Medical education during COVID-19 pandemic

This article was exclusively written for The European Sting by Ms. Lia Patricia Reyes Santos and Ms. Amanda Villalona, two fourth-year medical students at the Iberoamerican University (UNIBE) in Santo Domingo, Dominican Republic. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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“Crisis moments create opportunity. Problems and crises ignite our greatest creativity and thought leadership as it forces us to focus on the things outside the norm”.

 – Sam Cawthorn  The emergence of coronavirus disease 2019 (COVID-19), resulting from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has compromised medical education, in a way that faculty-student mentorship must manage multiple challenges to secure high-quality education. Even though medical schools have the authority of making decisions in the best interest for all students, the Association of American Medical Colleges (AAMC) suggested that medical students should not have direct contact with patients during the current pandemic (1). This decision was based on two factors. First, medical students are currently in training and at higher risk in the clinical workplace, due to lack experience in patient management and use of personal protective equipment. Second, most clinical educators are continuously assisting in the frontline efforts to meet community needs and are less available for teaching and supervision (1). Hence, the previous faculty-student mentorship gap has required adjustments of the entire medical curricula to virtual formats (2). As medical students in the Dominican Republic we have observed real-time changes across academic institutions in our country. The Ministry of Higher Education, Science, and Technology (MESCYT) recommended that all higher education institutions develop different strategies to ensure mentorship and overall academic assessment strategies (3). As a middle-income country, since academic institutions were currently in the process of transforming education to innovative methods that promote professional development, the COVID-19 pandemic has encouraged widespread acceleration of the online education experiences as a reliable learning resource. These changes will allow clinical educators to enhance classroom and clinical instruction on required learning principles. Pre-clinical coursework. Clinical educators can apply virtual teaching methods to enhance medical education and promote class discussions. For example, Blackboard Collaborate as well as Zoom can serve as platforms for virtual classes and videoconference, Microsoft Teams and Classroom can facilitate the delivery of class assignments, and Kahoot! can strengthen learning through game-based learning experiences of quizzes, surveys, and jumbles. Clinical coursework. Distance-learning can be challenging for medical students as they transition from pre-clerkship and clerkship rotations. Hence, some online alternatives that include simulation programs – such as virtual patients on virtual platforms (e.g. i-Human and Body Interact) can be used to review scenarios from inpatient and outpatient clinical scenarios. Furthermore, applications like Prognosis your Diagnosis and InSimu Patient can serve as integrated clinical cases that offer the review of evidence-based content focused on the specialty of interest. With these online platforms, medical students can maintain critical thinking skills and reinforce clinical competencies. This unprecedented global crisis has presented an opportunity for faculty-student mentorship to transform medical education using virtual platforms that strengthen problem-based learning. We acknowledge the efforts of the different international and national organizations for their guidance and protocols designed to assure and preserve health professions education. As such, we believe that faculty must prepare medical students to address the next pandemic as they represent the future clinical workforce. Throughout history, learning has resulted from emerging pandemics – such as HIV/AIDS and Influenza of 1918 – contributing to the advancement of medical education in the setting of curricular innovation for the next generation of health professionals (2). As the current cohort of future doctors, we have the moral obligation to seek all opportunities to advance our learning. In addition to our virtual coursework, we can seek additional online resources to keep updated on SARS-CoV-2 infections, One Health topics related to potential zoonotic spillover, and the secondary impacts of the COVID-19 pandemic. Students can serve as community educators by using social media as a tool to spread evidence-based information about disease transmission and prevention (4). After all, we believe that this pandemic is an opportunity to highlight the best of our global society, where we can offer creative solutions for societal benefit. References

1. Whelan A, Prescott J, Young G, Catanese VM, McKinney R. Guidance on medical students’ participation in direct patient contact activities [Internet]. 2020 [cited 2020 May 19]. Association of American Medical Colleges. Available from: https://www.aamc.org/system/files/2020-04/meded-April-14-Guidance-on-Medical-Students-Participation-in-Direct-Patient-Contact-Activities.pdf.
2. Rose S. Medical student education in the time of COVID-19. JAMA. 2020.
3. Ministry of Higher Education, Science, and Technology (MESCYT). MESCYT destaca labores durante cuarentena; resalta cumplimiento protocolo personal Instituciones Educación Superior [Internet]. 2020 [cited 2020 May 21]. Available from:https://presidencia.gob.do/noticias/mescyt-destaca-labores-durante-cuarentena-resalta-cumplimiento-protocolo-personal. Spanish.
4. Valdez-Garcáa JE, López Cabrera MV, Jiménez Martínez M, Diaz Elizondo JA, Dávila Rivas JAG, Olivares SL. Me preparo para ayudar: respuesta de escuelas de medicina y ciencias de la salud ante COVID-19. Inv Ed Med. 2020; 9(35).

About the authors Lia Patricia Reyes Santos is a fourth-year medical student at the Iberoamerican University (UNIBE) in Santo Domingo, Dominican Republic. She serves as an active member of the Standing Committee on Sexual and Reproductive Health (SCORA) of ODEM-Dominican Republic. She also serves as an active member of the UNIBE Hematology and Oncology Interest Group (GHEMOU), and as an active member of the UNIBE Neurology and Neurosurgery Interest Group (NEUROX). Amanda Villalona is a fourth-year medical student at the Iberoamerican University (UNIBE) in Santo Domingo, Dominican Republic. She serves as an active member of the Standing Committee on Professional Exchange (SCOPE) of ODEM-Dominican Republic. She also serves as an active member of the UNIBE Research Interest Group (BIOSEARCH), and as an active member of the UNIBE Hematology an Oncology Interest Group (GHEMOU).