With due permission, encouragement and active participation from the desk of the President, Anatomical Society of India (ASI) West Bengal Chapter; this cross-sectional study was carried out in the month of September 2020; amongst the 199 faculties of Anatomy posted in different medical teaching institutes of West Bengal, who were already included in the official WhatsApp group of the ASI-WB Chapter. Since formation six years ago, this WhatsApp group is considered to be official communication platform amongst faculties of Anatomy in this state under ASI-WB chapter.

A google form based questionnaire has been framed initially with 20 questions themed on: (a) general pattern of the topics covered in the online class; (b) practice and perception of faculties regarding the online classes and assessments; (c) perception for future planning of class and assessments in post-lockdown new normal phase when colleges would resume; and (d) self-assessments scoring by individual faculties using 5 point-likert scale for self-confidence level to conduct online class sessions, what they could gain after the practice in lockdown times, to see whether there would be any change or not.

The primary version of the questionnaire was first applied on departmental colleagues who responded on the understanding of the questions. Later, the set has been sent by e-mail to 20 members of Medical Education Units of different colleges (10 from inside the state and 10 from outside the state) for their opinion, who were not from Anatomy. By using Statistical Package for the Social Sciences (SPSS) Version 20 reliability analysis was done with calculated Cronbach’s Alpha value 0.72 and it has been the modified in final shape with 14 questions.

A sensitisation post was given in the ASI-WB Chapter WhatsApp group for the study and after that the link of the google form was shared with request to response by next 72 hours. The form was made with provisions for informed consent and inclusion criteria for participation for those, who only conducted online classes-cum-assessments in the lockdown times. Who, neither participated in the online teaching and/nor conducted any online assessment, requested for not to participate. Thus, out of total 199 participants of WhatsApp group, 163 have responded and enlisted finally.

All responses gathered by scheduled time was calculated using the Microsoft excel. Descriptive statistics was used in terms of frequency and percentages.

Amongst the 199 faculties of Anatomy included in the Anatomical Society of India-State chapters, 163 faculties have participated in this survey; in which 52 were Associate Professors, whereas Professors, Assistant Professor and Tutors were in equal population of 34. Only 9 respondents were residents [Table/Fig-1 (Please vide for 13^th question)]. During the lockdown phase, almost all respondent teachers participated in teaching of Gross Anatomy of Abdomen, Head and neck, Neuroanatomy, some parts of Histology as well as Embryology; except few who also taught some Gross Anatomy of Thorax [Table/Fig-2] (Q-1). A 73% of faculties confessed that it would not be always possible by them to take attendance in the online classes; though 12.8% faculties always could maintain it [Table/Fig-2] (Q-2).

[Table/Fig-1]:

Distribution of respondents according to designation (N=163).

Majority of the faculties used google classroom method (37.4%), whereas 31.2% used zoom meeting app for the online class. 25.7% faculties used google meet and below 10% used others methods as MS teams, jiomeet etc., [Table/Fig-2] (Q-3).

During theory classes majority of the faculties (84.6%) used didactic lecture sharing the PPT. A 7.36% of faculties used to share the PPT beforehand in the students’ forum and in the theory class hours, conducted doubt clearance. 4.29% faculties used to share their recorded lecture in YouTube and students were provided with the link. Only 1.6% faculties used to take class in chalk-board live in online platform [Table/Fig-2] (Q-4). On the other hand, sharing of pre-recorded demonstration class was mostly preferred (46%), followed by sharing of internet-available videos of demonstratable parts (30.1%). Only 12.8% faculties practiced live casting of the demonstration class [Table/Fig-2] (Q-5). Faculties’ self-assessment scores to judge own confidence level to conduct the online classes says that all of them felt significantly improved confidence to tackle online classes and assessments in anatomy [Table/Fig-3] (Please vide for 14^th question).

All of the respondent faculties opined for requirement of strong uninterrupted internet facility in both ends of teacher as well as students for conducting smooth online classes. Disturbed net connectivity mostly perceived as constrain. A 96.3% of faculties perceived the problem for time management in online session, where they could not conduct students’ interaction after the class gets over. An 80.3% agreed for the limited capacity of the online classes, for which every-time they needed to make supplemental sessions to cover the entire batch of students [Table/Fig-2] (Q-6). Besides the 5.5% of faculties, rest were not very sure whether such mode of teaching would be able to make competent learner as per the competency guidelines of National Medical Council (erstwhile Medical Council of India) curriculum, or not [Table/Fig-2] (Q-7).

