L'esperienza vissuta di didattica a distanze di studenti di medicina durante la pandemia CoViD-19 in Italia: una ricerca di fenomenologia descrittiva
10.13135/1971-8551/5670
Introduzione - La pandemia ha costretto le scuole di medicina italiane ad adottare molto rapidamente la formazione a distanza. A questo riguardo, manca ricerca qualitativa sugli effetti dell’adozione improvvisa di questa forma di didattica. Questo studio esplora da una prospettiva fenomenologica l'esperienza vissuta degli studenti di medicina circa la didattica a distanza durante la pandemia CoViD-19.
Metodi – E’ stata condotto una ricerca fenomenologica descrittiva di saggi narrativi scritti a proposito di una lezione a distanza. I testi sono stati raccolti attraverso la piattaforma di e-learning e analizzati secondo il metodo di Giorgi.
Risultati - Sono state analizzate diciotto narrazioni. Sono emersi tre temi che descrivono l'esperienza vissuta dei partecipanti: l'apprendimento a distanza non è stata una scelta educativa ma una risposta obbligatoria alla pandemia, che ha sconvolto il normale corso della nostra vita; l'apprendimento a distanza può rendere accogliente la classe; l'apprendimento a distanza ti mette in una "bolla".
Discussione - Questi risultati confermano quanto già noto in generale sull'apprendimento a distanza e aggiungono una nuova visione dell'importanza dei processi sociali e della presenza fisica degli studenti nello sviluppo della loro identità di studente. I nostri risultati sottolineano l'importanza dello sviluppo della facoltà sulle questioni dell'apprendimento a distanza.
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Giacomo Consorti
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distance learning, pandemic, phenomenology, undergraduate medical student
The lived experience of distance learning of medical students during the CoViD-19 pandemic in Italy: a descriptive phenomenological research
Text.Serial.Journal
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Original articles
2021-08-05
2021-03-18
2021-05-13
2021-08-13
1
Giacomo Consorti
2021/08/05
10.13135/1971-8551/5670
Education Department of Osteopathy (EDO) - Istituto Superiore Osteopatia (ISO), Milan, Italy - Clinical-based Human Research Department, Foundation COME Collaboration, Pescara, Italy
1971-8551
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distance learning, pandemic, phenomenology, undergraduate medical student
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The lived experience of distance learning of medical students during the CoViD-19 pandemic in Italy: a descriptive phenomenological research
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                                                                                         VOL. 21, N. 1, 2021: 142-159
                                                                                        DOI: 10.13135/1971-8551/5670




     The lived experience of distance
     learning of medical students during
     the CoViD-19 pandemic in Italy: a
     descriptive phenomenological
     research
     L’esperienza vissuta di didattica a distanza di
     studenti di medicina durante la pandemia CoViD-19
     in Italia: una ricerca di fenomenologia descrittiva

    Fabrizio Consorti 1, Giacomo Consorti 2 , 3

     1
         Faculty of Medicine and Dentistry, University Sapienza of Rome, Rome, Italy.
     2 Education   Department of Osteopathy (EDO) - Istituto Superiore Osteopatia (ISO), Milan, Italy
     3 Clinical-based   Human Research Department, Foundation COME Collaboration, Pescara, Italy


RIASSUNTO
La pandemia ha costretto le scuole di medicina italiane ad adottare molto rapidamente la formazione a
distanza. A questo riguardo, manca ricerca qualitativa sugli effetti dell’adozione improvvisa di questa forma
di didattica. Questo studio esplora da una prospettiva fenomenologica l'esperienza vissuta degli studenti
di medicina circa la didattica a distanza durante la pandemia CoViD-19. E’ stata condotta una ricerca
fenomenologica descrittiva di saggi narrativi scritti a proposito di una lezione a distanza. I testi sono stati
raccolti attraverso la piattaforma di e-learning e analizzati secondo il metodo di Giorgi. Sono state analiz-
zate diciotto narrazioni. Sono emersi tre temi che descrivono l'esperienza vissuta dei partecipanti: l'ap-
prendimento a distanza non è stata una scelta educativa ma una risposta obbligatoria alla pandemia, che
ha sconvolto il normale corso della nostra vita; l'apprendimento a distanza può rendere accogliente la
classe; l'apprendimento a distanza ti mette in una "bolla". Questi risultati confermano quanto già noto
sull'apprendimento a distanza e aggiungono una nuova visione dell'importanza dei processi sociali e della
presenza fisica degli studenti nello sviluppo della loro identità di studente. I nostri risultati sottolineano
l’importanza dei programmi di formazione dei docenti sulle questioni dell’apprendimento a distanza.




