|LETTER TO THE EDITOR
|Year : 2021 | Volume
| Issue : 1 | Page : 41-42
Training medical students in the clinical environment during COVID-19: A recipe for failure
Kishan Pankhania, Abdulaziz Alkhayyat
School of Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, Oxford Road, M13 9PL, United Kingdom
|Date of Submission||03-Jun-2020|
|Date of Acceptance||20-Mar-2021|
|Date of Web Publication||30-Jun-2021|
School of Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL
Source of Support: None, Conflict of Interest: None
|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
Medical students worldwide become doctors after immersing themselves in the clinical environment. Away from textbooks, real patients present complex challenges; interactions with these patients enhance learning and the development of clinical acumen. However, the nature of medical education is changing in light of the current pandemic. Clinical rotations have been cancelled for thousands of students, 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.”
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 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). 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
Conflicts of interest
There are no conflicts of interest.
| References|| |
Rose S. Medical student education in the time of COVID-19. JAMA 2020;323:2131-2.
Nordquist J, Hall J, Caverzagie K, Snell L, Chan MK, Thoma B, et al
. The clinical learning environment. Med Teach 2019;41:366-72.