various techniques to make the online classes learners' centric; of which, interactive question–answer sessions, use of animation/videos, and polling within classes were the commonly used ones [Figure 1].
Figure 1: Different methods adapted by faculties for learner-centric classes

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Half of the faculties thought online classes are learner-oriented while the other half thought that these were teacher oriented. Most of the faculties (86%) considered the traditional method of teaching to be better than online classes. The majority (70%) of faculties opined online classes are not a clear substitute for classroom teaching. According to 41% of the teachers, students were interested in online classes while 41% of the teachers thought that students may be interested [Table 3].
Table 3: Perception of teachers about synchronized e-classes for undergraduate students

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The faculty perspective of the advantages and disadvantages of online classes is given in [Table 4]. As initially, the faculties were taking classes per convenience rather than a class routine, the time flexibility remained one of the advantages among most faculties. Poor teacher–student relationships and no eye contact with students remained the major disadvantages.
Table 4: Perceived advantage and disadvantages of online classes

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The perception of faculties regarding the usefulness of online classes was significantly associated with the difficulty faced during online classes (P < 0.001) and with the perception that students are interested in online classes (P < 0.01). Faculty who thought online classes are not useful, either were troubled by students' annotations (P < 0.05) or faced internet discontinuity (P < 0.001). Faculties who opined online classes to be useful 77% of them thought students are interested in online classes.

There was a significant association between the rating of online classes with an orientation of online class (P < 0.001) and sharing of study materials before the online class (P < 0.05). Around 69% of faculty who thought online classes are learners' centric and 58% of faculties who opined sharing of study materials before online classes increase students' interaction rated the online classes to be excellent. There was no association of age or stream of faculty with any of the factors.

  Discussion Top

The COVID-19 pandemic does have an impact on education. Few opine there has been an adverse impact on education due to online teaching which is not equitable with traditional classroom teaching. Few students may not have proper gadgets or high-speed internet for continuous online classes. Teachers may be resistant to accepting this new way of teaching.[12],[13] In contrast, others state that the pandemic has enhanced the technology-enabled education by wider acceptability of online teaching which was not happening before.[14] This study expresses the experience and perspectives of faculty regarding online classes.

The response rate of 64% from the over-burdened faculty seems to be adequate in this sample; it expresses the attitude of faculty toward the importance of teaching even in this critical period when our institute is one of the COVID-designated hospitals in the state. Most of the faculty in this study used laptops/desktops as the gadget and mobile data for the internet connection. A recent statistic shows the majority of India's digital population access the internet through their mobile data.[15]

Most faculty in this study encountered disruption during online classes due to internet connectivity as compared to technical issues or students' annotations. The majority of the faculty opined time consumption for preparing for online classes was either less or similar to traditional classes. Continuous internet connectivity remains one of the major challenges of online classes.[16] There are conflicting views among researchers regarding the time consumption for the preparation of online classes. Where few think online classes require more time for preparation others opine the contrast.[17],[18] Fewer faculties suffered technical issues suggests faculties being techno-savvy. This may be also because the mean age group of faculties in our survey was around 40 years.

Though many faculties expressed PowerPoint presentation to be the most common way of content sharing during the classes still few faculties also shared videos, animations, or 3D images. The majority of the faculty agreed that sharing videos, animations, or 3D images related to the topic increased the attention of the students. A previous study suggested that animated characters might be useful as a peripheral tool to retain learners' attention and maintain engagement with the learning material.[19] Similarly, most of the participants among faculty thought that sharing study materials before the class does increase the interaction of students during the class and makes the class more interesting. Sharing links and related materials with students does increase the attention of students in the class.[20] Although a large number of faculties mentioned taking feedback from the students about the online classes, most of them agreed that the feedback taken was not structured. A recent study expressed student feedback for teaching techniques in medical education is in an infantile stage at present in India where feedbacks are not thoughtfully designed, validated, and implemented.[21] Most faculty in this sample were taking student feedback (though unstructured), which indicates a positive attitude of the former group toward the improvement of teaching skills and online classes. Half of the faculties in the present sample had conducted an internal assessment for their students. Although this study did not consider the challenges faced by faculty members during the conduct of online assessment, the teachers preferred the traditional assessment methods over the online assessment ways. A recent study from the past reported ideal conduct of student assessment is one of the challenges for faculty and students.[11]

