Medical Student's Perspective Regarding Undergraduate Surgical Education with Special Reference to Pandemic.

The COVID-19 pandemic has disrupted teaching in medical schools across the world. Online learning has become the core method of teaching during this pandemic. The aim of this study was to investigate the impact of this mode of education among medical students in India. A survey was conducted by distributing online questionnaires to medical students across India. Data gathered from the survey was analyzed using SPSS® version 16. The overall response rate of survey was 58.4%. Practical training was most severely affected by online classes (93.32%) as compared to theory classes (60.93%). A total of 71.98% students agreed that canceling of physical medical conferences adversely affected the building up of their resumes while only 28.79% agreed that virtual conferences and meetings enhanced their learning. A total of 56.81% agreed that online exams adversely affected their performance. A total of 46.79% feels that online classes using simulated patients and simulation technology is not useful but 41.90% think that simulated teaching should be a part of the medical curriculum. A majority of the students (87.66%) had technical issues with online classes and 89.72% complained of poor concentration during online teaching due to distractions. A total of ~75% felt that the pandemic has adversely affected the availability of research opportunities and development of skills, ethics, communication, and behavior. Online education has adversely affected all aspects of learning, performance in exams, research, and the overall future plans of students. Moving forward from this pandemic, in order to maximize the benefits of both face-to-face and online teaching, we suggest medical schools resort to a hybrid pattern.

A cross-sectional study on anxiety due to COVID-19 and its predictors among undergraduate medical students in a tertiary care teaching hospital of Kolkata, West Bengal.

Background: Medical education is recognized as stressful globally. COVID-19 pandemic is an additional source of anxiety to the medical students. Objectives: This study was conducted to assess the prevalence and to identify the factors associated with anxiety due to COVID-19 among undergraduate medical students in a teaching hospital of Kolkata, West Bengal. . Methods: An observational cross-sectional study was conducted among 363 undergraduate medical students using the stratified random sampling of a medical college from June to July 2021. Data were collected using a predesigned, pretested, and structured online questionnaire, including "Coronavirus Anxiety Scale." Descriptive statistics were used to estimate the prevalence of anxiety. Pearson's Chi-square test was performed to find out the factors associated with anxiety due to COVID-19. Results: About 25.6% of the medical students were found to have anxiety due to COVID-19. About 28.9% of them reported COVID-19 infection in family in recent past and 11.0% had themselves tested positive. Nearly 20% reported loss of family members, relatives, and close friends due to COVID-19. The factors associated with anxiety due to pandemic were socioeconomic status, social stigma, sleep disturbances, history of COVID-19 in family, loss of job. and vaccination status of family members missing practical classes and exam-related anxiety. Conclusion: The study found that one-fourth of the medical students had anxiety due to COVID-19. Social stigma due to COVID-19 and loss of job of parents were the most significant predictors. It is recommended that targeted psychological and clinical interventions need to be taken to alleviate students' anxiety due to COVID.

Prevalence of Dry Eye Disease in Undergraduate Medical Students and its Association with Online Overexposure Due to Coronavirus Disease (COVID-19)

Objectives: To understand the prevalence of dry eye disease (DED) in undergraduate medical students and assess its association with online overexposure due to COVID-19. Materials and methods: The study was carried out with 200 medical undergraduate students aged 18-25 years at North Indian Medical College during the third and fourth weeks of September, 2021 & enquired regarding the online exposure pattern, type of device used and presence of eight dry eye symptoms (foreign body sensation, vision difficulties, discharge, itching, ocular pain, redness, photophobia, watering) followed by Schirmer's strips examination. Cut off for dry eye disease was <10 mm. Data was analyzed using SPSS 21.0 package & Chi-square test for comparisons. Results: Mean age was 21.00±1.93 years. Majority were females (54.5%). Prevalence of dry eye symptoms was 85.5%. Vision difficulties (54.0%), itching (56.0%), watering (51.5%) were the most common symptoms. Majority (64.0%) had >3 symptoms. Use of mobile device, >4 hours of online exposure for other than study purposes and >1.5 increase in online exposure after COVID-19 were associated with presence of >3 dry eye symptoms. On Schirmer's test, prevalence of dry eye disease was 12.0%. Conclusion: Longer duration of online exposure and increase in online activities as a result of COVID-19 was associated with an increased risk of dry eye disease and its prevalence in undergraduate medical students. © 2022 by the Author(s).

