ArticlePDF Available

Abstract

Objective: The disruption caused by COVID-19 in anatomy education has forced the transition of in-person to online learning. Despite the increasing use of technology-enhanced tools in online classes, anatomy lecturers face significant difficulty in making classes interactive. Hence, this study explored the feasibility of a web-based virtual whiteboard, Google Jamboard (GJ) for two online anatomy practical classes. Methods: This was a qualitative phenomenology study conducted on 116 second-year medical students from two Malaysian public universities via teleconferencing applications that allowed synchronous small-group activities. Each group was given a different link to 10 GJ slides that featured plain anatomy diagrams and instructions for the group task. Upon completion of the tasks, the students presented their tasks to the whole class. An online feedback form was distributed at the end of the practical session to explore the experience of the students when using the tool. Results: Thematic analysis of student responses generated seven themes that reflected perceived learning benefits, challenges faced by the students, and suggestions for future improvement. Conclusions: These findings suggest that GJ is a useful tool for promoting collaborative learning in virtual anatomy education. Nevertheless, the impact of this tool on the attainment of learning outcomes remains unknown. Hence, more widescale research is needed to confirm our findings.
Original Article
Feedback from medical student on an interactive online anatomy
practical using the Google Jamboard platform
Shamsi A. Shamsuddin, MSc
a
,
*
, Choy K. Woon, PhD
b
and Siti N.H. Hadie, PhD
a
a
Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan,
Malaysia
b
Department of Anatomy, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
Received 19 June 2022; revised 29 July 2022; accepted 30 August 2022; Available online ---
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Abstract
Objective: The disruption caused by COVID-19 in
anatomy education has forced the transition of in-person
to online learning. Despite the increasing use of
technology-enhanced tools in online classes, anatomy
lecturers face significant difficulty in making classes
interactive. Hence, this study explored the feasibility of a
web-based virtual whiteboard, Google Jamboard (GJ) for
two online anatomy practical classes.
Methods: This was a qualitative phenomenology study
conducted on 116 second-year medical students from two
Malaysian public universities via teleconferencing appli-
cations that allowed synchronous small-group activities.
Each group was given a different link to 10 GJ slides that
featured plain anatomy diagrams and instructions for the
group task. Upon completion of the tasks, the students
presented their tasks to the whole class. An online feed-
back form was distributed at the end of the practical
session to explore the experience of the students when
using the tool.
Results: Thematic analysis of student responses gener-
ated seven themes that reflected perceived learning ben-
efits, challenges faced by the students, and suggestions for
future improvement.
Conclusions: These findings suggest that GJ is a useful
tool for promoting collaborative learning in virtual
anatomy education. Nevertheless, the impact of this tool
on the attainment of learning outcomes remains un-
known. Hence, more widescale research is needed to
confirm our findings.
*Corresponding address: Department of Anatomy, School of
Medical Sciences, Health Campus, Universiti Sains Malaysia,
Kubang Kerian, 16150, Kota Bharu, Kelantan, Malaysia.
E-mail: shamsiamalina@usm.my (S.A. Shamsuddin)
Peer review under responsibility of Taibah University.
Production and hosting by Elsevier
Taibah University
Journal of Taibah University Medical Sciences
www.sciencedirect.com
1658-3612 Ó2022 The Authors.
Production and hosting by Elsevier Ltd on behalf of Taibah University. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/). https://doi.org/10.1016/j.jtumed.2022.08.007
Journal of Taibah University Medical Sciences (xxxx) xxx(xxx), xxx
Please cite this article as: Shamsuddin SA et al., Feedback from medical student on an interactive online anatomy practical using the Google Jamboard
platform, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2022.08.007
Keywords: Anatomy education; COVID-19; Google Jam-
board; Interactive learning; Online learning
Ó2022 The Authors.
Production and hosting by Elsevier Ltd on behalf of Taibah
University. This is an open access article under the CC BY-
NC-ND license (http://creativecommons.org/licenses/by-nc-
nd/4.0/).
Introduction
The global disruption caused by Coronavirus disease 2019
(COVID-19) has profoundly affected essential activities and
services, including the education sector, causing physical classes
to be converted to online learning. In Malaysian medical
schools, the implementation of online learning during the
pandemic was very challenging, given the fact that the medical
curriculum requires in-person training for competency attain-
ment.
1
Similarly, in anatomy education, medical students are
required to acquire a sufficient level of psychomotor and
affective skills which are normally achieved through in-
person hands-on activities, namely cadaveric dissection.
2
Prior to the COVID-19 pandemic, gross anatomy subjects
in Malaysian medical schools were predominantly taught
through face-to-face modalities, namely lectures, problem-
based learning (PBL), team-based learning (TBL) and
blended learning approaches.
3e6
Prior to COVID-19, practical
anatomy sessions were commonly delivered through various
hands-on activities, namely cadaveric dissection, along with the
demonstration of anatomy models or prosected specimens, and
assessment-based activities.
