When medical students at Indiana University School of Medicine return to clinical rotations this summer, they’ll see a much different health care system amid the COVID-19 pandemic.
Hospitals have strict visitor policies. PPE is at a premium. Virtual visits are more common.
As frontline physicians and health care workers have had to quickly learn about best practices on treating the virus and keeping hospitals safe, Medical Student Education leaders at IU School of Medicine have had to also adjust how they’re training the next generation of doctors.
Pulling third- and fourth-year medical students out of clinical rotations in mid-March meant leaders were faced with a fast turnaround on revamping spring curriculum. Bradley Allen, MD, PhD, senior associate dean for medical student education, said the MD program needed new virtual courses to fill in the gap of rotations while still giving students an opportunity to build upon their skills.
At the top of the list for the program is a virtual COVID-19 course required for all IU School of Medicine third- and fourth-year learners—encompassing more than 700 students across all nine campuses.
Allen and Paul Ko, MD, associate dean for curricular development and oversight, said the course will likely be the largest in the United States. Few medical schools have implemented COVID-19-related coursework, but most universities offer it as an elective, they said.
The Association of American Medical Colleges also invited Allen and Ko to share their experiences in creating the course during a national webinar for medical schools. IU School of Medicine will join Harvard Medical School on the webinar to discuss their two courses.
“As health care professionals, how do we make ourselves aware of this new disease that’s out there, and how do we teach our students the skills to deal with times of uncertainty and a rapidly evolving disease state that we all need to learn about,” Allen said about the course’s inception.
The two-week course, which began on Wednesday, April 29, is divided into 15 different modules focusing on subjects, such as the science behind the disease, public policies, communication and social media, evidence-based medicine and leadership. Unlike most MD courses, it was the students that helped develop the course curriculum, with the review and guidance of faculty.
Students and faculty worked together over Zoom to develop the course curriculum.
Students will watch webinars with hundreds of their peers during the course, as well as view pre-recorded videos and have discussions on message boards and in small groups. Many of the webinars will feature panels of local and national health experts.
A group of 12 rising fourth-year medical students, and one third-year student, divided into teams to gather information for the modules, collecting and vetting data from nontraditional education sources, Ko said, such as podcasts, videos, articles, blogs and message boards.
“We didn’t tell the students this is what you need to learn,” Ko said. “We basically came up with the framework and then the 12 students went out and found a lot of up-to-date information.”
Megan Chiu and Gabe Gerena, fourth-year medical students, were part of a group of students who were already talking with faculty about potential curriculum changing in the midst of the pandemic. They wanted to act as liaisons between their classmates and faculty on next steps.
Chiu said while she and other students felt comfortable finding research articles and interviewing physicians about their expertise or experience with COVID-19, it’s reassuring the information will get vetted by clinicians and experts before being shared with 700-plus students.
“The curriculum is basically changing as we develop it,” Chiu said. “They’re also learning on the fly and applying all that information and clinical experience into those sessions.”
Rebekah Roll, also a fourth-year student, worked with her group of peers on an epidemiology module. They spoke with Aaron Carroll, MD, professor of pediatrics, who published opinion articles on the epidemiology of the disease in The New York Times and The Atlantic. The students also incorporated basic science research into the questions for the module.
The group of students who focused on the evidence-based medicine module knew much of the data surrounding COVID-19 would change throughout the course, said Christina Huang, a fourth-year medical student. So that’s why they reached out to physicians to join in on a panel to discuss best uses for social media and online journals to find the most up-to-date information.
One of the more unique modules is grand rounds. The students had to find a local COVID-19 case to adapt to the course. Mariel Luna Hinojosa, a fourth-year medical student, interviewed Sidney & Lois Eskenazi Health physicians about a COVID-19 case at the hospital. Through that, she came up with questions about the diagnosis, symptoms and how to manage the virus in a hospital setting.
“When I came up with the questions from scratch for the module, I had to start thinking more like a doctor and more like a faculty member to ask how to engage students,” Luna Hinojosa said. “So that was really challenging, but I think also has been really rewarding since I’m interested in academic medicine. It was a really great learning opportunity I wouldn’t have had in the first place.”
The MD program is also offering virtual courses on radiology, anesthesia as well as a new elective to prepare third-year students on reentry to clinics called KICC Start (Knowledge in Clinical Clerkships). Ko said the restructure of the curriculum, although laborious, has allowed education leaders to think differently and more creatively on how to engage students.
“The lessons learned from these last few months, I think, will change medical education both here at IU and across the country,” Ko said.
Allen added that the Association of American Medical Colleges has been advising medical schools to use technology more effectively in education, reaching students where they are and also preparing them for the way information is spread through technology in practicing medicine.
Maritza Gomez, a fourth-year medical student, said working with faculty professors, physicians and school deans gave them a different perspective on medical education. She hopes her fellow peers might also feel empowered to remain involved and provide feedback to future courses.
“Hopefully that encourages others to also participate in medical student education and hopefully have more academic medicine physicians,” Gomez said. “Knowledge is power.”
