key: cord-0814673-e8ujiy44 authors: Polujanski, Sabine; Schindler, Ann-Kathrin; Rotthoff, Thomas title: Academic-associated emotions before and during the COVID-19-related online semester – a longitudinal investigation of first-year medical students date: 2020-12-03 journal: GMS J Med Educ DOI: 10.3205/zma001370 sha: cb06ab38e4695deb361d498f05cfa17e9918d1ac doc_id: 814673 cord_uid: e8ujiy44 Background: Due to the COVID-19 pandemic, students have been confronted with an online semester. Because of the special requirements, online teaching can trigger negative emotions, which can have an unfavourable impact on the learning process and which therefore need to be regulated. This study investigates academic-associated emotions and the regulation of those emotions both before (December 2019) and during (June 2020) the online semester for first-year medical students. Methods: Questionnaire data (t1=Dec 2019; t2=Jun 2020) regarding academic-associated emotions and emotion regulation, taken from a longitudinal research project (Experienced Learning Medicine Augsburg; ELMA) at the University of Augsburg, was used. At t2, the students were also asked, as future physicians, to name their three most significant emotions regarding their studies, taking into account the COVID-19 situation. Results: Longitudinal analyses (Wilcoxon tests) showed few changes in academic-associated emotions. The emotions happy (r=.32) and proud (r=.33) increased significantly with moderate effects at the online semester. There also was an increased, but still low suppression of emotions (r=.22) at t2. The future physicians were most often curious, grateful and afraid about their medical studies with regard to the COVID-19 situation. Overall, medical studies were more often associated with positive than negative emotions during the online semester. Conclusions: The results show that the online semester did not have any worrying impacts on academic-associated emotions and emotion regulation. There was even some indication that students might benefit from online teaching formats. The COVID-19-related online semester has placed unusual demands on students (e.g. less social integration and higher self-regulation of the learning process than in faceto-face teaching), which could trigger negative emotions (e.g. frustration) [1] , [2] . This can be problematic, because a successful learning process, including high academic performance [3] and favourable motivational situation [4] , [5] , is ideally accompanied by positive emotions. Emotion regulation strategies enable individuals to consciously influence the intensity, duration and quality of the experience and expression of emotions [6] , [7] . The strategy suppression involves repressing emotional expression, while cognitive reappraisal is the active cognitive reinterpretation of emotional situations [8] . In the latter, the meaning of an emotionally triggering situation is reinterpreted [6] , which should lead to a more positive emo-tional reaction [8] . For example, frustration caused by the complexity of learning materials might be avoided or mitigated by viewing the situation not as a threat, but as an opportunity to acquire knowledge. Higher performing students have been found to more often apply cognitive reappraisal [9] , which simultaneously reduces negative emotions [10] . This study examines academic-associated emotions and their regulation in first-year medical students before and during the COVID-19-related online semester. The study used longitudinal data, which had been voluntarily provided via questionnaire, that was collected by 21 representative academic-associated emotions (10 positive, 11 negative) from the Medical Emotion Scale (MES; 5-point Likert scale from 0-not at all to 4-very strong) [11] were questioned. The emotion regulation strategies suppression (4 items, α=.74) and cognitive reappraisal (6 items, α=.76) were recorded by the mean values of the Emotion Regulation Questionnaire (ERQ; 7-point Likert scale ranging from 0not at all to 6-absolutely) [8] , [12] . In their role as future physicians, the students were also asked in the June survey to complete the following statement: "The COVID-19 situation makes me feel… about my medical studies. Please select the three most appropriate emotions." The data was analysed descriptively and using Wilcoxon tests (ordinal scale level and restricted normal distribution). The longitudinal analyses of academic-associated emotions are shown in table 2. Curiosity, gratitude and being afraid were the emotions most frequently described by the future physicians in regard to the COVID-19 situation. Overall, despite the COVID-19 situation, medical studies were more often associated with positive than negative emotions (see figure 1 ). While most academic-associated emotions did not change longitudinally, happy and proud did increase significantly during the COVID-19-related online semester. This might be because of the free allocation of time, individual adaptation to the pace of learning and the time saved by not commuting [13] , [14] . This latter reason was mentioned as a form of relief in an additional scale in the questionnaire that assessed burdens and reliefs. Semester-related teaching evaluation results across all courses also showed a high level of satisfaction with online teaching. The increase in pride could be related to the completion of a systemically relevant training, al-though there is no explanatory data