7,8
The use of e-learning, virtual
simulation, and anatomy software was minimal due to
financial constraints and was predominantly employed by
private medical institutions.
2,9
However, ever since the
COVID-19 lockdown, the implementation of online learning
in Malaysian medical schools has increased significantly with
the use of video teleconferencing applications (i.e., WebEx,
Zoom and Microsoft Teams), learning management systems,
game-based learning platforms (i.e., Kahoot, Mentimeter and
Quizizz), and three-dimensional (3D) anatomy atlas software
(i.e., Complete Anatomy and Visible Body).
2
Nevertheless,
anatomy lecturers face significant difficulties in incorporating
hands-on activities into online instructions; thus, they need to
be creative in finding ways to promote interaction and active
learning during formal classes.
2
The nature of gross anatomy requires 3D visualization
ability to develop a deep understanding of the fidelity and
intricate relations of anatomical structures.
10
Since cadaveric
dissection and other hands-on activities were limited during
the pandemic, anatomy lecturers need to rely on technology
to promote mental imagery.
11
For instance, the
implementation of pre-recorded demonstration video using
cadaveric specimens for practical classes, combined with
synchronous tutorial class, Kahoot online quizzes, body
painting, and anatomy clay model creation were carried
out.
12
Other modalities used in online anatomy practical
include dissection video incorporated with three-
dimensional (3D) anatomy software and quizzes on cadav-
eric structures identification.
13,14
Undoubtedly, the impact of
online anatomy practical classes has been substantial as it is
uncertain as to how the COVID-19 situation will unfold in
the near future.
15
Hence, this study explored the use of the Google Jam-
board (GJ) application, a free digital whiteboard application
that permits real-time collaborative work among students, in
online anatomy practical classes. The GJ can be accessed
through a website or mobile application and features several
tools (e.g., sticky note, pen and textbox), thus allowing stu-
dents to write or draw on the Jamboard.
16
Moreover,
students can add images from other sources and utilize
additional assistive drawing tools when using the mobile
version of Jamboard. The instructor can create up to 20
slides per Jamboard, which allows access to 50 students
simultaneously. However, the GJ application does not have
an audio or visual sharing option. Therefore, this platform
should be integrated with video teleconference applications,
such as WebEx, Zoom or Microsoft Teams.
17
Given the fact that GJ can promote collaborative and
interactive learning, this study explored the usability of this
application in online anatomy practical sessions in two
Malaysian public medical institutions. The preclinical year
students of these institutions have been taking online anat-
omy practical classes conducted using demonstration and
discussion approaches ever since the pandemic. Considering
their first encounter with the GJ application, we expected
that the students would be able to provide comprehensive
feedback on the use of GJ in an online anatomy practical
session and reflect their experience undergoing the collabo-
rative learning session.
Materials and Methods
Study design
A qualitative phenomenology study was conducted to
explore the learning experiences of pre-clinical year medical
students while taking online anatomy practical classes that
utilized the GJ application. The GJ anatomy practical ses-
sions were held online via two teleconferencing applications,
the WebEx by Cisco and Zoom. Verbal consent was obtained
from the students as permission for publishing their response
data.
Participants
A total of 116 second-year medical students from two
Malaysian public universities: Universiti Sains Malaysia
(USM) (n ¼76) and Universiti Teknologi Mara (UiTM)
(n ¼40) were involved in this study. For both institutions,
anatomy is taught in the first two years of the medical degree
program. In consideration of the convenient sampling
method, all students who attended the GJ practical session
were invited to voluntarily complete a feedback form that
explored their experience of learning using the GJ applica-
tion during the online anatomy practical session. The use of
the GJ application was repeated in the next online practical
session until saturation of response was achieved. Sample
saturation occurs when there is no new information about
the topic under investigation, and similar incidents occur
repeatedly.
18
For a qualitative study, a sample size of 7e89
people is recommended to achieve response saturation.
19
In
S.A. Shamsuddin et al.2
Please cite this article as: Shamsuddin SA et al., Feedback from medical student on an interactive online anatomy practical using the Google Jamboard
platform, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2022.08.007
Figure 1: Examples of Google Jamboard slides labelled by the students of different groups.
Student feedback on online Jamboard anatomy practical 3
Please cite this article as: Shamsuddin SA et al., Feedback from medical student on an interactive online anatomy practical using the Google Jamboard
platform, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2022.08.007
this study, three GJ practical sessions were conducted to
achieve the saturation response.
Google Jamboard online anatomy practical session
At the beginning of the GJ online anatomy practical, the
students from both institutions met on the WebEx through
the Cisco online or Zoom platforms, respectively. The tutor
began each session with a brief explanation of the learning
outcomes and activities, including the use of the GJ appli-
cation. To avoid interruptions and miscommunication
throughout the discussion session, general guidelines for the
session were emphasized.
