Lessons learned from Medical Education in the times of COVID-19

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This article was exclusively written for The European Sting by Ms. Massiel Méndez Jorge, a final-year medical student, physiology teacher, and research assistant at the Universidad Autónoma de Santo Domingo (UASD), Dominican Republic. She is affiliated with 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.


In a time of drastic change, it is the learners who inherit the future.Eric Hoffer

The first wave of the pandemic brought us to a never-seen-before adverse scenario that tested our capacity to observe particular situations, learn from them, plan strategies and offer solutions. Since our public institution has limited resources, the COVID-19 pandemic forced us to quickly implement innovative, cost-effective measures to facilitate the delivery of course content in a first-time virtual format. As a medical student and laboratory assistant in physiology and biophysics courses in Domnican Republic, I felt motivated to share this compilation of adjustments, lessons and obstacles faced during this transition to virtual education.

The DR is a middle-income country in the Caribbean, and has an estimated 21% of the population living under the national poverty line, according to the World Bank [1]. Inconsistent electricity coverage resulted in connectivity-related challenges, web servers with limited bandwidth, and limited broadband internet access in rural communities. Financial limitations constantly hindered the ability to  purchase appropriate electronic devices.

These described limitations highlighted the need for the implementation of innovative measures. We divided main curriculum topics into smaller modules than usual, gave asynchronous (pre-recorded) presentations of main experiments, and offered assistance to students using Whatsapp messaging groups. These adaptations offered students sufficient time to review concepts on a flexible schedule and provided rapid communication pathways, while minimizing their fatigue and anxiety and narrowing socioeconomic gaps to learning.

During synchronous (real-time) sessions, we randomly asked participants about course content in order to motivate their active participation. Making direct random questions by name during the full-length of the webinars helped us to ensure that students are actively engaged.

Since physiology laboratory sessions included mainly experiments and case discussions, we used a physiology simulation software to demonstrate experimental techniques and enhance critical thinking on the virtual platform. We also provided the students a detailed list of the competences that needed to be accomplished by the end of each unit and encoureged its development by experiments to do at home.

One review of virtual learning concluded that educators should focus on active learning, (rather than passive) techniques [2]. As many health professional educators know, maintaining class engagement during lockdown restrictions was challenging. By incorporating dynamic activities, such as crossword puzzles, polls, riddles, and other analogy games, students strengthened their recall of key course concepts.

The COVID-19 health crisis occurred while many Dominican medical schools were seeking international accreditation. As future steps, since these academic credentials require an audit of all administrative and teaching processes, there is a need to standardize all the included methods and record evidence of how virtual classes are now being prepared and assessed. 

Our recommendations offer insight to educators in low- and middle-income countries who seek novel didactic approaches to enhance virtual learning during and after this global pandemic. Since virtual platforms will inevitably form part of global medical education, effective innovative elements are crucial to ensure that future doctors are academically well-prepared to provide high-quality health services in their clinical and community practice.

References

  1. World Bank, World Development Indicators. Poverty headcount ratio at national poverty [Data file]. 2019. [cited 24 Oct 2014]. Available from: https://data.worldbank.org/country/dominican-republic
  2. Brady AN, Pradhan D. Learning without borders: asynchronous and distance learning in the age of COVID-19 and beyond. ATS Scholar. 2020;1:233–242.

About the author

Massiel Méndez Jorge is a final-year medical student, physiology teacher, and research assistant at the Universidad Autónoma de Santo Domingo (UASD), Dominican Republic. She has a keen interest in epidemiology, public health and ​​clinical research, which motivates her to voluntarily serve at the research institute of Dr. Hugo Mendoza Pediatric Hospital. Massiel is also an active member of the Standing Committee of Research Exchanges (SCORE) of the Organización Dominicana de Estudiantes de Medicina (ODEM) and volunteers at the Laboratorio de Investigación en Sustancias Naturales (LABISNAT), a local research laboratory.  She is also a passionate crafts and cats lover.

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