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  The lived experience of distance learning of medical students during the CoViD-19 pandemic in Italy



Parole-chiave. Distance learning, pandemic, phenomenology, undergraduate medical student




ABSTRACT
Introduction - The pandemic forced the quick adoption of distance education in Italian schools of
Medicine. Qualitative research about the sudden adoption of distance education is missing. This study
explores from a phenomenological perspective the lived experience of medical students of distance
education during the CoViD-19 pandemic.
Methods – A descriptive phenomenological research of written narrative essays about one distance
lesson was conducted. Texts were collected through the e-learning platform and analysed according
to Giorgi’s method
Results – Eighteen narratives were analysed. Three themes emerged, which described the lived expe-
rience of the participants: distance learning was not an educational choice but a mandatory answer
to the pandemic that disrupted the usual course of our lives; distance learning can make the class-
room cozy; distance learning puts you in a “bubble”.
Discussion – These findings confirm what is already known in general about distance learning and
add a new insight on the importance of the social processes and physical presence of students in the
development of their identity as a student. Our findings underline the importance of faculty develop-
ment on the issues of distance learning.


Keywords. Continuing medical Education, Family Medicine, Antimicrobial Resistance, Antibacterial
Drugs, Epidemiology


TAKE HOME MESSAGES
      ●   The sudden transformation of a traditional curriculum into a distance education curriculum is
          not just a matter of technology, especially if the reason is the reaction to an emergency
          situation
      ●   The loss of social contacts among students and of the physical presence at the University is
          perceived as a severe issue
      ●   Special ad hoc programs of faculty development should be designed and implemented



                                                      the world, in its different approaches. A re-
                                                      cent Best Evidence in Medical Education
INTRODUCTION                                          (BEME) systematic review (Gordon, 2020)
The CoViD-19 pandemic strongly increased              showed that the most common adaptation
the adoption of distance learning all over            of medical schools to the control measures


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Volume 21, numero 1



of the pandemic was pivoting teaching ac-        lived experience of this sudden transition in
tivities to online learning, both in synchro-    education. Descriptive phenomenology is
nous and asynchronous mode. Italian med-         aimed to seek the essence of a phenome-
ical schools adopted the same strategy           non through a detailed concrete description
(Consorti, 2021). Distance learning has          of what is “given” to the consciousness of
been widely investigated, as to its efficacy     the subject experiencing their own body
(O'Doherty, 2018; Pei, 2019) and per-            and environment. In being so fundamental,
ceived usefulness from students (George,         the phenomenological investigation is help-
2014; Gill, 2019; Wong, 2020). Qualitative       ful in understanding any situation, before
research also explored from a phenomeno-         any theoretic thematization.
logical perspective the lived experience of      The objective of this study is to describe
students with distance learning (Koukal,         and understand the lived experience of dis-
2002; Murders, 2017) or with discourse           tance learning of medical students during
analysis the construction of a social space      the CoViD-19 pandemic, with the goal to
in a virtual classroom (Anagnostopoulos,         provide useful indications to drive the pro-
2005). This body of research showed that         cess of sudden adoption during a situation
distance learning is as effective as in pres-    of crisis and to inform the decision of what
ence learning for cognitive learning out-        to maintain after the pandemic will resolve.
comes and that it relies on a rich and com-      Hence, the investigated phenomenon was
plex network of perceptions and relation-        the lived experience of medical students of
ships. During the critical time period of the    distance learning during the lockdown pe-
CoViD-19 pandemic, in which the usual            riod, and the research questions were:
teaching activities were abruptly trans-            ● What are the elements that describe
formed into online activities, researchers in-          the phenomenon?
vestigated with quantitative methods stu-           ● What is the awareness of the stu-
dents’ preferences for distance learning                dents of their lived condition?
(Lee, 2020; Kim, 2020) but few qualitative       Is it possible to identify hints of the effect
research was devoted to describe students’       that the sudden interruption of the usual
experience of distance learning (Langegård,      teaching and learning activities due to the
2021; Gruenberg, 2020; Khalil, 2020) and         pandemic had on students’ lived experience
- to the author’s knowledge - no phenome-        of distance learning?
nological research described the students’



