During the pandemic transition to online delivery, to overcome the challenge of remote learning and to support students during a highly stressful period, I embraced embedding self-determination theory (SDT) principles into the design of two remotely delivered courses in Phase I Medicine (AEB in 2020 and AEA in 2021).  In 2020, my focus was on building a connected learning supportive community focussing on the ‘relatedness and belonging’ domain of SDT.  A combination of curricular and extracurricular activities was embedded creatively using digital technology (see video summary), such as MS-Teams and Kahoot! as well as community social events like Trivia night. In addition, students received a weekly email from the convener summarising the learning outcomes of each week. These approaches were subsequently adopted by other conveners in Phase I courses in 2021. A sample of student comments (below) from myExperience demonstrate its effectiveness:

• Having all the learning materials in one place and being able to get live feedback during all forms of class has been rewarding and significantly improved my understanding of the course.
• Lots of tutorials and lectures were engaging and fun and you could see the effort that went into making online learning better for us.
• I particularly appreciated the trivia night at the start of the term which fostered a sense of community.
• Nalini provided really great support to us this term in the form of revision tutorials and lectures, check ins on Teams, restructuring pracs and various other social competitions throughout the term.

An independent survey of student perceptions, run through the Student Wellbeing CoP, found the initiatives well received and successful; for example, students rated Trivia Night and Kahoot!, and the weekly convener emails as being most effective in supporting their wellbeing:  96.3% and 93.8%, respectively.

While delighted with the positive reception of the 2020 course, on reflection I wanted to engage more with the SDT domains of ‘Autonomy’ and ‘Competency’, to increase students’ ownership of, and advocacy for, their learning. To do this, I experimented with

• a digital community board (Padlet) as a platform to encourage student agency in learning across the course, and
• an ‘adaptive’ curriculum design and delivery to respond to student feedback and to provide ‘in time’ learning support.

I encouraged students to advocate for their learning needs by requesting clarification of concepts, learning resources, and ‘in-time’ tutorials – other students were able to upvote/support requests.   I also regularly collected feedback from student representatives of the diverse student groupings (e.g. student year-group, rural school, and international student representatives) and provided reciprocal feedback. The representatives provided feedback on student issues and challenges, and I provided feedback on the students’ engagement with activities. Student requests for learning resources and ‘in-time’ tutorials were acted on as soon as possible through engaging discipline academics, and through sourcing resources freely available on the internet (e.g. short videos from Osmosis, Khan Academy).

The student reception was overwhelmingly positive.  A sample of student comments from 2021 course myExperience demonstrate effectiveness [course student satisfaction, 97%]:

Digital learning board:

• ‘Padlet really allowed me to ask questions freely and gave me a platform to reach out for help whenever I required help. I understand how difficult it must be to maintain this Padlet platform and I'm so very grateful for this.’
• ‘I loved that Nalini created a teams channel for us to get the numerous anatomy resources plus the tutorials organised outside of the compulsory ones was very much appreciated since they were tough to understand.’
• ‘We were given so many opportunities to connect with the cohort, give feedback, express concerns, ask questions and overall just share any thoughts and opinions … The resources were great and I felt much more supported and part of a community than I ever have in previous Phase 1 courses.’
• ‘The best thing was the amount of support that I felt throughout. Things like the padlet and periodical updates/check–ins made me feel more connected to a community despite online learning. There were also lots of amazing resources provided, including complete anatomy, extra lecture/practical notes, and extra tutorials and online modules.’
• ‘There was a clear focus on student engagement and I found this the most enjoyable term thus far. While I really struggled with the content, the padlet, ability to send through feedback or questions at any point, kahoots, drop in sessions, etc, made this course feel really accessible.’
• ‘The padlet, this my first time having this in a course, really allows to build an online learning community and very helpful to see what other people are struggling with so you feel less isolated, allows students to give feedback and more importantly have that feedback implemented real–time to the course content was such a wonderful thing to witness’.
• ‘It makes me feel a lot more confident to ask questions and embrace my learning and be really engaged, which is especially important in the online setting. ‘

Adaptive curriculum design and delivery:

• ‘AEA has been the most enjoyable course this year! Having so many different avenues of support and tailoring classes to focus on areas that students are confused on have been really great.’
• ‘Nalini's care for all of the students was the best – she always goes above and beyond in answering questions, organising tutorials, replying to people quickly and giving us amazing slides and lectures. She truly is the best facilitator, and made this term much more enjoyable.’
• ‘THE AMOUNT OF SUPPORT I HAVE NEVER BEEN SO SUPPORTED IN A COURSE AND I ACTUALLY UNDERSTOOD THINGS THIS TERM!!! Thank you so much for listening to our opinions and helping us out.’
• ‘The anatomy tutorials provided, and the answers given for the practical sessions. Additionally, how Nalini was very open to feedback, approachable, and asked us what we needed help with most!’
• ‘Optional tutorials, practicals, tutorials all felt relevant to the course’
• ‘Optional drop in anatomy tutorials were very helpful especially with difficult MSK anatomy.’
• ‘…. Also, the optional drop in tutorials were extremely helpful as this term was super anatomy heavy and these tutorials helped clarified so much information. I genuinely hope that the faculty continues these optional tutorials in future courses. as I personally consider this as an awesome method because it isn't mandatory yet so helpful if you do choose to come….’

Teaching Delivery:

myExperience feedback for 2021 (n=435 students): 100% satisfaction with quality of teaching

Some comments from students supporting the impact of my teaching strategy:

• Nalini was amazing! The additional notes she provided were great in helping me in my revision post class and I can clearly tell that a lot of effort was put into designing the worksheets for tutorials. Thank you for listening to our feedback and providing us with the appropriate resources for topics that we need help in!
• She addresses all questions so thoroughly, and structures her lectures amazingly. Nalini also goes above and beyond in listening to what we need (eg. extra tutorials, notes) and makes all students feel supported. She really is an amazing teacher.
• Nalini is an incredible teacher!! She explains things really clearly with really engaging slides. I really like how she encourages student interactions in a productive manner and she also has a very kind demeanour which makes students feel safe to ask questions and interact.
• Nalini clearly puts in a lot of time and effort into making the ageing and endings courses as student–friendly as possible and it really pays off. We really appreciate your approach and all your hard work.
• love the 10000 quizzes on moodle, they may be hard but there is no better way to test ur knowledge than practicing questions (active recall)
• There's such a clear distinction between the courses where Nalini is a course convenor and the courses where she is not. There were so many little things during AEA that demonstrated the effort Nalini went to, in order to empathise with the students and make their experience better.
• Nalini is always supportive and did all she could as a course convenor with extra resources and classes. She really listens to student feedback and opinions and responds to them as soon as possible. I really felt supported by her.
• Nalini explained concepts of anatomy really well and provided so much additional resources to ensure that we can understand what she is teaching. This made learning really enjoyable and easier. Throughout the course, Nalini provided us with continuous updates and encouragement which was really beneficial throughout the course. The effort that she puts into organising the SGs were commendable too. Found every SGs to be really beneficial to my overall learning for AEA.
• Nalini facilitates such a great online learning experience, she is connected with the students and it is evident she cares. Lecture slides and verbal explanations are great
• I just wanted to say from the bottom of my heart how grateful I am for your support as convenor of AEA and throughout anatomy. It really showed how much you cared for all of us and the time and dedication you put in to collate, write and organise teaching materials and sessions. I have gone from not enjoying or understanding anatomy to appreciating its significance within the body and I really do love the challenging aspects of the topic. Your happiness and calm nature radiates in your lectures and tutorials and makes me feel like I can get through all this anatomy!