|
 
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| REVIEW ARTICLE |
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| Year : 2021 | Volume
: 1
| Issue : 1 | Page : 9-11 |
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Medical education and COVID-19: A perspective
Sonam Maheshwari1, Pravesh Rawat2, Puneet Kumar Gupta3
1 Department of Community Medicine, Government Doon Medical College, Dehradun, India
2 MBBS Student, Government Doon Medical College, Dehradun, India
3 ICFAI Business School, The ICFAI University, Dehradun, India
| Date of Submission | 19-Sep-2020 |
| Date of Decision | 14-Jan-2021 |
| Date of Acceptance | 02-Apr-2021 |
| Date of Web Publication | 18-May-2021 |
Correspondence Address:
Dr. Puneet Kumar Gupta
ICFAI Business School, The ICFAI University, Dehradun
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JCDM.JCDM_1_20
The difference addressed earlier may not be a very hype intervention, unlike what science has been giving us, but this can do a lot in setting us free from this very pandemic, COVID-19. The fight against COVID-19 is a biological warfare that cannot be won at the cost of ammunitions but with proper knowledge, information, and communication, through various advertisements, banners, and posters. This is an hour-saving time where COVID-19 is rapidly evolving. The entire focus is placed on caring for the patient and on abandoning community spread of the disease in order to decrease disease burden; nevertheless, the rapidity of COVID-19 has proven to be grave for medical education and severely disrupted the medical curriculum. Keywords: COVID-19, medical education, on-line learning, pandemic
How to cite this article:
Maheshwari S, Rawat P, Gupta PK. Medical education and COVID-19: A perspective. J Cardio Diabetes Metab Disord 2021;1:9-11 |
| Introduction | |  |
In a country like India, the prime importance is solely placed on nurturing the budding future, in order to expand its economic status and hype in literacy statistics. The emergence of COVID-19 has truly stabbed the country’s backbone, making it functionally disabled along the path of growth and impeding its development.
The notorious virus has affected not only medical education but also various other educational streams. Talking in general, the “COVID-19 generation of students” have to continue their education in a setting that is continuously changing and adapting to the management of the virus by means of social distancing.[1] Students are forced to abandon their schools and colleges, making them rely on online educational platforms rather than normal chalk-and-board conservative teaching, where two-way interaction forms the basis to deliver concepts. Continuous feedback is reviewed for improvement; however, the scope of improvisation is limited on the “e-learning” platform, as it is the only basis to connect various bodies together under a single umbrella as a substitute for conservative learning.
Considering medical education where practice-based learning is the backbone of education, in true sense COVID-19 has affected the core of it making children deprive of their clinical skills. In the case of other disasters, including natural disasters, blackouts, fires etc., students were able to continue their education and helpful efforts. However, with the emergence of the contagious pandemic, medical schools are being shut down out of the fear of students transmitting the virus unknowingly.[2] In addition, the exposure of dozens of students to the clinical environment may increase the risk for spread of infection several folds, making them highly vulnerable to morbidity due to COVID-19 infection. Secondly, the contributory factor denying the clinical rotations of students in medical schools is lack of COVID-19 testing of enormous number of students on interval or daily basis as it may burden the load of samples over microbiology and pathology laboratories. Further adding to the issue is the lack of adequate personnel protective equipment and a transition to telehealth formats. The pile of issues does not end here.
The United Nations Educational, Scientific, and Cultural Organization is maintaining track records of the tremendous impact of COVID-19 on education worldwide. Due to the shutdown of educational facilities and estimates, approximately 1.579 billion learners have been affected globally, amounting to 90.2% of the world’s total population.[3] The data clearly reveal that the impact of COVID-19 is threatening the existing medical education. Over the past few decades, many medical schools have witnessed a paradigm shift from the traditional forms of “in-person” lecture-based teaching to web-based e-learning.[4] The delivery of live lectures through online platforms or tele-teaching might not be ideal but it seems to be an apt solution to the current collapsing medical educational system.
The COVID-19 outbreak may represent a lasting revolution in medicine through development in many areas such as telehealth and adaptive study protocols, with bendable approaches to overcome problems. Students and educators can help document and investigate the effect of current changes to learn and apply new philosophy and practices to the coming time. The evaluation of the students that is done in the competency-based curriculum (CBME) focuses on the students’ skill growth, for example, what the student can perform. To assess the cognitive and behavioral competencies, many kinds of methods can be used. Despite the problems that online learning imposes on the CBME curriculum, online learning might have certain benefits over traditional education methods. Institutions should encourage their educators to try to accommodate new skills and cooperate to exploit the efficacy of online content delivery to the students. Educators can encourage their students to actively participate in the online learning process and try to gain as much information as they can, because change is the only constant and changes need to be bought to evolve ourselves and human race. Multiple-choice questions, short-answer questions, and long-answer questions can be used to assess cognitive competency. For the assessment of clinical and practical skills, the methods used are objective structured clinical/practical examination (OSCE/OSPE) and direct observation of procedural skills (DOPS). For clinical reasoning assessment, virtual OSCE and virtual patients can be used.
| Medical Education and Teaching | | |
The budding doctors of the nation are the sufferers of this rampant pandemic, which may, however, change the way in which future physicians are educated. Now, where social distancing is the only preventive measure, students are prohibited from gathering in lecture halls, seminars, and clinical postings, thus not only impeding their annual syllabi but also making them deprived of doctor–patient interactions and how to clinch an appropriate clinical diagnosis. Theoretical knowledge might suffice the need to attempt theory professional exams, and the question arises as to how to build practical minds. Medical education pours its mainstream knowledge through clinical bedside interaction, where the student elicits various signs and clinical tests that are necessary to approach provisional diagnosis. In the hope to mitigate viral transmission, many medical schools have suspended their clinical postings and hospital rounds, having profound consequences that may make medical students unaware of the basic knowledge to deal with during a medical emergency.