The students were divided into several small groups con-
sisting of nine to twelve students per group, and each group
entered a breakout room that enabled them to conduct small-
group discussions. Each group was given a different link to
the application, with each link leading to 10 Jamboard slides
containing plain anatomy diagrams and learning instructions.
Within each small group, the tutor requested that the students
use the tools on GJ to label the anatomical structures presented
in each Jamboard slide (Figure 1). The students were given
10 min to complete each task. To ensure continuous active
discussion among the group members, the tutors went from
one group to another throughout the entire session and
provided opportunities for students to ask questions. Upon
completion of diagram labelling via GJ, the students returned
to the main hall of the WebEx and ZOOM platforms and
presented their tasks to the whole class. The session ended
with a debriefing session by the lecturers. Each practical
session lasted for two hours.
Measurement of the student perception of Google Jamboard
during practical session
A survey feedback form was distributed via the Google
form platform at the end of the practical session to explore
the perception of students with regards to the use of GJ for
online anatomy practical classes. The students were also
asked to reflect on their experiences of the collaborative
learning session through the GJ platform.
Thematic analysis
Feedback from the students on the use of GJ for online
anatomy practical classes was analysed using the thematic
analysis proposed by Saldana (2009). ATLAS.ti software
version 22 (Scientific Software Development, GmbH, Berlin,
Germany) was used to convert the feedback into electronic
representations and the analysis was carried out indepen-
dently by three researchers: the first author (SAS), the second
author (CKW) and the last author (SNH). First-cycle cod-
ing, known as open code (OC), was performed using the text
analysis tool in ATLAS.ti software, in which the transcripts
were divided into smaller codes depending on the phrases
expressed by the participants.
Second-cycle coding was performed to unite OCs with
comparable properties and linkages into a single category
(AC). The OC framework was examined at this point for any
connections, overlaps or duplicates. Following that, the re-
searchers collaboratively studied the content and
interrelationships between the ACs during the final coding
cycle and grouped them into numerous common codes,
known as the select code (SC). During the coding procedure,
the researchers kept track of trends and categories in a
memo, which they then used for comparison and triangula-
tion during the data analysis. This effort is important to
ensure the transferability and dependability of the data.
20,21
Results
The thematic analysis generated seven SCs that comprised
21 ACs and 92 OCs. In general, the seven SCs reflected the
learning benefits and problems faced by the students during
the GJ learning session. The SCs also reflected the sugges-
tions that need to be considered to overcome the challenges
and ensure the smooth running of the learning sessions. The
seven SCs included cognitive learning, collaborative
learning, interactive learning, innovative learning, high us-
ability, setback and challenges, and prerequisite and
requirement. Throughout the analysis, all students wrote in
simple English or Bahasa Melayu Language and there were
no vague or redundant sentences that could impair the clarity
of the sentences. Furthermore, all researchers analyzed each
transcript independently, and the findings were discussed
among the team members to achieve final consensus.
Theme 1: Cognitive learning
Cognitive learning in this context refers to the ability of the
online anatomy practical GJ session to stimulate attention
focus, prior knowledge and understanding of the learned ma-
terials. One student described how the GJ activities had made
her stay focused on conducting the allocated learning tasks:
“It was a great method for a practical class. I found it
interesting, and it was easy for me to keep my focus while
doing the task assigned to us using the GJ application.”
(Student 21, University A)
Another student described GJ activities as becoming more
engaging when the materials were learned in small groups
compared to learning in the whole class.
“Although it was a bit lagging at first, the task became
easier when we were assigned to smaller breakout rooms.
It was more engaging to do the GJ activities in small
group.” (Student 29, University B)
One student described how the GJ practical session
enhanced his understanding of the learned topic.
“The session allowed me to discuss with my friends. After
listening to my friends’ explanations, I understood the
topic better. Apart from that, the questions in the GJ
allowed me to test my knowledge on the anatomy of the
heart and blood vessels, which had strengthened my un-
derstanding.” (Student 18, University A)
One student perceived that the GJ practical session
complemented the online lecture method in enhancing stu-
dent understanding:
S.A. Shamsuddin et al.4
Please cite this article as: Shamsuddin SA et al., Feedback from medical student on an interactive online anatomy practical using the Google Jamboard
platform, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2022.08.007
“It was a very helpful way for us to review what we
learned during the lecture.” (Student 4, University A)
Another student felt that the GJ activities facilitated her
learning through the stimulation of prior knowledge:
“I really like the use of GJ because it helped me to actively
recall the things that I have learned before the class.”
(Student 39, University B)
Theme 2: Collaborative learning
In this study, collaborative learning represented a joint effort
by the students to perform group activities. Some students
described GJ activities as an enjoyable way to stimulate peer
interaction and strengthen their communication skills.
