Introduction
The virtual learning platform provides a high-quality and sustainable educational infrastructure [1-2]. In recent years, with the development of e-learning, its increasing impact on the educational system has received a lot of attention. Experts believe that leaders have two important responsibilities during a crisis like the COVID-19 pandemic: addressing the immediate problem and preventing its recurrence [2-5]. The first point is heavily emphasized, but the second has significant long-term implications. Therefore, leaders, officials, and managers in charge must pay special attention to the decisions made during crises. In most countries, including Iran, following the outbreak of the COVID-19 virus and in line with preventive policies to avoid infection and maintain social distancing, schools and universities were closed from early March 2020 [6]. Gradually, in most educational institutions, virtual education replaced traditional methods, and these online programs gained increasing popularity day by day [7-8]. In this study, we examined the satisfaction with the status of virtual education of basic medical sciences courses in medical students at Guilan University of Medical Sciences in terms of the educational content and its organization, the interaction-evaluation, the virtual education system and user support, and the general perspective of students during 2021-2022.

Methods
This cross-sectional study included 204 medical students enrolled in basic medical science courses at the Rasht and Anzali campuses. Participants were selected using stratified random sampling. To collect data, we used a 31-item, researcher-made online questionnaire. The questionnaire’s validity was 0.92, and its total reliability was 0.887, as determined by Cronbach’s α coefficient. Fisher, Pearson correlation, and SPSS software, version 26 were used.

Results
The average age of the participants was 20.01±1.35 years, with a minimum and maximum age of 18 and 23 years, respectively. According to the results obtained, 105 individuals (51.5%) were male, while the remaining were females. All participants in the study were single. Based on the results obtained, the highest frequency of academic semesters was found in the third semester, with 88 individuals (43.1%). Additionally, the mean grade point average (GPA) among the participants was 16.07±0.99, with minimum and maximum GPAs of 13.79 and 18.13, respectively. According to the results obtained, the most preferred teaching method for course instruction was the in-person method, with 106 individuals (52%).
The results of this study indicated that the mean score for the flexibility of the virtual learning course in basic sciences courses was 18.83±3.88, with minimum and maximum scores of 7 and 25, respectively. The mean score for educational content and its organization was 26.40±4.51, ranging from 8 to 35. The mean score for the interaction-evaluation was 40.20±8.70, with a range of 13 to 60. The mean score for the virtual education system and user support was 13.67±3.41, with minimum and maximum scores of 4 and 20. The mean general perspective of students’ scores was 6.78±2.15, ranging from 2 to 10. The mean total score for the overall status of the educational program was 105.88±17.12, with a range of 39-150.
The results showed that age, gender, academic semester, and GPA were not significantly associated with the flexibility of the virtual learning course (P>0.05). However, a statistically significant difference was observed in the mean flexibility score between Rasht Medical School and Anzali campus (P=0.031), with the mean flexibility score being higher at the Anzali campus.
Based on the results, no significant relationship was observed between age, gender, and place of study with the educational content and organization dimension of virtual education (P>0.05). However, the academic semester showed a significant negative correlation with the educational content and organization dimension (r=-0.15, P=0.032), indicating that as the academic semester increased, the score for this dimension decreased. Additionally, GPA had a significant negative correlation with the educational content and organization dimension (r=-0.21, P=0.002), indicating that as GPA increased, the score for this dimension decreased.
Age, gender, and GPA did not have a significant relationship with the interaction-evaluation dimension (P>0.05). Furthermore, the academic semester was significantly and negatively correlated with the interaction-evaluation dimension (r=-0.15, P=0.024), so that with increasing academic semester, the score for the interaction-evaluation dimension decreased. The results also showed a significant difference in the mean interaction-evaluation scores between the Rasht Medical School and Anzali campus (P=0.015), with the former having a higher mean score for this dimension.
Additionally, variables, such as age, gender, place of study, and GPA showed no statistically significant association with the dimension of the general perspective of students (P>0.05). However, the academic semester demonstrated a significant inverse correlation with this dimension (r=-0.20, P=0.004), indicating that as the academic semester increased, the score for the general perspective of students decreased.
Furthermore, age, gender, place of study, and GPA had no statistically significant relationship with the general status of virtual education (P>0.05). Conversely, the academic semester exhibited a significant inverse correlation with satisfaction from the general perspective of students (r=-0.16, P=0.019), revealing a decline in satisfaction scores as the academic semester advanced.

