Innovative Teaching in Hematology: Evaluating the Need for Social Media-Based Learning
Dr. Sindhu Rehman MBBS, FCPS, RCPATH (DIP)1, Dr. Abdul Mannan MBBS, FCPS, FRCPATH 2, Dr. Zunairah Mughal MBBS, FCPS 3*, Dr. Muhammad Aasim (PhD) 4, Dr. Umme Habiba MBBS, M.PHIL, FCPS, CHPE 5, Dr. Mehmood ul Hassan Malik MBBS, FCPS 6, Dr. Hajirah Syndeed Pal MBBS, FCPS 7
1. Assistant Professor, King Edward Medical University, Lahore, Pakistan.
2. Consultant Hematologist, North Wales Cancer Centre, Glan Clwyd Hospital.
Director, Bangor Hemophilia Centre Clinical Hematology Laboratory Lead Betsi Cadwaladr University Health Board, United Kingdom.
3. Senior Demonstrator, Shalamar Medical and Dental College, Lahore, Pakistan.
4. NHRC, HRI-NIH Research Centre, Shaikh Zaid Medical Complex, Lahore, Pakistan.
5. Assistant Professor, UHS, Lahore, Pakistan.
6. Consultant Hematopathologist, Regional Laboratory, Hafar-ul-Batin, Kingdom of Saudi Arabia.
7. Staff Pathologist, AKUH, Lahore Pakistan.
*Correspondence to: Dr. Zunairah Mughal MBBS, FCPS, Senior Demonstrator, Shalamar Medical and Dental College, Lahore, Pakistan.
Copyright.
© 2025 Dr. Zunairah Mughal This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 15 May 2025
Published: 09 June 2025
Abstract
Background: Learning in Hematology has traditionally relied on lectures, textbooks, and clinical exposure. However, the rapid integration of digital learning, especially through social media platforms, offers new avenues for enhancing engagement and academic performance thereby better education.
Objective: This study evaluated the effectiveness of social media-based collaborative learning in Hematology by assessing the impact of satisfaction, interactivity, and engagement on academic outcomes among postgraduate students and consultants.
Methods: A cross-sectional study was conducted involving 131 participants (hematology trainees and consultants) who had been part of a dedicated Hematology WhatsApp group for at least six months. Data were collected via structured questionnaires and analyzed using structural equation modeling, regression, and path analysis to examine the relationships between satisfaction, interactivity, engagement, and academic performance.
Results: The study revealed that satisfaction and interactivity individually influenced academic performance, but their combined interaction significantly enhanced learning outcomes (β = 0.157, p = 0.030). Interactivity acted as a partial mediator, amplifying the effect of satisfaction on academic performance. Engagement activities such as interactive case discussions, MCQs, and prompt mentor feedback were highly rated by participants, with 95.4% expressing satisfaction with the quality of content.
Conclusion: Social media-based learning fosters interactivity, engagement, and satisfaction, leading to improved academic performance in Hematology. Active engagement, rather than passive content consumption, is critical to effective learning. Educational strategies should focus on designing interactive, engaging environments with responsive mentorship to maximize learning outcomes.
Keywords: Social media learning, Hematology education, academic performance, engagement, interactivity, satisfaction
Introduction
Traditionally, medical education in Hematology has relied heavily on lectures, textbooks, and clinical practice. However, the increasing integration of technology and the rise of digital learning platforms offer new opportunities for enhancing educational outcomes. Broader educational trends emphasize the importance of digital literacy, equity, and personalized learning approaches, such as gamification and cognitive load management, to improve student engagement post-pandemic (1) One such opportunity is the use of social media as a tool for interactive and collaborative learning in Medical Fields.(2) This study approach is relevant in todays digital age, where students are constantly engaged with online platforms. Social media-based learning presents an innovative way to engage students, encourage collaboration, and improve academic performance. (3) Also this is an effective way to connect international students with their new peers can ease academic and social adjustment and enhance their learning (4)
This study aims to evaluate the potential of social media in the teaching of Hematology, focusing on its effectiveness in enhancing student engagement, interactivity with teachers, and academic performance. This research investigates the impact of Satisfaction and Interactivity (which encompasses Engagement) on Academic Performance. A regression analysis is used to establish the contribution of these factors to the academic results of students. Interaction effects are also examined to determine whether the link between Satisfaction and Academic Performance is conditioned by Interactivity.
