The COVID-19 pandemic has disrupted every aspect of modern society and its social fabric, especially educational institutions. It has very negative effects, especially in developing countries. As a result, it has transformed the world’s education system and forced us to redesign it. In addition, students lost internship opportunities and personal freedom, suffered personal losses, and their safety was threatened by infections and related morbidities [56].

The challenges posed by COVID-19 turned universities learning management systems and curricula upside down, particularly for various graduate programs. This has resulted in the cessation of all academic activity, reduced in-person educational opportunities, and severely restricted student access to institutions, particularly at universities where annual enrollment is mainly based on international students. The situation became increasingly unclear, with no planning and no clear end in sight, along with fears of contracting disease, a shortage of personal protective equipment (PPE) and the urgent need to maintain physical and social distancing [26, 28]. Social distancing measures forced students to be quarantined and relocated to remote settings. This also underlined the need for an alternative educational model [38, 40, 42, 49]. However, to ensure the provision of education for these students, online platforms such as video tutorials were introduced [53].

Institutions providing undergraduate and higher education had to deal with the consequences of the sudden closure of campuses, reduced hands-on attendance, diminished on-site learning environments, and the cessation of in-person classes [43, 53]. To deal with the fallout from these consequences, institutions had to develop innovative methods to ensure uninterrupted, quality education. The education system has made a rapid transition to online education, which indeed seems to be best practice under the circumstances [48]. In addition, professional graduate and postgraduate programs that offered and required internships or placements as part of their curriculum requirements had become a real problem for newcomers [57, 58].

Education before the pandemic featured a hands-on learning environment, case-based learning, and hands-on workshops. The Association of American Medical Colleges (AAMC) issued guidelines for students not to be allowed direct contact with patients who have tested positive for the coronavirus. As a result, universities prevented their students to continue hospital clerkships or other activities related to patient care [41, 45]. These strategies led to the discontinuation of various traditional learning activities due to the enforcement of physical distancing guidelines in classrooms and laboratories [51, 59]. The implementation of social distancing measures resulted in restricted access to research laboratories and restricted research on humans and animals. Retrospectives, literature reviews, and survey-based studies were the viable project options for research students. Research activities and opportunities at research institutes were also declined. The paradigm shift to e-learning was widely needed and accepted around the world. However, it could never replace the quality of learning that is mainly acquired through practical experience, such as learning instruments/equipment and troubleshooting manual skills. In addition, the transition to online education became a major challenge, with education struggling to adapt to technological innovations while COVID-19 acted as a catalyst for this slow transition [54, 60].

Most undergraduate students are computer newbies. Therefore, technology-based learning became a challenge. It was seen as a barrier to the rapid shift to online education [47]. A major challenge faced by the universities was the lack of tech-savvy human resources [29]. Online and virtual education also raised significant concerns about student assessment, as remote assessment was difficult to monitor and making remote assessment fair was therefore a difficult task [30]. In addition, poor Internet connections, lack of technical understanding, and limited resources made it difficult to provide quality education [31].

Postgraduate education was also significantly impacted by the pandemic. Theoretical learning became the only option for postgraduate medical students during the pandemic. Face-to-face classes, lectures, seminars, and conferences were reduced to a virtual environment [33]. It has become difficult for postgraduate students to continue their education within a safe environment as student health was a top priority. In addition, moving practical lectures to an online medium was a difficult task. Visiting teaching opportunities were canceled [34, 35]. Most online education platforms are expensive which puts a heavy strain on the annual budget. The surgical residency was one of the first to be affected by the pandemic and saw a sharp drop in elective surgeries with immediate effect [36]. In addition, only urgent surgeries were recommended in practice guidelines, and the cancelation of elective surgeries had a major impact on surgical resident training programs. The universities tried to meet the challenges with all available resources [61].

Social distancing strategies implemented included the use of home offices, individual reading rooms, the cancelation of conferences, and limited participation in hands-on training [37]. The University of Toronto’s Diagnostic Radiology Program, which covers eight hospitals with 50 residents, is one of the largest assistance programs in Canada and was also affected by the COVID-19 pandemic [44]. The education system was completely switched to online education, for example practical objects based on glass slide microscopy wer replaced by virtual microscopy for dermatology education [55].

