Challenges and acceptance of e-teaching among medical professionals during the COVID-19 pandemic

Background: Previously resistant to change, medical professionals have now embraced e-teaching as a modern technology and the COVID-19 pandemic has compelled the entire world to accept it as a fundamental tool for education. This study aimed to evaluate the challenges and acceptance of E-teaching by medical professionals during the COVID-19 pandemic. Methods: An electronic form questionnaire was designed and validated according to the Technology Acceptance Model (TAM) to find out the factors that affect the acceptance and use of E-teaching by medical professionals. Results: Most of the participants (88%) agreed that the technological skills of giving online courses increase the educational value and experience of teaching medical professionals. The highest barrier to E-teaching was unsteady internet connectivity (56%), inadequate internet data(48%), lack of computers/ laptops (16.5%), and technical problems (73%). The rate of

confidence of the students towards their faculty during the COVID-19 pandemic.
It is expected that with the effective implementation of E-teaching, the role of medical professionals will be transformed from the traditional teacher-centric to student-centric model which exists as the current new curriculum in many teaching medical colleges.Therefore, the aim of this study is to evaluate their experiences and challenges to E-teaching during the COVID-19 pandemic.
This study aimed to evaluate the challenges and acceptance of E-teaching by medical professionals during the COVID-19 pandemic.

Study area
Tertiary Care Teaching Medical College Hospital, Chennai.

Study population
The study included 200 medical professionals from preclinical, para-clinical, and clinical departments who are involved in the development and teaching of online courses.Medical professionals who were not involved in online teaching were excluded from the study.

Study procedure
The study protocol was reviewed and approved by the Scientific Research Committee and Institutional Ethics Committee.A questionnaire was designed on Google Forms by the principal investigator.The accuracy of the content and validity of the internal survey items were finalized with multidisciplinary departments from the study investigators.Finally, it was piloted with 10 medical professionals who were not enrolled in the study and a few modifications were made as per their suggestions.After validation, the Google form web link for participating in the study was shared via the mail portal and each department's WhatsApp group by the investigators.

Data analysis
Data were analyzed using the SPSS version 25.0.The normality of data distribution was assessed using the Shapiro-Wilk test.The descriptive analysis was performed to obtain quantitative data by mean and standard deviations.Qualitative data were obtained and analyzed using frequencies and percentages, as applicable.Finally, a multivariate regression analysis was performed to predict the potentially significant determinants of acceptance and use of E-teaching in education.A P value < 0.05 was considered statistically significant.

Results
The study included 200 Teaching medical professionals.1).Before evaluating the challenges, insight into the response of the medical professionals towards E-teaching revealed that the online class is more flexible compared to the direct contact class (50.5% strongly agreed and 28.5% agreed).Many faculty members (66.5% strongly agreed and 25.5% agreed) prefer face-to-face contact with students over online interaction.Additionally, 44% agreed that the design of online classes allows faculty to manage their time more effectively.While 44.5% of the faculties were neutral that the theoretical class is easy to take online compared to 93.5% of faculties admitted that the Practical modules are difficult for faculties to conduct in online classes (82.5% strongly agreed and 11% agreed) (Table 2).
A study on the challenges of E-teaching reported by medical professionals revealed that (56%) had issues with unsteady internet connectivity, (48%) encountered inadequate internet data, (33%) lacked computers or laptops and (73% )experienced technical problems (Table 3).
The application of the Technology Acceptance Model (TAM) to medical professionals revealed that 83.1% of the participants perceived the use of E-teaching as highly beneficial.This suggests that the majority of study participants believe E-teaching significantly improves and advances the educational process.
A significant 81.4% of participants strongly agreed that the E-teaching systems implemented were highly easy to use and operate, indicating a high level of perceived ease of use.Furthermore, the acceptance rate of E-teaching was found to be 88.6%, suggesting that, based on user perception, the implemented E-teaching system was highly accepted.
This was achieved because both perceived ease of use and perceived usefulness were assessed as satisfactory by the users (Table 4).
The limitations of our current study are due to time constraints and the consequences of the COVID-19 pandemic.Despite these challenges, a significant number of health professionals could have been included.

