COVID-19 and medical education in Africa: a cross sectional analysis of the impact on medical students

Abstract Background The African continent currently experiences 25% of the global burden of disease with only 1.3% of the world’s healthcare workers. The COVID-19 pandemic has caused unprecedented disruption to medical education systems, increasing the strain on already-vulnerable regions. Our study examines the impact of COVID-19 on medical students across 33 countries in the African continent. Methods A 39-item anonymous electronic survey was developed and distributed to medical students across Africa through social networks to assess the impact of the COVID-19 pandemic on medical education. The survey assessed the domains of: class structure changes and timing, patient interactions, exam administration, learning environment satisfaction, mental health impacts, and volunteer opportunities/engagement. Results 694 students across 33 countries participated. 80% of respondents had their classes suspended for varied lengths of time during the pandemic, and from these students 59% of them resumed their classes. 83% of students felt they were in a supportive learning environment before the pandemic, which dropped to 32% since the start. The proportion of students taking exams online increased (6–26%, p<0.001) and there was a decrease in the proportion of students seeing patients as a part of their education (72–19%, p<0.001). Conclusions COVID-19 is harming medical students in Africa and is likely to worsen the shortage of the future’s healthcare workforce in the region. Pandemic-related impacts have led to a degradation of the learning environment of medical students. Medical schools have shifted online to differing degrees and direct patient-care in training of students has decreased. This study highlights the urgent need for flexible and innovative approaches to medical education in Africa.

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COVID-19 and Medical Education in Africa: A Cross Sectional Analysis of the Impact on Medical Students

10.21203/rs.3.rs-477791/v1 ◽

2021 ◽

Author(s):

Alec Bernard ◽

Gnendy Indig ◽

Nicole Byl ◽

Amani Nureddin Abdu ◽

Dawit Tesfagiorgis Menegesha ◽

...

Keyword(s):

Medical Education ◽

Medical Students ◽

Learning Environment ◽

Direct Patient Care ◽

African Continent ◽

Cross Sectional ◽

Structure Changes ◽

Supportive Learning Environment ◽

The Impact ◽

Education In Africa

Abstract Background: The African continent currently experiences 25% of the global burden of disease with only 1.3% of the world’s healthcare workers. The COVID-19 pandemic has caused unprecedented disruption to medical education systems, increasing the strain on already-vulnerable regions. Our study examines the impact of COVID-19 on medical students across 33 countries in the African continent. Methods: A 39-item anonymous electronic survey was developed and distributed to medical students across Africa through social networks to assess the impact of the COVID-19 pandemic on medical education. The survey assessed the domains of: class structure changes and timing, patient interactions, exam administration, learning environment satisfaction, mental health impacts, and volunteer opportunities/engagement.Results: 694 students across 33 countries participated. 88% of respondents had their classes suspended for varied lengths of time during the pandemic, and from these students 51% of them resumed their classes. 83% of students felt they were in a supportive learning environment before the pandemic, which dropped to 32% since the start. The proportion of students taking exams online increased (6% to 26%, p<.001) and there was a corresponding decrease in the proportion of students seeing patients as a part of their education (72% to 19%, p<.001).Conclusion: COVID-19 is harming medical students in Africa and is likely to worsen the shortage of the future’s healthcare workforce in the region. Pandemic-related impacts have led to a degradation of the learning environment of medical students. Medical schools have shifted online to differing degrees and direct patient-care in training of students has decreased. This study highlights the urgent need for flexible and innovative approaches to medical education in Africa

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Impact of the COVID-19 pandemic on the clinical training of last year medical students in Mexico: a cross-sectional nationwide study

BMC Medical Education ◽

10.1186/s12909-021-03085-w ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Maximiliano Servin-Rojas ◽

Antonio Olivas-Martinez ◽

Michelle Dithurbide-Hernandez ◽

Julio Chavez-Vela ◽

Vera L. Petricevich ◽

...

