Medical students’ adoption and evaluation of a completely digital general practice clerkship – cross-sectional survey and cohort comparison with face-to-face teaching

Abstract

Background During the COVID-19 pandemic, the University of Leipzig completely switched to online teaching. Thus, we developed a practice-oriented digital substitute for a two-week mandatory general practice (GP) clerkship. Main components were processing of clinical cases and additional GP topics, visual diagnoses, information and examination videos, and regular remote exchanges with associated GP teachers. We took the chance to comprehensively evaluate the new teaching formats (acceptance, use, working enjoyment, learning gain, practical relevance, insights into general practice) and to compare evaluations with two previous semesters to gain insights for future blended learning concepts. Methods Cross-sectional post-hoc online evaluation among fourth year (of six) medical students participating in the digital mandatory 2-week GP clerkship during summer semester 2020; additional cohort comparison with two previous semesters (face-to-face clerkship). Results Out of 192 participants in the digital clerkship, 99 completed our questionnaire (response rate = 51.6%). Results were compared with 277 previous evaluations (face-to-face semesters). Most participants reported having enjoyed the online-based clerkship (87.9%), having learned a lot (89.9%), having gained insights into general practice (76.8%), and perceived high practical relevance (90.9%). Implementing the new teaching formats into future face-to-face clerkships was welcomed by 65.6%. Clinical cases, visual diagnoses, examination videos and communication with GP teachers were rated best regarding working enjoyment, learning gain, practical relevance and insights into a GP’s work. Cohort comparison revealed somewhat better evaluations regarding knowledge transfer for the digital clerkship while imparting of skills and attitudes was reportedly worse. Conclusions Students welcomed the digital content and perceived relevant learning gain. Our results may help to develop future blended learning concepts. Clinical cases, examination videos and visual diagnoses appear to be particularly suitable as useful online complements which could enrich face-to-face teaching. As students especially valued the exclusive time for exchanges with their preceptor, this should be facilitated in face-to-face clerkships.

Virtual Simulated Placements in Healthcare Education: A scoping review

“…There were no differences in grades when post-VSP exam scores were compared with previous cohorts’ who attended a FTF placement pre-pandemic. Student satisfaction was comparable in a study conducted in medical general practice, but professional exchange and learning scored higher in the VSP, while the attainment of new skills and attitudes scored higher in the FTF placement [33]. One paper compared students who participated in virtual readouts (the radiology equivalent of patient rounds) with students who attended workplace readouts pre-pandemic [28].…”

“…If framed within existing standards [40, 49], VSPs can align with specified learning outcomes. Principles in pedagogy such as andragogy [29, 30] and online learning [33, 50], ensure that VSPs build features that engage students with experiential learning [30], promote problem solving [29–30, 39] and active reflection [49]. The conceptual underpinnings documented across this body of literature could provide a blueprint for best practice in VSP design.…”

Students' and lecturers' perspectives on the implementation of online learning in medical education due to COVID-19 in Germany: a cross-sectional pilot study

“…Lecturers were able to acquire digital skills and taught more digitally as students wanted to create more teaching formats in attendance. Therefore, the different reasons are known ( 23 ). As one of the main reasons, the explicit students of study by Olmes et al named the poor quality of the teaching formats in digital form, the lack of human exchange with other students, or even the lecturers ( 24 ).…”

COVID-19 related disruptions to medical education and perceived clinical capability of new resident physicians: a nationwide study of over 1200 first-year residents

“…While many of the skills assessed could be obtained via small group discussions, simulated patient encounters, and online case discussions, others simply do not lend themselves easily to a distance learning environment. Taking a history and developing a plan for diagnosis and treatment likely was done repeatedly during online clerkships, leading to these students feeling comfortable with cognitive aspects of clinical skills [ 42 ]. Students also may feel that they developed basic physical examination skills during their third year of medical school which was less affected by COVID-19 in this cohort.…”