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Dear Editor,
Coronavirus Disease 2019 (COVID-19) was first diagnosed in Wuhan, China, in December 2019 (1). Since then, the infection has spread to all countries around the world. The World Health Organization declared the infection a pandemic on 11 March 2020 (2). In the Kurdistan Region of Iraq, strict measures were taken to prevent the spread of the infection. One measure included the closure of schools and educational institutes (3, 4). Due to the outbreak, more than 90% of the world's learners lost access to schools, as educational institutes were closed in 190 countries around the world (5). Therefore, electronic learning (E-learning) has become the mainstream of obtaining knowledge and keeping the teaching process. In the Kurdistan Region of Iraq, there are five medical colleges that adopted E-learning after the outbreak. Before the pandemic, the classical colleges of medicine in Iraq adopted pedagogical approaches of learning, including face-to-face lectures. With the beginning of E-learning, students and educators faced challenges. The lack of technical skills was one of the main challenges for students and educators, particularly senior educators. Some educators showed negative attitudes toward engagement in new technology and were overwhelmed by the whole process. Additionally, time was one of the challenges in the process of E-learning. Teachers of medical schools were already under pressure to find sufficient time to manage teaching, particularly after the COVID-19 pandemic. On the other hand, E-learning has enhanced the teaching skills of some educators, as they utilized technology that perhaps has not been used before. To avoid the issue of lacking skills for the next academic year, educators should be engaged in E-learning development programs to gain enough skills for online teaching.
Next, the lack of infrastructure and poor internet quality played a major role in the unwillingness to engage in the process. Although some internet companies provided internet access free for students, the students suffered from the lack of coverage of the internet in their areas. Besides, the outbreak and E-learning exacerbated the inequality gap between students in different financial situations. It is worth mentioning that the Kurdistan Region of Iraq has become the shelter of Internally Displaced People (IDP) who fled the war against the Islamic State in Iraq and Syria (ISIS). Currently, more than two million IDPs are living in the region. Underprivileged students, such as internally displaced students, faced increased obstacles securing electronic gadgets for E-learning and struggled to achieve good grades because they had limited online resources for scientific materials. This obstacle is difficult to overcome, and the government should provide the necessary gadgets and online recourses for those students.
We believe that the main challenge for E-learning is adequate clinical skills training. Fortunately, the majority of the curricula were covered this year and there was no need for extensive clinical training. Again, this will be the main challenge for the next year. Although simulation and video teaching are available options, medical students must be trained on using PPE and infection control measures during the summer holiday. After good training on the use of PPE, medical students should be trained in low-risk wards, and some risk should be accepted.
In Iraq, to the best of our knowledge, this is the first time that medical students took unsupervised exams from home. It was agreed that the exam should be done by submitting assignments about a specific subject. To overcome the problem of weak internet speed, a period of 12 hours was given to students. It is suggested that if the pandemic continues for the next year, the examination format should be changed into online video examinations where the student’s ability to diagnose patients’ conditions will be tested. The exam can be against time that may minimize cheating due to the limitation of time.
To conclude, in the Kurdistan Region, educational institutes moved to new ways of teaching and assessing during the lockdown. The main challenges were the lack of required infrastructures, skills, availability of gadgets, the achievement of adequate practical training, and the format of examinations. Good preparedness is needed to overcome the obstacles in the next academic year if the COVID-19 pandemic continues.
References
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1.
Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. American Journal of Roentgenology. 2020:1-6. https://doi.org/10.2214/AJR.20.22976.
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WHO. Rolling updates on coronavirus disease (COVID-19). World Health Organization; 2020, [cited 18/03/2020]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen.
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Hussein NR. Possible Factors Associated with Low Case Fatality Rate of COVID-19 in Kurdistan Region, Iraq. Journal of Kermanshah University of Medical Sciences. 2020;24(1). e103393.
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Hussein NR, Naqid IA, Saleem ZSM, Musa DH, Ibrahim N. The Impact of Breaching Lockdown on the Spread of COVID-19 in Kurdistan Region, Iraq. Avicenna J Clin Microbiol Infect. 2020;7(1):34-5. https://doi.org/10.34172/ajcmi.2020.07.
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UNESCO. Global Education Monitoring Report - Inclusion and education. The United Nations Educational, Scientific and Cultural Organisation; 2020, [cited 20/06/2020]. Available from: https://events.unesco.org/event/sessions?id=2433003514&lang=1033.
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