Keyword(s):

Medical Education ◽

Public Schools ◽

Medical Students ◽

Private Schools ◽

Clinical Training ◽

Online Survey ◽

Medical Training ◽

Clinical Instruction ◽

Cross Sectional ◽

The Impact

Abstract Background The COVID-19 pandemic has brought unprecedented changes to medical education. However, no data are available regarding the impact the pandemic may have on medical training in Mexico. The aim of our study was to evaluate and identify the medical school students’ perceptions of the changes in their clinical training due to the pandemic in Mexico. Methods This was a cross-sectional study where a previous validated online survey was translated and adapted by medical education experts and applied to senior medical students from March to April of 2021. The 16-item questionnaire was distributed online combining dichotomous, multiple-choice, and 5-point Likert response scale questions. Descriptive and multivariate analyses were performed to compare the student’s perceptions between public and private schools. Results A total of 671 responses were included in the study period. Most participants were from public schools (81%) and female (61%). Almost every respondent (94%) indicated it was necessary to obtain COVID-19 education, yet only half (54%) received such training. Students in private schools were less likely to have their clinical instruction canceled (53% vs. 77%, p = 0.001) and more likely to have access to virtual instruction (46% vs. 22%, p = 0.001) when compared to students from public schools. Four out of every five students considered their training inferior to that of previous generations, and most students (82%) would consider repeating their final year of clinical training. Conclusions The impact of the COVID-19 on medical education in Mexico has been significant. Most final-year medical students have been affected by the cancellation of their in-person clinical instruction, for which the majority would consider repeating their final year of training. Efforts to counterbalance this lack of clinical experience with virtual or simulation instruction are needed.

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The digital age: is this the future of medical education? A cross-sectional study to assess medical students’ opinions about e-learning in psychiatry undergraduate medical education

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2014.15 ◽

2014 ◽

Vol 31 (2) ◽

pp. 89-96

Author(s):

D. Mullins ◽

F. Jabbar ◽

N. Fenlon ◽

K. C. Murphy

Keyword(s):

Medical Education ◽

Medical Students ◽

Learning Environment ◽

Learning Styles ◽

Student Performance ◽

Undergraduate Medical Education ◽

Cross Sectional Study ◽

Virtual Learning Environment ◽

Cross Sectional ◽

E Learning

ObjectivesThe main objectives were to assess medical students’ opinions about e-learning in psychiatry undergraduate medical education, and to investigate a possible relationship between learning styles and preferences for learning modalities.MethodDuring the academic year 2009/2010, all 231 senior Royal College of Surgeons in Ireland (RCSI) medical students in their penultimate year of study were invited to answer a questionnaire that was posted online on Moodle, the RCSI virtual learning environment.ResultsIn all, 186 students responded to the questionnaire, a response rate of 80%. Significantly more students stated a preference for live psychiatry tutorials over e-learning lectures. Students considered flexible learning, having the option of viewing material again and the ability to learn at one’s own pace with e-learning lectures, to be more valuable than having faster and easier information retrieval.ConclusionStudents prefer traditional in-class studying, even when they are offered a rich e-learning environment. Understanding students’ learning styles has been identified as an important element for e-learning development, delivery and instruction, which can lead to improved student performance.

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Attitude Towards and Adoption of the Novel Learning Environment Among Undergraduate Medical Students During COVID-19

Frontiers in Education ◽

10.3389/feduc.2021.714526 ◽

2021 ◽

Vol 6 ◽

Author(s):

Sonja Mohr ◽

Birgit Küfe ◽

Anke Rheingans ◽

Jennifer Guse

Keyword(s):

Medical Education ◽

Medical Students ◽

Learning Environment ◽

Student Satisfaction ◽

Large Scale ◽

Digital Learning ◽

The Novel ◽

Undergraduate Medical Students ◽

Cross Sectional ◽

Digital Formats

Higher education has changed significantly since the beginning of the COVID-19 pandemic. Medical education programs with extensive practical and interactive components faced major challenges to protect students, faculty and patients. In response to COVID-19, many medical schools worldwide shut down undergraduate medical education and converted most of their teaching to digital formats. The aim of this paper is to assess the attitude towards and adoption of the novel learning environment among undergraduate medical students during COVID-19. Two studies were conducted to analyze specific aspects of the adaption of digital teaching during the digital summer semester 2020 (study 1), and to compare student satisfaction and their feeling of preparedness for exams in the digital semester compared to traditional semesters (study 2). Results show that there are numerous pros and cons of digital teaching. Pros were the large flexibility and large-scale availability of digital teaching materials. Cons were the lack of interactions with peers, professionals, and patients in practice. Results also show that female students as well as year 1 students seemingly coped better with the digital learning environment. Students with childcare or job obligations also benefited from the large flexibility. While student satisfaction decreased in the digital semester, they did not feel less prepared for exams. Cross-sectional comparisons revealed that student satisfaction and agreement gradually decreased in the comparison of the different cohorts with fourth year students being the least satisfied and showing the least agreement regarding the feeling of preparedness for exams. Altogether, our results indicate that students were able to cope with digital teaching, but clearly, some groups of students were able to better adapt to the novel learning environment. This might demand the introduction of tailored educational support services for different groups of students during COVID-19 as they progress through medical school.

