Infectious and tropical diseases, Hospital for Tropical Diseases, University College London Hospitals, London, UK
Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
Postgrad Med J. 2021 Jul;97(1149):417-422. doi: 10.1136/postgradmedj-2021-139728. Epub 2021 Feb 16.
COVID-19 led to the widespread withdrawal of face-to-face hospital-based clinical placements, with many medical schools switching to online learning. This precipitated concern about potential negative impact on clinical and interprofessional skill acquisition. To overcome this problem, we piloted a 12-week COVID-19 safe face-to-face clinical placement for 16 medical students at the Hospital for Tropical Diseases, London, during the first wave of the COVID-19 pandemic. COVID-19 infection control measures necessitated that students remained in 'social bubbles' for placement duration. This facilitated an apprenticeship-style teaching approach, integrating students into the clinical team for placement duration. Team-based learning was adopted to develop and deliver content. Teaching comprised weekly seminars, experiential ward-based attachments and participation in quality improvement and research projects. The taught content was evaluated through qualitative feedback, reflective practice, and pre-apprenticeship and post-apprenticeship confidence questionnaires across 17 domains. Students' confidence improved in 14 of 17 domains (p<0.05). Reflective practice indicated that students valued the apprenticeship model, preferring the longer clinical attachment to existent shorter, fragmented clinical placements. Students described improved critical thinking, group cohesion, teamwork, self-confidence, self-worth and communication skills. This article describes a framework for the safe and effective delivery of a longer face-to-face apprenticeship-based clinical placement during an infectious disease pandemic. Longer apprenticeship-style attachments have hidden benefits to general professional training, which should be explored by medical schools both during the COVID-19 pandemic and, possibly, for any future clinical placements.
COVID-19 导致广泛取消了基于医院的面对面临床实习,许多医学院转而采用在线学习。这引发了对潜在负面影响的担忧,包括临床和跨专业技能的获取。为了解决这个问题,我们在 COVID-19 大流行的第一波期间,在伦敦热带病医院为 16 名医学生试点了为期 12 周的 COVID-19 安全面对面临床实习。COVID-19 感染控制措施要求学生在实习期间保持“社交隔离”。这促进了学徒式教学方法的实施,将学生融入临床团队进行实习。采用团队学习来制定和提供内容。教学包括每周研讨会、体验式病房实习以及参与质量改进和研究项目。通过 17 个领域的定性反馈、反思性实践以及入职前和入职后信心问卷,对所教授的内容进行了评估。学生在 17 个领域中的 14 个领域(p<0.05)的信心得到了提高。反思性实践表明,学生重视学徒模式,更喜欢更长的临床实习,而不是目前较短、碎片化的临床实习。学生们表示,他们的批判性思维、团队凝聚力、团队合作、自信心、自我价值感和沟通技巧都有所提高。本文描述了在传染病大流行期间安全有效地提供更长时间的基于学徒模式的面对面临床实习的框架。更长时间的学徒式实习对一般专业培训有潜在的好处,医学院应该在 COVID-19 大流行期间以及未来的任何临床实习中对此进行探索。