Perception of the study situation and mental burden during the COVID-19 pandemic among undergraduate medical students with and without mentoring

Development and implementation of digital peer mentoring in small groups for first-year medical students

Introduction

Mentoring has become an important educational strategy in medical training. Peer mentoring (PM) can enhance student experience and support transition to higher education. This article documents the implementation of an online peer mentoring program for first year medical students at a newly founded medical school in Germany during the COVID-19 pandemic and its development into in-person PM.

Project description

We developed the program in close collaboration between students and teachers. Students were invited to apply as peer mentors via email; they received instructions and reflected on their role and experiences in meetings before, during and after the semester. One or more peer mentors were assigned randomly to a student group. We evaluated the program with an online survey inspired by the "Modified Mentorship Effectiveness Scale". After successful piloting PM was implemented into the core curriculum.

Results

In 2020 we assigned 17 peer mentors to 14 groups of 6-7 students. Groups met 3 or more times via Zoom®. Overall satisfaction was high. Both student groups reported benefits for their personal and professional identity formation. Atmosphere in online meetings was excellent. Most important topics were exams/learning strategies. In 2021 meetings were held in person. Overall satisfaction, perceived benefits and learning atmosphere were again rated very positively. Most students preferred many-to-many PM and random matching.

Conclusion

The implementation of PM was successful and beneficial for the participating students. PM can help first-year medical students reduce anxiety, improve self-organization and orientation at university. It fosters identity formation and has positive effects on peer mentees as well as on peer mentors.

Objective and subjective consequences of pandemic-related study program changes for the perception of the practical year - a comparison of medical students in Germany with and without a second national board examination

Background

Due to SARS-CoV-2, the Bavarian Ministry of Health decided in April 2020 to postpone the second national board examination in human medicine and to bring forward the start of the practical year (in German: Praktisches Jahr, further abbreviated with PJ) from May to April 2020. The different tertial times made it necessary for affected students to reorganise the PJ and rendered the preparation for the national board examination that had already taken place obsolete. As a result, students had to prepare for it again after the PJ and take it together with the third national board examination.

Research question

How do students affected by the early PJ differ in their perception of the practical year and in their psychological well-being from the comparison groups with a regular PJ schedule?

Methodology

The study is based on quantitative data from the Dean of Studies Office of the Medical Faculty of Ludwig-Maximilians-Universität München (LMU) and an online survey. The sample consists of LMU students who started the early PJ in April 2020 (n=86) and two comparison groups: The cohort of LMU students who started their PJ regularly in May 2019 (n=50), and students from other German universities who started their PJ regularly in May 2020 (n=98) and took the second national board examination in human medicine in spring 2020.

Results

For students affected by the early PJ, there were measurable negative effects on the choice of training institutions, the quality of the PJ content, preparation for the national board examinations, and career planning. Compared to regular students from other federal states, affected students reported higher psychological stress, with comparable resilience.

Conclusion

It can be assumed that the insights gained apply to the entirety of medical students in the affected federal states of Bavaria and Baden-Württemberg. As a conclusion, we make the recommendation to include the position of the students in decisions of great consequence.

Correlation analysis of self-directed learning ability, self-efficacy and academic burnout of junior nursing college students in closed management colleges

AIMS

To understand the status quo of self-directed learning ability, self-efficacy and academic burnout of junior nursing college students, since the closed management mode was implemented during COVID-19 pandemic disease.

DESIGN

Cross-sectional study.

METHODS

Participants came from 3,051 junior nursing college students of a college in Zhengzhou City, Henan Province, China. Data were collected by online questionnaire and analysed by SPSS25.0 (a statistical package for social science) and AMOS24.0 software.

RESULTS

High self-directed learning ability and self-efficacy were related to low levels of academic burnout (p < .01). In addition, the analysis of mediation effect indicated that the influence of self-directed learning ability on academic burnout was not mediated by self-efficacy.