Methodology
This study uses a cross-sectional quantitative research approach to assess the impact of social media-based learning on Hematology education.
Study Duration
The data was collected from the group members from October 2022 to October 2024.
Study Population
Inclusion Criteria
Exclusion Criteria
Sample size
A sample size of 131 participants is calculated using formula:
n= (z2 {1- α/2}.p. (1-p)) / d2
Where:
Confidence level (1 - α): 95%
Anticipated population proportion (P): 0.79
Absolute precision required (d): 0.07
Sample size (n): 131
Study Platform: Social media platforms used for academic purposes including WhatsApp, Zoom and Microsoft teams for interactive sessions.
Data collection
Data was collected through surveys administered to students enrolled in Hematology Group on WhatsApp that incorporate social media as part of their learning process. The questionnaire was made using Google Forms. The survey consisted of a series of statements, each measured on a standardized Five-point Likert scale (1-Strongly Disagree to 5-Strongly Agree). (Table 1).
The variables measured included:
1. Interactivity with teachers: This was assessed by using five indicators (Q3, Q9, Q13, Q14).
2. Engagement: Measured through a single variable indicator (Q4).
3. Effectiveness and satisfaction: Assessed using seven variables (Q1, Q2, Q5, Q6, Q7, Q8, Q12).
4. Academic performance: Evaluated through students' academic outcomes facilitated by social media usage. (Q8 and Q11)
5. Limitations and challenges: Measured with one variable (Q10).
The study examined the relationship between several independent variables and academic performance. The independent variables include Satisfaction_Eng, which represents satisfaction integrated with engagement, and Interactivity_Eng, which captures interactivity combined with engagement. Additionally, an interaction term (Satisfaction_Eng × Interactivity_Eng) is included to assess the combined effect of these factors. The dependent variable in the analysis is Academic Performance, which is measured as the average of six academic indicators (Aca1 to Aca5).
Data analysis
Descriptive analysis was measured using Frequency and percentages for questions with nominal variables. A structural equation modeling (SEM) approach was employed to test interactions, regression, and correlation between these variables. Exploratory factor analysis (EFA) was conducted to ensure validity and reliability by the application of Structural Equation Modeling (SEM) and Cronbach's alpha coefficient.
This methodological approach allowed for a comprehensive analysis of the interactions between social media usage, teacher engagement and student satisfaction with academic performance in Hematology education.
Figure 1: SEM model for collaborative learning of Hematology students
Hypothesis
Based on the objectives, the following hypotheses will be tested:
H1: Interaction of students with teachers through social media based collaborative learning increase the engagement of students.
H2: More engagement with teachers leads to the higher students' satisfaction and improve academic performance.
H3: Student’s interaction, engagement and satisfaction are positively associated with the students' academic performance.
To analyze these relationships, various statistical techniques are employed. Multiple Regression Analysis is conducted to determine the predictive power of the independent variables on academic performance. A Multicollinearity check using the Variance Inflation Factor (VIF) ensures that the independent variables are not highly correlated. Furthermore, an Interaction Effect Analysis examines whether the combined effect of satisfaction and interactivity differs from their individual contributions. Mediation Analysis is also performed to explore indirect pathways influencing academic performance. Lastly, Path Analysis using Visualization provides a graphical representation of the relationships among the variables, offering a clearer understanding of the structural connections within the model.
Objectives
The primary objectives of this study were:
1. To analyze the impact of social media on fostering interactivity and engagement between Hematology students and educators.
2. To assess the effectiveness of social media as a platform for enhancing student satisfaction and academic outcomes in Hematology education.
3. To investigate the challenges and limitations associated with integrating social media into medical education, with a focus on Hematology.
