metricas
covid
Buscar en
Educación Médica
Toda la web
Inicio Educación Médica E-learning in pathology courses in the times of COVID-19
Journal Information

Statistics

Follow this link to access the full text of the article

Original
E-learning in pathology courses in the times of COVID-19
El e-learning en los cursos de Patología en los tiempos de COVID-19
Ghada Sahraoui1,2,3, Farah Sassi1,2,3,
Corresponding author
sassi.farah@outlook.fr

Corresponding author.
, Raoudha Doghri1,2,3, Lamia Charfi1,2,3, Maha Driss1,2,3, Karima Mrad1,2,3
1 Service d’Anatomie et Cytologie pathologiques, Institut Salah Azaiez, Tunis, Tunisie
2 Precision Medicine, Personalized Medicine and Oncology Investigation laboratory, LR21SP01, Tunis, Tunisia
3 Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Read
891
Times
was read the article
236
Total PDF
655
Total HTML
Share statistics
 array:24 [
  "pii" => "S1575181322000687"
  "issn" => "15751813"
  "doi" => "10.1016/j.edumed.2022.100776"
  "estado" => "S300"
  "fechaPublicacion" => "2023-01-01"
  "aid" => "100776"
  "copyright" => "The Authors"
  "copyrightAnyo" => "2022"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Educación Médica. 2023;24:"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1575181322000663"
    "issn" => "15751813"
    "doi" => "10.1016/j.edumed.2022.100774"
    "estado" => "S300"
    "fechaPublicacion" => "2023-01-01"
    "aid" => "100774"
    "copyright" => "The Author(s)"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Educación Médica. 2023;24:"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Los problemas de salud m&#225;s prevalentes en los estudiantes de Medicina&#58; revisi&#243;n de la literatura"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "The most prevalent health concerns of medical students&#46; A literature review"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "f0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 3903
              "Ancho" => 2848
              "Tamanyo" => 596108
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "al0005"
              "detalle" => "Figura "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">A&#41; Cuatro estudios por ser estudios de seroprevalencia o riesgo de exposici&#243;n &#40;no son exclusivamente enfermedades&#41;&#44; 2 excluidos por no ser un estudio &#250;nicamente de estudiantes de Medicina&#44; y 2 por ser cartas al editor&#46;</p> <p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">B&#41; Un art&#237;culo excluido por no ser exclusivo de estudiantes de Medicina&#46; Un art&#237;culo exclu&#237;do por ser revisi&#243;n de estrategias de prevenci&#243;n&#46;</p> <p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">C&#41; Dos de los art&#237;culos tienen un componente mixto entre enfermedad de psiquiatr&#237;a &#40;adicciones y uso de drogas&#41; y enfermedad org&#225;nica &#40;enfermedad traumatol&#243;gica y consumo de f&#225;rmacos&#47;psicoestimulantes&#41;&#46; Se incluyen en el apartado de enfermedad org&#225;nica inicial por haber sido escogidos dentro de esta categor&#237;a tras la revisi&#243;n de texto&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Alba G&#225;llego-Royo, Candela P&#233;rez-&#193;lvarez, B&#225;rbara Marco-G&#243;mez, In&#233;s Sebasti&#225;n S&#225;nchez, Mar&#237;a Pilar Astier-Pe&#241;a, Oscar Urbano Gonzalo, Rogelio Altisent Trota, Mar&#237;a Teresa Delgado-Marroqu&#237;n"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Alba"
              "apellidos" => "G&#225;llego-Royo"
            ]
            1 => array:2 [
              "nombre" => "Candela"
              "apellidos" => "P&#233;rez-&#193;lvarez"
            ]
            2 => array:2 [
              "nombre" => "B&#225;rbara"
              "apellidos" => "Marco-G&#243;mez"
            ]
            3 => array:2 [
              "nombre" => "In&#233;s"
              "apellidos" => "Sebasti&#225;n S&#225;nchez"
            ]
            4 => array:2 [
              "nombre" => "Mar&#237;a Pilar"
              "apellidos" => "Astier-Pe&#241;a"
            ]
            5 => array:2 [
              "nombre" => "Oscar"
              "apellidos" => "Urbano Gonzalo"
            ]
            6 => array:2 [
              "nombre" => "Rogelio"
              "apellidos" => "Altisent Trota"
            ]
            7 => array:2 [
              "nombre" => "Mar&#237;a Teresa"
              "apellidos" => "Delgado-Marroqu&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1575181322000663?idApp=UINPBA00004N"
    "url" => "/15751813/0000002400000001/v2_202303211046/S1575181322000663/v2_202303211046/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1575181322000675"
    "issn" => "15751813"
    "doi" => "10.1016/j.edumed.2022.100775"
    "estado" => "S300"
    "fechaPublicacion" => "2023-01-01"
    "aid" => "100775"
    "copyright" => "The Author&#40;s&#41;"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Educaci&#243;n M&#233;dica. 2023;24:"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Revistas de enfermer&#237;a&#58; presencia&#44; visibilidad y calidad&#46; Estudio descriptivo"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Nursing Journals&#58; Presence&#44; Visibility and Quality&#46; Descriptive Study"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "f0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1507
              "Ancho" => 1486
              "Tamanyo" => 98053
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "al0010"
              "detalle" => "Figura "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Porcentaje de revistas indexadas en SJR y JCR en funci&#243;n del cuartil&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Mar&#237;a Sobrido-Prieto, Santiago Mart&#237;nez-Isasi, Juan G&#243;mez-Salgado, Alejandro Montero-Salinas, Daniel Fern&#225;ndez-Garc&#237;a"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Mar&#237;a"
              "apellidos" => "Sobrido-Prieto"
            ]
            1 => array:2 [
              "nombre" => "Santiago"
              "apellidos" => "Mart&#237;nez-Isasi"
            ]
            2 => array:2 [
              "nombre" => "Juan"
              "apellidos" => "G&#243;mez-Salgado"
            ]
            3 => array:2 [
              "nombre" => "Alejandro"
              "apellidos" => "Montero-Salinas"
            ]
            4 => array:2 [
              "nombre" => "Daniel"
              "apellidos" => "Fern&#225;ndez-Garc&#237;a"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1575181322000675?idApp=UINPBA00004N"
    "url" => "/15751813/0000002400000001/v2_202303211046/S1575181322000675/v2_202303211046/es/main.assets"
  ]
  "en" => array:17 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "E-learning in pathology courses in the times of COVID-19"
    "tieneTextoCompleto" => true