Study of computer vision syndrome among medical undergraduates of Kumaon region, Uttarakhand

Background: Activity on digital screen has increased so much during the COVID era that there is surge in persons complaining of symptoms of computer vision syndrome (CVS). Aims and Objectives: The aim of the study was to determine the prevalence of CVS among the medical students and its associated factors during COVID period and to compare it with pre-COVID period. Materials and Methods: A cross-sectional study was conducted among 337 undergraduate medical students at Government Medical College, Haldwani, Uttarakhand using pretested structured questionnaire which was filled through Google form for which link was circulated in class WhatsApp group. Data were analyzed using SPSS version 16. Frequency, percentage, binary logistic regression, and McNemar test was applied. P<0.05 was considered significant. Results: The prevalence of CVS was significantly higher during COVID period, 54.9% (95% CI=49.7–60.1) that was significantly higher than non-COVID period. Eye strain (16.6%) was the most common CVS symptom during both pre-COVID and COVID period. The prevalence of CVS was significantly associated with use of preventive measures. During COVID period, average hours spent in digital screen was significantly higher as compared to non-COVID period. Conclusion: This study showed that there was increase in CVS among the study participants during COVID era as there was increase in spending hours on digital screen and not or reduction in adopting preventive measures. It is important to increase awareness regarding the symptoms and precautions related to CVS. [ FROM AUTHOR]

International curriculum for undergraduate sonographer education in China during the COVID-19 era: International remote teaching mode vs. domestic on-site teaching mode.

Background: Sichuan University West China Medical School was the first institution in China to develop an undergraduate sonographer education program in 2016. This program was certificated by American Registry for Diagnostic Medical Sonography (ARDMS) and students are qualified for the ARDMS credential verification test. In this 4-year program, the international curriculum of ultrasound physics and hemodynamics was set for students in the third year since 2018. This study is aimed to compare the teaching effect of international remote teaching mode and domestic on-site teaching mode of this international curriculum before and during the COVID-19 pandemic. Methods: All undergraduate sonographer students after completing ultrasound physics and hemodynamics in the academic years 2018-2019 (30 students; before the COVID-19 pandemic) and 2020-2021 (47 students; during the COVID-19 pandemic) were included in the study. The scores of 77 students were analyzed for their curriculum. Independent samples t-test or Mann-Whitney test was employed to compare students' scores before and during the COVID-19 pandemic. The Chi-square test was used to compare students' feedback about this curriculum through an online self-administered questionnaire. A p < 0.05 was considered statistically significant. Results: Total scores were comprised of four parts: in-class tests, homework, mid-term, and final exam scores. The mean in-class test score for domestic on-site teaching mode during the COVID-19 pandemic was significantly higher than that for international remote teaching mode before the COVID-19 pandemic. However, there was no observed a statistically significant difference in homework, mid-term, final exam, and total scores between the two types of teaching modes. For questionnaire feedback, no significant difference was observed between the two groups regarding the satisfaction toward teachers, class atmosphere, teaching mode, curriculum content, exam difficulty, scores, and knowledge students gained. For the overall evaluation of the curriculum, 73.3% (22/30) of students were very satisfied before the COVID-19 pandemic, while 44.7% (21/47) of students felt very satisfied during the COVID-19 pandemic (p = 0.02). Conclusion: The general teaching effect of domestic on-site teaching mode during the COVID-19 pandemic was comparable to that of international remote teaching mode before the COVID-19 pandemic, and domestic on-site teaching mode may provide a better in-class teaching effect.

