COVID‐19 prohibited clinical clerkships for 3 months. At the VCU SOM, a decision was made to move the non‐clinical didactic portion of each clerkship to a virtual learning platform. During the course of the 2‐week Pediatrics Clerkship non‐clinical curriculum, initially mandatory with students required to take the NBME Shelf examination to pass, George Floyd was murdered by Minneapolis police, triggering widespread protests. Students requested excused absences from the mandatory sessions to be permitted to protest; however, these are limited to 4 excused absences per year and reserved primarily for illness. Therefore, many students struggled with the emotional conflict and sense of unpreparedness given the social turmoil. Thus, how do educational leaders address student needs in response to conflict between educational commitments and social responsibility in a time of already limited curricular flexibility due to the COVID disruption?
WHAT WAS TRIED?
The Clerkship Administration decided to make all session recordings available to all students without the need for excused absences. To address the concern of Shelf preparedness, a mandatory session facilitated by the clerkship directors was held as an open forum for students to explore how the curriculum could adapt to the changing learning environment. The students chose for the clerkship to offer each student one of two options for taking the test: as previously planned at the end of the 2‐week non‐clinical curriculum or later in the year after completion of their 4‐week clinical block to take place once students were allowed back into the clinical setting.
WHAT LESSONS WERE LEARNED?
To assess the curricular adaptation to the COVID disruption, we designed a brief, voluntary and anonymous survey of the students after the completion of the 2‐week non‐clinical curriculum. We also surveyed the students regarding attendance at protests and whether this affected their decision to participate in the live curriculum or take the Shelf examination.Of 185 students, 124 took the examination as scheduled (67%). Of those who completed the exam, the mean score was 79.8, as compared to 77.0 for the 2019‐20 academic year. Forty‐three per cent of students reported attending protest events, and of these, 42% postponed the examination. The majority of students reported a positive perception of how the Clerkship Administration responded to COVID‐19 pandemic and the social justice movements (mean score of 4.3 and 4.9 on a 5‐point scale, respectively). Themes highlighted in the survey comments included the high level of stress students experienced and their appreciation for curriculum adaptations to address these concerns.Self‐determination theory favours autonomy supportive environments for facilitating optimal learning, specifically in medical education.
Our results highlight how medical educators can provide fluid learning options for their curricula in the face of challenges externally imposed, and how students perceive the ability to participate in curricular adaptation. Moreover, initial data suggest that students are able to successfully navigate a complex academic situation based on their own experiences, rather than following a one‐size‐fits‐all model.