COVID-19 Pandemisinde Tıp Eğiticilerinin Mezuniyet Öncesi ve Sonrası Tıp Eğitimindeki Deneyimleri: Nitel Çalışma

Year 2023, Volume: 22 Issue: 66, 30 - 46, 30.04.2023

Mustafa Daloğlu , Meral Demirören

https://doi.org/10.25282/ted.1179232

Abstract

Amaç: COVID-19 pandemisinde tıp eğitimi, eğitimin temel bileşenleri olan program, öğrenci ve eğiticilerin yeni ve hızla değişen koşullara adaptasyonunu sağlayarak yanıt vermeye çalışmıştır. Bu çalışmada, tıp eğiticilerinin COVID-19 pandemisinin mezuniyet öncesi (MÖE) ve sonrası (MSE) tıp eğitimine etkilerine yönelik görüşlerinin ve eğiticilik deneyimlerinin incelenmesi amaçlanmıştır.
Yöntem: Temel nitel araştırma desenli çalışma, Hacettepe ve Akdeniz Üniversitesi Tıp Fakülteleri’nde, Ekim- Kasım 2020 döneminde temel bilimlerden 4, dahili bilimlerden 6 ve cerrahi bilimlerden 3 olmak üzere toplam 13 tıp eğiticisinin katılımı ile gerçekleştirilmiştir. Katılımcılarla derinlemesine bireysel görüşmeler yapılmış ve tematik analiz ile bulgular değerlendirilmiştir.
Bulgular: Katılımcıların COVID-19 pandemisinin MÖE ve MSE’e etkilerine yönelik görüşlerinde olumsuz etkiler daha sıklıkla paylaşılmıştır. Tıp eğiticileri yaygın olarak MÖE’de pandemi nedeniyle klinik eğitimin (Dönem 4-5) yüz yüze sürdürülememesinin klinik yeterliklerin ve profesyonel tutum ve değerlerin kazanımını olumsuz etkilediğini düşünmektedir. MSE’de pandemi sürecinde özellikle klinik uzmanlık alanlarında yeterli sayı ve çeşitlilikte hasta görememe ve girişimsel uygulamalar yapamama olumsuz etkiler olarak öne çıkmıştır. Klinik öğretim etkinlikleri (vizit, hasta başı tartışma vb.) enfeksiyon riski gözetilerek uygulanmıştır. Tıp eğiticilerinin çevirim içi öğretim deneyimleri, öğretimi planlama/adapte etme, materyal hazırlama, çevirimiçi öğrenci katılımını, eğitici-öğrenci etkileşimini ve motivasyonunu sağlama, güvenilir ve yöntemsel olarak zengin sınavlar yapabilme açısından zorluklar içermiştir. Uzaktan eğitim için eğitim materyallerinin geliştirilmesi ve ulaşılabilirliğinin arttırılması olumlu gelişmeler olarak değerlendirilmiştir. Tıp eğiticileri pandemi sürecinde uzaktan eğitime uyum sürecini teknoloji kullanımı ve öğretimi hızla adapte etmek açısından bir zorlanma olarak görürken, aynı zamanda önemli bir kazanım olarak da algılamaktadır. Öğrenci ile yüz yüze etkileşimin olamamasının sosyal ve psikolojik olumsuz etkileri yaygın olarak paylaşılmıştır.
Sonuç: Tıp eğiticilerinin COVID-19 pandemisindeki uzaktan eğitim deneyimleri tıp fakültelerinin teknolojik altyapılarını geliştirmeleri ve eğiticilerin desteklenmesinin (teknoloji kullanımı, uzaktan öğretim-ölçme yöntemleri) önemine dikkat çekmektedir. İlaveten, tıp eğiticilerini sosyal ve motivasyonel olarak destekleyici düzenlemeler (sosyal ağlar, geribildirimler vb.) yapılabilir. Pandemi koşullarında eğitimin yüz yüze sürdürülmesi açısından eğiticiler, öğrenenler ve hastalar açısından güvenli klinik ve öğrenme ortamlarının sağlanması ve sürdürülebilirliği önemlidir. Ulusal düzeyde fırsat eşitliğini sağlamaya yönelik çalışmalar yapılması, tıp fakülteleri arasında iş birliğinin ve paylaşımın (eğitim materyalleri ve altyapısı) arttırılması önerilir.