“I love it! GJ made it easier for all group members to work
together at the same time.” (Student 2, University B)
“It was a nice way to learn from and interact with our
friends.” (Student 6, University A)
“GJ practical session allowed more active interaction
compared to previous semester practical session where we
will just listen to Dr.’s explanation.” (Student 19, Uni-
versity A)
Several students believed that the GJ practical session
managed to stimulate peer discussion and develop good
teamwork among the team members, despite the online
format of the activities:
“The GJ activities provide opportunity for everyone to
answer the questions. Although we were online, I think we
had good teamwork because we discussed among ourselves
and did the activities together.” (Student 16, University B)
“I enjoyed it very much because everyone was engaged
and voluntarily throwing out their ideas.” (Student 49,
University A)
Two students felt that GJ practical session allowed the
synchronization of activities among the team members when
the activities were performed in a small group:
“It was much easier for us to do the labelling of the dia-
grams in a small group compared to when we were in the
large group, as everyone were doing the same thing at the
same time, which can be a little bit of confusing.” (Student
33, University B)
“The session was fun and interactive. I love how Dr.
divided us into several small groups for us to brainstorm
among ourselves on the questions, followed by discussion
with the whole class. GJ allows us to write our answers
simultaneously.” (Student 40, University B)
One student expressed her appreciation that the GJ
practical session provided a platform for them to make new
friends, as they were the first-year students who enrolled in
medical schools during the COVID-19 pandemic and had
not met each other physically.
“It is a nice method for me to learn new things, and I got
to meet new friends, which I have not met or communi-
cated with before.” (Student 55, University A)
Theme 3: Interactive learning
In this study, interactive learning refers to the active
participation of students in performing hands-on activities
during the GJ online anatomy practical session. One student
reflected on how she had been actively involved in the activity
despite previous online practical sessions, which were mainly
non-interactive.
“I definitely like and support the idea of having GJ ac-
tivity. Since most of the practical sessions were done on-
line and, in the afternoon, staying focused is not easy.
However, in this session, I could see myself actively
joining the practical session. It was not like before, when
we just listened to the demonstration by the lecturers.”
(Student 26, University A)
One student stated that the drawing and activity toolbars
of the GJ application facilitated interactivity among the
students.
“The use of GJ is very convenient and easy because there are
a lot of features that can be used while doing the task, such
as sticky notes and laser pointer. We can easily discuss and
do the activity concurrently. (Student 34, University B)
One student expressed her excitement about being able to
synchronously perform learning activities with her team
members:
“Really enjoy using it since it was my first time, and I
really like it very much because everyone with the link can
participate to do the task given. Interestingly, we accessed
GJ at the same time.” (Student 46, University A)
Theme 4: Innovative learning
Innovative learning in this study refers to the new learning
approach that was introduced in anatomy practical classes. Two
students described this method as unique and effective in stim-
ulating discussion during an online anatomy practical session.
“GJ is a new learning method to me. It’s very unique, as it
is different from other sessions. I think it is quite useful
because we could discuss it in a small group.” (Student 15,
University A)
“GJ is very good for online practical because we can
discuss with our teammates and see what our friends’
Student feedback on online Jamboard anatomy practical 5
Please cite this article as: Shamsuddin SA et al., Feedback from medical student on an interactive online anatomy practical using the Google Jamboard
platform, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2022.08.007
answers. So, if there is a mistake, we can straightaway
discuss what should be the correct and the best answer.”
(Student 39, University B)
Theme 5: High usability
In general, the GJ online anatomy practical sessions had
good usability, as they were perceived to be fun, user-
friendly, and beneficial for learning anatomy, particularly
in practical sessions of the subject. Two students perceived
the GJ application as easy to use, despite having no prior
exposure to the application:
“At first, it took some time to get used to GJ, but once I got
the hang of it, it was easy to use.” (Student 18, University B)
“It was my first-time using GJ, but I think learning using
it was very convenient.” (Student 36, University B)
One student described GJ as a convenient tool for
learning because it has many features that allow students to
have visual collaborations among team members.
“It was very convenient and easy to use since there are a
lot of features for us to work on the diagrams together. It
also allowed us to jot down the notes.” (Student 34,
University B)
Three students perceived learning through the GJ prac-
tical session as an enjoyable new learning experience. One of
them was motivated to use GJ for his future learning.
“The practical session using GJ was interactive, fun. With
GJ, it was easy to work in a small group.” (Student 56,
University A)
“The practical session provided me a chance to do self-
learning and connect with my mates and learn together;
it was a fun practical.” (Student 39, University A)
“New experience. Totally love to do more!” (Student 58,
University A)
Two students perceived the GJ online practical session as
beneficial for practical learning, as it provides a platform for
them to share their opinions and perform hands-on activity
in an online session. One student felt that the session had
facilitated her active recall of her prior knowledge.
“The session was effective because we had the chance to
give our opinion during the discussion, as we are learning
in a small group instead.” (Student 26, University B)
“It was a very interactive and effective way for us to
directly discuss the topic and perform some activities. We
were able to test our understanding and knowledge by
doing hands-on activities.” (Student 32, University A)
Theme 6: Setback and challenges
Despite the positive perceptions of students with regards
to the GJ online anatomy practical, the students raised their
concerns about the challenges that they faced throughout the
practical sessions. One student felt that the use of GJ in the
online anatomy practical failed to stimulate discussion due to
uncoordinated students’ involvement.
