Published On May 20, 2021
IT IS NOW POSSIBLE TO IMAGINE a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic.
After all of the disruptions that the COVID-19 pandemic forced on traditional medical school and graduate medical education in the past year, can anything be gained? We now have a unique opportunity to transform medical education and ensure that we equip the next generation of physicians with the tools to fulfill the social compact of medicine.
In March 2020, the Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education both called a halt to in-person educational and clinical activities for medical students, residents and fellows. With a sense of urgency brought by the pandemic, educators rapidly deconstructed traditional models of medical education that required physical contact, replacing them with alternatives that could prepare trainees to graduate on time without compromising standards of education and care.
As challenging as it was, the necessity of this change led to many innovations. Residents and fellows benefited not only from observing local clinicians; they could also watch lecturers from across the nation via video-based platforms. Virtual chalkboards, which let remote users collaborate digitally, and other technologies provided a canvas for innovative, engaging ways of teaching. Asynchronous learning experiences meant lectures and presentations could be prerecorded, supplemented with other digital materials, and then viewed and responded to when it fit students’ schedules.
All of these changes came at the cost of social interaction and personal contact among teachers and learners. Yet much was gained, especially for digitally native trainees, who embraced the ability to make virtual visits to patients’ homes, network virtually with master clinicians and learn from “flipped classrooms,” an educational method in which students complete readings before class and work on problem-solving during class time. Centralizing resources reduced duplication of efforts. Tight timelines enabled educators to bypass burdensome bureaucratic processes.
During these uncertain times, medical education has remained robust and grounded in the values of compassion, professionalism and excellence in patient care. The pandemic has taught us to embrace change and to be agile and adaptable. We are finding ways to incorporate novel technology to meet the needs of learners and to engage in scholarly work that informs and enhances the delivery of care to all patients equitably and without barriers. Curricular changes that incorporate health care disparities and structural racism increase trainees’ awareness of these urgent problems that need rapid solutions. Lectures now incorporate clinical photos and findings representing racially diverse patients; highlight disparities in health care access, quality and outcomes by race or socioeconomic status; and show how current clinical decision tools, metrics and guidelines may perpetuate racism.
As we emerge from the COVID-19 pandemic, we must remain committed to the ongoing redesign of educational programs that benefit students and trainees while putting the patient in the center of these efforts. We must learn the lessons of this past year and move forward with the same flexibility, freedom and creativity that helped us adapt on the fly, yielding continuous quality improvement of medical education throughout the spectrum of training.
Jatin Vyas // Internal Medicine Residency Program Director at MGH. Alberto Puig // director of the Clinician Educator Service in the Department of Medicine at MGH
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