Presented By: Rosemary Poku, Central Michigan University College of Medicine
Co-Authors: Michael Elftman, Central Michigan University College of Medicine

Purpose 
In recent years, medical schools have shifted educational approaches from exclusively face-to-face to virtual or hybrid formats. Several applications used in synchronous instruction have a chat feature that students could use to explore session content through inquiry or discussion. Little is known about how the use of online chat in synchronous eLearning affects students' sense of autonomy, competence and relatedness. The objective of this study is to determine how student perceptions of online chat relate to these domains of self-determination theory.

Methods 
We administered a survey containing open- and close-ended questions to a single cohort of 96 first-year medical students who used synchronous virtual models of instruction. We used closed-ended questions to characterize students' perceptions on the use of chat in synchronous didactic sessions. We performed qualitative analysis on narrative responses.

Results 
Our survey had a 26% response rate. Participants mostly utilized chat for inquiry and/or feedback during synchronous didactic sessions. Most participants (14/25) reported that using chat in didactic sessions facilitated learning; however, some (8/25) expressed that chat disrupted learning. Many participants (14/25) also expressed that using chat helped the feel connected to peers and faculty, whereas none (0/25) of the participants felt that chat isolated them from peers or faculty. Narrative responses supported data from the closed-ended questions and provide evidence for best practices for implementing chat to support student needs.

Conclusion 
This study indicates that the option to use chat during synchronous virtual instruction promoted students' autonomy by providing options for interactions with peers and faculty. Discussion in the chat can promote competence; however, it can also be perceived as disruptive. Finally, chat fostered a sense of community and safety amongst students. Institutions which rely on hybrid or e-learning strategies are encouraged to consider the benefits and disadvantages of chat functionality presented in this study.