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      Designing and Implementing a Novel Virtual Rounds Curriculum for Medical Students' Internal Medicine Clerkship During the COVID-19 Pandemic

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          Abstract

          Introduction

          During the COVID-19 pandemic, third-year medical students were temporarily unable to participate in onsite clinical activities. We identified the curricular components of an internal medicine (IM) clerkship that would be compromised if students learned solely from online didactics, case studies, and simulations (i.e., prerounding, oral presentations, diagnostic reasoning, and medical management discussions). Using these guiding principles, we created a virtual rounds (VR) curriculum to provide IM clerkship students with clinical exposure during a virtual learning period.

          Methods

          Held three times a week for 2 weeks, VR consisted of three curricular components. First, clerkship students prerounded on an assigned hospitalized patient by remotely accessing the electronic health record and calling into hospital rounds. Second, each student prepared an oral presentation on their assigned patient. Third, using videoconferencing, students delivered these oral presentations to telemedicine VR small groups consisting of three to four students and three tele-instructors. Tele-instructors then provided feedback on oral presentations and taught clinical concepts. We assessed the effectiveness of VR by anonymously surveying students and tele-instructors.

          Results

          Twenty-nine students and 34 volunteer tele-instructors participated in VR over four blocks. A majority of students felt VR improved their prerounding abilities (86%), oral presentation abilities (93%), and clinical reasoning skills (62%). All students found small group to be useful.

          Discussion

          VR allowed students to practice rounding skills in a supportive team-based setting. The lessons learned from its implementation could facilitate education during future pandemics and could also supplement in-person clerkship education.

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          Most cited references20

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          The Impact of COVID-19 on Medical Education

          In the wake of the novel coronavirus (COVID-19) pandemic, it is abundantly clear to all the necessity of studying the pathology and widespread health consequences associated with the virus. However, what is much less clear is the impact of COVID-19 on medical education. Already, faculty and medical students are grappling with the changes that have been made and attempting to consolidate these with their plan of career development. Changes that may seem relatively minor in comparison to the global pandemic have the potential to be drastic turning points in the career progression of many. As not much is known regarding the long-lasting impact of COVID-19 on medical education, it is therefore also necessary to record and study the full impact of the changes being made. The path to entering a successful residency has been predictable for the last few years - do well on Step 1, give conference presentations, go the extra mile in clerkships and shadowing opportunities, and have meaningful non-academic extracurricular activities - all of which designed to best demonstrate a student's knowledge, persistence, collaborative spirit, and dedication to medicine. This trajectory has been changed with COVID-19 disrupting routines in hospitals, medical schools and beyond. The replacement of in-person classes with online equivalents is an obvious necessity at this time but creates a loss of collaborative experiences that has the potential to be a significant detriment to education. Likewise, the cancellation of clerkships, which are necessary for both skill acquisition as well as for relationship building, is a serious issue which students and medical schools must now resolve. Many medical students have also lost the opportunity for personal development through conference presentations. These presentations play a large role in distinguishing applicants during the residency application process, and therefore these lost opportunities have the potential to be a serious detriment to medical students’ career trajectory. While implementing technology to help resolve these issues is a unique way to help students to develop these skills, it is now necessary for medical students to demonstrate the same set of skills which they would have previously in a completely new and innovative manner. Persistence and adaptability during this time of challenge are attributes that medical students can demonstrate more readily. While every student has a personal story of how COVID-19 has impacted their education, there is no question that the impacts of COVID-19 will be felt on an extensive level. The panic in the community is palpable, and many are confused by how to proceed in the wake of COVID-19. This is no different for medical students and faculty and the questions that arise regarding medical education and their future careers.
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            Virtual Learning during the COVID-19 Pandemic: A Disruptive Technology in Graduate Medical Education

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              COVID-19 Implications on Clinical Clerkships and the Residency Application Process for Medical Students

              The coronavirus disease 2019 (COVID-19) pandemic has caused significant disruption to undergraduate medical education (UME). Although the immediate scheduling challenges are being addressed, there has been less discourse regarding how this pandemic will impact medical students in their preparation for and application to residency programs. While some historical disasters and pandemics provide a loose precedent for UME response during COVID-19, the impact of the current pandemic has surpassed any other events. COVID-19 will likely impact UME in the suspension of clinical rotations, alterations in grading, suspension or elimination of away rotations, changes in medical licensing exams, and ramifications on mental health. This review assesses governing medical bodies’ recommendations regarding UME during the COVID-19 pandemic and how this may impact preparation for residency. In particular, residency programs will likely have to create new guidelines for assessing applicants during this unique cycle.
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                Author and article information

                Journal
                MedEdPORTAL
                MedEdPORTAL
                mep
                MedEdPORTAL : the Journal of Teaching and Learning Resources
                Association of American Medical Colleges
                2374-8265
                2021
                2 March 2021
                : 17
                : 11106
                Affiliations
                [1 ] Medical Student, University of California, San Francisco, School of Medicine
                [2 ] Professor, Department of Medicine, and Director, Internal Medicine Clerkship, University of California, San Francisco, School of Medicine
                [3 ] Assistant Professor–Volunteer, Department of Medicine, University of California, San Francisco, School of Medicine
                [4 ] Associate Professor, Department of Medicine, University of California, San Francisco, School of Medicine
                [5 ] Assistant Professor, Department of Medicine, and Assistant Site Director, Internal Medicine Clerkship, University of California, San Francisco, School of Medicine
                Author notes
                Corresponding author: smrithi.sukumar@ 123456ucsf.edu
                Author information
                https://orcid.org/0000-0003-0356-4875
                Article
                11106
                10.15766/mep_2374-8265.11106
                7970635
                33768143
                84cc1bc1-ff55-408f-afcd-9b8f94eca256
                © 2021 Sukumar et al.

                This is an open-access publication distributed under the terms of the Creative Commons Attribution license.

                History
                : 29 July 2020
                : 24 November 2020
                Page count
                Tables: 4, References: 20, Pages: 9
                Categories
                Original Publication

                covid-19,distance learning,clinical medical education,clerkship,internal medicine,virtual rounds,telemedicine,chart review,clinical teaching/bedside teaching,hospital medicine,virtual learning

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