Medical students’ preference for returning to the clinical setting during the COVID‐19 pandemic

Abstract

Objectives The coronavirus disease 2019 (COVID‐19) pandemic has led to widespread disruptions in the clinical education of medical students. In managing students’ return to the clinical setting, medical schools face the challenge of balancing education, service and risk considerations. To compound this challenge, medical students may prefer not to re‐enter during a period of great uncertainty, leading to substantive downstream sequelae on individual, institutional and national levels. Understanding students’ views on resuming clinical experiences, therefore, is an important consideration. The purpose of this study was to assess medical students’ preference for re‐entering the clinical setting during the COVID‐19 pandemic and to explore personal and environmental characteristics associated with that preference. Methods We conducted an electronic survey of currently enrolled medical students at the Duke‐NUS Medical School, less than a month into the COVID‐19 pandemic. Survey items were aligned with a conceptual framework related to medical students’ preference for returning to the clinical setting. The framework consisted of three domains: (a) non‐modifiable demographic information; (b) factors thought to be modifiable through the course of medical education, including burnout, tolerance for ambiguity, motivation and professionalism, and (c) students’ perception of COVID‐19 infection risk to self. Results Approximately one‐third (n=63) of 179 students preferred not to return to the clinical setting. Results of a multivariable analysis indicated that compared to this group, the two‐thirds (n=116) of students favouring return showed evidence of greater autonomous (or internal) motivation, a greater sense of professional responsibility and a lower self‐perception of harbouring risk to patients. Conclusions Students’ preference on returning to the clinical environment stems from the interplay of several key factors, and is substantively associated with perceptions of professional responsibility and their own potential risk to the health care system. Mindfully considering and addressing these issues may help medical schools in their preparation for returning students to the clinical setting.

Response to: ‘Medical students’ preference for returning to the clinical setting during the COVID‐19 pandemic’

“…Editor -As fourth-year medical students in the United Kingdom who have had to adapt to working from home amidst the nationwide cancellation of clinical placements, we read with interest Compton et al's survey assessing the prevalence of medical students' preference for re-entering clinical environments during the coronavirus disease 2019 (COVID-19) pandemic. 1 The finding that approximately two-thirds of surveyed students expressed a preference to return to clinical placements resonates with us. 1 Following the cancellation of undergraduate clinical learning activities, our institution provided a series of online problem-based learning seminars to ensure we met our learning objectives.…”

Attitudes and concerns of health sciences students in Croatia regarding complete switch to e-learning during COVID-19 pandemic: a survey

“…Compton et al surveyed medical students of Duke-NUS Medical School in Singapore, less than a month after the pandemic onset, and found that about a third of the surveyed 179 students would not prefer to return to the clinical setting; the students' willingness to return to the clinical environment was associated with personal characteristics and students' perceptions about the risk to the healthcare systems [15,16].…”

Alternative approaches for clinical clerkship during the COVID-19 pandemic: Online clinical practice for inpatients and outpatients - A mixed method -

“…Since it is unclear when the situation will be under control and there is a possibility of a recurrence of the epidemic due to various factors, such as intensive care capacity, development of vaccines and treatments, and the in ux of visitors from foreign countries (17,18), CC may be discontinued again. Furthermore, some medical students may not want to return to the clinical setting under the current circumstances (19). Therefore, the demand for online alternatives will be high.…”