Keywords

Mezuniyet Öncesi Tıp Eğitimi, Mezuniyet Sonrası Tıp Eğitimi, Tıp Eğiticileri, COVID-19 Pandemisi

Experiences of Educators in Undergraduate and Postgraduate Medical Education in COVID-19 Pandemic: A Qualitative Study

Abstract

Aim: Since the beginning of the COVID-19 pandemic, medical faculties have been trying to adapt their program, their students and educators, which are the main components of education, to new and rapidly changing conditions. For this reason, this study aims to investigate medical educators’ point of view about the effects of pandemic on undergraduate and graduate medical education, and their experiences during the pandemic.
Methods: It is a basic qualitative study. The study was carried out with the participation of a total of 13 medical educators, 4 from basic sciences, 6 from internal sciences and 3 from surgical sciences, at Hacettepe and Akdeniz University Faculty of Medicine, between October and November 2020. In-depth individual interviews were conducted with the participants and the findings were evaluated with thematic analysis.
Results: Participants most commonly shared negative opinions about the effect of the pandemic. Medical educators commonly think that the inability to continue face-to-face clinical education (Terms 4-5) in undergraduate education due to the pandemic negatively affects the acquisition of clinical competencies and professional attitudes and values. During the pandemic process, the negative effects of insufficient number and variety of patients and interventional practices, especially in clinical specialties, are reported in postgraduate education. Clinical teaching activities (visit, bedside discussion, etc.) were applied considering the risk of infection. Medical educators' online teaching experiences have included difficulties in planning/adapting teaching, preparing materials, providing online student participation, teacher-student interaction, motivation, and conducting reliable and methodically rich exams. Developing and increasing the accessibility of educational materials for distance education were evaluated as positive developments. While medical educators see the adaptation process to distance education as a challenge in terms of using technology and rapidly adapting teaching during the pandemic process, they also perceive it as an important gain. The negative effects of the lack of face-to-face interaction with the student in the social and psychological context were widely shared.
Conclusions: The distance education experiences of medical educators in the COVID-19 pandemic draw attention to the importance of improving the technological infrastructure of medical faculties and supporting educators (use of technology, distance education-assessment methods). In addition, arrangements (social networks, feedback, etc.) that support medical educators socially and motivationally are recommended. In the context of carrying on face-to-face education in pandemic conditions, it is important to provide and maintain safe clinical and learning environments for educators, learners and patients. It is recommended to carry out studies to ensure equal opportunity at the national level, and to increase cooperation and sharing (educational materials and infrastructure) among medical faculties.

Keywords

Undergraduate Medical Education, Postgraduate Medical Education, Medical Educators, COVID-19 Pandemic