“To me, the session was not effective, as we were not
familiar with each other yet. It might work better if stu-
dents already know each other.” (Student 1, University A)
One student conveyed his disappointment in the passive
response of their team members during the practical session,
despite being given the opportunity to conduct hands-on
activities using the GJ application.
“For me, using the GJ did not satisfy me enough in un-
derstanding and having discussion with others, as I rarely
know the members in the group. I asked something during
the discussion, but none of them gave any quick response.
I didn’t think that we had an active discussion on that
practical day. I think it can be modified by changing the
grouping. Maybe it can just be done by following the PBL
group.” (Student 73, University A)
Two students indicated that they had difficulty navigating
the GJ application because they were not familiar with the
application.
“It’s a bit hard to use because we are not familiar with it. I
can’t find the correct tool for me to write down the an-
swers in the beginning.” (Student 57, University A)
“In general, the practical session was okay, but it was a bit
hard to control the annotation key of the GJ.” (Student
10, University B)
Some students complained about the technical problems
that they faced during the GJ practical session, despite
perceiving that the session was beneficial.
“It was a good way to have group discussion during
practical using GJ. But because of the internet connection
problem, sometimes the Jamboard became too messy.”
(Student 5, University A)
“I thought it was difficult to write on the board simulta-
neously with other friends due to poor internet connec-
tions in my area.” (Student 34, University A)
“I like the idea of sharing the thoughts among my
groupmates. However, it was quite disappointing that
there was lagging while using the website, causing diffi-
culties for most of us to contribute to writing on the
board.” (Student 59, University A)
Some students perceived that the implementation of the
GJ online practical session was not organized.
“Too many people working on the board at one time
caused it to be messy.” (Student 9, University A)
“It was quite fun, actually, but a little messy because at
first we received a wrong link so we got them mixed up
among each other.” (Student 16, University A)
S.A. Shamsuddin et al.6
Please cite this article as: Shamsuddin SA et al., Feedback from medical student on an interactive online anatomy practical using the Google Jamboard
platform, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2022.08.007
Theme 7: Prerequisite and requirement
To enhance the efficacy of the GJ online anatomy practical
in promoting student learning, the students suggested several
prerequisites and requirements for the session. Proper plan-
ning, dynamic groups and good technical support might ensure
the smooth running of the session. A few students suggested
that the lecturers should plan the design of the questions ac-
cording to the capacity of the GJ display and allocate enough
time for each question to optimize student activities.
“Although it was very convenient for a small group dis-
cussion, but the Jamboard was just small page and we
need to adjust accordingly if want to write a lot of in-
formation” (Student 32, University B)
“It was easy to use GJ, as it enhanced our communication
skills with the group members. The team was very
responsive. But the only lack was that we did not have
enough time to discuss our answers with the lecturers.”
(Student 24, University B)
The students in University-A enrolled in the medical
schools during the COVID-19 pandemic and had limited
opportunities to get to know each other, except among their
PBL group members. Therefore, the students complained of
not having a good team dynamic during the small group
work, in which they were randomly assigned. A student
suggested that group allocation should be according to the
PBL group to ensure good group dynamics.
“I think GJ was not efficient, as most of my team mem-
bers were not willing to get involved in the discussion.
Besides, we were not familiar with each other, as we had
never met since we enrolled in medical school due to
pandemic, and the group was formed randomly. It would
have been better if the breakup session had followed the
PBL groups. And I think personally, I prefer the old
practical sessions, as the Jamboard session could be a
chaos, as everyone was doodling on the same page
without even communicating. Besides, a long time was
used for the presentation and discussion. Since no one is
willing to talk, I just wait for the time to pass. This is not
equivalent to the efficacy of the session. That is my
opinion, personally.” (Student 27, University A)
One student also highlighted the importance of having
good coordination among team members during the activ-
ities. A student suggested a briefing of ground rules should be
communicated before the session.
“It was fun to discuss with the groupmates, but I was
having difficulty typing something on the Jamboard. If
my groupmate clicks the same textbox, all the things I
wrote will disappear.” (Student 35, University B)
One student highlighted the importance of having a good
internet connection to ensure smooth running for the session.
“Even though this session was new for us, I think it was
fun. GJ is a learning platform that allows us to interact
with each other and share our opinions. But those who
did not have a strong internet connection would have
problems using it.” (Student 24, University A)
Discussion
The use of digital tools and applications in anatomy edu-
cation has markedly increased amid the COVID-19 lockdown,
as these instructional tools allow the continuation of education
provision.
2,15
Indeed, the GJ application provides a platform
for interactive learning in remote anatomy classes, including
practical sessions.
