Annals of Medicine and Surgery 59 (2020) 186–194

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Annals of Medicine and Surgery

journal homepage: www.elsevier.com/locate/amsu
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Cross-sectional Study

Distance education during the COVID-19 outbreak: A cross-sectional study

among medical students in North of Jordan
Amer Mahmoud Sindiani a, *, Nail Obeidat a, Eman Alshdaifat b, Lina Elsalem c,
Mustafa M. Alwani d, Hasan Rawashdeh a, Ahmad S. Fares d, Tamara Alalawne d,
Loai Issa Tawalbeh e
a
Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
b
Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, Irbid, Jordan
c
Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbi, Jordan
d
Medical Students, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
e
Princess Salma, Faculty of Nursing, Al-al-Bayt University, Jordan

A R T I C L E I N F O A B S T R A C T

Keywords: Introduction: In the spot of the new emerging COVID-19 pandemic and its major impact worldwide on day-to-day
Covid-19 activities many rules had to be changed in order to fight this pandemic. Lockdown started in Jordan and around
Online learning the globe affecting several aspects of life including economy, education, entertainment, and government policies.
Medical students
Regarding education, the priority was to ensure the safety and progress of the educational process. Thus, new
Jordan
methods of teaching had to be applied using the online learning at Jordan University of Science and Technology
(JUST), Faculty of Medicine. This study was done to assess (1) Class Experience (2) Students and Lecturers’
Interaction (3) Online Learning Advantages & Disadvantages (4) Students’ Preference.
Methods: A cross sectional study was conducted Convenience sampling technique was used to collect the data
from the participants using a survey composed of 18 questions on Google Forms platform. A link was sent to the
undergraduate medical students at the Jordan University of Science & Technology via their e-learning accounts
(n = 3700). The form was available from May 22nd, 2020 to May 30th, 2020 for 8 days long. Data analysis was
done using SPSS V 23.
Results: 2212 out of 3700 students responded, (55.8%) of them were in the basic years and (44.2%) of them were
in the clinical years. (55.8%) of students started to take online lectures after 3 weeks. (45.7%) used the hybrid
teaching method (asynchronous and synchronous), (31.4%) used live classes, and 22.8% recorded classes. Zoom
was the most used platform. (48.7%) and (57%) of clinical students and basic students express their interaction
as bad, while the others had good and excellent interaction. Maintaining social distance was the most advantage
of online teaching, while poor technical setup and no direct contact were the most disadvantage, furthermore
inability to have real clinical access was a significant problem for clinical students (p < .001). With reference to
students’ preferences 75% of students were not pleased with their experience and 42% of students prefer to
integrate online learning with traditional learning.
Conclusion: Most medical students at JUST preferred the traditional face-to-face teaching method over the solo
online teaching methods with recommendations to convert to a more integrated educational system. Also, a well-
established infrastructure should be done in involving online teaching.

1. Introduction Later, the causative agent was identified as a SARS-CoV-2 (COVID-19)

virus, leading to a worldwide outbreak of COVID-19 virus which was
In December 2019, an outbreak of pneumonia cases of an unknown classified as a global pandemic from the World Health Organization
etiology was recorded in the city of Wuhan in Hubei province, China. WHO on March 11th, 2020 [1]. After that, most countries started to

* Corresponding author. Department of Obstetrics and Gynecology, Faculty of medicine, Jordan University of Science and Technology, P.O.Box: (3030), Irbid,
22110, Jordan.
E-mail address: [email protected] (A.M. Sindiani).

https://doi.org/10.1016/j.amsu.2020.09.036
Received 15 August 2020; Received in revised form 17 September 2020; Accepted 18 September 2020
Available online 2 October 2020
2049-0801/© 2020 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
 A.M. Sindiani et al. Annals of Medicine and Surgery 59 (2020) 186–194

