Power distance within online and face-to-face medical education in Sri Lanka and the UK.

Introduction: The student-teacher relationship can impact learning - power distance is an integral component of this relationship. This study drew on Hofstede's Model of National Culture to compare UK and Sri Lankan students' and teachers' experiences of power in online and face-to-face learning environments.

Methods: A qualitative, exploratory approach was employed. Fourteen interviews and two focus groups were undertaken with undergraduate medical students and teachers in the two settings, during which participants drew their perceptions of power in both learning environments (online and face-to-face). These rich pictures were analysed using aesthetic analysis alongside participants' interview responses, to explore patterns and construct themes for reporting.

Results: Though differences between cultures and learning environments were expected, teachers and students in both countries shared understandings of power distance in the teacher-student relationship and expected the teacher to hold power in both online and face-to-face environments. Teachers expressed a desire to lessen hierarchical relationships and attempted to minimise power differentials when online or face-to-face. Strategies for reducing power distance included addressing students by name, using informal and respectful communication, establishing common ground and showing their 'humane' side.

Discussion: To achieve greater partnership with students, it is recommended that educators recognise students' strengths and leverage possibilities within their chosen learning environment to modulate the degree of power distance, promote participation and optimise learning.