We Need to Rethink on Medical Education for Pandemic Preparedness: Lessons Learnt From COVID-19

Perception of pediatric residents from a tertiary hospital in the city of México regarding their training during the COVID-19 pandemic

BACKGROUNDS

On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus (COVID-19) outbreak a global pandemic, which changed the residents' teaching and learning process. The purpose of this study was to determine residents' satisfaction and impressions on their training during the pandemic in a tertiary pediatric hospital.

METHODS

This was a descriptive cross-sectional study. An online survey was designed to determine residents' demographic and personal characteristics, as well as their perception about the theoretical and practical training, as well as about their emotional situation. The analysis separated medical students from surgical students in order to identify any differences existing between these groups, for which χ2 was calculated.

RESULTS

Overall, 148 of 171 residents (86.5%) responded to the questionnaire; 75% belonged to the medical specialty and 25% to the surgical specialty. Statistically significant differences were found in terms of those training aspects they were concerned about during the pandemic (p < 0.001) and about the difficulties associated with online learning (p = 0.001). Differences were also found regarding their satisfaction toward the time needed to complete their thesis (p = 0.059) and activities outside the hospital (p = 0.029). Regarding their degree of satisfaction in general, most medical specialty students felt slightly satisfied (43.2%) and surgical specialty students felt mostly neutral (37.8%). Regarding their feelings about their mental health, statistically significant differences were found between both groups (p = 0.038) although both groups reported the same percentage of overall dissatisfaction (2.7%) in this area.

CONCLUSION

The COVID-19 pandemic has brought significant challenges to medical education systems. Lack of practice in decision-making and maneuver execution are concerns for residents and may affect their future professional performance.

Competencies required for medical students to confront the COVID-19 pandemic: A needs assessment study

BACKGROUND

The outbreak of coronavirus disease 2019 (COVID-19) has turned attention to the essential competencies needed to confront pandemics for a physician. However, medical students, as future physicians, are not adequately trained for such a situation. This study aimed to determine the essential competencies for a medical student to face the COVID-19 pandemic.

MATERIALS AND METHODS

We performed this mixed-method needs assessment study at Shiraz University of Medical Sciences in May-June 2020 in three steps: the first step was a brainstorming session followed by a nominal group technique with the experts' participation. The second step was determining the validity of competencies by calculating the content validity ratio. In the third and last step, three rounds of the modified Delphi technique were held with the participation of 22 medical faculty members and 45 undergraduate medical students to reach a consensus about the competencies utilizing quantitative analysis.

RESULTS

A total of 30 key competencies essential for a medical student were obtained through the current study. They were categorized into four major themes: (1) developing knowledge and abilities for effective diagnosis and treatment of COVID-19, (2) demonstrating safety principles correctly, (3) demonstrating effective behavior, and (4) determining the meta-competencies.

CONCLUSIONS

Although medical students will be the frontline physicians in the future pandemics, they are not prepared to display the diversity of requisite skills to practice effectively and safely. This study provides essential competencies for medical students during the COVID-19 pandemic and underlines the importance of a paradigm shift from traditional time-based to competency-based education.

Main Factors Affecting the Readiness and Responsiveness of Healthcare Systems during Epidemic Crises: A Scoping Review on Cases of SARS, MERS, and COVID-19

Background:

Given the significance of the preparedness and responsiveness of healthcare systems in relation to epidemics, this study aimed to determine their influencing factors during epidemic crises with a view to utilizing the findings in the battle against the coronavirus disease 2019 (COVID-19) outbreak.

Methods:

This scoping study was conducted in 2020 via the Arksey and O’Malley approach. A systematic search was conducted on five online databases from January 2000 to June 15, 2020. Initially, 1926 English articles were retrieved based on their abstracts. After the screening process, 60 articles were considered for the final analysis. Data were charted by applying Microsoft Office Excel 2013 and were synthesized via thematic analysis.

Results:

Five main factors have affected the responsiveness and preparedness of countries during the epidemics of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19: community-related interventions, managerial interventions, socioeconomic factors, the readiness of hospitals and health centers, and environmental factors. These themes are associated with 38 related sub-themes. The thematic framework shows that interactions between these five determinantes can affect the preparedness and responsiveness of healthcare systems during pandemics/epidemics.

