Medical students consulting from home: A qualitative evaluation of a tool for maintaining student exposure to patients during lockdown

Abstract

Introduction: Lockdowns during the COVID-19 pandemic had a disruptive effect on medical education when they prevented medical students accessing real patients. To address this, we piloted 35 medical students at home consulting remotely with patients. Method: We evaluated the intervention using qualitative analysis of post-experience interviews with a sample of 13 students and 10 clinical supervisors. Results: The experience was perceived by all those interviewed to be both acceptable and educationally valuable. Data analysis revealed different models of implementation according to type of patients involved (acute, recently treated or expert patients) and type of communication platform used (AccuRx, Microsoft Teams or telephone). Practical and educational challenges were identified in relation to the following elements of the experience: patients consulting with students remotely, students being remotely supervised and students undertaking patient contact from home. Strategies for addressing these challenges were directly suggested by interviewees and also inferred from our analysis of the data. Conclusions: Remotely supervised medical students at home undertaking remote consultations with patients can be acceptable and educationally valuable. The intervention was piloted in a UK graduate entry medical course and so it would be useful to replicate this study in other medical student populations.

A scoping review on adaptations of clinical education for medical students during COVID-19

“…Adding to previous reviews, we found reports using telemedicine to overcome the challenges in clinical education amidst the pandemic disruption ( Table 2 ). 17 papers [ 8 , 9 , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] ] described the use of telemedicine as an educational tool mostly for clerkship rotations but three also included pre-clinical year students. Whilst telemedicine was mainly implemented in university hospitals, six programs were also executed in the community.…”

“… 4,6,8,9 Comm FM US Ruiz Colon et al [ 22 ] Students performed history taking, delivery of patient education and counselling after receiving basic telehealth training. 2,4,5 Comm FM US Darnton et al [ 23 ] a pre-clinical students already educated in basic clinical communication and exam skills consulted from own home whilst supervised by primary care physician in three-way telemedicine clinic. 1,2,4 Comm FM GB Paul et al [ 24 ] Community care medicine involved final year students in telemedicine clinics and provided online small group teachings.…”

“…A unique program led by Stanford University’s students, called Cardinal Free Clinics, opened immediately after the onset of the pandemic, and changed to a telehealth clinic model when in-person patient clinics were forced to close due to university COVID-19 policies [ 22 ]. In the UK, Darnton et al [ 23 ] used telemedicine for teaching pre-clinical medical student in the community. 35 second year students were spread across nine primary care organisations and participated in real-life telemedicine consultations.…”

“…Some studies reported online delivery of clinical education for preclinical students [ 23 , [25] , [26] , [27] , [28] ]. Knie et al [ 27 ] implemented communication skills by interviewing simulated patients over Zoom, resulting in higher satisfaction levels than role-playing among themselves.…”

Medical education challenges and innovations during COVID-19 pandemic

“…37 38 These difficulties can be more evident in developing countries which encounter many more technological challenges compared with technologically advanced countries that can implement ODE much easier. [13][14][15] In summary, the outbreak of COVID-19 has brought on new and unforeseen challenges in the field of medical education, related to the development of online learning. As the shift to online education poses important challenges, medical schools should be prepared to ensure a successful educational environment for medical students through emphasising the tech-based pedagogy, advising, motivating, inviting medical students' feedback, as well as through supporting medical educators to adapt to the new reality.…”