Online Medical Education in the COVID-19 Era: Undergraduate Students' Perspectives

Online education became a norm during the recent COVID-19 pandemic and medical education institutes in India accepted the new normal. It was timely to assess the perceptions and experiences of medical students to find out its relevance and application, if required, in future. Method(s): Following permission from the Institutional Ethics Committee, a cross-sectional observational questionnaire-based study was conducted among undergraduate medical students in the fifth semester using a Google form. A validated questionnaire consisting of 21 items was circulated. The data were analyzed using descriptive statistics. Result(s): A total of 150 students out of 180 (83.3%), who were approached participated in the study. About 46% of the students were of the opinion that online teaching-learning was not as effective as classroom teaching and 25% gave a neutral response. Only half the number of students (50.7%) felt attentive throughout the class and 40.7% attended solely for the purpose of attendance. Around 70% felt that their doubts were clarified while using this method of teaching, but 54% of them felt the amount of interaction was inadequate. Nearly 18% of students found it impossible to prepare for their examinations after learning through online classes. All the students (98.7 %) responded that they lost out on ward postings and clinical training. Although 79.3% of students agreed that online education was a useful option during the pandemic, only 46% of them felt that hybrid mode can be adopted in the post-pandemic era. Conclusion(s): As per medical students' perspectives noted in this study, online medical teaching should not completely replace traditional modes of teaching. Copyright © 2022, Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.

Mental burden among Chinese undergraduate medical students: A prospective longitudinal study before, during, and after the COVID-19 outbreak.

Background: Increasing evidence indicated a clear association between COVID-19 pandemic and mental health. This study aimed to assess the dynamic change of mental burden during and after the COVID-19 outbreak and related predictive factors among Chinese undergraduate medical students. Methods: This longitudinal survey was conducted among Chinese undergraduate medical students before, during, and after the COVID-19 outbreak. We focused on COVID-19 related mental burdens including psychological distress, stress reaction, and insomnia symptoms, and defined the sum score of the three specific mental burden indexes as the overall mental burden index. The prevalence of specific and overall mental burdens and their changing patterns at two phases of the pandemic (during vs. after the COVID-19 outbreak) were measured. In addition, multinomial logistic regressions were used to assess the associations between the psychosocial status before the pandemic and specific and overall mental burden changing patterns. Results: Our findings showed that the prevalence of overall mental burden increased (from 27.46 to 37.28%) after the COVID-19 outbreak among the 863 Chinese undergraduate medical students who participated in the surveys at baseline, during, and after the COVID-19 outbreak. Specifically, the prevalence of stress reaction symptoms decreased (from 10.90 to 3.60%), while the rates of psychological distress (from 28.06 to 37.95%) and insomnia symptoms (from 12.54 to 20.71%) increased. Participants, with obsessive-compulsive symptoms, somatic symptoms, internet addiction, childhood adversity, stressful life events, and being neurotic were found to have a higher risk of developing mental burden in at least one survey (during or after the COVID-19 outbreak). Healthy family function and being extravert were found to positively impact mental burden. Conclusion: Psychological distress, stress reaction and insomnia symptoms have been prevalent among Chinese undergraduate medical students during the COVID-19 outbreak, and the prevalence of overall mental burden increased after the COVID-19 outbreak. Some students, especially those with the risk factors noted above, exhibited persistent or progression symptoms. Continued mental health care was in demand for them even after the COVID-19 outbreak.

A study on predictors of nomophobia among undergraduate medical students of a Tertiary Care Teaching Institute in Kolkata, West Bengal

Background and Objectives: Undergraduate medical students are more prone to develop stress, anxiety, and depression;and COVID-19 is an additional source of pressure for them. The present study was conducted with the objectives to estimate the proportion of nomophobia among undergraduate medical students of a tertiary care teaching institute in Kolkata and to find the factors associated with it. Materials and Methods: An observational study, cross-sectional in design, was conducted at a tertiary care teaching institute in Kolkata among 395 undergraduate medical students for a period of 8 weeks. Nomophobia Questionnaire scale was used to measure nomophobia. Data were analyzed using the SPSS software version 25.0. Multivariable multinomial logistic regression was performed to find the predictors of moderate and severe nomophobia. Results: All the medical students had some degree of nomophobia. About 26.8% of them had severe nomophobia, 61.3% had moderate nomophobia, and 11.9% had mild nomophobia. Age up to 20 years and the presence of addiction had statistically significant higher odds of severe nomophobia. Age up to 20 years, the presence of addiction, and up to 6 h' time spent per day with smart phone had significantly higher odds of moderate nomophobia. Conclusion: There was a high proportion of nomophobia among young budding doctors. Those who have already got moderate nomophobia should use smart phones more wisely and judiciously and avoid downloading addictive applications.