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Chinese medical students’ disposition for critical thinking: a mixed methods exploration

BMC Medical Education ◽

10.1186/s12909-021-02801-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lei Huang ◽

Angela Pei-Chen Fan ◽

Na Su ◽

Jessica Thai ◽

Russell Olive Kosik ◽

...

Keyword(s):

Medical Education ◽

Critical Thinking ◽

Longitudinal Study ◽

Medical Students ◽

Medical Training ◽

Cross Sectional ◽

Chinese Medical Students ◽

One Year ◽

The Impact

Abstract Background Critical thinking (CT) is an essential competency for medical students. This study’s aim was to evaluate Chinese medical students’ disposition for CT and to explore the impact of current trends in medical education on students’ CT development. Methods We used multistage stratified cluster sampling to recruit a total of 1241 medical students among five different years of training and from three medical institutions in China. The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) and self-reported information were used to collect cross-sectional data. Based on the data from the CTDI-CV, 112 medical students in clinical course training from a single institution continued one-year follow-up. Their one-year CTDI-CV score changes were collected regarding various medical education variables. Results The mean CTDI-CV score of the 1241 medical students was 287.04 with 729 (58.7%) students receiving a score of 280 or higher. There were statistically significant differences in schools attended(F = 3.84, P < 0.05), year of school attended(F = 10.32, P < 0.001), GPA(F = 6.32, P < 0.01), weekly time spent learning after class(F = 14.14, P < 0.001), attitude toward medicine(F = 28.93, P < 0.001), desire to be a doctor after graduation(t = − 3.35, P < 0.001), familiarity with CT(F = 20.40, P < 0.001), and perception of importance of CT(F = 22.25, P < 0.001). The participants scored the highest on the CTDI-CV subscales of “inquisitiveness” and the lowest on “truth seeking.” The 112 students in the longitudinal study had significantly lower total CT scores after one academic year follow-up. Conclusions Chinese medical students generally exhibited positive CT dispositions. The cross-sectional survey and one-year longitudinal study indicated that students’ CT disposition diminished as they progressed through traditional medical training. Our study contributes to understanding the status of Chinese medical education of and influential factors on medical students’ CT disposition.

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The Medical Education Environment at the University of Nairobi, Kenya: An Assessment with the DREEM Tool

Annals of African Surgery ◽

10.4314/aas.v18i2.7 ◽

2021 ◽

Vol 18 (2) ◽

pp. 96-102

Author(s):

Daniel Ojuka ◽

Faith Aseta ◽

Beth Githambo ◽

Brian Wambua

Keyword(s):

Medical Students ◽

Learning Environment ◽

Educational Environment ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Knowledge And Skills ◽

School Of Medicine ◽

Education Environment ◽

The University ◽

Supportive Learning Environment

Background: The supportive learning environment can enhance impartating of knowledge and skills. Objective: To assess the learning environment at the School of Medicine of the University of Nairobi using the Dundee Ready Educational Environment Measure(DREEM) tool. Methods: A cross-sectional survey carried in 2019 out among medical students during their clinical years to obtain their perceptions about the learning environment at the School of Medicine of the University of Nairobi. The DREEM tool was used for the survey. Data were entered and analyzed in SPSS version19. Comparisons were performed using analysis of variance (ANOVA). p≤0.05 was consideredstatistically significant. Results: We obtained 619 responses (77.4%) from 800 tools distributed. The total mean score of DREEM was 93.3/200. This is a 46.7%score overall indicating a poor perception of the learning environment. Year IV was the class with the poorest perception with a p<0.05. Conclusion: The DREEM score shows numerous problems, with perception of learning and social support being the areas requiring themost improvement. Although teachers are knowledgeable, students are wary of their ability to transfer knowledge and skills. Keywords: Learning environment, DREEM, Medical students

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Gender differences on medical students’ attitudes toward patient-centred care: a cross-sectional survey conducted in Heilongjiang, China

PeerJ ◽

10.7717/peerj.7896 ◽

2019 ◽

Vol 7 ◽

pp. e7896 ◽

Cited By ~ 2

Author(s):

Wei Liu ◽

Yanhua Hao ◽

Xiaowen Zhao ◽

Tao Peng ◽

Weijian Song ◽

...

