Digital Clinical Placement for Medical Students in Response to COVID-19.

To the Editor:

The COVID-19 pandemic has closed medical schools and necessitated the remote delivery of medical education across the world. Medical educators must rapidly adapt to continue teaching students. The greatest challenge is students have increasingly limited access to patients, the key component of a clinical education. We propose a possible interim solution, in the form of a “digital clinical placement.”

In this scenario, students initially receive a weekly set of interactive online cases to simulate a clinical placement. The students review a patient’s history, their physical examination findings, investigation results, and management plan on an online platform. The material is subsequently discussed at a webinar with the speciality clinician, during which students can ask and answer questions using an interactive cloud-based tool. This real-time digital interaction simulates bedside teaching and can be supplemented with patient video cases if available.

A systematic review of e-learning for undergraduate health care professionals suggests that it is equivalent to traditional teaching in terms of knowledge and skills gained and student satisfaction.[1] Teaching for senior medical students, however, heavily focuses on direct patient contact, which is not easily delivered online. Patient video cases are already successfully used in pediatrics, general practice, and geriatrics.[2,3] They can increase student exposure to a wider variety of patients and provide opportunities to practice clinical reasoning skills.[3] Their use as the sole source of patient contact is untried, though, so it will be vital to evaluate and share any findings.

During this global crisis, we anticipate that many of our colleagues are facing similar challenges. It is imperative, therefore, that we share our proposed solutions with a wide audience. The ability to reflect and adapt is central to maintaining and improving medical education in a rapidly changing environment.

The “digital clinical placement” uses easily available technology to simulate difficult to reach patients. It is one potential solution for the temporary loss of student access to patients.