Prevalence of Anxiety and Burnout, and Coping Mechanisms among Clinical Year Medical Undergraduate Students in Universiti Kebangsaan Malaysia Amidst the COVID-19 Pandemic.

This study aimed to determine the prevalence of anxiety and burnout, and the coping mechanisms among clinical year undergraduate medical students in Universiti Kebangsaan Malaysia (UKM) during the coronavirus disease 2019 (COVID-19) pandemic. In total, 378 clinical year undergraduate medical students in UKM participated in this cross-sectional study from May to July 2021. A self-administered questionnaire consisting of questions on the participant's sociodemographic data and items from the DASS-21, CBI, and Brief-COPE was distributed. Chi-square and Spearman's correlation tests were used to calculate the correlation coefficient between both anxiety and burnout, and coping mechanisms. The prevalence of anxiety and burnout were 44.2% and 22.2%, respectively. There was a significant difference in the percentage of students with extremely severe anxiety in the presence and absence of burnout, 23.8% vs. 4.8% (p < 0.001). Among the three coping mechanisms, avoidant coping had a significant positive moderate correlation with both the presence of anxiety (r = 0.3966, p < 0.001) and the presence of burnout (r = 0.341, p < 0.001). Meanwhile, coping that was neither approach nor avoidant had a positive weak correlation with the presence of burnout (r = 0.176, p = 0.001). The prevalence of anxiety and burnout was concerning. Increased anxiety and burnout among students may negatively impact aspects of their personal, professional, and academic lives. Early recognition and preventive measures should be emphasised to prevent negative ramifications.

Perceived Stress among Medical Students during COVID-19 Pandemic and its Impact on Sleep and Studies - A Cross-sectional Study in South India

Background: COVID-19 pandemic has adversely affected the mental health of medical students due to the lockdown of colleges and educational institutions that had imposed a feeling of uncertainty and insecurity in students. Objectives: The present study aims todetermine the prevalence of stress among medical undergraduate students and its association with sleep and studies during the COVID-19 pandemic. Method: Perceived stress and sleep quality during COVID-19 pandemic was assessed among 446 undergraduate medical students using Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI) tools. An online questionnaire containing questions retrieved from PSS and PSQI tools was prepared in Google Forms and was shared by e-mail to the students. The students were classified into three categories based on PSS total scores and compared for differences in sleep quality and learning difficulties. Results: The mean score of PSS was 13.38 ± 6.87. 252 (56.5%) had low perceived stress, 146 (32.7%) had moderate and 48 (10.8%) had high perceived stress. First year and final year medical students perceived more stress when compared with others. Among the 446 study participants, 34 (7.6%) reported poor sleep quality and it was significantly associated with the presence of stress (pvalue<0.001). 215 (48.2%) students had difficulty in concentrating on their studies. Conclusion: The COVID-19 pandemic has resulted in perceived stress among medical undergraduate students of which most of them had moderate perceived stress which warrants immediate action. Copyright (c) 2022: Author(s).

Self-Directed Learning During the COVID-19 Pandemic: Perspectives of South African Final-Year Health Professions Students.