Keyword(s):

Gender Differences ◽

Medical Education ◽

Medical Students ◽

Education Reform ◽

Demographic Data ◽

Cross Sectional ◽

Patient Centred Care ◽

Medical Undergraduate ◽

Students Attitudes ◽

The Impact

Objectives Assessing medical students’ attitudes toward patient-centred care is essential to bettering medical education. Based on doctor-patient relationships and the medical system in China, it is important to explore the impact of gender differences and other background factors on patient-centred attitudes and to provide references for medical education reform. Methods A cross-sectional study was conducted on fourth-year medical undergraduate students from November 2017 to March 2018 in Heilongjiang Province, Northeast China. The Chinese-revised Patient-Practitioner Orientation Scale (CR-PPOS), which has been validated in previous research, was used to measure the medical students’ attitudes. The medical students’ demographic data was collected, including their gender, age, information on whether they have siblings, family residence location, doctor(s) for parents, year in which the student first experienced clinical practice, and student category. Results A total of 513 students (91.12%) completed the survey. The Chinese medical students scored considerably higher for ‘Caring’ (including patients’ preferences into the decision-making process) than for ‘Sharing’ (sharing information/responsibility with patients). These students tended to have patient-centred attitudes, as measured by an average overall CR-PPOS score of 3.63 (scores higher than 3.5 indicate patient-centred attitudes), which is higher than Malian (3.38) and Pakistani (3.40) medical students but lower than American (4.57) and Brazilian (4.66) students. Female students (P < 0.05) were significantly associated with more patient-centred attitudes and with higher ‘Sharing’ and ‘Caring’ subscale scores. Student category (P < 0.05) was associated with ‘Sharing’ and ‘Caring’ scores. Clinical hospital students (P < 0.05) were associated with more patient-centred attitudes and with higher ‘Sharing’ and ‘Caring’ subscale scores, Students without siblings (p < 0.07) were associated with the higher ‘Sharing’ subscale scores. Conclusions In China, gender has a significant impact on medical students’ patient-centred attitudes, which is similar to findings from other countries. If medical schools want to raise patient-centred attitudes across the board and bridge the gap between male and female patient-centred attitudes, gender, student category, and other factors should be incorporated into medical education.

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The impact of integrating environmental health into medical school curricula: a survey-based study

BMC Medical Education ◽

10.1186/s12909-020-02458-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Benjamin Kligler ◽

Genevieve Pinto Zipp ◽

Carmela Rocchetti ◽

Michelle Secic ◽

Erin Speiser Ihde

Keyword(s):

Climate Change ◽

Medical Education ◽

Medical Students ◽

Medical School ◽

Environmental Health ◽

School Curriculum ◽

Learning Objectives ◽

Lead Contamination ◽

Institute Of Medicine ◽

The Impact

Abstract Background Inclusion of environmental health (EH) in medical education serves as a catalyst for preparing future physicians to address issues as complex as climate change and health, water pollution and lead contamination. However, previous research has found EH education to be largely lacking in U.S. medical education, putting future physicians at risk of not having the expertise to address patients’ environmental illnesses, nor speak to prevention. Methods Environmental health (EH) knowledge and skills were incorporated into the first-year medical school curriculum at Hackensack Meridian School of Medicine (Nutley, New Jersey), via a two-hour interactive large group learning module with follow up activities. Students completed the Environmental Health in Med School (EHMS) survey before and after the year 1 EH module. This survey evaluates medical students’ attitudes, awareness and professionalism regarding environmental health. In year 2, students completed the Environmental Health Survey II, which measured students’ perceptions of preparedness to discuss EH with future patients. The research team created both surveys based upon learning objectives that broadly aligned with the Institute of Medicine six competency-based environmental health learning objectives. Results 36 year 1 students completed both the pre and post EHMS surveys. McNemar’s test was used for paired comparisons. Results identified no statistically significant changes from pre to post surveys, identifying a dramatic ceiling. When comparing year 2, EHS II pre-survey (n = 84) and post-survey (n = 79) responses, a statistically significant positive change in students’ self-reported sense of preparedness to discuss environmental health with their patients following the curriculum intervention was noted. Conclusions Our conclusion for the EHMS in Year 1 was that the current generation of medical students at this school is already extremely aware of and concerned about the impact of environmental issues on health. Through the EHS II in Year 2, we found that the six-week environmental health module combining didactic and experiential elements significantly increased medical students’ self-reported sense of preparedness to discuss environmental health issues, including climate change, with their patients.

