Academic, clinical and personal experiences of undergraduate healthcare students during the COVID-19 pandemic: A prospective cohort study

The COVID-19 pandemic and adolescents' and young adults' experiences at school: A systematic narrative review

The COVID-19 pandemic upended the lives of adolescents and young adults across the globe. In response to the pandemic onset, educational institutions were forced to pivot to online learning, a new teaching and learning format for most secondary and university students. This systematic narrative review summarizes findings from 168 publications spanning 56 countries on students' educational outcomes and school climate as well as the internal assets and contextual supports that promoted academic well-being during the pandemic. Our findings suggest that young people commonly reported declines in their academic-related outcomes and school-based relationships due to the COVID-19 pandemic. Internal assets (e.g., intrinsic motivation and self-efficacy) and contextual supports (i.e., relationships with teachers, peers, and parents) promoted academic well-being during the pandemic. Next steps for research on young people's academic well-being during the pandemic are suggested.

Enhancing Professionalism Online (Netiquette) in Medical Schools: A Systematic Scoping Review

Background

The relaxing of COVID-19 pandemic restrictions has not seen the return to previous in-person teaching formats. As blended training continues to be used, there is emphasis on the need to better appreciate the expectations, etiquette, and professional code of conduct ("netiquette") surrounding online learning, especially in light of evidence that poor online professionalism compromises learning and clinical practice.

Objectives

This review seeks to map regnant netiquette guidelines in medical schools that will inform and provide preliminary recommendations for a clinically relevant framework.

Design

This study is a systematic scoping review (SSR).

Methods

Krishna's Systematic Evidence-Based Approach (SEBA)'s Constructivist ontological and Relativist epistemological lens was used to guide this SSR. The SEBA process involves 6 stages, including the Systematic Approach, Split Approach, Jigsaw Perspective, Funneling, Analysis of evidence-based and non-data-driven literature, and Synthesis of the SSR in SEBA.

Results

In total, 7941 abstracts were reviewed, 198 full text articles were evaluated, and 83 articles were included. The analysis of the results revealed 4 key domains: (1) current guidelines, (2) manifestations, (3) contributing factors, and (4) implications. This SSR in SEBA highlights variability and gaps in current guidelines and reveals the impact of sociocultural factors on breaches in netiquette. Unsurprisingly, contextual and clinical considerations shape the contributory factors impacting lapses in netiquette and their implications.

Conclusions

Based on the data accrued, this article proposes basic guidelines on netiquette and measures to support their effective employment. This includes curricular adaptations, methods of teaching and enhancing engagement with the students and faculty training. Drawing on prevailing studies, it also recommends methods of assessing netiquette, online professionalism, and the learning environment. Suggestions are also made for future areas of study.

The PRE-registration podiatry: Accessible recruitment and employment (PREPARE) project: A commentary on the novel approach to the podiatry workforce crisis in Glasgow

The profession of podiatry is facing significant workforce challenges and urgent solutions are required to increase workforce capacity. Apprenticeship models are available in England but as yet, not available in Scotland. This paper explores the local context of the current workforce challenges and summarises a novel solution collaboratively developed in Glasgow. A collaborative initiative between NHS Greater Glasgow and Clyde and Glasgow Caledonian University developed the PRE-registration Podiatry: Accessible Recruitment and Employment (PREPARE) Project. Creative use of vacancy savings are being used to employ a limited number of individuals on a whole-time Band 5 Annex 21 basis at the start of their podiatry degree for the duration of their studies. Academic timetables were consolidated with no change to module or learning outcomes with candidates spending 3 days per week on academic studies and 2 days per week employed within the host podiatry service during term time. If academic milestones are achieved, substantive Band five opportunities are available once registration is achieved. This project opens opportunities for graduate level study to the support workforce and others not in a position to pursue traditional models of full-time education. To date, two additional health boards in Scotland have adopted this model and it has the potential to be a national approach for Scotland. High applicant numbers were achieved demonstrating increased interest in podiatry from this approach. This project has the potential to have a transformative impact on educating and training the future workforce, potentially being adopted by other professions facing similar workforce challenges.