PURPOSE: Self-directed learning (SDL) has been advocated for effective training of final-year health professions students. COVID-19 challenges conventional teaching, learning, and assessment in the clinical environment. This study aimed to identify and explore enablers and barriers to SDL among final-year health professions students training during the COVID-19 pandemic. METHODS: Adopting the SWOT (strengths, weaknesses, opportunities and threats) framework, this study explored the clinical learning and training experiences of final-year health professions students during the pandemic. A survey was conducted via online platforms. Data from 155 respondents were thematically analyzed. RESULTS: Personal attributes such as reflection, self-determination, motivation, resilience, and positive learning behaviors and skills were identified as SDL enablers. Collaborative learning networks and online learning platforms facilitate learning needs and goals. Fear and anxiety, untrusted learning sites, uncertainty about graduation, financial issues and challenges in the learning environments were the major themes related to barriers to SDL. CONCLUSION: The importance of SDL as a skill for uncertain times warrants further investigation in the training of future healthcare professionals. Inclusive planning and engagement with final-year health professions students to address identified stressors, as well as the creation of shared platforms where students are part of the decision-making processes for clinical learning and training are recommended. Responsive curricula that optimize unpredictable disruptions in clinical training are needed to equip students to diagnose their own learning needs and implement appropriate learning strategies.

Understanding Mental Burden and Factors Associated With Study Worries Among Undergraduate Medical Students During the COVID-19 Pandemic.

The Coronavirus disease 2019 (COVID-19) pandemic is affecting many areas of life and has led to major changes in undergraduate medical education. Even before the COVID-19 pandemic, high mental burden of medical students has frequently been reported in the literature. Additional pandemic-specific stressors could exacerbate this situation. This study aimed to assess mental health outcomes among medical students during the first semester after the COVID-19 outbreak and perception of the students on how the learning environment has changed. In May 2020, we conducted a cross-sectional survey among undergraduate medical students at a large medical school in Germany. The survey included validated mental health instruments (Distress Thermometer, Patient Health Questionnaire 4) and self-developed items to examine the perception of the study situation during the COVID-19 pandemic. Open-ended questions were analyzed by conventional content analyses. The response rate was 59.2% (914/1,545). Overall, 61.9% of the students reported distress levels above the cutoff. Year 1 students reported significantly higher levels of distress, anxiety and depression than students during their second to fourth year of studies. 48.3% of the students indicated a decrease in their study motivation since the beginning of the COVID-19 pandemic with significant differences between study years. The binary logistic regression model showed that male gender, being in study year 2, higher distress scores and higher symptoms of depression were significantly associated with a higher likelihood for experiencing serious worries. In the open-ended questions on current concerns related to the impact of the COVID-19 pandemic on their studies, students most frequently reported concerns about missing relevant practical learning experience, difficulties with self-regulated learning and self motivation as well as study-related worries. Year 4 students reported significantly more worries about the lack of practical training than students from study years 1 to 3. Analysis of gender differences showed that female students reported more frequently diverse worries. In contrast, female students shared more frequently helpful strategies in all the categories compared to male students. Our findings suggest that medical students experience significant levels of distress and mental burden during the COVID-19 pandemic and highlight the need for ongoing psychological and educational support for medical students during the COVID-19 pandemic and after.

Knowledge, attitude, and practice of undergraduate medical students in Indonesia on the COVID-19 prevention.

BACKGROUND: Coronavirus Disease 2019 (COVID-19) caused a global pandemic since March 2020. Undergraduate medical students were encouraged to educate Indonesian society about COVID-19. This study aimed to evaluate the knowledge, attitude, and practice of Indonesian students on COVID-19 prevention. METHODS: An online cross-sectional study was conducted online between August 22 and September 2, 2020, with a minimum sample size of 1,068 subjects. The questionnaire was sent to 86 Faculty of Medicine (FoM) in Indonesia. The questionnaire consisted of knowledge, attitude, and practice section, with the scores above median were considered as sufficient knowledge, positive attitude, and positive practice. Association between knowledge, attitude, and practice, which were dependent variables, with gender, year of study, location of FoM, and source of information, which were independent variables, were tested using Chi-Square Test. Correlation among knowledge, attitude, and practice scores was tested using Spearman Rank Test. RESULTS: Among 1,390 participated students, 51.4, 55.7, and 56.3% had sufficient knowledge, positive attitude, and, positive practice, respectively. There were associations between knowledge and gender (p = 0.005), year of study (p = 0.000), location of FoM (p=0.000), and source of information (p = 0.000); between attitude and gender (p = 0.022), year of study (p = 0.004), and source of information (p = 0.015); and between practice and gender (p = 0.000) and source of information (p = 0.000). There were weak correlations between knowledge and attitude (r = 0.246, p<0.001); and between attitude and practice (r = 0.272, p < 0.001). CONCLUSIONS: Half of Indonesian medical students showed sufficient knowledge, positive attitude, and positive practice on COVID-19 prevention. Hence, improvement towards COVID-19 prevention is required.

