A phenomenological exploration of the impact of COVID‐19 on the medical education community

Abstract

Introduction The COVID‐19 pandemic has caused unprecedented stress to the medical education community, potentially worsening problems like burnout and work‐life imbalance that its members have long been grappling with. However, the collective struggle sparked by the pandemic could generate the critical reflection necessary for transforming professional values and practices for the better. In this hermeneutic phenomenological study, we explore how the community is adapting—and even reconceptualising —their personal and professional roles amidst the COVID‐19 crisis. Method Between April and October 2020, we conducted 27 (17F, 10M) semi‐structured interviews with medical trainees (8), physicians (8), graduate students (3) and PhD scientists (8) working in medical education in Canada, the United States and Switzerland. Data analysis involved a variety of strategies, including coding for van Manen's four lifeworld existentials, reflexive writing and multiple team meetings. Results Participants experienced grief related to the loss of long‐established personal and professional structures and boundaries, relationships and plans for the future. However, experiences of grief were often conflicting. Some participants also experienced moments of relief , perceiving some losses as metaphorical permissions slips to slow down and focus on their well‐being. In turn, many reflected on the opportunity they were being offered to re‐imagine the nature of their work. Discussion Participants' experiences with grief, relief and opportunity resonate with Ratcliffe's account of grief as a process of relearning the world after a significant loss. The dismantling of prior life structures and possibilities incited in participants critical reflection on the nature of the medical education community's professional practices. Participants demonstrated their desire for more flexibility and autonomy in the workplace and a re‐adjustment of the values and expectations inherent to their profession. On both individual and systems levels, the community must ensure that long‐standing calls for wellness and work‐life integration are realised—and persist—after the pandemic is over.

From struggle to opportunity: Reimagining medical education in a pandemic era

“…In an unintended way, the pandemic seems to have motivated us to engage in praxis, albeit in different ways and admittedly, with varying levels of consciousness and consequence. For many, the last year has heightened concern towards pre-existing systemic inequities like access to healthcare and health outcomes for different groups within society—motivating individuals to speak up about structural stigma and invest time and resources into building meaningful relationships within their communities to address identified needs [ 4 , 27 , 28 ]. For others, the pandemic has served as a catalyst to acknowledge and voice how deeply onerous learning and working in medicine and medical education can be [ 29 , 30 ], and how easy it is to become complacent to these often harmful and invisible structures so steeped in our professional culture.…”

“…Perhaps, then, one of the hopeful elements surfacing because of the pandemic is permission to slow down, reimagine routines, enforce new boundaries, assess role priorities, and adopt work schedules that have the potential to protect, rather than hamper, personal and professional efficacy [ 4 ]. For some, this may mean carving out greater space for intellectual exploration, critical introspection, or advocacy work.…”

“…For many, the pandemic era has shown that time is flexible, presence is malleable, and productivity ebbs and flows [ 4 ]. Perhaps, then, we need to re-envision what working amidst a global pandemic has come to mean and, more specifically, what we can realistically expect from people in a time of precarity.…”

“…Medical education faculty and staff have worked tirelessly to mitigate the impact of the COVID-19 pandemic on admission processes, clinical placements, examinations, and the sustainability of the medical workforce [ 1 – 3 ]. Undeniably, COVID-19 has demanded an ‘all hands-on deck’ response, and conversations occurring throughout the medical education community and across social media this past year suggest that those working and learning in medical education are shifting—and, in some cases, re-conceptualizing—their personal and professional roles and responsibilities [ 4 ].…”

Time to reflect: How has COVID‐19 transformed you? A commentary

“…In this issue of Medical Education, Luong and colleagues describe the effects of the pandemic on the personal and professional roles of the medical education community 1 . The effects of the health crisis on the roles and responsibilities in clinical clerkships are described by Noerholk and colleagues 2 .…”