Perceptions and attitudes toward COVID-19 vaccination among health professional students in Australia: a qualitative study

Using two qualitative data sources: free-text responses to an open-ended question of an online survey and subsequent interviews and focus groups, we explored perceptions and attitudes toward COVID-19 vaccination among health professional students enrolled in Australian universities during the pandemic with data collected from October 2021 to April 2022. Students provided free-text responses to the open-ended question (n = 313) in the online survey and participated in interviews or focus groups (n = 17). Data analysis revealed three themes, including perceptions of COVID-19 seriousness and the risk of contracting the virus, information dissemination, and attitudes toward the vaccine mandate. The study identified evolving perceptions of COVID-19 seriousness among Australian health professional students and their sentiments toward the vaccine mandate. There is a need to ensure the quality of information dissemination related to the vaccine mandate. This may not only support students' uptake of mandatory vaccination but also provide a means for them to address vaccination with healthcare consumers and patients.

The COVID-19 Lived Experience Through the Eyes of Nursing and Social Work Students

Purpose: The purpose of this study was to explore the lived experiences of nursing and social work students who were taking courses during the COVID-19 pandemic. Focus group discussions gave students a chance to express the pandemic's effects on their education and life. Methods: A hermeneutic phenomenological approach using Van Manen's Four Lifeworld Existentials guided this study. Using an open-ended format, interviews were conducted in 6 small groups ranging from 2 to 9 individuals, in person or via Zoom. The study was conducted from May to August 2022 in a university setting with 23 participants. Results: Ten existential themes emerged: Being Behind, Groundhog Day, Trying to Keep Up, Loss of Community, Fear of COVID, Being Alone, What is Self-Care?, Is This Career Right for Me?, What is Healthy?, and Access to Counseling. Conclusions: Participants indicated that the COVID-19 pandemic negatively impacted educational delivery, limiting learning opportunities and increasing feelings of isolation, stress, and anxiety. Implications for Education and the Future Workforce: Projected health-care workforce shortages may be exacerbated by students departing from the health-care professions as a result of increased burnout. Resilience training while in school is necessary to help promote coping, self-care strategies, and retention in the health-care professions.

The impact of online education during the Covid-19 pandemic on the professional identity formation of medical students: A systematic scoping review

Evolving individual, contextual, organizational, interactional and sociocultural factors have complicated efforts to shape the professional identity formation (PIF) of medical students or how they feel, act and think as professionals. However, an almost exclusive reliance on online learning during the COVID-19 pandemic offers a unique opportunity to study the elemental structures that shape PIF and the environmental factors nurturing it. We propose two independent Systematic Evidence-Based Approach guided systematic scoping reviews (SSR in SEBA)s to map accounts of online learning environment and netiquette that structure online programs. The data accrued was analysed using the clinically evidenced Krishna-Pisupati Model of Professional Identity Formation (KPM) to study the evolving concepts of professional identity. The results of each SSR in SEBA were evaluated separately with the themes and categories identified in the Split Approach combined to create richer and deeper 'themes/categories' using the Jigsaw Perspective. The 'themes/categories' from each review were combined using the Funnelling Process to create domains that guide the discussion. The 'themes/categories' identified from the 141 included full-text articles in the SSR in SEBA of online programs were the content and effects of online programs. The themes/categories identified from the 26 included articles in the SSR in SEBA of netiquette were guidelines, contributing factors, and implications. The Funnelling Process identified online programs (encapsulating the content, approach, structures and the support mechanisms); their effects; and PIF development that framed the domains guiding the discussion. This SSR in SEBA identifies the fundamental elements behind developing PIF including a structured program within a nurturing environment confined with netiquette-guided boundaries akin to a Community of Practice and the elemental aspect of a socialisation process within online programs. These findings ought to be applicable beyond online training and guide the design, support and assessment of efforts to nurture PIF.

