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Innovation and Missed Opportunities in Internal Medicine Undergraduate Education During COVID-19: Results from a National Survey.
Alexandraki, Irene; Walsh, Katherine J; Ratcliffe, Temple; Onumah, Chavon; Szauter, Karen; Curren, Camilla; Osman, Nora; Lai, Cindy J; DeWaay, Deborah; Duca, Nicholas S; Weinstein, Amy; Ismail, Nadia; Jacob, Jackcy; Kisielewski, Michael; Pincavage, Amber T.
  • Alexandraki I; Office of Medical Education, Paul L. Foster School of Medicine Texas Tech University Health Sciences Center, 5001 El Paso Drive, El Paso, TX, 79905, USA. irene.alexandraki@ttuhsc.edu.
  • Walsh KJ; Department of Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Ratcliffe T; Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA.
  • Onumah C; Department of Medicine, George Washington School of Medicine and Health Sciences, Washington, DC, USA.
  • Szauter K; Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
  • Curren C; The Ohio State University College of Medicine, Columbus, OH, USA.
  • Osman N; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Lai CJ; Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
  • DeWaay D; Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
  • Duca NS; Department of Medicine, Penn State College of Medicine, Hershey, PA, USA.
  • Weinstein A; Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
  • Ismail N; Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
  • Jacob J; Department of Medicine, Albany Medical College, Albany, NY, USA.
  • Kisielewski M; Alliance for Academic Internal Medicine, Alexandria, VA, USA.
  • Pincavage AT; Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
J Gen Intern Med ; 37(9): 2149-2155, 2022 07.
Article in English | MEDLINE | ID: covidwho-2075547
ABSTRACT

BACKGROUND:

COVID-19 disrupted undergraduate clinical education when medical schools removed students from clinical rotations following AAMC recommendations. Clerkship directors (CDs) had to adapt rapidly and modify clerkship curricula. However, the scope and effects of these modifications are unknown.

OBJECTIVE:

To examine the effects of the initial phase of COVID-19 on the internal medicine (IM) undergraduate clinical education.

DESIGN:

A nationally representative web survey.

PARTICIPANTS:

IM CDs from 137 LCME-accredited US medical schools in 2020. MAIN

MEASURES:

Items (80) assessed clerkship structure and curriculum, assessment in clerkships, post-clerkship IM clinical experiences, and CD roles and support. The framework of Understanding Crisis Response (Royal Society for Encouragement of Arts, Manufactures, and Commerce) was used to determine whether curricular modifications were "amplified," "restarted," "let go," or "ended." KEY

RESULTS:

Response rate was 74%. In response to COVID-19, 32% (32/101) of clerkships suspended all clinical activities and 66% (67/101) only in-person. Prior to clinical disruption, students spent a median of 8.0 weeks (IQR 2) on inpatient and 2.0 weeks (IQR 4) on ambulatory rotations; during clinical re-entry, students were spending 5.0 (IQR 3) and 1.0 (IQR 2) weeks, respectively. Bedside teaching and physical exam instruction were "let go" during the early phase. Students were removed from direct patient care for a median of 85.5 days. The sub-internship curriculum remained largely unaffected. Before the pandemic, 11% of schools were using a pass/fail grading system; at clinical re-entry 47% and during the survey period 23% were using it. Due to the pandemic, 78.2% of CDs assumed new roles or had expanded responsibilities; 51% reported decreased scholarly productivity.

CONCLUSIONS:

Curricular adaptations occurred in IM clerkships across US medical schools as a result of COVID-19. More research is needed to explore the long-term implications of these changes on medical student education and clinical learning environments.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Students, Medical / Clinical Clerkship / Education, Medical, Undergraduate / COVID-19 Type of study: Observational study / Prognostic study / Qualitative research Limits: Humans Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11606-022-07490-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Students, Medical / Clinical Clerkship / Education, Medical, Undergraduate / COVID-19 Type of study: Observational study / Prognostic study / Qualitative research Limits: Humans Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11606-022-07490-9