Medical internship training during the COVID-19 pandemic ­ A case of 'sacrificial pawns' or not?

Background: Newly qualified medical practitioners in South Africa (SA) are part of the frontline health care workers who face Africa's most severe coronavirus disease 2019 (COVID-19) pandemic. The experiences of interns during the pandemic reflect SA's preparedness to respond in a crisis and inform strategies that could be adopted to balance training and service in resource-challenged contexts. Aim: To explore the strengths, weaknesses, opportunities and threats posed during the first wave of the COVID-19 pandemic as reflected on by interns within the clinical training platforms in SA. Setting: Public hospitals in KwaZulu-Natal. Methods: An online questionnaire consisting of eight open-ended questions based on the SWOT framework related to personal and professional perspectives to clinical training during the COVID-19 pandemic was developed using SurveyMonkey. All data were collected remotely via social media platforms. Data were thematically analyzed. Results: Forty-six interns reflected on personal and systemic challenges as the major threats and weaknesses in intern training during the COVID-19 pandemic. Extrapolating on strengths and opportunities, there were three overarching learnings interns reflected on. These related to being a medical professional, communities of practice and the development and enhancement of clinical and non-clinical competencies. Existing challenges in the environment exacerbated the threats posed by COVID-19 and innovative strategies related to improving support, feedback, broadening the intern curriculum and online training. Conclusion: Although the clinical environment where interns learn and work is often stressful and overpowered by high service burdens, there are unique opportunities to enhance self-directed learning and graduate competencies, even in the midst of the COVID-19 pandemic.

Third-year medical students' and clinical teachers' perceptions of formative assessment feedback in the simulated clinical setting

Background. Clinical skills training in the clinical skills laboratory (CSL) environment forms an important part of the undergraduate medical curriculum. These skills are better demonstrated than described. A lack of direct observation and feedback given to medical students performing these skills has been reported. Without feedback; errors are uncorrected; good performance is not reinforced and clinical competence is minimally achieved. Objectives. To explore the perceptions of 3rd-year medical students and their clinical teachers about formative clinical assessment feedback in the CSL setting.Methods. Questionnaires with open- and closed-ended questions were administered to 3rd-year medical students and their clinical skills teachers. Quantitative data were statistically analysed while qualitative data were thematically analysed. Results. Five clinical teachers and 183 medical students participated. Average scores for the items varied between 1.87 and 5.00 (1: negative to 5: positive). The majority of students reported that feedback informed them of their competence level and learning needs; and motivated them to improve their skills and participation in patient-centred learning activities. Teachers believed that they provided sufficient and balanced feedback. Some students were concerned about the lack of standardised and structured assessment criteria and variation in teacher feedback. No statistical difference (p0.05) was found between the mean item ratings based on demographic and academic background. Conclusion. Most teachers and students were satisfied with the feedback given and received; respectively. Structured and balanced criterion-referenced feedback processes; together with feedback training workshops for staff and students; are recommended to enhance feedback practice quality in the CSL. Limited clinical staff in the CSL was noted as a concern