Impact of the COVID-19 Pandemic on Perceived Stress and Eating Behaviors of Undergraduate and Postgraduate Students of UWI, Cave Hill Campus, Barbados

Objective: The impact of the COVID-19 pandemic on perceived stress, anxiety, depression, and eating behaviors of university students in Barbados was investigated. Design and Methods: Students completed an online survey between June and July 2021 including the Patient Health Questionnaire (PHQ-4), SCOFF Questionnaire, and Salzburg Stress Eating Scale. We used bivariate and multivariable logistic regression to assess factors associated with eating behaviour and eating disorders. Result(s): Of 506 respondents (mean age 26 years, 81.4% female, 85.2% undergraduates), 7.23% were underweight, 52.34% normal weight, 20.85% overweight, and 19.57% obese. PHQ-4 screening suggested anxiety prevalence of 46% (95% CI 42% to 51%) with 22% (95% CI 17% to 25%) severe anxiety, and 43% (95% CI 39% to 47%) depression prevalence. 22.5 % of students screened positive for eating disorders on the SCOFF;positive screen for eating disorder was more likely positive in obese (36%) vs underweight (15%) students (p Conclusion(s): The screening instruments indicated concerning levels of anxiety, depression, and eating disorders associated with the COVID-19 pandemic among university students in Barbados. These conditions may remain undetected unless students seek help or are referred. Proactive health services and educational outreach are needed. Prevalence estimates should be viewed with caution until cut-off scores are empirically established for students in Barbados.

Self-Reported Post-Vaccination Adverse Events of COVID-19 Vaccines among Bangladeshi Medical Students

Objective: To investigate self-reported post-vaccination adverse events for COVID-19 vaccines among medical students in Bangladesh. Design and Methods: A cross-sectional study was conducted using an online questionnaire for Bangladeshi medical students (n = 3,545). Students who received at least one dose of COVID-19 vaccine were included. The study was carried out from October 2021 to January 2022 in 75 public and private medical colleges. Result(s): The majority of respondents were female (60.6%) and third-year (26.5%) students. >11% had tested positive for COVID-19 infection, and 97.6% of respondents (n = 3,461) received both first and second doses of COVID-19 vaccination. Most students (79.1%) received Sinopharm and 11.2% got AstraZeneca. More than two-thirds (67.9%) indicated that COVID-19 vaccines are safe in the long term. 54.8% of respondents (n = 1,842) reported one or more adverse events. Pain at injection site (78.2%), fever (49.3%), tiredness and fatigue (46.8%), headache (41.1%), generalized body ache (21.4%), over sleepiness/laziness (18.4%) and myalgia (17.5%) were the most commonly reported adverse events. 47.4% of respondents characterised adverse events as "mild". Majorities experienced symptoms within 12 hours of vaccination (68%) and for 1-3 days (56.8%). More than two-thirds (66.2%) of respondents had rest at home, and almost one-third (31.8%) took painkillers. Thirty-nine respondents visited physicians, mainly due to high fever, severe body ache, and severe headache, but there was no need for hospitalization. Conclusion(s): The majority of students reported adverse events, but symptoms were mild and of short duration. Further multi-centre studies with larger cohorts are required to monitor vaccine safety and strengthen public confidence in vaccines.

Medical student satisfaction in online modified clinical clerkship curriculum during the COVID-19 pandemic

Objective: The COVID-19 pandemic has caused significant disruption to medical education and clinical training. This not only affected delivery of the clinical curriculum but also resulted in stressors which may impede learning. This study aimed to assess the impact of a modified on-line curriculum in selected clinical clerkships in the Faculty of Medical Sciences, UWI, Cave Hill Campus, during the COVID-19 pandemic. Design and Methods: Fourth and Fifth year medical students completed an online survey in January 2021 covering the following areas: student satisfaction, self-efficacy (Online Learning Self-Efficacy Scale) and perceived effectiveness of online versus face-to-face learning. Students who agreed/strongly agreed to the statement "Overall, I was highly satisfied with the clerkship placement" were classified as satisfied. Result(s): 88 of 131 students completed the survey (response rate = 67 %). More than half of students (51%) were satisfied with online clerkship delivery. Fewer than half of students (46%) believed online learning effectively increased their knowledge, compared to 56% for face-to-face learning. Perception of effectiveness of online learning and face-to-face teaching of clinical skills was 18% and 89%, respectively (p < 0.0001). Fewer students perceived online teaching to be effective for developing social competencies (27%) compared to face-to-face instruction (67%) (p < 0.001). Students satisfied with online learning were more likely to be female (OR = 2.6) and older respondents. Mean self-efficacy scores were higher for persons who perceived online teaching to be effective for increasing knowledge, improving clinical skills, and social competencies. Students' perception of online learning was strongly associated with online selfefficacy. Conclusion(s): Students perceived online learning to be least effective for enhancing clinical skills. Students' perception of effectiveness of online learning was strongly associated with online self-efficacy. Further research to examine how the perception of online delivery impacts student performance in online learning is recommended. Educators have been challenged to design online programmes that facilitate development of clinical and social skills. Understanding medical students' experiences and identifying unmet needs will help improve clerkship curriculum and support medical students during and after the COVID-19 pandemic.