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Ghada Sahraoui, Farah Sassi, Raoudha Doghri, Lamia Charfi, Maha Driss, Karima Mrad"
        "autores" => array:6 [
          0 => array:3 [
            "nombre" => "Ghada"
            "apellidos" => "Sahraoui"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "af0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "af0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "af0015"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "Farah"
            "apellidos" => "Sassi"
            "email" => array:1 [
              0 => "sassi.farah@outlook.fr"
            ]
            "referencia" => array:4 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "af0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "af0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "af0015"
              ]
              3 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cr0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Raoudha"
            "apellidos" => "Doghri"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "af0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "af0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "af0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Lamia"
            "apellidos" => "Charfi"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "af0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "af0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "af0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Maha"
            "apellidos" => "Driss"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "af0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "af0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "af0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Karima"
            "apellidos" => "Mrad"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "af0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "af0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "af0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Service d&#8217;Anatomie et Cytologie pathologiques&#44; Institut Salah Azaiez&#44; Tunis&#44; Tunisie"
            "etiqueta" => "1"
            "identificador" => "af0005"
          ]
          1 => array:3 [
            "entidad" => "Precision Medicine&#44; Personalized Medicine and Oncology Investigation laboratory&#44; LR21SP01&#44; Tunis&#44; Tunisia"
            "etiqueta" => "2"
            "identificador" => "af0010"
          ]
          2 => array:3 [
            "entidad" => "Faculty of Medicine of Tunis&#44; University of Tunis El Manar&#44; Tunis&#44; Tunisia"
            "etiqueta" => "3"
            "identificador" => "af0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cr0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "El e-learning en los cursos de Patolog&#237;a en los tiempos de COVID-19"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0065">Introduction</span><p id="p0005" class="elsevierStylePara elsevierViewall">All facets of human existence&#44; including healthcare facilities&#44; business prospects&#44; travel and transportation&#44; and social structure&#44; have undergone significant changes as a result of the global spread of the coronavirus illness 2019 &#40;COVID-19&#41; brought on by SARS-CoV 2&#46;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a> Because of COVID-19&#39;s effects on the education sector&#44; schools and universities including health area have had to close in the majority of the affected countries as well as teaching hospitals which are solely handling &#8220;on-duty&#8221; shifts&#46;<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a></p><p id="p0010" class="elsevierStylePara elsevierViewall">Distance learning &#40;DL&#41; is a technique that is frequently utilized as a tool to spread information and culture&#46; The use of DL in the field of health is a topic that is frequently discussed&#46; Many nations have used this tool&#44; and in Tunisia&#44; some specialty colleges have adopted it to ensure the sustainability of medical resident training&#46; It has demonstrated its effectiveness of sharing knowledge&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a></p><p id="p0015" class="elsevierStylePara elsevierViewall">Given the particularity of the Pathology speciality&#44; the importance of analyzing slides through traditional histology workshop in acquiring diagnostic skills and the manipulation of light microscopes in the training of residents&#44; the substitution of face-to-face training devices by digital means is an unprecedented experience as pathology residents had to quickly adapt to learning exclusively online&#46; Due to the absence of double-scoping&#44; educational innovation has been required to keep teaching microscopy&#46; Whole slide imaging &#40;WSI&#41; is one alternative for digital pathology&#44; however due to funding restrictions experienced by many departments this option is frequently unaffordable&#44; especially in Tunisia&#46; Alternatively&#44; a trend toward teaching pathology through dynamic virtual microscopy provides an easily available&#44; physically distant&#44; and cost-effective option&#46; A standard light microscope&#44; a mounted digital camera&#44; laptops&#44; and videoconferencing software are necessary tools to share a slide image with the student &#40;s&#41;&#46;<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a> Thus&#44; the question of DL impact on the pathology residency curriculum was raised&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">In this study&#44; we propose to evaluate this teaching method of the Pathology College with reference to the learner&#39;s point of view&#46;</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0070">Methods</span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0075">Study design and sample</span><p id="p0025" class="elsevierStylePara elsevierViewall">This is a descriptive cross-sectional study including pathology residents&#46; It was based on a questionnaire created via &#8220;Google Forms&#8221; and sent to residents after attending synchronous online teaching sessions with&#44; at the end of the course&#44; accompanying images slide sets from surgical specimens anonymized by removing all identifiable information&#44; including the coded specimen number assigned for internal department tracking purposes from the Pathology College&#44; during the period between March 2020 and December 2021&#46; Following the presentation&#44; students were given a quiz consisting of 5 questions based on digital pathology image slides&#46; The questions in several modules were just multiple choice of &#8220;what is the most likely diagnosis&#63;&#8221; This session was also recorded and is available for later playback&#46;</p><p id="p0030" class="elsevierStylePara elsevierViewall">The questionnaire