Introducing an Open-Source Course Management System (Moodle) for Blended learning on infectious diseases and microbiology: A pre-post observational study.

Introduction: Attendance at face-to-face courses is low in the 2nd and 3rd years of medical school in France, possibly because of a lack of interactivity. We used Moodle (an open-source course management system) to introduce blended learning on Infectious Diseases and Microbiology through interactive quizzes and sessions of online-based continuous assessment. This pre-post observational study assessed changes in students' attendance and student as well as teacher satisfaction.

Methods: During the 2017-2018 academic session of Infectious Diseases and Microbiology, we used Moodle to include interactive quizzes during courses and to organize five continuous assessment sessions. Pre-post comparisons (2017-2018 vs. 2016-2017) were performed for the following outcomes: attendance rate, satisfaction questionnaire and exam performance. In addition, the students' and teachers' perception of Moodle-based interactive quizzes and continuous assessment sessions in 2017-2018 was assessed with Likert-like scales, closed and open-ended questions. A thematic analysis of the free comments was performed through inductive coding by two coders.

Results: In 2017-2018 vs. 2016-2017, mean (±SD) attendance rate was higher [12.5 (±7.2) % vs. 7.9 (±3.5) % of students, P<0.001] and clinical case-based courses, which encompassed 93% of Moodle-based courses in 2017-18, were more frequently considered to improve teaching and learning (81.9% vs. 73.8%, P=0.01). Students more frequently judged the teaching organization and structure to be adequate (85.5% vs. 80.2%, p=0.03) and more frequently recommended to next-year students that they attend courses (96.1% vs. 42.1%, P<0.001).

Conclusion: Using Moodle for blended learning on Infectious Diseases and Microbiology improved student satisfaction and attendance at face-to-face courses.