Table 1: A 14 Questions Satisfaction Survey focusing on teaching experience and effectiveness of the content delivered via Whatsapp group Hematology
|
Question No |
Questions |
|
|
1 |
Overall, how satisfied are you with the quality of content shared in the group (webinars, case discussions, MCQs, etc.)? |
Very Satisfied / Satisfied / Neutral / Unsatisfied / Very Unsatisfied |
|
2 |
How helpful do you find the webinars in preparing for your FCPS Part II or FRCPath Part I and II exams? |
Very Helpful / Helpful / Neutral / Not Helpful / Not Helpful at All |
|
3 |
How would you rate the interactive case discussions in enhancing your understanding of haematology topics? |
Very Beneficial / Beneficial / Neutral / Not Beneficial / Not Beneficial at All |
|
4 |
How engaging do you find the MCQs, polls, and picture questions in terms of testing and reinforcing your knowledge? |
Very Engaging / Engaging / Neutral / Not Engaging / Not Engaging at All |
|
5 |
How relevant do you find the topics covered in the group to your FCPS or FRCPath exam preparation? |
Highly Relevant / Relevant / Neutral / Not Relevant / Not Relevant at All |
|
6 |
How satisfied are you with the responsiveness of the group mentors during webinars or case discussions? |
Very Satisfied / Satisfied / Neutral / Unsatisfied / Very Unsatisfied |
|
7 |
Do you feel that the materials (e.g., slides, videos, case summaries) shared in the group are clear and easy to understand? |
Very Clear / Clear / Neutral / Unclear / Very Unclear |
|
8 |
How effective do you think the group is in enhancing your knowledge in the following areas? (Rate each area) |
|
|
|
Haematopathology, Transfusion Medicine, Haemostasis and Thrombosis, Malignant Haematology |
Very Effective / Effective / Neutral / Ineffective / Very Ineffective |
|
9 |
How do you rate the overall communication and organization of the group? |
Excellent / Good / Fair / Poor / Very Poor |
|
10. |
What improvements or additional features would you like to see in the group to enhance your learning experience? |
Open-ended |
|
11. |
Is it helpful to achieve your goals |
Very Helpful /Helpful /Neutral /ineffective/ very ineffective |
|
12. |
Did the group mentor ask for any monetary or other benefits? |
Yes / No |
|
13. |
How speedily do mentors/seniors in this group help participants in solving actual scenarios of lab and clinical haematology? |
Within 5 minutes / Within an hour / Within a day |
|
14. |
Does the group let participants ask very basic questions without any hesitation? |
Yes / No |
Results
The study analyzed the gender distribution of participants, revealing a significant female predominance, with 84.7% (n=111) being female and only 15.3% (n=20) being male. This gender disparity highlights the growing involvement of female professionals in hematology education and clinical practice. Furthermore, the professional roles of the participants were fairly balanced, with 54.2% (n=71) being consultants and 45.8% (n=60) being trainees. This near-equal distribution suggests that the need for social media-based learning extends across different levels of expertise, making digital platforms a potentially effective tool for continuous education and professional development in hematology.
Geographical distribution of participants spanned multiple cities, with the majority hailing from Lahore (40.5%, n=53), followed by Karachi (10.7%, n=14) and Islamabad (8.4%, n=11). Other notable contributions came from Rawalpindi (7.6%, n=10) and Peshawar (5.3%, n=7), with smaller representations from various national and international locations, including Birmingham, UK, and Riyadh, KSA.
Figure 1: Frequency of Participants from different ares
A total 95.4% of participants expressed satisfaction with the quality of content, with 58.8% being very satisfied. Similarly, 94.6% found the webinars helpful for FCPS and FRCPath exam preparation, emphasizing their effectiveness. Furthermore, 89.3% considered the topics relevant to their exams, and 92.4% praised the responsiveness of mentors during discussions. The materials shared were deemed clear and easy to understand by 91.6% of participants, reinforcing the effectiveness of social media-based education.
Regarding engagement and academic performance, 91.9% found interactive case discussions beneficial in enhancing their understanding of hematology topics. Additionally, 92.4% rated the group's communication and organization as good or excellent. Mentor responsiveness was particularly noted, with 48.9% receiving responses within an hour. Participants overwhelmingly felt comfortable asking basic questions (92.5%), and 92.4% found MCQs, polls, and picture questions were engaging. Overall, 89.3% of participants found the group helpful in achieving their educational goals.
