Cases in Bioethics: Health Research Ethics in Southeast Asia
Keywords

education research, online learning, COVID-19, survey, study design, student participants, IRB review, dentistry degree students in Cambodia

During the COVID-19 pandemic, many countries experienced various forms of lockdown.1 Across Southeast Asia, universities and other professional schools provided online education to their students to ensure continuity in learning,2 and both students and teachers gradually adapted to this form of learning. However, even though some virtual classes had been available in the region prior to the pandemic, there were still many concerns about educational quality compared to in-person classes.3 Specific concerns included reduced interactions between and among students and faculty, reliance on screen-based devices, attentiveness, and a lack of student motivation to attend virtual classes.4 Teachers have also had difficulty adapting to online teaching, and a vast majority have no prior online teaching experience.5

Research has demonstrated that online teaching can positively affect students and keep them motivated if done effectively and efficiently; however, questions remain about whether and to what extent a rapid, substantial increase in online activity for students and teachers may adversely affect health. Researchers at one university in Cambodia conducted a cross-sectional study to analyze the impact of online teaching on student performance and satisfaction in a dentistry degree program. To be eligible for the study, students had to 1) be enrolled in the dentistry school, 2) attend a minimum of 80 percent of classes offered each month, and 3) attend a minimum of 4 hours of class every day. The research team developed, validated, and distributed an online questionnaire to 25 students to capture their views and challenges of online education. The researchers then replicated the study with a larger group of students recruited using convenience and snowball sampling.

No personally identifying information was obtained from any student during the study. Upon opening the survey link, study participants were informed that they should only proceed if they consented to complete the questionnaire and provide the data by their own free will. The first page of the questionnaire contained demographic data such as age, gender, and location. Questions focused on the number of classroom hours, number of days, challenges, and positive experiences with virtual learning.

Questions

  1. Do you think this study should be reviewed by an institutional review board (IRB)? What are some factors that might suggest whether IRB review and approval is or is not needed for such a study?

  2. What are some of the considerations that might need to be accounted for by the researchers in using convenience and snowball sampling for this study? Do any of these considerations have ethical implications?

  3. What are the implications of the use of an online survey for this study? How might this relate to particular research ethics requirements?

  4. What, if any, ethical tradeoffs might be associated with conducting such a survey anonymously?

References

Engzell, Per, Arun Frey, and Mark D. Verhagen. “Learning Loss due to School Closures during the COVID-19 Pandemic.” Proceedings of the National Academy of Sciences 118, no. 17 (April 7, 2021). https://doi.org/10.1073/pnas.2022376118.
Hattar, Susan, Abeer AlHadidi, Faleh A. Sawair, Islam Abd Alraheam, Ahmad El-Ma’aita, and Fouad Kadim Wahab. “Impact of COVID-19 Pandemic on Dental Education: Online Experience and Practice Expectations among Dental Students at the University of Jordan.” BMC Medical Education 21, no. 1 (March 8, 2021). https://doi.org/10.1186/s12909-021-02584-0.
Mundula, Luigi, and Andrea Salustri. “Growth of the ASEAN Countries: Determinants and Perspectives.” SSRN Electronic Journal, 2012. https://doi.org/10.2139/ssrn.2332665.
Quinn, Barry, James Field, Ronald Gorter, Ilze Akota, Maria‐Cristina Manzanares, Corrado Paganelli, Julia Davies, et al.COVID‐19: The Immediate Response of European Academic Dental Institutions and Future Implications for Dental Education.” European Journal of Dental Education 24, no. 4 (May 11, 2020): 811–14. https://doi.org/10.1111/eje.12542.
Schlenz, Maximiliane Amelie, Alexander Schmidt, Bernd Wöstmann, Nobert Krämer, and Nelly Schulz-Weidner. “Students’ and Lecturers’ Perspective on the Implementation of Online Learning in Dental Education due to SARS-CoV-2 (COVID-19): A Cross-Sectional Study.” BMC Medical Education 20, no. 1 (October 9, 2020). https://doi.org/10.1186/s12909-020-02266-3.

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