lockdown progressively to control the outbreak by isolating cases and Online learning helps saving up to 60% of traditional learning time,
tracing contacts [2]. decreasing costs by millions of dollars, saving the environment, and
Until June 20th, 2020 COVID-19 infected more than 8.5 million and developing more interactive ways [8].
killed 460 thousand people worldwide. Locally, Jordan reported 1015 As a part of Faculty vision and mission to deliver the most creative,
cases with 722 recovered patients and 9 deaths [3]. innovative and high-quality teaching method to our students, providing
On March 1st, 2020, the first case of COVID-19 was diagnosed in permanent recommendations to develop the teaching and learning
Jordan for a citizen who recently returned from Italy. The pandemic is methods, it was a chance to experience a new method of remote teaching
expected to have enormous economic consequences as well as a marked using the online learning for all the courses with no exception during
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impact on global education. On March 15th, 2020, The Hashemite these critical circumstances to ensure the progress and safety of teaching
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Kingdom of Jordan prime ministry issued an order to suspend studying practice without any interruption.
at universities and schools. The order also included closing mosques and To meet our objectives, we should understand the students’ prefer­
churches, shutting down the borders, and suspending all incoming/ ences during this period of remote teaching, in order to engage the
outgoing flights, in preparation to start a curfew on March 23rd, 2020 students in developing the remote teaching process to be able to achieve
under the supervision of Jordan’s Military force and National Defence the most satisfying and reliable results that balance between students’
Law [4]. preference and teaching quality, thus we have conducted this study.
In order to remedy education issues, The Ministry of Higher Educa­
tion and Scientific Research issued new recommendations toward con­ 2. Methods
verting to online teaching in the universities, setting up the way to a new
method of learning in Jordan University of Science and Technology 2.1. Design
(JUST), the leading university in North of Jordan.
The faculty of Medicine at JUST has approximately 3700 on-seat A cross-sectional study was conducted in order to asses (1) Class
students, the curriculum of medicine classify the students into two Experience (2) Students and Lecturers Interaction (3) Online Learning
main levels: Basic science and Clinical practice groups depending on Advantages & Disadvantages (4) Students’ Preference among medical
their year of study, the main focus of the first three years is studying students at JUST during the period of COVID-19 pandemic.
basic science and organ systems while the remaining three years are
concerned with clinical training through teaching the art of medicine
practice, contributing to 6 years of studying in total. 2.2. Sample
All the lectures of basic sciences are given by face-to-face methods in
the classrooms at JUST, while student’s clinical training is provided at A convenience sampling technique was used to utilize the sample of
King Abdullah University as the main hospital, in addition to other pe­ this study, in which an electronic survey was set on the Google Forms
ripheral hospitals in the north of Jordan. It is worth mentioning that platform. A link was sent to the undergraduate medical students at the
King Abdullah University Hospital is the official assigned hospital from Jordan University of Science & Technology via their e-learning accounts
the Ministry of Health to admit and treat COVID-19 patients in the north (n = 3700). The inclusion criteria includes any on-seat undergraduate
of Jordan [5]. medical student who experienced online teaching during COVID-19
With the emergence of education and learning technologies, new pandemic.
platforms for remote studying were innovated making online study A Population proportion equation was used to figure out the rec­
much easier, Google and Microsoft announced Google Meet, and ommended sample size with margin of error 1%.
Microsoft team since 2017 respectively, leading to a new era of mass
virtual meetings [6,7].bib7 2.3. Instrument
In addition, the online E-learning platform such as Moodle (our
university E-learning) and Google Classroom, contributed to the sharing A survey of 18 questions was submitted to students using Google
of study material, holding small discussions and contacting the lecturer Forms online platform. Responding to all 18 multiple choice questions
at any time. was a prerequisite for submission and recording the response in which
Most companies are using the online courses platform to improve two of them depends on the type of classes.
their staff abilities by preloaded courses on several websites for example
Udacity, Kajabi, and Datacamp. In addition, some universities such as
Harvard University hosts online courses on their websites. It is believed 2.4. Data collection
that global online E-learning is growing by 19% annually [8].
The form was available from May 22nd, 2020 to May 30th, 2020 for
8 days long. A follow up reminder was sent after two and five days.
Table 1
The respondent’s distribution and their previous online teaching experience.
Survey Questions Response n (%) Total n 2.5. Ethical consideration
options = 2112

