title: Perception and use of massive open online courses among medical students in a developing country: multicentre cross-sectional study.
abstract: OBJECTIVE
  To assess the prevalence of awareness and use of massive open online courses (MOOCs) among medical undergraduates in Egypt as a developing country, as well as identifying the limitations and satisfaction of using these courses.
  
  
  METHODS
  A multicentre, cross-sectional study using a web-based, pilot-tested and self-administered questionnaire.
  
  
  METHODS
  Ten out of 19 randomly selected medical schools in Egypt.
  
  
  METHODS
  2700 undergraduate medical students were randomly selected, with an equal allocation of participants in each university and each study year.
  
  
  METHODS
  Primary outcome measures were the percentages of students who knew about MOOCs, students who enrolled and students who obtained a certificate. Secondary outcome measures included the limitations and satisfaction of using MOOCs through five-point Likert scale questions.
  
  
  RESULTS
  Of 2527 eligible students, 2106 completed the questionnaire (response rate 83.3%). Of these students, 456 (21.7%) knew the term MOOCs or websites providing these courses. Out of the latter, 136 (29.8%) students had enrolled in at least one course, but only 25 (18.4%) had completed courses earning certificates. Clinical year students showed significantly higher rates of knowledge (p=0.009) and enrolment (p<0.001) than academic year students. The primary reasons for the failure of completion of courses included lack of time (105; 77.2%) and slow Internet speed (73; 53.7%). Regarding the 25 students who completed courses, 21 (84%) were satisfied with the overall experience. However, there was less satisfaction regarding student-instructor (8; 32%) and student-student (5; 20%) interactions.
  
  
  CONCLUSIONS
  About one-fifth of Egyptian medical undergraduates have heard about MOOCs with only about 6.5% actively enrolled in courses. Students who actively participated showed a positive attitude towards the experience, but better time-management skills and faster Internet connection speeds are required. Further studies are needed to survey the enrolled students for a better understanding of their experience.
authors.affiliation: Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt.
authors.forename: Omar A
authors.initials: OA
authors.lastname: Aboshady
authors.affiliation: Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt.
authors.forename: Ahmed E
authors.initials: AE
authors.lastname: Radwan
authors.affiliation: Faculty of Medicine, Alexandria University, Alexandria, Egypt.
authors.forename: Asmaa R
authors.initials: AR
authors.lastname: Eltaweel
authors.affiliation: Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Azzam
authors.affiliation: Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Amr A
authors.initials: AA
authors.lastname: Aboelnaga
authors.affiliation: Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.
authors.forename: Heba A
authors.initials: HA
authors.lastname: Hashem
authors.affiliation: Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
authors.forename: Salma Y
authors.initials: SY
authors.lastname: Darwish
authors.affiliation: Faculty of Medicine, Benha University, Benha, Egypt.
authors.forename: Rehab
authors.initials: R
authors.lastname: Salah
authors.affiliation: Faculty of Medicine, Assiut University, Assiut, Egypt.
authors.forename: Omar N
authors.initials: ON
authors.lastname: Kotb
authors.affiliation: Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Afifi
authors.affiliation: Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Aya M
authors.initials: AM
authors.lastname: Noaman
authors.affiliation: Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Dalal S
authors.initials: DS
authors.lastname: Salem
authors.affiliation: Department of Cardiothoracic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hassouna
mesh_terms: D000328:Adult; D001290:Attitude; D003430:Cross-Sectional Studies; D003479:Curriculum; D003625:Data Collection; D003906:Developing Countries; D004534:Egypt; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010465:Perception; D012577:Schools, Medical; D013337:Students, Medical; D011795:Surveys and Questionnaires
keywords: Computer-Assisted Instruction; Distance Education; Egypt; MOOCs; Medical Education