While for the methods of assessments followed, faculties in maximum (88.9%) preferred to conduct the online assessment by sharing the questions to the students and asking them to write answers with to scan-upload and email the answer copy to the provided e-mail ID of faculty; whereas in half a times (57.7%) they conducted the assessment by using MCQ quizzes with shuffled questions and shuffled options along with real time scoring system. In 26.3% times faculties conducted the online viva-voce exam for the students; but in 12.8% they could practice feedback sessions positively [Table/Fig-2] (Q-8,9).

When the students will rejoin their institutes at the near future unlock phases and college will resume; only 6.1% faculties liked to resume the classes in traditional ways as were in pre-COVID times. Majority (47.8%) faculties opined to maintain the practice of online sessions for lecture, histology as well as demonstration topics followed-up by gallery-walk of histology slides and demonstratable parts/viscera in ‘mini’ groups. Almost equal proportion of faculties were in favour of physical class sessions for demonstration and histology followed-up with mini-group gallery walk along with the online lecture classes [Table/Fig-2] (Q.10).

Regarding the planning of theory assessment in future days at new-normal period, maximum faculties (63.8%) expressed their support for online 3 hours MCQ with shuffled options and questions. Only 12.9% liked to conduct the theory examination in traditional physical exam-hall system. For practical assessment in Anatomy, 50.3% polled for Objective Structured Physical Examination (OSPE) with checklist observation by CCTV monitoring. A 21.5% of faculties wished to maintain the provision of physical viva-voce exam along-with OSPE, with an installed barrier screen in between assessee and assessor. A 14.7% of faculty opined for online assessment for histology and radiology tables with physical assessment for cadaver table and viva tables with barrier screen. An 11.04% of faculties liked only the cadaver table to be in physical mode with all other portions in online platform. Only 2.4% wished to conduct the practical examination in traditional way as used to be in pre-COVID times [Table/Fig-2] (Q-11,12).

As on this date there are more than 9 lac active cases in country out of total confirmed for 65 lacs till date and in West Bengal more than 27 thousand active cases out of till date diagnosed more than 2 lac [8,9] and as the trend is going on increasing, the pandemic is expected to prevail over the coming months. During the lockdown phases, when the students were in their home, faculties continued to teach them Anatomy over the online platform and even they conducted different assessments. Major parts of Anatomy syllabus covering huge numbers of competencies from Abdomen, Head neck, Neuroanatomy etc., got covered in online mode. For these, the major constrains as were perceived is the unstable internet facility. Broadband connections although available in different institutes but, it could be assured in students’ end in each of their residence. Faculties needed to conduct multiple sessions for limited intake allowances by the meeting apps. This could be minimised by institutes’ endeavour for opting in paid versions of the online platforms. Faculties favoured the ‘mini-group’ gallery walk for the demonstration classes in coming days. Traditionally, the ‘Small Group’ demonstration batches (SGT) are carried on with 60 to 70 students in each institute; which seemed to be a quasi-lecture class!! Even in demonstration times it is also not possible to carry on the sub-batches not less than 30-40 students per each batch. Definitely, if such huge mass of students gather in the so-called SGT classes as well as 30 students comes at a time in demonstration batches; even average 200 students comes in lecture classes, then the social distancing could never be feasible. So the opinion of ‘online lecture’ not only decreases the gathering of entire batch of students at a time; but also spares that ‘lecture hour’ to get utilised for demonstration purpose, if demonstration batch get managed with not more than 10 students at a time.

The Government of India in the advisory of conduct of examinations in this post-lockdown new normal COVID-19 times has suggested for maintenance of atleast six feet distances between each candidates and different rules to maintain the crowd management. However, the problem in institutes is the crunch of space for such crowd maintenance. So, the option for online theory examination by online-MCQ appeared to be rational, if the questions get framed in problem-centered approach targeting the higher levels of cognitive domain. The research work of Singh T described that the 4 hours MCQ session get equally reliable than other practical modes of assessments as MiniCEX etc., [10]. For practical parts of examination, the OSPE with Closed Circuit Television (CCTV) observation is also possible to implement and this will definitely decrease teacher-student disease communication. Face-to-face interaction also could be barrier by putting transparent screen as faculties suggested for the viva voce tables. So, overall these faculties statements and opinions could be presented to university authorities for future implication in the coming days when we would to learn to live with COVID.

This study was carried on by online survey gathering opinion by Google questionnaire. For the time constrain, we could not approach individual colleges, and carry on focused group discussion and in-depth interview followed by qualitative analysis; which can be carried on in later days.

This study not only provides the experience shared by faculties in conducting the online teaching of Anatomy in the lockdown phases, but also provides insight in planning of the classes and examinations in the post-lockdown COVID-19 times which can be presented as recommendation to the university, which is yet to plan out the examination in ‘new normal’ era.