{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T20:29:17Z","timestamp":1763238557517,"version":"build-2065373602"},"reference-count":40,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EJIHPE"],"abstract":"<jats:p>Background: The COVID-19 pandemic forced medical programs to rapidly switch to remote teaching from scratch, impacting hands-on skills training. This study compared the efficacy of a hybrid online format to a regular in-person session for a mandatory surgical skills class. Methods: Third-year undergraduate medical students attending the surgical skills class in the winter semester of 2020\/21 at the Medical University of Graz were randomly assigned to either the hybrid or in-person class, depending on their course schedule and government regulations. The hybrid class involved online videos, one-on-one peer tutoring, and an Objective Structured Clinical Examination (OSCE). Pre- and post-class self-assessments were conducted to evaluate their theoretical and practical knowledge of a single interrupted suture. Results: The study included 85 students in the regular in-person class and 50 in the hybrid class. A pre-class assessment revealed higher self-assessments in the hybrid class for theoretical and practical knowledge, but a post-class assessment showed no significant difference. The advantages and disadvantages of both modalities were identified, providing valuable insights for future curriculum development. Conclusions: Both teaching modes were effective for undergraduate surgical skills training. This study recommends implementing positive aspects of both the hybrid and in-person formats while recognizing their respective limitations.<\/jats:p>","DOI":"10.3390\/ejihpe13070090","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T02:05:21Z","timestamp":1689041121000},"page":"1219-1228","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Undergraduate Skills Training in Pandemic Times: Where Is the Future of Medical Education?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4493-9891","authenticated-orcid":false,"given":"Andrzej","family":"Hecker","sequence":"first","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6621-4891","authenticated-orcid":false,"given":"Sebastian P.","family":"Nischwitz","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Petritsch","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2244-2817","authenticated-orcid":false,"given":"Judith C. J.","family":"Holzer-Geissler","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8344-7796","authenticated-orcid":false,"given":"Alexander","family":"Draschl","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Wegscheider","sequence":"additional","affiliation":[{"name":"Clinical Skills Center (CSC), Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0903-252X","authenticated-orcid":false,"given":"David Benjamin","family":"Lumenta","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"},{"name":"Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"ref_1","first-page":"157","article-title":"WHO Declares COVID-19 a Pandemic","volume":"91","author":"Cucinotta","year":"2020","journal-title":"Acta Bio. Medica Atenei Parmensis"},{"key":"ref_2","first-page":"515","article-title":"Mental Health of Teachers Who Have Teleworked Due to COVID-19","volume":"11","author":"Carrasco","year":"2021","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_3","first-page":"1440","article-title":"COVID-19 Lockdown-Related Changes in Mood, Health and Academic Functioning","volume":"11","author":"Hendriksen","year":"2021","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_4","first-page":"1082","article-title":"Pharmacy Students\u2019 Mental Health and Resilience in COVID-19: An Assessment after One Year of Online Education","volume":"12","author":"Younes","year":"2022","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Bork-H\u00fcffer, T., Kulcar, V., Brielmair, F., Markl, A., Immer, D.M., Juen, B., Walter, M.H., and Kaufmann, K. (2021). University Students\u2019 Perception, Evaluation, and Spaces of Distance Learning during the COVID-19 Pandemic in Austria: What Can We Learn for Post-Pandemic Educational Futures?. Sustainability, 13.","DOI":"10.3390\/su13147595"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e16675","DOI":"10.1016\/j.heliyon.2023.e16675","article-title":"Digital Transformation in Higher Education: A Qualitative Evaluative Study of a Hybrid Virtual Format Using a Smart Classroom System","volume":"9","author":"Iriondo","year":"2023","journal-title":"Heliyon"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"100203","DOI":"10.1016\/j.tine.2023.100203","article-title":"Performance Increases in Mathematics during COVID-19 Pandemic Distance Learning in Austria: Evidence from an Intelligent Tutoring System for Mathematics","volume":"31","author":"Spitzer","year":"2023","journal-title":"Trends Neurosci. Educ."