A SWOT analysis of Italian medical curricular adaptations to the COVID-19 pandemic: A nationwide survey of medical school leaders.

BACKGROUND: There is a growing literature on how medical education adapts to the COVID-19 pandemic. However, there is a need to examine the facilitators and barriers of these adaptations. This study explores the strengths, weaknesses, opportunities, and threats (SWOT) of how Italian medical schools adapted their curricula to the COVID -19 pandemic. METHODS: The authors conducted an online survey of directors of medical curricula in Italy. Free-text responses to open-ended questions about curricular adaptations and reflections on these adaptations were analysed using qualitative thematic analysis. RESULTS: Twenty out of 60 Italian medical school directors completed the survey. Strengths identified were rapid responses and a spirit of cooperation. Weaknesses included dependency on clinical facilities, teachers' limited skills to use technology, and lack of mental health support for staff. Opportunities highlighted were clear government rules, new ways of teaching and a renewed focus on underrepresented topics. Threats expressed included impaired relationships, difficulties related to online assessment, lack of IT access, and legal and insurance issues. CONCLUSIONS: This study, in documenting the curricular adaptations of Italian medical schools during an active global pandemic, and recording the perspectives of medical education leaders, offers important lessons for the future.

The need for changes in medical education and the perception of teachers before the Covid-19 pandemic / Necessidade de mudanças na educação médica e a percepção de professores antes da pandemia da Covid-19 / Necesidad de cambios en la educación médica y la percepción de profesores antes de la pandemia de Covid-19

Este estudo objetiva analisar questões da educação médica evidenciadas pelas medidas de distanciamento social provocadas pela pandemia do coronavírus19 associadas às percepções de professores de medicina sobre esses mesmos aspectos, em um momento prévio à eclosão da crise sanitária. Realizamos um recorte de resultados de uma pesquisa de natureza qualitativa e conduzimos a discussão com base na triangulação de dados entre observações de campo e entrevistas com professores. A pandemia reacendeu debates sobre a relevância de conteúdos, a utilização de tecnologias digitais para fins pedagógicos e o valor do trabalho colaborativo. Além disso, resgatou questões que envolvem habilidades de comunicação e a saúde de estudantes nas práticas do cuidado. Discutiremos a experiência passada articulando-a às experiências recentes e o que poderemos recolher para (re)construirmos os rumos da formação dos médicos.(AU)

El objetivo de este estudio es analizar cuestiones de la educación médica puestas en evidencia por las medidas de distancia social adoptadas por la pandemia del coronavirus 19, asociadas a las percepciones de profesores de medicina sobres esos mismos aspectos, en un momento previo a la eclosión de la crisis sanitaria. Realizamos un recorte de resultados de una investigación de naturaleza cualitativa y dirigimos la discusión a partir de la triangulación de datos entre observaciones de campo y entrevistas con profesores. La pandemia reencendió debates sobre la relevancia de contenidos, la utilización de tecnologías digitales para fines pedagógicos y el valor del trabajo colaborativo. Además, rescató cuestiones que envuelven habilidades de comunicación y la salud de estudiantes en las prácticas del cuidado. Discutiremos la experiencia pasada articulándola con las experiencias recientes y lo que podremos recoger para (re)construir los rumbos de formación de los médicos.(AU)

This study aims to analyze medical education issues evidenced by the measures of social distancing due to the coronavirus pandemic19, associated with the perceptions of medical professors about these same aspects, in a moment prior to the outbreak of the health crisis. We focused in the results of a qualitative research and conducted a discussion based on the triangulation of data between field observations and interviews with professors. The pandemic has rekindled debates about the relevance of contents, the use of digital technologies for educational purposes and the value of collaborative work. Additionally, it provoked the emergence of issues involving communication skills and the health of students in care practices. We discuss past experiences articulating them with recent experiences and what we can collect to (re)build the direction of medical training.(AU)

COVID-19 and medical education: an opportunity to build back better.

The coronavirus disease 2019 (COVID-19) outbreak in the Hubei province of China has rapidly transformed into a global pandemic. In response to the first few reported cases of COVID-19, the government of Ghana implemented comprehensive social and public health interventions aimed at containing the disease, albeit its effect on medical education is less clear. Undoubtedly, the COVID-19 has brought changes that may impact the plan of career progression for both students and faculty. Hitherto, medical education had students getting into contact with patients and faculty in a facility setting. Their physical presence in both in-and outpatients' settings has been a tradition of early clinical immersion experiences and the clerkship curriculum. Rotating between departments makes the students potential vectors and victims for COVID-19. COVID-19 has the potential to affect students throughout the educational process. The pandemic has led to a complete paradigm shift in the mode of instruction in a clinical care setting. Inperson training has either been reduced or cancelled in favour of virtual forms of pedagogy. The clinics have also seen a reduction in a variety of surgical and medical cases. This situation may result in potential gaps in their training. Outpatient clinics have transitioned mainly to telemedicine, thus minimizing students' exposure to clinic encounters. Faced with this pandemic, medical educators are finding ways to best ensure rigorous training that will produce competent physicians. This article discusses the status of medical education and the effect of COVID-19 and explores potential future effects in a resource-limited country. FUNDING: None declared.

