Student's experiences with online teaching following COVID-19 lockdown: A mixed methods explorative study.

BACKGROUND: The COVID-19 pandemic lead to a sudden shift to online teaching and restricted campus access. AIM: To assess how university students experienced the sudden shift to online teaching after closure of campus due to the COVID-19 pandemic. MATERIAL AND METHODS: Students in Public Health Nutrition answered questionnaires two and 12 weeks (N = 79: response rate 20.3% and 26.6%, respectively) after the lockdown in Norway on 12 March 2020 and participated in digital focus group interviews in May 2020 (mixed methods study). FINDINGS AND DISCUSSION: Two weeks into the lockdown, 75% of students reported that their life had become more difficult and 50% felt that learning outcomes would be harder to achieve due to the sudden shift to online education. Twelve weeks into the lockdown, the corresponding numbers were 57% and 71%, respectively. The most pressing concerns among students were a lack of social interaction, housing situations that were unfit for home office purposes, including insufficient data bandwidth, and an overall sense of reduced motivation and effort. The students collaborated well in digital groups but wanted smaller groups with students they knew rather than being randomly assigned to groups. Most students agreed that pre-recorded and streamed lectures, frequent virtual meetings and student response systems could improve learning outcomes in future digital courses. The preference for written home exams over online versions of previous on-campus exams was likely influenced by student's familiarity with the former. The dropout rate remained unchanged compared to previous years. CONCLUSION: The sudden shift to digital teaching was challenging for students, but it appears that they adapted quickly to the new situation. Although the concerns described by students in this study may only be representative for the period right after campus lockdown, the study provide the student perspective on a unique period of time in higher education.

A longitudinal course pilot to improve surgical resident acquisition of quality improvement skills.

PROBLEM: Despite mounting evidence that incorporation of QI curricula into surgical trainee education improves morbidity and outcomes, surgery training programs lack standardized QI curricula and tools to measure QI knowledge. In the current study, we developed, implemented, and evaluated a quality improvement curriculum for surgical residents. INTERVENTION: Surgical trainees participated in a longitudinal, year-long (2019-2020) curriculum based on the Institute for Healthcare Improvement's online program. Online curriculum was supplemented with in person didactics and small group projects. Acquisition of skills was assessed pre- and post- course via self-report on a Likert scale as well as the Quality Improvement Knowledge Application Tool (QIKAT). Self-efficacy scores were assessed using the General Self-Efficacy Scale. 9 out of 18 total course participants completed the post course survey. This first course cohort was analyzed as a pilot for future work. CONTEXT: The project was developed and deployed among surgical residents during their research/lab year. Teams of surgical residents were partnered with a faculty project mentor, as well as non-physician teammates for project work. IMPACT: Participation in the QI course significantly increased skills related to studying the process (p = 0.0463), making changes in a system (p = 0.0167), identifying whether a change leads to an improvement (p = 0.0039), using small cycles of change (p = 0.0000), identifying best practices and comparing them to local practices (p = 0.0020), using PDSA model as a systematic framework for trial and learning (p = 0.0004), identifying how data is linked to specific processes (p = 0.0488), and building the next improvement cycle upon success or failure (p = 0.0316). There was also a significant improvement in aim (p = 0.037) and change (p = 0.029) responses to one QIKAT vignette. LESSONS LEARNED: We describe the effectiveness of a pilot longitudinal, multi component QI course based on the IHI online curriculum in improving surgical trainee knowledge and use of key QI skills.

COVID-19 pandemic and remote teaching: transition and transformation in nursing education.

Remote teaching (RT) was the only option left to educators to continue education with public policy of lockdowns and social distancing during COVID-19 pandemic. RT is the online mode of instructional delivery. Globally it has become mandatory for all nurse educators to switch to RT mode. Many factors have been identified for effective implementation of RT, of which the major elements are choice of online teaching mode, pedagogy to choose the platform or technology, faculty preparedness, and the learner motivation and expectations. The dire need to meet the educational objectives demanded sudden transition to online mode. The paradigm shifts to RT brought many challenges and pragmatic guidance for teachers and institutions Remote teaching is flexible, student centered and feasible with opportunities to develop technically empowered faculty and coherent digital education strategies. However, tackling threats like academic integrity, inequity in accessibility and limited faculty preparedness necessitates attention. RT being flexible tool is weakened by low self-motivated students and low connectivity with digital inequity and security issues. The challenges opened opportunity to enhance faculty technical competency and learning management system.