On the other hand, the students were not able to understand the course of events. They did not have enough mentoring options and could not build a team relationship. These changes had a serious impact on students’ self-confidence and personality information [62, 63]. In addition, the most difficult challenge faced by teachers was to simulate the practical teaching in order to be able to demonstrate it easily. The education ministers of different countries suggested that education should not suffer, which is why educational tools based on virtual simulation were integrated into the education system [64]. Therefore, it has become necessary for institutions to adopt alternative teaching methods and explore virtual delivery of education through social media or online platforms [65].

Distance learning (DL) or technology-based learning (TB) is nothing new to many developing countries. The approach is used as synchronous learning based on real-time interactive lectures and asynchronous learning based on self-study and discussion in various forums such as emails [66, 67]. Video conferencing has been used in education since the 1960s [68]. Flexibility, accessibility, reduced costs, portable learning materials, self-based learning, time efficiency, and reduced risk are some of the stated benefits of online learning. Even before the current pandemic, online platforms are being used by various institutions around the world, especially in developed countries [69, 70], showing that online education as an academic norm is not only associated with the COVID-19 pandemic and several online education-related video-conferencing software have been used, including Zoom, Skype, and Cisco Webex [71, 72].

Zoom turned out to be the most widely used video-conferencing platform for synchronous education, which offers useful features for smooth communication, such as these include a chat board, a hand-raising system that increases student attention and engagement, screen sharing that allows presenters to view slides, and the recording of lectures for later viewing [34, 73]. It could be observed that not only the students, as a generation with an affinity for social media, accepted this form of learning, but also that the feedback from the faculty members in a study showed that, despite the use of new teaching methods, there was a significant degree of satisfaction with online teaching ruled [74].

Distance learning provided an opportunity for educators to develop a close connection and dialogue with students, particularly those with intellectual disabilities and learning difficulties [51]. Student reviews were mixed, with some advocating a blended strategy for the post-pandemic era, others expressing a negative opinion of online learning, calling it an unsuitable mode, particularly for medical education, and still others expressing the need for one comprehensive training to adopt the online mode learning. Studies have shown that most students favor hybrid learning because it overcomes some traditional teaching barriers but requires appropriate teacher training and institutional support [74]. The flipped classroom is a common pre-pandemic approach and can therefore be used for asynchronous and synchronous lessons [75]. Virtual meetings were found to be more engaging for students as they have the feel of a live presentation, and online video lectures and webinars are expected to continue post-pandemic due to greater international exposure and lower costs [61, 76].

It is believed that while providing valuable content to students, most online education platforms lack the ability to provide economically personalized feedback. For this reason, a web-based mobile platform called LAPP was set up. This application connects students with tutors remotely via their phones. Students can submit their exercises and receive feedback via video, drawing, audio, or text content. Almost 3700 replies were reported as successfully submitted. Another application, Epidemix, was developed to provide security and convenience for teachers and students. The applications can be used on a user-friendly interactive interface or on a mobile phone and are free for all users [26].

Social media is a tool that allows information to be shared in various formats, including videos [77]. There has been an increasing trend to use social media for teaching and learning purposes, and a number of social media platforms such as Facebook, WhatsApp, and Instagram have been used for collaborative learning and better communication [33]. A preference for “YouTube” for technical lectures can already be seen in the literature, as videos are a useful, expressive, and easily accessible information tool [77].

YouTube is the most popular source of tutorial videos because of its free content, ease of use, and familiarity among web users [77]. However, an evaluation of YouTube videos revealed that more than 95% of the videos watched by students for learning purposes were of poor educational quality. Therefore, it has been suggested that academics must conduct a critical evaluation of YouTube videos before proposing them to students [33, 53, 78]. Likewise, the Telegram application is considered a valuable mobile application with numerous utilities and many helpful features, including easy access to educational videos, no file size or file format limitation, unlimited member capacity, good connectivity and security, and subscriptions to journals and e-books without the need a browser or website support. Some limitations such as limited group member capacity and file-sharing ability have been found to be associated with applications such as WhatsApp and Facebook [79]. Although these two applications are considered to be widely used platforms worldwide that offer free services. The applications provide opportunities for knowledge sharing, assessment tools, and cognitive enhancement, even when resources are scarce [33]. WhatsApp is reported to have been used effectively for both training and assessments during the pandemic. However, students cited a lack of real-world interaction and problems related to Internet connectivity and device availability as the main disadvantages of this teaching method [53].

The main advantages of using social media platforms for teaching include avoiding wasted time, easy curriculum coverage, standardized assessments, preparing and conducting exams with the active participation of students, economic feasibility, familiarity with technology, and formative assessments continue academic education in an effective manner [33, 53]. However, the few inherent disadvantages include the lack of hands-on training and real-time skills-based learning, the risk of cheating during an online assessment, and limited experience with a variety of real-world scenarios [33].