A National Pediatric Telepsychiatry Curriculum for Graduate Medical Education and Continuing Medical Education.

Objectives: Our goal was to develop an open access nationally disseminated online curriculum for use in graduate and continuing medical education on the topic of pediatric telepsychiatry to enhance the uptake of telepsychiatry among child psychiatry training programs and improve access to mental health care for youth and families. Methods: Following Kern's 6-stage model of curriculum development, we identified a core problem, conducted a needs assessment, developed broad goals and measurable objectives in a competency-based model, and developed educational content and methods. The curriculum was reviewed by experts and feedback incorporated. Given the urgent need for such a curriculum due to the COVID-19 pandemic, the curriculum was immediately posted on the American Academy of Child and Adolescent Psychiatry and American Association of Directors of Psychiatric Residency Training websites. Further evaluation will be conducted over the next year. Results: The curriculum covers the six areas of core competence adapted for pediatric telepsychiatry and includes teaching content and resources, evaluation tools, and information about other resources. Conclusion: This online curriculum is available online and provides an important resource and set of standards for pediatric telepsychiatry training. Its online format allows for ongoing revision as the telepsychiatry landscape changes.

Changes in undergraduate medical education due to COVID-19: a systematic review.

OBJECTIVE: This study aims to provide medical educators with insights into the current status and prospects of undergraduate medical education, which has been affected by the COVID-19 pandemic. MATERIALS AND METHODS: We conducted a database search of PubMed, Embase, and ERIC and identified articles on COVID-19-related undergraduate medical education. We independently reviewed titles and abstracts and extracted data on the geographic location of the study, area of specialty, phase in medical school (preclinical year, clerkship year, etc.), type of paper, and the main content of the study. RESULTS: A total of 49 articles published across multiple countries were included in this study. These were categorized as dealing with either (1) curriculum changes in undergraduate medical education due to COVID-19 or (2) student-led educational activities related to COVID-19. The 41 articles in the first category showed two main trends: replacing in-person lectures with online classes in the preclinical years and adopting various remote educational methods to compensate for the discontinued or truncated clerkship in the clinical years. The eight articles in the second category showcased various student educational activities that were conducted to meet the public's medical needs during the pandemic. CONCLUSIONS: This review summarized the essential changes in undergraduate medical education worldwide and reflected on the various teaching methods adopted by medical schools. In preparation for the post-COVID era, a comprehensive online curriculum and evaluation tools are needed, which require the development of necessary infrastructure and adequate resources. Education aimed at helping students be more socially aware and responsible as medical professionals must be promoted.

The Challenge of Dental Education After COVID-19 Pandemic - Present and Future Innovation Study Design.

The present work suggests research and innovation on the topic of dental education after the COVID-19 pandemic, is highly justified and could lead to a step change in dental practice. The challenge for the future in dentistry education should be revised with the COVID-19 and the possibility for future pandemics, since in most countries dental students stopped attending the dental faculties as there was a general lockdown of the population. The dental teaching has an important curriculum in the clinic where patients attend general dentistry practice. However, with SARS-CoV-2 virus, people may be reluctant having a dental treatment were airborne transmission can occur in some dental procedures. In preclinical dental education, the acquisition of clinical, technical skills, and the transfer of these skills to the clinic are extremely important. Therefore, dental education has to adapt the curriculum to embrace new technology devices, instrumentations systems, haptic systems, simulation based training, 3D printer machines, to permit validation and calibration of the technical skills of dental students.

Overview of digital health teaching courses in medical education in Germany in 2020.

