Eight months ago, most parents were not thinking about the intricacies of remote, or virtual, learning and how it compares with an in-person experience for their children. Thanks to COVID-19, though, the differences and challenges that can come with online education are at the forefront as kids of all ages begin the new school year.

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A recent JAMA Pediatrics Viewpoint essay acknowledges that while teachers deserve high praise for their response to the pandemic and shifted to online learning, “the educational outcomes were unsatisfying, families were burdened, and most are hesitant to repeat the same format.”

The article, “K-12 Virtual Schooling, COVID-19 and Student Success” was written by Erik Black, PhD, MPH; Richard Ferdig, PhD; and Lindsay A. Thompson, MD. The authors examine the history of virtual schooling and share questions that parents should consider if they face a choice between online and in-person learning.

In a follow-up interview with the AMA, Dr. Thompson offered additional advice for pediatricians and family doctors on the keys to help children and their parents get the most out of online learning.

“It will be really interesting to see how all these different models protect our children’s health,” she said, “and hopefully protect their education trajectory.”

Dr. Thompson said the shift to remote learning was really important to implement. While remote learning raises new challenges, they are secondary to principal goal of keeping children, families, teachers and school staff safe and limiting spread of the coronavirus.



The American Academy of Pediatricians issued a statement in March that acknowledged screen time for children was likely going to increase during the pandemic. No limit of recommended screen time was given for school-aged children, although parents were encouraged to maintain or create offline family experiences as much as possible.  

With many schools expecting children to participate in multiple hours of virtual learning, Dr. Thompson implored doctors to remind parents about establishing offline experiences such as playing outside, taking a walk or finding other ways to get exercise.

“Children are having a big spike in weight issues; I see it daily in my clinic,” said Dr. Thompson, professor of pediatrics at the University of Florida College of Medicine, Gainesville. “Kids have been sitting around since March, and that’s going to be tough with our ongoing obesity epidemic.”

Weight issues are, rightly, lower on the list of concerns for parents right now, Dr. Thompson noted, following well behind the need to stay safe during the pandemic and ensure that education proceeds apace.

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Dr. Thompson also wondered about how effective so much screen-time teaching will be for younger children such as kindergarteners and first graders.

“How do we engage these children in the learning process when it’s online?” she said. “The best answer, I think, is a short amount of Zoom time followed by unstructured recess or independent study with an adult nearby or checking in.”

Learn more about what physicians can say to parents weighing back-to-school decisions.

While Dr. Thompson worries about the engagement of young children, she also is concerned about the well-being of older kids, speaking from personal experience as a mother with one child in high school and one in college.

“I worry about their mental health,” she said. “Most kids are social animals. They want to be around each other.”

Part of that mental health concern comes with a loss of connection among kids. Another element that physicians and parents should watch for is the lost bond between students and their teachers, and what that could mean for certain kids.

“Will the iPad be enough interaction with teachers to protect really vulnerable children?” she asked. “Teachers often see abuse or neglect, but there may not be enough screen time to know that a child is in trouble. That’s one of the differences of not being face to face, and I think we'll learn about the repercussions for years and years.”

Learn more with the AMA as pediatricians share their learnings from the surge in COVID-19 cases among children.

Despite the worries, Dr. Thompson believes there is also reason for optimism. In the JAMA Pediatrics article, she and her co-authors noted that research finds that online learning can be beneficial, particularly for children with special health care needs.  

Young kids are resilient, Dr. Thompson said, and they will handle the changes that result from COVID-19, even when in-person schooling returns.

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“They may be so grateful to get back into school that new regulations may feel minor to them,” she said. “Sitting socially distant rather than shoulder to shoulder at lunch won’t bug them.”

Lastly, when physicians talk with parents about online learning, they should acknowledge the ingenuity and creativity that exists among teachers. Just as the business world and even parts of the medical world have discovered that employees don’t always have to be at work to productively do work, Dr. Thompson thinks online learning this fall will breed new models of teaching and academic experiences for students across the country.

“There really could be an opportunity for some out-of-the-box thinking, and specifically an acceleration of knowledge gain,” she said. “We all want children to get back to a strong learning trajectory. No one wanted this to happen, but I think there can be some good lessons learned.”

Learn about one university’s science-based approach to in-person classes amid the pandemic.

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