Overcoming financial and social barriers during COVID-19: A medical student-led medical education innovation.

Background: Underrepresented minorities in medicine (URMM) may face financial and social limitations when applying to medical schools. The computer-based assessment for sampling personal characteristics (CASPER) test is used by many medical schools to assess the nonacademic competencies of applicants. Performance on CASPER can be enhanced by coaching and mentorship, which URMMs often lack, for affordability reasons, when applying to medical schools. Methods: The CASPER Preparation Program (CPP) is a free, online, 4-week program to help URMM prepare for the CASPER test. CPP features free medical ethics resources, homework and practice tests, and feedback from tutors. Two of CPPs major objectives include relieving URMM of financial burdens and increasing their accessibility to mentorship during the COVID-19 pandemic. A program evaluation was conducted using anonymous, voluntary postprogram questionnaires to assess CPPs efficacy in achieving the aforementioned objectives. Results: Sixty URMMs completed the survey. The majority of the respondents strongly agreed or agreed that CPP relieves students of financial burden (97%), is beneficial for applicants with low-socioeconomic statuses (98%), provides students with resources they could not afford (n = 55; 92%), and enables access to mentors during the pandemic (90%). Discussion: Pathway coaching programs, such as the CASPER Preparation Program, have the potential to offer URMMs mentorship and financial relief, and increase their confidence and familiarity with standardized admission tests to help them matriculate into medical schools.

The CASPER preparation program innovation: increasing self-perceived competence and confidence of underrepresented applicants on the novel CASPER Snapshot and CanMEDS roles.

BACKGROUND: Underrepresented Minorities in Medicine (URMMs) may face financial and social limitations when matriculating into medical schools. Performance on situational judgment tests such as Computer-based Assessment for Sampling Personal Characteristics (CASPER) can be enhanced by coaching and mentorship. The CASPER Preparation Program (CPP) coaches URMMs to prepare for the CASPER test. During the coronavirus 2019 pandemic (COVID-19), CPP implemented novel curricula on the CASPER Snapshot and CanMEDS roles. METHODS: Pre and post-program questionnaires were completed by the students, which assessed their: 1) confidence in understanding the CanMEDS roles, and 2) perceived confidence in performing well and their familiarity and preparedness with the CASPER Snapshot. With a second post-program questionnaire, participants' scores on the CASPER test as well as medical school application outcome were also assessed. RESULTS: Participants reported a significant increase in the URMMs' knowledge, self-perceived competency to complete the CASPER Snapshot, and their anxiety significantly decreased. The level of confidence in understanding CanMEDS roles for a career in healthcare increased as well. The majority (91%) agreed that the feedback received from tutors was adequate and the virtual component of the program was beneficial during COVID-19. 51% of students scored in the highest quartile on the CASPER test and 35% received an offer of admission from CASPER-requiring medical schools. CONCLUSION: Pathway coaching programs have the potential to increase confidence and familiarity amongst URMMs for the CASPER tests and CanMEDS roles. Similar programs should be developed with the aim to increase the chances of URMMs matriculating into medical schools.

Health workforce strategies in response to major health events: a rapid scoping review with lessons learned for the response to the COVID-19 pandemic.

BACKGROUND: The early weeks of the COVID-19 pandemic brought multiple concurrent threats-high patient volume and acuity and, simultaneously, increased risk to health workers. Healthcare managers and decision-makers needed to identify strategies to mitigate these adverse conditions. This paper reports on the health workforce strategies implemented in relation to past large-scale emergencies (including natural disasters, extreme weather events, and infectious disease outbreaks). METHODS: We conducted a rapid scoping review of health workforce responses to natural disasters, extreme weather events, and infectious disease outbreaks reported in the literature between January 2000 and April 2020. The 3582 individual results were screened to include articles which described surge responses to past emergencies for which an evaluative component was included in the report. A total of 37 articles were included in our analysis. RESULTS: The reviewed literature describes challenges related to increased demand for health services and a simultaneous decrease in the availability of the workforce. Many articles also described impacts on infrastructure that hindered emergency response. These challenges aligned well with those faced during the early days of the COVID-19 pandemic. In the published literature, the workforce strategies that were described aimed either to increase the numbers of health workers in a given area, to increase the flexibility of the health workforce to meet needs in new ways, or to support and sustain health workers in practice. Workforce responses addressed all types and cadres of health workers and were executed in a wide range of settings. We additionally report on the barriers and facilitators of workforce strategies reported in the literature reviewed. The strategies that were reported in the literature aligned closely with our COVID-specific conceptual framework of workforce capacity levers, suggesting that our framework may have heuristic value across many types of health disasters. CONCLUSIONS: This research highlights a key deficiency with the existing literature on workforce responses to emergencies: most papers lack substantive evaluation of the strategies implemented. Future research on health workforce capacity interventions should include robust evaluation of impact and effectiveness.