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Medical education challenges and innovations during COVID-19 pandemic

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2021-140032 ◽

2021 ◽

pp. postgradmedj-2021-140032

Author(s):

Michail Papapanou ◽

Eleni Routsi ◽

Konstantinos Tsamakis ◽

Lampros Fotis ◽

Georgios Marinos ◽

...

Keyword(s):

Medical Education ◽

Medical Students ◽

Student Assessment ◽

Well Being ◽

Educational Institutions ◽

Healthcare Staff ◽

Academic Trajectories ◽

Traditional Structure ◽

Physical Presence ◽

The Impact

COVID-19 pandemic has undoubtedly disrupted the well-established, traditional structure of medical education. Τhe new limitations of physical presence have accelerated the development of an online learning environment, comprising both of asynchronous and synchronous distance education, and the introduction of novel ways of student assessment. At the same time, this prolonged crisis had serious implications on the lives of medical students including their psychological well-being and the impact on their academic trajectories. The new reality has, on many occasions, triggered the ‘acting up’ of medical students as frontline healthcare staff, which has been perceived by many of them as a positive learning and contributing experience, and has led to a variety of responses from the educational institutions. All things considered, the urgency for rapid and novel adaptations to the new circumstances has functioned as a springboard for remarkable innovations in medical education,including the promotion of a more “evidence-based” approach.

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The Impact of exposure to screen during COVID-19 Lockdown on the General health of students in Punjab, Pakistan

Medical & Clinical Research ◽

10.33140/mcr.06.07.04 ◽

2021 ◽

Vol 6 (7) ◽

Keyword(s):

Medical Students ◽

Screen Time ◽

General Health ◽

Cross Sectional Study ◽

Mental Wellbeing ◽

Long Term Effects ◽

Cross Sectional ◽

Dry Eyes ◽

Mental Symptoms ◽

The Impact

Background: Since Covid-19 was declared a pandemic and a worldwide lockdown was imposed, it was predicted that there would be an increase in screen usage, especially among students, which could potentially have a lot of negative symptomology associated with it. Objective: The objective of our study was to determine the extent of screen exposure among medical students during lockdown and to study the symptoms that they faced due to it along with their frequency. Methods: In our descriptive cross-sectional study, we distributed the specifically designed questionnaire through online media to the concerned population, in order to gather important data about the physical and mental symptoms experienced by the medical students as a result of excessive screen exposure. Results: Of the 400 participants, 93.75 % reported an increase in screen time during the lockdown. As a consequence of increased screen usage, 207 (51.75%) of the participants reported headache, 267 (66.75%) reported fatigue, 283 (70.75%) reported eye strain, 121 (30.25%) reported dry eyes, 143 (35.75%) reported blurry vision, 154 (38.5%) reported teary eyes, 154 (38.5%) reported ear ache, 247 (61.75%) reported neck and back stiffness and 148 (37%) participants agreed to having experienced fingers and hand fatigue. We also established that increasing screen time was associated with a progressive decrease in physical activity (p=0.11) and increase in food consumption (p=0.002). A significant association was also recorded with weight gain (p=0.03). We found that the students previously diagnosed with a refractive error were more likely to complain of eye strain (p=0.004) and those diagnosed with migraine experienced more screen related headache (p=0.001). Of the 11 symptoms related to mental health in the questionnaire, students with screen usage of less than 4 hours marked a median of 2 symptoms, those with screen time of 4-8 hours marked a median of 4 symptoms and those with a screen usage >8 hours ticked a median of 5 symptoms. Students who had been diagnosed with anxiety or depression in the past checked an average of 5.24 symptoms while those with no such diagnosis had only 3.51 symptoms on average. Conclusion: The results proved a potential impact on the general health of the medical students. A significant increase in weight was observed along with other serious short and long term effects on their physical and mental wellbeing.

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