consisted of multiple choice and short free response questions&#46; The questionnaire focused on the following items&#58;<ul class="elsevierStyleList" id="l0005"><li class="elsevierStyleListItem" id="li0005"><span class="elsevierStyleLabel">-</span><p id="p0035" class="elsevierStylePara elsevierViewall">Organization of courses</p></li><li class="elsevierStyleListItem" id="li0010"><span class="elsevierStyleLabel">-</span><p id="p0040" class="elsevierStylePara elsevierViewall">Organization of slide pathology images</p></li><li class="elsevierStyleListItem" id="li0015"><span class="elsevierStyleLabel">-</span><p id="p0045" class="elsevierStylePara elsevierViewall">Overall assessment of online teaching</p></li><li class="elsevierStyleListItem" id="li0020"><span class="elsevierStyleLabel">-</span><p id="p0050" class="elsevierStylePara elsevierViewall">Supervision and interaction with individual teachers</p></li><li class="elsevierStyleListItem" id="li0025"><span class="elsevierStyleLabel">-</span><p id="p0055" class="elsevierStylePara elsevierViewall">Supervision and interaction with the course coordinator</p></li><li class="elsevierStyleListItem" id="li0030"><span class="elsevierStyleLabel">-</span><p id="p0060" class="elsevierStylePara elsevierViewall">Learner motivation to attend online versus face-to-face instruction</p></li><li class="elsevierStyleListItem" id="li0035"><span class="elsevierStyleLabel">-</span><p id="p0065" class="elsevierStylePara elsevierViewall">Strengths of video-conferencing compared to face-to-face teaching</p></li><li class="elsevierStyleListItem" id="li0040"><span class="elsevierStyleLabel">-</span><p id="p0070" class="elsevierStylePara elsevierViewall">Difficulties and constraints encountered by students during this period of distance learning</p></li><li class="elsevierStyleListItem" id="li0045"><span class="elsevierStyleLabel">-</span><p id="p0075" class="elsevierStylePara elsevierViewall">Learners&#39; choice of teaching mode for future college courses</p></li><li class="elsevierStyleListItem" id="li0050"><span class="elsevierStyleLabel">-</span><p id="p0080" class="elsevierStylePara elsevierViewall">Suggested ways to improve the distance learning system</p></li></ul></p><p id="p0085" class="elsevierStylePara elsevierViewall">The coordinator of each session is required to create the event via google calendar&#46; He&#47;she would send an invitation to attend a &#8220;google meet&#8221; to the learners involved in the session&#46; At the beginning of each session&#44; the coordinator accepted participants&#44; introduced the speakers&#44; and noted any questions asked via chat&#46;</p><p id="p0090" class="elsevierStylePara elsevierViewall">The coordinator also ensured the coordination between the different speakers&#44; in particular the respect of time limit and the closing of the session with a summary of the content presented and the announcement of possible future sessions&#46;</p></span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0080">Study population</span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0085">Inclusion criteria</span><p id="p0095" class="elsevierStylePara elsevierViewall">We included all questionnaires completed by pathology residents assigned to pathology departments in Tunisian university hospitals&#44; who attended the online teaching of the college courses&#46;</p></span><span id="s0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0090">Non-inclusion criteria</span><p id="p0100" class="elsevierStylePara elsevierViewall">We did not send a questionnaire to residents of other specialties assigned to a pathology department for optional stage&#46;</p></span><span id="s0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0095">Exclusion criteria</span><p id="p0105" class="elsevierStylePara elsevierViewall">We excluded pathology residents who are assigned to hospitals and did not attend online courses &#40;1st year residents in 2022&#41;&#46;</p></span></span><span id="s0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0100">Statistical analysis</span><p id="p0110" class="elsevierStylePara elsevierViewall">The statistical analysis was performed by Microsoft Office 2016 Excel software&#46; It was descriptive focusing first on the study population and then on the learners&#39; responses to the different questions in the online questionnaire&#46;</p></span></span><span id="s0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0105">Ethical considerations</span><p id="p0115" class="elsevierStylePara elsevierViewall">Consent was obtained from all students included in this study to conduct this work&#46; There were no conflicts of interest&#46;</p></span><span id="s0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0110">Results</span><p id="p0120" class="elsevierStylePara elsevierViewall">A total of 26 pathology residents participated in the study among the 33 invited&#46; The characteristics of the cohort are presented in <a class="elsevierStyleCrossRef" href="#t0005">Table 1</a>&#46;</p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0125" class="elsevierStylePara elsevierViewall">Out of the 33 pathology residents&#44; 22 &#40;84&#46;6&#37;&#41; were females&#46; They were from Faculty of Medicine of Tunis in 10 &#40;38&#46;5&#37;&#41; cases and Monastir in 7 &#40;26&#46;9&#37;&#41; cases&#46; Regarding the level of residency&#44; 16 &#40;61&#46;5&#37;&#41; were in 4<span class="elsevierStyleSup">th</span> year&#46; Twenty-four residents &#40;92&#46;3&#37;&#41; had already an E-learning experience&#46; The most used tool to follow DL was the laptop in 23 &#40;88&#46;5&#37;&#41; cases&#46; All residents had access to internet connection&#44; and it was through WIFI in 22 &#40;88&#37;&#41; cases&#46; Residents followed the courses at home in 25 &#40;96&#37;&#41; cases and only one at a stage &#40;4&#37;&#41;&#46; The time spent for DL was &#8805; 4 hours in 14 &#40;54&#37;&#41; cases&#46; PowerPoint was the most used presentation program &#40;81&#37;&#41;&#46;</p><p id="p0130" class="elsevierStylePara elsevierViewall">Almost 70&#37; of participants were satisfied with their DL experience&#46; Thirty percent of the participants thought that DL should replace face-to-face theoretical courses&#46;</p><p id="p0135" class="elsevierStylePara elsevierViewall">All participants reported that they were informed of the date of the online course in time&#46; Nearly 54&#37; of participants said they did not have the resources available in time&#46;</p><p id="p0140" class="elsevierStylePara elsevierViewall">Technical difficulties were encountered in 42&#37; of cases&#46; The most common difficulty was related to internet connection &#40;66&#46;7&#37;&#41;&#46; More than half of the residents &#40;53&#46;8&#37;&#41; felt that DL should be complementary to face-to-face teaching&#46; Student