Insights from COVID-19 Pandemic for improving HMS Medical Student Clerkship Patient Care and Learning Experiences

Abstract

Introduction: Medical students represent key stakeholders whose perspectives are often lacking in curricular design. In response to the COVID-19 pandemic, medical education shifted abruptly from in-person clinical experience to the virtual learning setting, providing unique opportunity to study the impact of educational innovations. Because the benefits of these changes to overall student learning is unclear, we aimed to determine the educational strategies that medical students found to be most useful in progressing towards entrustability. Methods: An online survey instrument was developed and distributed to Harvard Medical School students in their last year of clerkship to determine their perspective regarding the usefulness of key educational strategies (including in-person and virtual patient care, in-person and virtual synchronous didactics, simulation, and self-directed learning) for progressing in the core entrustable professional activities (EPAs). Secondary measures included the use of self-directed learning strategies and characterization of virtual learning experience prior to March 2020 and from June 2020 onwards as surrogates of the onset COVID-19 pandemic and the return of students to the clinical milieu. Results: A total of 39 students were surveyed in this study (response rate 32.5%). In-person patient care was the highest rated educational strategy for all EPAs. Globally, the relationship between the perceived value of other learning strategies varied based on the goal of a pedagogical activity. Most students started using virtual patient care and synchronous didactics upon their return to the clinical milieu but found them less effective than in-person instruction. Students preferred self-direction included reading electronic texts, using question banks or review books, and watching educational videos. Timely access to resources free of charge was the most important characteristic when selecting a particular resource. Conclusion: This exploratory study of students’ perceived value of educational strategy revealed significant variability in usefulness scores to achieve entrustability. Although virtual learning increased in the post COVID-19 era, in-person patient care remained the most valued strategy by medical students. Further studies are needed to understand the variability in ratings to guide faculty in developing educational experiences that align with what students believe is most useful in their training and strengthen hybrid curricula in medical education.