The novel COVID-19 outbreak has led to the emergence of online teaching in many universities around the world for more than two years [8]. The online teaching system is constantly supplemented and improved, and more and more research on online teaching is conducted to provide more suggestions on online teaching [9, 10]. Our research provides more data and theoretical basis for online teaching in the field of dermatology teaching.

As young college teachers, we have a lot of confusions in the process of online dermatology teaching. Most internships and clinical skills practice have been transferred to online teaching, so students cannot accurately experience the learning of skin lesions and the patients perception. Meanwhile, the medical history collection can only be completed between students, and they cannot deeply understand the feelings of patients themselves and various emergencies in the process of medical history collection, which results in the limitations of online learning of clinical practice ability [11, 12]. Our research results also reflect this teaching problem. Many students can learn from textbooks on their own, do well in the theoretical study of dermatology, and get satisfactory results in the final examination, but the clinical practice of identifying skin lesions cannot be the same as the theoretical learning process. We selected some confused outpatient clinical pictures for students to judge and write the main points of skin disease inquiry, and the scores were not good. The reason is that the profound understanding of morphology cannot be completely learned from the books [13]. It is necessary to have face-to-face communication with patients through outpatient and ward internship and practice, and students can well define skin diseases combined with comprehensive actual touching of skin lesions, some dermatological physical examination (such as detection of Nikolsky sign, dermographism and Auspitz sign), actual feelings of patients and other clinical data [14,15,16].

Furthermore, from the learning feedback and questionnaire survey of students, it also reflected the problems of clinical skills test. The students in the online teaching group reported less interaction with their classmates and teachers, some limitations in palpation and understanding of skin lesions, and some limitations in their overall knowledge of skin diseases. These findings are in line with our expectations and are consistent with other studies on online teaching [17, 18], which has pointed out many similar limitations of online teaching in other disciplines. It is easy to understand that there are space limitations in online teaching, and students focus will be scattered, and they will not be able to communicate with patients. This poses a challenge to the teaching of morphology. We are also thinking about whether we can develop better online teaching software or system through artificial intelligence technology. Through haptic simulation system and Virtual Reality system [19, 20], students can feel the touching feeling of skin lesions online or conduct physical examination of skin diseases, so that students can better experience skin lesions in their own position. It may be better to improve the effect of online teaching in dermatology.

Firstly, this study was only conducted in our hospital, and perhaps the online teaching system in our hospital is not perfect enough, which may also lead to insufficient teaching effect. Therefore, a multi-center study with a larger sample size is needed to comprehensively evaluate the shortcomings of online teaching in dermatology. Secondly, our survey was conducted through an online questionnaire, and the validity of the questionnaire has not been verified, and recall bias and misclassification may exist. Thirdly, we think that there is a lack of more evaluation methods in the examination of clinical skills. If necessary, we can add the actual operation such as fungal microscopic examination and Nikolsky sign examination to evaluate.

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Multidimensional evaluation of offline and online education in ... - BMC Medical Education