In response to COVID-19 mitigation policies, mental health and social service agencies have had to rapidly change their operations, creating challenges for patients with serious mental illness (SMI). This study aimed to explore the experiences of adults with SMI navigating these altered systems during the pandemic. In-depth interviews were conducted with 20 hospitalized adults with SMI in the fall of 2020; they were coded using thematic analysis. Most participants found the new systems effective at meeting their essential needs. However, several reported significant unmet needs, including inability to access mental health care and public benefits. These participants lacked identification documents, housing, and/or a personal device. Although none of the participants used telemedicine before COVID-19, most reported no or minimal problems with telemental health. Those reporting difficulties did not have personal devices, were receiving audio-only services, or viewed telemedicine as less personal or too distracting.
Phenomenon: The American medical student perspective on the coronavirus pandemic, particularly in terms of its effects on medical education and future curricular approach, is valuable. This study seeks to provide future physicians with a voice to share their personal experience with distance learning and suggestions for medical education reform in the era of COVID-19. Approach: A virtual focus group of medical students was conducted on April 30, 2020. Each student was asked to broadly and candidly reflect on their personal experiences relative to the COVID-19 pandemic, and to specifically expound upon how their personal growth and medical education has been impacted. Consent was obtained. Data was coded by key ideas and themes. The content of the discussion was analyzed. Findings: Seven third-year medical students attending a United States traditional school of medicine consented to participate. All participants provided extensive responses to the question. The focus group lasted for 2 hours. The group expounded upon five self-initiated themes: guilt, anxiety, self-awareness, volunteerism, and autonomy. Analysis of these themes from the context of medical student wellness and the future of medical curricula led to the conclusion that three general concepts should be emphasized in reforming medical education. Insights: The coronavirus pandemic has uniquely affected medical students. Their perspectives can inform medical education reform relative to curricular design and student wellness. Key concepts to consider include prioritizing routine virtual delivery of content through innovative technology, encouraging increased student autonomy and self-directed learning through less prescriptive schedules, and emphasizing reflection training and sharing.
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