Abstract

Introduction/ObjectiveSince the start of the Covid‐19 pandemic, a consensus has emerged among students and educators that the connectedness inherent in face‐to‐face (F2F) learning is beneficial, and that something is lost with online course delivery. Feelings of isolation and estrangement from faculty and peers are common, and the potential impact on learning and on the development of social skills needed for patient care is of concern to health educators. The goal of our research project was, therefore, to perform a review of the neuroscience and pedagogical literature to assess the current state of knowledge on the impact of isolation and distance on brain morphology, neurophysiology, and learning.MethodologyOur group chose to divide literature search activities into two broad categories and to work in pairs focusing either on the neuroscience or the pedagogical literature. Our approach was loosely based on Arksey and O’Malley, and while not a formal scoping review, did use a methodology that was rapid, broad, and aimed at identifying the different types of existing evidence related to our research question. Using various scientific databases the group performed searches using keywords such as “immediacy,” “face to face,” ”social isolation,” and “brain volume.” After screening by title 431 abstracts were reviewed by the team, and 76 articles were chosen for full‐text review. Please click the following link to see our final reference list: Reference List.ResultsFrom the Neuroscience Literature: Both social isolation and loneliness cause brain atrophy, primarily in the medial temporal region. Gene expression decreases and remains low in the hippocampus during periods of prolonged isolation, reflecting decreased ability to consolidate new long‐term memories. Significantly more neural coupling takes place between partners during F2F than during back to back or computer mediated dialogue, and natural verbal communication, increased eye contact, and observation of non‐verbal facial expressions enhance neural coupling.From the Pedagogical Literature: Interaction, collaboration, and sharing thoughts and feelings F2F all contribute to a sense of community. Students report F2F interactions feel more real, create a feeling of connectedness, and facilitate the formation of relationships. Increased social presence in the classroom can predict actual and perceived cognitive learning. Immediacy that is verbal (e.g. posing questions, discussing personal experience, and informal conversations) and non‐verbal (e.g. hand movements, facial expressions, and eye contact) both increase with F2F interactions. Both actual and perceived cognitive learning increase with immediacy.ConclusionsWith multiple studies showing brain changes with isolation, a student appreciation for immediacy, and the potential impact on cognitive and affective learning of F2F instruction, the evidence presented in this review suggests that caution, and further research, are warranted as educators consider continuation of online course delivery begun during the current pandemic.

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