Face-to-face versus virtual education in biostatistics: a comparative study among medical students in Ecuador during the COVID-19 pandemic

Introduction: The abrupt shift from face-to-face to virtual teaching during the COVID-19 pandemic challenged universities worldwide. In this study, we examine how this transition affected learning outcomes and student experiences in a biostatistics course for medical students at the Universidad de Las Américas in Quito, Ecuador. Methods: We surveyed 57 students (34 face-to-face in 2019, 23 virtual in 2020–21) to explore perceptions of learning facilitation, teacher and peer interaction, and self-regulated learning. Additionally, we compared academic performance across modalities using statistical analysis. Results: We found that students taught in person reported significantly higher levels of instructor contact and peer collaboration (p ≤ 0.05), while no statistically significant difference emerged in final grades between modalities (face-to-face mean = 8.89 ± 0.89; virtual mean = 9.01 ± 0.56; p = 0.967). Conclusion: These findings suggest that although virtual instruction can achieve comparable academic outcomes, the student experience differs markedly and may favor in-person formats for interaction and collaboration. For medical education contexts, our results highlight the value of integrating robust instructional design and peer collaboration in online environments. Future research should adopt longitudinal designs and explore mixed-mode (blended) strategies to harness the strengths of both modalities. Copyright © 2026 González, Fors and Torres.