Objective: The digitalization of the healthcare system poses new challenges for physicians. Thus, the relevance of learning digital competencies (DiCo), such as dealing with data sets, apply telemedicine or using apps, is already growing in medical education. DiCo should be clearly separated from digitized teaching formats, which have been increasingly used since the COVID 19 pandemic. This article outlines the faculties in Germany where DiCo are already integrated into medical education. Methods: Courses with DiCo as teaching content were collected by a literature research on Pubmed and Google as well as by contacting all dean's offices and other persons responsible for teaching at German medical faculties. The courses were summarized in a table. Results: In a first survey, 16 universities were identified that offer courses on DiCo. In the elective area at the universities, 17 courses and in the compulsory area eight courses could be identified. The scope and content of the courses diverged between compulsory curricula, integrated courses of different lengths, and elective courses that are one-time or longitudinally integrated. The topics taught are heterogeneous and include fundamentals of medical informatics such as data management on the one hand and a collection of e.g. ethics, law, apps, artificial intelligence, telemedicine and robotics on the other hand. Conclusion: Currently, only some German medical faculties offer courses on DiCo. These courses vary in scope and design. They are frequently part of the elective curriculum and only reach some of the students. The possibility of embedding DiCo in the already existing cross-sectional area appears limited. In view of the ongoing digitalization of healthcare, it is necessary to make future courses on DiCo accessible to all medical students. In order to drive this expansion forward, the implementation of the new learning objectives catalogue, in which DiCo are integrated, a network formation, a teaching qualification as well as the involvement of students is recommended.

Learning During and From a Crisis: The Student-Led Development of a COVID-19 Curriculum.

PROBLEM: The speed and scope of the upheaval that COVID-19 inflicted on medical education made innovation a necessity. While medical students wanted high-quality, consolidated educational resources on COVID-19, the medical school faculty who typically produced such resources were increasingly burdened with clinical, administrative, and personal commitments. However, students eager to contribute to the pandemic response were well suited to create these instructional materials for their peers. APPROACH: In mid-March 2020, a group of students at Harvard Medical School came together to synthesize the key facts and collate the best existing educational materials about the COVID-19 pandemic into a unified learning resource. The materials were faculty reviewed and shared freely online. The curriculum now contains 8 modules that are updated regularly. Throughout this process, the student authors prioritized accessibility, iterative improvement, and effective pedagogy. OUTCOMES: To date, nearly 80,000 users from 132 countries have accessed the curriculum. It has been referenced or incorporated into courses at Harvard Medical School and more than 30 other medical schools across the country. About 40% of all users are from outside the United States, and the materials have been translated into 28 languages. This effort has spurred a number of other educational initiatives led by medical student groups in the United States and abroad. NEXT STEPS: As understanding of the COVID-19 pandemic is constantly changing, the student authors' immediate goal is to keep the curriculum up to date in the months to come. They plan to maintain existing partnerships with medical schools and student groups around the world while pursuing new opportunities to expand the curriculum's reach, provide education, and build community. Students and educators alike should leverage student-driven education efforts to benefit other learners both within and, importantly, beyond their institutions.

Increasing Short- and Long-Term Buprenorphine Treatment Capacity: Providing Waiver Training for Medical Students.

In the face of an ongoing opioid crisis in the United States, persistent treatment gaps exist for vulnerable populations. Among the 3 Food and Drug Administration-approved medications used to treat opioid use disorder, many patients prefer buprenorphine. But physicians are currently required to register with the Drug Enforcement Administration and complete 8 hours of qualifying training before they can receive a waiver to prescribe buprenorphine to their patients. In this article, the authors summarize the evolution of buprenorphine waiver training in undergraduate medical education and outline 2 potential paths to increase buprenorphine treatment capacity going forward: the curriculum change approach and the training module approach. As part of the 2018 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, the Substance Abuse and Mental Health Services Administration has provided funding for medical schools to adapt their curricula to meet waiver training requirements. To date, however, only one school has had its curriculum approved for this purpose. Additionally, recent political efforts have been directed at eliminating aspects of the waiver training requirement and creating a more direct path to integrating waiver qualification into undergraduate medical education (UME). Other medical schools have adopted a more pragmatic approach involving the integration of existing online, in-person, and hybrid waiver-qualifying training modules into the curricula, generally for fourth-year students. This training module approach can be more rapidly, broadly, and cost-effectively implemented than the curriculum change approach. It can also be easily integrated into the online medical curricula that schools developed in response to the COVID-19 pandemic. Ultimately both curricular changes and support for student completion of existing training modules should be pursued in concert, but focus should not be single-mindedly on the former at the expense of the latter.

Medical education in Greece: Necessary reforms need to be re-considered.

For the past years, and even more now with the major challenge of the COVID-19 pandemic, we are faced with the inadequacies that undermine the healthcare system in Greece. As healthcare system performance and medical education are directly and reciprocally linked, a substantial part of healthcare services' dysfunctions could be partially attributed to the training of the young doctors. Thus, in order to improve the performance of the healthcare system in the best interest of patients and communities, the education of healthcare personnel should be a priority. By reviewing the existing literature in combination with our experience we attempt to delineate the weak points of the undergraduate and postgraduate medical education in Greece. Additionally, based on medical curricula from other countries, we suggest reforms in order to achieve a uniform, clinically oriented, emphasis on training in public health issues in undergraduate medical education. Reforms are also suggested for postgraduate training with regard not only to specialization curricula, but also to the accredited institutions which provide specialty training. Finally, the necessity for Continuing Medical Education (CME) is underlined; medical education must have a continuum that begins with undergraduate training but does not end there; it is life-long learning.

Gross Anatomy Education in China during the Covid-19 Pandemic: A National Survey.

The Covid-19 pandemic launched the use of online courses in Chinese medical schools during February 2020. To evaluate the state of gross anatomy education in China during the pandemic, a nationwide survey was conducted through convenience sampling by email or respondent invitations on social media. A total of 359 questionnaires were received from the respondents. The first response from a given school was included in the study to represent that school, thus, 77 questionnaires were used for analyses. Schools represented were from all provinces in mainland China as well as Hong Kong and Macao. The survey found that before the pandemic, 74.0% and 33.8% of the 77 schools conducted online theoretical and practical sessions, respectively, on gross anatomy, and 36 (46.8% of 77) had temporarily suspended practical sessions at the time the survey was conducted. Body donation programs were also affected with 26.0% and 27.3% of the 77 schools having suspended donation programs or saw a decreased number of donations. During the pandemic, 40.3% of the 77 schools kept or initiated the implementation of active learning, and online assessment was continued in 49.4% of the 77 medical schools. Another 26 (33.8%) schools initiated online assessment during the pandemic. A total of 359 answers were included for the analysis of the "teachers' perception of the online teaching experience." Over half (51.0%) of the 359 responded teachers were very statisfied or satisfied with the effectiveness of online teaching during the pandemic. A total of 36.2% of these respondents preferred to implement online teaching of theoretical sessions after the pandemic, and 89 (24.8%) teachers were keen to return to traditional face-to-face anatomy education.

COVID-19 Planning Among Radiologic Science Programs: Response Mitigation Activities.

PURPOSE: To examine radiologic science programs' mitigation activities and educators' experiences related to coronavirus disease 2019 (COVID-19) response planning. METHODS: Using a mixed-methods approach, educators in magnetic resonance, medical dosimetry, radiation therapy, and radiography programs were surveyed to capture their experiences and mitigation strategies related to COVID-19 response planning. Quantitative data were summarized using descriptive statistics and percentages. Thematic analyses were performed on the qualitative responses. RESULTS: A total of 274 educators responded. Educators reported being somewhat comfortable with modifying clinical experiences (79, 28.8%), moderately comfortable with adjusting assessment procedures (112, 40.9%), and extremely comfortable with changing delivery of didactic content (115, 42%). Incidentally, 220 (80.3%) educators thought adjusting to a new course delivery approach (eg, face-to-face to online format) was the greatest challenge for faculty during the pandemic. Notably, half of the educators in this study questioned the quality of online (remote) learning. Specific to program policies, educators indicated that access restrictions to campus buildings (263, 96%) and removal of students from clinical sites (254, 92.7%) were implemented during the pandemic. DISCUSSION: Educators self-reported a moderate to strong comfort level with curricular modification. The area of modification that yielded the most uncertainty arose from alterations of clinical experiences. Thematic analyses revealed concerns related to personal protective equipment procurement and clinical sites prohibiting students from completing rotations. However, educators created innovative alternatives to enhance clinical education by providing simulations, case study analyses, and virtual tours of facilities during the pandemic. Securing educational technology resources, such as lockdown browser software, and working with institutional instructional designers might provide some resolution to educators' concerns regarding the quality of online (remote) learning. CONCLUSION: Archiving radiologic science programs' COVID-19 response efforts is important. The compilation of mitigation strategies will inform and guide programs on contingency planning for future pandemic and emergent conditions.

Guiding principles for undergraduate medical education in the time of the COVID-19 pandemic.

As the early epicenter of the COVID-19 pandemic, New York City's medical schools experienced dramatic disruptions in every aspect of medical education. Remote learning was created, seemingly overnight, clerkships were disrupted, licensing examinations were cancelled, teaching faculty were redeployed, student volunteers rallied, and everyone was required to shelter at home. Seismic changes were required to adapt the authors' educational programs to a constantly evolving, unpredictable, and ever-worsening public health crisis. Entirely new communication strategies were adopted and thousands of decisions had to be made, often with little time to carefully reflect on the consequences of those decisions. What allowed each school to navigate these treacherous waters was a set of guiding principles that were used to ground each conversation, and inform every decision. While the language varied somewhat between schools, the core principles were universal and framed a way forward at a time when information, data, precedent, and best practices did not exist. The authors share these guiding principles in the hope that colleagues at other medical schools will find them to be a useful framework as we all continue to cope with the impact of COVID-19 on the future of medical education.