17
This study explored feedback from
medical students from two public universities in Malaysia on
the use of the GJ application during online anatomy practical
sessions. The findings clearly indicate that students benefitted
from the GJ online anatomy practical, as they perceived it as
an innovative learning method that promoted collaborative
learning. The sessions were perceived as a new learning
experience, as they could easily understand the anatomy
content through various hands-on activities. Nevertheless,
this study also echoed the students’ concerns about the chal-
lenges that they faced during the GJ online anatomy practical
session and outlined their suggestions for future improvement.
It is evident from this study that the use of GJ in online
anatomy practical sessions promoted collaborative virtual
learning, which is potentially important for learning perfor-
mance. It has been argued that collaborative learning promotes
the development of higher cognitive skills, problem-solving
skills and attitudes toward autonomous learning.
22
Although
a collaborative virtual environment is not uncommon, its
implementation can sometimes be costly and requires prior
preparation by tutors, especially when it is conducted via
video-based instruction, gamification and virtual reality simu-
lations.
23
Given the fact that GJ is accessible through a
computer or a mobile device, this application is suitable for
synchronous online group activities, provided that students
have a good internet network connection.
24
Indeed, the
virtual whiteboards of GJ, known as Jams, are accessible by
everyone with the link, and thus allow them to edit the Jams
and contribute to the discussion.
16
Various types of group
activities can be conducted using the GJ application, as it
features several tools that allow synchronous drawing,
labelling and note writing.
25
Furthermore, diagrams and
images can be exported from other sources and students can
manipulate these diagrams to fit the purpose of their
learning.
17
The use of the laser pointer tool in the GJ
application could enhance visual cues during group
discussion, thus making discussion more effective.
17
Apart
fromthesefeatures,theGJwebversionisavailableforfree
for a maximum of 20 slides and does not require a high-
technology tool or complex preparation prior to class, thus
making it a user-friendly learning tool for collaborative virtual
learning.
Some students in this study perceived learning through GJ
online anatomy practical sessions as an engaging learning
experience that promoted their understanding of anatomy
topics. In this practical session, students were exposed to
different learning experiences rather than routine online
anatomy practical sessions, which lacked hands-on activities.
In fact, the GJ online practical session aligned with three out
Student feedback on online Jamboard anatomy practical 7
Please cite this article as: Shamsuddin SA et al., Feedback from medical student on an interactive online anatomy practical using the Google Jamboard
platform, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2022.08.007
of four stages of Kolb’s experiential learning theory, as the
students were exposed to a new learning experience that
required them to navigate the GJ application (concrete
experience); were required to complete several guided tasks
and questions through group discussion and reflection
(reflective observation); presented their task in the big group
(abstract conceptualization); and generated final conclusion
and reflected on the impact of the activities on their future
learning.
26
The findings of this study supported the fact that
new knowledge could be generated from the transformation
of experience, as the students perceived that they could easily
understand what they had learned after completing several
group activities. The hands-on activities indeed provided
them with a concrete experience that could have promoted
cognitive engagement, stimulated their motivation and
affection toward learning, and subsequently bridged their
perceptions of the actual learning gaps.
27
Furthermore, with
reflective observation and abstract conceptualization,
students were able to link the hands-on activities with the
learning outcomes and conceptual content of the topic, thus
allowing them to reflect on their own thinking processes and
tangible outcomes of their learning.
27
In the cognitive load
theory context, this reflection activity is an effortful
metacognitive process, known as germane load, that could
have contributed to the higher perceived ability to
understand the instructional content.
28
Nonetheless, to ensure a successful GJ session, several social
aspects of learning need to be considered. For instance, three
important elements that ensure the smooth running of any
collaborative virtual learning are visual socialization skills (i.e.,
communication), virtual collaboration skills (i.e., behavioural
rules and feedback), and technical skills (i.e., the ability to
navigate the digital tool).
29
In this study, some students echoed
their concern about not being able to communicate well with
their group members, to whom they were not close, or who
were too passive during the discussion. Consequently, there
was uncoordinated involvement from the group members
when navigating the Jams, which further complicated the
group task. A previous study reported that group member
familiarity is important in an online learning environment, as
familiar students spend less time regulating their task-related
activities and developing group dynamics, thus leading to bet-
ter group performance.
30
Similarly, introverted students,
although reported to be more active in asynchronous online
sessions compared to face-to-face classes as they have enough
time to gain confidence and respond to a task, may have dif-
ficulty interacting in a synchronous session.
31
Since the GJ
online anatomy practical sessions were synchronously
conducted, the students needed to interact with their group
members in real time. Hence, introverted students might be
reluctant to be involved in the discussion. In fact, previous
studies have proven that students are less compelled to
participate in an online learning environment when compared
to an in-person session for various reasons.
32,33
Moreover,
the lack of body language and facial expression during the
GJ online anatomy learning environment could have
prevented effective communication, as these two elements
play a role in the emotional perceptions of social interaction.
