The coronavirus disease (COVID-19) pandemic has changed the education system, including problem-based learning (PBL), which is the main curriculum model in medical education. Social interaction and acquisition of knowledge and skills are one of the challenges in online learning during a pandemic. This study evaluated the use of the flipped classroom in the PBL curriculum of medical education. This study used mixed-methods design with a concurrent approach. The data collection technique was secondary data collection in the form of data from the block learning evaluation form. The evaluation form contains statements regarding the quality of the learning process, in the form of Likert scales. At the end of the form, there was a fill-in/essay question for more in-depth exploration. The quantitative data were analysed using descriptive univariate analysis, meanwhile, the qualitative data were analysed using thematic analysis techniques. Unbalanced learning load on the block, block learning management, and knowledge retention in block learning were considered lacking in flipped classroom block implementation. The management of time delays, a stage for students to be ready, a step to lessen psychological stress, and the use of media to generate different learning experiences are particular areas that need improvement.

Purpose: The development of students’ clinical reasoning skills should be a consideration in the design of instruction and evaluation in medical education. In response to the coronavirus disease 2019 (COVID-19) pandemic, several changes in the medical curriculum have been implemented in promoting clinical reasoning. This study aims to explore medical students’ perceptions and experiences with the clinical reasoning curriculum during the COVID-19 pandemic and determine their skills development.Methods: The study used a mixed-method design with a concurrent approach. A cross-sectional study was conducted to compare and examine the relationship between the outcomes of the structured oral examination (SOE) and the Diagnostic Thinking Inventory (DTI). Then, the qualitative method was used. A focus group discussion using a semi-structured interview guide with open-ended questions was conducted, then the verbatim transcript was subjected to thematic analysis.Results: There is an increase in SOE and DTI scores between second-year to fourth-year students. The diagnostic thinking domains and SOE are significantly correlated (r=0.302, 0.313, and 0.241 with p<0.05). The three primary themes from the qualitative analysis are perceptions regarding clinical reasoning, clinical reasoning activities, and the learning component.Conclusion: Even if students are still studying throughout the COVID-19 pandemic, their clinical reasoning skills can improve. The clinical reasoning and diagnostic thinking skills of medical students increase as the length of the school year increases. Online case-based learning and assessment support the development of clinical reasoning skills. The skills are supported in their development by positive attitudes toward faculty, peers, case type, and prior knowledge.

Empathy is one of the core competencies that doctors must possess. Teaching empathy is carried out since students are in undergraduate medical education. One of the learning activities that can be used to improve empathy skills is reflection. Many studies have reported on the empathic abilities of medical students. In addition, there have also been many scientific articles discussing the factors that affect the ability of empathy. However, how medical students learn empathy is still unclear, especially for first-year students who have just been exposed to medical science after graduating from high school. This study aimed to understand how first-year medical students learn empathy. A qualitative study with a phenomenological approach was carried out. We selected randomly, a total of 30 medical student reflection journals were analyzed using content analysis techniques. There are three themes, namely stimulus, process, and effect. Medical students learn empathy driven by internal and external stimuli so that a thinking process occurs through several learning activities. The existence of this stimulus and process influences both the self and the patient/client. The whole process of empathy learning can show how early-year students learn and the factors that influence student empathy learning. This study supports other research that discusses the learning process and factors that affect medical students' empathy. This result can encourage curriculum planners to design appropriate empathy learning for students.