Discussion
The abrupt transition from face-to-face learning to online teaching has produced numerous challenges for teachers, as this transition occurred unexpectedly and without prior preparation.E-teaching, a crucial tool in medical education, can offer an effective alternative to the traditional in-person education system.The use of electronic teaching has increased worldwide over the past few decades, and several medical colleges in developing countries have already embraced this trend. 11However, the challenges of accessing new technologies, dealing with unreliable internet connections, and navigating a weak institutional framework for implementing e-teaching are significant obstacles to its successful establishment. 12,13-teaching is one of the best platforms that provides an interactive learning environment online for medical students without getting much affected during the COVID-19 pandemic lockdown.E-teaching poses a significant challenge for medical professionals, as they must adapt to delivering lectures on online platforms. 14ur study investigated the challenges and obstacles encountered by medical professionals in accepting e-teaching as a learning method during the COVID-19 pandemic, participants strongly agreed (83.1%) that the technological skills to deliver online classes increase the educational value of experience of teaching medical professionals.Similarly, these findings from our research correlate with the results of research studies conducted by Kleiman 15 and Jamlan. 16ost participants in our study agreed (44%) concerning the advantages of time flexibility in teaching on the online platform.Contrary to this, Bhardwaj et al 17 reported that some faculty members believe e-teaching can be timeconsuming, lead to difficulties in monitoring students, and reduce interest in traditional face-to-face teaching.
Furthermore, in our study, the majority of participants strongly agreed that online classes accelerate their work and improve their performance.Similarly, Tullis and Benjamin acknowledged the benefits of self-paced online learning. 18n our study, a significant 43.5% of participants strongly disagreed with the notion that conducting exams via an online platform is challenging for faculty.This perception among medical professionals could be due to the fact that many online exams are structured around multiple-choice questions.This format allows for automated grading, significantly reducing the time and effort required by faculty members. 19ontrary to our findings, Hannafin et al observed that many observational and participatory evaluations of web-based learning posed challenges. 20Similarly, Oncu and Cakir 21 found that the absence of direct face-to-face interaction and informal assessment made online teaching a challenge for faculty members.The application of the TAM on our study participants revealed that a higher percentage of the respondents agreed with the perceived usefulness of E-teaching and accepted that E-teaching is valuable in improving the learning process.A study by Poon et al revealed that their participants were not fully comfortable with the Online platforms as an alternate tool for teaching. 22This perception is related to many factors such as technological challenges, difficult interactions and discussions with students, lack of adequate internet connectivity, and personal learning preferences. 23ontrary to the findings by Chokri, 24 our study depicted that most of the respondents were satisfied and strongly agreed with the use of E-teaching in the future.Medical professionals should respond by recognizing the impact of the COVID-19 pandemic on medical students.This understanding will enable them to adapt to the changes implemented to enhance their learning experience.Consequently, students will be better equipped to manage their time effectively and continue their education.
Academic strategies such as special classes and MCQ tests could potentially lead to improvement.Other strategies like feedback collection on a regular basis can be implemented to engage students.However, these initiatives may require institutional support and interactive learning by the medical students.

Conclusion
Despite the sudden migration of instructional delivery to online platforms by medical colleges and other citadels of E-teaching during this pandemic, the challenges experienced by medical professionals are well explored and transformed into opportunities.In our current study, the majority of the participants strongly agreed with the perceived usefulness, perceived ease of use, and acceptance of E-teaching.It is evident that virtual learning will only be a complimentary method for traditional learning methods and education will become more hybrid.

Table 2 .
Insights of medical professionals towards E-teaching

Table 3 .
Challenges of E-Teaching among medical professionals (N = 200)

Table 4 .
Technology Acceptance Model (TAM) results of medical professionals to E-teaching (N = 200)