Academic Year 1st Year 554 (26.2) In order to collect participants data, ethical approval was obtained
(Basic) from the JUST Institutional Research Board (IRB approval number: 219/
2nd Year 316 (15) 132/2020). Research Registry was done (UIN: researchregistry5912) in
(Basic)
3rd Year 309 (14.6)
accordance to Helsinki declaration.
(Basic)
4th Year 375 (17.8)
(Clinical) 2.6. Data analysis
5th Year 256 (12.1)
(Clinical) Data was exported in. CSV file from Google Forms, then processed to
6th Year 302 (14.3)
be used by IBM SPSS STATISTICS V23 for data analysis.
(Clinical)
A Pearson Chi-Square analysis p-value <.05 used to exhibit the
Have you ever experienced online teaching Yes 1554 (73.6) suggested statically difference among categorical parameters. A
before COVID-19 pandemic? No 558 (26.4)
STROCSS guidelines used to report our study [21].

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Table 2 3. Results
The students’ class experience.
Survey Questions Response options n (%) Total n 3.1. Participants’ data
= 2112

On which week of the lockdown did After that 1178 (55.8) Overall, 2212 out of 3700 students at JUST faculty of medicine
you start your online learning? During the 1st week of 277 (13.1) participated in this survey. The distribution of students was as follows:
lockdown 554 (26.2%) in 1st year, 316 (15%) in 2 nd year, 309 (14.6%) in 3rd
During the 2 nd week of 657 (31.1) year, 375 (17.8%) in 4th year, 256 (12.1%) in the 5th year, and 302
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lockdown
(14.3%) in the 6th year. Those groups had subdivided into two groups:
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How many Online classes do you have 1 424 (20.1) Basic’s group including the first three years in which the basic courses
in a week? 2 324 (15.3)
are given and Clinical’s group including the remaining years where the
3 300 (14.2)
4 300 (14.2) clinical rotations take place, contributing to 1179 (55.8%) and 933
5 or more 764 (36.2) (44.2%) of the respondents, respectively. Most of these students had not
Type of online class Live Classes 664 (31.4)
experienced online teaching before as indicated in Table 1.
(synchronous)
Recorded Classes 482 (22.8)
(asynchronous) 3.2. class experience
Both 966 (45.7)
The majority of the students (55.8%) started to take online lectures
after 3 weeks of lockdown, while (31.1%) started during the 2 nd week
of the lockdown, and (13.1%) started from the 1st week of the lockdown.
A Pearson Chi-Square analysis showed a significant association be­
tween the academic year divided into two main groups (Basic and
Clinical) and the starting week of online learning (1st, 2nd and 3rd

Fig. 1. Live classes platforms.

Fig. 2. Asynchronous classes materials.

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Table 3 applications such as Zoom and Microsoft Teams. In the first place, Zoom
The students’ Attitude. was used in the majority of live classes (62.8%), while 11% used
Survey Question Response n (%) Total n Microsoft Teams, 11.7% used the two aforementioned apps and 14.5%
options = 2112 used another platform [Fig. 1].
What is the percentage of your online classes that Less than 850 (40.2) For students who attended the asynchronous classes, the most
you were able to attend at home? 50% frequently used method was PDF files and Slides as a source for asyn­
50–80% 684 (32.4) chronous classes, though the narrated PowerPoint and recorded videos
More than 578 (27.4) were used in a less frequent manner. [Fig. 2].
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80%
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week), χ2 (2) = 63, (p < .001). 3.3. Students and Lecturers’ Interaction
36.2% of students have 5 or more classes per week, while the rest
have less than 5 classes. Most of them (43.7%) took between 2 and 4 Regarding the student attendance of online classes, of all re­
classes per week. spondents, about (59%) of students were able to attend more than half of
Around 45.7% of students attended a hybrid of Live Classes (Syn­ their online lectures, while the rest attended less than half of the lectures
chronous) and Recorded Classes (Asynchronous), while 31.4% took Live [Table 3].
Classes only, and the rest 22.8% took only Recorded Classes. As Table 2 When asked about the causes that prevent the students from
shows. attending the online classes using multiple-choice questions, most of the
Most of the live classes were held on well-known online meeting students found that bad internet connection and inappropriate timing to
be the main obstacle, that prevents them from attending, although about

Fig. 3. The preventive cause to attent online classes.

Fig. 4. Student-lecturer interaction (live classes).

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Fig. 5. Student-lecturer interaction (asynchronous classes).