However, face-to-face practical sessions weigh more for medical students, where learning is built in an atmosphere where students can interact, engage, and learn. The discussion and exchange of ideas held during such interactive sessions not only develops a high level of practical clinical skills but also potentiates a clinical thought-developing cortical area. Clinically bent minds can broaden their arena of knowledge when they visualize the patient in front of them. However, the shift to online learning is posing an inherent challenge for those who need clinical exposure to consummate their knowledge. With the notion that “it’s better to have something rather than to have nothing,” the online educational platform proves its worth, which will guide students’ learning and stock them with the necessary content of their curriculum during this period of shutdown. Although online platform interactions may be sufficient for students in preclinical years, senior medical students placed in a clinical environment necessarily require patient contact. Therefore of its limitation of restricted interactivity and inability to ask questions freely proves it to be with multiplex of loopholes. Further, the tracking of student activities during lectures cannot be made as well as missed lectures cannot be caught up with, adding to the list of lacunae that they hold. Patients, belonging to different educational backgrounds and socioeconomic status, arrive at hospitals; they exhibit multiple pathologies, as well as a varying magnitude of signs and symptoms. Thus, each patient presents unique challenges and requires individualized workup; hence, actual patient contact cannot be sufficed through online platforms. Thus, with no student–patient engagement, the polishing of clinical skills will be difficult.[5]
Furthermore, with the rising cases of the disease every day, the workload on the medical faculty is continuously increasing: In addition to them logging in with the zoom app, medical students require to wear dozens of personnel protective equipment, risking their lives and resulting in them landing up with various psychological problems. In medical education, students are continuously assessed throughout the year with partial completion test, ward and lab leaving viva voce, seminar presentation, and lab skills performance test. However, the ongoing assessment of students is being hampered. To overcome this, many medical schools have begun remote assessment through tele-technologies to ensure that students have sufficient caliber before they start practicing medicine.[6]
In our state Uttarakhand, an unexceptionally hilly terrain, the students reside at such an altitude where the reach of these online lectures is just a milestone to be unturned due to poor network connectivity, thus resulting in students’ inability to explore online classes and in them being the leading sufferers. Online teaching has not been a cakewalk either way: At times, there is no access, the video and audio quality is not satisfactory, and hindrance due to background noises masks the lecture’s utility. Above all this, the premature ending of online reunion due to loud interference noise made by an Internet connection is yet another hurdle.
| Results | | |
Preferably, of course, live patients serve as the best teaching tool because the student or trainee in the medical profession learns more after interacting and empathizing. In the pandemic episode, physical contact with patients in need of care lays the students at risk, leading to a development to utilize the vast resources of “patient surrogates.”
Identifying the opportunity that the COVID-19 pandemic could result in a shortage in the medical profession, students may need to handle in the clinical side. The COVID-19 epidemic may signify a lasting change in treatment with the progression of tele-health, research protocols, and clinical research with flexible methods to accomplish clarifications. Medical students can help in texting and analyze the effects of existing variations to study and put on new ethics and observation to the imminent changes in future.
| Conclusions | | |
The harm to medical education is inevitable across the world, so necessary arrangements need to be made whereby students can have a firm hold over their clinical skills and knowledge. The pandemic has brought about a shift in the way in which medicos learn, forcing them to abide by the change, which in the long run may land them with facing hardships and affect their clinical hands, thereby providing an e-learning platform with opportunities to develop their professional skills such as adaption and improvisation.
A lot still needs to be done, especially for the welfare of medical students who are future frontiers in this fight and in any forthcoming crisis due to such pandemics. A student-centered approach needs to be implemented, including doubt-clearing sessions via online portals, virtual bedside stimulation on software, creative conceptualization, and student engagement while keeping in mind four key pillars: skills, resources, institutional strategies, and attitude.[7] Such an approach may not only be necessary for effectively raising the drowning medical education during this current crisis but will also serve to lay a foundation for future epidemics and pandemics in future. However, let us have our fingers crossed.
Acknowledgments
The first author sincerely acknowledges the colleagues at Department of Community Medicine, Govt. Doon Medical College for their suggestions and comments.
Financial support and sponsorship
Nil.
Conflicts of interest
The authors report no conflict of interest.
| References | | |
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| 4. | Moran J, Briscoe G, Peglow S Current technology in advancing medicaleducation: Perspectives for learning and providing care. Acad Psychiatry 2018;42:796-9. |
| 5. | Mian A, Khan S Medical education during pandemics: A UK perspective. BMC Med 2020;18:1-2. |
| 6. | MacKay M COVID-19 response: EdTech expertise strengthening remote learning transition. London:Imperical College; 2020. Available from: http://www.imperial.ac.uk/news/ 196253/covid-19-response-edtechexpertise-strengthening-remote/. [Last accessed on 2020 May 27]. |
| 7. | O’Doherty D, Dromey M, Lougheed J, Hannigan A, Last J, McGrath D Barriers and solutions to online learning in medical education – an integrative review. BMC Med Educ 2018;18:130. |
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