Conclusion
In general, the medical students at Guilan University of Medical Sciences were satisfied with the status of virtual education in basic science courses. The results of this study can be effective in policy-making under the direct supervision of the Ministry of Health and the universities of medical sciences. It is also important to mention that necessary actions are required to provide effective virtual education, such as conducting empowerment training courses for instructors and students, increasing interaction between instructors and users, planning to establish the necessary infrastructure for delivering virtual education, developing and implementing supportive and motivational support systems, and evaluating and monitoring the quality of virtual education programs. Therefore, it is recommended that medical universities pay attention to the underlying factors that influence the achievement of quality virtual education.

Ethical Considerations

Compliance with ethical guidelines
This study was approved by the Ethics Committee of Guilan University of Medical Sciences, Rasht, Iran (Code: IR.GUMS.REC.1401.080).

Funding
This research did not receive any financial support from funding organizations in the public, commercial, or nonprofit sectors.

Authors contributions
Conceptualization and study design: Davoud Roostaei and Mandana Golipoor; Data collection and data analysis: Fariba Asgari and Zahra Mohammadi; Drafting of the manuscript: Davoud Roostaei and Zahra Rafat; Critical revision: Fariba Asgari and Zahra Rafat; Statistical analysis, Administrative: Zahra Rafat; Study supervision: Fariba Asgari and Mandana Golipoor.

Conflicts of interest
The authors declared no conflicts of interest.



 

1. Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: Retrospective case series. BMJ. 2020; 368:m606. [DOI:10.1136/bmj.m606] [PMID] 
2. Nakhaeizadeh M, Jahani Y, Sharifipour E, Mohammadbeigi A, Koohpaei A, Sharifi H, et al. Projection of the epidemics trend of covid-19 in Qom, Iran: A modeling study. Archives of Clinical Infectious Diseases. 2021; 16(6):e113091. [DOI:10.5812/archcid-113091]
3. Farsi Z, Ahmadi Y, Alazmani Noodeh F, Hamidi Farahani R, Baniyaghoobi F. [Presenting characteristics, comorbidities, and outcomes among hospitalized patients with 2019 Novel Coronavirus-infected pneumonia in Tehran, Iran (Persian)]. Jundishapur Journal of Chronic Disease Care. 2020; 9(3):e104512. [DOI:10.5812/jjcdc.104512]
4. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Bio-Medica : Atenei Parmensis. 2020; 91(1):157-60. [PMID]
5. Dewart G, Corcoran L, Thirsk L, Petrovic K. Nursing education in a pandemic: Academic challenges in response to COVID-19. Nurse Education Today. 2020; 92:104471. [DOI:10.1016/j.nedt.2020.104471] [PMID] 
6. Dastani M. [COVID 19: A new beginning in virtual education at the medical universities of Iran (Persian)]. Horizon of Medical Education Development. 2020; 11(1):1-4. [DOI:10.29252/edcj.13.38.1]
7. Rose S. Medical Student Education in the Time of COVID-19. JAMA. 2020; 323(21):2131-2. [DOI:10.1001/jama.2020.5227] [PMID]
8. Ferrel MN, Ryan JJ. The Impact of COVID-19 on Medical Education. Cureus. 2020; 12(3):e7492. [DOI:10.7759/cureus.7492] [PMID] 
9. Boursicot K, Kemp S, Ong TH, Wijaya L, Goh SH, Freeman K, et al. Conducting a high-stakes OSCE in a COVID-19 environment. MedEdPublish. 2020; 9:54. [DOI:10.15694/mep.2020.000054.1] [PMID] 
10. Monfared A. [Evaluation of anatomy and histology internship students’ satisfaction with modern virtual teaching during the Covid-19 pandemic (Persian)]. Paper presented at: 1st National Conference on Modern Veterinary Technologies. 2021 September 8; Amol, Iran. [Link]
11. Nazeri N, Dari S, Atashi A. [The effective factors on success of E-learning in medical sciences fields (Persian)]. Journal of Health and Biomedical Informatics. 2017; 4(2):98-107. [Link]
12. Noghan N, Cheraghi M, Mahjub H. [Urvey on satisfaction from quality of passed educational course from last year students’ perspective of Hamadan University of Medical Sciences (Persian)]. Iranian Journal of Nursing Research. 2013; 8(1):76-86. [Link]
13. Shahrabadi E, Rezaeian M, Haghdoost A. [Prediction of academic achievement evaluation in university of medical sciences based on the students course experience (Persian)]. Strides in Development of Medical Education. 2014; 10(4):485-93. [Link]
14. Faize FA, Nawaz M. Evaluation and improvement of students' satisfaction in online learning during COVID-19. Open Praxis. 2020; 12(4):495-507. [DOI:10.5944/openpraxis.12.4.1153]
15. Fatani TH. Student satisfaction with videoconferencing teaching quality during the COVID-19 pandemic. BMC Medical Education. 2020; 20(1):396. [DOI:10.1186/s12909-020-02310-2] [PMID] 
16. Coman C, Țîru LG, Meseșan-Schmitz L, Stanciu C, Bularca MC. Online teaching and learning in higher education during the coronavirus pandemic: Students’ perspective. Sustainability. 2020; 12(24):10367. [DOI:10.3390/su122410367]
17. Nashwan AJ, Mohamed AS, Kelly DR. Nursing education in the emergence of covid-19. Open Journal of Nursing. 2020; 10(06):595. [DOI:10.4236/ojn.2020.106040]
18. Nasiri F, Fathi-Vajargah K. [A feasibility study of using virtual in–service education in the ministry of education (Persian)]. Journal of Educational Innovations. 2005; 4(1):111-29. [Link]
19. Yilmaz Ince E, Kabul A, Diler İ. Distance education in higher education in the COVİD-19 pandemic process: A case of Isparta applied sciences university. International Journal of Technology in Education and Science. 2020; 4(4):343-51. [DOI:10.46328/ijtes.v4i4.112]
20. Schlenz MA, Schmidt A, Wöstmann B, Krämer N, Schulz-Weidner N. Students' and lecturers' perspective on the implementation of online learning in dental education due to SARS-CoV-2 (COVID-19): A cross-sectional study. BMc Medical Education. 2020; 20(1):354. [DOI:10.1186/s12909-020-02266-3] [PMID] 
21. Sharifi F, Feizi A, Artishdar E. [Knowledge and satisfaction of medical students with two methods of education for endocrine pathophysiology course: E-learning and lecture in classroom (Persian)]. Journal of Medical Education Development. 2013; 6(11):30-40. [Link]
22. Osmani F. Analysis of students satisfaction with virtual education in medical science university during the pandemic outbreak of covid-19. International Journal of Assessment Tools in Education. 2021; 8(1):1-8. [DOI:10.21449/ijate.854675]
23. Angelova M. Students' attitudes to the online university course of management in the context of covID-19. International Journal of Technology in Education and Science. 2020; 4(4):283-92. [DOI:10.46328/ijtes.v4i4.111]
24. Chakraborty P, Mittal P, Gupta MS, Yadav S, Arora A. Opinion of students on online education during the COVID‐19 pandemic. Human Behavior and Emerging Technologies. 2021; 3(3):357-65. [DOI:10.1002/hbe2.240]
25. Hussein E, Daoud S, Alrabaiah H, Badawi R. Exploring undergraduate students’ attitudes towards emergency online learning during COVID-19: A case from the UAE. Children and Youth Services Review. 2020; 119:105699. [DOI:10.1016/j.childyouth.2020.105699]