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    The lived experience of distance learning of medical students during the CoViD-19 pandemic in Italy



METHODS                                              must enter the phenomenological attitude
This article followed the COnsolidated crite-        (also called reduction), that is to put aside
ria for REporting Qualitative research               (bracketing, in technical terms) all previous
(COREQ) (Tong, 2007)                                 knowledge or beliefs about the topic of in-
                                                     terest. This is not literally possible, but the
Descriptive phenomenology                            researcher can achieve this state with the
The method of descriptive phenomenology              awareness of his/her system of pre-concep-
derives from the Edmund Husserl philo-               tions. After several consecutive readings of
sophical approach (Husserl, 1913/2002).              the data, aimed to get the global sense, the
The German philosopher advocated a new               researcher breaks the text into “meaning
approach to knowledge, starting from the             units”, portions of text in which the re-
subjective experience of the “world-of-life”,        searcher perceives a transition in meaning.
as it appears to consciousness. One of the           The meaning is identified concerning a dis-
main concepts in Husserl’s philosophy is the         ciplinary perspective that must be declared
“intuition”, intended as the presence of the         in advance. The researcher rephrases the
objects of the world as they are “given” to          units in the disciplinary language, using the
the consciousness as existents, in space,            “free imaginative variation”, to make the
time and causal regularity. This presence is         meaning more explicit. Finally, the emerg-
called a phenomenon. From this premise,              ing elements of the studied phenomenon
the psychologist Amedeo Giorgi developed             are organized in a structure, that is the rep-
a     procedure    of    qualitative    research     resentation of the essence of the phenome-
(Giorgi,1997) that is articulated in the 5           non.
steps of collection of data, reading of data,
breaking of data in parts, organization and          Researchers’ characteristics
expression of data from a disciplinary per-          FC is an academic general surgeon (MD),
spective, and synthesis of data.                     with a long-lasting experience of teaching
The core steps are the reading and breaking          in a medical school, GC is an osteopath
of data. In the phenomenological method,             (MSc, DO), teaching in a school of osteopa-
data have the format of a text, either col-          thy. Both the researchers followed and de-
lected through interviews and subsequently           livered programs of faculty development
transcribed or directly recorded as a writing        with particular regard to curriculum plan-
of the subjects of study. The researcher


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ning, assessment methodologies, teach-          narrative about their experience of a single
ing/learning activities and systemic assess-    distance lesson, on their choice. We issued
ment of the effects of newly introduced ed-     a general invitation through the forum of
ucational strategies and had previous expe-     the e-learning platform, with two recalls af-
rience of phenomenological research. FC         ter one week each. The sampling was
organized the task for the data collection as   stopped when we reached data saturation.
described in the data gathering section.        Therefore, the sample has to be considered
Both researchers identify themselves as         a consecutive convenience one. Participa-
males. FC is the teacher of general surgery     tion was on a voluntary basis, without any
(6th year) and clinical methods (3rd year) in   reward but formative feedback about their
the participants’ medical school, and there-    text. The texts were not anonymized for the
fore well known by the students. This could     two researchers, but we granted students’
have introduced a possible selection or re-     anonymity toward the faculty and the fellow
sponse bias. On the contrary, students did      students, as well as in the publication of re-
not know GC. Students were informed of the      sults. The anonymization process started in
goal of the research and those who partici-     parallel with the text analysis. Each text was
pated, agreed that the final aim was to im-     renamed with a study ID and before the
prove the quality of their experience of dis-   analysis all the information matching the ID
tance teaching.                                 with a specific student were deleted (e.g.
                                                students’ name in the file metadata). The In-
Context, sampling and ethical issues            stitutional Review Board (IRB) of the Univer-
The context of this research is the medical     sity Hospital of Sapienza University of Rome
school of one of the medical Faculties of Sa-   issued a general authorization for educa-
pienza University in Rome. The school com-      tional studies (CE 297/2020 on May 14th,
pletely pivoted in presence teaching to dis-    2020). Since the anonymity was granted
tance teaching at the breakout of the           and the participation was voluntary, they
CoViD-19 pandemic, in March 2020. With          did not require IRB review because the
only a few weeks short return to in presence    study did not meet the definitions of human
education in October 2020, distance edu-        research by the Italian regulation.
cation continued till February 2021. We in-
vited 3rd and 6th year medical students to      Data collection and units of study
contribute to this research with a written



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   The lived experience of distance learning of medical students during the CoViD-19 pandemic in Italy



