DOI: https://doi.org/10.

53350/pjmhs211592248
ORIGINAL ARTICLE

Online versus Traditional Learning: Outcomes of First Online Learning

Experience
UZAIR ABBAS1, MEMOONA PARVEEN2, AMBREEN ASHFAQUE3, RAMLAH NAZ4, SIDRA ZAHEER5, ZAHEER AMJAD6
1-3
Lecturers, Department of Physiology,
4
Associate professor Department of Forensic Medicine,
5
Lecturer Institute of Medical Technology,
6
Assistant Professor, Department of Anatomy. Dow University of Health Sciences, Karachi
Correspondence to Dr. Uzair Abbas, e-mail [email protected] Cell: 0300-3280080

ABSTRACT
Aim: To evaluate the learning outcomes of first experience with online learning in a medical college in Pakistan.
Study design: Retrospective cross-sectional study
Place and duration of study: Dow University of Health Sciences, Karachi, Pakistan from 1stJanuary 2021 to 30th
May 2021.
Methodology: This study compared the module exam scores of pre-clinical first-year MBBS students of the year
2019 (group A) and year 2020 (group B). Group A was taught in 2019 through the traditional method of teaching
while group B was taught online in 2020.
Results: The mean score of group B online teaching was significantly higher than that of group A, studied through
the traditional method in all three modules, foundation module, locomotor module, and blood module. Group B
secured a significantly higher mean score than that of group A with a significant p-value of <0.001, 0.043, and
0.001respectively.
Conclusion: The score gained by online learners using virtual teaching methods was significantly higher than those
who were taught by traditional method. The results of this study imply that using online educational teaching and
learning can lead to the promotion of educational level and enhancement of score levels in students.
Keywords: Online learning, Traditional learning, Medical education

INTRODUCTION However, this system has its drawbacks as well; first

and foremost, it deems it necessary to have computer
Well-learned and well-trained health care workers are an access to participate. Furthermore, creating a virtual
indispensable requirement of any healthcare system to education network for tutors as well as students comes at a
meet the needs of patients. As a pre-requisite to this, it is high cost for the education system9. The program needs to
the responsibility of medical education systems to impart be user-friendly, to allow students with limited computer
knowledge, educate and train students, so that they skills to be able to take full advantage without any
become well prepared to provide high-quality care to limitations9-10. Besides this, the effectiveness of such
patients1-3. independent education is questionable, especially in the
Formulating strategies that would engage students field of medicine where group discussions and peer
and provide them with effective education has always been interactions are necessary for knowledge and skill
a challenge to medical educators. Engagement in both development.11-12 However, concluding the effectiveness of
academic and clinical settings has been associated with online and offline education is much difficult and has failed
favourable outcomes in terms of learning and building to conclude13.
confidence in students4. Over the years there has been a In developing countries like Pakistan and India,
constant change over how new methods of education can traditional learning is under much focus. But due to recent
be implemented in the model of classroom education in pandemic conditions due to COVID-19, where the whole
ways that can benefit the student5-6. world was affected, the education sector was also affected
The methods previously used in a traditional and there was a sudden and complete shift of learning from
classroom setup heavily depended on the presence of a traditional to online teaching methods for which there was
tutor and students in an educational environment. less preparedness by institutes as well as students.
However, advancements in technology have made it a This study aimed to compare the teaching methods
possibility for the same education to be provided long- i.e. traditional versus online teaching by measuring the
distance, be archived for later use and so, has increasingly learning outcomes of medical students.
become in demand worldwide7,8. They also show student
preference for such novel methods of education over MATERIALS AND METHODS
classroom learning, which allows access to the latest
findings and employment of evidence-based knowledge. This retrospective study was conducted among pre-clinical
Virtual education uses computer-based learning on an medical students of the age group (18-21 years) of Dow
online or offline network which can be accessed anytime International Medical College, Karachi after permission
and anywhere8. from IRB. The participants were divided into group A and
------------------------------------------------------------------------------ group B. Group A (traditional learning group) included 150
Received on 24-03-2021 students who had learnt through traditional learning. Group
Accepted on 13-08-2021 B also comprised of 150 students who had learnt through