The Impact of the COVID-19 Pandemic on Quality Education of the Medical Young Generation

(1) Generating the need to impose social distancing to reduce the spread of the virus, the COVID-19 pandemic altered the ways in which the teaching process normally happens. The aim of our study was to determine the impact of online teaching on medical students during this period. (2) Our study included 2059 medical, dental and pharmacy students from the University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania. We used a modified metacognition questionnaire after translation into Romanian and validation. Our questionnaire included 38 items, and it was divided into four parts. Academic results and preferences regarding the on-site or online courses, information regarding practical training, self-awareness in terms of one's feelings such as anger, boredom and anxiety and also substance use linked to online teaching, and contextualization of the relationship with colleagues, teachers, friends and family were among the most important points evaluated. A comparison was made between preclinical and clinical students. A five-item Linkert-like scale was used for rating the answers in the last three parts that evaluated the impact of the SARS-CoV-2 pandemic on the educational process. (3) Preclinical medical students, compared to preclinical dental students, obtained statistically significant improvements in their evaluation results, with fewer failed exams (p < 0.001) and with similar results being obtained by comparing dental with pharmacy students. All students obtained statistically significant improvements in their academic results during the online evaluation. A statistically significant increase in anxiety and depression with a p-value of <0.001 was registered among our students. (4) The majority found it difficult to cope with this intense period. Both teachers and students found it difficult to adjust on such short notice to the challenges posed by the new concept of online teaching and learning.

Online teaching, learning, and health outcomes: Impact on medical undergraduate students

Background

Online education has become a norm since the pandemic and it was a complete change for the medical curriculum. Many students missed patient interaction, which was a crucial part of their learning.

Aim

This study was designed to know the perceptions of online teaching of both the non-competency-based medical education (non-CBME) and competency-based medical education (CBME) curriculum during the coronavirus disease 2019 (COVID-19) pandemic, learning outcomes, and health-related problems due to online teaching-learning in medical undergraduates.

Materials and Methods

It was an online survey done after ethics approval. The survey questionnaire was sent to all medical undergraduates via email or WhatsApp and responses were recorded after informed consent. The total number of students who completed the survey was 346.

Results

66% of students found that online classes were not as enjoyable as offline. 66% found them time-saving with learning at their own pace. 85% felt they learned no clinical skills, and 80.6% said there was a lack of practical demonstrations. 71% experienced digital fatigue, 62% missed learning in a group, and 73% felt the poor motivation to study. Only 30% and 18.7% were confident enough to take a history or do an examination of the patient, respectively, after online clinics. 33% were confident to appear for university theory and only 11% for practical exams. The health problems faced due to online teaching included somatic complaints, sleep disturbances anxiety, and depressive symptoms in 40% of students.

Conclusions

The students were dissatisfied with online teaching. Learning outcomes were affected, as they were not confident to appear for university exams. Hence, though teaching happened during the pandemic, the online education imparted revealed lacunae and health effects.

COVID-19 and mental health: A systematic review of international medical student surveys

Background

The medical school curriculum has imposed psychological stressors on students worldwide, some of which may induce feelings of increased depression and anxiety. Meanwhile, the COVID-19 pandemic has exacerbated the feelings of stress, depression, and anxiety that a portion of medical students experience in their daily life. The aim of this systematic review is to gather concrete data from medical schools around the globe, and further evaluate how the COVID-19 pandemic has impacted medical students' mental health.

Materials and methods

Systematic search of data from PubMed, EMBASE, psycINFO, MEDLINE Complete, and Global Health for studies conducted between December 2019 and July 2021 was conducted. Data from 47 different surveys of medical students from various medical institutions throughout the world were included in this review. These surveys, administered in the form of questionnaires that utilized rating scales, measured anxiety, depression, and stress levels in medical students amidst the COVID-19 outbreak.

Results

The COVID-19 outbreak was found to have negative effects on medical students, most notably causing emotional and behavioral changes and detrimental mental health impacts. Higher levels of stress, depression, and anxiety have been found in medical students since the outbreak.

Conclusion

This systematic review highlights the sustained high prevalence of moderate depression, anxiety and stress among medical students during the COVID-19 pandemic. Appropriate support and research on which interventions could mitigate these risks is essential in order to ensure that future physicians are properly cared for, and ultimately have the adequate tools needed to provide high quality and empathetic care to future patients.

Online mentoring of medical students during COVID-19 pandemic: Another new normal

OBJECTIVES

To determine the impact of online mentoring sessions on the students during the pandemic time.

METHODS

The cross-sectional descriptive study was conducted at Bahria University Medical and Dental College, Karachi. The total study duration was 5 months from March 2021 to July 2021. Quantitative research design was used. Categorical data was scored on a three point Likert scale (1= 'Disagree', 2= 'Neutral' and 3= 'Agree'). Frequencies and percentages were calculated to determine the impact of online mentoring.