We asked a written narrative to students            We followed Lincoln and Guba (1985) to
and provided a set of questions to drive the        improve the trustworthiness of qualitative
writing. The questions are reported in Table        data. To strengthen the data credibility, we
1. The instructions stated that they should         conducted frequent debriefings to discuss
not answer the questions as if they were be-        the meaning units, the categories, the
ing interviewed, but rather consider them as        themes and the overarching theme. To en-
a list of possible topics. It was not manda-        sure dependability, we reported the study
tory to consider all the questions. The nar-        processes in detail. Confirmability was
ratives were collected in electronic format         achieved through a shared process to con-
(.doc or .pdf) from the e-learning platform         firm that findings were data driven.
and immediately anonymized, as already re-          Finally, participants’ characteristics were re-
ported above.                                       ported to enable the transferability of the
We read and coded all the received 22 nar-          findings.
ratives, and after the 12th one, the analysis
of textual data did not show new codes, so          RESULTS
we agreed that the saturation was reached.          We received narratives from 22 partici-
Data processing and analysis                        pants, including 18 women and 4 men.
The two authors acted independently as              Eleven students attended the 3rd year and
coders, with two meetings to share the              11 the 6th year. They were all Italian, 14 of
codes and agree on a coding tree. Themes            them were off-site students.
and categories were derived inductively
from data, in a final meeting, after the deci-      Findings
sion that saturation was reached. The anal-         Three main themes emerged, with seven
ysis was managed without the use of any             categories (Table 2). The three main
specific software, highlighting the units with
                                                    themes have been merged in an over-
different colours in the word processing
                                                    arching theme “A cozy bubble in the
software and then attaching labels with the
                                                    pandemic”. In the following section we
codes. Finally, participants were asked to
                                                    describe the themes and related catego-
provide feedback on the synthesis of data.
                                                    ries. Table 3 reports examples of quotes

Validity and Reliability                            for each category, translated into Eng-
                                                    lish by the authors. Table 4 reports the



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original Italian text. The number in pa-                  Theme 1 - Distance learning was not an
renthesis identifies the participant.                     educational choice but a mandatory an-
                                                          swer to the pandemic that disrupted the
                                                          usual course of our lives.


 Where were you? In which room? Alone? Briefly describe the furniture, devices and other objects you used.
 Were you comfortable?
 Are you confident in using communication technology?
 What was the structure and development of the lesson? At what pace? With what proposed activities?
 What did you do during the lesson?
 How exhausting was it? Was your attention level constant? Did you have any difficulty with perception?
 Did you have any interactions with the teacher? With other students, also through other channels besides the
 chat line?
 Did the time go by quickly or did you feel it "still"?
 Do you remember particular emotions? Can you call them back and name them? Associate them with a particular
 moment of the lesson?
 Did your mind ramble and generate thoughts, external to the lesson or associated in any way with it? Had you
 any other external sources of distraction?
 Finally, express your general opinion on the lesson, especially on how "you lived it": did you feel "present"? in
 the same way you are present in the classroom? What is the difference?
 Can you imagine a metaphor to represent this lesson? And a metaphor for distance learning in general?


Table 1. The questions we proposed to participants to drive their narratives.



 Overarching       A cozy bubble in the pandemic.
 theme

 Theme 1           Distance learning was not an educational choice but a mandatory answer to the pandemic
                   that disrupted the usual course of our lives.




 Theme 2           Distance learning can make the classroom cozy.

 Category 2.1      The context in which distance learning takes place.

 Category 2.2      Technology has strengths and weaknesses.




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   The lived experience of distance learning of medical students during the CoViD-19 pandemic in Italy



 Category 2.3    Distance learning can make teaching and learning activities active.




 Theme 3         Distance learning puts you in a “bubble”.

 Category 3.1    Distance learning can put you in a passive mood during teaching and learning activities.


 Category 3.2    Distance learning can be strongly demanding from a mental and emotional point of view.


 Category 3.3    Distance learning imposes a different kind of social relationship.



Table 2. Overarching theme, themes and categories.