Fig. 6. Student-lecturer interaction.

one-third of the students think that live attendance is not important, 3.4. Online Learning Advantages & Disadvantages
while a minority of them believe that online learning makes them un­
comfortable [Fig. 3]. Limited social contact such as social distancing and saving money
Student lecturer interaction revealed that the majority were inter­ and energy from using the university transportations were the most
acting directly during live lectures, while the E-Mail and university E- advantages of online learning, while the second main advantage was
learning massages were used less frequently [Fig. 4]. considered as an easier method of learning. Most of the disadvantages
On the other hand, student-instructor interaction for asynchronous were regarded as the need for technical setup as well as on-ground direct
classes was through E-learning massages, University E-mail, or discus­ contact and no clinical access.
sion forum on e-learning platform in an equal manner [Fig. 5]. At the same time, the inability of providing a calm environment for
About (48.7%) of Clinical students described their interaction with the students during the online class and lower academic achievement
the lecturer as bad, in contrast to (42.1%) and (9.2%) of them reported was considered the second most reported disadvantage of the online
good and excellent interaction, respectively. However, more than half learning, while the minority of disadvantages were due to inability to
(57%) of Basic students had bad interaction, the remaining (31.2%) and adapt, more absence and feeling the online class are not safe. As Table 4
(11.8%) had good and excellent interaction, respectively [Fig. 6]. manifest.
A Pearson Chi-Square indicated a significant association between the A Pearson Chi-Square analysis exhibits a significant difference be­
academic year divided into two main groups (Basic and Clinical) and the tween the academic year divided into two main groups (Basic and
interaction with the lecturer, χ2 (2) = 27.22, (p < .001). Clinical) and the availability of clinical access to medical students, χ2
(1) = 240.09, (p < .001).

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Table 4 3.5. Students’ preference

Online learning advantages and disadvantages.
Survey Questions Response options n (%) Out of Five questions targeted the student’s preference regarding their
total n = experience with the last online courses and how to improve it.
2112 The majority of the students agreed that the lecturer and the students
Advantages of Online Limited consequences of social 1232 (58.3) should have a better technical setup, whereas in the second place more
learning (Multi-choices) contact improvement should be considered in class timing, class interactivity,
Saves money and energy from using 1028 (48.7) classes privacy, and simpler ways of explanation and discussion during
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transportation from and to University

An easier method of learning 712 (33.7)
classes [Table 5].
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Less absences than traditional 488 (23.1) Nearly (75%) of students (Basic and Clinical) weren’t pleased with
teaching their online experience, didn’t prefer this method of teaching rather
Better interaction of students in 475 (22.5) than the traditional one and don’t wish to use it as an official teaching
classes
method in the upcoming future [Fig. 7] [Fig. 8] [Fig. 9].
Better/higher academic achievement 262 (12.4)
While about (42%) of students would prefer to integrate online
Disadvantages of Online Needs technical means 1218 (57.7) learning with the traditional one after COVID-19 pandemic [Fig. 10].
learning (Multi-choices) No direct contact with the lecturer 964 (45.6)
No clinical access 928 (43.9)
A Pearson Chi-Square analysis exhibited a significant association
Inability to provide a calm 768 (36.4) between experienced online learning before COVID-19 and being satis­
environment in the house while fied with online learning, χ2 (1) = 142.731, (p < .001).
having the online class
Worse/lower academic achievement 601 (28.5)
4. Discussion
Cannot yet adapt with Online 497 (23.5)
learning
More absences than in traditional 431 (20.4) During the last 3 years, the Faculty of Medicine at Jordan University
teaching of Sciences and Technology (JUST) committed to integrating online
Feeling online classes are not safe 286 (13.5) learning using the Moodle platform (JUST E-learning). These efforts
succeeded to convert two courses MED362 MEDICAL ETHICS &
MED382 HEALTH ADMINISTRATION which are part of the third-year
Table 5 curriculum to completely online courses using asynchronous lecture
Online learning improvement. videos, online assignments and study material files, This conversion
Survey Question Response options n (%)Out of enabled the students to save their time in order to focus more on the
total n = other tough courses such as MED322 NEUROSCIENCE (1), MED332
2112 NEUROSCIENCE (2), and MED352 URINARY & REPRODUCTIVE SYS­
What are the points that you think For the lecturer to have a 1171 (55.4) TEM which are all part of the same semester in that year, it was an initial
may improve the online better technical setup setup for establishing online approach in our Faculty of Medicine.
learning? (Multi-choices) For the student to have a 861 (40.8)
This year as COVID-19 became a pandemic and lockdown started
better technical setup
Different classes timings 749 (35.5) worldwide, most of the academic facilities converted to use online
More dynamic and 657 (31.1) learning as an alternative during this period to ensure the safety of staff
interactive classes and students [9]. In addition to that, some medical colleges adopted
More private environment at 638 (30.2) open-book examination shifting toward a new entirely system of online
student’s house
Simpler ways of explanation 604 (28.6)
teaching and examination [19].
and discussion during As we experienced a massive transition to online learning, it was
classes extremely important to study the effects of online learning using several
parameters on medical students especially, it is known that clinical