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 U. Abbas, M. Parveen, A. Ashfaque et al

online teaching methods in 2020. Traditional teaching was DISCUSSION

employed through large group teaching and small group
teaching including problem-based learning (PBL), case- The first instance of distance learning came from the
based learning (CBL), and tutorials while online teaching University of Chicago back in the 1800s when students and
was carried out using MOODLE and ZOOM applications. teachers used to connect with each other through written
Along with PowerPoint presentations, students were letters14. The online distance learning programs were
provided with tutorials, videos, and notes for a better started by many colleges and universities with online
understanding of topics during the e-learning session. All education programs in the second half of the 20 th century15.
teaching faculty were trained for online teaching through The online education system has a huge number of
three online courses of Coursera to provide a better issues not only for the faculty but mainly for the students 16.
teaching experience to students. These may include lack of training, lack of awareness,
Both groups appeared in the same pattern of module hesitation in adopting the change, poor internet
tests i.e. Best Choice Questions (BCQs) to assess the connections, portal examination, and keeping the students
theoretical knowledge. The exam comprised 100 marks for involved in the lecture while looking at their computer
each module. The mean score of three module exams was screens17. Some universities already provided online
compared between both groups. Group A had received classes but these classes were only limited18,19.
traditional lectures in 2019 while group B received the In countries like Pakistan, where traditional learning
same lectures from the same tutors but online in 2020. was the main tool for medical universities, sudden and
Mean scores of the Foundation module, Locomotor module complete shift to online education during COVID-19
(muscle and skeletal system), and Blood module were pandemic was a new experience. The main focus of the
compared between both groups. The results were compiled study was to assess the learning outcomes of this online
and analyzed in SPSS 21.0. The mean difference was learning session-2020. As in the future, these results can
calculated from the independent ‘t’ test. help in modification of the learning and teaching strategies
to deliver the knowledge in the best possible way.
RESULTS Our study revealed significant higher scores achieved
by online learning group which is accordance with Mitchell
In the foundation module, the mean score of group A was et al20 and Nourian et al21 who stated that students with
50.12% and that of group B was 70.13%. There was a frequent exposure to e-learning gained higher scores in
significant difference in mean scores of both groups while a exams. While Hugenholtz et al22 found no significant
higher score was achieved by group B who was involved in
difference in e-learning and traditional learning outcomes
online learning in the year 2020 (p<0.001). In the locomotor
module mean score of group B (53.72%) was significantly for continuing medical education in theoretical exam scores
higher as compared to group A (50.95%) with a significant of dental students. Moazami et al23 found similar results as
p-value of 0.043.Meanwhile, in the blood module, the same our study, in which he compared mean exam scores of
pattern was seen in which group B was able to achieve online and traditional learning groups and found e-learning
significantly higher score (73.28%) as compared to group A had better results. Belcher et al24 also reported e-learning
(50.70%) who was involved in traditional learning in the and easy access to educational content produced better
year 2019 with a p-value of 0.001 (Fig. 1). results. Our results show online learning has produced
better results as compared to traditional learning. This may
Fig. 1: Mean score of group A and group B in module examinations be because of recent training of faculty for online teaching
and students were provided with more reference materials
along with books like videos, notes, and online discussion
sessions.
Thurmond19 and Khatami et al25 reported better
outcome of exam scores through traditional teaching and
learning methods over virtual and the results are different
from our study and may have different reasons like
unavailability of the resources, required infrastructure, cost
issues, decreased motivation, and interest of students. This
was very first experience of online learning of pre-clinical
medical students of our institute which proved to produce
better results. In the future same technology-based
learning can be used to impart online courses in the
curriculum.

CONCLUSION
The score gained in online learning were higher than those
who appeared in traditional learning. The results of this
study imply that using online educational teaching and
learning can lead to the promotion of educational level and
enhancement of score levels in students. In the future, the
same technology can be used to impart online courses to

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Conflict of interest: Nil a meta-analysis. JAMA 2008;300(10):1181-96.
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