34
Nevertheless, the students’ receptivity toward the GJ
application varied, as it was largely dependent on their famil-
iarity with the application. Although there was much feedback
on the perceived ease of the use of the GJ application, some
students felt that learning via the platform was not optimized,
as they had little acquaintance with the application prior to the
practical session. These students faced difficulty at the begin-
ning of the class, as they took time to become familiar with the
features of the GJ application. It has been argued that a stu-
dent’s familiarity with a learning tool, including an online
application or software, determines their willingness and
receptivity to use the tools.
35
This could be explained by
cognitive load theory, which emphasizes the increased
cognitive burden of learners when they are exposed to
additional information that is not related to the actual
instructional content (i.e., as in this study, the students need
to learn how to navigate the GJ application concurrent with
learning the anatomy content).
36
This condition could lead to
ineffective learning.
Notwithstanding these challenges, the students suggested
some prerequisites and requirements that may ensure a more
efficient GJ practical session in optimizing student learning;
for example, proper planning, dynamic groups and good
technical support. To ensure that students can benefit better
from the session, lecturersneed to properly plan and design the
learning session so that the students will have enough time to
get familiarized with the learning environment. Good
instructional design is of utmost importance in a synchronous
online collaborative environment, given the fact that tutors
and students are not present physically and have to commu-
nicate through a virtual platform. Indeed, a study conducted
on synchronous distance learning reported that ill-defined
instructional design could result in significant variation in
the learning process among various groups.
37
Furthermore,
tutors need to consider allowing a socially constructed group
to ensure group dynamics. A previous study reported that a
learning session and discussion in a constructed group was
more efficient because the students felt comfortable
expressing their opinions and views when compared to those
in a natural group, who were less enthusiastic.
38
Ultimately,
it is important to provide good technical support, namely a
stable internet connection network and suitable
teleconferencing application that can allow small group
discussion. This effort would ensure the smooth running of
the GJ session and lead to successful experiential and
collaborative virtual learning.
Nevertheless, this study had several limitations that need
to be considered. This study demonstrated the perceptions of
students regarding utilization of GJ as a tool when used in
online practical session for anatomy. Despite the fact that
some students claimed that it was an effective and efficient
way of learning, the effectiveness of the practical session
using GJ cannot be concluded. The ability to retain knowl-
edge by applying GJ in practical session were not evaluated
in this study. Additionally, GJ received more positive than
negative feedback from students, but their perception on GJ
in comparison to other methods or tools used for practical
sessions were not compared. Hence, the preference and su-
periority of GJ in comparison to other methods used for
online practical sessions in anatomy cannot be concluded. In
addition, this study did not control for confounding factors
as a consequence of convenient sampling. Hence, students
with prior exposure to GJ application may have perceived a
positive learning experience when compared to those without
prior exposure to GJ application. Conducting a well-
designed interventional study that utilizes probability
S.A. Shamsuddin et al.8
Please cite this article as: Shamsuddin SA et al., Feedback from medical student on an interactive online anatomy practical using the Google Jamboard
platform, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2022.08.007
sampling is required in the future to explore the effectiveness
of this method.
Furthermore, this study included student participants
from two public universities that offered medical courses in
largely identical settings. In the future, it will be advanta-
geous to recruit medical students from private medical
schools, particularly those with global connections with
international medical institutions. Such studies may provide
a better generalization of the perceptions of students and
lecturers with regards to GJ usage in online practical ses-
sions. Finally, this study concentrated solely on the use of
the GJ application. Given the fact that the GJ application
is not a stand-alone tool in promoting real-time live inter-
action, future studies should also explore the impact of
various teleconferencing tools in promoting a successful
remote anatomy practical session. The use of other tele-
conferencing software that allows live discussion and file
sharing through breakout rooms are pertinent features in
ensuring successful remote learning.
Conclusion
Overall, this study strengthens the idea that the GJ
application is a highly useable tool that can promote expe-
riential and collaborative virtual learning in anatomy edu-
cation. Indeed, the use of GJ in practical anatomy is a
pertinent move to enhance hands-on activities during the
COVID-19 pandemic, especially in developing countries that
are disadvantaged by a lack of financial support for virtual
and augmented reality simulation. Despite some technical
setbacks during the learning sessions, the introduction of GJ
in the anatomy practical sessions was well received by many
students. Although this study focused on students feedback
on the GJ online anatomy practical session, the findings may
well have a bearing on the implications of this application for
online anatomy learning. The study has raised an important
question about the effectiveness of the GJ application in
enhancing knowledge acquisition and retention, as well as
the development of psychomotor skills and affective learning
in anatomy learning. Hence, more widescale research using
controlled trials is needed to confirm the postulation.
Source of funding
This work was supported by the Universiti Sains
Malaysia Research University Grant under [1001/PPSP/
8016121].
Conflict of interest
The authors have no conflict of interest to declare.