A longitudinal investigation of mental health, perceived learning environment and burdens in a cohort of first-year German medical students' before and during the COVID-19 'new normal'.

BACKGROUND: Medical students' propensity to develop mental morbidity has been described for decades but remains unresolved. To assess student mental health person-centred and longitudinally, we have been investigating a cohort of German students since October 2019. After their first semester under 'normal' conditions, rapid changes became necessary due to the COVID-19 situation. In line with the initial aim, we investigated students' change of mental health, perceived learning environment and burdens in the 'new normal'. METHODS: Students in a newly founded German medical study programme (n = 63) answered a questionnaire each semester (October 2019 = entering medical school; December 2019 = 'old normal'; June 2020 = 'new normal'; December 2020 = 'new normal') on their well-being (FAHW-12), burnout (Maslach Inventory), depression (PHQ-9), perception of the learning environment (DREEM), burdens and protective attitudes in the 'new normal' (items designed for the study). RESULTS: Friedman tests reveal overall significant differences (all p < .001) in depression and burnout (emotional exhaustion, depersonalisation, personal accomplishment); changes in well-being were identified as just non-significant (p = .05). The effects were explained by a significant increase in burnout and depression identified post-hoc from October 2019 to December 2019. No increase in severity was identified in the 'new normal' semesters. The learning environment was perceived positively even with a significant improvement for June 2020 (repeated measures ANOVA p < .001). Study-related burdens (e.g. procrastination of online-learning material) took on greater relevance than burdens related to physicians' occupation (e.g. potential for students' recruitment to the healthcare system during their studies). CONCLUSIONS: The 'new' when entering medical school had a greater impact on our students' mental health than the 'new normal'. The readiness for change in the context of a newly designed study programme may have been beneficial with regard to students' positively perceived learning environment during the virtual semesters. Monitoring medical students' mental health longitudinally should be a concern regardless of a pandemic.

Prevalence of insomnia and related psychological factors with coping strategies among medical students in clinical years during the COVID-19 pandemic.

We explored the prevalence of insomnia, confirm the associated psychological factors and current coping strategies among undergraduate medical during their clinical years. This cross-sectional, quantitative, descriptive study was conducted at the department of medical education, college of medicine, King Saud University (KSU), Riyadh, Saudi Arabia. The participants (n = 463) were the 3rd to 5th year, and intern medical clinical students. We collected responses about sleep, using the Insomnia Severity Index (ISI). We also used Kessler-10 (K10), Psychological Distress and the Patient Health Questionnaire (PHQ-9). Items related to Coping strategies were also used from our previously published study and COVID-19 issues were explored using a self-developed questionnaire. According to the ISI ranking, 162 (34.9 %) of the participants had insomnia, among them 57.4% of females and 42.6% were males. Age groups between 22 and 25 have more sleeping disorder (43.2%) as compared to other age groups. 3rd-year students have more insomnia 36.41% as compared to other years. Individuals with insomnia symptoms were more likely (1.67 times higher) to be female students (OR = 1.67; P = 0.005) as compared to male students. A significantly high prevalence (3.37 times high) of insomnia was noted for those students or interns who have attended their clinical training irregularly as compare to regularly attending participants (OR = 2.32; P = 0.12) during COVID-19. Transition time i.e. year 3 of medical program was more stressful for the students and female students perceived stress and insomnia more than their male counterparts. It is important to address identified disorder early in order to reduce psychological morbidity and its harmful implications for medical students and young physicians.

A validated audio-visual educational module on examination skills in ophthalmology for undergraduate medical students in the COVID-19 season - An observational longitudinal study.

