gms | German Medical Science

Since January 2020, more than 429,000 people in Germany have been diagnosed with SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), of which about 10,000 patients have died (as of October 2020, [1]). Germany has made numerous efforts to manage and control the outbreak, following the recommendations of the National Pandemic Plan COVID-19 [2], [3]. In addition to diagnostics, case identification and measures on infection hygiene measures, these include a broad range of activities to communicate health information, e.g. on symptoms of the COVID-19 disease, protective behavior, support services and legal regulations. As a result of the increasing availability and use of digital technologies and media, communication takes place primarily via digital sources and channels. In this context, information is not only disseminated by public institutions or professional experts, but also processed communicatively by a wide range of recipients (e.g. comments on social media). The continuous improvement of knowledge about COVID-19 as well as the possibility to actively participate in digital communication independent of time and place have led to an increase in the amount of information available within a short period of time. This phenomenon of information overload is increasingly referred to as infodemic [4]. Against the background of possible adverse health effects of false and misinformation [5], [6], prospective Public Health professionals must be enabled to develop and disseminate evidence-based and targeted health information and preventive messages during their studies.

At Fulda University of Applied Sciences, health communication is one of the main areas of study in the Bachelor‘s program in Health Promotion. According to Rossmann [7] health communication can be defined as a field of research and application, “[...] which deals with the social conditions, consequences and meanings of health-related and health-relevant, intended and unintended, intrapersonal, interpersonal, media and public communication”. The special course of study lasts over two semesters, with the first semester focusing on evidence-based health information. In the second semester an introduction to digital health communication is given. In addition to learning and applying methods of empirical social research, health literacy is understood as a cross cutting issue. Health literacy refers to people's knowledge, motivation and ability to access, understand, appraise, and apply health information to promote, maintain and restore one’s own health [8] (see figure 1 [Fig. 1]).

The teaching module “Health Communication in Digital Media” is based on the concept of problem-based and research-based learning, starting from a comprehensive topic for which a communication concept has to be developed in small working groups. The concept should (1) address different levels of communication (e.g. mass communication and individual communication) and media (e.g. social media, blog, podcast) (2), take current quality requirements into account and (3) not exceed a defined fictional budget. Next to the overall concept, first insights into the implementation via media snippets (e.g. teaser of a podcast or a social media account) should be given. The students were provided with a model with nine work steps to complete the task. After an initial phase of brainstorming, the steps included a target group analysis and a media analysis as well as the definition and theory-based development of communication levels, formats and strategies.

Due to the corona-related university closure, the teaching module “Digital Health Communication” was realized in a digital format using the platform Microsoft (MS) Teams. The main reasons for choosing this platform were the different possibilities for collaboration and the use of various communication tools (see table 1 [Tab. 1]). Due to problems with the quality of internet speed, the initial phase of the semester was mainly characterized by asynchronous teaching and learning scenarios (lessons, videos). However, during the course of the semester, synchronous formats could increasingly be integrated via MS Teams and Cisco WebEx (group meetings, discussions of teaching units). The Online Inverted Classroom Model was also applied [9], in which students had to complete various online self-study phases to acquire knowledge of the facts. In subsequent synchronous sessions, the content was applied by the students and deepened in accordance with Bloom's taxonomy [10]. To promote the activation of the students according to the ICAP model [11], we used audience response systems such as Kahoot! [12].

Two of the biggest challenges were the short time span to develop a course concept implemented exclusively in a digital format and the limited possibilities for student activation. In addition, a block seminar originally designed for three days (by an external lecturer) as part of the teaching module had to be spread over two weeks (through screencasts and synchronous teaching), resulting in a higher workload for the students. Working with MS teams proved to be advantageous, as students were able to use different ways of communication (chat, video) as well as self-determined cooperation in the groups (own group channel with project management tools) integrated in one platform. Hence, our experience confirms the results of a recently published scoping review, which emphasizes the importance of self-directed digital learning [13]. However, the use of MS teams was associated with some difficulties. For example, the integration of external lecturers turned out to be complex, some features or applications could not be used or only to a limited extent. Cross-university cooperation with MS teams is therefore currently still difficult. However, a process of reinforcement also became clear, i.e. already active and high-performing students had hardly any adaptation problems, while rather weaker students were even less involved in the course. This required a higher degree of support from the teaching staff (e.g. through regular meetings with the groups, chats and small-step feedback processes).

Despite various challenges posed by the COVID-19 pandemic, the experience in implementing this teaching module has been positive (see table 2 [Tab. 2]). The mix of methods used made it possible to better address the different learning preferences of the students. These efforts are reflected in the positive feedback from the students, which was collected using a mixed-method approach, including quantitative course evaluation, short feedback questions via MS teams and oral discussion groups. In addition to the general digital format, the use of playful elements and the flexible implementation were rated positively. In the forthcoming semesters, the course concept can be used as an online-only teaching module or further developed as a blended learning format.

The authors declare that they have no competing interests.