Changes in rehabilitation students' clinical placement and clinical competence at graduation during the COVID-19 pandemic: A pilot study

BACKGROUND

The COVID-19 pandemic has affected physical and occupational therapist education in various ways.

OBJECTIVE

This study investigated whether the pandemic changed clinical placement, thus influencing the clinical competence of physical and occupational therapists at a hospital in Japan.

METHODS

Eleven therapists (seven physical and four occupational) participated in this study in April 2021. Clinical placement teaching methods were surveyed using an online questionnaire. The Objective Structured Clinical Examination (OSCE), comprising attitudinal and technical items, was used to examine clinical competence. The results were calculated as the sum of the attitudinal and technical scores, and the ratios of these scores to the full score were compared using a paired-sample Wilcoxon signed-rank test.

RESULTS

During the pandemic, some schools implemented shortened practical clinical placements. The substituted classes included online-only classes and combined online and face-to-face classes. Regarding clinical competence, scores on the OSCE were mostly high. The median proportion of the total attitudinal score to the perfect score was 100% for all three items (range-of-motion test, muscle strength test, Stroke Impairment Assessment Set). The median proportion of the total technical score to the perfect score ranged from 56.7% to 76.7% for the three items. The ratio of the total attitudinal score to the full score was significantly higher than that of the total technical score to the full score (p = 0.001).

CONCLUSIONS

Most clinical placements were canceled or partially administered through online learning during the pandemic. This decrease in clinical placements did not affect newly recruited physical and occupational therapists' clinical competence.

The impact of social support and emotion dysregulation on COVID-19 depressive symptoms

Introduction

Stress resulting from the global COVID-19 pandemic has been linked to psychological consequences, such as depressive symptoms, for individuals worldwide. Outbreaks and pandemics are known to accentuate stressors or generate new ones owing to health-related worries, reduced mobility, and social activity due to quarantine, and sudden life changes. Although post-lockdown U.S. research findings suggest a greater risk of depression among 18- to 25-year-olds, familiarity with technology and virtual socializing may offer college students some protective effect, warranting research with such groups.

Methods

The current study thus explored emotion dysregulation (ED) and perceived social support (PSS) as potential mechanisms for the relationship between COVID-19 stress and depressive symptoms among students at a southern university in the United States. Participants (N = 489) completed a cross-sectional survey assessing their current levels of COVID-19 stress, ED, PSS, and depressive symptoms.

Results

Path analysis showed that PSS buffered the effect of ED on depressive symptoms. The results support the explanatory role of ED in the relationship between COVID-19 stress and depressive symptoms.

Discussion

The perceived social connection may be an essential factor for psychological outcomes during periods of stress and isolation, particularly for those reporting high ED.

Supporting radiography clinical placements in Ireland during the COVID-19 pandemic: The practice educators perspective

INTRODUCTION

The COVID-19 pandemic has significantly impacted healthcare services and the clinical learning environment. Several studies have investigated radiography students' experiences of clinical placement during the pandemic; however, few have investigated the Clinical Practice Educator's (CPEs) perspective. CPEs play a pivotal role in supporting clinical education.

METHOD

A qualitative study was conducted using a purposeful sample of twenty-two CPEs, each working in a different Irish hospital. Four semi-structured focus groups were used to gather data. To maintain reasonable homogeneity, CPEs who were new to the role (n = 8) were assigned a separate focus group from experienced CPEs (n = 14). Inductive thematic analysis was applied.