                                                       This theme groups three categories, that
This theme has no categories, it is based              in different ways express the perception
on the constant finding that almost all                that the context in which distance learn-
participants at the beginning of their                 ing takes place is more comfortable and
text mentioned that they were forced to                more easily integrated in everyday life
stay home and attend the lectures online               than in presence learning.
because of the pandemic. From the
point of view of the research questions,               2.1 The context in which distance learn-
this theme expressed the perception                    ing takes place.
that learning activities were usually                  This category gathers all the meaning
smoothly integrated in a student’s eve-                units that describe the context from
ryday life and the extent to which the                 which the participants accessed distance
pandemic disrupted the usual course of                 learning. More often the participants
a day in life. Nevertheless, data showed               were at home, and this was particularly
also that distance learning became part                relevant for those who are off-site. There
of this new, dystopian normality.                      were also instances of participants ac-
                                                       cessing from outdoors. The narratives
Theme 2 - Distance learning can make                   usually highlighted a cozy environment:
the classroom cozy.


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the participants joined the lesson in a si-   Participants perceived the educational
lent room, on a comfortable seat, with a      value of distance learning in a contradic-
large table on which they could take          tory way. In this theme, we put the cate-
notes and look at a textbook or at the        gory that groups the statement about
mobile phone or tablet. When needed,          the positive value of distance learning in
water to drink, the toilette and the          facilitating a more active teaching. Many
kitchen for a snack were at hand.             narratives report about the skill of the
                                              teacher in involving the class asking
2.2 Technology has strengths and weak-        questions or seeking feedback. Partici-
nesses.                                       pants felt more comfortable with the
The pros and cons of technology were          chat line of the teleconference environ-
frequently mentioned. The participants        ment as a channel of communication, ra-
reported both a poor and a good atti-         ther than asking questions on voice.
tude and skill for technology, as well as     Many participants observed that they
the issue of the quality of the Internet      had no problems in maintaining the at-
connection. The most interesting finding      tention and they felt the time flowing
was that technology was perceived as a        quickly. Finally, it was easier to access
tool that facilitates a cozy environment,     other sources of knowledge during the
in which they could move to stretch their     lesson or also to interact with fellow stu-
legs or have a cup of tea without losing      dents to comment and elaborate.
any part of the lesson. Furthermore,
technology allowed them to attend a           Theme 3 - Distance learning puts you in
lesson also when they were ill, or a mis-     a “bubble”.
hap would prevent them from being pre-        This theme groups three categories and
sent in the lecture hall.                     expresses the contradictory perception
                                              that students have of distance learning,
2.3 Distance learning can make teaching       especially in the difficult time of the
and learning activities active.               CoViD-19 pandemic. The categories are:




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   The lived experience of distance learning of medical students during the CoViD-19 pandemic in Italy



3.1 Distance learning can put you in a              frustration, due to the feeling of isola-
passive mood during teaching and                    tion, and anxiety of being called by the
learning activities.                                teacher to interact during the lesson. In
This category gathers units expressing              these cases, participants declared that
the opposite perception of the category             keeping the attention was harder than in
2.3. We found instances of unprofes-                presence.
sional behaviours of teachers, who were
unprepared and unhappy to use the                   3.3 Distance learning imposes a differ-
technology or - since they were not lim-            ent kind of social relationship.
ited by the availability of the lecture hall        This is the richest category in highlight-
- they suddenly changed the schedule of             ing the interaction between distance
the lesson. We also found instances of a            learning and the social limitations im-
passive attitude from participants, like a          posed by the pandemic. Even if partici-
“spectator”, and the sense of isolation of          pants acknowledged that distance learn-
attending the lectures alone in a room              ing was a solution to go on with teach-
increased this attitude.                            ing and to keep in touch with the rest of
                                                    the classmates, they expressed a sense
3.2 Distance learning can be strongly               of strong isolation, “like in a bubble”,
demanding from a mental and emotional               without those social interactions that
point of view.                                      only could “disconnect [me] from the
Many units expressed the perception of              endless cycle of breakfast-lesson-lunch-
an intense both positive and negative               study-dinner-rest that has been going
emotional engagement during the activ-              on since March without interruptions”
ities of distance learning. The positive            (P. 12).
emotions were mainly associated with                The Internet allows a social environment,
the cozy environment that put the par-              and it is commonly used by the students,
ticipants at ease, and in these instances           but if the technology is the only mean of
distance learning enhanced their con-               social interaction, then the lived experi-
centration and ability to follow the lec-           ence is “a bit like trying to look at me in
ture. The negative emotions were mainly             the mirror in the dark” (P. 1)

