Adjusting to Disrupted Assessments, Placements and Teaching (ADAPT): a snapshot of the early response by UK medical schools to COVID-19

Ashcroft

Alexander

et al. 2021

Preprint

Self Cite

Background and objectives: Covid-19 has led to global disruption of healthcare. Many students volunteered to provide clinical support. Volunteering to work in a clinical capacity was a unique medical education opportunity; however, it is unknown whether this was a positive learning experience or which volunteering roles were of most benefit to students. Methods and Design: The COVIDReady2 study is a national cross-sectional study of all medical students at UK medical schools. The primary outcome is to explore the experiences of medical students who volunteered during the pandemic in comparison to those who did not. We will compare responses to determine the educational benefit and issues they faced. In addition to quantitative analysis, thematic analysis will be used to identify themes in qualitative responses. Discussion: There is a growing body of evidence to suggest that service roles have potential to enhance medical education; yet, there is a shortage of studies able to offer practical advice for how these roles may be incorporated in future medical education. We anticipate that this study will help to identify volunteer structures that have been beneficial for students, so that similar infrastructures can be used in the future, and help inform medical education in a non-pandemic setting.

Section: Discussionmentioning

confidence: 99%

COVIDReady2 Study Protocol: Cross-sectional Survey of Medical Student Volunteering and Education During the COVID-19 Pandemic in the United Kingdom

Ashcroft

Alexander

et al. 2021

Preprint

Self Cite

“…In response to this, medical schools accelerated the graduation of over 5000 final year medical students to act as interim postgraduate year one doctors 2 , and volunteering opportunities were created for non-final year students 3 . As clinical placements were cancelled and medical school examinations postponed or replaced, there was the potential for many students to volunteer 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Examining Medical Student Volunteering During The COVID-19 Pandemic As A Prosocial Behavior During An Emergency

Ashcroft

Wan

et al. 2021

Preprint

Introduction: COVID-19 has caused major disruptions to healthcare, with voluntary opportunities offered to medical students to provide clinical support. We used the conceptual framework of prosocial behavior during an emergency - behaviors whose primary focus is benefiting others - to examine volunteering during COVID-19. Methods: We conducted an in-depth, mixed-methods cross-sectional survey, from 2nd May to 15th June 2020, of medical students studying at UK medical schools. Data analysis was informed by Latane and Darley's theory of prosocial behavior during an emergency and aimed to understand students' decision-making processes. Results: A total of 1145 medical students from 36 medical schools completed the survey. While 947 (82.7%) of students were willing to volunteer, only 391 (34.3%) had volunteered. The majority (92.7%) of students understood that they may be asked to volunteer; however, we found that deciding one's responsibility to volunteer was mitigated by a complex interaction between the interests of others and self-interest. Further, concerns revolving around professional role boundaries influenced students' decisions over whether they had the required skills and knowledge to volunteer. Deciding to volunteer depended not only on possession of necessary skills, but also seniority and identification with the nature of volunteering roles offered. Conclusions: We propose two additional domains to Latane and Darley's theory of prosocial behavior during an emergency that students consider before making their final decision to volunteer. These are 'logistics' - whether it is logistically feasible to volunteer - and 'safety' - whether it is safe to volunteer. This study highlights a number of modifiable barriers to prosocial behavior that medical students encounter and provides suggestions regarding how Latane and Darley's theory of prosocial behavior can be operationalized within educational strategies to address these barriers. Optimizing the process of volunteering can aid healthcare provision and may facilitate a safer volunteering process for all.

“…During the Covid-19 pandemic, all three curricula (formal, informal and hidden) were disrupted by reformulations to university studies and clinical placements. The formal curriculum shifted online, with relative success in transforming didactic teaching and assessment into digital formats [11][12][13] . By moving these sessions online, and, in many cases, removing students from the clinical environment 12 , medical students had less access to informal conversations with their peers and seniors.…”

Section: Introductionmentioning

confidence: 99%

“…The formal curriculum shifted online, with relative success in transforming didactic teaching and assessment into digital formats [11][12][13] . By moving these sessions online, and, in many cases, removing students from the clinical environment 12 , medical students had less access to informal conversations with their peers and seniors. The structures, social norms and culture that comprise the hidden curriculum to which medical students are usually exposed were also disrupted, if not irrevocably changed, by such an international crisis.…”

Section: Introductionmentioning

confidence: 99%

‘I don’t feel like I’m learning how to be a doctor’: early insights regarding the impact of Covid-19 on UK medical student professional identity

Harvey

Brown

et al. 2021

Preprint

Phenomenon Professional identity development is recognised as a core goal of medical education alongside knowledge and skill acquisition. Identity is a complex entity that can be conceptualised as externally influenced, but individually constructed. Integration from legitimate bystander to "old timer" of the medical community of practice provides a backdrop for individual negotiation of professional identity. During Covid-19, the medical community of practice and education experienced significant disruption. We sought to investigate how these disruptions impacted professional identity development by examining conflicts between students' identities highlighted by the pressures of the pandemic. Approach A mixed-methods survey was distributed to medical students in the UK. The survey was active from 2nd May to 15th June 2020, during the height of the first wave of the Covid-19 pandemic in the UK. Operating within the paradigm of constructivism, we conducted a reflexive thematic analysis of qualitative responses. Analysis was focused around the disruption to medical education, actions taken by medical students during this disruption, and the tension between student actions where they existed in conflict. Findings Three themes were constructed to describe the identities that participants felt were in conflict during the first wave of the Covid-19 pandemic: Status and role as a future doctor; status and role as a student; and status and role as a member of the wider community. Students noted that lack of clinical exposure was detrimental to their education, implicitly recognising that many aspects of professional identity formation are forged in the clinical environment. Participants were keen to volunteer clinically but struggled to balance this with academic work. Participants worried about the risk to their families and the wider community, and wanted to ensure that their skills would add value to the clinical environment. Volunteers felt frustrated when they were unable to perform tasks which aligned with their identities future doctors, with the exception of participants who worked as interim FY1s (FiY1s), which aligned well with the roles of FY1s. Insights As hypothesised, the participants in this study experienced disruptions to their professional identity development during the first wave of the Covid-19 pandemic in 2020. This work provides early evidence, collected at the beginning of the pandemic, that the effects of disruptions to professional identity development were wide-reaching, often negative, and represent an important topic for future exploration. Given that the pandemic has highlighted areas of identity tension, these findings have the potential to provide insight into how medical training can better nurture professional identity development during and beyond international crises.