Table 2: Satisfaction Survey Results among Participants of the Study
Model Development Process
1. Initial Factor Analysis and Refinements
The initial model was developed using Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA) to assess whether the items appropriately aligned with their respective constructs. During this process, several refinements were made to enhance the model's validity and reliability.
Firstly, Engagement (Eng) was identified as a single-item construct, raising concerns about its reliability. To address this issue, Engagement was integrated with both Satisfaction and Interactivity, guided by Principal Component Analysis (PCA) loadings. Additionally, the Interactivity construct included a dichotomous variable (Int4), which was removed as it did not fit well within the factor structure. Another adjustment involved Int3, which was rescaled to a Likert scale to ensure consistency across measurement items.
2. Regression and Interaction Testing
After having refined the factor structure, multiple regression was conducted:
The first model had shown that Satisfaction_Eng and Interactivity_Eng both individually were significant predictors of Academic Performance with β = 0.375, p < 0.001 for Satisfaction_Eng and β = 0.240, p = 0.005 for Interactivity_Eng.
On introducing an Interaction Term (Satisfaction × Interactivity) to the regression model, both the individual predictors were rendered insignificant whereas the interaction term was statistically significant at β = 0.157, p = 0.030.
This showed that Interactivity moderates the Satisfaction-to-Academic Performance relationship.
3. Mediation and Path Analysis
To explore more about the underlying dynamics, the mediation analysis was performed:
The indirect effect of Satisfaction on Academic Performance through Interactivity was 0.280 which was a strong partial mediation.
Direct effect of Interactivity on Academic Performance was 0.240 which indicated that it significantly contributed to academic performance on its own.
The total effect (sum of direct and indirect effects) was 0.520, demonstrating the combined influence of these factors.
The 0.747 here, coefficient between S & E (Satisfaction & Engagement) and I & E (Interactivity & Engagement) represents the correlation or predictive path coefficient between these two variables.
Path analysis was then used to visualize these findings. The model showed that:
Satisfaction & Engagement (S & E) significantly influences Interactivity & Engagement (I & E), which in turn has a direct impact on Academic Performance (AP). Moreover, the combined effect of Satisfaction and Interactivity is stronger than their independent contributions, highlighting the importance of fostering both engagement and interactive learning environments to maximize academic success.
4. Interpretation of the Final Model
This model suggests that Academic Performance is best explained by an interactive relationship between Satisfaction and Interactivity, rather than by their separate influences. In educational settings, students who experience higher satisfaction are more likely to engage in interactive learning, and this engagement further enhances their academic success.
By combining Engagement into both Satisfaction and Interactivity, this model is consistent with previous research that indicates students who are both satisfied and actively engaged in interactive learning environments perform better academically. The mediation effects indicate that Interactivity is a key mechanism by which Satisfaction influences Academic Performance.
Figure 2: Original path analysis diagram
Path Model of Satisfaction, Interactivity, and Engagement Influences on Academic Performance
Figure 3: Modified path analysis diagram
Path Model Demonstrating Direct and Indirect Effects of Satisfaction & Engagement and Interactivity & Engagement on Academic Performance
Discussion
Our study provides a comprehensive examination of the impact of satisfaction, interactivity, and engagement on academic performance among hematology professionals. Utilizing social media have always been used as an educational tool and in our study we explored how digital learning environments facilitate knowledge acquisition and professional development. (5)
Gender distribution in our study shows female predominance (84.7%) among participants. Increasing ratio of women is pursuing specialized fields such as hematology which shows broader gender trends in medical profession. The lesser number of male participants (15.3%) can be due to a genuine gender imbalance in Hematology or a greater inclination of female hematologists toward digital learning. Similar trends have been observed in educational technology studies, where younger students and females dominate the sample. (6,7).