available to support this hypothesis. Disappointment also increased significantly during the online semester, but with only a small effect size. This could be due to the elimination of practical teaching units and reduced peer contact, both were reported as burdens. Presumably, the COVID-19 online semester led to a severely different student life, which might also be a reason for increased disappointment. The emotion regulation strategy suppression saw a significant increase, but with a small effect size, which might be related to the home learning environment during the online semester, which was perceived as a burden. When asked which three emotions towards medical studies were most triggered by the COVID-19 situation, curiosity, gratitude and being afraid were most frequently mentioned. Curiosity might refer to the many unknown variables associated with the pandemic [15] and the possibility of acquiring new knowledge [16] , while gratitude might relate to the benefits of the online semester described above [13] , [14] . However, examinations without prior class attendance were seen by a majority of students as a burden and thus possibly an indicator of being afraid, but the data does not allow for a causal explanation and so these hypotheses should be treated as a cautious interpretation. The results suggest that the exclusive online teachingat least, after a short period of time -had no worrying impact on the students' emotions. However, it should be noted that the data is from a model study programme currently being developed with a small student cohort. With regard to the ongoing significant reduction in faceto-face teaching, the student cohort will continue to be monitored longitudinally, with a view to a (gradual) reintegration process [17] . There will also be additional investigation of study-life balance to better clarify emotional developments. Es wurden 21 repräsentative Emotionen (10 positive; 11 negative) der Medical Emotion Scale (MES; 5-stufig von 0-überhaupt nicht bis 4-sehr stark) [11] gegenüber dem Studium abgefragt. Die Emotionsregulations-Strategien Unterdrückung (4 Items, α=.74) und kognitive Neubewertung (6 Items, α=.76) wurden mittels des Emotion Regulation Questionnaire (ERQ; 7-stufig von 0-stimmt überhaupt nicht bis 6-stimmt vollkommen) [8] , [12] erfasst. In ihrer Rolle als zukünftige Ärztinnen und Ärzte, wurden die Studierenden in der Juni-Erhebung zusätzlich zu folgender Angabe gebeten: "Die COVID-19 Situation macht mich gegenüber meinem Medizinstudium… Bitte wählen Sie die drei zutreffendsten Emotionen aus." Die Auswertung der Daten erfolgte deskriptiv und mittels Wilcoxon-Tests (Ordinal-Skalierung sowie nicht gewährleistete Normalverteilungsvoraussetzung). Die längsschnittlichen Entwicklungen der Emotionen sind Tabelle In Bezug auf die anhaltend stark reduzierte Präsenzlehre wird die Studierendenkohorte weiter im Längsschnitt begleitet, auch mit Blick auf einen (unsteten) Wiedereingliederungsprozess [17] . Zudem werden Gründe auch im Verständnis einer Study-Life-Balance miterhoben, um eine bessere Aufklärung emotionaler Entwicklungen abbilden zu können. Die Autor*innen erklären, dass sie keinen Interessenkonflikt im Zusammenhang mit diesem Artikel haben. 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Learn Instruct The Role of Negative Emotions and Emotion Regulation on Self-Regulated Learning with MetaTutor2018 Emotions in medical education: Examining the validity of the Medical Emotion Scale (MES) across authentic medical learning environments Emotion Regulation Questionnaire -Eine deutschsprachige Fassung des ERQ von Students' perception of online learning during the COVID-19 pandemic: a survey study of Polish medical students What You Gain and What You Lose in COVID-19: Perception of Medical Students on their Education Choices for the "New Normal The Impact of Coronavirus Disease 2019 on Plastic Surgery Training: The Resident Perspective The Impact of COVID-19 on Medical Education Inside Out: Detecting Learners' Confusion to Improve Interactive Digital Learning Environments Emotion and e-learning The Control-Value Theory of Achievement Emotions: Assumptions, Corollaries, and Implications for Educational Research and Practice Emotion and Achievement During Adolescence Achievement Emotions in Higher Education Emotion Regulation: Current Status and Future Prospects Emotion regulation: Taking stock and moving forward Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being Examining the interplay of affect and self regulation in the context of clinical reasoning. Learn Instruct The Role of Negative Emotions and Emotion Regulation on Self-Regulated Learning with MetaTutor2018 Emotions in medical education: Examining the validity of the Medical Emotion Scale (MES) across authentic medical learning environments Emotion Regulation Questionnaire -Eine deutschsprachige Fassung des ERQ von Students' perception of online learning during the COVID-19 pandemic: a survey study of Polish medical students What You Gain and What You Lose in COVID-19: Perception of Medical Students on their Education Choices for the "New Normal The Impact of Coronavirus Disease 2019 on Plastic Surgery Training: The Resident Perspective The Impact of COVID-19 on Medical Education Academic-associated emotions before and during the COVID-19-related online semester -a longitudinal investigation of first-year medical students The authors declare that they have no competing interests.