Educational and psychological support for medical students during the COVID‐19 outbreak

Abstract

Student support services have become central to the work of health professional education programmes as a strategy for optimising trainees’ emotional well-being, educational progress, personal development and employment prospects. In general, they aim at increasing adaptability and resilience, especially for at-risk students, such as those with learning difficulties or psychological concerns.1 The need for such services has become even more pronounced in the past year as COVID-19 propagates across the world, and medical students feel its substantial negative impacts, both physically and mentally. Hence, consideration of student health and the development and adoption of appropriate interventions to support learners’ educational journey are more critical now than ever.2 Consideration of student health and the development and adoption of appropriate interventions to support learners’ educational journey are more critical now than ever. Around the world, many medical schools have implemented a variety of policies that shutdown trainees’ education out of concern for exposure to the virus and reducing the number of individuals who could further transmit it.3 Ironically, the desire to protect students through such a policy has the capacity to harm them by boosting uncertainty regarding their capacity or willingness to participate in health care services as future physicians.4 Also ironic is that the face-to-face communication that would typically be deemed vital to supporting students through emotional conflicts and psychological troubles5 is itself what students were being encouraged to avoid. Alternative solutions such as using distance technology and social media platforms for consultation are needed to be generated quickly and required to rapidly become as productive as face-to-face interaction during this unexpected crisis. Alternative solutions such as using distance technology and social media platforms for consultation are needed to be generated quickly and required to rapidly become as productive as face-to-face interaction during this unexpected crisis. In the weeks and months that followed the World Health Organization (WHO) naming COVID-19 a pandemic, a variety of strategies for providing student support despite social distancing mandates began to emerge, many of which were highlighted in Medical Education's Adaptations series. To no one's surprise, technology quickly became a means through which to overcome interruptions to student support services: Social media platforms,6 video calls and text messaging supports,7 and novel e-learning curricula8 were all included in initial responses. Common in these reports, however, was a clear indication that a human element underlaid the successful use of each of these strategies. Senior medical students were recruited to support more junior colleagues with both psychological and educational issues. In doing so, peer mentoring appeared not only to address a practical need but also developed increased possibilities for senior students to improve their leadership capabilities and accelerate their own professional growth.6 Although online conversations and virtual mentoring required a learning curve for some, it was quickly found by many to be as efficient and convenient as traditional tutoring.7 As per usual, it was not the medium that enabled success, but the application of recognised educational practices such as coaches’ utilisation of adaptive learning (ie application of ‘Planning, Learning, Assessing, and Adjusting’ steps to guide learners’ educational development) that offered particular value. Training faculty members and academic coaches to provide educational and emotional support in this way offers the potential to boost academic achievements and improve students’ sense of security when asking for support.9 Training faculty members and academic coaches to provide educational and emotional support in this way offers the potential to boost academic achievements and improve students’ sense of security when asking for support. We can likely take for granted that medical students desire to make a contribution to their field and that they will, as a result, take advantage of useful learning resources, electronic or otherwise; we cannot lose sight of the fact, however, that personal connection is critical to providing a safe way in which they can gain support dealing with psychological issues such as stress, fear and anxiety that may arise from academic struggles or for other reasons. As we continue to move forward and adjust our practices more deliberately, enabling ongoing personal connectivity will be crucial for helping learners develop the strong professional identities they will need regardless of how long they may have been withdrawn from training or enmeshed in virtual reality.8 The conversion of existing student support into virtual platforms and online services appears achievable given commonly accessible web-based services and smartphone applications. However, universities and medical schools would do well to continue innovating to determine how these applications (or those that are developed in-house) can be implemented to take full advantage of their potential to help students and tutors/counsellors communicate about academic and emotional issues. In addition, we wonder how the need to move into a virtual world can be treated as an opportunity to enable advantages that extend beyond traditional support services. The conversion of existing student support into virtual platforms and online services appears achievable given commonly accessible web-based services and smartphone applications. For example, we would advocate initiating a global framework of discussion platforms such as a specialised cloud-based social media/website to enable medical students from all over the world to express their feelings and thoughts about their particular situation, helping one another to better understand their own experiences as well as broader educational objectives. For some things, a deep understanding of one's local context might be vital; for others, the opportunity to connect with peers, coaches and medical education experts from different schools might help create a greater sense of safety and freedom to seek the counselling one most needs. Policies will be required to determine how to utilise such virtual consultation services in truly supportive ways, and services may need to be classified in a manner that can steer students towards the support that is most relevant to their particular needs. Despite being just one possibility that possesses many challenges, we can be confident that students' familiarity with technological communication platforms will continue to grow in ways that enable access to supports that are geographically separate from their home institution, whether the home institution plays a role in setting those policies or not. We also anticipate declining resistance to using new technologies and increasingly user-friendly platforms that take appropriate consideration of participants' privacy, thus ensuring the security and confidentiality required if students are to share information and support providers are to gain their trust. With time, a more comprehensive array of webinars, virtual teaching rounds and simulated hospital wards will become more accessible as supplements to hands-on in-person learning. As these opportunities grow, financial and accessibility limitations of individual students should not be ignored because they have the opportunity to create the very strain that support services are meant to reduce. Technology will not be the determinant of students’ knowledge gain or well-being, but we need to continue to think about how it can be used for good without inducing harm, given that it opens so many opportunities for various types of support that may be difficult to secure in other ways. With time, a more comprehensive array of webinars, virtual teaching rounds and simulated hospital wards will become more accessible as supplements to hands-on in-person learning. The authors sincerely thank all authors of medical education adaptations and the editor in chief, Kevin W Ava. None. PT and MA designed the study and wrote the manuscript. They also read and approved the final article. This is a reflection on medical education adaptation.

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