Student's perception towards challenges and difficulties to established E-learning Medical Education in a high burden developing country 

Abstract Background : In High-income countries, many academic institutions are using E-learning during COVID 19 Pandemic. However, in limited-resource countries, like Sudan, shifting towards E-learning requires many adjustments to be made in order to make sure the E-learning is held in a proper manner, as best as possible. This study was undertaken to assess medical students’ perception towards implementing E-learning during COVID 19 Pandemic and to highlight difficulties of E-learning implementation in Sudan as an example of a limited-resource setting. Methods: A cross-sectional survey was conducted between 10 and 25 of May 2020 among the undergraduate medical students at the Faculty of Medicine, University of Gezira, Sudan. A predesigned online-based questionnaire was used for data collection and snowball sampling methodology was used. Results : The total numbers of 358 undergraduate medical students responded to the online survey questionnaire. The majority (87.7%) of students agreed that the closure of the university is an essential decision to control the spread of the COVID-19 infection. Approximately two-thirds (64%) of students perceived that E-learning is the best solution during COVID 19 lockdown. The level of students in the university and residence has a strong relation to students’ opinion the level of medical students (Pre-clerkship and Clerkship) and place of residence have significant correlation (p-value < 0.05) with medical students opinion regards starting the E-learning online education. Internet bandwidth and connectivity limitation, unfamiliarity with E-learning system, technical support limitation and time flexibility in case of technical problems during online exams, and Lack of face-to-face interaction were the factors considered by medical students to be against the E-learning implementation. Conclusion : Most medical students had a positive perception of E-learning. However, there are many challenges considered as an inhibitory factor for utilizing electronic technologies for medical education. We recommend that challenges of E-learning in our limited resource setting should be systematically evaluated and that effective strategies should be developed to overcome their inhibitory effects.