Ethical approval
Since the sessions were part of formal teaching and
learning activities scheduled on the academic calendar, the
requirement for USM ethical approval was waived by the
Human Research Ethics Committee, USM. Otherwise,
ethical approval from Research Ethics Committee, UiTM
was obtained [REC/05/2022 (ST/MR/93)].
Authors contributions
SAS conducted and provided research materials, analysed
data, and preparing first draft. CKW conducted and pro-
vided research materials, collected and analysed data, and
preparing first draft. SNH designed the study, conducted and
provided research materials, collected, analysed and inter-
preted data, preparing first and final draft of article. All
authors have critically reviewed and approved the final draft
and are responsible for the content and similarity index of the
manuscript.
Acknowledgment
We would like to express our greatest appreciation to the
116 students who participated in this study.
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How to cite this article: Shamsuddin SA, Woon CK,
Hadie SNH. Feedback from medical student on an
interactive online anatomy practical using the Google
Jamboard platform. J Taibah Univ Med Sc
xxxx;xxx(xxx):xxx.
S.A. Shamsuddin et al.10
Please cite this article as: Shamsuddin SA et al., Feedback from medical student on an interactive online anatomy practical using the Google Jamboard
platform, Journal of Taibah University Medical Sciences, https://doi.org/10.1016/j.jtumed.2022.08.007
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The abrupt transition from face-to-face to online anatomy teaching amidst the COVID-19 pandemic has posed great challenges to anatomy lecturers in Malaysia, as they have had to adapt to new skills to prepare and deliver online classes. These online classes were delivered either synchronously via a web teleconferencing application or asynchronously through pre-recorded videos that were uploaded to the learning management system (LMS). The online delivery of anatomy practical classes has become a major concern among anatomy lecturers and students, especially in public institutions, as there is a lack of hands-on experience and social interaction. Nevertheless, some private medical schools have adapted well to both online lectures and practical classes, as they had been venturing towards online learning and virtual reality tools even before the pandemic commenced. The Malaysian Anatomical Association (MAA) webinar, "Transformation of Anatomy Education in Malaysia during COVID-19 Pandemic", discussed the issues related to lecturers' and students' receptivity to online anatomy classes. This study discusses the issues related to online anatomy teaching and learning (T&L) and
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Coronavirus disease 2019 (Covid‐19) created unparalleled challenges to anatomy education. Gross anatomy education has been particularly impacted given the traditional in‐person format of didactic instruction and/or laboratory component(s). To assess the changes in gross anatomy lecture and laboratory instruction, assessment, and teaching resources utilized as a result of Covid‐19, a survey was distributed to gross anatomy educators through professional associations and listservs. Of the 67 survey responses received for the May–August 2020 academic period, 84% were from United States (US) institutions, while 16% were internationally based. Respondents indicated that in‐person lecture decreased during Covid‐19 (before: 76%, during: 8%, P < 0.001) and use of cadaver materials declined (before: 76 ± 33%, during: 34 ± 43%, P < 0.001). The use of cadaver materials in laboratories decreased during Covid‐19 across academic programs, stand‐alone and integrated anatomy courses, and private and public institutions (P ≤ 0.004). Before Covid‐19, cadaveric materials used in laboratories were greater among professional health programs relative to medical and undergraduate programs (P ≤ 0.03) and among stand‐alone relative to integrated anatomy courses (P ≤ 0.03). Furthermore, computer‐based assessment increased (P < 0.001) and assessment materials changed from cadaveric material to images (P < 0.03) during Covid‐19, even though assessment structure was not different (P > 0.05). The use of digital teaching resources increased during Covid‐19 (P < 0.001), with reports of increased use of in‐house created content, BlueLink, and Complete Anatomy software (P < 0.05). While primarily representing US institutions, this study provided evidence of how anatomy educators adapted their courses, largely through virtual mediums, and modified laboratory protocols during the initial emergence of the Covid‐19 pandemic.
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Background: The impact of coronavirus disease 2019 (COVID-19) has profoundly affected education, with most universities changing face-to-face classes to online formats. To adapt to the COVID-19 pandemic situation, we adopted a blended learning approach to anatomy instruction that included online lectures, pre-recorded laboratory dissection videos, and 3D anatomy applications, with condensed offline cadaver dissection. Methods: We aimed to examine the learning outcomes of a newly adopted anatomy educational approach by 1) comparing academic achievement between the blended learning group (the 2020 class, 108 students) and the traditional classroom learning group (the 2019 class, 104 students), and 2) an online questionnaire survey on student preference on the learning method and reasons of preference. Results: The average anatomy examination scores of the 2020 class, who took online lectures and blended dissection laboratories, were significantly higher than those of the 2019 class, who participated in an offline lecture and dissection laboratories. The questionnaire survey revealed that students preferred online lectures over traditional large group lecture-based teaching because it allowed them to acquire increased self-study time, study according to their individual learning styles, and repeatedly review lecture videos. Conclusion: This study suggests that a blended learning approach is an effective method for anatomy learning, and the advantage may result from increased self-directed study through online learning.
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