Medical Education during COVID-19: Response at one medical school

Did the students' satisfaction rates at Avalon University School of Medicine correlate with the occurrence of accreditation site visits?

INTRODUCTION

Accreditation of medical education programs can be observed from different perspectives. Regulatory/accreditation agencies consider it vital to assure a certain level of quality. Other stakeholders may perceive the accreditation process as a negative experience, draining resources, and efforts. Although accreditation may improve the program's governance and administration, its direct or indirect impact on students must be further investigated. This study explores the relationship between the occurrence of accreditation site visits and student satisfaction rates at Avalon University School of Medicine.

METHODS

A comparison study was conducted with retrospective satisfaction data from two accreditation cycles at AUSOM. We used the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP) student surveys for data collection, and data from 2017, 2019, and 2022 were used. The response rate was 70% (n = 71), 72% (n = 47), and 60% (n = 56) for basic science students and 80% (n = 111), 82% (n = 115), and 70% (n = 76) for clinical students in 2017, 2019, and 2022, respectively. The survey for basic sciences students included 37 questions/items, and the survey for clinical students included 39 questions/items. The responses for the questionnaire were on the five-point Likert scale. The retrospective data were evaluated using the unpaired Wilcoxon-rank sum test.

RESULTS

The ratings for the basic science students' survey increased from 2017 to 2019 (first accreditation cycle) only for 11 items/questions and they were increased from 2019 to 2022 for all items/questions. The ratings for clinical science students' surveys increased from 2017 to 2019 (the first accreditation cycle) for all items/questions with a statistically significant p-value. They increased for 28 questions/items from 2019 to 2022, and two items (availability and adequacy of career counseling) showed statistically significant p-values.

CONCLUSIONS

The pre-accreditation preparation and the self-evaluation process while correcting the program's deficiencies are essential triggers for the quality improvement process associated with accreditation.

Medical Student Enrollment in a Voluntary Medical Innovation Course

Background

There is an increasing need for medical innovators to help address the growing challenges within health care. Despite this, the rate of adoption of new medical innovation programs at the United States (US) medical schools has been slow. Existing literature explaining this slow rate of adoption is scant. We examined the rate of student enrollment in a voluntary medical innovation course during an unscheduled summer at our institution and the educational backgrounds of these enrollees.

Methods

This mixed qualitative and quantitative survey study comprised consecutive surveys quantifying a two-stage sign-up process for a voluntary summer medical innovation course for Medical Doctorate (MD) candidates at the David Geffen School of Medicine. After a "General interest" survey, interested students completed an "Enrollment" survey to indicate enrollment, educational background, and open-ended comment about motivations for enrollment. Surveys were administered electronically via email listservs. Statistical methods included chi squared testing with statistical significance defined as p < 0.05.

Findings

A total of 12% of UCLA Class of 2024 expressed an interest in participation in the program, and 10.3% ultimately enrolled. Enrollees were motivated primarily by the opportunity to learn about medical innovation (72%) and also shadow (28%). Enrollees were similar in undergraduate degrees and majors to the general medical student class and US MD candidate population.

Conclusion

A lack of medical student willingness to participate may not underlie the observed slow rate of adoption of medical innovation programs at US MD programs given the observed high voluntary enrollment rate. Enrollee educational background did not differ significantly from non-enrollees or the broader US MD candidate population. Educators should be encouraged by these data to explore student willingness to participate in medical innovation education at their institutions.

An online case-based teaching and assessment program on clinical history-taking skills and reasoning using simulated patients in response to the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has created unprecedented challenges for medical students and educators worldwide. Groups 1, 2 and 3 of year 3, semester 2 medical students at the Royal College of Surgeons in Ireland (n = 275) had only completed 2, 5 and 7 weeks, respectively, of their scheduled 10-week clinical medicine and surgery attachments, prior to the Irish shutdown of all in-person non-essential activities, including medical student education.

METHODS

We developed and delivered an online case-based program, focused on history-taking skills and clinical reasoning, using simulated patients and video technologies. 12 tutorials were delivered over 6 weeks to 35 subgroups of 8 students in line with program learning outcomes. Both simulated patients (n = 36), and tutors (n = 45, from retired clinical professors to newly graduated physicians), were rapidly upskilled in Blackboard Collaborate and Microsoft Teams, and also in the provision of constructive feedback. We evaluated this newly developed program by the following three criteria: student attendance, achieved grades, and student feedback.

