Variations in Medical Students' Educational Preferences, Attitudes and Volunteerism during the COVID-19 Global Pandemic

A qualitative assessment of barriers and facilitators of telemedicine volunteerism during the COVID-19 pandemic in India

BACKGROUND

The COVID-19 pandemic further propelled the recent growth of telemedicine in low-resource countries, with new models of telemedicine emerging, including volunteer-based telemedicine networks. By leveraging existing infrastructure and resources to allocate health personnel more efficiently, these volunteer networks eased some of the pandemic burden placed on health systems. However, there is insufficient understanding of volunteer-based telemedicine models, especially on the human resources engagement on such networks. This study aims to understand the motivations and barriers to health practitioner engagement on a volunteer telemedicine network during COVID-19, and the mechanisms that can potentially sustain volunteer engagement to address healthcare demands beyond the pandemic.

METHODS

In-depth qualitative interviews were conducted with health practitioners volunteering on an Indian, multi-state telemedicine network during the COVID-19 pandemic. Data were analyzed using thematic content analysis methods.

RESULTS

Most practitioners reported being motivated to volunteer by a sense of duty to serve during the pandemic. Practitioners suggested organizational-level measures to make the process more efficient and facilitate a more rewarding provider-patient interaction. These included screening calls, gathering patient information prior to consultations, and allowing for follow-up calls with patients to close the loop on consultations. Many practitioners stated that non-financial incentives are enough to maintain volunteer engagement. However, practitioners expressed mixed feelings about financial incentives. Some stated that financial incentives are needed to maintain long-term provider engagement, while others stated that financial incentives would devalue the volunteer experience. Most practitioners highlighted that telemedicine could increase access to healthcare, especially to the rural and underserved, even after the pandemic. Practitioners also expressed an interest in continuing to volunteer with the network if the need arose again.

CONCLUSION

Our study findings suggest that practitioners are highly intrinsically motivated to volunteer during large healthcare emergencies and beyond to address the healthcare needs of the underserved. Following the recommendations presented in the study, telemedicine networks can more successfully engage and maintain volunteer practitioners. Volunteer-based telemedicine networks have the potential to bridge shortages of health personnel in resource-constrained settings both in times of crises and beyond.

Health worker education during the COVID-19 pandemic: global disruption, responses and lessons for the future-a systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis identified early evidence quantifying the disruption to the education of health workers by the COVID-19 pandemic, ensuing policy responses and their outcomes.

METHODS

Following a pre-registered protocol and PRISMA/AMSTAR-2 guidelines, we systematically screened MEDLINE, EMBASE, Web of Science, CENTRAL, clinicaltrials.gov and Google Scholar from January 2020 to July 2022. We pooled proportion estimates via random-effects meta-analyses and explored subgroup differences by gender, occupational group, training stage, WHO regions/continents, and study end-year. We assessed risk of bias (Newcastle-Ottawa scale for observational studies, RοB2 for randomized controlled trials [RCT]) and rated evidence certainty using GRADE.

RESULTS

Of the 171 489 publications screened, 2 249 were eligible, incorporating 2 212 observational studies and 37 RCTs, representing feedback from 1 109 818 learners and 22 204 faculty. The sample mostly consisted of undergraduates, medical doctors, and studies from institutions in Asia. Perceived training disruption was estimated at 71.1% (95% confidence interval 67.9-74.2) and learner redeployment at 29.2% (25.3-33.2). About one in three learners screened positive for anxiety (32.3%, 28.5-36.2), depression (32.0%, 27.9-36.2), burnout (38.8%, 33.4-44.3) or insomnia (30.9%, 20.8-41.9). Policy responses included shifting to online learning, innovations in assessment, COVID-19-specific courses, volunteerism, and measures for learner safety. For outcomes of policy responses, most of the literature related to perceptions and preferences. More than two-thirds of learners (75.9%, 74.2-77.7) were satisfied with online learning (postgraduates more than undergraduates), while faculty satisfaction rate was slightly lower (71.8%, 66.7-76.7). Learners preferred an in-person component: blended learning 56.0% (51.2-60.7), face-to-face 48.8% (45.4-52.1), and online-only 32.0% (29.3-34.8). They supported continuation of the virtual format as part of a blended system (68.1%, 64.6-71.5). Subgroup differences provided valuable insights despite not resolving the considerable heterogeneity. All outcomes were assessed as very-low-certainty evidence.

CONCLUSION

The COVID-19 pandemic has severely disrupted health worker education, inflicting a substantial mental health burden on learners. Its impacts on career choices, volunteerism, pedagogical approaches and mental health of learners have implications for educational design, measures to protect and support learners, faculty and health workers, and workforce planning. Online learning may achieve learner satisfaction as part of a short-term solution or integrated into a blended model in the post-pandemic future.

