The impact of the COVID-19 pandemic on UK medical education. A nationwide student survey

COVIDAssist: Exploring the perspectives on student assistance during the COVID-19 pandemic

INTRODUCTION

COVID-19 resulted in medical students volunteering to join the health care workforce. Our study aimed to evaluate the perception of clinical staff on the benefit of students' pandemic response. The secondary aims were to (i) evaluate medical students' team working skills, (ii) identify specialties where medical students were most effective, and (iii) identify areas for further training.

METHODS

We conducted a national survey of doctors and nurses. This was conducted in line with a pre-specified protocol by the International Student Surgical Network UK (Incision UK), with support from The Royal Society of Medicine Students Section Collaborative and MedEd Collaborative. A questionnaire was developed and disseminated following AMEE guidance. Survey responses were quantitatively and qualitatively analysed.

RESULTS

Of the recorded responses (n = 283), the largest group of respondents was junior doctors, (n = 110, 38.9%), and medicine was the most reported specialty (n = 76, 26.9%) of respondents, followed by primary care, with the lowest responses coming from surgery (n = 25, 8.8%). Of the total responses (n = 283), 76.8% of respondents reported that the student response had a positive impact during the pandemic. Four themes were identified: (i) impact on health care service, (ii) impact on health care staff and patients, (iii) student's professional development and (iv) additional training that students require.

CONCLUSION

Students were an effective part of the pandemic. However, without appropriate definition of their role within a clinical setting, students may be forced to balance learning and service provision. Providing students with dedicated clinical support roles and ward-based learning roles with a competency-based approach holds potential to be both a powerful learning tool and strengthen health care systems to face future crises.

Medical Education in Costa Rica. From Flexner to COVID-19: Integrative Answers for Old and New Challenges

This monograph describes key aspects of medical education in a middle-income country such as Costa Rica, with an emphasis on public education. The main strengths and challenges of our curriculum are presented, as well as some recently implemented modernization measures to address the challenges described. Special attention is given to simulation training in medicine to promote systematic and integrative medical education in a problem-solving context. The SPICES model of educational strategies is used as a paradigm for curricular analysis. Finally, the impact of the COVID-19 pandemic on student, faculty, and staff acceptance of the curriculum modernization measures introduced is briefly discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01886-w.

Key aspects of teaching that affect perceived preparedness of medical students for transition to work: insights from the COVID-19 pandemic

BACKGROUND

The self-perceived preparedness of medical students to transition into practising junior doctors has implications for patient safety, graduate well-being and development of professional identity.

AIMS

To examine the impact of changes to final-year education and placements and determine key elements that contribute to self-perceived preparedness for transition to work.

METHODS

An online survey among final-year medical students at one Australian medical school in 2020 (the cohort most affected by the coronarvirus disease 2019 [COVID-19] pandemic), exploring overall self-perceived preparedness and specific competencies, including questions in previous Australian Medical Council/Medical Board of Australia annual national surveys. Quantitative and qualitative content analyses were performed.

RESULTS

Thirty-three percent of eligible participants completed the survey. There was a significant decline in overall self-perceived preparedness among participants (mean preparedness, 3.55 ± 0.88) compared with 2019 graduates from the same medical school (mean preparedness, 4.28 ± 0.64, P < 0.001) and the national average (mean preparedness, 3.81 ± 0.93, P = 0.04). There was a decline in self-perceived preparedness for all specific competencies, with complex competencies more greatly affected. Qualitative content analysis of free text responses identified limitations of an online compared with a face-to-face formal education program and specific aspects of placements, which contribute to perceived preparedness.

CONCLUSION

The current study highlights key aspects of clinical placements and formal teaching programs that contribute to perceptions of preparedness for transition to clinical practice. Relevant experiential learning in the clinical setting, opportunities for deliberate practice of necessary skills (in simulation and the clinical setting) and reflective opportunities from formal teaching programs contribute to perceived preparedness and are important elements to be included in the final phase of any medical program.

Differential attainment in specialty training recruitment in the UK: an observational analysis of the impact of psychometric testing assessment in Public Health postgraduate selection

OBJECTIVES

To determine how current psychometric testing approaches used in selection of postgraduate training in UK Public Health are associated with socioeconomic and sociocultural background of applicants (including ethnicity).

DESIGN

Observational study using contemporaneous data collected during recruitment and psychometric test scores.

SETTING

Assessment centre of UK national Public Health recruitment for postgraduate Public Health training. The assessment centre element of selection comprises three psychometric assessments: Rust Advanced Numerical Reasoning, Watson-Glaser Critical Thinking Assessment II and Public Health situational judgement test.

PARTICIPANTS

629 applicants completed the assessment centre in 2021. 219 (34.8%) were UK medical graduates, 73 (116%) were international medical graduates and 337 (53.6%) were from backgrounds other than medicine.

MAIN OUTCOME MEASURE

Multivariable-adjusted progression statistics in the form of adjusted OR (aOR), accounting for age, sex, ethnicity, professional background and surrogate measures of familial socioeconomic and sociocultural status.

RESULTS

357 (56.8%) candidates passed all three psychometric tests. Candidate characteristics negatively associated with progression were black ethnicity (aOR 0.19, 0.08 to 0.44), Asian ethnicity (aOR 0.35, 0.16 to 0.71) and coming from a non-UK medical graduate background (aOR 0.05, 0.03 to 0.12); similar differential attainment was observed in each of the psychometric tests. Even within the UK-trained medical cohort, candidates from white British backgrounds were more likely to progress than those from ethnic minorities (89.2% vs 75.0%, p=0.003).

CONCLUSION

Although perceived to mitigate the risks of conscious and unconscious bias in selection to medical postgraduate training, these psychometric tests demonstrate unexplained variation that suggests differential attainment. Other specialties should enhance their data collection to evaluate the impact of differential attainment on current selection processes and take forward opportunities to mitigate differential attainment where possible.

The perceived impact of the COVID-19 pandemic on medical students' future careers

Background: The COVID-19 pandemic disrupted medical education on multiple levels, and medical students have been forced to adjust to distance learning, altered clinical opportunities, and standardized testing inconsistencies. We sought to identify the effects of these dramatic deviations on medical students' career plans. Methods: We conducted a cross-sectional online survey of medical students between July 13, 2020, and September 9, 2020 in order to assess the implications of the COVID-19 pandemic on students' career decisions. Descriptive statistics were calculated for all variables. Results: Of the 585 eligible medical students, we had a final sample of 76 responses (n=76) (13% response rate). Students felt neutral regarding having more time to explore research projects (Mean ± SD; 3.06 ± 1.18) and hobbies (3.43 ± 1.28). Most survey respondents somewhat disagreed that they considered quitting medical school during the pandemic (1.55 ± 1.10). Students somewhat agreed that they view the field of medicine more positively since the onset of the COVID-19 pandemic (3.60 ± 1.09). Respondents somewhat agreed that they would be unable to explore other specialties and find their best fit (3.55 ± 1.32). We found that the minority (4/66, 6%) of students had considered changing their specialty. Students felt neutral in terms of their Step 1 (3.25 ± 1.05) or Step 2 (2.81 ± 1.02) score deterring them from future career opportunities. Conclusions:  Most medical students have experienced barriers in their career pathway as a direct cause of COVID-19 restrictions on medical education, including the ability to explore different specialties to discover their best fit or find a chance to network with mentors. However, despite these obstacles, most students remain committed to medicine.