Fig. 7. Experience satisfaction.

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Fig. 8. Do you prefer online learning method than classroom traditional learning?.

Fig. 9. Keep using Online Learning alone.

courses need on-ground interaction for the purpose of clinical practice Students believe that bad internet connection and inappropriate
(physical examination, history taking and clinical skills), on the con­ timing was preventing them from attending the classes, it is worth to
trary, basic science courses are more flexible to be converted to online as mention that Jordan telecommunication companies had suffered from a
it needs a minimal real-time interaction between the lecturer and the massive load on the internet network that decreased the internet speed
students. and connection in several areas. Some of the students think that online
Starting with class experience, most of the courses took more than 2 live attendance is not important as they can study from the sources
weeks to start as it took about two weeks to have a full lockdown in directly, this was found to be congruous with the concerns of some ed­
Jordan. Most of the students had on average 2 to 4 classes per week. ucators that these methods may lead to loss of fundamental knowledge
Zoom was the most used platform for live classes as it was the most such as on-hand clinical practice that provided by the educator work
famous cloud meeting app during that period [10]. experience due to consuming more time focusing on things that the
We noted a significant relation between clinical students and basic students should prepare themselves [12].
students due to the previous experience using the online learning before When asked about online learning advantages, most of the students
COVID-19 as clinical students had passed the Medical Ethics and Health stratify that online learning would help on maintaining social distance
administration online courses and have established a background about as they are at home and have less contact with others as well as it will
online teaching, this is consistent with Leslie Hamilton et al. of which save them some money [13] and energy though our university located
the older students prefer to use online scientific sources such as e-books out of Irbid city and it’s far away from the capital Amman approximately
and online libraries, due to the experiential nature of their courses that 90 km. Kay D et al. believes that the online teaching provides the stu­
requires more literature knowledge [11]. dents with more comfortable space and increases their focus on studying

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Fig. 10. Use more Integrated System.

