Purposeful Inaction in COVID-19. A Medical Student Perspective.
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ABSTRACT:
SUBMITTER: Pingali H
PROVIDER: S-EPMC8357071 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe COVID-19 pandemic has revealed the importance of teaching medical students pandemic preparedness and COVID-19 related clinical knowledge. To fill the gap of COVID-19 instruction backed by evaluation data, we present a comprehensive COVID-19 pilot curriculum with multiple levels of evaluation data.MethodsIn the spring of 2020, the University of California, Irvine (UCI) School of Medicine piloted a two-week, primarily asynchronous COVID-19 elective course for medical students. The goal of the course is to provide a foundation in clinical care for COVID-19 while introducing students to emerging issues of a modern pandemic. Objectives align with institutional objectives, and instruction is delivered in thematic modules. Our curriculum utilizes numerous instructional strategies effective in distance learning including independent learning modules (ILM), reading, video lectures, discussion board debates, simulation and evidence-based argument writing. We designed a three-level, blended evaluation plan grounded in the Kirkpatrick and Kirkpatrick evaluation model that assessed student satisfaction, relevance, confidence, knowledge and behavior.ResultsOur end of course survey revealed that students had high levels of satisfaction with the curriculum, and felt the course was relevant to their clinical education. Various assessment tools showed excellent levels of knowledge attainment. All respondents rated themselves as highly confident with the use of personal protective equipment, though fewer were confident with ventilator management.ConclusionOverall our pilot showed that we were able to deliver relevant, satisfying COVID-19 instruction while allowing students to demonstrate knowledge and desired behaviors in COVID-19 patient care.
| S-EPMC8782135 | biostudies-literature
Project description:BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has created significant obstacles within medical education. For medical students interested in pursuing neurosurgery as a specialty, the educational policies surrounding COVID-19 have resulted in unique challenges. The present study used a nationwide survey to identify the concerns of medical students interested in pursuing neurosurgery during the COVID-19 pandemic.MethodsStudents who had previously registered for medical student neurosurgery training camps were sent an online Qualtrics survey requesting them to assess how the COVID-19 pandemic was affecting their neurosurgical education. The Pearson ?2 test and post hoc pairwise Fisher exact test were used for analysis of categorical variables, and the 2-tailed paired Student t test was used for continuous variables.ResultsThe survey was distributed to 852 medical students, with 127 analyzed responses. Concerns regarding conferences and networking opportunities (63%), clinical experience (59%), and board examination scores (42%) were most frequently cited. Of the third-year medical students, 76% reported ?1 cancelled or postponed neurosurgery rotation. On average, students were more likely to take 1 year off from medical school after than before the start of the COVID-19 pandemic, measured from 0 to 100 (25.3 ± 36.0 vs. 39.5 ± 37.5; P = 0.004). Virtual mentorship pairing was the highest rated educational intervention suggested by first- and second-year medical students. The third- and fourth-year medical students had cited virtual surgical skills workshops most frequently.ConclusionsThe results from the present nationwide survey have highlighted the concerns of medical students regarding their neurosurgery education during the COVID-19 pandemic. With these findings, neurosurgery organizations can consider targeted plans for students of each year to continue their education and development.
| S-EPMC7229732 | biostudies-literature
Project description:BackgroundUndergraduate medical education was severely impacted by the COVID-19 pandemic. As traditional clinical rotations were suspended, medical students quickly began alternative, novel educational experiences. Third-year medical students at an academic medical center were given the opportunity to join inpatient eConsult teams within the department of medicine. This study describes the development and implementation of this program as well as the experiences of student and faculty participants.MethodsStudent eConsult participation was rapidly developed and implemented within medical subspecialty teams in either infectious diseases (ID) or nephrology. Twelve third-year medical students and 15 subspecialty attendings participated in this program during an eight-week period from April 6 through May 29, 2020. Breadth of student clinical experience was assessed via review of clinical documentation and surveys. Participating students and attending physicians completed surveys to reflect upon their impressions of the program. Surveys were returned by nine students and eight faculty members. Survey responses were summarized with descriptive statistics.ResultsOver an eight-week period, student consultants wrote 126 notes on 100 patients; 74 of these patients (74%) were hospitalized with COVID-19. Student experiences were largely positive with most strongly agreeing that attendings promoted interactive and engaged learning (N = 8 of 8, 100%), that the experience helped to expand their knowledge about consultant roles (N = 6, 75%), and that they would participate in a remote eConsult program again if given the opportunity (N = 6, 75%). Faculty also were largely positive about the experience with most agreeing or strongly agreeing with the importance of teaching medical students about telehealth (N = 7 of 8, 88%) and eConsults (N = 6, 75%). In narrative responses, students and faculty agreed that teaching was a strength of the program whereas lack of in-person contact was a challenge.ConclusionsRapid development of an inpatient eConsult-based educational experience for third-year medical students was feasible and successful. Student-consultants saw a range of pathology including COVID-19 and related complications. Students were satisfied with the program. They were able to develop a strong relationship with attendings while learning about the role of a consultant. Faculty agreed with the importance of teaching students about telehealth and eConsults specifically.
