By Debra Wood, RN, contributor Oct 12, 2020
The COVID-19 pandemic has led to changes in the methods used
to teach the next generation of physicians, while ensuring the medical students
meet all of the critical milestones.
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“Students, administrators and faculty have pulled together
in extraordinary circumstances,” said Daniel Topping, MD, associate professor
of medicine at the University of Central Florida (UCF) College of Medicine in
Orlando. “I am proud of the students and my colleagues. I have faith in our
profession. It’s all about improving the welfare of human beings, and we will
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Virtual learning with COVID-19 and medical students
Most first-year and second-year students are learning about
medicine virtually. At UCF, students may watch pre-recorded lectures and at other
times, the professor is live with a group of students. The faculty may quiz
students using online tools.
“Students are a resilient bunch, and they have tech
experience and are digital natives, having grown up with the Internet,” Topping
Group activities and in-person physical exams at UCF have
been placed on hold. Students are learning how to do telemedicine visits with
standardized patients, rather than performing in-person assessments.
While learning virtually reduces the risk that med students
will become infected with the novel coronavirus, it limits their ability to
meet and mingle with their peers and study together.
“The biggest challenge is the connectedness [with other
students] they are not having, like team experiences,” Topping said. “And this
makes it less than ideal for them to get the professional identity [of being a
At Tulane University School of Medicine in New Orleans,
small groups can occasionally gather,
socially distanced, in a large room to get to know one another. Some schools
are using Zoom to help students connect with one another.
Changes with in-person learning
When the pandemic arrived in the spring, many medical
schools stopped providing students with in-person clinical rotations, in part
to conserve personal protective equipment (PPE). A survey by AAMC found 80
percent of its members planned to return to clinical rotations this fall. But
not all will assign students COVID-19 patients. Much depends on cases in local
areas and supplies of PPE. The schools often provide PPE for their learners.
An additional challenge for students that need experience is
that the volume of elective surgeries has not rebounded in many areas. The
Morehouse School of Medicine in Atlanta has switched to monitoring students’
competencies, rather than being concerned about the number of certain
experiences the student has completed.
In their last two years in medical school, students see
patients at the clinical sites.
“They are rounding on patients,” Topping said. “We are being
cautious about where we send our learners.”
Among the new ways to learn for medical students is
modifications to anatomy labs. At UCF, Topping developed a combination of
virtual learning and in-lab dissection. Rather than six students working on one
cadaver, four teams of two students at a time will work on each cadaver and use
a discussion board to practice providing the next team with a strong handoff, a
valuable skill for physicians.
“It’s an opportunity to learn how to communicate,” Topping
said. “Handoffs are an important part of patient safety.”
At the Keck School of Medicine at the University of Southern
California in Los Angeles, a faculty member performs the dissections, wearing a
camera as students watch online from their homes.
The pandemic has provided many students with an up-close
experience with an out-of-control virus, a valuable lesson that many practicing
physicians have not experienced when they were in medical school.
“It’s challenging for everybody,” Topping said. “We have to
live in the world we are in and accept the things we cannot change, while I
give them the best experiences I can.”
Ready for residency
Most fourth-year students are completing residency
interviews virtually, saving them time and travel expenses.
Zoran J. Pavlovic, MD, an OB-GYN resident physician at Rush
University Medical Center in Chicago, reported during an American Medical
Association webinar that residency programs are downsizing inpatient teams, so
more residents are able to help in the emergency department or intensive care
unit, and orientations and grand rounds take place virtually.
Throughout medical education, COVID-19 has brought changes
and challenges. Yet, today’s leaders in education remain confident the students
and residents will learn and become competent physicians.
“This will have an end,” Topping said. “There will be a new
normal. Things have changed drastically. It will be a long time, if ever, that
medical education returns to what it was.”
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