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

Increased adherence to influenza vaccination among Palermo family pediatricians: a study on safety and compliance of qLAIV vaccination

BACKGROUND

Influenza represents a serious public health threat, especially for the management of severe cases and complications of the disease, requiring the implementation of control measures. We aimed to assess the acceptance and impact of qLAIV vaccination among a representative sample of family paediatricians (FPs) operating in Palermo Local Health Authority (LHA). To this end we evaluated vaccination coverage rates, comparing it with that observed in Sicilian context, while actively monitoring possible adverse reactions and their severity.

METHODS

An observational descriptive non-controlled study was conducted in two phases, from September 2022 to June 2023. The first phase involved a formative and educational intervention with a pre-intervention questionnaire to assess the knowledge and attitudes of FPs on paediatric influenza vaccination. The second phase consisted of an active surveillance on qLAIV safety and acceptance among the paediatric population assisted by the participating FPs, from October 2022 to April 2023. Frequencies, chi-squared tests, and comparisons statistics were performed using Stata/MP 14.1.

RESULTS

The overall coverage rate among the paediatric population involved in the intervention was 13.2%, with an I.M./qLAIV ratio of vaccine administered of 1/4.25. This coverage rate was significantly higher (p-value <0.001) when compared to the average values reported in the population under the Palermo Local Health Authority (LHA) (6.7%) and in the entire Sicily (5.9%). Adverse events in the qLAIV group were mild, with only 3.3% experiencing them, primarily presenting as a feverish rise (3.2%). No severe adverse reaction was reported.

CONCLUSIONS

The educational intervention significantly raised paediatric influenza vaccination rates among the participating FPs, and in general improved influenza vaccination coverage rates in the Palermo's LHU. Minimal, non-serious adverse events underscored the vaccine's safety. Training sessions ensured paediatricians stayed informed, enabling them to provide comprehensive information to parents for secure and informed vaccination decisions in their practices.

Opinion of medical students and instructors on the challenges of in-person learning postcoronavirus disease 2019 pandemic

BACKGROUND

Several universities switched back to face-to-face teaching in 2022 after 2 years of online classes during the coronavirus disease 2019 (COVID-19) crisis. There is no data from these students/teachers on the challenges in postpandemic face-to-face teaching and learning. The current study's aim was to identify the challenges of face-to-face teaching and learning postpandemic from the perspective of students and instructors.

MATERIALS AND METHODS

Undergraduate medical students (n = 210) registered in Imam Abdulrahman Bin Faisal University and instructors (n = 72) filled out online questionnaires from November 2022 to March 2023 on teaching-learning challenges in the postpandemic period. The questionnaires asked students about their interest in education, scores, degree of shyness, how clear the voices of the instructors wearing face masks were, fear of COVID-19, preferred mode of teaching, and advantages/disadvantages of face-to-face teaching. Descriptive statistics included frequencies and percentages for qualitative variables; Chi-square test was applied to assess association between categorical variables.

RESULTS

Students reported a decrease in their educational interest postpandemic (47.1%), diffidence in interaction (42.4%), blurred teachers' voices because of the face masks (63.3%), and lack of teachers' empathy (47.6%). There was a significant association between preclinical year students and a decrease in educational interest (P = 0.002), diffidence in class interactions (P = 0.001), and fear of contracting COVID-19 infection while interacting with teachers (P = 0.04). Instructors complained of a decrease in students' interest in education (65.3%), especially the instructors of the clinical years (16.7% vs. 2.1%; P = 0.022). About 10% students reported taking leave from university on purpose due to fear of contracting COVID-19 infection; students and instructors both supported lecture recordings (98.6% and 63.9%, respectively). The students' and instructors' preferred platform for learning was "hybrid" (80.5% and 63.9%, respectively).

CONCLUSION

Challenges faced by the students include decreased interest in learning, drop in scores, muffled voices because of the face masks, increased shyness, waste of time in commutes, lack of flexibility in schedules, increased workload, and fear of catching COVID-19 infection. There is strong support for hybrid/blended learning and recording lectures.

Online Training or Face-to-Face Training from the Perspective of Ear, Nose, and Throat and Head and Neck Surgeons?

PURPOSE

To determine the preferences of Ear, Nose, and Throat (ENT) and Head-Neck Surgery (HNS) specialists and residents undergoing training for online or face-to-face training and the factors affecting the preference.

METHODS

An 16-item questionnaire was created using Google Forms and was administered to residents undergoing training in ENT departments and to specialists working in the same field. The questionnaires were distributed online and requested to be completed between August and October 2020. The study participants were analyzed in two groups according to the preference for online training or face-to-face training.