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 1. Distance learning is a mandatory answer   This year has been shocking for everyone: the rapid spread of the
 to the pandemic                              virus has forced all schools and universities to activate remote
                                              teaching methods (P.8)
                                              The lesson for me begins in the morning with the alarm clock,
                                              continues in the steps I walk and in the faces I see on the street
                                              walking towards the University, then it reaches its peak when the
                                              professor begins to explain (P. 6)
                                              It was a morning like any other, during the quarantine I didn't
                                              even have a clue what day it was. I woke up and passively looked
                                              at the schedule of lessons to know what was the subject (P. 4)

 2.1 The context in which distance learning   I am an off-site student, I live more than 500 km from Rome. I
 takes place                                  took advantage of the distance learning to go home. (P. 3)
                                              I was late and it was raining, I was on my mobile phone and I
                                              connected in the hallway, under the portico (P. 10)
                                              My class starts at 2 pm, on a large table in an empty living room.
                                              I always have the water bottle, mobile phone, pens and notebook.
                                              I think it's very comfortable to have such a large table because it
                                              allows me to have everything close at hand. Plus I'm in overalls,
                                              essential to be more comfortable! (P. 5)

 2.2 Technology has strengths and weak-       I always start connecting a little earlier, I have a bad relationship
 nesses                                       with technology, I am clumsy and inexperienced, I am always
                                              afraid of doing something wrong, turning on the camera or acti-
                                              vating the audio by mistake (P. 10)
                                              Technology allows us to be more present in class, for example for
                                              those who have a flu or a commitment that cannot be postponed
                                              (it can also be followed via a smartphone) (P. 8)
                                              I get up several times to stretch my legs or to have some tea
                                              while still listening to the lesson (P. 5)

 2.3 Distance learning can make teaching      Every now and then [the teacher] stops to make sure that we are
 and learning activities active               actually following, asks if everything is clear, if we see and hear
                                              everything. There is always someone who answers or asks ques-
                                              tions by interrupting the teacher (P. 5)
                                              Many of my classmates began to interact with the teacher, in re-
                                              ality few dared to turn on the microphone, the chat instead was
                                              full of messages. (P. 2)




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   The lived experience of distance learning of medical students during the CoViD-19 pandemic in Italy



 3.1 Distance learning can make teaching       [The teacher] also added that online lessons bore him and made
 and learning activities passive               him fall asleep. In giving online lectures, teachers sometime seem
                                               Don Quijote fighting with windmills (P. 7)
                                               If I had to use one word to describe how I felt those two hours,
                                               that would be "spectator". (P.2)

 3.2 Distance learning can be strongly de-     Emotions then fluctuated from a sense of frustration for not shar-
 manding from the mental and emotional         ing the last moments with people who from simple colleagues
 point of view                                 have become friends, to a sense of relaxation in order to better
                                               understand and follow the lessons and to be able to spend time
                                               at home. (P.3)

 3.3 Distance learning imposes a different     It is a bit like trying to look at me in the mirror in the dark” (P. 1)
 kind of social relationship                   to keep the camera and microphone off allows me to attend the
                                               lesson comfortably and without distractions, like in a bubble, but
                                               on the other hand I feel in an empty room, without friendly faces,
                                               exposed to a list of names who can hear everything I say. (P. 10)
                                               Face-to-face teaching is also an opportunity to get to know the
                                               teacher better, to share your concerns and doubts with other col-
                                               leagues, to "disconnect" from the endless cycle of breakfast-les-
                                               son-lunch-study-dinner-rest that has been going on since March
                                               without interruptions. (P. 12)



Table 3. Examples of quotes for themes and categories. The author translated texts into English, the original
quotes are reported in Table 4.




 1. Distance learning is a mandatory answer    Quest’anno è stato un anno sconvolgente per tutti: la rapida dif-
 to the pandemic                               fusione del virus ha costretto tutte le scuole ed università ad at-
                                               tivare modalità di didattica a distanza (P. 8)
                                               La lezione per me inizia la mattina con la sveglia, continua nei
                                               passi che percorro ed i volti che scorgo per strada camminando
                                               verso l’Università, per raggiungere poi il suo apice nel momento
                                               in cui il professore inizia a spiegare (P.6)
                                               Era una mattina come un’altra, durante la quarantena nemmeno
                                               avevo più idea di che giorno fosse. Mi sveglio e guardo passiva-
                                               mente il calendario delle lezioni per sapere che materia mi
                                               avrebbe aspettato (P.4)



