Questions of Well-Being and Inclusion in Online Undergraduate Medical Education During COVID-19: A 2-Phased Focused Scoping Review.

PURPOSE: Undergraduate medical education (UGME) was transformed by the rapid move to online curriculum delivery during the COVID-19 pandemic. Most research on online UGME has focused on measuring its effectiveness. However, medical educators also require evidence regarding its implications with respect to well-being and inclusion. METHOD: To explore online learning transition, particularly the effect on well-being and inclusion, this 2-phased focused scoping review employed a revised Joanna Briggs Institute approach: (1) developing review questions and objectives; (2) determining eligibility criteria; (3) developing the search strategy; (4) extracting, analyzing, and discussing findings; (5) drawing conclusions; and (6) discussing implications for practice and further research. RESULTS: The review ultimately included 217 articles, of which 107 (49%) explored student and staff well-being during online UGME, 64 (30%) focused on inclusion in this context, and 46 (21%) examined both well-being and inclusion. Additionally, 137 of included articles (63%) were research/evaluation, 48 (22%) were descriptive, and 32 (15%) were opinion. Of the 137 research/evaluation studies, 115 (84%) were quantitative, 10 (7%) were qualitative, 8 (6%) were mixed methods, and 4 (3%) were Reviews. Among these research/evaluation studies, the most commonly used data collection method was surveys (n = 120), followed by academic tests (n = 14). Other methods included interviews (n = 6), focus groups (n = 4), written reflections (n = 3), user data (n = 1), and blood tests (n = 1). CONCLUSIONS: Important questions remain regarding the safety and inclusiveness of online learning spaces and approaches, particularly for members of historically excluded groups and learners in low-resource settings. More rigorous, theoretically informed research in online medical education is required to better understand the social implications of online medical education, including more in-depth, qualitative investigations about well-being and inclusion and more strategies for ensuring online spaces are safe, inclusive, and supportive.

From struggle to opportunity: Reimagining medical education in a pandemic era.

The COVID-19 pandemic has disrupted the international medical education community in unprecedented ways. The restrictions imposed to control the spread of the virus have upended our routines and forced us to reimagine our work structures, educational programming and delivery of patient care in ways that will likely continue to change how we live and work for the foreseeable future. Yet, despite these interruptions, the pandemic has additionally sparked a transformative impulse in some to actively engage in critical introspection around the future of their work, compelling us to consider what changes could (and perhaps should) occur after the pandemic is over. Drawing on key concepts associated with scholar Paulo Freire's critical pedagogy, this paper serves as a call to action, illuminating the critical imaginings that have come out of this collective moment of struggle and instability, suggesting that we can perhaps create a more just, compassionate world even in the wake of extraordinary hardship.

A phenomenological exploration of the impact of COVID-19 on the medical education community.

INTRODUCTION: The COVID-19 pandemic has caused unprecedented stress to the medical education community, potentially worsening problems like burnout and work-life imbalance that its members have long been grappling with. However, the collective struggle sparked by the pandemic could generate the critical reflection necessary for transforming professional values and practices for the better. In this hermeneutic phenomenological study, we explore how the community is adapting-and even reconceptualising-their personal and professional roles amidst the COVID-19 crisis. METHOD: Between April and October 2020, we conducted 27 (17F, 10M) semi-structured interviews with medical trainees (8), physicians (8), graduate students (3) and PhD scientists (8) working in medical education in Canada, the United States and Switzerland. Data analysis involved a variety of strategies, including coding for van Manen's four lifeworld existentials, reflexive writing and multiple team meetings. RESULTS: Participants experienced grief related to the loss of long-established personal and professional structures and boundaries, relationships and plans for the future. However, experiences of grief were often conflicting. Some participants also experienced moments of relief, perceiving some losses as metaphorical permissions slips to slow down and focus on their well-being. In turn, many reflected on the opportunity they were being offered to re-imagine the nature of their work. DISCUSSION: Participants' experiences with grief, relief and opportunity resonate with Ratcliffe's account of grief as a process of relearning the world after a significant loss. The dismantling of prior life structures and possibilities incited in participants critical reflection on the nature of the medical education community's professional practices. Participants demonstrated their desire for more flexibility and autonomy in the workplace and a re-adjustment of the values and expectations inherent to their profession. On both individual and systems levels, the community must ensure that long-standing calls for wellness and work-life integration are realised-and persist-after the pandemic is over.