involvement in DL was rated low to moderate in 69&#37; of cases&#46; Most of participants agreed&#44; either totally &#40;38&#46;5&#37;&#41; or partially &#40;34&#46;6&#37;&#41;&#44; that the environment offered in the DL was as realistic as the one offered in the classroom&#47;amphitheater&#46; Over 73&#37; of participants rated the level of technical support provided by course coordinators as at least satisfactory&#46; More than 90&#37; of participants were at least satisfied with the level of teacher involvement in the online training&#46; Interaction with teachers during DL courses was considered more difficult than face-to-face by 61&#46;5&#37; of participants&#46; Only 38&#46;5&#37; of the participants thought that the time management of DL course by the teachers was more difficult than in the classroom&#46;</p><p id="p0145" class="elsevierStylePara elsevierViewall">Participants felt that face-to-face courses were presented in a clearer manner compared to online courses in 73&#37; of cases&#46; Nearly 90&#37; of participants found the course materials used by teachers interactive&#46;</p><p id="p0150" class="elsevierStylePara elsevierViewall">Concerning virtual pathology slides&#44; participants found that acquiring diagnostic skills via the virtual slide websites was better than learning in the traditional double or multi-headed scope in 53&#46;8&#37; of cases&#46; The main two reasons were&#58; more time to analyze virtual slides than in the traditional histology workshop &#40;42&#46;9&#37;&#41; and the ability to view virtual slides at any time &#40;35&#46;7&#37;&#41;&#46; Only 11&#46;5&#37; felt that DL was not beneficial for life skills&#46; More than 90&#37; of the participants felt confident in making diagnoses after attending DL via the virtual slides&#46; More than 60&#37; of participants felt able to take exams on courses taught online in actual practice&#46; The main strength identified by participants was the flexibility of learning locations and schedules &#40;73&#46;1&#37;&#41;&#46; The main weaknesses of DL were the dependence on technical means &#40;42&#46;3&#37;&#41;&#44; the lack of interactivity with colleagues &#40;26&#46;9&#37;&#41; and the lack of interactivity with teachers &#40;26&#46;9&#37;&#41;&#46; The main conditions for a successful DL experience identified by participants were willingness to adapt to a new technology &#40;38&#46;5&#37;&#41; and acceptability by students and teachers &#40;34&#46;6&#37;&#41;&#46; The suggestions and proposals of the participants were the creation of a media library gathering all the video presentations and virtual slides&#46; Finally&#44; learners&#39; choices for how to teach future college courses was not in favor of online courses &#40;70&#37;&#41;&#46;</p></span><span id="s0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0115">Discussion</span><p id="p0155" class="elsevierStylePara elsevierViewall">Since E-learning is the predominate method of academic activities among medical residents during the COVID19 pandemic&#44; it is essential to evaluate their perception and satisfaction with the method to find weaknesses&#44; enhance the program&#39;s quality&#44; and make necessary revisions&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a> Thus&#44; the current study sought to evaluate how pathology residents perceived and were satisfied with DL during the COVID-19 epidemic&#46;</p><p id="p0160" class="elsevierStylePara elsevierViewall">The main results of the study showed that DL is a satisfactory method from the learner&#39;s point of view&#46; Students believe in 70&#37; of cases that DL is a useful tool for carrying out academic activities&#46; The main benefits identified by the residents were accessibility to the sessions from any location and schedules and the possibility of reviewing virtual slides at any time&#46; However&#44; only 30&#37; of the participants think that DL should replace face-to-face theoretical courses&#46;</p><p id="p0165" class="elsevierStylePara elsevierViewall">The lack of face-to-face connection with the teachers and colleagues and the incidence of technological issues that occasionally hindered the smooth running of the sessions were the shortcomings highlighted by pathology residents&#46;</p><p id="p0170" class="elsevierStylePara elsevierViewall">The Pathology College chose to carry on its training programs for residents at various levels during the period of confinement imposed by our nation&#39;s government due to the worldwide health crisis&#46; The only viable choice in these circumstances was DL&#46;</p><p id="p0175" class="elsevierStylePara elsevierViewall">Several authors have compared real audience teaching versus DL&#46;<a class="elsevierStyleCrossRefs" href="#bb0030"><span class="elsevierStyleSup">6&#8211;8</span></a> They have concluded that they were equivalent in terms of knowledge improvement&#46; In our study&#44; participants felt that face-to-face courses were presented in a clearer manner compared to online courses in 73&#37; of cases&#46; On contrary&#44; according to several reports&#44; the instructor&#39;s presentation style and visual presence play a key role in getting students interested in the content&#46;<a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a> In traditional courses&#44; pathologists typically focus their teaching efforts on tumor boards&#44; conferences on medical autopsies&#44; and directly under the microscope with visiting clinical teams&#46; However&#44; in a synchronous e-learning environment&#44; the professor has additional responsibilities as a teacher&#44; including helping students transition smoothly from traditional classroom settings to online classes&#44; engaging the audience in conversation&#44; and ensuring that everyone has a positive and active e-learning experience&#46;</p><p id="p0180" class="elsevierStylePara elsevierViewall">To overcome some of the drawbacks of e-pathology courses&#44; one study proposed to combine the two teaching methods into a so-called hybrid &#8220;bent learning&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a> Recent studies proposed game-based learning&#44; like &#8220;Kahoot&#33;&#8221; which is a mobile game-based online digital formative assessment tool that has recently been examined by medical students&#46;<a class="elsevierStyleCrossRef" href="#bb0050"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0055"><span class="elsevierStyleSup">11</span></a> Since gaming technologies are thought to be suitable for opportunistic learning and offer helpful learning techniques that promote continuing academic results&#44;<a class="elsevierStyleCrossRef" href="#bb0060"><span class="elsevierStyleSup">12</span></a> pathology department should take this new tool into account to promote e-pathology courses&#46; In our study&#44; residents