RESULTS

CPEs experienced role expansion, particularly in managerial and administrative aspects of the role. They described arranging COVID-19 vaccinations locally for radiography students and the complexities of student rostering during the pandemic. CPEs perceived the pandemic to have impacted students' emotional wellbeing with 'high anxiety levels' and 'loneliness' being reported. They also perceived issues with clinical readiness and the student transition to clinical practice. Many challenges were faced by CPEs including arranging clinical recovery time for numerous students when sites were already at full capacity, fewer learning opportunities due to decreased patient throughput and range of imaging examinations, social distancing constraints, resistance from staff to student placements, and a shortage of staff for student supervision. Flexibility, communication, and multi-level support helped CPEs to fulfil their role.

CONCLUSION

The results provide insight into how CPEs supported radiography clinical placements during the pandemic and into the challenges faced by CPEs in their role. CPEs supported student placement through multi-level communication, teamwork, flexibility, and student advocacy.

IMPLICATIONS FOR PRACTICE

This will aid understanding of the support mechanisms needed by CPEs to provide quality clinical placements.

Motivational Design for Web-Based Instruction in Health Professions Education: Protocol for a Systematic Review and Directed Content Analysis

BACKGROUND

Web-based instruction plays an essential role in health professions education (HPE) by facilitating learners' interactions with educational content, teachers, peers, and patients when they would not be feasible in person. Within the unsupervised settings where web-based instruction is often delivered, learners must effectively self-regulate their learning to be successful. Effective self-regulation places heavy demands on learners' motivation, so effective web-based instruction must be designed to instigate and maintain learners' motivation to learn. Models of motivational design integrate theories of motivation with design strategies intended to create the conditions for motivated engagement. Teachers can use such models to develop their procedural and conceptual knowledge in ways that help them design motivating instruction in messy real-world contexts. Studies such as randomized controlled trials (RCTs) and other quasi-experimental designs that compare different motivational design strategies play a critical role in advancing models of motivational design. Synthesizing the evidence from those studies can identify effective strategies and help teachers and researchers understand the mechanisms governing why strategies work, for whom, and under what circumstances.

OBJECTIVE

The planned review aims to analyze how studies comparing motivational design strategies for web-based instruction in HPE support and advance models of motivational design by (1) controlling for established risks to internal validity, (2) leveraging authentic educational contexts to afford ecological validity, (3) drawing on established theories of motivation, (4) investigating a wide breadth of motivational constructs, and (5) analyzing mediators and moderators of strategy effects.

METHODS

The planned review will use database searching, registry searching, and hand searching to identify studies comparing motivational design strategies for web-based instruction, delivered to learners in HPE. Studies will be considered from 1990 onward. Two team members will independently screen studies and extract data from the included studies. During extraction, we will record information on the design characteristics of the studies, the theories of motivation they are informed by, the motivational constructs they target, and the mediators and moderators they consider.

RESULTS

We have executed our database and registry searches and have begun screening titles and abstracts.

CONCLUSIONS

By appraising the characteristics of studies that have focused on the motivational design of web-based instruction in HPE, the planned review will produce recommendations that will ensure impactful programs of future research in this crucial educational space.

TRIAL REGISTRATION

PROSPERO CRD42022359521; https://tinyurl.com/57chuzf6.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/42681.

Comparison of Academic Motivation between Business and Healthcare Students in Online Learning: A Concurrent Nested Mixed-Method Study

While the demand for online education and the diversity of online students have been increasing worldwide, how online students motivate themselves to continuously engage in learning remains to be appraised. Research in the face-to-face contexts reports that academic motivation is central to student success and wellbeing, and the type of motivation can differ by subject. In particular, the motivation of business students and healthcare students can differ considerably. This study aimed to understand the motivation of online students, and compare them between business and healthcare students using a concurrent nested mixed-method design with correlation and thematic analyses. A survey regarding motivation, learning enjoyment, and study willingness was responded to by 120 online students (61 business and 59 healthcare). Business students were associated with extrinsic motivation, whereas healthcare students were associated with intrinsic motivation. While students in both groups enjoyed the pursuit of knowledge, healthcare students valued the process and accomplishment, whereas business students regarded education as steppingstones in their careers. Findings can help educators develop effective motivational support for these student groups.