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      Stress and behavioral changes with remote E-exams during the Covid-19 pandemic: A cross-sectional study among undergraduates of medical sciences

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          Background

          Emergence of coronavirus disease 2019 (COVID-19) forced the worldwide higher educational institutes to adopt distance learning mode. Further, remote electronic exams (E−exams) were considered as mode of assessment. Objectives: This cross-sectional study evaluated the students' experience of remote E-exams during the COVID-19 pandemic among Medical Sciences students in Jordan. Materials and Methods: A survey of 29 questions was prepared on Google forms and distributed among students at Faculties of Medical Sciences (Medicine, Dentistry, Pharmacy, Nursing and Applied Medical Sciences) at Jordan University of Science and Technology. The questions include students' demographics, stress experience, and factors contributing to stress as well as behavioral changes related to remote E-exams. Responses were analyzed using descriptive, cross tabulation and Chi-square tests. Results: Among 1019 respondents, 32% reported more stress with remote E-exams. This was associated with academic major and gender. Among students with more stress during remote E-exams, the exam duration, mode of questions navigation and technical problems (exam platform and internet connectivity) appeared as the main factors related to stress in 78%, 76% and >60%, respectively. Other factors include concern regarding the teaching methods, exam environment and students' dishonesty. Remote E-exams had negative impact on students' dietary habits (increase consumption of caffeine and high energy drinks, high sugar food, fast food), sleep (reduction in sleeping hours, more consumption of insomnia medications), physical activity (less exercises) and smoking habits (increase). Conclusion: Results suggested a negative impact of E-exams on students within Medical Faculties. Robust exam platform and remote mock E-exams are recommended to reduce students' potential stress. A stress-free environment is very essential to encourage students to adopt remote E-exams, particularly if the pandemic will take longer. Various awareness programs about students' habits related to dietary, sleep quality, physical activity and smoking are highly valuable for students’ health benefits. This is of particular importance since the current students at Faculties of Medical Sciences are the future health care providers.

          Highlights

          • •

            Remote E-exams are more stressful in one third of students from faculties of medical sciences.

          • •

            Exam duration, mode of questions navigation and technical problems are major causes for students stress with remote E-exams.

          • •

            Remote E-exam experience has negative impact on students' habits related to diet, sleep, physical activity and smoking.

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          STROCSS 2019 Guideline: Strengthening the reporting of cohort studies in surgery

          Riaz Agha, Ali Abdall-Razak, Eleanor Crossley … (2019)
          The STROCSS guideline was developed in 2017 to improve the reporting quality of observational studies in surgery. Building on its impact and usefulness, we sought to update the guidelines two years after its publication.
          Article 0 comments Cited 713 times – based on 0 reviews     Review now
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            The effects of stress on physical activity and exercise.

            Matthew Stults-Kolehmainen, Rajita Sinha (2014)
            Psychological stress and physical activity (PA) are believed to be reciprocally related; however, most research examining the relationship between these constructs is devoted to the study of exercise and/or PA as an instrument to mitigate distress. The aim of this paper was to review the literature investigating the influence of stress on indicators of PA and exercise. A systematic search of Web of Science, PubMed, and SPORTDiscus was employed to find all relevant studies focusing on human participants. Search terms included "stress", "exercise", and "physical activity". A rating scale (0-9) modified for this study was utilized to assess the quality of all studies with multiple time points. The literature search found 168 studies that examined the influence of stress on PA. Studies varied widely in their theoretical orientation and included perceived stress, distress, life events, job strain, role strain, and work-family conflict but not lifetime cumulative adversity. To more clearly address the question, prospective studies (n = 55) were considered for further review, the majority of which indicated that psychological stress predicts less PA (behavioral inhibition) and/or exercise or more sedentary behavior (76.4 %). Both objective (i.e., life events) and subjective (i.e., distress) measures of stress related to reduced PA. Prospective studies investigating the effects of objective markers of stress nearly all agreed (six of seven studies) that stress has a negative effect on PA. This was true for research examining (a) PA at periods of objectively varying levels of stress (i.e., final examinations vs. a control time point) and (b) chronically stressed populations (e.g., caregivers, parents of children with a cancer diagnosis) that were less likely to be active than controls over time. Studies examining older adults (>50 years), cohorts with both men and women, and larger sample sizes (n > 100) were more likely to show an inverse association. 85.7 % of higher-quality prospective research (≥ 7 on a 9-point scale) showed the same trend. Interestingly, some prospective studies (18.2 %) report evidence that PA was positively impacted by stress (behavioral activation). This should not be surprising as some individuals utilize exercise to cope with stress. Several other factors may moderate stress and PA relationships, such as stages of change for exercise. Habitually active individuals exercise more in the face of stress, and those in beginning stages exercise less. Consequently, stress may have a differential impact on exercise adoption, maintenance, and relapse. Preliminary evidence suggests that combining stress management programming with exercise interventions may allay stress-related reductions in PA, though rigorous testing of these techniques has yet to be produced. Overall, the majority of the literature finds that the experience of stress impairs efforts to be physically active. Future work should center on the development of a theory explaining the mechanisms underlying the multifarious influences of stress on PA behaviors.
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              Online teaching-learning in higher education during lockdown period of COVID-19 pandemic

              Lokanath Mishra, Tushar Gupta, Abha Shree (2020)
              The whole educational system from elementary to tertiary level has been collapsed during the lockdown period of the novel coronavirus disease 2019 (COVID-19) not only in India but across the globe. This study is a portrayal of online teaching-learning modes adopted by the Mizoram University for the teaching-learning process and subsequent semester examinations. It looks forward to an intellectually enriched opportunity for further future academic decision-making during any adversity. The intended purpose of this paper seeks to address the required essentialities of online teaching-learning in education amid the COVID-19 pandemic and how can existing resources of educational institutions effectively transform formal education into online education with the help of virtual classes and other pivotal online tools in this continually shifting educational landscape. The paper employs both quantitative and qualitative approach to study the perceptions of teachers and students on online teaching-learning modes and also highlighted the implementation process of online teaching-learning modes. The value of this paper is to draw a holistic picture of ongoing online teaching-learning activities during the lockdown period including establishing the linkage between change management process and online teaching-learning process in education system amid the COVID-19 outbreak so as to overcome the persisting academic disturbance and consequently ensure the resumption of educational activities and discourses as a normal course of procedure in the education system.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Med Surg (Lond)
                Journal ID (iso-abbrev): Ann Med Surg (Lond)
                Title: Annals of Medicine and Surgery
                Publisher: The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
                ISSN (Electronic): 2049-0801
                Publication date PMC-release: 1 November 2020
                Publication date (Print): December 2020
                Publication date (Electronic): 1 November 2020
                Volume: 60
                Pages: 271-279
                Affiliations
                [a ]Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
                [b ]Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
                [c ]Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, 22110, Jordan
                [d ]Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
                [e ]Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
                Author notes
                [∗ ]Corresponding author. Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.
                Article
                Publisher Item ID: S2049-0801(20)30413-1
                DOI: 10.1016/j.amsu.2020.10.058
                PMC ID: 7604013
                PubMed ID: 33163179
                SO-VID: a0dcb771-d112-42a1-be49-753324c0631e
                Copyright © © 2020 The Authors
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 7 October 2020
                Date accepted : 25 October 2020
                Categories
                Subject: Cross-sectional Study

                Keywords: covid-19,remote e-exams,higher education,stress,behavioral changes,medical sciences
                Data availability:
                Keywords: covid-19, remote e-exams, higher education, stress, behavioral changes, medical sciences

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