Simulation-based training has been suggested as the main solution for training practical skills [52]. Various simulation techniques have been developed or used. These techniques are often based on virtual reality such as the LapSim simulator, are based on 3D models such as silicon 3D simulation kits, or are based on real-time hands-on experiences such as head-mounted camera devices and whole slide imaging [62, 80,81,82,83]. Although many of the simulation-based platforms are considered quite expensive and require a fast Internet connection, they allow learners to see and interact with the lecturer and offer the best alternative for technical students during the period of social distancing [62, 80].

The strength of the present study is in providing an in-depth overview of the strategies implemented by different universities in response to the educational challenges during the pandemic. It also summarizes the innovative solutions adopted in the selected studies to reduce the educational gap at the time of COVID-19. The research articles generated from the databases were included, such as editorials, letters, and letters to the editors. However, there may be some limitations, for example, the data obtained from selected databases did not contain information on educational approaches for other programs, such as graphic design, engineering, and visual studies in art, but mainly related to medical education. The selected studies are unstructured and show large design variations. The selection criteria were limited to undergraduate and postgraduate education. The main source of the scientific database used was PubMed, EMBASE, and supplemental searches were provided by Google Scholar.

The present study offers practical and experienced solutions adopted by several universities from both developed and underdeveloped countries for the implementation of online education. Although online learning cannot replace hands-on learning and also has many limitations, it can be used effectively for study continuation in an uncertain period. Our goal was to explore the best alternative method available for the continuation of the education system, especially for college or university students, and to bridge the gap between students and education during the time of the pandemic. There has been much criticism of online education and related technologies, but the availability of these technological advances represents the only alternative solution to combating the education crisis caused by a pandemic.

Means of communication such as interactive video tools, digitized content, visual media, and other web-based platforms have proven to be efficient training and learning tools in the learning process, regardless of time and place [84]. There are various social media tools like WhatsApp, Telegram, YouTube, Facebook, Skype, Twitter, Snapchat, and Instagram and other platforms like ZOOM, Google Classroom, Google Meet, Microsoft Team, GoToMeeting, WebEx, and Adobe Connect, which have proven valuable in delivering distance learning [56, 77, 79, 85, 86]. But certain challenges have been observed, in particular the need for digital devices such as smartphones, laptops, or desktops and the requirement for an uninterrupted Internet connection [87]. Affordability of such electronic or digital devices for people from countries with low-income economies and a per capita income of less than $1050, where basic needs such as food, clothing, and shelter are already the greatest problems, such as in Somalia, Sudan, Afghanistan, Yemen, Tajikistan, and Guinea, is another challenge that needs to be addressed [88].

In addition, the lack of electricity, which is a prerequisite for functioning electronic devices, poses an additional challenge in the least developed countries. The lack of literacy skills and the availability, accessibility, or affordability of the Internet have also been considered insignificant in these regions as classified [89]. Affordability of digital devices should be ensured and Internet connectivity should be restructured by governments.

People in countries with middle economies like India, Pakistan, China, and Brazil have access to electronic devices to some extent, but uneconomical online platforms, lack of digital literacy, and lack of strong Internet infrastructure have been reported as the main barriers to online education [33, 53, 89, 90]. Social media platforms such as WhatsApp, Facebook Live, YouTube, Twitter, Snapchat, and Instagram as well as free or low-cost video conferencing tools such as Microsoft Team and ZOOM have been widely used as distance learning platforms in these regions [20, 32, 33, 44, 56, 58, 85]. As problems with Internet availability and connectivity were recognized as major obstacles in these countries, recorded video lectures were more welcomed. Although online education continued in these countries, the lack of trained staff and limited Internet services in remote areas meant that students could not properly access the live or recorded lectures [47]. However, it has been found that students in these regions favor a hybrid or blended education system [33, 53, 89, 90].

The countries with high-income economies like the USA, Australia, Singapore, Japan, Korea, the UK, Ireland, Italy, Hungary, Canada, Chile, and Mexico have succeeded in developing effective online virtual simulation education based on 3D devices such as Echo360, LabCam, Netter 3D Anatomy, Canvas-LMS [80, 81]. The platforms, based on a 360-degree virtual operating room, are essential for an education system where learning is almost based on practice rather than theoretical knowledge [20, 55]. These