Fayngersh Alla, Sudyn Alexander, Jain Nishma, Asri Rijul, Traba Christin, Matassa Daniel, Wong Kristin
Department of Medicine, Rutgers New Jersey Medical School, 150 Bergen St., UH I-248, Newark, NJ 07103 USA.
Department of Medicine, Columbia University Vagelos College Physicians and Surgeons, 630 West 168th Street, New York, USA.
Med Sci Educ. 2022 Jul 12;32(4):907-915. doi: 10.1007/s40670-022-01589-8. eCollection 2022 Aug.
The COVID-19 pandemic forced changes to undergraduate medical education with its impact still not fully understood. This is the first US study to assess the pandemic's perceived impact on medical education after return to in-person clerkships.
We conducted a survey of third-year medical students completing their medicine clerkship during the 2020-2021 and 2021-2022 academic years (AY). Survey questions assessed students' attitudes on perceived risk of COVID-19 infection, impact on clinical encounters, and students' specialty interests.
Of 312 students enrolled, 283 (90.71%) completed the survey. Concern for COVID-19 infection was highest in the second rotation (3.98 [95% CI 3.64, 4.31]) of the 2020-2021 AY and the third rotation of the 2021-2022 AY (3.41 [95% CI 3.06, 3.76]), corresponding to the surges of COVID-19 cases and subsequent variants. Conversely, as incidence increased, students reported a greater perceived impact on histories, physicals, and time spent with patients with no differences in patient rapport or specialty interests.
Although concern for infection was initially high, it decreased after the introduction of the COVID-19 vaccine despite increasing incidence nationally and then peaked again during the Omicron surge. The degree of concern did not exceed initial levels, despite unprecedentedly high disease prevalence. Higher infection rates correlated with greater perceived impact on clinical experiences. Our study underscores the importance of vaccination, highlights learners' concerns and resilience throughout the pandemic, and should be considered in balancing student exposure with maintaining clinical opportunities.
The online version contains supplementary material available at 10.1007/s40670-022-01589-8.
新冠疫情迫使本科医学教育发生变革，其影响尚未完全明晰。这是美国首项评估恢复面对面临床实习后疫情对医学教育的感知影响的研究。
我们对在2020 - 2021学年和2021 - 2022学年完成内科临床实习的三年级医学生进行了一项调查。调查问题评估了学生对新冠感染感知风险的态度、对临床接触的影响以及学生的专业兴趣。
在312名登记的学生中，283名（90.71%）完成了调查。对新冠感染的担忧在2020 - 2021学年的第二轮实习（3.98 [95%置信区间3.64, 4.31]）和2021 - 2022学年的第三轮实习（3.41 [95%置信区间3.06, 3.76]）时最高，这与新冠病例及后续变异毒株的激增相对应。相反，随着发病率上升，学生报告对病史采集、体格检查以及与患者相处时间的感知影响更大，而在医患融洽关系或专业兴趣方面没有差异。
尽管最初对感染的担忧很高，但在引入新冠疫苗后有所下降，尽管全国发病率上升，随后在奥密克戎毒株激增期间再次达到峰值。尽管疾病患病率空前高，但担忧程度并未超过初始水平。更高的感染率与对临床体验的更大感知影响相关。我们的研究强调了疫苗接种的重要性，凸显了学习者在整个疫情期间的担忧和适应能力，并且在平衡学生接触风险与维持临床机会时应予以考虑。
在线版本包含可在10.1007/s40670 - 022 - 01589 - 8获取的补充材料。
