Aaron J Harries1, Carmen Lee2, Lee Jones3, Robert M Rodriguez2, John A Davis3, Megan Boysen-Osborn4, Kathleen J Kashima5, N Kevin Krane6, Guenevere Rae7, Nicholas Kman8, Jodi M Langsfeld9, Marianne Juarez10. 1. Department of Emergency Medicine, University of California San Francisco School of Medicine, San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Room #6A4, San Francisco, California, 94110, USA. aaron.harries@ucsf.edu. 2. Department of Emergency Medicine, University of California San Francisco School of Medicine, San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Room #6A4, San Francisco, California, 94110, USA. 3. University of California San Francisco School of Medicine, San Francisco, California, USA. 4. Clinical Emergency Medicine, University of California Irvine School of Medicine, Irvine, CA, USA. 5. University of Illinois College of Medicine, Chicago, IL, USA. 6. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA. 7. Basic Science Education, Tulane University School of Medicine, New Orleans, Louisiana, USA. 8. Emergency Medicine, Ohio State College of Medicine, Columbus, OH, USA. 9. Department of Science Education, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA. 10. Department of Emergency Medicine, University of California San Francisco School of Medicine, San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Room #6A4, San Francisco, California, 94110, USA. marianne.juarez@ucsf.edu.
Abstract
BACKGROUND: The COVID-19 pandemic disrupted the United States (US) medical education system with the necessary, yet unprecedented Association of American Medical Colleges (AAMC) national recommendation to pause all student clinical rotations with in-person patient care. This study is a quantitative analysis investigating the educational and psychological effects of the pandemic on US medical students and their reactions to the AAMC recommendation in order to inform medical education policy. METHODS: The authors sent a cross-sectional survey via email to medical students in their clinical training years at six medical schools during the initial peak phase of the COVID-19 pandemic. Survey questions aimed to evaluate students' perceptions of COVID-19's impact on medical education; ethical obligations during a pandemic; infection risk; anxiety and burnout; willingness and needed preparations to return to clinical rotations. RESULTS: Seven hundred forty-one (29.5%) students responded. Nearly all students (93.7%) were not involved in clinical rotations with in-person patient contact at the time the study was conducted. Reactions to being removed were mixed, with 75.8% feeling this was appropriate, 34.7% guilty, 33.5% disappointed, and 27.0% relieved. Most students (74.7%) agreed the pandemic had significantly disrupted their medical education, and believed they should continue with normal clinical rotations during this pandemic (61.3%). When asked if they would accept the risk of infection with COVID-19 if they returned to the clinical setting, 83.4% agreed. Students reported the pandemic had moderate effects on their stress and anxiety levels with 84.1% of respondents feeling at least somewhat anxious. Adequate personal protective equipment (PPE) (53.5%) was the most important factor to feel safe returning to clinical rotations, followed by adequate testing for infection (19.3%) and antibody testing (16.2%). CONCLUSIONS: The COVID-19 pandemic disrupted the education of US medical students in their clinical training years. The majority of students wanted to return to clinical rotations and were willing to accept the risk of COVID-19 infection. Students were most concerned with having enough PPE if allowed to return to clinical activities.
BACKGROUND: The COVID-19 pandemic disrupted the United States (US) medical education system with the necessary, yet unprecedented Association of American Medical Colleges (AAMC) national recommendation to pause all student clinical rotations with in-person patient care. This study is a quantitative analysis investigating the educational and psychological effects of the pandemic on US medical students and their reactions to the AAMC recommendation in order to inform medical education policy. METHODS: The authors sent a cross-sectional survey via email to medical students in their clinical training years at six medical schools during the initial peak phase of the COVID-19 pandemic. Survey questions aimed to evaluate students' perceptions of COVID-19's impact on medical education; ethical obligations during a pandemic; infection risk; anxiety and burnout; willingness and needed preparations to return to clinical rotations. RESULTS: Seven hundred forty-one (29.5%) students responded. Nearly all students (93.7%) were not involved in clinical rotations with in-person patient contact at the time the study was conducted. Reactions to being removed were mixed, with 75.8% feeling this was appropriate, 34.7% guilty, 33.5% disappointed, and 27.0% relieved. Most students (74.7%) agreed the pandemic had significantly disrupted their medical education, and believed they should continue with normal clinical rotations during this pandemic (61.3%). When asked if they would accept the risk of infection with COVID-19 if they returned to the clinical setting, 83.4% agreed. Students reported the pandemic had moderate effects on their stress and anxiety levels with 84.1% of respondents feeling at least somewhat anxious. Adequate personal protective equipment (PPE) (53.5%) was the most important factor to feel safe returning to clinical rotations, followed by adequate testing for infection (19.3%) and antibody testing (16.2%). CONCLUSIONS: The COVID-19 pandemic disrupted the education of US medical students in their clinical training years. The majority of students wanted to return to clinical rotations and were willing to accept the risk of COVID-19infection. Students were most concerned with having enough PPE if allowed to return to clinical activities.
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Keywords:
COVID-19 pandemic; Medical student anxiety; Undergraduate medical education