suggested the creation of a media library gathering all the video presentations and virtual slides which can be viewed at any time&#46;</p><p id="p0185" class="elsevierStylePara elsevierViewall">There are several obvious and evident benefits to using WSI instead of glass slides in acquiring diagnostic skills in DL pathology lessons&#46; Scanning the original glass slide allows for the dissemination of a precisely replicated reproduction of the slide without having to resort to cutting more sections &#40;which may or may not be representative of the original slide&#47;pathology&#41;&#44; depletion of a tissue block&#44; which is important for ancillary studies that frequently affect patient treatment&#44; obviating the necessity for packaging and posting slides&#44; the possibility of glass slide breakage and delays&#47;losses in transit&#44; and the time WSI offers the students and teachers the chance to view the slide in real time while geographically apart&#44; despite certain technical difficulties&#46;<a class="elsevierStyleCrossRef" href="#bb0065"><span class="elsevierStyleSup">13</span></a> The latter capacity strengthens and even encourages distance education because glass slides do not allow both participants to see the slide at the same time&#46; Therefore&#44; there are many and significant benefits of adopting WSI that much outweigh any drawbacks&#46;<a class="elsevierStyleCrossRef" href="#bb0065"><span class="elsevierStyleSup">13</span></a> However&#44; the deployment of WSI is within the means of several departments in Tunisia&#46; The routine currency in all pathology departments are glass slides and&#44; for teaching purpose&#44; scanning slides via a mounted digital camera and a standard light microscope&#46; In our study&#44; participants found that acquiring diagnostic skills via the scanned images slides was better than learning in the traditional double or multi-headed scope in 53&#46;8&#37; of cases as they had more time to analyze virtual slides than in the traditional histology workshop and were able to view them at any time&#46; More than 90&#37; of the participants felt confident in making diagnoses after attending DL via the virtual slides&#46;</p><p id="p0190" class="elsevierStylePara elsevierViewall">In order to encourage and enable ongoing support and motivation of the learner&#44; a continuous formative evaluation procedure is also to be carefully considered in this learning process&#46;</p><p id="p0195" class="elsevierStylePara elsevierViewall">The main limitation of our study is the small number of participants included&#46; Indeed&#44; this is a preliminary experiment&#44; and the study should be extended to other groups of students with an inclusion of a control group for more objectivity&#46;</p></span><span id="s0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0120">Conclusion</span><p id="p0200" class="elsevierStylePara elsevierViewall">Despite some limitations&#44; the experience in e-pathology courses was efficient and welcomed by residents&#46; In order to improve our understanding of the online teaching process and its quality&#44; we also think that more research in the area of e-learning pathology should be done in the future&#46;</p></span><span id="s0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0125">Sources of funding</span><p id="p0205" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="s0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0130">Ethics</span><p id="p0210" class="elsevierStylePara elsevierViewall">The present study has been conducted according to the principles of the declaration of Helsinki&#46; Ethical approval for the study was not required&#46; Participants were made aware of the purpose of the study&#44; the anonymous nature of the purpose&#44; the anonymous nature of the dataset generated and the option to not respond if they so wished&#46;</p></span><span id="s0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0135">Provenance and peer review</span><p id="p0215" class="elsevierStylePara elsevierViewall">Not commissioned&#44; externally peer-reviewed&#46;</p></span><span id="s0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0140">Credit authorship contribution statement</span><p id="p0220" class="elsevierStylePara elsevierViewall">All the authors read and approved the final version of the manuscript&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:15 [
        0 => array:3 [
          "identificador" => "xres1864656"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "as0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "as0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "as0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "as0020"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1620314"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1864657"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "as0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "as0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "as0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "as0040"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1620315"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "s0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "s0010"
          "titulo" => "Methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "s0015"
              "titulo" => "Study design and sample"
            ]
            1 => array:3 [
              "identificador" => "s0020"
              "titulo" => "Study population"
              "secciones" => array:3 [
                0 => array:2 [
                  "identificador" => "s0025"
                  "titulo" => "Inclusion criteria"
                ]
                1 => array:2 [
                  "identificador" => "s0030"
                  "titulo" => "Non-inclusion criteria"
                ]
                2 => array:2 [
                  "identificador" => "s0035"
                  "titulo" => "Exclusion criteria"
                ]
              ]
            ]
            2 => array:2 [
              "identificador" => "s0040"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "s0045"
          "titulo" => "Ethical considerations"
        ]
        7 => array:2 [
          "identificador" => "s0050"
          "titulo" => "Results"
        ]
        8 => array:2 [
          "identificador" => "s0055"
          "titulo" => "Discussion"
        ]
        9 => array:2 [
          "identificador" => "s0060"
          "titulo" => "Conclusion"
        ]
        10 => array:2 [
          "identificador" => "s0065"
          "titulo" => "Sources of funding"
        ]
        11 => array:2 [
          "identificador" => "s0070"
          "titulo" => "Ethics"
        ]
        12 => array:2 [
          "identificador" => "s0075"
          "titulo" => "Provenance and peer review"
        ]