The majority of faculty thought eye contact between student and teacher is an important component while teaching–learning process. A recent review pointed out that students find online teaching to be boring and unengaging as personal attention and two-way interactions are sometimes difficult to implement.[16] According to faculties, the attentiveness of students is less in online classes than in traditional class. Many expressed discontinuous audios due to slow internet, easy distraction at home, and no supervision ultimately result in inattentiveness during online classes.[9] The flexibility of time, recording of the classes were major advantages of online classes. The recording also provides the faculties to review their classes regarding their teaching styles, syllabus covered, points missed out, and continuity of class. A group of faculty from Jordan also expressed similar advantages.[22] In this study, majority of faculties thought the ongoing online classes were learner's centric. The introduction of polls within the class, interactive question–answer sessions, student seminar presentations, small group discussions, and image descriptions were the different ways undertaken by the faculties to make the classes' learner's centric. Most of the faculties rated the ongoing online classes to be excellent. Many faculties adapted to above-mentioned new techniques for the first time during online classes to increase the attentiveness of students. This does show a positive attitude of faculties regarding the online classes. A study from a post-graduate institute in Haryana suggests online classes can be part of post-graduate training in India beyond the pandemic period.[23]

A great number of faculty agreed that online classes are not a substitute of traditional lectures during normal curricular activities. Many suggested blended teaching can be considered while following the normal curriculum if planned properly. Studies from India during the pandemic lockdown reveal online classes to be less preferred by the students over traditional teaching.[8],[24] However, a recent meta-analysis opined that there is no evidence that offline learning works better. Compared to offline learning, online learning has advantages to enhancing undergraduates' knowledge and skills, therefore, can be considered a potential method in undergraduate medical teaching.[25] Interactive web-based tutorials were found to be better for cognitive learning compared to traditional teaching methods.[26] Learners using blended learning preferred and also performed better than traditional teaching methods.[22],[26] The faculties in this study preferred traditional classes or blended classes to online classes maybe because of the noncognitive skills such as communication (language, empathy, integrity), collaboration (responsibility, respect, and duty), and continuous improvement (recognition of limitations and motivation to improve) were lacking in the present online classes.[27] Techniques and innovations have to be introduced to incorporate these components into teaching–learning sessions which will further motivate the students and faculty toward online classes.[28] Faculties who thought students are interested in online classes, faculties who opined sharing of materials increased the students' interaction, and faculties who opined online classes were learner's centric rated the online classes to be excellent. Those faculties who had internet disruption, faced trouble while taking online classes thought these classes are not useful. Continuous high-speed internet connectivity remains one of the major necessities of online classes.[29]

In this study, there was no association between age and any of the factors. This may be due to faculty in this study being in an age range of 30–50 years and their positive attitude toward acceptance of synchronized e-learning. A recent study explains the acceptance of technology-assisted work is not age dependent rather attitude dependent.[30]


First, the faculties who participated in this study are from the health school of a single private university, so it may not represent the scenario of government colleges. Second, no information regarding practical teaching or clinical teaching has been taken into consideration which is a very important component of medical education. Third, we have not taken into consideration the mental state of faculty members; however, this study represents the faculty perspective of online teaching in medical education during this pandemic condition.

  Conclusion Top

This study delineates even though there are many challenges of online classes for faculties, there seems to be a positive attitude in them for the acceptability of online classes. Synchronous e-learning can be practiced together with the traditional methods during normal curricular activities to bring efficiency and productivity in imparting quality education. Dedicated faculty members should invent newer techniques in this blended method to impart teaching of both cognitive and noncognitive domains of the curriculum, make sure to engage student attentiveness and involvement, deal with fairways of assessment, and acquire honest feedback.


Synchronized e-learning has been the savior of the educational system during this pandemic lockdown. However, in a developing country like India, the acceptability and attitude of faculties and students toward such a new technique of teaching and learning remains a question. This study highlights even though there are many challenges for the faculties and students for imparting medical education through synchronized e-learning still the acceptability of the same is also immense. The incorporation of online classes along with traditional classroom classes (blended teaching) is essential in normal curricular activities for undergraduate students to facilitate synchronized e-learning and gradually take steps to overcome the challenges for the latter. The regular use of the blended technique in the curriculum will strengthen the efficiency of faculties and the acceptability of students to such techniques in similar circumstances in the future.


We are thankful to all the faculty members those all spared their time and participated in the study. Heartfelt thanks to all the faculty members who helped in the content validation of the questionnaire and the biostatistician for her help.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

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  [Figure 1]

  [Table 1], [Table 2], [Table 3], [Table 4]


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