References

• 1. Irby DM, Cooke M, O’Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of teaching: 1910 and 2010. Acad Med [Internet]. 2010 [cited 2021 Mar 26];85(2):220–7. Available from: https://pubmed.ncbi.nlm.nih.gov/20107346/
• 2. Skochelak SE, Stack SJ. Creating the Medical Schools of the Future [Internet]. Vol. 92, Academic Medicine. Lippincott Williams and Wilkins; 2017 [cited 2021 Mar 26]. p. 16–9. Available from: https://pubmed.ncbi.nlm.nih.gov/27008357/
• 3. Rose S. Medical Student Education in the Time of COVID-19. JAMA - J Am Med Assoc [Internet]. 2020 Jun 2 [cited 2021 Mar 26];323(21):2131–2. Available from: https://www.aamc.org/
• 4. Jiang Z, Wu H, Cheng H, Wang W, Xie A, Fitzgerald SR. Twelve tips for teaching medical students online under COVID-19. Med Educ Online [Internet]. 2021;26(1). Available from: https://doi.org/10.1080/10872981.2020.1854066
• 5. Emanuel EJ. The Inevitable Reimagining of Medical Education [Internet]. Vol. 323, JAMA - Journal of the American Medical Association. American Medical Association; 2020 [cited 2021 Mar 26]. p. 1127–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32105294/
• 6. Guze PA. Using Technology to Meet the Challenges of Medical Education [Internet]. Vol. 126, Transactions of the American Clinical and Climatological Association. American Clinical and Climatological Association; 2015 [cited 2021 Mar 26]. p. 260–70. Available from: /pmc/articles/PMC4530721/
• 7. Theoret C, Ming X. Our education, our concerns: The impact on medical student education of COVID-19 [Internet]. Vol. 54, Medical Education. Blackwell Publishing Ltd; 2020 [cited 2021 Mar 26]. p. 591–2. Available from: https://pubmed.ncbi.nlm.nih.gov/32310318/
• 8. Shibu A. Medical student engagement during the COVID‐19 pandemic—A student perspective. Med Educ [Internet]. 2021 Mar 8 [cited 2021 Mar 26];medu.14474. Available from: https://onlinelibrary.wiley.com/doi/10.1111/medu.14474
• 9. Wise CE, Bereknyei Merrell S, Sasnal M, Forrester JD, Hawn MT, Lau JN, et al. COVID-19 Impact on Surgical Resident Education and Coping. J Surg Res [Internet]. 2021; Available from: https://doi.org/10.1016/j.jss.2021.01.017
• 10. Durrani M. Debate style lecturing to engage and enrich resident education virtually. Med Educ [Internet]. 2020 Oct 12 [cited 2021 Mar 26];54(10):955–6. Available from: https://onlinelibrary.wiley.com/doi/10.1111/medu.14217
• 11. Sandhu P, de Wolf M. The impact of COVID-19 on the undergraduate medical curriculum [Internet]. Vol. 25, Medical Education Online. Taylor and Francis Ltd.; 2020 [cited 2021 Mar 26]. Available from: https://www.tandfonline.com/action/journalInformation?journalCode=zmeo20
• 12. Lindseth A, Norberg A. A phenomenological hermeneutical method for researching lived experience. Scand J Caring Sci. 2004;18(2):145–53.
• 13. Alsoufi A, Alsuyihili A, Msherghi A, Elhadi A, Atiyah H, Ashini A, et al. Impact of the COVID-19 pandemic on medical education: Medical students’ knowledge, attitudes, and practices regarding electronic learning. PLoS One [Internet]. 2020;15(11 November):1–20. Available from: http://dx.doi.org/10.1371/journal.pone.0242905
• 14. Shehata MH, Abouzeid E, Wasfy NF, Abdelaziz A, Wells RL, Ahmed SA. Medical Education Adaptations Post COVID-19: An Egyptian Reflection. J Med Educ Curric Dev. 2020 Jan;7:238212052095181.
• 15. Adkoli B, Parija SC. Medical Professionalism: during COVID-19 Times and Beyond. SBV J Basic, Clin Appl Heal Sci. 2020;3(3):93–5.
• 16. ten Cate O, Schultz K, Frank JR, Hennus MP, Ross S, Schumacher DJ, et al. Questioning medical competence: Should the Covid-19 crisis affect the goals of medical education? Med Teach [Internet]. 2021;43(7):817–23. Available from: https://doi.org/10.1080/0142159X.2021.1928619
• 17. Chen CH, Mullen AJ. COVID-19 can catalyze the modernization of medical education. JMIR Med Educ. 2020;6(1):6–8.
• 18. Monaghan AM. Medical Teaching and Assessment in the Era of COVID-19. J Med Educ Curric Dev. 2020;7:238212052096525.
• 19. Hall AK, Nousiainen MT, Campisi P, Dagnone JD, Frank JR, Kroeker KI, et al. Training disrupted : Practical tips for supporting competency-based medical education during the COVID-19 pandemic education during the COVID-19 pandemic. Med Teach [Internet]. 2020;42(7):756–61. Available from: https://doi.org/10.1080/0142159X.2020.1766669
• 20. Dong C, Lee DWC, Aw DCW. Tips for medical educators on how to conduct effective online teaching in times of social distancing. Proc Singapore Healthc. 2021;30(1):59–63.
• 21. Keegan DA, Bannister SL. More than moving online: Implications of the COVID-19 pandemic on curriculum development. Med Educ. 2021;55(1):101–3.
• 22. Gillis A, Krull LM. COVID-19 Remote Learning Transition in Spring 2020: Class Structures, Student Perceptions, and Inequality in College Courses. Teach Sociol. 2020;48(4):283–99.
• 23. Wilcha RJ. Effectiveness of virtual medical teaching during the COVID-19 crisis: Systematic review. JMIR Med Educ. 2020;6(2):1–16.
• 24. Chandratre S. Medical Students and COVID-19: Challenges and Supportive Strategies. J Med Educ Curric Dev. 2020;7:238212052093505.
• 25. Zis P, Artemiadis A, Bargiotas P, Nteveros A, Hadjigeorgiou GM. Medical studies during the COVID-19 pandemic: The impact of digital learning on medical students’ Burnout and mental health. Int J Environ Res Public Health. 2021;18(1):1–9.
• 26. Komer L. COVID-19 amongst the Pandemic of Medical Student Mental Health. Int J Med Students. 2020;8(1):56–7.
• 27. Arima M, Takamiya Y, Furuta A, Siriratsivawong K, Tsuchiya S, Izumi M. Factors associated with the mental health status of medical students during the COVID-19 pandemic: A cross-sectional study in Japan. BMJ Open. 2020;10(12):1–7.
• 28. Upadhyaya GK, Jain VK, Iyengar KP, Patralekh MK, Vaish A. Impact of COVID-19 on post-graduate orthopaedic training in Delhi-NCR. J Clin Orthop Trauma [Internet]. 2020;11:S687–95. Available from: https://doi.org/10.1016/j.jcot.2020.07.018
• 29. Edigin E, Eseaton PO, Shaka H, Ojemolon PE, Asemota IR, Akuna E. Impact of COVID-19 pandemic on medical postgraduate training in the United States. Med Educ Online. 2020;25(1).
• 30. Alvin MD, George E, Deng F, Warhadpande S, Lee SI. The Impact of COVID-19 on Radiology Trainees. Radiology. 2020;296(2):246–8.
• 31. Kulikowski K, Przytuła S, Sułkowski Ł. E-learning? Never again! On the unintended consequences of COVID-19 forced e-learning on academic teacher motivational job characteristics. High Educ Q. 2021;(February):1–16.
• 32. Minter DJ, Geha R, Manesh R, Dhaliwal G. The Future Comes Early for Medical Educators. J Gen Intern Med. 2021;36(5):1400–3.