In 2020, the world was experiencing a pandemic due to the rapid spread of coronavirus disease 2019 (COVID-19). The COVID-19 pandemic is considered the most powerful pandemic since the Spanish flu of 1918, which was recorded as the first pandemic of humankind [1]. Outbreaks of 2002 to 2003 severe acute respiratory syndrome and 2015 Middle East respiratory syndrome showed high mortality rates, but are not considered pandemics. As the first pandemic since the 2009 swine flu, COVID-19 caused fear and confusion around the world due to its rapid infection and mortality rates.

Previous outbreaks of infectious diseases have also caused great losses to individuals, society, and the economy; however, these effects are difficult to compare with those of COVID-19. The COVID-19 pandemic is rated as the world’s largest medical catastrophe, causing the largest economic loss since World War II. COVID-19 quickly spread to more than 200 countries on five continents within a few months, completely changing the lives of people around the world, including their economies, societies, and cultures [2]. One of the biggest changes was a change in communication, which appeared the fastest in the education field [3].

During COVID-19, online education, which had been provided previously by educational facilities with special purposes, such as cyber universities, was adopted by all universities across the country, and each school had no choice but to undergo trial and error to provide high-quality online education in the absence of preparation [4]. With the transition from face-to-face to online classes, both students and professors were faced with the task of adapting to online teaching and learning within a short period of time.

In particular, because of the nature of the curriculum dealing with human life, medical school education has a large number of subjects and a large amount of material to learn. Classes are centered on practice and case studies, increasing the impact of forced remote learning [4].

In the last decade, medical school education has been transforming education by implementing team-facilitated, active, and self-directed learning. In most medical schools today, discussion-oriented problem-based learning, small-group activities, clinical practice, and academic projects occupy a large part of medical school education, and the educational effectiveness of these practices has been recognized [5].

Prior to COVID-19, medical education was based on meetings in physical space, and this rapidly changed due to the COVID-19 pandemic. The entire process of medical education shifted online through platforms, and this phenomenon was common in all countries, including the United States, the United Kingdom, Canada, and other countries with advanced education. Medical school students around the world had to adapt quickly to home-based learning, and some medical school students lost sight of their educational goals during the transition to online courses [6-9].

Korea was no exception to this change. Korea was classified as a country with entry restrictions by almost all other countries due to an explosive increase in the number of confirmed cases since the first confirmed case of COVID-19 in February 2020. In particular, in the Daegu and Gyeongbuk regions, the COVID-19 situation was so serious that 82% of all confirmed cases in Korea occurred in these regions as of March 30, 2020, resulting in the declaration of a special disaster area [10]. Under these circumstances, medical colleges in Daegu and Gyeongbuk had no choice but to utilize non-face-to-face online curricula.

In Korea’s medical education, medical humanities education aims to cultivate competence in affective areas necessary for future doctors, rather than to simply transfer knowledge. Activity-oriented educational methods, such as team-facilitated, active, and self-directed learning, have been widely applied for this purpose. Yeungnam University College of Medicine operates a series of subjects called ‘Medical Humanities’ for integrated humanities education.

This study summarizes the experience of operating the ‘Medical Humanities’ course, which had been operated mainly in person at a medical school in the Daegu area, in an online classes setting during the COVID-19 pandemic.

Yeungnam University College of Medicine’s ‘Medical Humanities’ series courses are offered in all grades. The students are divided into 12 groups for each grade, and group guidance professors are assigned. This subject consists of activity-oriented topics, discussion-oriented topics, peer evaluation, and portfolio evaluation, with the guidance of professors and students at the center. This course is designed and operated as a learning method in which interactions between professors and students and between students and students are important. Before COVID-19, all class activities in the ‘Medical Humanities’ subject were conducted face-to-face, but due to COVID-19, all meetings and activities had to be conducted online classes. Accordingly, students’ experiences with online classes medical humanities subjects were studied.

This study examined the experiences with online classes medical humanities courses of medical students who faced sudden changes due to COVID-19. Some of these students had already experienced active activity-centered medical humanities classes before COVID-19. The recommendations based on the research results are as follows.

First, despite the sudden situation caused by COVID-19, medical students were found to be highly satisfied overall with online medical humanities classes according to self-evaluation and program evaluation; however, it was found that difficulties in the class environment were great.

