Medical Education and Safety as Co-priorities in the Coronavirus Disease 2019 (COVID-19) Era

Baecher-Lind, Laura; Fleming, Angela C.; Bhargava, Rashmi; Cox, Susan M.; Everett, Elise; Graziano, Scott; Katz, Nadine T.; Sims, Shireen Madani; Morgan, Helen; Morosky, Christopher M.; Sonn, Tammy; Sutton, Jill M.; Royce, Celeste

doi:10.1097/aog.0000000000004113

Cited by 10 publications

(7 citation statements)

References 10 publications

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“…More importantly, the findings made in our study are likely to be reproduced in future health crises as medical education strategies have a tendency to repeat themselves 53 . The conflicts demonstrated between stakeholder groups and the negative effects reported in our study as well as in numerous others 1,7,54–59 may at first be perceived as the result of a dysfunctional or collapsed health care system. However, the mechanisms may also demonstrate the resilience of our current educational systems that it responds adequately to a health crisis that requires prioritisation between imminent needs (patient care) and postponable needs (education) for a period of time before returning to a new normal 60 .…”

Section: Discussionsupporting

confidence: 53%

Business as (un)usual: A qualitative study of clerkship experiences during a health crisis

et al. 2022

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Introduction: During a health crisis, hospitals must prioritise activities and resources, which can compromise clerkship-based learning. We explored how health crises affect clinical clerkships using the COVID-19 pandemic as an example.Methods: In a constructivist qualitative study, we conducted 22 semi-structured interviews with key stakeholders (i.e. medical students and doctors) from two teaching hospitals and 10 different departments. We used thematic analysis to investigate our data and used stakeholder theory as a sensitising concept.Results: We identified three themes: (1) emotional triggers and reactions; (2) negotiation of legitimacy; and (3) building resilience. Our results suggest that the health crisis accentuated already existing problems in clerkships, such as students' feelings of low legitimacy, constant negotiation of roles, inconsistencies navigating rules and regulations and low levels of active participation. Medical students and doctors adapted to the new organisational demands by developing increased resilience. Students responded by reaching out for guidance and acceptance to remain relevant in the clinical clerkships. Doctors developed a behaviour of closing in and focused on managing themselves and their patients. This created tension between these two stakeholder groups. Conclusion:A health crisis can critically disrupt the hierarchical structure within the clinical clerkships and exacerbate existing conflicts between stakeholder groups.When medical students are not perceived as legitimate stakeholders in clinical clerkships during a health crisis, their attendance is perceived as unnecessary or even a nuisance. Despite increased student proactiveness and resilience, their roles inevitably shift from being doctors-to-be to students-to-be-managed.

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Section: Discussionsupporting

confidence: 53%

Business as (un)usual: A qualitative study of clerkship experiences during a health crisis

et al. 2022

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“…The removal of students from clinical medical situations has been well documented within the literature as medical and radiology students are removed from their frontline positions. 8,9 Suggestions to overcome this include better access to PPE, the use of telemedicine and video interaction with patients and the increase in virtual learning experiences. 8,9 Participant numbers from the Northern Territory, Western Australia, Tasmania, and New Zealand were low, so these results should be viewed with caution.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 Suggestions to overcome this include better access to PPE, the use of telemedicine and video interaction with patients and the increase in virtual learning experiences. 8,9 Participant numbers from the Northern Territory, Western Australia, Tasmania, and New Zealand were low, so these results should be viewed with caution. The perceptions of how the changes during COVID-19 impacted routine work is based on sonographers' self-reports only, presenting another limitation to this study.…”

Section: Discussionmentioning

confidence: 99%

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The initial impact of COVID‐19 on Australasian sonographers part 2: Changes to sonographic examination protocols and access to personal protective equipment

et al. 2021

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Introduction: COVID-19 brought with it the requirement for healthcare workers to limit community transmission of the virus as much as possible by limiting patient contact and wearing Personal Protective Equipment (PPE). This study aimed to capture the initial adaptations to sonographic examination protocols within ultrasound departments and sonographer access to PPE.Methods: An online survey was used to gather data on sonographer reflections of sonographic examination protocol changes seen in their departments and access to PPE between the 11th of March 2020 and the 14th of June 2020. Results:To reduce the time sonographers spent with the patients and hence reduce the risk of exposure to COVID-19, sonographers reported adjustments to sonographic examination protocols including their duration and scheduling. Access to PPE was reported as poor. Conclusion:Numerous sonographic examination protocol changes were observed within ultrasound departments in Australasia in the initial response to COVID-19.Access to PPE was varied along with sonographer feelings around the impact of these changes.

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“…In some countries, BST is in decline, a situation that may only be exacerbated by the SARS-CoV2 pandemic [ 12 – 15 ]. Fifty years ago, three-quarters of clinical teaching was documented as at the bedside; just over ten years ago estimates suggested 17% of teaching was at the bedside, with most of this being the teaching of physical examination [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Validation of a questionnaire exploring patient attitudes towards bedside teaching

et al. 2022

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Background Bedside teaching (BST) facilitates medical education and has reduced in practice, often due to patient-related concerns. This study aimed to validate a questionnaire exploring patients attitudes towards BST. Methods International guidelines for questionnaire development were followed. Seven steps were included: literature review, patient interviews, development of clear and understandable items, expert validation, cognitive interviewing and pilot testing. Statistical analyses included exploratory factor analysis, internal consistency, investigation of demographic influences and discriminant validity across subscales. Results Following the literature review, 32 interviews were conducted. Potential items were developed, reviewed and adapted. Experts in medical education and statistics reviewed the draft questionnaire. Fifteen patients consented to cognitive testing and 401 consenting patients completed the final version. The median age of participants was 35 years of age (range: 18 to 70 years). Participants included women attending for antenatal (40%), postnatal (32%) and gynaecology issues (28%). Just under one third (29%) had taken part in medical student teaching previously. Statistical analyses found a two-factor solution, consisting of Educate medical professionals and Conditions for participation subscales with good internal consistency; responses did not vary by age or education. Participants who had opted-in for teaching in the ward and bedside endorsed higher levels of Educate medical professionals, suggesting discriminant validity. A majority of patients (> 92%) reported that they were happy to be involved in BST. Patients believed that they should not be asked to participate in BST should they feel stressed or unwell (68.2%). Conclusion This study shows extensive patient support for BST, independent of age or education. The desire to educate is a strong motivating factor. This strong support by patients for BST is an area that medical schools and universities can potentially develop. Future versions of this questionnaire may include virtual bedside teaching, in the context of social distancing.

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Medical Education and Safety as Co-priorities in the Coronavirus Disease 2019 (COVID-19) Era

Abstract: Personal or nonessential information may be redacted at the editor's discretion.

Cited by 10 publications

References 10 publications

Business as (un)usual: A qualitative study of clerkship experiences during a health crisis

Business as (un)usual: A qualitative study of clerkship experiences during a health crisis

The initial impact of COVID‐19 on Australasian sonographers part 2: Changes to sonographic examination protocols and access to personal protective equipment

Validation of a questionnaire exploring patient attitudes towards bedside teaching

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