11:24am 06/07/2020
Online learning among undergraduates: challenges and suggestions for optimal health
Professor Dr Moy Foong Ming.
Professor Dr Moy Foong Ming.

By Professor Dr Moy Foong Ming and students

It was all over the news when a Sabahan girl stayed up a tree for better internet access, just so that she could do her online exams. What is the deal with online learning? The emergence of the COVID-19 pandemic has made online learning the primary source of teaching and learning for undergraduate students. The implementation of physical distancing has made it impossible to learn in a traditional environment, hence, online learning being crucial at this time to ensure continuity of education.

In order for online learning to be carried out effectively, the needs of having good internet connection, lecturers' skills in conducting online teaching effectively and efficiently are essential. Ineffective online teaching can cause boredom among students, making them uninterested to access or attend classes. High levels of frustration emerge when a course is poorly organized.1

Thus, it is of utmost importance for the lecturers to organize the online classes well in order for knowledge to be delivered effectively. Instructions should be given clearly, and clear expectations should be set. Passages of text and videos should be kept concise, as concentration declines very quickly online, particularly with the distractions of social media being close at hand. To retain students' attention, a variety of modes of presentation, i.e. synchronous and asynchronous (examples: pre-recorded video lessons, online forums and discussion boards) should be used.

Lecturers can make the learning sessions engaging by giving out quizzes via some free, game-based learning platform that makes learning fun. Asynchronous teaching, would be of great benefit to students living in different time zones. It would allow them to have a more flexible learning experience and would not interrupt their activities of daily living. 

From the students' perspective, self-regulation and motivation are two critical factors that may affect the success of online learning.2 Long duration of time spent on screen and lack of engagement between lecturers and students will cause the motivation level to reduce among students, leading to difficulty in concentrating to learn. In addition, lack of direct human interaction when doing assignments and group works may lead to their inability to complete tasks efficiently. These factors can contribute to a lower motivation level and poorer quality of work being produced. 

When students are involved in a long-term course of online learning, they are predisposed to having a sedentary lifestyle. Not having to walk around the campus to attend classes, the cafeteria or the library, would lead to a lack of physical activity, which in turn, could lead to weight gain. This is justified by a recent article on how the obesity rate has increased in Malaysia during this Movement Control Order (MCO) period, which was not only contributed by lack of physical activity, but also the type of diet consumed.

To avoid being sedentary altogether, some form of physical activity should be incorporated in their daily lives. It could be something as simple as walking, or to perform a few at-home exercises. Various forms of workout videos can be accessed online, and to motivate themselves to keep them active, students can always video call their friends and workout together. Students should also eat healthy. They should start their day with breakfast to help them study better. As for having snacks during or in between classes, healthy snacks like nuts and fruits instead of junk food are recommended.

Spending a long time looking at gadgets could take a toll on the eyes, causing dry eyes and eye irritation. Having long hours of classes could also mean a long duration of sitting in front of the laptop. Poor posture could lead to back pain for many, contributing to the discomfort that students are already facing due to the change of learning mode.

To prevent any computer-related vision problems, students should take sufficient breaks in between online classes or when they're working on their assignment using their laptop. A simple method to follow would be the 20-20-20 rule. Look away from the screen every 20 minutes and look at something 20 feet away, for about 20 seconds. They should not forget to blink in order to keep the eyes moist. 

A good sitting posture should be practiced to prevent back pain. They should not slouch, but sit upright, with the shoulders relaxed and the body supported against the back of the chair. A pillow or a rolled towel can be put between the lower back and the seat, and their feet should be flat on the floor. Apart from maintaining a good posture, students could perform stretch exercises for their back to prevent or reduce backaches.

Social interaction is strongly related to online learning enjoyment and effectiveness of learning online. Learning online at home could result in a lack of physical interaction. When they face difficulties in doing assignments or to understand certain topics, it will be harder for them to reach out to friends compared to being in the campus, where it is much easier to find friends to talk to – this may make them feel isolated.

 Being involved in online learning in the long run may also expose undergraduate students to the risk of developing depression, anxiety, and other mental illnesses. On top of that, sedentary behavior was linked to 25% higher likelihood of depression.3 Some students may have problems with their family, making them more prone to be in a depressive state.

Lecturers should foster a sense of community through collaborative assignments, frequent discussions, and the use of technology to facilitate alternative channels of communication. It would be helpful to give regular small assignments that permit students to work together, and video conferences for students to participate in discussion with peers and lecturers. As much as students' can do to take care of their mental health, the respective institutions should play their role too. They should provide a platform for the students to seek help if needed, as simple as providing a counselor when they need someone for emotional support.

A comfortable workspace with good ventilation and sufficient natural daylight is important for students to feel fresh and focus in online classes. Another way to focus better during online classes would be to take care of sleep hygiene, which would also be a benefit to their mental health. Students should limit their screen time before bed by avoiding intensive work before bed. They should avoid working on the bed too. It would be helpful for students to stick to a well-planned schedule to avoid procrastination. 

To sum up, despite the challenges of online learning that have been discussed, and many more that may not be listed, it is imperative that online learning should be as effective as face-to-face teaching, as we are in the midst of adapting to the new norm. Until online learning can be fully utilized by all students without compromising their health, we can never say we are prepared for the next pandemic.


1. Brocato, Bonanno & Ulbig (2015) Student perceptions and instructional evaluations: A multivariate analysis of online and face-to-face classroom settings.

2. Matuga, J. M. (2009). Self-regulation, goal orientation, and academic achievement of secondary students in online university courses. Journal of Educational Technology & Society, 12(3), 4-n/a.

3. Zhai, L., Zhang, Y., & Zhang, D. (2015). Sedentary behavior and the risk of depression: a meta-analysis. British journal of sports medicine, 49(11), 705–709.

(Prepared by Final year medical students of Group 5A Community Project Posting (Suja a/p Mogan @ Mohan, Lee Yee Sin, Nursyahida binti Zulkarnain, Tan Zhi Boon, Thanmidraaj Kaur a/p Balraj Singh, Khor Pei Yi, Nurdini Amani Kamaruddin, Muhammad Danial bin Putra) and supervisor, Professor Dr Moy Foong Ming, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya.)



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