A Virtual World: New Graduate Education in the Era of COVID-19.

In this article, the authors share strategies of adult learning principles for successful transition to virtual learning for new graduate clinical nurses. Knowles' theory was used to redesign a simulation-based education approach to fulfill the diverse learning needs during the COVID-19 pandemic. The delivery of efficient, effective, and meaningful education was achieved by leveraging technology. This evidence-based strategy was delivered via a cost-effective virtual platform that offered improved accessibility and convenience of education without compromising the quality of the educational outcomes, participant engagement, or learner satisfaction. This virtual platform incorporating a variety of active learning strategies exhibited effective practices, engaging the new graduate clinical nurses and enhancing their acquiring, retaining, and applying knowledge in providing high-quality and safe patient care. It demonstrated the promise that virtual education holds for future programs to enhance professional development and build the nursing workforce. Nurse educators can be instrumental in advancing this virtual agenda. [J Contin Educ Nurs. 2022;53(7):307-311.].

Distance learning in the COVID-19 pandemic: acceptance and attitudes of physical therapy and rehabilitation students in Turkey.

INTRODUCTION: To reduce the rate of spread of the COVID-19 pandemic in Turkey, distance education was initiated in all universities on 23 March 2020. Distance learning had not been experienced in physical therapy and rehabilitation education before the COVID-19 outbreak. This study aimed to (a) determine the acceptance and attitudes of Pamukkale University Physical Therapy and Rehabilitation undergraduate students towards distance learning during the COVID-19 outbreak and (b) compare the results among years. METHODS: This study was conducted from May 2020 to June 2020 at the Pamukkale University School of Physical Therapy and Rehabilitation in Turkey. A total of 381 students (271 female, 110 male) participated. The Distance Learning Systems Acceptance Scale (ease of use, benefit), the Community Feeling Scale (affective and actional dimension), and the Distance Learning Attitude Scale (general acceptance, individual awareness, perceived usefulness, effective participation) were used to measure students' acceptance and attitudes towards distance education. RESULTS: Students had partly positive attitudes towards distance learning but were undecided about individual awareness, usefulness, and effective participation. The sense of community among students was moderate in the distance learning environment. Distance learning acceptance and attitude, and the sense of community levels, were highest in fourth-year students (last year of the school), followed by first-, third-, and then second-year students. The distance learning and sense of community scores of first- and fourth-year students were significantly higher than those of second- and third-year students (p≤0.01). CONCLUSION: Physical therapy and rehabilitation undergraduate students' attitudes towards distance learning during the COVID-19 outbreak were positive. However, when comparing between years, students in the second and third academic years had less positive attitudes. This may be because most of their curricula consisted of practical courses and summer field internships, and there were no opportunities to practise on mannequins, peers, and patients in distance education. In this study, the sense of community among students in the distance learning environment was also moderate. This may be because students were not enthusiastic about attending course lectures online, and because they did not have to view the lectures at a set time.

Solutions, enablers and barriers to online learning in clinical medical education during the first year of the COVID-19 pandemic: A rapid review.

AIMS: The COVID-19 pandemic has seen a major disruption to undergraduate and postgraduate clinical medical education. The aim of this rapid review was to identify and synthesize published literature relating to the solutions, enablers and barriers to online learning implemented in clinical medical education during the first year of the COVID-19 pandemic. METHODS: All articles published before March 2021 in peer-reviewed journals, including MedEdPublish, that described authors' experience of online learning in response to the COVID-19 pandemic. A descriptive analysis of the solutions and a qualitative template analysis of enablers and barriers. RESULTS: 87 articles were identified for inclusion. Face to face teaching was maintained with interactive approaches between learners and/or learners and teachers. Several innovative solutions were identified. The enablers were a readiness and rapid response by institutions, with innovation by teachers. The barriers were the lack of planning and resources, usability problems and limited interactivity between teachers and students. CONCLUSIONS: Important and timely evidence was obtained that can inform future policy, practice and research. The findings highlighted the urgent need to use rapid design and implementation methods with greater explicit descriptions in published articles to ensure applicability to other contexts.

Accelerated Implementation of a Virtual Neurology Clerkship Amid a Global Crisis.

The standard neurology clinical experience in medical school focuses primarily on bedside patient encounters; however, the limitations of the clinical environment due to the current COVID-19 pandemic have accelerated the need for virtual curriculum development. To provide guidance to Neurology clerkship directors during this unprecedented time, the American Academy of Neurology (AAN) Undergraduate Education Subcommittee (UES) formed a workgroup to develop an outline for a virtual curriculum, provide recommendations, and describe models of integrating virtual curricula into the neurology clerkship. In this overview, we discuss different methods of virtual instruction, hybrid models of clerkship training and the challenges to its implementation, professionalism issues, and modification of feedback and assessment techniques specific to the virtual learning environment. We also offer suggestions for implementation of a hybrid virtual curriculum into the neurology clerkship. The virtual curriculum is intended to supplement the core neurology in-person clinical experience and should not be used for shortening or replacing the required neurology clinical clerkship.

Twelve tips for teaching medical students online under COVID-19.

Universities worldwide are pausing in an attempt to contain COVID-19's spread. In February 2019, universities in China took the lead, cancelling all in-person classes and switching to virtual classrooms, with a wave of other institutes globally following suit. The shift to online platform poses serious challenges to medical education so that understanding best practices shared by pilot institutes may help medical educators improve teaching. Provide 12 tips to highlight strategies intended to help on-site medical classes moving completely online under the pandemic. We collected 'best practices' reports from 40 medical schools in China that were submitted to the National Centre for Health Professions Education Development. Experts' review-to-summary cycle was used to finalize the best practices in teaching medical students online that can benefit peer institutions most, under the unprecedented circumstances of the COVID-19 outbreak. The 12 tips presented offer-specific strategies to optimize teaching medical students online under COVID-19, specifically highlighting the tech-based pedagogy, counselling, motivation, and ethics, as well as the assessment and modification. Learning experiences shared by pilot medical schools and customized properly are instructive to ensure a successful transition to e-learning.

Remote clinical training practice in the neurology internship during the COVID-19 pandemic.

Background: During the current COVID-19 pandemic, offline clinical education was mandated to suspend at the neurology department of many teaching hospitals globally, yet there is insufficient evidence regarding the preferred practice and methods for online neurology intern training course.Objective: The investigation aimed to examine whether the online neurology training course based on Small Private Online Course (SPOC) and blending learning mode can achieve a good effect and cater for interns from different medical programs and whether the learning group size affects the teaching effect.Design: The subjects were 92 students enrolled in the neurology internship at the Second Xiangya Hospital of China from 9 March to 9 August 2020. After completing the online course, the final scores and evaluation results were compared among different groups of interns, and their preference to distinct contents of the course was analyzed. Statistical analysis was performed using the SPSS program (version 22.0).Results: Our online course received consistent positive recognition from the interns. Ninety-nine percent of the interns recommended incorporating the online course into the conventional offline training program after the pandemic. There was no significant difference between interns from different programs concerning the final scores and course evaluation. A smaller learning group size (<15 students) could achieve a better teaching effect than a larger group size (p < 0.05). The interns preferred interactive discussions, and course contents that they can get practice and feedback from, rather than video watching and didactic lectures.Conclusions: The online neurology intern training course based on SPOC and blending learning mode is worthy of popularization in a large student base. The teaching effect of an online intern training program may be improved by limiting the group size to less than 15 students and encouraging more interactive discussion, more practice and feedback.

COVID-19 pandemic: a catalyst for transformation of a summer online research program.

In view of limited resources during the COVID-19 pandemic, there is an urgent need to create novel programs to meet the changing demands of trainees towards developing and strengthening their skills in healthcare research. During the COVID-19 pandemic, digital learning has become an invaluable tool by providing more learning opportunities. Through the use of platforms available for distant learning, we made our pre-existing online research program more interactive. Through collaboration in small groups, the trainees developed their research and mentorship skills and were able to meet the goal of submitting their research projects as abstracts. All of the abstracts were accepted for publication.

Innovating patient care and gynecologic surgery instruction through tele-education.

PURPOSE OF REVIEW: Effects of the coronavirus disease 2019 pandemic prompted the need for rapid, flexible change in the delivery of care, education, and commitment to the well-being of obstetrics and gynecology (OB/GYN) residents. RECENT FINDINGS: Published literature shows multiple models for surge scheduling for residency programs in other specialties. We describe our experience creating a surge schedule for OB/GYN residents that allowed for sufficient coverage of inpatient care while minimizing resident exposure and limited hospital resources, respecting work hour requirements, and plans for coverage due to illness or need for home quarantine. We also report innovative approaches to trainee education through the use of remote-learning technology and gynecologic surgery skills training in absence of normal clinical exposure. SUMMARY: Our approach serves as a model for adapting to unprecedented challenges and offers suggestions for creative transformations of traditional teaching that can be continued beyond the immediate crisis.

Future of Education or Present Reality?

CONTEXT.­: The main focus of education in most pathology residency and subspecialty pathology fellowships is the light microscopic examination of pathology specimens. Classes with multiheaded scopes are the most popular among pathology trainees. Until recently, it was difficult to imagine that this educational approach could change. In the beginning of March 2020, our country faced a serious challenge, which all of us now know as the coronavirus disease 2019 (COVID-19) pandemic. The rules of social distancing and work from home were applied. These types of restrictions were implemented in almost all parts of our life, including work and pathology education. OBJECTIVE.­: To share our experience in the Department of Hematopathology at the University of Texas MD Anderson Cancer Center during the COVID-19 pandemic. We describe our experience in modifying our approaches to education. We show how we overcame many obstacles to learning by building one of the largest virtual hematopathology educational platforms via Cisco WebEx and using social media, in particular Twitter. These tools facilitated the learning of hematopathology by medical students, pathology trainees, and practicing pathologists from all over the world. DATA SOURCES.­: During the first 3 months of the pandemic (April, May, and June, 2020), we evaluated the visitor attendance to the MD Anderson Cancer Center Hematopathology Virtual Educational Platform using data collected by the Cisco WebEx Web site. To determine the impact that the platform had on medical education for the hematopathology community on Twitter, the analytic metrics obtained from Symplur LLC (www.symplur.com, April 27, 2020) were used via its Symplur Signals program. CONCLUSIONS.­: Our experience using the MD Anderson Hematopathology Virtual Platform showed that there is substantial global interest and desire for virtual hematopathology education, especially during the COVID-19 pandemic.

Switching from face-to-face to an online teaching strategy: how anatomy and physiology teaching transformed post-COVID-19 for a university preprofessional program.

The College of Science and Health Professions offers a university preprofessional program. Like most medical schools in Saudi Arabia, the teaching delivery strategy in the university preprofessional program is on campus and face-to-face. During the month of March 2020, teaching activities of the spring semester were proceeding as normal; however, the sudden emergence of COVID-19 disturbed routine activities and compelled authorities to switch all teaching activities from face-to-face to online. Training sessions and workshops for all stakeholders on online delivery methods were arranged. Blackboard and other online facilities were utilized. All teaching materials, including newly made video clips for anatomy and physiology practicals, were uploaded on Blackboard and discussed online with students. Students' anxiety related to the exam was reassured by giving them the option of open book quizzes during summative continuous assessment. All scheduled teaching sessions, lectures, and practicals were conducted proficiently. Revision sessions and assessment quizzes were conducted with students' satisfaction. At the end of the semester, a final exam was conducted online as an open book exam. Students with technical issues while attempting the exam were given an opportunity to make up for it. After a successful final exam, the cumulative block grades showed students secured higher grades in the open book exam. Following that, the King Saud bin Abdulaziz University for Health Sciences has managed to conduct on-campus close book exams that abide by self-distancing and standard operating procedure policies.

Online-rotation in paediatrics - digital live-interaction with children.

The two-week block rotation in paediatrics (tenth semester) took place for 62 students purely as online teaching in the summer semester of 2020, at the time of the initial restrictions. As a teaching module, virtual patient presentations including debriefing took place as synchronous teaching. Patients and one parent were broadcast from the wards and outpatient clinics via video conference. Students were able to interact in small groups with 15-22 patients or their parents, respectively, via a doctor and both conduct the case history interview and brief the examination steps. Despite the limitation of not being able to perform the clinical examination themselves, participants rated the block rotation with good marks. They particularly appreciated the ability to interact with the children online as an indispensable compromise in times of suspended classroom teaching during the SARS-CoV-2 pandemic.

Using real patients in e-learning: case-based online training in child and adolescent psychiatry.

Objectives: In undergraduate medical education and in the subject of child and adolescent psychiatry, examining young patients face-to-face is a key element of teaching. With the abrupt shutdown of face-to-face teaching caused by the SARS-CoV-2 pandemic, a case-based online training program integrating audio and video of real patients was developed. Methods: The blended learning platform CaseTrain guides medical students in their final year through real child-psychiatric patient cases, such as anorexia, autism, or attention deficit disorder, through presentation of video and audio of real patients and parents. The teaching format complements lectures on child psychiatric topics, comprising asynchronous elements (self-study using the digital material) as well as synchronous elements (web-conferences with a specialist). Learning objectives for students were set to develop knowledge of the spectra of psychiatric disorders that affect children and to recognize approaches how to assess and manage common psychiatric problems of childhood and adolescence. Results: The feedback from medical students through oral and written evaluation was positive. They appreciated getting to know 'real-world patients' in times of such a pandemic, to learn explorative techniques from role models, and to be in close contact with the supervising specialist. In consequence of critical feedback on the length of some video sequences, these training units will undergo revision. Conclusions: Case-based online training may continue to be a useful option in a post-pandemic future as integral part of medical education, complementing face-to-face lectures and training in (child) psychiatry.

Crisis as a chance. A digital training of social competencies with simulated persons at the Medical Faculty of RWTH Aachen, due to the lack of attendance teaching in the SARS-Cov-2 pandemic.

Objective: The AIXTRA Competence Center for Training and Patient Safety at RWTH Aachen University has developed a concept to enable learning of communication skills with simulated persons (SP) digitally. Methodology: Existing SP cases in curricular teaching were checked for digital applicability and modified. Digital seminars with the methodology of simulated conversations with SP, for planned 690 students for the courses "history taking", 6th semester, conversations in psychiatry, 8th semester, and in the clinical competence course, 10th semester, were conducted via video conferencing software. The structure is similar to SP-seminars in classroom teaching with a case presentation, a doctor/patient dialogue and a feedback session. In the 6th and 10th semester, the seminars were evaluated anonymously by the students using an online questionnaire. SP were asked by e-mail for their assessment. The lecturers were asked about their experience with the digital seminars by means of qualitative interviews. Results: The survey of students with 92 completed questionnaires indicates a high level of acceptance. Digital teaching with SP was rated "very good" by 63% of the students and "good" by 37% as an overall mark for the course. The digital implementation is well practicable, the retention and accessibility of all learning goals is rated as given. Conclusion: Digital teaching with SP can be well realized with appropriate preparation. Specific aspects of digital implementation (e.g. role and data protection) must be taken into account. The differentiated evaluation of the surveys will bring further results and deductive questions.

The Effects of the COVID-19 Pandemic on Resident Education and Wellness: A National Survey of Plastic Surgery Residents.

BACKGROUND: The coronavirus disease of 2019 (COVID-19) pandemic has had a profound effect on surgical training programs, reflecting decreases in elective surgical cases and emergency restructuring of clinical teams. The effect of these measures on U.S. plastic surgery resident education and wellness has not been characterized. METHODS: An institutional review board-exempted anonymous survey was developed through expert panel discussion and pilot testing. All current U.S. plastic surgery trainees were invited to complete a cross-sectional 28-question survey in April of 2020. Respondents were queried regarding demographic information, educational experiences, and wellness during the COVID-19 pandemic. RESULTS: A total of 668 residents responded to the survey, corresponding to a 56.1 percent response rate. Sex, training program type, postgraduate year, and region were well represented within the sample. Nearly all trainees (97.1 percent) reported restructuring of their clinical teams. One-sixth of respondents were personally redeployed to assist with the care of COVID-19 patients. A considerable proportion of residents felt that the COVID-19 pandemic had a negative impact on their education (58.1 percent) and wellness (84.8 percent). Residents found virtual curriculum effective and meaningful, and viewed an average of 4.2 lectures weekly. Although most residents did not anticipate a change in career path, some reported negative consequences on job prospects or fellowship. CONCLUSIONS: The COVID-19 pandemic had a considerable impact on U.S. plastic surgery education and wellness. Although reductions in case volume may be temporary, this may represent a loss of critical, supervised clinical experience. Some effects may be positive, such as the development of impactful virtual lectures that allow for cross-institutional curriculum.

Impact of the COVID-19 Pandemic on the Clinical Learning Environment: Addressing Identified Gaps and Seizing Opportunities.

The clinical learning environment (CLE) encompasses the learner's personal characteristics and experiences, social relationships, organizational culture, and the institution's physical and virtual infrastructure. During the COVID-19 pandemic, all 4 of these parts of the CLE have undergone a massive and rapid disruption. Personal and social communications have been limited to virtual interactions or shifted to unfamiliar clinical spaces because of redeployment. Rapid changes to the organizational culture required prompt adaptations from learners and educators in their complex organizational systems yet caused increased confusion and anxiety among them. A traditional reliance on a physical infrastructure for classical educational practices in the CLE was challenged when all institutions had to undergo a major transition to a virtual learning environment. However, disruptions spurred exciting innovations in the CLE. An entire cohort of physicians and learners underwent swift adjustments in their personal and professional development and identity as they rose to meet the clinical and educational challenges they faced due to COVID-19. Social networks and collaborations were expanded beyond traditional institutional walls and previously held international boundaries within multiple specialties. Specific aspects of the organizational and educational culture, including epidemiology, public health, and medical ethics, were brought to the forefront in health professions education, while the physical learning environment underwent a rapid transition to a virtual learning space. As health professions education continues in the era of COVID-19 and into a new era, educators must take advantage of these dynamic systems to identify additional gaps and implement meaningful change. In this article, health professions educators and learners from multiple institutions and specialties discuss the gaps and weaknesses exposed, opportunities revealed, and strategies developed for optimizing the CLE in the post-COVID-19 world.