Are medical students happy despite unhappy conditions: a qualitative exploration of medical student cohorts during disruptive conditions.

BACKGROUND: Shortly after the World Health Organization declared the SARS-CoV-2 outbreak a worldwide pandemic, medical school governing bodies issued guidance recommending pausing clinical rotations. Prior to the availability of COVD-19 vaccines, many schools implemented exclusively online curriculums in the didactic and clinical years. These unprecedented events and paradigm changes in medical education could contribute to trainee burnout, wellness, and mental health. METHODS: This single-institution study interviewed first, second, and third-year medical students from a medical school in the southwestern United States. A semi-structured interview was conducted with paper-based Likert scale questions rating perceived happiness were administered both at the time of the interview and one year later in order to understand how their student experience and happiness were impacted. In addition, we asked participants to describe any major life events they experienced since the first interview. RESULTS: Twenty-seven volunteers participated in the original interview. Twenty-four from the original cohort participated in the one-year follow-up. Happiness as a sense of self and who you "should be" was challenged during the pandemic and changes in happiness over time were not systematic across classes. Stress was caused not only by the pandemic which was experienced by all, but by a tripartite state of individual circumstances, academic workload requirements, and the world at large. Primary themes from the interviews were clustered around the individual, learner, and future professional levels and focused on the primacy of relationships, emotional wellness, stress management, professional identity, and impacts of educational disruptions. These themes created risk factors for developing imposter syndrome. Students demonstrated resiliency across cohorts and were able to utilize a variety of strategies to achieve and maintain both physical and mental health, but the primacy of relationships both personally and professionally was noted. CONCLUSION: Medical students' identities as individual persons, a learner, and future medical professionals were all impacted by the pandemic. The results from this study suggest that the COVID-19 pandemic and changes in the learning format and environment may create a new risk factor in the development of imposter syndrome. There is also an opportunity to re-consider resources to achieve and maintain wellness during a disrupted academic environment.

Predictive Factors of Positive E-Learning Experience.

BACKGROUND AND OBJECTIVES: During the COVID-19 pandemic, medical schools and residencies have utilized electronic learning (e-learning). Factors such as internet access, age, degree of introversion/extroversion, and propensity to adopt new technologies impact attitudes toward e-learning. This study investigates family medicine educators' satisfaction, effectiveness, and feasibility perceptions of e-learning, characterizes demographic factors impacting attitudes, and identifies which aspects of e-learning are important to educators. METHODS: In fall 2020, a cross-sectional survey via the 2020 Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) general membership survey was conducted. Members of CAFM-affiliated associations were invited by email to participate. RESULTS: The response rate for the survey was 20.1% (n=862). Of the respondents, 40.4% (n=311) reported satisfaction with e-learning, 47.8% (n=368) found e-learning feasible, and 24.2% (n=186) reported e-learning met their educational goals. No differences were found in satisfaction, feasibility, or effectiveness scores according to generation, introvert/extrovert status, or technology adopter status. Interactive capabilities were the most important factor for e-learning satisfaction (55.9%) and effectiveness (62.0%). Sufficient time was the most frequently selected factor for ease of adoption. Baby Boomer respondents reported platforms not user-friendly, insufficient prior experience as the greatest obstacle more frequently than other generations, and insufficient time less frequently than other generations. Otherwise, rankings of e-learning factors were similar among groups. CONCLUSIONS: Satisfaction with and perceived feasibility and effectiveness of e-learning varies among family medicine educators. No differences were found in satisfaction, feasibility, or effectiveness scores according to generation, introvert/extrovert status, or technology adopter status. Respondents consistently ranked interactive capabilities most important for e-learning satisfaction and effectiveness. More research is needed to compare student and learner perspectives regarding e-learning.

On pandemics and pivots: a COVID-19 reflection on envisioning the future of medical education.

The required adjustments precipitated by the coronavirus disease 2019 crisis have been challenging, but also represent a critical opportunity for the evolution and potential disruptive and constructive change of medical education. Given that the format of medical education is not fixed, but malleable and in fact must be adaptable to societal needs through ongoing reflexivity, we find ourselves in a potentially transformative learning phase for the field. An Association for Medical Education in Europe ASPIRE Academy group of 18 medical educators from seven countries was formed to consider this opportunity, and identified critical questions for collective reflection on current medical education practices and assumptions, with the attendant challenge to envision the future of medical education. This was achieved through online discussion as well as asynchronous collective reflections by group members. Four major themes and related conclusions arose from this conversation: Why we teach: the humanitarian mission of medicine should be reinforced; what we teach: disaster management, social accountability and embracing an environment of complexity and uncertainty should be the core; how we teach: open pathways to lean medical education and learning by developing learners embedded in a community context; and whom we teach: those willing to take professional responsibility. These collective reflections provide neither fully matured digests of the challenges of our field, nor comprehensive solutions; rather they are offered as a starting point for medical schools to consider as we seek to harness the learning opportunities stimulated by the pandemic.