Topic modeling and sentiment analysis of Chinese people’s attitudes toward volunteerism amid the COVID-19 pandemic

The COVID-19 pandemic has created an urgent need for volunteers to complement overwhelmed public health systems. This study aims to explore Chinese people’s attitudes toward volunteerism amid the COVID-19 pandemic. To this end, we identify the latent topics in volunteerism-related microblogs on Weibo, the Chinese equivalent of Twitter using the topic modeling analysis via Latent Dirichlet Allocation (LDA). To further investigate the public sentiment toward the topics generated by LDA, we also conducted sentiment analysis on the sample posts using the open-source natural language processing (NLP) technique from Baidu. Through an in-depth analysis of 91,933 Weibo posts, this study captures 10 topics that are, in turn, distributed into five factors associated with volunteerism in China as motive fulfillment (n = 31,661, 34.44%), fear of COVID-19 (n = 22,597, 24.58%), individual characteristic (n = 17,688, 19.24%), government support (n = 15,482, 16.84%), and community effect (n = 4,505, 4.90%). The results show that motive fulfillment, government support, and community effect are the factors that could enhance positive attitudes toward volunteerism since the topics related to these factors report high proportions of positive emotion. Fear of COVID-19 and individual characteristic are the factors inducing negative sentiment toward volunteerism as the topics related to these factors show relatively high proportions of negative emotion. The provision of tailored strategies based on the factors could potentially enhance Chinese people’s willingness to participate in volunteer activities during the COVID-19 pandemic.

Becoming a Doctor During a Pandemic: Impact on Medical Student Social Identity Formation

The COVID-19 pandemic required modifications to undergraduate medical education that likely affected medical students' social identity formation (SIF). SIF is shaped by experiences throughout the medical education continuum. This commentary explores factors potentially affecting medical student SIF during the COVID-19 pandemic focusing on students' perceptions of being part of the healthcare team, their role in medicine, and their engagement during the pandemic. Based on such considerations, we propose that educators should aim to design effective learning environments to support a full educational experience that encompasses acquiring medical knowledge and building strong social identities even during a pandemic.

Health professional student's volunteering activities during the COVID-19 pandemic: A systematic literature review

Background

The Coronavirus Disease 2019 (COVID-19) crisis has forced health and education services to use additional human resources, such as health professional students. Students in the health professions, particularly those in the medical field, can participate in a variety of voluntary activities, both directly and indirectly in health services. The aim of this review was to determine the affecting factors, types of activity, and benefits of undertaking a volunteering role by the health professional student.

Methods

A systematic review of health professional student volunteering during the COVID-19 pandemic was conducted using seven databases: Epistemonikos, ProQuest, Scopus, EBSCOhost, JSTOR, Cochrane Library, and PubMed. This literature search included published articles from March 2020 through to December 2021 using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines.

Result

We included 41 studies that met the selection criteria that assessed the factors and specific programs related to health profession students' volunteering involvement during the COVID-19 pandemic era. The most frequently observed supporting factor of the eagerness to be a volunteer was the feeling of moral responsibility (such as social dedication, sense of duty, and care), potential learning opportunities, personal interest, and financial compensation. Factors that contributed to a person's refusal to participate in a volunteer position were the fear of COVID-19 itself (such as transmission, risk of being infected, and personal identification as a risk group).

Conclusion

The review of available literature has shown that understanding the motivation and barriers to the willingness of health professional students to volunteer and the impact of volunteering activities on their future lives is a key for supporting them.

Medical Student Perspectives on Their Role as Emerging Physicians During the COVID-19 Pandemic

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 INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01374-z.

COVID-19 Readiness and Career Aspirations of South Indian Medical Students: A Cross-Sectional Survey Study

PURPOSE

The second wave of COVID-19 devastated the medical sector on India and the government has implored medical students to aid the frontline workforce. This study aims to assess the knowledge, attitude and practice (KAP) of South Indian Medical students regarding the COVID-19 pandemic and their career aspirations.

PATIENTS AND METHODS

This is an online questionnaire based, cross-sectional study featuring a pre-validated questionnaire with a KAP section and a career aspiration survey section, which was distributed to South Indian medical schools between November and December 2020. Three hundred and four responses were included for analysis.

RESULTS

Good knowledge levels were seen in 65.5% of participants, 51% had good attitude scores and 80.6% had good practice scores. The mean KAP score was 14.81 ± 1.77. 1.3% of the respondents had low level KAP scores, 57.2% had moderate level KAP scores and 41.4% of them had good level KAP scores. Majority aspired to continue post graduate medical training in Clinical medicine in India (n = 116, 38.2%), followed by Clinical Medicine outside India (n = 80, 26.3%). Students who chose "Research Work" (average rank [AR] = 192.70), "Clinical Medicine outside India" (AR =173.64) "Undecided" (AR = 148.59) and "Clinical Medicine in India" (AR = 146.63) as career aspiration featured better KAP scores compared to those students who preferred non-clinical specialties (AR = 96.73) and or a career change (AR =76.69) (p = 0.001).

CONCLUSION

The KAP questionnaire revealed inadequate readiness amongst the majority of student participants. Targeted, structured educational interventions may be recommended in order to rapidly rectify the situation and deploy medical students to supplement the frontline workers in the COVID pandemic.