since they are accessing the lectures from their homes [20]. Further research studies are recommended using a more representative
Given that should ease and rise the expectations of student atten­ sample of medical students from all over Jordan, applying a longitudinal
dance. This is consistent with a study of Orthopaedic Education, though design that is based on a valid and reliable tool to help improving the
higher residents’ attendance was noticed in the virtual learning sessions external validity of the results.
compared to the traditional one [18]. However, our students’ online Finally, keeping the progress of the teaching process is of high value
attendance rate was below than usual. This may be due to the unes­ during this critical situation with maintaining students and lecturers’
tablished online teaching infrastructure and our limited experience in health as our priority. COVID-19 changed the world, a high number of
this field. casualties and cases are being reported around the hour, in the other
On the other side, most of the students stated that online learning side, it helps us to discover a new way of learning by setting up the
needs more technical means. No direct contact between the lecturers borders for a new era of online learning also it helps us to bring the
and students is a significant obstacle as students and lecturers have been world together in fighting this pandemic, we hope that this nightmare
making a long way of on-ground interaction during the regular lectures will stop as soon as possible.
before COVID-19, this is consistent with Friedman CP et al. [16] The lack
of clinical access to medical students exhibits one of the most disad­ 5. Conclusion
vantages for them, this owed to the essentiality of patients exposure for
this period of medical training. Although, a further step should be taken The world is always changing and progressing whether intentional or
to integrate more skill labs sessions in our School of Medicine as most by circumstances against our will, hence we should always aspire to
medical schools started to change their curriculum to include more move forward and try to develop our vision and tools, in the meaning
educational simulation in order to ensure the safety and quality of time solo online education experience was not favourable amongst the
teaching. Ethically, this will save the patient autonomy [17]. majority of our students, due to various reasons, some of which we can
A minimal count of students don’t feel safe using online learning due modify, and some we can’t, however, it is very important to investigate
to security reasons that surrounded Zoom App as it is the most used app and alter our deficiencies to deliver the maximum quality of teaching.
in our online learning [10]. It is worth mentioning that JUST Faculty of Also, we should setup a well-established infrastructure to integrate the
Medicine will convert to use Microsoft Teams in the whole upcoming online teaching in the correct manner based on international
online classes for a privacy concern about the Zoom app and as the experiences.
university offers free access to it by using university E-mail.
Most of the students weren’t pleased with their online experience,
Ethical approval
nonetheless, a significance between students who had past online
experience and being pleased with online learning stratifying some
IRB approval number: 219/132/2020.
studies results suggesting that first-time online experience being sub­
stantially worse comparing to experienced students, this is congruent
Sources of funding
with Freeze R et al. [15].
We share our beliefs with other studies that the effectiveness of on­
No funding.
line learning is affected by several diverse parameters such as age,
attitude, satisfaction, and level of engagement [14].
As doctors, health care is becoming more digitized in several ways Author contribution
such as documentations that will be recorded in electronic health re­
cords thus online learning will provide capabilities to the students to Study concept or design: Amer Sindiani, Nail Obeidat, Mustafa
deal with the upcoming digitized medicine [16]. Mohamed Alwani. Data collection: Amer Sindiani, Lina Elsalem, Eman
The use of convenience sampling technique and cross-sectional Alshdaifat, Tamara Alalawn. Data analysis: Amer Sindiani, Mustafa
design that is based on a questionnaire are the main limitations of the Mohamed Alwani, Ahmad Salah Fares. Writing the paper: Amer Sin­
current study which may affect the generalizability of the findings. diani, Nail Obeidat, Mustafa Mohamed Alwani, Ahmad Salah Fares,
Hasan Rawashdeh, Loai Twalbeh.

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Registration of Research Studies References

1 Name of the registry: Distance education during the COVID-19 [1] Coronavirus Disease (COVID-19) – World Health Organization. https://www.who.
int/emergencies/diseases/novel-coronavirus-2019. (Accessed 31 December 2019).
outbreak: a cross-sectional study among medical students in North Accessed 26 June 2020.
of Jordan. [2] J. Hellewell, S. Abbott, A. Gimma, et al., Feasibility of controlling COVID-19
2 Unique Identifying number or registration ID: researchregistry5912. outbreaks by isolation of cases and contacts, Lancet Glob Health 8 (4) (2020)
e488–e496, https://doi.org/10.1016/S2214-109X(20)30074-7.
3 Hyperlink to your specific registration (must be publicly accessible [3] COVID-19 Map, Johns Hopkins Coronavirus Resource Center. https://coronavirus.
and will be checked): https://www.researchregistry.com/browse-th jhu.edu/map.html. (Accessed 20 June 2020). Published 2020.
kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 11/12/2024

e-registry#home/registrationdetails/5f36ea72735ea600152340fd/. [4] National Defense Law, Jordan prime ministry. http://www.pm.gov.jo. (Accessed
Downloaded from http://journals.lww.com/annals-of-medicine-and-surgery by BhDMf5ePHKav1zEoum1tQfN4a+

