We normally teach this course through dialogue with students in lectures, but we did not think lectures could be interactive enough online. Therefore, we replaced these lectures with exercises aimed to let the students think.

For example, instead of lecturing on study design in the first week, students made a video clip explaining an epidemiologic study design to a fellow student. Students are bored from sitting behind the screen, so we suggested creative ways to present such as drawing or using a door(way)as a whiteboard. We saw that they really got creative and dug much deeper into the study design theory than usually on campus!

Figure 2: Students gave each other feedback on the peer instruction video's using the FeedbackFruits video assignment.

Figure 3: We highlighted the best peer instruction video's and recommended students to study these for the exam.

Another way we challenged students was to let them think about confounders and effect modifiers, which are easy to understand conceptually but really difficult to identify in practice. To challenge students, we let several PhD students present their study design in a video clip and asked the students to help identify confounders and effect modifiers. We let students share and respond to each other on the Brightspace forum. This became a very lively a-synchronous discussion.

Instead of giving individual feedback to the assignments, we identified six or seven common misconceptions and posted these in the Brightspace forum for all students to see. We followed up with a live Q&A session during which students asked a lot of questions and we had very lively discussions.

We didn’t give answers, we did not lecture at all. We asked students to come up with answers together, and this helped us get a clear idea of the gaps in student understanding.

In this way, each week in the first half of the course was structured well. Students appreciated that they had one thing to focus on and a clear closure every week.

The second half of the course focussed on applying the acquired knowledge. . For this we used a very different design. Students were ready to do something freer: to design their own epidemiological study. In three weeks, they wrote a grant proposal for their study design in traditional groupwork. Online, everything is more blurred in their heads, so this is why we decided to present every assignment after each other with a clearly scheduled start and stop. This is the reason we did the group work after they finished the individual assignments, to make sure they did not run parallel.

We made students partly responsible for the course. One student group hosted a Q&A session each, introducing the lecturer, managing time, moderating the chat, and stimulating other students to turn their camera on. At first, the students were nervous about hosting a Q&A session. After we stressed it is not a problem if things go wrong (it happens to lecturers too), the students became more relaxed after the first Q&A session. The shared responsibility really helped to get most students engaged.

Figure 4: Giving students responsibility for their learning: four students introduce the two lecturers and facilitate the chat in Virtual Classroom. 

The fun in a face-to-face lecture of seeing students understand something is missing when lecturing online. That is why we decided to skip the whole lecturing part. The Q&A sessions were much more fun for the lecturers: the students were much more active, it showed if they understood something and they asked follow-up questions. In this way, the same amount of fun was experienced compared to lecturing on-campus. It did take more time than normal, you had to get to know the students and we all had to get used to the new format. After the second Q&A, we could feel we were interacting as humans just like in an on-campus setting.

The assignments provide lecturers with the eyes they need. The first assignment really helped because students made creative video’s. Video’s, forum discussions in Brightspace, etc. provide the online alternative for seeing students on campus and seeing what they did or did not understand.

It took a lot of thinking to decide how to assess students in this course. The whole purpose of the course is learning the students to think. You want to allow them to make mistakes so we could give feedback. However, if assignments don’t count toward the course grade, students are reluctant to do them. Taking this into account it was decided that half the course grade is based on the effort students put into doing the assignments and giving feedback to peers, It did not matter whether they provided the correct answers. The other half of the course grade is based on the exam. Students have to pass the exam to make sure they understand the theory.

Next year the course will be taught in the same way, this new overall course design will stay the same: no lectures but assignments and Q&A sessions. Preferably, the synchronous sessions such as group work and Q&A sessions can take place on campus and not in the virtual classroom.