The rapid advancement of digital technologies in education is revolutionizing learning environments and influencing the future of educational methodologies. This study seeks to determine the parameters affecting students’ satisfaction with e-learning platforms utilized during the COVID-19 pandemic, within a multimodal educational framework. A Structural Equation Modeling (SEM) approach was used to examine the contributions of different components to students’ views of e-learning tools and the inter-relationships between them. Data were gathered from 314 students via a questionnaire, with the dependent variable being student satisfaction with e-learning platforms and the independent variables comprising the perceived benefits and disadvantages, ease of use, prior experience, perceptions of the platforms, perceived risks, and communication efficiency between students and professors. The results indicated that 78% of the variance in student satisfaction was explained by these parameters (R-squared = 0.78), underscoring the substantial impact of these features on the digital learning experience. This study enhances the comprehension of the influence of e-learning platforms within a multimodal educational framework on students’ learning experiences, especially with the challenges presented by the pandemic. The collected insights can guide the development of more effective, accessible, and user-focused educational tools.

Background and Objectives: Transesophageal echocardiography (TEE) is considered an indispensable tool for perioperative evaluation in mitral valve (MV) surgery. TEE is routinely performed by anesthesiologists competent in TEE; however, in certain situations, the expertise of a senior cardiologist specializing in TEE is required, which incurs additional costs. The purpose of this study is to determine the indications for specialized perioperative TEE based on its utility and the correlation between intraoperative TEE diagnoses and surgical findings, compared with routine TEE performed by an anesthesiologist. Materials and Methods: We conducted a three-year prospective study involving 499 patients with MV disease undergoing cardiac surgery. Patients underwent intraoperative and early postoperative TEE and at least one other perioperative echocardiographic evaluation. A computer application was dedicated to calculating the utility of each type of specialized TEE indication depending on the type of MV disease and surgical intervention. Results: The indications for performing specialized perioperative TEE identified in our study can be categorized into three groups: standard, relative, and uncertain. Standard indications for specialized intraoperative TEE included establishing the mechanism and severity of MR (mitral regurgitation), guiding MV valvuloplasty, diagnosing associated valvular lesions post MVR (mitral valve replacement), routine evaluations in triple-valve replacements, and identifying the causes of acute, intraoperative, life-threatening hemodynamic dysfunction. Early postoperative specialized TEE in the intensive care unit (ICU) is indicated for the suspicion of pericardial or pleural effusions, establishing the etiology of acute hemodynamic dysfunction, and assessing the severity of residual MR post valvuloplasty. Conclusions: Perioperative TEE in MV surgery can generally be performed by a trained anesthesiologist for standard measurements and evaluations. In certain cases, however, a specialized TEE examination by a trained senior cardiologist is necessary, as it is indirectly associated with a decrease in postoperative complications and early postoperative mortality rates, as well as an improvement in immediate and long-term prognoses. Also, for standard indications, the correlation between surgical and TEE diagnoses was superior when specialized TEE was used.