Medical students and COVID-19: lessons learnt from the 2020 pandemic

Medical student wellbeing during COVID-19: a qualitative study of challenges, coping strategies, and sources of support

BACKGROUND

Medical students face challenges to their mental wellbeing and have a high prevalence of mental health problems. During training, they are expected to develop strategies for dealing with stress. This study investigated factors medical students perceived as draining and replenishing during COVID-19, using the 'coping reservoir' model of wellbeing.

METHODS

In synchronous interactive pre-recorded webinars, 78 fourth-year medical students in the UK responded to reflective prompts. Participants wrote open-text comments on a Padlet site. Responses were analysed using reflexive thematic analysis.

RESULTS

Analysis identified five themes. COVID-19 exacerbated academic pressures, while reducing the strategies available to cope with stress. Relational connections with family and friends were affected by the pandemic, leading to isolation and reliance on housemates for informal support. Relationships with patients were adversely affected by masks and telephone consultations, however attending placement was protective for some students' wellbeing. Experiences of formal support were generally positive, but some students experienced attitudinal and practical barriers.

CONCLUSIONS

This study used a novel methodology to elicit medical students' reflections on their mental wellbeing during COVID-19. Our findings reinforce and extend the 'coping reservoir' model, increasing our understanding of factors that contribute to resilience or burnout. Many stressors that medical students typically face were exacerbated during COVID-19, and their access to coping strategies and support were restricted. The changes to relationships with family, friends, patients, and staff resulted in reduced support and isolation. Recognising the importance of relational connections upon medical students' mental wellbeing can inform future support.

Gauging the effects of COVID-related changes to the medical student surgical clerkship experience: a mixed-methods study

Purpose

This study sought to understand the medical student experience on the restructured surgical clerkship during the COVID-era to provide guidance for future scenarios affecting student participation in clinical activities.

Methods

Medical students completing an anonymous 70-question survey at the conclusion of their surgical clerkship from June 2019 to October 2020 were divided into 2 cohorts: students completing their clerkship prior to March 2020 and after June 2020. Quantitative assessment was performed to evaluate the clerkship performance and perceptions. Resulting findings were used to construct an interview guide and conduct semi-structured interviews.

Results

Fifty-nine medical students rotated through the surgical clerkship prior to COVID and 23 during the COVID-era. No differences in perception of the surgical clerkship, participation in essential activities, or shelf examination scores were found. Students completing their clerkship during the COVID-era reported a lower perception of interaction and professional relationships with attending and resident surgeons (p = 0.03). Qualitatively, students completing their clerkship during the COVID-era struggled to balance clinical experiences with personal wellness and noted that building relationships with faculty was substantially more difficult.

Conclusions

There does not appear to be a difference in the level of participation in essential clerkship activities nor a diminished perception of learning between students completing their surgical clerkship before or during the pandemic. However, there does appear to be a difference in the relationships formed between students and attending surgeons. Altered didactic structures and apprenticeship-type rotations may help mitigate such effects.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44186-022-00015-2.

SPICE-19: a 3-Month Prospective Cohort Study of 640 Medical Students and Foundation Doctors

INTRODUCTION

There is paucity of data around the support that medical students have been provided with, need to be provided with, and would like to be provided with during the COVID-19 pandemic. This study sought to explore the effects of the COVID-19 pandemic on medical students and establish the support they require.

METHODS

A prospective, observational, multicentre study was conducted in 2020. All medical students and interim foundation year 1 doctors were eligible to participate.

RESULTS

Six hundred forty individuals participated from 32 medical schools. Participants reported a drop in their mood following the onset of the pandemic (p < 0.001). This drop in mood was evident in both May and August. Participants did have an improved mood in August compared to May (p < 0.001). There was a significant decrease in pandemic disease-anxiety (13.8/20 to 12.4/20, p < 0.001) and consequence-anxiety (6.3/10 to 6.0/10, p < 0.001) between May and August. Nineteen percent of participants (n = 111/596, 19%) had not received the support they needed from their university by August. The most common area of support that our participants needed and had not received from their medical schools by August was support with course material (n = 58/111, 52%). 'Clinical knowledge' was thought to have been affected by the greatest number of participants in both May and August.

CONCLUSION

Medical students' mental well-being has been adversely affected during the COVID-19 pandemic. Our findings have actionable implications that can better protect medical students as they acclimatise to a working environment that has been radically changed by COVID-19.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at (10.1007/s40670-021-01349-0).

Changing face of medical education during a pandemic: tragedy or opportunity?

The COVID-19 pandemic has changed forever the way we do certain things. Although the race for a cure and vaccine has taken centre stage, traditional face-to-face medical education has slowly metamorphosised in the background to a virtual world with innumerable webinars, virtual tutorials and lectures in the World Wide Web. Despite this seemingly 'perfect' solution, there remains a hidden cost. Educators are forced to learn new skills to engage students as well as manipulate the electronic platform. Impact on learning for students, both undergraduate and postgraduate from a lack of social interactions, remains unknown. In this article, the authors share their experiences from different specialities about the pros and cons of virtual learning and teaching. Suggestions and practical tips are offered to enhance the learning experience. More emphasis may need to be placed on the creation of learning communities rather than lecture-based curricula. Hybrid curricula or conferences may become the future norm. As we slowly move out of lockdown into a changed world and new ways of doing things, lessons learnt can be harnessed for future hybrid models that can combine the best of technology and physical teaching to reduce worldwide inequalities.