The ratio of consultants to trainees (54.2% vs. 45.8%) indicates that both senior professionals and hematologists in their early careers require ongoing medical education. Consultants are hired for professional networking, teaching, and knowledge updates, while trainees may look for structured learning to prepare for exams. According to our study's findings, digital learning should accommodate a range of expertise levels, guaranteeing the delivery of both basic and advanced content in line with earlier research. (8). With the largest concentration in Lahore (40.5%), Karachi (10.7%), and Islamabad (8.4%), the study participants were geographically dispersed. The fact that participants came from a variety of cities and countries (such as Birmingham, UK; Riyadh, KSA) highlights how digital platforms can help close the gap in education and expand students' horizons. Our Study depicts that Social media-based education provides excellent content regardless of location and can be used as a potent equalizer. A latent need for flexible, remote learning is evident from the wide participation across several cities, especially in areas with few options for organized postgraduate study and exposure. (9)
A key finding of our study is highlighted by CFA analysis: academic success is not best predicted by satisfaction alone; rather, interaction greatly increases its influence. The usefulness of digital learning materials is demonstrated by the overall 95.4% satisfaction percentage with content quality (58.8% of participants were extremely satisfied). Similarly, a study by Zhu C revealed that the organized format of the webinars, case discussions, and multiple-choice questions—all of which support competency-based learning—is responsible for the high levels of satisfaction. models. (10) However, our regression analysis revealed that satisfaction alone does not directly translate into improved academic performance unless reinforced by interactive engagement. These findings are consistent with prior research indicating that perceived content quality positively correlates with knowledge retention. (11)
Introducing interactivity as a moderator in the statistical model altered the predictive significance of satisfaction. The interaction term (Satisfaction × Interactivity) became statistically significant (β = 0.157, p = 0.030), while the individual effects of satisfaction and interactivity became insignificant. This suggests that satisfaction enhances academic performance only when learners actively engage in interactive learning activities. Similar results were seen in a Study by Ha et al showing high level of interactivity and engagement reported (93.2% agreement) (12) In an educational perspective, passive consumption of content does not yield optimal learning outcomes. Instead, engagement through discussion-based learning, active participation in case analyses, and real-time interaction with mentors strengthens knowledge acquisition as shown in the study done by Zhao Y et al. (13)
Engagement is a critical determinant of knowledge acquisition. Our findings show that 92.4% of participants found the MCQs, polls, and picture questions engaging, suggesting that active participation drives deeper cognitive processing. Interactive case discussions were rated beneficial by 92.5% of participants, with 52.7% finding them very beneficial. This supports established educational theories, such as the students have the willingness to communicate via social media platform than face to face as constructivist learning, which emphasize that learners construct knowledge more effectively through social interaction and problem-solving instead of passive content consumption. (14)
The response time of mentor was a key engagement factor in our study with 48.9% of participants receiving responses within an hour. This immediate response from experts enhances the learning experience and ensures that knowledge gaps are addressed well in time. This responsiveness encourages a collaborative learning culture, allowing learners to clarify doubt thus refining clinical reasoning skills, and applying theoretical concepts to real-world scenarios. (15) The timely and constructive feedback provided by the platform, as reported by the majority of the students, underscores the role of immediate feedback in online learning environments, as highlighted by Qureshi MA et al (16)
Our mediation analysis revealed a strong indirect effect of Satisfaction on Academic Performance via Interactivity (0.280, p < 0.001). This highlights that:
Satisfaction alone is insufficient to improve performance.
Interactivity serves as a key pathway, reinforcing satisfaction-driven learning.
The total effect (0.520) was greater than the sum of individual contributions, indicating a synergistic impact.
The path analysis visualization confirmed that Satisfaction & Engagement (S & E) significantly influences Interactivity & Engagement (I & E), which in turn enhances Academic Performance (AP). This structural relationship supports the idea that higher interactivity amplifies the benefits of satisfaction, leading to superior academic outcomes.
Conclusion
This study describes the role of satisfaction, interactivity, and engagement in shaping academic performance. Satisfaction and Interactivity do not predict Academic Performance as strongly as their interaction does. Their impact is significantly enhanced when active engagement and interactive learning strategies are incorporated. Higher Interactivity improves the benefits of Satisfaction, further enhancing Academic Performance. By leveraging social media-based learning, hematology professionals irrespective of gender, location, or experience level—can access high-quality, interactive, and mentor-driven education. Educational strategies need to increase Satisfaction and Interactivity together rather than in isolation including designing engaging and interactive learning environments and enhancing mentor responsiveness.
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