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 2.1 The context in which distance learning   Sono una studentessa fuori sede, abito a più di 500 km da Roma.
 takes place                                  Ho approfittato della DaD per tornare a casa. (P. 3)
                                              Ero in ritardo e pioveva, ero col cellulare e mi sono collegata
                                              nell’androne, sotto il porticato (P. 10)
                                              a mia lezione inizia alle 14, su un grande tavolo in un soggiorno
                                              vuoto. Ho sempre accanto la bottiglia d'acqua, il cellulare, l’astuc-
                                              cio e il blocco degli appunti. Penso sia molto comodo avere un
                                              tavolo così grande perché mi permette di avere tutto a portata di
                                              mano. Inoltre sono in tuta,
                                              essenziale per stare più comodi! (P. 5)

 2.2 Technology has strengths and weak-       Comincio a collegarmi sempre un po’ prima, ho un cattivo rap-
 nesses                                       porto con la tecnologia, sono goffa e inesperta, ho sempre paura
                                              di fare danni, di accendere per sbaglio la fotocamera o attivare
                                              l’audio (P. 10)
                                              La tecnologia ci permette di essere più presenti a lezione, ad
                                              esempio chi ha l’influenza o un impegno da non poter rimandare
                                              (si può anche seguire con uno smartphone) (P. 8)
                                              Mi alzo diverse volte per sgranchirmi le gambe o per farmi un tè
                                              continuando a sentire la lezione. (P. 5)


                                              mi è stato particolarmente utile seguire la lezione e nel frattempo
                                              cercare online approfondimenti riguardo a ciò che nel frattempo
                                              il docente spiegava. (P.12)

 2.3 Distance learning can make teaching      Ogni tanto [il docente] si ferma per accertarsi che stiamo effetti-
 and learning activities more active          vamente seguendo, chiede se è tutto chiaro, se si vede e si sente
                                              tutto. C’è sempre qualcuno che risponde o fa domande interrom-
                                              pendo il prof. (P.5)
                                              Molti dei miei compagni iniziarono a interagire con il docente, in
                                              realtà pochi si azzardarono ad accendere il microfono, la chat
                                              invece era piena di messaggi (P.2)

 3.1 Distance learning can make teaching      [il professore] ha anche aggiunto che le lezioni online lo annoiano
 and learning activities more passive         e lo fanno addormentare […] i professori, in questa DaD, mi ri-
                                              cordano don Quijote che lotta con i mulini a vento (P. 7)
                                              Se dovessi usare una parola per descrivere come mi sono sentita
                                              quelle due ore, quella sarebbe “spettatrice”. (P.2)




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 3.2 Distance learning can be strongly de-   Le emozioni quindi altalenavano da un senso di frustrazione per
 manding from the mental and emotional       non condividere gli ultimi momenti insieme alle persone che da
 point of view                               semplici colleghe sono diventate amiche, ad un senso di rilassa-
                                             mento per poter capire e seguire meglio le lezioni e per poter
                                             passare del tempo a casa. (P. 3)

 3.3 Distance learning imposes a different   il poter tenere fotocamera e microfono chiuso, mi permettano di
 kind of social relationship                 seguire la lezione nel modo più libero possibile e confacente alle
                                             mie esigenze, con comodità e senza distrazioni, come in una
                                             bolla, ma dall’altra mi sento in una stanza vuota, senza facce ami-
                                             che vicino, esposta ad una lista di nomi che possono ascoltare
                                             tutto ciò che dico. (P. 10)
                                             Ho registrato alcune note negative quali la
                                             mancanza del rapporto diretto e il confronto con le persone (P.
                                             11)
                                             La didattica in presenza è anche un’occasione per conoscere me-
                                             glio il professore, per condividere le tue preoccupazioni e i tuoi
                                             dubbi con altri colleghi, “staccare” dal ciclo infinito colazione-le-
                                             zione-pranzo-studio-cena-riposo che va avanti da Marzo senza
                                             interruzioni. (P. 12)
                                             Cerco, soprattutto durante un colloquio faccia a faccia, continua-
                                             mente lo sguardo del mio interlocutore. Questa mancanza l'ho
                                             avvertita molto questi mesi ed è la cosa che più recrimino a que-
                                             sta nuova modalità, in cui mi sembra ci sia una distanza incolma-
                                             bile tra me e l’altro (P. 2)



Table 3. Original Italian quotes.




