ABSTRACT
BACKGROUND: In May 2020, first-year students at Imperial College School of Medicine attended a 'digital hospital placement'. Occurring in the early months of the COVID-19 pandemic, this replaced their first planned hospital placement. The authors analysed student experiences to understand how a digital hospital placement impacted self-perceived clinical and professional development and whether it improved preparedness for face-to-face hospital placements. METHODS: Three hundred ten students participated in this week-long digital placement, which integrated clinical skills, communication and professional behaviour domains. It aimed to prepare students for safe participation in clinical environments. Resources included self-directed and peer learning, virtual simulations (Oxford Medical Simulation) and staff-led debriefing. Surveys were administered after the digital placement and after students' first face-to-face placement to collect quantitative and qualitative data. A reflexive thematic analysis was conducted. RESULTS: Eighty-three and twenty-nine students completed the postdigital and post-face-to-face placement evaluation respectively. Quantitative results indicated a high self-rated achievement of learning objectives and enthusiasm for digital placements; 83% of respondents supported digital simulations as part of regular medical education. Qualitative analysis identified three superordinate themes: (1) domain integration in digital placements helped students feel better prepared; (2) digital experiential learning is ideally suited to early clinical learning; and (3) virtual placements are a compliment, not an alternative, to face-to-face placements. CONCLUSION: Digital placements are a promising means of supporting the challenging transition from classroom learner to clinical learner. They provide a feasible and scalable option for building student confidence and improving preparedness.
Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Students , Learning , CommunicationABSTRACT
Introduction: Professional identity development is a central aim of medical education, which has been disrupted during COVID-19. Yet, no research has qualitatively explored COVID-19's impact across institutions or countries on medical students' identities. Kegan proposes a cognitive model of identity development, where 'disorientating dilemmas' prompt student development. Given the potential of COVID-related disruption to generate disorientating dilemmas, the authors investigated the ways in which COVID-19 influenced students' identity development. Methods: The authors conducted an international qualitative study with second year medical students from Imperial College London, and third year students from Melbourne Medical School. Six focus groups occurred 2020-2021, with three to six students per group. Authors analysed data using reflexive thematic analysis, applying Kegan's model as a sensitising theoretical lens. Results: COVID-19 has resulted in a loss of clinical exposure, loss of professional relationships, and a shift in public perception of physicians. Loss of exposure to clinical practice removed the external validation from patients and seniors many students depended on for identity development. Students' experiences encouraged them to assume the responsibilities of the profession and the communities they served, in the face of conflicting demands and risk. Acknowledging and actioning this responsibility facilitated identity development as a socially responsible advocate. Conclusions: Educators should consider adapting medical education to support students through Kegan's stages of development. Measures to foster relationships between students, patients, and staff are likely necessary. Formal curricula provisions, such as spaces for reflection and opportunities for social responsibility, may aid students in resolving the conflict many have recently experienced. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01592-z.