19 March 2020). Accessed 20 June 2020.

[5] Coronavirus Disease, Ministry of health. https://corona.moh.gov.jo/en. (Accessed
Guarantor 16 March 2020). Accessed 20 June 2020.
[6] Microsoft Teams, En.wikipedia.org. https://en.wikipedia.org/wiki/Micros
oft_Teams. (Accessed 21 June 2020). Published 2017.
Amer Sindiani. [7] Google Meet, En.wikipedia.org. https://en.wikipedia.org/wiki/Google_Meet.
(Accessed 21 June 2020). Published 2017.
[8] 100 Essential E-Learning Statistics for 2020, E-student.org. https://e-student.org/e
Consent -learning-statistics/. (Accessed 22 June 2020). Published 2020.
[9] Coronavirus communications, Hms.harvard.edu. https://hms.harvard.edu/cor
IRB has been obtained (IRB approval number: 219/132/2020). onavirus/coronavirus-communications. (Accessed 25 June 2020). Published 2020.
[10] S. Keane, Zoom Chalks up 300 Million Daily Participants Despite Security Issues,
Data has been collected using survey on Google form send to all CNET. https://www.cnet.com/news/zoom-chalks-up-300-million-daily-particip
students via e-learning and the survey did not include any personal data ants-despite-security-issues/. (Accessed 25 June 2020). Published 2020.
(name, university ID …etc). [11] L. Hamilton, K. Suda, R. Heidel, et al., The role of online learning in pharmacy
education: a nationwide survey of student pharmacists, Curr Pharm Teach Learn 12
(6) (2020) 614–625, https://doi.org/10.1016/j.cptl.2020.01.026.
[12] Amanda R. Margolis, Andrea L. Porter, Michael E. Pitterle, Best practices for use of
Declaration of competing interest blended learning, Am. J. Pharmaceut. Educ. 81 (3) (2017) 49, https://doi.org/
10.5688/ajpe81349.
[13] D. Deming, C. Goldin, L. Katz, et al., Can online learning bend the higher education
No Conflict of interest.
cost curve? Am. Econ. Rev. 105 (5) (2015) 496–501, https://doi.org/10.1257/aer.
p20151024.
Acknowledgements [14] L. Pei, H. Wu, Does online learning work better than offline learning in
undergraduate medical education? A systematic review and meta-analysis, Med.
Educ. Online 24 (1) (2019) 1666538, https://doi.org/10.1080/
Special thanks to Maram Mohammad Shehab, Omar Mohammad 10872981.2019.1666538.
Obeidat, Iyad Al-Bustami, Abdel Rahman Elsayed, Muhammad Alameen [15] R. Freeze, K. Alshare, P. Lane, et al., IS success model in E-learning context based
on students’ perceptions, J. Inf. Syst. Educ. 21 (2) (2010) 173–184. https://aisel.
Daise, Saad Saidan, Thair Alghazo, Al-Hakam Mahmoud, Ramez Shur­ aisnet.org/jise/vol21/iss2/4. (Accessed 1 July 2020).
baji, Abdulrahim Alkaddah, Sajeda Omar, Mohmmad Obeidat and [16] C.P. Friedman, K.M. Donaldson, A.V. Vantsevich, Educating medical students in
Mohammad Shana’ah for their great effort to make this work success. the era of ubiquitous information, Med. Teach. 38 (5) (2016) 504–509, https://doi.
org/10.3109/0142159X.2016.1150990.
[17] Y. Okuda, E. Bryson, S. DeMaria, et al., The utility of simulation in medical
Appendix A. Supplementary data education: what is the evidence? Mt. Sinai J. Med. 76 (4) (2009) 330–343, https://
doi.org/10.1002/msj.20127.
[18] M. Kogan, S. Klein, C. Hannon, M. Nolte, Orthopaedic education during the COVID-
Supplementary data to this article can be found online at https://doi. 19 pandemic, J. Am. Acad. Orthop. Surg. 28 (11) (2020) e456–e464, https://doi.
org/10.1016/j.amsu.2020.09.036. org/10.5435/jaaos-d-20-00292.
[19] P. Sandhu, M. de Wolf, The impact of COVID-19 on the undergraduate medical
curriculum, Med. Educ. Online 25 (1) (2020) 1764740, https://doi.org/10.1080/
Funding 10872981.2020.1764740.
[20] D. Kay, M. Pasarica, Using technology to increase student (and faculty satisfaction
with) engagement in medical education, Adv. Physiol. Educ. 43 (3) (2019)
No funding received. 408–413, https://doi.org/10.1152/advan.00033.2019.
[21] R. Agha, A. Abdall-Razak, E. Crossley, et al., STROCSS 2019 Guideline:
strengthening the reporting of cohort studies in surgery, Int. J. Surg. 72 (2019)
Provenance and peer review
156–165, https://doi.org/10.1016/j.ijsu.2019.11.002.

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