        13 => array:2 [
          "identificador" => "s0080"
          "titulo" => "Credit authorship contribution statement"
        ]
        14 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-10-10"
    "fechaAceptado" => "2022-11-23"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1620314"
          "palabras" => array:3 [
            0 => "Medical residents"
            1 => "e-learning evaluation"
            2 => "Pathology course"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1620315"
          "palabras" => array:3 [
            0 => "residentes de medicina"
            1 => "evaluaci&#243;n de e-learning"
            2 => "curso de patolog&#237;a"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0010">Introduction</span><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Distance learning &#40;DL&#41; is a promising educational approach for teaching medical courses&#46; Our Pathology College was faced with the difficulty of a complete online transition of the classes because of the public health measures implemented during the COVID-19 pandemic&#46; The objective is to evaluate this teaching method of the Pathology College with reference to the learner&#39;s point of view&#46;</p></span> <span id="as0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0015">Methods</span><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">After attending DL sessions in the Pathology College&#44; pathology residents completed the questionnaire using Google Forms&#46; Twenty-six out of 33 initially enrolled in the pathology course returned fully filled out&#44; valid questionnaires&#46;</p></span> <span id="as0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Results</span><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">Twenty-four residents &#40;92&#46;3&#37;&#41; had already an E-learning experience&#46; Almost 70&#37; of participants were satisfied with their DL experience&#46; Thirty percent of the participants thought that DL should replace face-to-face courses&#46; Technical difficulties were encountered in 42&#37; of cases with the most common one related to internet connection &#40;66&#46;7&#37;&#41;&#46; Interaction with teachers during DL courses was considered more difficult than face-to-face courses by 61&#46;5&#37; of participants&#46; Participants found that learning via the virtual slide websites was better than learning in the histology workshop in 53&#46;8&#37; of cases&#46; The main weaknesses of DL were the dependence on technical means &#40;42&#46;3&#37;&#41;&#44; the lack of interactivity with colleagues &#40;26&#46;9&#37;&#41; and teachers &#40;26&#46;9&#37;&#41;&#46;</p></span> <span id="as0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Conclusion</span><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">Pathology lessons were successfully taught via DL&#44; which was highly embraced by the students&#46; Our findings shed light on a variety of areas of the students&#39; DL experiences&#44; and we strongly urge the faculty to take the students&#39; opinions into account when formulating guidelines for higher-quality medical education&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "as0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "as0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "as0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "as0020"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="as0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0035">Introducci&#243;n</span><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">el aprendizaje a distancia &#40;AD&#41; es un enfoque educativo prometedor para la ense&#241;anza de cursos de Medicina&#46; Nuestra Facultad de Patolog&#237;a se enfrent&#243; a la dificultad de una transici&#243;n completa de las clases en l&#237;nea debido a las medidas de salud p&#250;blica aplicadas durante la pandemia de COVID-19&#46; El objetivo es evaluar este m&#233;todo de ense&#241;anza de la Facultad de Patolog&#237;a con referencia al punto de vista del alumno&#46;</p></span> <span id="as0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0040">M&#233;todos</span><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">despu&#233;s de asistir a las sesiones del AD en el Colegio de Patolog&#237;a&#44; los residentes de patolog&#237;a completaron el cuestionario utilizando Google Forms&#46; Veintis&#233;is de los 33 matriculados inicialmente en el curso de patolog&#237;a devolvieron los cuestionarios v&#225;lidos y totalmente cumplimentados&#46;</p></span> <span id="as0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0045">Resultados</span><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall">Veinticuatro residentes &#40;92&#44;3&#37;&#41; ya hab&#237;an tenido una experiencia de E-learning&#46; Casi el 70&#37; de los participantes estaban satisfechos con su experiencia de AD&#46; El 30&#37; de los participantes pensaba que el AD deber&#237;a sustituir a los cursos presenciales&#46; Se encontraron dificultades t&#233;cnicas en el 42&#37; de los casos&#44; siendo la m&#225;s com&#250;n la relacionada con la conexi&#243;n a Internet &#40;66&#44;7&#37;&#41;&#46; La interacci&#243;n con los profesores durante los cursos del AD fue considerada m&#225;s dif&#237;cil que los cursos presenciales por el 61&#44;5&#37; de los participantes&#46; Los participantes consideraron que el aprendizaje a trav&#233;s de los sitios web de diapositivas virtuales era mejor que el aprendizaje en el taller de histolog&#237;a en el 53&#44;8&#37; de los casos&#46; Los principales puntos d&#233;biles del AD fueron la dependencia de los medios t&#233;cnicos &#40;42&#44;3&#37;&#41;&#44; la falta de interactividad con los colegas &#40;26&#44;9&#37;&#41; y los profesores &#40;26&#44;9&#37;&#41;&#46;</p></span> <span id="as0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0050">Conclusi&#243;n</span><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">las clases de patolog&#237;a se impartieron con &#233;xito a trav&#233;s del AD&#44; que fue muy aceptado por los estudiantes&#46; Nuestros hallazgos arrojan luz sobre una variedad de &#225;reas de las experiencias del AD de los estudiantes&#44; e instamos encarecidamente al profesorado a tener en cuenta las opiniones de los estudiantes a la hora de formular directrices para una educaci&#243;n m&#233;dica de mayor