RESULTS

Attendance at the 12 tutorials was higher amongst group 1 and 2 students (75 and 73%) by comparison with group 3 students (60%) (p = < 0.001). Of the 273 students that sat the Year 3 Semester 2 online long case assessment, 93% were successful. Despite group 1 students having the least prior clinical experience, results were similar to those of groups 2 and 3 (1st honors, 2nd honors, pass, and fail grades for group 1, 39%, 33%, 23% and 6%; group 2, 34%, 41%, 17% and 8%; group 3, 39%, 25%, 28% and 7%) (p = 0.48). An increased attendance rate at tutorials was associated with higher numbers of honors grades (p = < 0.001). Anonymous feedback from the students demonstrated considerable satisfaction with program: > 85% agreed that the online program was interactive and very educational.

CONCLUSIONS

Use of online video technology, tutors of varied experience, and simulated patients were demonstrated to replicate patient encounters, and to facilitate the development of clinical skills remotely during the COVID-19 pandemic.

Impact of COVID-19 on postgraduate medical education: Cross sectional survey from an Indian Medical College

BACKGROUND

The corona virus disease (COVID-19) pandemic has caused widespread effect on the lives of health care professionals. The postgraduate medical students, who are the major pillars of medical institutions had to bear multitude of setbacks due to the pandemic involving academic, research and well-being issues.

MATERIALS AND METHODS

This was a cross sectional feedback based online survey done in the month of October 2021 to study the effect of COVID-19 pandemic induced changes in the postgraduate medical education; amongst 78 students pursuing MD/MS degree in all departments of a tertiary medical institute in Himalayan foothills of North India. The questionnaire consisted of ten questions; each of which needed to be answered on a five point Likert scale ranging from strongly disagree to strongly agree. Results were assessed for the most common answers of each question (represented by mode) and association between various components of the questionnaire analyzed by Spearman's rho correlation coefficient.

RESULTS

The internal consistency of the questionnaire as tested by Cronbach's Alpha (0.82) was good. Most number or respondents were from surgical branches (n = 31, 39.74%). There was a generalized agreement towards preference of resumption of onsite education (75.64%), the lack of variety of cases causing hampering of thesis work (88.46%) and increased mental stress during the pandemic (58.9%). While more time for self-study was seen as the only consensual positive aspect of online teaching (64%), most students opined that technical glitches are a major roadblock in online education (80.76%). Significant positive correlation was seen between disciplinary ease and punctuality in online teaching (R = 0.543, P < 0.001), lack of interaction and its effect on learning and mental health (R = 0.471; P < 0.001) and the lack of diversity in cases and difficulties in dissertation work (R = 0.351; P < 0.05). Negative correlation was observed between the satisfaction from overall learning through online teaching and the desire of resumption of offline classes (R = -0.491; P < 0.001).

CONCLUSION

COVID-19 pandemic and its effects on medical education are long lasting. A comprehensive approach is required to rebuild the medical education curriculum, inculcating both traditional and newer virtual methods of education. A consistent support in academics and overall growth needs to be provided to medical postgraduate residents who have been the first line fighters in face of the massive disaster compromising their basic needs and education.

Preferences and Scores of Different Types of Exams during COVID-19 Pandemic in Faculty of Veterinary Medicine in Spain: A Cross-Sectional Study of Paper and E-exams

The World Health Organization (WHO) officially declared the novel coronavirus (COVID-19) as a pandemic on 11 March 2020, and educational institutions have had to modify most of their activities (face-to-face activities were suspended). This situation forced academic institutions to modify the evaluation format of students. The use of proctoring systems quickly became widespread, although some controversies arose. The two main discussions regarding these systems are the integrity of the assessment and the capacity of the students to adapt to this new assessment method, without changes in theirs scores. To elucidate two controversies, we have analyzed the preferences and the scores obtained from a trial of 660 scores from 332 students of the third grade of Veterinary Medicine. The experiment involved three modalities of exam: an online format from home using the Respondus Lockdown Browser system (Modality 1), online in person using the Respondus Lockdown Browser system with the supervision of a teacher (Modality 2), or paper format in person with the supervision of a teacher (Modality 3). The results obtained showed that the students preferred Modality 1 (online at home with Respondus Lockdown Browser system). No statistical differences between the scores obtained by students were found between the three modalities analyzed. The proctoring system is a good method to adjudicate exams in higher education institutions, and the scores of students are similar to those obtained through traditional evaluation and control systems.