Student Perspectives on Remote Medical Education in Clinical Core Clerkships During the COVID-19 Pandemic

Abstract

Purpose To assess student perceptions of remote learning curricula implemented by clinical clerkships at a single US medical school during the COVID-19 pandemic. Method Students enrolled in core clinical clerkships at the UC San Diego School of Medicine from March to April 2020 were sent an anonymous online survey, assessing components of remote learning curricula via quantitative rating and free-response questions. Results Of 132 students enrolled, 96 (73%) completed the survey. Online question banks, remote progress reviews, and telehealth sessions were rated as the most valuable resources, while textbooks were rated least valuable. Most students felt that the number of resources was adequate (69/94, 74%), the quantity of required content was appropriate (77/93, 83%), and there was a good balance of rigidity versus flexibility in the schedule (81/94, 86%). Most students felt "prepared" or "somewhat prepared" for the shelf examination (61/91, 67%) and for the next year of medical training (73/94, 78%). In narrative reflections, students valued the flexibility afforded by remote curricula but desired some weekly structure. Students enjoyed expanded access to learning resources and participating in interactive remote sessions. Students expressed anxiety about the pandemic and uncertainty regarding medical education, but transparent communication from clerkship directors helped assuage these concerns. Conclusions Student participation in direct patient care is fundamental to medical school core clerkships and was negatively impacted by the COVID-19 pandemic. Strategic incorporation of select remote learning components into clinical clerkships may permit a favorable student experience even when opportunities for on-site participation are limited.

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.…”

“…5 ). Practice guidelines [ 11 , 12 , 20 , 22 ] and training for faculty and students were provided [ 10 , 14 , 16 , 18 , 20 , 22 , 24 ] prior to encountering patients over the telehealth platform. In-advance informed consent from the patients were obtained and screening took place to ensure patients had the appropriate virtual interfaces [ 18 , 19 , 21 ].…”

“…Rapid protocol and practice guideline updates by hospital leadership, EMR education and academic credit reward for student participation. 1,2,4,8,9,12 Univ OBGYN US Coffey et al [ 12 ] Provision of practice guidelines for telehealth visits. Students joined as observers or participation.…”

The Clinical Information Systems Response to the COVID-19 Pandemic

“…Direct observation and participation in clinical care is a critical component of medical education, yet in response to the need to minimize infection exposure and enable social distancing, many medical students and other trainees were initially excluded from the clinical setting or thrust into new modalities of care that disrupted traditional clinical supervision practices. Creative deployment of telehealth technologies such as virtual rounds [ 79 ] and proctored telehealth visits [ 80 ] enabled trainees to safely rejoin clinical conversations and participate in clinical care [ 81 ]. Similarly, where appropriate, telehealth has also been recommended and deployed to enable the continued conduct of clinical trials while minimizing risks to participants [ 82 ].…”

Teaching psychiatry to medical students in the time of COVID-19: experiences from UK medical schools

“…Students have responded positively to the adaptations to teaching and, mirroring the changes predicted by our respondents, want to continue with online lectures and increased access to online resources in the future. 39 It remains to be seen whether reactive adaptations implemented during the pandemic will be sustainable, and help to manage another impending challenge: the surge in student numbers resulting from the government temporarily lifting the cap on medical school places. 40 One year on from the first national lockdown, the course of the pandemic remains uncertain.…”