Medical students' preference for returning to the clinical setting during the COVID-19 pandemic
Medical students' preference for returning to the clinical setting during the COVID-19 pandemic
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DOI：
10.1111/medu.14268
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发表时间：
2020-07-22
影响因子：
6
通讯作者：
Radha Krishna, Lalit Kumar
中科院分区：
文献类型：
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作者：
Compton, Scott;Sarraf-Yazdi, Shiva;Radha Krishna, Lalit Kumar
2019冠状病毒病（COVID-19）大流行导致医学生的临床教育普遍中断。在管理学生返回临床环境时，医学院面临着平衡教育、服务和风险考虑的挑战。使这一挑战更加复杂的是，医科学生可能不愿意在一个非常不确定的时期重新入学，从而在个人、机构和国家各级造成严重的下游后遗症。因此，了解学生对恢复临床经验的看法是一个重要的考虑因素。本研究旨在评估医学院学生在COVID-19大流行期间重新进入临床环境的偏好，并探讨与该偏好相关的个人和环境特征。方法我们对新加坡杜克国立大学医学院目前就读的医学生进行了一项电子调查，当时COVID-19大流行还不到一个月。调查项目与医学生返回临床环境的偏好相关的概念框架相一致。该框架由三个领域组成：（a）不可修改的人口统计信息;（B）被认为可以在医学教育过程中修改的因素，包括倦怠、对模糊性的容忍、动机和专业精神，以及（c）学生对自我的COVID-19感染风险的看法。结果约三分之一（n=63）的179名学生不愿意回到临床环境。多变量分析的结果表明，这一组相比，三分之二（n=116）的学生赞成返回表现出更大的自主（或内部）的动机，更大的专业责任感和自我感知窝藏风险病人的证据。结论学生对返回临床环境的偏好源于几个关键因素的相互作用，并与专业责任感和他们自己对医疗保健系统的潜在风险有实质性的关联。有意识地考虑和解决这些问题可能有助于医学院为学生返回临床环境做好准备。
Objectives The coronavirus disease 2019 (COVID-19) pandemic has led to widespread disruptions in the clinical education of medical students. In managing students' return to the clinical setting, medical schools face the challenge of balancing education, service and risk considerations. To compound this challenge, medical students may prefer not to re-enter during a period of great uncertainty, leading to substantive downstream sequelae on individual, institutional and national levels. Understanding students' views on resuming clinical experiences, therefore, is an important consideration. The purpose of this study was to assess medical students' preference for re-entering the clinical setting during the COVID-19 pandemic and to explore personal and environmental characteristics associated with that preference. Methods We conducted an electronic survey of currently enrolled medical students at the Duke-National University of Singapore Medical School, less than a month into the COVID-19 pandemic. Survey items were aligned with a conceptual framework related to medical students' preference for returning to the clinical setting. The framework consisted of three domains: (a) non-modifiable demographic information; (b) factors thought to be modifiable through the course of medical education, including burnout, tolerance for ambiguity, motivation and professionalism, and (c) students' perception of COVID-19 infection risk to self. Results Approximately one-third (n=63) of 179 students preferred not to return to the clinical setting. Results of a multivariable analysis indicated that compared to this group, the two-thirds (n=116) of students favouring return showed evidence of greater autonomous (or internal) motivation, a greater sense of professional responsibility and a lower self-perception of harbouring risk to patients. Conclusions Students' preference on returning to the clinical environment stems from the interplay of several key factors, and is substantively associated with perceptions of professional responsibility and their own potential risk to the health care system. Mindfully considering and addressing these issues may help medical schools in their preparation for returning students to the clinical setting.