| S-EPMC7897886 | biostudies-literature
Project description:COVID-19 has had significant effects on the field of veterinary medicine. Adaptation to pandemic-related and post-pandemic challenges requires engagement from all levels of the professional pipeline, including veterinary college students. Insights gained from this group may inform curriculum design, help the veterinary profession innovate, maximize opportunities for positive change, and avoid negative outcomes. The current study aimed to understand the potential impacts of the COVID-19 pandemic on veterinary medicine, as foreseen by second-year veterinary students in an online discussion during a public health course in the spring of 2020. Twenty-one percent of the 113 students agreed to participate in this qualitative research study. We used an inductive coding process and distilled the student responses into descriptive themes to capture diverse perspectives and understand possible post-pandemic pathways for the veterinary profession. Four themes emerged from the student discussion posts, describing how veterinarians might be affected by the COVID-19 pandemic: (1) economic and social impacts, (2) adapting to challenges, (3) collaborations to improve public health, and (4) disparities and diversity. These themes are a starting point for discussion and innovation as veterinarians plan for the post-pandemic world; further investigation will provide additional guidance for veterinary leaders.
| S-EPMC8551393 | biostudies-literature
Project description:BackgroundDuring the Covid-19 pandemic medical students were offered paid roles as medical student healthcare assistants. Anecdotal reports suggested that students found this experience rich for learning. Previous studies have explored alternative models of student service, however this defined medical student support role is novel.MethodsIndividual semi-structured interviews were recorded with 20 medical students at a UK medical school exploring their experiences of placement learning and experiences of working as healthcare assistants. Responses were analysed qualitatively using a framework approach. The framework was developed into a model describing key findings and their relationships.ResultsInterviews yielded data that broadly covered aspects of (1) Medical students' experiences of clinical placement learning (2) Medical students' experiences of working as medical student healthcare assistants (3) Learning resulting from working as a healthcare assistant (4) Hierarchies and professional barriers in the clinical environment (5) Influences on professional identity. Participants described barriers and facilitators of clinical learning and how assuming a healthcare assistant role impacted on learning and socialisation within the multidisciplinary team. Students became increasingly socialised within the healthcare team, contributing directly to patient care; the resulting social capital opened new opportunities for learning, team working and enhanced students' interprofessional identity. Students described the impact of these experiences on their aspirations for their future practice.ConclusionsChanges to work patterns in healthcare and delivery models of medical education have eroded opportunities for students to contribute to healthcare delivery and be embedded within a team. This is impacting negatively on student learning and socialisation and we suggest that medical curricula have much to learn from nursing and allied health professional training. Longitudinal embedment with a multidisciplinary team, where students have a defined role and work directly with patients may not only add value to clinical service, but also overcome current barriers to effective placement learning and interprofessional identity formation for medical students.
| S-EPMC8131173 | biostudies-literature
Project description:This medical review addresses the hypothesis that CD38/NADase is at the center of a functional axis (i.e., intracellular Ca2+ mobilization/IFNγ response/reactive oxygen species burst) driven by severe acute respiratory syndrome coronavirus 2 infection, as already verified in respiratory syncytial virus pathology and CD38 activity in other cellular settings. Key features of the hypothesis are that 1) the substrates of CD38 (e.g., NAD+ and NADP+) are depleted by viral-induced metabolic changes; 2) the products of the enzymatic activity of CD38 [e.g., cyclic adenosine diphosphate-ribose (ADPR)/ADPR/nicotinic acid adenine dinucleotide phosphate] and related enzymes [e.g., poly(ADP-ribose)polymerase, Sirtuins, and ADP-ribosyl hydrolase] are involved in the anti-viral and proinflammatory response that favors the onset of lung immunopathology (e.g., cytokine storm and organ fibrosis); and 3) the pathological changes induced by this kinetic mechanism may be reduced by distinct modulators of the CD38/NAD+ axis (e.g., CD38 blockers, NAD+ suppliers, among others). This view is supported by arrays of associative basic and applied research data that are herein discussed and integrated with conclusions reported by others in the field of inflammatory, immune, tumor, and viral diseases.
| S-EPMC8313238 | biostudies-literature
Project description:IntroductionWe assessed students' perception of the impact of the pandemic on their well-being, education, academic achievement, and whether grit and resilience alter students' ability to mitigate the stress associated with disruptions in education. We hypothesized that students would report a negative impact, and those with higher grit and resilience scores would be less impacted.MethodsA multidisciplinary team of educators created and distributed a survey to medical students. Survey results were analyzed using descriptive statistics, ANOVA, and multivariate linear regressions. A p-value <.05 was considered statistically significant.ResultsA total of 195 students were included in the study. Approximately 92% reported that clinical education was negatively affected, including participants with higher grit scores. Students with higher resilience scores were more optimistic about clinical education. Those with higher resilience scores were less likely to report anxiety, insomnia, and tiredness.ConclusionMore resilient students were able to manage the stress associated with the disruption in their education. Resiliency training should be year-specific, and integrated into the UME curriculum due to the different demands each year presents.