calidad&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "as0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "as0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "as0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "as0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "t0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "al0005"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gender&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;15&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;84&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">University&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tunis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;38&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Monastir&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;26&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sousse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;23&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sfax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;11&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Year of residency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4<span class="elsevierStyleSup">th</span> year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;61&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3<span class="elsevierStyleSup">rd</span> year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;23&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2<span class="elsevierStyleSup">nd</span> year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;15&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Previous E-learning experience&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;92&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Technological means used to follow the E-learning&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Laptop&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;88&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tablet&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Smartphone&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Access to a personal internet connection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wifi&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;88&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Location of e-learning course&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Home&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;96&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time spent for E-learning per month&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;4 hours&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;54&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;4 hours&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;46&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the study participants&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bs0005"
          "bibliografiaReferencia" => array:13 [
            0 => array:3 [
              "identificador" => "bb0005"
              "etiqueta" => "&#91;1&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The emotional impact of COVID-19&#58; From medical staff to common people"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "N&#46; Montemurro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bbi.2020.03.032"
                      "Revista" => array:5 [
                        "tituloSerie" => "Brain Behav Immun"
                        "fecha" => "2020"
                        "volumen" => "87"
                        "paginaInicial" => "23"
                        "paginaFinal" => "24"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bb0010"
              "etiqueta" => "&#91;2&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of school closures for COVID-19 on the US health-care workforce and net mortality&#58; a modelling study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Bayham"
                            1 => "E&#46;P&#46; Fenichel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2468-2667(20)30082-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Public Health"
                        "fecha" => "2020"
                        "volumen" => "5"
                        "paginaInicial" => "e271"
                        "paginaFinal" => "e278"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32251626"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bb0015"
              "etiqueta" => "&#91;3&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Distance learning and telemedicine in the area of Otorhinolaryngology&#58; lessons in times of pandemic"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;J&#46; Machado J&#250;nior"
                            1 => "H&#46;F&#46; Pauna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bjorl.2020.03.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Braz J Otorhinolaryngol"
                        "fecha" => "2020"
                        "volumen" => "86"
                        "paginaInicial" => "271"
                        "paginaFinal" => "272"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32295739"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bb0020"
              "etiqueta" => "&#91;4&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Using dynamic virtual microscopy to train pathology residents during the pandemic&#58; perspectives on pathology education in the age of COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;J&#46; Christian"
                            1 => "M&#46; VanSandt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/23742895211006819"
                      "Revista" => array:3 [
                        "tituloSerie" => "Acad Pathol"
                        "fecha" => "2021"
                        "volumen" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bb0025"
              "etiqueta" => "&#91;5&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#8217;enseignement &#224; distance &#224; l&#8217;aire de la covid 19&#58; un saut vers l&#8217;avenir&#63; - PMC"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "WWW" => array:2 [
                        "link" => "https&#58;&#47;&#47;www&#46;ncbi&#46;nlm&#46;nih&#46;gov&#47;pmc&#47;articles&#47;PMC8759320&#47;"
                        "fecha" => "2022"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bb0030"
              "etiqueta" => "&#91;6&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Learning about screening using an online or live lecture&#58; does it matter&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Spickard"
                            1 => "N&#46; Alrajeh"
                            2 => "D&#46; Cordray"
                            3 => "J&#46; Gigante"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1525-1497.2002.10731.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gen Intern Med"
                        "fecha" => "2002"
                        "volumen" => "17"
                        "paginaInicial" => "540"
                        "paginaFinal" => "545"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12133144"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bb0035"
