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 Table of Contents  
LETTER TO THE EDITOR
Year : 2021  |  Volume : 34  |  Issue : 1  |  Page : 41-42

Training medical students in the clinical environment during COVID-19: A recipe for failure


School of Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, Oxford Road, M13 9PL, United Kingdom

Date of Submission03-Jun-2020
Date of Acceptance20-Mar-2021
Date of Web Publication30-Jun-2021

Correspondence Address:
Kishan Pankhania
School of Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/efh.EfH_215_20


How to cite this article:
Pankhania K, Alkhayyat A. Training medical students in the clinical environment during COVID-19: A recipe for failure. Educ Health 2021;34:41-2

How to cite this URL:
Pankhania K, Alkhayyat A. Training medical students in the clinical environment during COVID-19: A recipe for failure. Educ Health [serial online] 2021 [cited 2021 Dec 5];34:41-2. Available from: https://www.educationforhealth.net/text.asp?2021/34/1/41/320360



Dear Editor,

Medical students worldwide become doctors after immersing themselves in the clinical environment.[1] Away from textbooks, real patients present complex challenges; interactions with these patients enhance learning and the development of clinical acumen.[2] However, the nature of medical education is changing in light of the current pandemic. Clinical rotations have been cancelled for thousands of students,[3] leaving them with online material that attempts to replicate the clinical setting. Here, we discuss the importance of and challenges surrounding re-introducing medical students into clinical environments.

As 4th-and 5th-year medical students in the United Kingdom, we learn and benefit from working alongside doctors who treat their patients while they expand our knowledge. As Nordquist et al. point out, “there is no comparison to the learning that comes from managing patients in a real clinical context.”[2]

We realize the short-term effects of cancelling placements– less experience means fewer opportunities for knowledge based and technical skills to develop. Third- and 4th-year students across the UK could miss out on up to 4 months of core and specialty placements. That time may never be fully recovered before graduation. This may result in them becoming less-able clinicians, although research to this end is lacking.

Nevertheless, the decision to resume placements for the next academic year[4] poses enormous risks. The number of people with this highly contagious virus is expected to remain at concerning levels (IHME COVID-19 health service utilization forecasting team, Murray CJL, prepublication, 2020). Should students return to the clinical setting, they could risk infection, threatening their health as well as that of any close contacts. For both ethical and legal reasons, these risks should not be accepted because institutions lack the capabilities to ensure the learning environment is safe. Second, health care professionals have reported shortages of personal protective equipment (PPE).[5] Students would not and should not be competing for this.

Students would likely not be able to simply avoid interacting with patients with coronavirus. The Institute for Health Metrics and Evaluation suggests that only 13% of infected people have been tested and are positive (IHME COVID-19 health service utilization forecasting team, Murray CJL, prepublication, 2020). Not every patient in the hospital is tested while many NHS staff only get tested when they become symptomatic, putting their colleagues and patients at risk. Even with PPE, students, in all likelihood, would find themselves exposed to the virus.

We propose that universities substitute the clinical experience; technology could be used to digitalize hospital learning experiences. Interactions between doctors and patients could be recorded to help develop communication and clinical reasoning skills. Tutorials could be delivered over live web-streaming services. Implementing these suggestions, however, may be difficult in developing countries where technology has little input into education. As for technical skills, select wards where health care professionals and patients are all tested could be designated safe zones for these activities to occur. In summary, researchers should thoroughly and rapidly explore how to substitute clinical environments, given that a vaccine is still beyond the horizon.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Rose S. Medical student education in the time of COVID-19. JAMA 2020;323:2131-2.  Back to cited text no. 1
    
2.
Nordquist J, Hall J, Caverzagie K, Snell L, Chan MK, Thoma B, et al. The clinical learning environment. Med Teach 2019;41:366-72.  Back to cited text no. 2
    
3.
Lee YJ. The Coronavirus is Preventing Medical Students from Getting Hands-On Training in Hospitals. Frustrated Future Doctors are Looking for New Ways to Help. Available from: https://www.businessinsider.com/medical-students-taken-off-hospital-rotations -want-to-help- 2020-3?r=US&IR=T. [Last accessed on 2020 Jun 03].  Back to cited text no. 3
    
4.
Atherton J, Reed M, Petty-Saphon K. Advice from Medical Schools Council to UK Medical Schools on Actions Surrounding COVID-19. Available from: https://www.medschools.ac.uk/media/2620/msc-covid-19-advice-for-uk-medical-schools.pdf. [Last accessed on 2020 Jun 03].  Back to cited text no. 4
    
5.
Haynes C, Clayton J. Coronavirus: Doctors 'Told Not to Discuss PPE Shortages'. Available from: https://www.bbc.co.uk/news/uk-52671814. [Last accessed on 2020 Jun 03].  Back to cited text no. 5
    




 

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