RESULTS

Sixty two percent of 2nd year MBBS students were of the opinion that online mentoring was helpful as compared to 58% 1st year and 50% 3rd year students. Students were anxious while sharing their issues online. A total of 61.66% were eager to have classes on campus as compared to online as learning difficulties were felt in 70%, 77% and 81% of 1st, 2nd and 3rd year classes respectively. Of the 1st year 39%, 2nd year 46% and 3rd year 32% showed relief after the mentoring session but were in favor of face to face sessions. Technical issues were faced by 54% 1st year, 66% 2nd year and 64% 3rd year students.

CONCLUSION

The study suggested that students were overall satisfied with the online mentoring sessions. They do have certain apprehensions like privacy and confidentiality issues but on the whole, they considered this medium as being a powerful one in times of the pandemic.

Academia's responses to crisis: A bibliometric analysis of literature on online learning in higher education during COVID-19

This paper aimed to provide a holistic view of research that investigated online learning in higher education around the globe during COVID-19 utilizing a bibliometric analysis. The researchers used co-citation analysis and text mining afforded by VOSviewer to document and analyze research patterns and topics reported in peer-reviewed documents published between January 2020 and August 2021. Findings of this study indicated that scholars from 103 countries or regions from the Global North and Global South investigated a wide array of topics, such as use of various technologies and strategies, redesigned curriculum, student perceptions and psychological impacts of the pandemic-imposed online learning. Many researchers applied technology acceptance theories and structural equation modeling to investigate factors associated with adoption and impacts of the pandemic-imposed online learning. Of the large quantity of research, medical education and chemical education were the most investigated disciplines. Inquiry-based learning, discovery learning, hands-on learning and collaborative learning emerged as instructional approaches frequently discussed or utilized across the target studies. This paper discussed (a) ongoing and emerging challenges to online higher education, (b) placing innovative pedagogies at the forefront of online learning, and (c) rapid, but imbalanced distribution of evolving literature based on the findings.

Mental burden and perception of the study situation among undergraduate students during the COVID-19 pandemic: a cross-sectional study and comparison of dental and medical students

OBJECTIVES

To investigate levels of distress, depression, anxiety, stress and perception of their current study situation during the COVID-19 pandemic among undergraduate dental and medical students.

DESIGN

Observational, cross-sectional study including two consecutive surveys (May and July 2020).

SETTING

A large medical school in Germany.

PARTICIPANTS

All first year dental and medical students were invited. 132 participating first year students (44 dental, 88 medical) from the first survey and 150 students (50 dental, 100 medical) from the second were included in our analyses.

PRIMARY AND SECONDARY OUTCOME MEASURES

Mental burden (distress thermometer, Patient Health Questionnaire-4, Perceived Stress Scale-4) and self-reported changes in mental health and perception of study situation during the COVID-19 pandemic (self-developed items) were compared. Open-ended questions were analysed by conventional content analyses.

RESULTS

A considerable proportion of students (t1: May 2020: 84.1%; t2: July 2020: 77.3%) reported distress levels above cut-off. In July 2020, dental students reported significantly higher distress scores than medical students (dental: M=7.0, SD=2.3; medical: M=5.7; SD=2.1; p<0.001). More dental than medical students reported mild, moderate and severe levels of anxiety and depression symptoms. The majority stated that their mental health and study motivation had not changed during the pandemic. Logistic regression showed that being a dental student was significantly associated with a higher likelihood for serious worries regarding the study situation during COVID-19 at t1 (OR 4.0; 95% CI 1.1 to 14.2). At t2 higher distress was significantly associated with a higher likelihood for experiencing serious worries (OR 1.8; 95% CI 1.3 to 2.5). Regarding current concerns related to the pandemic, students most frequently reported difficulties with self-regulated learning (15.2%), study-related worries and uncertainty (14.4%), missing feedback of students and lecturers (11.4%) and lack of practical training (9.8%).

CONCLUSION

The results suggest that high mental burden and the lack of practical training among medical and dental students is an increasing problem, with a possibly even higher urgency in dental students. Tailored psychological and educational support offers during and after the COVID-19 pandemic might help them as they progress through (medical and) dental school.