Using Kern's 6-Step Approach to Integrate Health Systems Science Curricula Into Medical Education.

The term "health systems science" (HSS) has recently emerged as a unifying label for competencies in health care delivery and in population and community health. Despite strong evidence that HSS competencies are needed in the current and future health care workforce, heretofore the integration of HSS into medical education has been slow or fragmented-due, in part, to a lack of evidence that these curricula improve education or population outcomes. The recent COVID-19 pandemic and the national reckoning with racial inequities in the United States further highlight the time-sensitive imperative to integrate HSS content across the medical education continuum. While acknowledging challenges, the authors highlight the unique opportunities inherent in an HSS curriculum and present an elaborated curricular framework for incorporating health care delivery and population health into undergraduate medical education. This framework includes competencies previously left out of medical education, increases the scope of faculty development, and allows for evidence of effectiveness beyond traditional learner-centric metrics. The authors apply a widely adopted 6-step approach to curriculum development to address the unique challenges of incorporating HSS. Two examples-of a module on quality improvement (health care delivery) and of an introductory course on health equity (population and community health)-illustrate how the 6-step approach can be used to build HSS curricula. The Supplemental Digital Appendix (at http://links.lww.com/ACADMED/B106) outlines this approach and provides specific examples and resources. Adapting these resources within local environments to build HSS curricula will allow medical educators to ensure future graduates have the expertise and commitment necessary to effect health systems change and to advocate for their communities, while also building the much-needed evidence for such curricula.

Quality Improvement Amid a Global Pandemic: A Virtual Curriculum for Medical Students in the Time of COVID-19.

Introduction: The COVID-19 pandemic in March of 2020 necessitated the removal of medical students from direct patient care activities to prevent disease spread and to conserve personal protective equipment. In order for medical student education to continue, virtual and online electives were designed and implemented expeditiously. We created a virtual curriculum that taught quality improvement (QI) skills within the context of the global pandemic. Methods: This 4-week curriculum enrolled 16 students. Students completed the revised QI knowledge application tool (QIKAT-R) before and after the course to assess QI knowledge. Students completed prereading, online modules, and received lectures on QI and incident command systems. Each group designed their own QI project related to our hospital system's response to the pandemic. Finally, groups presented their projects at a peer symposium and completed peer evaluations. Results: Students' QIKAT-R scores improved throughout the course from a mean of 5.5 (SD = 1.3) to a mean of 7.5 (SD = 1.1; p < 0.001). Students reported that the virtual learning experience delivered the material effectively, and all students agreed that they would participate in QI work in the future. Discussion: Patient safety and QI topics are content areas for multiple medical licensing examinations. Virtual learning is an effective way to deliver QI content to medical students and residents, especially when projects are trainee-led, QI-trained faculty serve as mentors, and the projects harmonize with institutional goals. Our virtual pandemic-focused curriculum has demonstrated efficacy in increasing medical student QI knowledge.

Strategies for General Surgery Training Programs During the COVID-19 Pandemic.

The COVID-19 pandemic presented a unique challenge for Medical systems worldwide. Initial response to the crisis situation for the pandemic closely mirrored plans for a mass casualty event. By leveraging resources including human and physical, and by dividing our surgeon workforce into micro teams we were able to create a flexible and responsive infrastructure to address the crisis as it unfolded. By adoption of virtual platforms and equal division of labor, surgical resident education was continued. Specific adjustments to the schedule and curriculum for medical students allowed them to continue their studies safely and on schedule. Our model serves as an example by which hospital systems of similar size may utilize principles of mass casualty preparedness to craft their own plan for a future contagion response strategy.

Transforming a clerkship with telemedicine.

The coronavirus disease 2019 (COVID-19) pandemic had an overwhelming impact on both clinical practices and learning environments. On March 17th, 2020, the American Association of Colleges of Osteopathic Medicine and Commission on Osteopathic College Accreditation issued a statement recommending a "pause" in medical student participation in-person at clinical sites. In response, the Family Medicine Department at the Rowan University School of Osteopathic Medicine recognized the need to evolve the traditional curriculum and quickly transitioned to an online format, incorporating telemedicine into the clerkship. This new model enabled 44 third-year medical students to obtain high-quality, offsite, virtual education and learn new skills.

The Role of Medical Student Government in Responding to COVID-19.