The difficulties in the classroom environment due to suddenly adopting online classes can be considered to be caused by changes resulting from COVID-19. The biggest change caused by COVID-19 was a change in communication, and it first appeared in the education field [3]. As schools rapidly shifted from in-person to online classes, medical school students were reported to experience problems due to ill-prepared classes and learning environments resulting from the sudden change in online class structure [11]. Due to COVID-19, the learning space called ‘school’ disappeared for students, and medical students, in particular, were reported to have difficulties due to the loss of the learning space where they spent most of their time studying [12,13].

In this study, it was found that most students attended medical humanities classes and had discussions at home. In the sudden transition to online classes, despite providing the students with basics such as a medium and space for classes and learning, the students had to prepare by themselves, and there were many difficulties due to the sudden pandemic situation. In addition, medical school students had problems adjusting to online classes due to ill-prepared online education and professors who had no experience in preparing online lectures [2].

Second, when comparing various applications such as Zoom, Google Classroom, Google Forms, and face-to-face meetings, it was found that students preferred Zoom and KakaoTalk.

It has already been reported that Zoom is the application with which college students are most satisfied in practice classes because it enables instant conversation and chatting with other parties in real time [14]. Because KakaoTalk also allows real-time conversations, student satisfaction should be high. Various studies and methods have been proposed to solve the problems of real-time conversations in situations where online classes are inevitable. In online classes, a virtual whiteboard that enables mutual communication, collaborative thinking, and an interactive pad for stimulating learner participation has been developed and presented [15]. Therefore, in online classes, professors should apply a teaching method that allows interaction in various ways, and research on this topic should continue.

Students preferred Zoom or KakaoTalk to face-to-face meetings, even though face-to-face meetings are the most active way to communicate. This shows the fear of safety caused by the pandemic that students were aware of at the time [16].

Although there are many concerns about online classes, research results on positive aspects have recently been reported. One of the biggest advantages of online classes is that they can help self-directed learning and provide intrinsic motivation for learning [15]. Due to the nature of medical school education, self-directed learning and intrinsic motivation are important; therefore, it is necessary to prepare for effective learning by exploiting the advantages of online classes.

Finally, even after the COVID-19 pandemic ended, medical students preferred online medical humanities classes. It can be seen that there are several advantages if the learning environment for online classes is adequately prepared, and a positive effect has been reported, especially in activity-oriented classes [17-19]. In the lecture-centered online class, the students were passive, had reduced concentration, and experienced boredom; however, in the activity-centered online class, the students demonstrated active class participation and interest. In online classes centered on discussion and participation, students experienced more active participation and interaction than in face-to-face classes, and it was reported that the students demonstrated free expression [18]. Although there is a negative emotional impact of online classes, they have been shown to strengthen student agency and have a positive effect on cooperation and overcoming challenges [19]. As such, online classes have the advantage of improving students’ self-directed learning, intrinsic learning, class participation, and interest through online teaching methods.

An opportunity arose during the COVID-19 pandemic for the development and application of online education. If one can enjoy the advantages of both online and in-person lectures, one can aim for a learning outcome that is superior to the teaching and learning that occurred before the pandemic. Now is the time to build know-how and move beyond trying and preparing for online lectures; analyses of member perceptions and needs for online education must be continued. It is expected that the present study will serve as useful basic data to understand the perceptions of changes in the educational environment in such a situation and to improve deficiencies.

COVID-19 has also taught us about the need for flexibility and adaptability. This should be extended to governments, medical institutions, and students [20]. Our experiences from COVID-19 will undoubtedly help the education and development of medical schools. It is also necessary to reflect on how these experiences and reorganized medical education programs can be integrated [21].

In response to such a rapidly changing situation, difficulties such as adapting to different methods and learning new technologies were highlighted. In contrast, the situation can be interpreted differently in that changes that would normally be made relatively slowly were accelerated during the pandemic. In other words, it can be said that the pandemic shortened the time to change, which normally would have been delayed slightly, and thus, innovation was hastened faster than the existing speed of social change. In addition, an opportunity was provided to discuss changing teaching and learning methods and to move forward in a positive direction.