Internal Medicine Clerkship Amidst COVID-19 Pandemic: A Cross-Sectional Study of the Clinical Learning Experience of Undergraduate Medical Students at Makerere University, Uganda

Abstract

Background The coronavirus-2019 (COVID-19) pandemic continues to impose a significant impact on medical education. We aimed to describe the clinical learning experience of undergraduate medical students undertaking internal medicine clerkship during the COVID-19 pandemic at Makerere University, Uganda. Methods A descriptive, cross-sectional study among medical students in clinical years of study pursuing the Bachelor of Medicine and Bachelor of Surgery undergraduate degree program was conducted in November 2020. Only 3rd (junior clerks) and 5th (senior clerks) year medical students whose internal medicine clerkships were interrupted by the COVID-19 pandemic were studied. Results Data of 188 (95%) eligible clinical year students; junior (101, 54.0%) and senior (86, 46.0%) were analysed. Median age was 24 (range: 22–42) years. Majority (70.1%) were male and Ugandan nationals (94.1%). Sixty-four (30.3%) students reported inadequate personal protective equipment, 152 (81.7%) felt at risk of contracting COVID-19, and 127 (67.9%) said it was difficult to observe COVID-19 standard operating procedures. Twenty-two students (11.9%) were discouraged from pursuing a career in internal medicine. Overall, most students reported good or excellent clinical experience pre-COVID-19 era compared to during the COVID-19 era (4.0 vs 3.5, p<0.0001). Senior clerks significantly believed that the time allocated for the rotation was adequate (p<0.0001) and they were able to complete their study objectives (p<0.001), compared to the junior clerks. Senior clerks believed that learning was difficult when combined with junior clerks (p=0.013). About half of the students (51.4%, n=95) reported clinical teaching should remain as it was in the pre-COVID-19 era. Conclusion The COVID-19 pandemic has had a significantly negative effect on the clinical learning experience of the students. There is need to review the current teaching and learning methods to suit teaching and learning during pandemics of highly infectious diseases to ensure safe and effective learning experience.

Health professional student’s volunteering activities during the COVID-19 pandemic: A systematic literature review

“…In this unprecedented era, e-learning may be an ideal option ( 3 ). However, it seems more applicable to preclinical phases of medical education, which are lecture-based.…”

“…In contrast, clinical stages of medical education oblige students to work in interdisciplinary teams to practice their newly acquired clinical abilities while learning about the healthcare system. Therefore, the shift to e-learning may not facilitate clinical skills and competency acquisition during this stage ( 3 , 4 ). However, it is understandable that medical schools had to postpone clinical clerkships to reduce student exposure, flatten the curve, and protect healthcare workers during the pandemic due to a lack of personal protective equipment (PPE) ( 5 ).…”

Interest in Infectious Diseases specialty among Japanese medical students amidst the COVID-19 pandemic: A web-based, cross-sectional study

“…Looking back, emerging pandemics such as Severe Acute Respiratory Syndrome (SARS) [ 9 – 11 ], the 2009 H1N1 influenza [ 12 ], and the Middle East Respiratory Syndrome [ 13 ] have significantly impacted medical students. The negative effects of the COVID-19 pandemic on medical education have also been reported in various fields such as surgical training [ 14 ], pre-clerkship, and clerkship learning [ 15 , 16 ], A survey on medical students in the United States suggested that about one-fifth of the respondents considered that the COVID-19 pandemic would unfavourably influence their choices of professional specialty [ 17 ]. Another report revealed that career choices for being good physicians markedly increased among two-thirds of students, although they focused on paediatric fields [ 18 ]; however, to the best of our knowledge, no survey has specifically investigated medical students’ career choices toward becoming ID specialists during an emerging pandemic.…”

The Virtual Team Member: Remote Engagement of Medical Students in COVID-19 Care

“…Depending on the location, the impact of COVID-19 continues to vary widely among AAMC-member medical schools with geographic containment seen but also simultaneous outbreaks and surges in cases across the country and the world where regions in south-east Asia and South America are being disproportionately affected during this spring resurgence. Medical students across the world have been placed in a challenging situation where the disruption of valuable clinical education adds to the sense of inadequate preparedness as future healthcare providers [ 23 – 25 ]. Telemedicine has been increasingly adopted during the pandemic and will likely have a permanent place in the future of healthcare [ 26 ].…”