An innovative, blended, and supplementary clerkship to minimize clinical training gaps identified during the COVID-19 pandemic

Objective: 1. To identify training gaps in junior clerkship rotations during the COVID-19 pandemic. 2. To develop a Clinical Transition Selective Clerkship (CTSC) during Year 4. 3. To seek student feedback on organization and management of the CTSC. Design and Methods: An online cross-sectional survey of medical students was conducted during June-September 2021 to identify training gaps. In response to identified gaps, the 4-week CTSC was developed to provide further opportunities to develop core competencies. Result(s): Just under half of students reported the opportunity to observe (45.7%) and perform (44.5%) core skills >3 times during the medicine junior clerkship. For the surgical clerkship, 48.3% observed and 44.2% performed core skills 1-3 times. For child health, 39.6% observed and 34.8% performed skills 1-3 times. More than half of respondents (55.3%) expressed concern that they missed the usual clinical clerkship training experiences during online rotations. Three-quarters (74.5%) expressed the need to acquire additional clinical experience. The majority of students rated the following aspects of the CTSC as 'Good' or better: clarity of goals and objectives (58.3%);educational value/amount learned (56.2%);professionalism of faculty (66.7%) and other clinical staff (75%);usefulness of feedback (75%);workload challenge/level of material appropriate (70.8%);overall rating/quality of CTS (60.4%). However, the following aspects were rated as 'Poor' or "Fair": organization and coherency (77.1%);commitment of coordinators (64.6%);CTS achieved stated goals (62.5%). Conclusion(s): Our study identified training gaps in junior clerkship rotations during the COVID-19 pandemic. The CTSC provided opportunities to develop clinical competencies disrupted by the pandemic.

Resilient Coping is More Important than Previous Experience with Virtual Learning: Predicting Stress Experienced by Pharmacy Students in Trinidad and Tobago During the COVID-19 Pandemic

Objective: To summarize pharmacy students' previous experience and current confidence with online learning and explore the association of prior experience with online learning and resilient coping with perceived stress at the beginning of the COVID-19 pandemic. Method(s): Students completed an online cross-sectional survey during April-June, 2020. Measures included Likert items for experience and current comfort levels with online learning;the Brief Resilient Coping Scale (BRCS);and the Perceived Stress Scale-10 Item Version (PSS-10). We summarized experience and comfort with online learning;reported scores and internal consistency for the BRCS and PSS-10;and estimated a regression model of perceived stress as a function of prior experience with online education, gender, and resilient coping. Result(s): Of 113 respondents (response rate 41%, 78% female, mean age 22.3 years) >50% had only occasional prior experience with online learning, coursework, and examinations, but 63% expressed confidence with online learning. Mean PSS-10 and BRCS scores were 23.8 and 13.3 respectively, and both scales demonstrated good internal consistency (a > .80). BRCS score was the single predictor of PSS-10 score (r2 = 0.18, p < 0.001). Gender was not a significant predictor of perceived stress (p = 0.11). A simultaneous regression model explained a moderate amount of variation in perceived stress (adjusted R2 = 0.19). Conclusion(s): Most students had limited previous online learning, coursework, and examination experience. Responses indicated moderate levels of stress and coping skills after introducing online teaching. Lower resiliency scores, but not lack of virtual learning experience, predicted higher perceived stress. Results underscore the importance of efforts to enhance coping and resilience of students.