Assessing the Impact of the COVID-19 Pandemic on Medical Student Education

Background: The full impact of the COVID-19 global pandemic has yet to be seen, yet medical education has already been critically disrupted. As U.S. hospitals were forced to aggressively limit non-essential care to preserve personal protective equipment and minimize COVID-19 exposure, in-person education and hands-on training was nearly eliminated for students. The objective of this study was to immediately and comprehensively investigate the impact of the COVID-19 pandemic on medical student education. Medical students in the U.S. were invited to complete an online survey about the impacts of the COVID-19 pandemic on their medical education experience. Students provided basic demographic information and answered questions about the impact of COVID-19 on their training/education, finances, and mental health. Results: Medical students reported nearly 18 fewer hours of patient care per week, an immediate switch to virtual learning (74%) along with grading changes (62%), and widespread cancellation of national exams. Additionally, 55% of fourth year students graduated early to provide direct clinical care. Students across years felt that changes from the pandemic would negatively affect their residency applications and that upcoming rotations would be impacted (p<0.001). Students reported that the pandemic had negatively affected their finances, increased their anxiety/stress, increased their feelings of burnout, and negatively impacted their work-life balance (p<0.001). Conclusion: Medical education has been critically impacted by COVID-19. Student perceptions and evaluation of experiences to date should be considered as educators prepare to ready students for academic and professional transitions in the context of continued COVID-19 disruptions and distanced learning.

Reskilling Internationally Educated Nurses

In light of a projected shortage of registered nurses, nurses trained overseas may present a viable solution. However, these nurses will likely need to surmount many obstacles in order to integrate into the profession in the United States. This chapter reviews the barriers faced by internationally trained nurses to entering the nursing profession. Secondly, it argues for the importance of addressing and facilitating personal and professional transitions in helping deskilled nurses as they pursue nursing licensure. In doing so, it will reflect on the researcher's research with internationally educated nurses and their experiences in a National Council Licensure Examination (NCLEX) preparation program. Finally, implications for adult education practitioners who help internationally educated nurses, as well as other deprofessionalized immigrants rebuild their careers in the United States are discussed.

Medical hybridity and beyond: professional transitions in Italian outpatient settings

The marketization of public healthcare has brought about organizational transformations, affecting health professionals' ways of working in hospitals and outpatient organizations. As a result of the reforms in the 1990s, the principle of business-like healthcare has been introduced in the Italian health system. This paper presents the main findings of a study of specialist doctors working in two local health organizations in the Tuscany region. Drawing on semi-structured interviews with specialist doctors working in an outpatient setting, the article examines the manifold reactions to changes of the medical profession within outpatient settings. In particular, the combination of professional and organizational dimensions has been taken into consideration. The results show that a change is involving outpatient specialist doctors' identity: organizational change affects several dimensions of the medical professional ethos. The change has been understood by categorizing three major types of approaches to medical professionalism, which are aimed to understand the complexity of the domain and to summarize professionals' reactions: the first is linked to a traditional model of professionalism; the second accepts partially business-like organizational issues, while trying to create individual spaces of autonomy in daily tasks; the third co-opts new organizational issues, which become part of the medical professional ethos.

The rationality of decisions in the university professors’ inter-professional transitions

Resumo O estudo apresentado neste artigo teve como objetivo analisar a racionalidade das decisões tomadas por professores universitários, em sua transição de outras profissões para a carreira docente. Foram analisados 357 respondentes, que consideram ter mudado de profissão na época em que decidiram seguir a carreira de docentes de nível superior. Quatro hipóteses foram avaliadas, relacionando a influência da profissão anterior, dos impulsionadores da transição, dos atributos da transição e dos recursos acionados pelo indivíduo sobre a racionalidade de suas decisões. Os resultados mostraram que os atributos e os recursos influenciam tanto as decisões racionais como as que extrapolam a racionalidade; a menor carga de trabalho na profissão atual permite que a pessoa identifique mais positivamente os atributos da transição que viveu; a percepção da incerteza na profissão anterior leva a decisões mais emocionais e mais sujeitas a variações contextuais. De forma geral, embora os estudos atuais considerem fortemente a emoção no processo decisório, para evitar frustrações futuras, é importante equilibrar a racionalidade e a subjetividade nas decisões de carreira.