Virtual Emergency Medicine Clerkship Curriculum during the COVID-19 Pandemic: Development, Application, and Outcomes

Abstract

The COVID-19 pandemic has been a significant catalyst for change in medical education and clinical care. The traditional model of bedside clinical teaching in required advanced clerkships was upended on March 17, 2020, when the Association of American Medical Colleges recommended removing medical students from direct patient care to prevent further spread of the disease and also to help conserve scarce personal protective equipment (PPE). This created unique challenges for delivering a robust, advanced emergency medicine (EM) clerkship since the emergency department is ground zero for the undifferentiated and potentially infected patient and has high demand for PPE. Here, we describe the development, application, and program evaluation of an online-based, virtual advanced EM curriculum developed rapidly in response to the COVID-19 pandemic. Starting March 23, 2020, we began rotating fourth-year medical students through a four-week rotation. We completed a total of four virtual clerkship experiences comprised of 56 students through July 27, 2020. Through analysis of the students’ performance on a national standardized EM shelf exam, students participating in this virtual clerkship demonstrated a fund of knowledge that was not significantly different from that of their peers who completed a traditional clerkship in the specialty prior to the pandemic interruptions. Additionally, the critical review of the traditional course created the opportunity to make improvements and enrich the medical student educational experience in a virtual environment and upon resumption of the traditional course when students returned to the in-person environment. The resources provided for those interested in adopting our pedagogical approach include a course syllabus, calendar, and learner summative assessment.

A rapid review of the effectiveness of alternative education delivery strategies in medical, dental, nursing and pharmacy education during the COVID-19 pandemic

“…28,31 Outcomes explored were confidence (n= 5), 21,22,24,25,27 competency (n=2) 20,23 and knowledge (n=6). 26,[28][29][30]32,33 Levels of competency, confidence and knot tying and suturing skills were found to have improved across the course of learning and a further study suggested that levels of competency were the same when learning was conducted virtually (2020) compared to in-person pre-COVID (2019). Evidence from RCTs showed that knowledge was greater when learning was conducted using bespoke interactive platforms with a standard video format reported during the COVID pandemic.…”

“…Most studies (n=7) were conducted in the USA. 21–25,29,33 The remaining studies were conducted in Germany, 26,27,31 Japan, 20 South Korea, 28 Switzerland 32 and Greece. 30…”

“…30 Five studies also incorporated asynchronous elements using pre-recorded lectures 23,28,30 or readily available podcasts. 25,33 For one further study the course content (8 topics) was organised by 12 rising 1 fourth-year medical students under supervision. 25 The two RCTs used bespoke interactive online platforms 31,32 and compared the outcomes to those students learning the same topic via a standard video format 31 or textbook based preparation.…”

“…28,31 Outcomes explored were confidence (n= 5), 21,22,24,25,27 competency (n=2) 20,23 and knowledge (n=6). 26,28–30,32,33…”

“…The flow of citations through each stage of the review process is displayed in a PRISMA flowchart, 19 see Figure 1. Studies were conducted with students in their final year (Clerkship / Interns) (n=7), 20,22,24,25,27,32,33 first year (n=2), 29,30 second and third years (n=1), 26 third year only (n=1), 23 across all years (n=1), 21 and a further two did not specify the year of study. 28,31 Outcomes explored were confidence (n= 5), 21,22,24,25,27 competency (n=2) 20,23 and knowledge (n=6).…”