An investigation of stress and anxiety among health professions students in the early stages of the COVID-19 pandemic.

Background: Early studies during the COVID-19 pandemic identify the dissonance between feeling anxious about contracting the illness and the innate desire to serve the sick, as a main stressor for students. Purpose: The purpose of this study is to better understand psychological stress and self-reported wellness of Physician Assistant (PA), Physical Therapy (PT), dental, and medical students during the early portions of the COVID-19 pandemic. Methods: We utilized the 10-item Perceived Stress Scale (PSS) together with additional questions to assess self-perceived stress, anxiety, and wellness of healthcare students. Discussion: There were no significant differences in PSS between professions. As PSS increased (indicating more stress), the odds of answering "worse" versus "same" or "better" to descriptions of anxiety level increased (OR: 2.318). Conclusion: Student survey respondents experienced similar levels of perceived stress throughout the COVID-19 pandemic. Institutions should consider students' perceived levels of stress and the many aspects of student wellness that may have been affected by the COVID-19 pandemic.

Design and Evaluation of a Novel Health Security, Infectious Diseases, Health Systems Science, and Service Learning Course During the COVID-19 Pandemic.

During the COVID-19 pandemic, academic health centers suspended clinical clerkships for students. A need emerged for innovative virtual curricula to continue fostering professional competencies. In March 2020, a multidisciplinary team from the University of Nebraska Medical Center had 2 weeks to create a course on the impact of infectious diseases that addressed the COVID-19 pandemic in real time for upper-level medical and physician assistant students. Content addressing social determinants of health, medical ethics, population health, service learning, health security, and emergency preparedness were interwoven throughout the course to emphasize critical roles during a pandemic. In total, 320 students were invited to complete the survey on knowledge gained and attitudes about the course objectives and materials and 139 responded (response rate 43%). Students documented over 8,000 total hours of service learning; many created nonprofit organizations, aligned their initiatives with health systems efforts, and partnered with community-based organizations. Thematic analysis of qualitative evaluations revealed that learners found the greatest value in the emphasis on social determinants of health, bioethics, and service learning. The use of predeveloped, asynchronous e-modules were widely noted as the least effective aspect of the course. The COVID-19 pandemic introduced substantial challenges in medical education but also provided trainees with an unprecedented opportunity to learn from real-world emergency preparedness and public health responses. The University of Nebraska Medical Center plans to create a health security elective that includes traditional competencies for emergency preparedness and interrogates the social and structural vulnerabilities that drive disproportionately worse outcomes among marginalized communities. With further evaluation, many components of the curriculum could be broadly scaled to meet the increasing need for more public health and health security medical education.