| S-EPMC8782734 | biostudies-literature
Project description:The COVID-19 pandemic caused a large strain on the US medical system, with shortage of medical personnel being a key issue. The role of medical school students during a pandemic is not well established. Understanding the perspectives of medical students with regard to their role is essential in determining how to facilitate the use of their skills in combating the pandemic. To evaluate medical student perspectives on the COVID-19 pandemic, an anonymous online survey was distributed to medical students, primarily in the Northeastern United States. In the sample of 232 students, there were significant differences between students in different class years when assessing moral obligations to assist with the COVID-19 pandemic (p = 0.002). A higher percentage of first and second year medical students (pre-clinical training, around 48%) felt that healthcare students are morally obligated to assist as compared to third and fourth year students (clinical training, 30.43% of third years and 23.19% of fourth years). In all class years, the majority said they would regret their decision if they had chosen not to study medicine (62.32% to 79.31%) and most students did not feel their motivation to become a physician had been decreased (84.78% to 87.50%). Though the study was limited because the majority of subjects were from New York, the results provide insight into medical students' attitudes about the COVID-19 pandemic and can be used in the planning of how best to utilize medical students in this and in future situations.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-021-01374-z.
| S-EPMC8425853 | biostudies-literature
Project description:BackgroundThe coronavirus pandemic has exerted significant impacts on primary care, causing rapid digital transformation, exacerbating social isolation, and disrupting medical student and General Practice [GP] trainee education. Here we report on a medical student telephone initiative set-up by a final year GP trainee (the equivalent of a family medicine resident), which aimed to support patients at high risk and vulnerable to the Coronavirus Disease of 2019 [Covid-19]. In addition, it was hoped the project would mitigate a digital divide, enable proactive anticipatory planning, and provide an active learning environment to compensate for the pandemic's impact on medical education.MethodsThirty-three medical students conducted daily telephone conversations with high risk and vulnerable patients as specified by the initial NHSE published lists. They confirmed public health messages, offered details for voluntary support groups, established need for medication delivery, explored levels of digital connectivity, and prompted discussions around end-of-life choices. Students had access to online reflective resources and daily remote debriefing sessions with the GP trainee. A convergent mixed-methods evaluation was subsequently undertaken, using quantitative process and descriptive data and individual qualitative interviews were conducted according to a maximal variation sampling strategy with students, General Practitioners [GPs], and the GP trainee. Inductive thematic analysis was then applied with cross-validation, respondent validation, and rich evidential illustration aiding integrity.ResultsNinety-seven 'high risk' and 781 'vulnerable' calls were made. Individuals were generally aware of public heath information, but some struggled to interpret and apply it within their own lives. Therefore respondents felt students provided additional practical and psychological benefits, particularly with regard to strengthening the links with the community voluntary groups. The project was widely liked by students who reported high levels of skill development and widened awareness, particularly valuing the active learning environment and reflective feedback sessions.ConclusionThis study demonstrates utilization of medical students as wider assets within the primary health care team, with an initiative that enables support for vulnerable patients whilst promoting active medical education. Ongoing integration of students within 'normal' primary health care roles, such as chronic disease or mental health reviews, could provide similar opportunities for supported active and reflective learning.
| S-EPMC7578590 | biostudies-literature
Project description:PurposeResponding to the COVID-19 pandemic, American medical schools made swift changes to clinical education based on guidelines provided by the Association of American Medical Colleges. The purpose of this study was to collect medical student perceptions of the solely online learning environment, their quality of life (QoL), and the pandemic response by their School of Medicine (SoM) to provide suggestions to inform medical schools' responses during the continuation of this pandemic and the next.MethodsBetween April 29, 2020 and May 16, 2020, the authors distributed a 60-item questionnaire that assessed demographics, learning environment, QoL, and the SoM response. Likert-type items were analyzed on an item-by-item basis, whereas themes were identified for open-ended questions.ResultsA total of 330 medical students (of 632; 52.2%) responded. Those who responded had positive perceptions of the online learning environment with moderate QoL disruptions to concentration and sleep. Although most students perceived being able to contribute meaningfully to the healthcare setting, they viewed themselves as underutilized. Three themes encapsulated both positive and negative perceptions of the SoM's response-communication, learning environment, and empathy and support.ConclusionThese findings provide insight into medical student perceptions of their learning environment and QoL as they acclimated to changes resulting from the COVID-19 pandemic. Results can help inform a SoM's response during the continuation of the COVID-19 pandemic as well as during future pandemics or crises. Follow-up surveys of medical students at multiple institutions across the USA and abroad will be essential to better characterize student perceptions.
| S-EPMC7864474 | biostudies-literature