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.urology.2021.06.025","article-title":"CASE-Based and Guidelines-Based Lectures Are the Most Preferred Form of Online Webinar Education: Results from the Urology Collaborative Online Video Didactics Series (COVID)","volume":"158","author":"Li","year":"2021","journal-title":"Urology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s13014-021-01927-x","article-title":"Medical Student Education through Flipped Learning and Virtual Rotations in Radiation Oncology during the COVID-19 Pandemic: A Cross Sectional Research","volume":"16","author":"Kim","year":"2021","journal-title":"Radiat. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/medu.14181","article-title":"Our Education, Our Concerns: The Impact on Medical Student Education of COVID-19","volume":"54","author":"Theoret","year":"2020","journal-title":"Med. Educ."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1097\/SLA.0000000000003927","article-title":"COVID-19\u2014Considerations and Implications for Surgical Learners","volume":"272","author":"Daodu","year":"2020","journal-title":"Ann. Surg."},{"key":"ref_12","first-page":"91","article-title":"High-Fidelity Simulation-Based Education: Description of an Original Crisis Resource Management and Sedation Learning for Dental Surgeons","volume":"12","author":"Tanoubi","year":"2022","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_13","first-page":"617","article-title":"Choosing the New Normal for Surgical Education Using Alternative Platforms","volume":"38","author":"Keller","year":"2020","journal-title":"Surgery"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1016\/j.jsurg.2020.06.003","article-title":"Difficulties Faced by General Surgery Residents. A Qualitative Systematic Review","volume":"77","author":"Yaow","year":"2020","journal-title":"J. Surg. Educ."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jsurg.2009.03.032","article-title":"Developing Surgical Skills Curricula: Lessons Learned from Needs Assessment to Program Evaluation","volume":"66","author":"Chipman","year":"2009","journal-title":"J. Surg. Educ."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.ijsu.2014.05.069","article-title":"Surgical and Procedural Skills Training at Medical School\u2014A National Review","volume":"12","author":"Davis","year":"2014","journal-title":"Int. J. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jsurg.2012.09.001","article-title":"Early Intervention to Promote Medical Student Interest in Surgery and the Surgical Subspecialties","volume":"70","author":"Patel","year":"2013","journal-title":"J. Surg. Educ."},{"key":"ref_18","unstructured":"Treves, F. (1891). A Manual of Operative Surgery, Cassell and Company."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1111\/medu.14198","article-title":"Online Team-Based Learning Sessions as Interactive Methodologies during the Pandemic","volume":"54","author":"Gaber","year":"2020","journal-title":"Med. Educ."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3319","DOI":"10.1007\/s00402-022-04597-w","article-title":"Impact of the COVID-19 Pandemic on Early Clinical Outcome after Total Knee Arthroplasty: A Retrospective Comparative Analysis","volume":"143","author":"Reinbacher","year":"2022","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses","volume":"41","author":"Faul","year":"2009","journal-title":"Behav. Res. Methods"},{"key":"ref_22","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Routledge Academic."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1177\/105960117700200220","article-title":"SELF-DIRECTED LEARNING: A GUIDE FOR LEARNERS AND TEACHERS Malcol m Knowles New York: Association Press, 1975. 135 pp., Paperbound","volume":"2","author":"Knowles","year":"1977","journal-title":"Group Organ. Stud."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1111\/j.1365-2929.2005.02115.x","article-title":"Self-Directed Learning\u2014The Importance of Concepts and Contexts","volume":"39","author":"Greveson","year":"2005","journal-title":"Med. Educ."