Comparing the impact of online and in-person active learning in preclinical medical education

Case-based active learning groups (ALGs) are an approach to learning medicine through the exploration of patient cases in a collaborative small group setting. Owing to the COVID-19 pandemic, this institution had to convert the preclinical curriculum to a virtual format. Currently, few studies have explored the effects of this change on relationships and skills in case-based learning, and our study aimed to explore the impact of the virtual curriculum on future physicians' interpersonal development and learning preferences.

An anonymous Qualtrics survey consisting of multiple choice questions (MCQs) and an optional open-ended commentary was distributed to medical students in Classes 2023-2025 enrolled at our institution. Only the MCQs were quantitatively analyzed. Comparisons between 2025 and 2023 and 2024 responses, as well as between 2023 and 2024 responses were performed via chi-square analysis, with an alpha level of 0.05 for all the statistical tests.

A total of 158 responses were collected. The class of 2025 students served as a control, as they enrolled after in-person learning was reinstated, whereas Classes 2023 and 2024 students experienced one year of virtual learning. There was no significant difference between virtual or in-person learning in terms of positive impacts on education (p = 0.7), participation (p = 0.2), or teamwork (p = 0.1), but most students rated these skills overall better with in person delivery methods. Additionally, while there was no significant difference across student groups regarding preference for a delivery method, 50.4% of students preferred a hybrid model versus 40.4% who wanted completely in person format, and a 9.2% minority of students were in favor of fully virtual ALG (p = 0.2).

Our study revealed that students do not prefer a completely in-person or virtual format. Our data provide a valuable post pandemic evaluation of preclinical students' engagement and well-being, suggesting that the skills and relationships fostered through virtual case-based learning are preserved.