PURPOSE: The aim of this study was to assess the impact of an audio visual (AV) teaching module on basic torchlight examination of the eye and direct ophthalmoscopy for undergraduate medical students. METHODS: This observational longitudinal study was done on 33 consecutive medical interns during their Ophthalmology posting from December 2019 to March 2020 at a medical college in South-India. An AV-module was created using animation graphics, narratives, demonstrations on normal individuals and on patients with positive signs. All interns had a pretest consisting of Multiple-choice questions, (MCQs) and an Objective Structured Clinical Examination (OSCE) on torchlight examination and direct ophthalmoscopy (DO). They were then shown the 20-minute AV-module. A posttest was performed immediately and after one week. RESULTS: The mean pretest MCQ score was 5.84 ± 1.98. It improved to 8.81 ± 1.15 in the immediate posttest and 8.87 ± 1.66 in the one-week posttest. The mean pretest OSCE score was 12.21 ± 3.39. It improved to 23.21 ± 3.39 in the immediate posttest and 23.90 ± 3.7 in the one-week posttest. Using Generalized Estimating Equation, MCQ score improved by 2.97 units and 3.03 units and the OSCE score improved by 11 units and 11.69 units in the immediate posttest and one-week posttest respectively when compared to the pretest corresponding to the MCQ score and OSCE score (p < 0.001). CONCLUSION: AV teaching modules-for torchlight examination and DO has a significant benefit in improving knowledge and skill in undergraduate medical students. These significant results have the great translatory capacity in the current COVID-19 pandemic, where physical demonstrations involving close proximity and groups of students are highly risk prone.

Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study.

BACKGROUND: The COVID-19 pandemic is found to affect the mental health of the population. Undergraduate medical students are especially prone to mental health disorders and hence could be more vulnerable to the impact of the pandemic. METHODS: A prospective longitudinal study was conducted on 217 undergraduate medical students in a medical college at Chennai, India. Depression, anxiety, and stress levels were recorded using Depression Anxiety Stress Scale 21 Items (DASS21) before and during the COVID-19 outbreak in India in December 2019 and June 2020, respectively. In the follow-up survey, in addition to DASS21, the Pittsburgh Sleep Quality Index to assess sleep quality and a self-administered questionnaire to assess the impact of COVID-19 related stressors were used. The self-administered questionnaire assessed the status of COVID-19 testing, interactions with COVID-19 patients, self-perceived levels of concerns and worries related to academics (COVID-19-AA (academic apprehensions)) and those pertaining to the self and family/friends (COVID-19-GA (general apprehensions)). Cross-sectional and longitudinal comparison of overall scores of depression, anxiety, and stress and scores stratified by gender, year of study, place of residence and monthly family income were performed. Predictors for depression, anxiety, and stress during COVID-19 were investigated using adjusted binary logistic regression analysis and results were expressed as adjusted odds ratio with 95% confidence interval (CI). A P value < 0.05 was considered statistically significant. RESULTS: The average scores of depression, anxiety, and stress during the baseline survey were 7.55 ± 7.86, 4.6 ± 6.19 and 7.31 ± 7.34 with the prevalence (95% Cl) of 33.2% [27-39.9%], 21.2% [16-27.2%] and 20.7% [15.5-26.7%]; in follow-up survey, the mean scores were 8.16 ± 8.9, 6.11 ± 7.13 and 9.31 ± 8.18 with the prevalence being 35.5% [29.1-42.2%], 33.2% [27-39.9%] and 24.9% [19.3-31.2%] for depression, anxiety, and stress respectively. There was a significant increase in both the prevalence and levels of anxiety and stress (P < 0.001), with depression remaining unchanged during COVID-19, irrespective of gender, year of study, place of residence and family's monthly income. Poor sleep quality, higher levels of baseline depression, anxiety, and stress, higher COVID-19-GA, COVID-19 patients in family/friends and direct interactions with COVID-19 patients were found to be significant predictors of negative mental health in undergraduate medical students. COVID-19-AA was not significantly associated with depression, anxiety, and stress. CONCLUSION: The COVID-19 pandemic appears to negatively affect the mental health of the undergraduate medical students with the prevalence and levels of anxiety and stress being increased, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population is crucial.