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"580","DOI":"10.47102\/annals-acadmedsg.V37N7p580","article-title":"Self-Directed Learning in Health Professions Education","volume":"37","author":"Murad","year":"2008","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1007\/s00595-021-02229-1","article-title":"Online Teaching of Basic Surgical Skills to Medical Students during the COVID-19 Pandemic: A Case\u2013Control Study","volume":"51","author":"Co","year":"2021","journal-title":"Surg. Today"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wu, S.-J., Fan, Y.-F., Sun, S., Chien, C.-Y., and Wu, Y.-J. (2021). Perceptions of Medical Students towards and Effectiveness of Online Surgical Curriculum: A Systematic Review. BMC Med. Educ., 21.","DOI":"10.1186\/s12909-021-03014-x"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.amjsurg.2022.04.038","article-title":"How Does Telementoring Impact Medical Education within the Surgical Field? A Scoping Review","volume":"224","author":"Pfennig","year":"2022","journal-title":"Am. J. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e195","DOI":"10.1016\/j.surge.2021.08.001","article-title":"Distance Education for Anatomy and Surgical Training\u2014A Systematic Review","volume":"20","author":"Co","year":"2022","journal-title":"Surgeon"},{"key":"ref_30","first-page":"112","article-title":"Design and Transition of an Emergency E-Learning Pathology Course for Medical Students-Evaluation of a Novel Course Concept","volume":"13","author":"Jedlicska","year":"2023","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_31","first-page":"580","article-title":"Is Satisfaction with Online Learning Related to Depression, Anxiety, and Insomnia Symptoms? A Cross-Sectional Study on Medical Undergraduates in Romania","volume":"13","author":"Ionescu","year":"2023","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1007\/s11701-021-01330-4","article-title":"Evaluating the Ability of Students to Learn and Utilize a Novel Telepresence Platform, Proximie","volume":"16","author":"Patel","year":"2022","journal-title":"J. Robot Surg."},{"key":"ref_33","first-page":"1780","article-title":"Virtual and Augmented Reality versus Traditional Methods for Teaching Physiotherapy: A Systematic Review","volume":"12","year":"2022","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.2196\/mededu.9068","article-title":"Instructional Video and Medical Student Surgical Knot-Tying Proficiency: Randomized Controlled Trial","volume":"4","author":"Bochenska","year":"2018","journal-title":"JMIR Med. Educ."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1111\/medu.14672","article-title":"Peer-assisted Learning in Medical Education: A Systematic Review and Meta-analysis","volume":"56","author":"Brierley","year":"2022","journal-title":"Med. Educ."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"27579","DOI":"10.3402\/meo.v20.27579","article-title":"Peer-Assisted Teaching of Basic Surgical Skills","volume":"20","author":"Preece","year":"2015","journal-title":"Med. Educ. Online"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/0142159X.2021.1970732","article-title":"Self\u2013Regulatory Learning Theory as a Lens on How Undergraduate and Postgraduate Learners Respond to Feedback: A BEME Scoping Review: BEME Guide No. 66","volume":"44","author":"Spooner","year":"2022","journal-title":"Med. Teach."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1111\/medu.14206","article-title":"Peer Mentoring for Medical Students during the COVID-19 Pandemic via a Social Media Platform","volume":"54","author":"Amini","year":"2020","journal-title":"Med. Educ."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/j.1365-2923.2009.03421.x","article-title":"Motor Skill Learning and Performance: A Review of Influential Factors: Motor Skill Learning and Performance","volume":"44","author":"Wulf","year":"2010","journal-title":"Med. Educ."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/medu.13830","article-title":"The Stress Paradox: How Stress Can Be Good for Learning","volume":"54","author":"Rudland","year":"2020","journal-title":"Med. Educ."}],"container-title":["European Journal of Investigation in Health, Psychology and Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2254-9625\/13\/7\/90\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:08:39Z","timestamp":1760126919000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2254-9625\/13\/7\/90"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,7]]},"references-count":40,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["ejihpe13070090"],"URL":"https:\/\/doi.org\/10.3390\/ejihpe13070090","relation":{},"ISSN":["2254-9625"],"issn-type":[{"type":"electronic","value":"2254-9625"}],"subject":[],"published":{"date-parts":[[2023,7,7]]}}}