Conclusion:

According to the results, healthcare systems need to pay attention to their internal capacities, managerial interventions, and health centers to overcome the current pandemic. They should also consider such external factors as socioeconomic and environmental determinants that can affect their potential preparedness against pandemic/epidemic crises. Community-related interventions such as improvement of the community health literacy, teamwork, and social responsibility can enhance the readiness of healthcare systems against the COVID-19 outbreak.

The deep impact of the COVID-19 pandemic on medical students: An online cross-sectional study evaluating Turkish students' anxiety

AIM

Coronavirus Disease 2019 (COVID-19) changed the delivery of medical education in Turkey by moving to an emergency remote teaching system and led to many challenges for future doctors. In this study, we aimed to explore the impact of the COVID-19 pandemic on medical students, to assess their anxiety level and their main anxiety sources related to this pandemic.

METHODS

A Google Form was distributed to medical students using the virtual snowball sampling method. The form included the Beck Anxiety Inventory and additional 19 questions on sociodemographic characteristics, perceived level of knowledge about the epidemic, self-risk perceptions of COVID-19 and their anxiety levels about some other topics related to COVID-19.

RESULTS

Overall, 3105 medical students with a mean age of 22.37 ± 2.46, took the survey. Amongst the participants, only 32% of the students defined their knowledge about the precautions that should be taken during an epidemic disease as acceptable. Students reported highest anxiety level for the continuing spread of COVID-19 in Turkey and transmitting coronavirus to another person. Clinically significant anxiety prevalence was 23.2%. Regression analysis revealed that factors that increased the risk of being anxious included being female, being other than a 5th-year student, thinking that being a medical student would increase the risk of coronavirus transmission or being uncertain about it, being exposed to a patient with COVID-19 or being uncertain about it, being anxious about the continuing spread of COVID-19 in Turkey, being anxious about acquiring COVID-19, being anxious for graduating and being on active duty, being anxious about a medical training interruption.

CONCLUSION

Our results suggest that anxiety is prevalent amongst Turkish medical students during the COVID-19 pandemic and they have a weak preparedness for a pandemic such as COVID-19. Based on our results, new strategies should be implemented for medical education and for alleviating students' anxiety levels.

The Uncertainty of COVID-19 Inducing Social Fear and Pressure on the Continuity of Rural, Community-Based Medical Education: A Thematic Analysis

Rural community-based medical education (CBME) enriches undergraduate and postgraduate students' learning but has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. We identified the challenges faced by stakeholders as well as the relevant solutions to provide recommendations for sustainable CBME in community hospitals during the COVID-19 pandemic. A total of 31 pages of field and reflection notes were collated through direct observation and used for analysis. Five physicians, eight nurses, one clerk, fourteen medical trainees, and three rural citizens were interviewed between 1 April and 30 September 2020. The interviews were recorded and their contents were transcribed verbatim and analyzed using thematic analysis. Three themes emerged: uncertainty surrounding COVID-19, an overwhelming sense of social fear and pressure within and outside communities, and motivation and determination to continue providing CBME. Rural CBME was impacted by not only the fear of infection but also social fear and pressure within and outside communities. Constant assessment of the risks associated with the pandemic and the implications for CMBE is essential to ensure the sustainability of CBME in rural settings, not only for medical educators and students but also stakeholders who administrate rural CBME.

COVID-19 outbreak: How the public health network could function better in disseminating information and instruction for action: Lessons learned

The priority for the period of COVID-19 outbreak was to provide fast, well-timed dissemination of information to the general population (especially vulnerable groups) as well to health professionals and professionals from other areas of public life (police, army, local governments, education, and the business sector) on behavior change and prevention measures, in terms of guidance for the current epidemiological situation. At the Public Health Institute Niš, Serbia, we directed activities relying primarily on formal intervention approaches, WHO guidance and on information and knowledge gained at the April 2019 WHO "Emergency Risk Communication training and plan-writing workshop" in Belgrade/Serbia. To define the advantages and disadvantages of the applied method for dissemination of information, we followed the reporting guidance contained in Duncan E and colleagues', Guidance for reporting intervention development studies in health research (GUIDED). Guidelines for treatment and recommendations were disseminated through standard communication channels. A local public health network with a large number of partners from the governmental and non-governmental sector, established in recent years, was a kind of channel for dissemination of materials. We realized that formal intervention approaches should be rapidly improved by better mapping of all population groups, by modern ways of communication, by urgent introduction of digital communication channels such as telemedicine, smart phone engagement and internet applications, in order to educate and exchange information more efficiently and quickly, especially in crisis situations such as COVID-19 epidemics/pandemics.