Undergraduate medical education amid COVID-19: a qualitative analysis of enablers and barriers to acquiring competencies in distant learning using focus groups

Due to comprehensive social distancing measures related to the COVID-19 pandemic, medical faculties worldwide have made a virtue of necessity in resorting to online teaching. Medical faculties grapple with how to convey clinical competencies to students in this context. There is a need for research not only to map but also to explain the effect of these secondary measures on students' learning and mental wellbeing. During a period of ongoing comprehensive social distancing measures in Germany, we translated a competency-based curriculum including obstetrics, paediatrics, and human genetics to an e-learning course based on online patient and teacher encounters. In our qualitative study on students' and teachers' views, we identify potential enablers and drivers as well as barriers and challenges to undergraduate medical education under lockdown. In summer 2020, we conducted six focus group interviews to investigate medical students' and teachers' perspectives, experiences and attitudes. All focus groups were videotaped, transcribed verbatim and coded. To guide our deductive and inductive analysis, we applied the theoretical framework of Regmi and Jones. Content analysis was performed in a multi-perspective group. We identified five major themes contributing to a successful use of clinical competency-based e-learning under lockdown: Communication (with teachers, students, and patients), Mental wellbeing, Structure and self-organization, Technical issues, and Learning and commitment. We discuss enablers and potential barriers within all themes and their overlap and link them in an explanatory model. In our setting, students and teachers find e-learning holds strong potential and especially in times of COVID-19 it is greatly appreciated. We broaden the understanding of the impact of distant learning on acquiring competencies, on attitudes, and on mental wellbeing. Our model may serve for a thoughtful, necessary transition to future e-learning and hybrid programs for a competency-based medical education with ongoing social distancing measures.

Now, I think doctors can be heroes … Medical student's attitudes towards the COVID-19 pandemic's impact on key aspects of medical education and how the image of the medical profession has changed due to the COVID-19 pandemic

Background

The COVID-19 (coronavirus disease 2019) pandemic hit the world in early 2020 and influenced medical education worldwide. Distance learning, risk of infection and patient care, telehealth literacy, medical ethics and research in medical education are key factors of medical education challenged by the pandemic. Additionally, the following question arises: “What do medical students think about their future profession in the face of this crisis?”

Methods

A cross-sectional survey was conducted among all undergraduate medical students of the Medical University of Vienna. 872 students answered the self-developed questionnaire. Qualitative and quantitative data analyses were conducted.

Results

The data show that the COVID-19 pandemic has raised awareness for the key aspects. In all areas of interest, students’ feeling of petaredness is limited. Limitations in practical training and distance learning as well as social isolation concern a majority of students. Neutral, positive, and negative themes emerged in qualitative data analysis. Only 8% of the students of the first 3 years of study versus 13.4% of the students in higher years commented negatively. 18.7% of male vs. only 12.5% of all female students’ comments were positive. A large proportion of positive comments were dedicated to the relevance and deeper meaning of the medical profession. Infection risk and the demanding nature of the medical profession were predominant in negative comments.

Conclusion

The COVID-19 crisis has turned the spotlight on several aspects of medical education in need of reform. In addition, the occupational image of the medical profession seems to shift under the weight of this pandemic.

The impact of COVID-19 on mentoring early-career investigators: "Everything can wait. Listen more than usual and share your own struggles"

The COVID-19 pandemic disrupted almost all sectors of academic training and research, but the impact on human immunodeficiency virus (HIV) research mentoring has yet to be documented. We present the perspectives of diverse, experienced mentors in a range of HIV research disciplines on the impact of COVID-19 on mentoring the next generation of HIV researchers.In November to December, 2020, we used an online data collection platform to cross-sectionally query previously-trained HIV mentors on the challenges related to mentoring during the pandemic, surprising/positive aspects of mentoring in that context, and recommendations for other mentors. Data were coded and analyzed following a thematic analysis approach.Respondents (180 of 225 mentors invited [80% response]) reported challenges related to relationship building/maintenance, disruptions in mentees' training and research progress, and mentee and mentor distress, with particular concerns regarding mentees who are parents or from underrepresented minority backgrounds. Positive/surprising aspects included logistical ease of remote mentoring, the relationship-edifying result of the shared pandemic experience, mentee resilience and gratitude, and increased enjoyment of mentoring. Recommendations included practical tips, encouragement for patience and persistence, and prioritizing supporting mentees' and one's own mental well-being.Findings revealed gaps in HIV mentors' competencies, including the effective use of remote mentoring tools, how to work with mentees in times of distress, and the prioritization of mentor well-being. Mentors are in a unique position to identify and potentially address factors that may lead to mentees leaving their fields, especially parents and those from underrepresented backgrounds. We discuss implications beyond the COVID-19 pandemic.