DISCUSSION                                            student and for the teacher. Moreover, we
The result of this research offers valuable           believe that the most important finding is
insight into the experience of students in            the participants’ perception that all the ed-
distance learning. Participants declared to           ucational activities in higher education and
be comfortable with distance learning as an           their role as a student are a building block
educational environment, although they                of their self as a person. All that hampers
acknowledge its limitations and the need of           this status, is perceived as a threat to one's
specific technological skills either for the          own identity (Campbell, 2018).


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Volume 21, numero 1



These results are coherent with many other        year, can display the attributes of a real pro-
findings, showing that students overall           fessional identity. Our data seem rather to
were satisfied with distance learning, de-        point to a developing identity, still strongly
spite the problems that can arise because         focused on the idea of being a medical stu-
of technological failure. Aristovnik et al        dent. Nevertheless, it will be important to
(2020), in a large international survey on        follow up all the cohorts of students of the
30.383 students found that students were          pandemic era, to detect defects in their pro-
satisfied with the ways in which their Uni-       fessional image at an early stage.
versities reacted to the pandemic. Never-         Two studies on Italian medical students
theless, many of them expressed concern           showed a rather high prevalence of psycho-
about their future professional career and        logical and mental issues (Meda, 2021;
studies, while this issue was not present in      Quintiliani, 2021), mainly perceived stress
our data.                                         but also a reduction in attention span and
The feeling of isolation our students ex-         difficulty in studying. We found both the op-
pressed, linked with the perception of a loss     posite instances of decrease and increase in
of opportunity is coherent with the concern       attention, the latter linked to the cozy do-
raised by Cullum et al. (2020) about the          mestic environment. In the narratives there
threat to identity formation. In their com-       were no mention of psychological disor-
mentary, these authors argued that mainly         ders.
the suspension of clinical placements held        The main limitation of this research, beyond
the potential to negatively influence identity    its idiographic value implied in its qualita-
acquisition. None of our respondents ex-          tive nature, is that it relies on written narra-
plicitly addressed the issue of professional      tives driven by a list of suggested topics.
identity, rather they wrote about their not       This could have limited the freedom of ex-
living the status of students to a full extent,   pression, preventing some themes to
including the social experience of the phys-      emerge, like the fear for their future or psy-
ical presence in the lecture hall and in the      chological issues. The study population is
other environments of the university. Iden-       composed of students of the same curricu-
tity formation is a dynamic process achieved      lum, who knew one of the researchers, that
through socialization (Cruess, 2015) and it       is one of their teachers. This could have pro-
is disputable that a student, also at the last    duced a distortion of some of the narratives
                                                  in the sense of social desirability.



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   The lived experience of distance learning of medical students during the CoViD-19 pandemic in Italy



Our results have some implications for                 transitions. Higher Education Research &
teaching activities. First, they highlight the         Development. 1: 1-15.
importance of a focussed program of faculty         Consorti F, Kanter SL, Basili S, Ho MJ.
development addressed not only to the
                                                       (2021). A SWOT analysis of Italian medi-
technicalities of online teaching but also to          cal curricular adaptations to the COVID-
the educational deeper aspects, connected              19 pandemic: A nationwide survey of
with a virtual classroom. Virtual cannot be            medical school leaders. Med Teach, 8:1-
considered a synonym of false or fictitious,
                                                       8.
and it cannot be only the electronic trans-
                                                    Cruess RL, Cruess SR, Boudreau JD, Snell L,
position of what a teacher is used to do in
                                                       Steinert Y. (2015). A schematic represen-
a lecture hall. Virtuality is a type of reality
                                                       tation of the professional identity for-
(Dillembourg, 2002), with its own rules to
                                                       mation and socialization of medical stu-
be followed to grant an educational out-
                                                       dents and residents: a guide for medical
come. A second important implication, es-
                                                       educators. Acad Med, 90(6):718-25.
pecially while the pandemic is still running,
is to grant the students social learning, for       Cullum RJ, Shaughnessy A, Mayat NY, & El
example through online small groups activ-             Brown M. (2020). Identity in lockdown:
ities. When possible, also asking the stu-             supporting primary care professional
dents to keep the video on can be useful to            identity development in the COVID-19
increase the sense of presence, to avoid the           generation. Education for Primary Care,
effect of “being in a bubble” (P.10), “in front        31:4, 200-204.
of a mirror in the dark” (P.1).                     Dillenbourg P, Schneider D, Synteta P.
                                                       (2002). Virtual Learning Environments.
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