RESULTS

Evaluation was made of a total of 173 participants, as 68 (39.3%) in online training, and 105 (60.7%) in face-to-face training. Online training comprised 47 (69.1%) females and 21 (30.9%) males with a mean age of 38.9 ± 8years and face-to-face training comprised 68 (64.8%) females and 37 (35.2%) males with a mean age of 37.9 ± 7.5years (gender: P = 0.55, age: P = 0.10). Of the total sample, 39 (22.5%) subjects were single and 134 (77.5%) were married. Face-to-face training was preferred by 61.2% of the married respondents and by 59% of those who were single. While 43.4% stated that visuals and documents were similar in both forms of training, those who stated that documentation was better in face-to-face training constituted 90.2% of the group that preferred face-to-face training (P = 0.0001). Of the total participants, 65.4% stated that concentration was easier in face-to-face training (P = 0.0001). When the groups were compared according to areas of interest, more of those involved in rhinology and head-neck surgery were in face-to-face training, and those with an interest in otology were seen to be in online training (P = 0.002). A wish to continue online training after the pandemic was expressed by 80.9% of the whole sample, and 68.6% wished to continue with face-to-face training (P = 0.0001). Hybrid meetings were determined to have been selected by 86.1% (P = 0.0001).

CONCLUSION

Online web seminars have an important role as a teaching and learning tool. There is a need for further research to evaluate how these clinically focused seminars can be presented at high quality and how they can provide benefit in training.

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.

Defining a Role for Webinars in Surgical Training Beyond the COVID-19 Pandemic in the United Kingdom: Trainee Consensus Qualitative Study

BACKGROUND

The COVID-19 pandemic posed several challenges for surgical training, including the suspension of many in-person teaching sessions in lieu of webinars. As restrictions have eased, both prepandemic and postpandemic training methods should be used.

OBJECTIVE

This study investigates trainees' experiences of webinars during the COVID-19 pandemic to develop recommendations for their effective integration into surgical training going forward.

METHODS

This project was led by the Association of Surgeons in Training and used an iterative process with mixed qualitative methods to consolidate arguments for and against webinars, and the drivers and barriers to their effective delivery, into recommendations. This involved 3 phases: (1) a web-based survey, (2) focus group interviews, and (3) a consensus session using a nominal group technique.

RESULTS

Trainees (N=281) from across specialties and grades confirmed that the COVID-19 pandemic led to an increase in webinars for surgical training. While there were concerns, particularly around the utility for practical training (80.9%), the majority agreed that webinars had a role in training following the COVID-19 pandemic (90.2%). The cited benefits included improved access or flexibility and potential standardization of training. The majority of limitations were technical. These perspectives were refined through focus group interviews (n=18) into 25 recommendations, 23 of which were ratified at a consensus meeting, which was held at the Association of Surgeons in Training 2021 conference.

CONCLUSIONS

Webinars have a role in surgical training following the COVID-19 pandemic. The 23 recommendations encompass indications and technical considerations but also discuss important knowledge gaps. They should serve as an initial framework for ensuring that webinars add value and continue to evolve as a tool for training.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2200055325; http://www.chictr.org.cn/showprojen.aspx?proj=142802.

Outcomes of Remote Pathology Instruction in Student Performance and Course Evaluation

The coronavirus disease 2019 (COVID-19) pandemic has disrupted undergraduate medical education, including preclinical class-based courses, by requiring social distancing and essentially eliminating in-person teaching. The aim of this study was to compare student performance and satisfaction before and after implementation of remote instruction in a first-year introductory pathology course. Assessments (3 quizzes, 1 practical exam, and 1 final) were compared between courses given before (January 2020) and during (January 2021) the COVID-19 pandemic, in terms of mean scores, degree of difficulty, and item discrimination, both overall and across different question types. Students’ evaluations of the course (Likert scale-based) were also compared between the 2 years. Significantly higher mean scores were observed during remote instruction (compared to the prior, in-person year) on verbatim-repeated questions (94.9 ± 8.8 vs 89.4 ± 12.2; P = .002) and on questions incorporating a gross specimen image (88.4 ± 7.5 vs 84.4 ± 10.3; P = .007). The percentage of questions that were determined to be moderate/hard in degree of difficulty and good/very good in item discrimination remained similar between the 2 time periods. In the practical examination, students performed significantly better during remote instruction on questions without specimen images (96.5 ± 7.0 vs 91.2 ± 15.2; P = .004). Finally, course evaluation metrics improved, with students giving a higher mean rating value in each measured end point of course quality during the year of remote instruction. In conclusion, student performance and course satisfaction generally improved with remote instruction, suggesting that the changes implemented, and their consequences, should perhaps inform future curriculum improvements.