Dental Students in Germany throughout the COVID-19 Pandemic: A Psychological Assessment and Cross-Sectional Survey

Multiple investigations have reported high psychological distress among students since the coronavirus (COVID-19) outbreak started. This survey examined the associations between psychological features, and several demographic and social factors among dental students in German universities. Dental students registered in German universities nationwide were asked to join this survey via a self-directed online questionnaire, from July 2020 to January 2021. This study assembled data on demographic statistics, the depression anxiety stress scales (DASS-21), and the impact of events scale-revised (IES-R) instrument. The relationships between demographic-related variables and mental consequences of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were inspected. Two hundred and eleven students contributed to the questionnaire and conveyed overall normal or mild outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal. In addition, female gender, cardiovascular diseases, smoking habits, and seeing the COVID-19 outbreak as a financial risk were stated as significant related factors (p < 0.05), with increased IES-R and DASS-21 scores. These results highlight the features that should be considered to better protect dental students' mental health in German universities during the crisis.

Student support systems for undergraduate medical students during the COVID-19 pandemic: a systematic narrative review of the literature

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has boosted medical students' vulnerability to various problems. Given the stressful nature of medical disciplines, considerable attention must be paid to student support systems during pandemics. This study aimed to review the current literature regarding medical student support systems systematically.

METHODS

We performed a systematic review of six databases and grey literature sources in addition to a hand search in the references of the articles on April 5, 2021. We included all studies about support for undergraduate medical students delivered in response to the COVID-19 pandemic. In conducting this review, we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

RESULTS

A total of 3646 articles were retrieved from the databases, and 16 additional papers were extracted from other sources. After removing duplicates, we screened 2434 titles and abstracts according to our criteria. Among them, 32 full-text articles were assessed for eligibility. Ultimately, 10 studies were included for review. We identified two major themes: (a) academic support and (b) mental health support. All of the included studies utilized online methods whether for transitioning from previous support systems or developing novel approaches. Students and faculty members seemed to be receptive to these new systems. Despite indicating outstanding program outcomes, most studies merely described the positive effects of the program rather than providing a precise evaluation.

CONCLUSION

There are several methods of supporting medical students who are experiencing unprecedented changes in their educational trajectory. Due to substantial differences in undergraduate medical education in different regions of the world, cultural and contextual-oriented support is indispensable for developing a safe learning environment. Future research should investigate the question of the extent to which online support can supersede in-person strategies.

Evaluation of a Mentor training program for midwives in two hospitals in Warsaw, Poland - a qualitative descriptive study

BACKGROUND

Mentoring is a recognized, but still underutilized strategy for effective clinical training of midwifery students. The success of formally recognized course-embedded mentoring depends on adequate preparation of clinical teacher to act as mentors and effective developing of their mentoring skills. The aim of this study was to evaluate a Mentor Training Program for midwives, the first of its kind in Poland.

METHODS

Twenty-one midwives who completed a dedicated Mentor Training Program organized by the Medical University of Warsaw (12-14 June 2017) participated in this study. In Stage 1, 7 days prior to the training course, the participants completed an online questionnaire that identified their motivations and expectations. In Stage 2, they assessed the training program they had completed as well as described any perceived needs of further mentor training. Subsequently a qualitative study of the data was performed using content analysis.

RESULTS

In Stage 1, the participants expressed their interest in the Mentor Training Program mostly expecting to develop skills allowing them to implement mentoring in clinical training of student midwives. They were aware of the potential benefits of mentoring for hands-on instruction on the wards and wanted to gain knowledge of this strategy. In Stage 2, the overall satisfaction with the program was high, but the participants assessed their preparedness to act as midwifery mentors as inadequate. The results suggest that the Mentor Training Program should be further refined and expanded while the outcomes need to be evaluated in more detail by both new mentors and their trainers over a longer period of time, possibly after the participants have gained actual experience of mentoring in the clinical setting.

CONCLUSION

The participants described the Mentor Training Program as innovative, valuable and largely meeting their expectations. They gained knowledge of the concept of mentoring and its potential application in clinical training of midwifery students in Poland. Future mentor training programs should be expanded with a greater focus on developing, strengthening and applying mentoring skills in the clinical setting.