Response to Letter to the Editor: “Integration of Massive Open Online Course (MOOC) in Ophthalmic Skills Training for Medical Students: Outcomes and Perspectives”

Abstract

To the Editor: We sincerely thank Dr. Zaki for the interest in our study on integrating massive open online courses (MOOC) into traditional clinical ophthalmology teaching.1 As we discussed in the paper, there are 2 types of MOOCs: xMOOC (extended) and cMOOC (connectivism). The ophthalmology MOOC created by our team is an xMOOC available on XuetangX, a well-known MOOC platform launched by Tsinghua University. Our MOOC is an educational program for undergraduate medical students who want to learn the basics and practical skills in ophthalmology. The content of the MOOC was designed according to the relevancy of the traditional curriculum, including anatomy of the eye, assessment of the eye, external eye diseases, conjunctival diseases, cornea, dry eye, uveitis, retina, cataract, glaucoma, ocular trauma, refractive error, strabismus and amblyopia, neuro-ophthalmology, and orbit. The detail of the MOOC can be found at https://www.xuetangx.com/course/stu1002fu122902intl/12451190. We agree that learners’ personalities and motivations are critical for the success of MOOCs, and there are high dropout rates among students enrolled in MOOCs. Therefore, in this study, we did not simply use MOOCs for teaching but integrated MOOCs with traditional ophthalmic skill teaching classes. Participants were asked to preview the slit-lamp microscopy or visual acuity test through MOOCs, and then they attended the conventional clinical training courses. At the end of the course, most students agreed that the MOOC enhanced their learning interests and motivation (4.13 of 5 points). We do not think that the results of this study can be generalized to the situation that MOOC is the only teaching method, but this study suggests that MOOCs provide additional value in clinical ophthalmic skill training. The time arranged for slit-lamp and visual acuity teaching sessions are both 45 minutes, which we believe was reasonable since the skill assessments are targeted at undergraduate medical students and the time allocated for undergraduate clinical teaching of ophthalmology is very limited. In addition, we have simplified the Direct Observation of Procedural Skills forms, which have only 7 items and are more suitable for the assessment in a limited time. The suggestion of interviewing students to collect qualitative data is highly appreciated. Although we interviewed some participants concerning their comments on the MOOCs, the interview was informal and in a loose environment after class, and the results were not recorded. We will design a proper study to collect qualitative data on the students’ insight on MOOCs, aiming to improve the design and implementation of MOOCs.