The COVID-19 outbreak has sown clinical and administrative chaos at academic health centers throughout the country. As COVID-19-related burdens on the health care system and medical schools piled up, questions from medical students far outweighed the capacity of medical school administrators to respond in an adequate or timely manner, leaving students feeling confused and without clear guidance. In this article, incoming and outgoing executive leaders of the University of Michigan Medical School Student Council and medical school deans outline the specific ways they were able to bridge the gap between medical students and administrators in a time of crisis. To illustrate the value of student government during uncertain times, the authors identify the most pressing problems faced by students at each phase of the curriculum-preclerkship, clerkship, and postclerkship-and explain how Student Council leadership partnered with administrators to find creative solutions to these problems and provide guidance to learners. They end by reflecting on the role of student government more broadly, identifying 3 guiding principles of student leadership and how these principles enable effective student representation.

What might COVID-19 have taught us about the delivery of Nurse Education, in a post-COVID-19 world?

For Nurse Education in the UK, pre-existing challenges already included the need to develop curricula to align with new Nursing and Midwifery Council (NMC) educational standards; and increased numbers entering pre-registration Nurse Education programmes in order to address workforce deficits. Further disruption due to COVID-19, forced Nurse Educators overnight to rapidly adopt and to innovatively use current and emerging technologies to maintain engagement with, and to continue delivering education to, students during the pandemic. Although the full extent of these enforced changes is unknown at this time, this paper argues that online delivery is a necessary and inevitable transition, addressing some of these pre-existing challenges, and that the pandemic has hastened this. It is therefore crucial that Nurse Educators lead the way in navigating this period of uncertainty, viewing the pandemic as an opportunity to plan for the future, to establish how online teaching and learning can continue to benefit Nurse Education in a post-COVID-19 world, not just in the UK, but across the globe.

The knowledge level and perceptions toward COVID-19 among Turkish final year medical students.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has upended medical education as well as the lives of healthcare professionals. Higher education institutions have a crucial role in the solution of public health problems by training young doctor candidates, and it is also essential to increase the knowledge level of physician candidates about the epidemic. So, in this study, we aimed to examine Turkish final year medical students' knowledge level and perceptions toward the COVID-19 pandemic. METHODS: The present descriptive multicentered study was conducted with the medical students in the final year of six medical schools located in six geographic regions of Turkey. After ethical approval, data were gathered using an online questionnaire through Google forms between 10 April 2020, and 20 April 2020. RESULTS: In this national survey study, 860 volunteers answered the questions thoroughly. The median age was 24 (22-38) years. A total of 55.3% of the participants were female. The median knowledge level score was 69.0 (0-93.1). The knowledge level was moderate. A total of 34.2% of the participants had a high level of knowledge. A total of 48.7% of participants stated that they felt the most competent about performing CPR. Updates about COVID-19 were followed regularly by 84.5% of the participants. CONCLUSION: We determined that final year medical students are knowledgeable and aware of this pandemic. We, medical educators, should inculcate relevant knowledge and educate the medical students to improve practices in the current pandemic, as well as for future epidemics. Different learning techniques should be added to the curriculum, especially at the time which widespread panic and uncertainty are prevalent.

Clinical nursing and midwifery education in the pandemic age.

The COVID-19 pandemic has disrupted clinical nursing and midwifery education. This disruption has long-term implications for the nursing and midwifery workforce and for future healthcare responses to pandemics. Solutions may include enhanced partnerships between schools of nursing and midwifery and health service providers and including schools of nursing and midwifery in preparedness planning. These suggestions notwithstanding, we call upon national and international nursing and midwifery bodies to study how to further the clinical education of nurses and midwives during pandemics and other times of crisis.

Practical approaches to pedagogically rich online tutorials in health professions education.

Health professions education in tertiary, industrial and other contexts often entails face-to-face small group learning through tutorials. The current novel coronavirus, COVID-19, has reduced face-to-face contact, and this has challenged how health professionals and clinical students can access training, accreditation and development. Online and other remote mechanisms are available to tutors and course designers; however, they might not feel comfortable with such affordances, in light of expectations to so rapidly change familiar teaching and delivery styles. This may result in the loss of interaction and disruption of peer learning, which are hallmarks of the small group tutorial. Collaborative learning is essential to develop and refine an emerging sense of belonging to a professional community through formal studies, and interactive learning is a requirement for some registered health professions to satisfy ongoing professional accreditation. Online media has been used to promote social learning in regional, rural and remote communities for some time. Strategies for learning activity design and tutor training are proposed to equip course designers and educators to support health professions education remotely, through the synchronous, online small group. This may herald a new era of increased access to training and professional development for non-urban learners, beyond COVID-19.