              "etiqueta" => "&#91;7&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of the instructional efficacy of Internet-based CME with live interactive CME workshops&#58; a randomized controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Fordis"
                            1 => "J&#46;E&#46; King"
                            2 => "C&#46;M&#46; Ballantyne"
                            3 => "P&#46;H&#46; Jones"
                            4 => "K&#46;H&#46; Schneider"
                            5 => "S&#46;J&#46; Spann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.294.9.1043"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2005"
                        "volumen" => "294"
                        "paginaInicial" => "1043"
                        "paginaFinal" => "1051"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16145024"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bb0040"
              "etiqueta" => "&#91;8&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Educating generalist physicians about chronic pain&#58; live experts and online education can provide durable benefits"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Harris"
                            1 => "T&#46;E&#46; Elliott"
                            2 => "B&#46;E&#46; Davis"
                            3 => "C&#46; Chabal"
                            4 => "J&#46;V&#46; Fulginiti"
                            5 => "P&#46;G&#46; Fine"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1526-4637.2007.00399.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pain Med"
                        "fecha" => "2008"
                        "volumen" => "9"
                        "paginaInicial" => "555"
                        "paginaFinal" => "563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18266811"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bb0045"
              "etiqueta" => "&#91;9&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "&#40;PDF&#41; Examining Interactivity in Synchronous Virtual Classrooms"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "WWW" => array:2 [
                        "link" => "https&#58;&#47;&#47;www&#46;researchgate&#46;net&#47;publication&#47;272151781&#95;Examining&#95;Interactivity&#95;in&#95;Synchronous&#95;Virtual&#95;Classrooms"
                        "fecha" => "2022"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bb0050"
              "etiqueta" => "&#91;10&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluating e-learning in the pathology course during the COVID-19 pandemic"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Manou"
                            1 => "E&#46;-C&#46; Lazari"
                            2 => "A&#46;C&#46; Lazaris"
                            3 => "G&#46; Agrogiannis"
                            4 => "N&#46;G&#46; Kavantzas"
                            5 => "G&#46;-E&#46; Thomopoulou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/AMEP.S353935"
                      "Revista" => array:5 [
                        "tituloSerie" => "AMEP"
                        "fecha" => "2022"
                        "volumen" => "13"
                        "paginaInicial" => "285"
                        "paginaFinal" => "300"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bb0055"
              "etiqueta" => "&#91;11&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Innovating pathology learning via Kahoot&#33; game-based tool&#58; a quantitative study of students&#96; perceptions and academic performance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "F&#46;A&#46;A&#46; Elkhamisy"
                            1 => "R&#46;M&#46; Wassef"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/20905068.2021.1954413"
                      "Revista" => array:6 [
                        "tituloSerie" => "Alexandria J Med"
                        "fecha" => "2021"
                        "volumen" => "57"
                        "paginaInicial" => "215"
                        "paginaFinal" => "223"
                        "itemHostRev" => array:3 [
                          "pii" => "S0889852915000420"
                          "estado" => "S300"
                          "issn" => "08898529"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bb0060"
              "etiqueta" => "&#91;12&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medical students&#58; what educational resources are they using&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46; Wynter"
                            1 => "A&#46; Burgess"
                            2 => "E&#46; Kalman"
                            3 => "J&#46;E&#46; Heron"
                            4 => "J&#46; Bleasel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12909-019-1462-9"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Med Educ"
                        "fecha" => "2019"
                        "volumen" => "19"
                        "paginaInicial" => "36"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30683084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bb0065"
              "etiqueta" => "&#91;13&#93;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of whole slide imaging &#40;WSI&#41; for distance teaching"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Evans"
                            1 => "N&#46; Depeiza"
                            2 => "S&#46;-G&#46; Allen"
                            3 => "K&#46; Fraser"
                            4 => "S&#46; Shirley"
                            5 => "R&#46; Chetty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/jclinpath-2020-206763"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Pathol"
                        "fecha" => "2021"
                        "volumen" => "74"
                        "paginaInicial" => "425"
                        "paginaFinal" => "428"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32646928"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15751813/0000002400000001/v2_202303211046/S1575181322000687/v2_202303211046/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "41661"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15751813/0000002400000001/v2_202303211046/S1575181322000687/v2_202303211046/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1575181322000687?idApp=UINPBA00004N"
]
Article information
ISSN: 15751813
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 5 2 7
2024 October 34 10 44
2024 September 46 16 62
2024 August 49 12 61
2024 July 40 11 51
2024 June 37 22 59
2024 May 35 10 45
2024 April 46 21 67
2024 March 21 4 25
2024 February 27 8 35
2024 January 25 7 32
2023 December 18 8 26
2023 November 15 6 21
2023 October 24 12 36
2023 September 13 5 18
2023 August 13 4 17
2023 July 24 4 28
2023 June 36 9 45
2023 May 43 2 45
2023 April 36 16 52
2023 March 32 44 76
2023 February 27 3 30
2023 January 9 0 9
Show all

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos