Medical students' perceptions and motivations during the COVID-19 pandemic.

BACKGROUND: There has been a rapid increase in the number of cases of COVID-19 in Latin America, Africa, Asia and many countries that have an insufficient number of physicians and other health care personnel, and the need for the inclusion of medical students on health teams is a very important issue. It has been recommended that medical students work as volunteers, undergo appropriate training, not undertake any activity beyond their level of competence, and receive continuous supervision and adequate personal protective equipment. However, the motivation of medical students must be evaluated to make volunteering a more evidence-based initiative. The aim of our study was to evaluate the motivation of medical students to be part of health teams to aid in the COVID-19 pandemic. METHODS AND FINDINGS: We developed a questionnaire specifically to evaluate medical students' perceptions about participating in the care of patients with suspected infection with coronavirus during the COVID-19 pandemic. The questionnaire had two parts: a) one part with questions on individual characteristics, year in medical school and geographic location of the medical school and b) a second part with twenty-eight statements assessed on a 5-point Likert scale (totally agree, agree, neither agree nor disagree, disagree and totally disagree). To develop the questionnaire, we performed consensus meetings with a group of faculty and medical students. The questionnaire was sent to student organizations of 257 medical schools in Brazil and answered by 10,433 students. We used multinomial logistic regression models to analyze the data. Statements associated with greater odds ratios for participation of medical students in the COVID-19 pandemic were related to a sense of purpose or duty ("It is the duty of the medical student to put himself or herself at the service of the population in the pandemic"), altruism ("I am willing to take risks by participating in practice in the context of the pandemic"), and perception of good performance and professional identity ("I will be a better health professional for having experienced the pandemic"). Males were more prone than females to believe that only interns should participate in the care of patients with COVID-19 (odds ratio 1.36 [coefficient interval 95%:1.24-1.49]) and that all students should participate (OR 1.68 [CI:1.4-1.91]). CONCLUSIONS: Medical students are more motivated by a sense of purpose or duty, altruism, perception of good performance and values of professionalism than by their interest in learning. These results have implications for the development of volunteering programs and the design of health force policies in the present pandemic and in future health emergencies.

COVID-19 pandemic restrictions continuously impact on physical activity in adults with cystic fibrosis.

BACKGROUND: We have recently reported reduced physical activity (PA) in people with cystic fibrosis (pwCF) with and without lung transplantation (LTX) during a 6-week stringent lockdown in Switzerland. This follow-up study explores the impact of coronavirus-2019 disease (COVID-19) related pandemic restrictions on individuals' therapy regimens and health-related aspects in pwCF. METHODS: We conducted a cross-sectional web-based national survey in Spring 2021. The survey included questions on daily PA, airway clearance and inhalation therapy, questions on COVID-19-compatible symptoms, diagnostic tests and vaccination status, and enquired health-related aspects covering the pandemic period between March 2020 to April 2021. RESULTS: 193 individuals with CF (53% female; 25% LTX recipients) participated. Among pwCF, 10 reported COVID-19 (n = 2 LTX recipients), two subjects were hospitalized, no invasive ventilation required, no deaths. The clinical course was generally mild. Overall, 46% reported less PA during the pandemic, mostly due to closed fitness facilities (85%), lack of motivation (34%), and changes in daily structures (21%). In contrast, 32/193 (17%) pwCF were able to increase their PA levels: 12 (38%) and 11 (34%) reported undertaking home-based training and outdoor activities more frequently; 6 (19%) reported an increase in routine PA, and another 3 (9%) started new activities. Among pwCF without LTX, 5% and 4% reported to undertake less airway clearance and inhalation therapy, respectively. CONCLUSIONS: Our study reveals unfavorable consequences of COVID-19 pandemic restrictions on PA of pwCF with unknown long-term consequences for their overall physical fitness and lung health. Strategies to overcome this undesirable situation are needed; increased uptake of telehealth PA programs and virtual exercise classes to promote PA participation might be one promising approach along with vaccination of pwCF and their close contacts.

Delivering a Novel Medical Education "Escape Room" at a National Scientific Conference: First Live, Then Pivoting to Remote Learning Because of COVID-19.

Escape Rooms are gaining prominence as education modalities; the use of principles of game design have been shown to augment knowledge acquisition in a fun, team-based learning experience ("edutainment"). In this report, we outline some of the medical literature and then provide our step-by-step approach and lessons learned when building what was, to our knowledge, the first continuing medical education Escape Room at a national scientific meeting. We then comment on how this innovative educational offering was reimagined the following year for remote (virtual) learning because of the COVID-19 pandemic.

Worry about COVID-19 in relation to cognitive-affective smoking processes among daily adult combustible cigarette smokers.

Cigarette smoking is a known risk factor for severe disease and death from respiratory infection. Initial data suggest that smoking is a risk factor for COVID-19 symptom severity. Exposure to increased pandemic-related stress and subsequent worry about COVID-19 may amplify the desire to smoke to down-regulate distress. The present investigation sought to test this conceptual model by evaluating worry about COVID-19 in relation to COVID-19 coping motives for smoking, perceived barriers for smoking cessation, and smoking abstinence expectancies. Participants were 219 daily combustible cigarette smokers (55.70% female, Mage = 41.43 years, SD = 11.06). Six separate, two-step hierarchical linear regression models were conducted for each of the criterion variables. As expected, worry about COVID-19 was significantly and positively related to COVID-19 coping motives for smoking and perceived barriers for smoking cessation. Worry about COVID-19 also was a positively significant predictor of smoking abstinence expectancies of negative mood, somatic symptoms, and harmful consequences, but not positive consequences. The present study provides novel empirical evidence that worry about COVID-19 is related to key cognitive-affective smoking processes beyond the effects of age, sex, race, ethnicity, COVID-19 exposure, smoking rate, e-cigarette use status, and anxiety symptoms. These results highlight the potential utility in assessing level of worry about COVID-19, a transdiagnostic construct, among combustible cigarette smokers to better understand cognitive-affective factors that may maintain smoking behavior in the context of the COVID-19 pandemic.

COVID-19 disruption on college students: Academic and socioemotional implications.

Objective: The coronavirus (COVID-19) pandemic represents an acute worldwide public health crisis causing an immediate disruption to every demographic group. One group significantly affected both educationally and psychosocially is college students, as they experienced an abrupt cancellation of in-person courses, were forced to leave their dormitories, and witnessed a loss of social activities. Method: This study utilizes survey data from college students in the throes of COVID-19-based home schooling collected for a Belgium-based international study including more than 134,000 participants from 28 countries around the world. Two hundred fifty-seven college students from a U.S. university participated in this study. Results: Results indicate that college students are affected by COVID-19 on several levels, including fear of themselves or others in their social network contracting the virus, apprehension about the changes in coursework delivery and unclear instructional parameters, overall loneliness, compromised motivation, and sleep disturbances, as well as anxious and depressive symptoms. Conclusions: Analyses reveal a positive relationship between academic frustrations and mental health symptoms, the latter also negatively related to trust in the government regarding the preventive measures being implemented. Worries about becoming infected were positively related to mental health symptoms and negatively related to trust in the government. Results and implications are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Maintaining and maximising motivation to progress scholarly work during challenges times - Reflections from the pandemic.

INTRODUCTION: Maintaining self-motivation during challenging times can be difficult. In this commentary, we consider self-determination theory to explore factors that can influence intrinsic motivation to progress scholarly work. The place of extrinsic motivation is also considered, on the continuum of self-determination. COMMENTARY: Using the components of self-determination theory, autonomy, mastery, and connection; academics, clinicians, and students, working in different environments, were asked to provide personal experiences and perspectives on their ability to maintain motivation during the 2019 coronavirus disease (COVID-19) pandemic. Self-assessment questions were used to guide reflections. IMPLICATIONS: Motivation, and in particular intrinsic motivation, can be impacted negatively during challenging times. Using a motivation framework can help identify personal factors that can be strengthened and developed over time. It is recognised that extrinsic factors are important in maintaining motivation. However, intrinsic motivation is a powerful driver to sustain and progress high quality work. Practical strategies and ideas are described to harness and develop self-motivation to pursue scholarly work, during challenging times.