Online and In-Person Instruction in Laboratory Diagnostics: a Four-Year Student Cohort Study

The rapid shift to online medical education in practical disciplines like Laboratory Diagnostics during the COVID-19 pandemic raised widespread concerns about its effectiveness. This retrospective study aimed to compare the effectiveness of online and in-person instruction and to evaluate the impact of this pedagogical change on student academic performance.

A retrospective mixed-methods study was conducted. Final exam scores from four consecutive cohorts of clinical medicine students for Laboratory Diagnostics (Classes of 2018 - 2021, 2021 - 2024 academic years) were analyzed, and 91 students with direct online learning experience were surveyed.

Quantitative results showed a significant academic performance decline during the online teaching period. Median scores (100-point scale) dropped from 83 (Class 2018) to 72 (Class 2019) and 79 (Class 2020), before recovering to 84 (Class 2021) (p < 0.001). The failure rate surged from 2.2% in Class 2018 to 18.3% in Class 2019, returning to 0% in Class 2021 (p < 0.001). The questionnaire revealed mixed experiences of students with online learning. A notable 18.7% of students felt online learning "worse than in-person", while 17.6% reported "decreased learning efficiency" and 42.9% had "extended study time". Although most students provided positive feedback on instructional support and teacher performance, a minority identified shortcomings including insufficient course materials (6.6%), platform instability (4.4%), and limited instructor-student interaction (8.8%).

The findings firmly revealed that online instruction was associated with a significant performance decline in a practical discipline. The robust recovery upon returning to in-person instruction underscores its irre-placeable role. The four-year student cohort study recommends a strategic hybrid pedagogical model for Laboratory Diagnostics, combining online theory with dedicated in-person practical training.