The Executive Suite: Providing a Learning Environment for Medical Students During the COVID-19 Crisis

Most physicians who work in an academic or private practice setting teach medical students. If students who have been assigned to you for their clinical rotations have had limitations placed on their level of patient contact due to the coronavirus 2019 (COVID-19) pandemic, you are likely very concerned about their medical education. There are some approaches you can use to maximize your medically students’ learning—even during this unusual time.

Assign Critical Data Evaluation

Most of us have never experienced anything like the COVID-19 crisis ever before. The infection can alter the way patients in many specialties are cared for. Your students can work on finding the most accurate and reliable information available when it comes to the implications for patients that are cared for in your specialty.

Students can learn how to research updated information about local and worldwide statistics, the risks for your patient population, and preventative strategies. Even if your students aren’t allowed to have personal contact with your patients, they can become proficient in issues that weren’t ever considered prior to this crisis, like assessing information about patient immunity. And students will be able to use skills built through this process for the remainder of their medical careers.

It is impossible to predict which new challenges may emerge in the future and how these challenges will affect different patient populations. Guiding your students to critically evaluate data that is emerging in real time is valuable for their eventual independence as future physicians.

Promote Technology Proficiency

Students will soon walk into residency training with the expectation to use electronic medical records (EMR) for documentation, billing, and communication between different providers. And the doctors of tomorrow also have a high likelihood of incorporating telemedicine and remote patient monitoring into their practices.

While telemedicine certainly has its limitations, it can be a safe vehicle for students to observe patient care and decision making. Students can get valuable experience by understanding the utility of different methods used for patient care besides the traditional clinic visit and in-hospital modes of delivery. Medical students can learn to appreciate the ways that patients can benefit from discussing concerns like subtle changes in their symptoms or possible medication side effects.

And home monitoring devices that provide you with updates on your patients’ readings of blood glucose and heart rhythm may be taken into consideration when making medication adjustments without an in-person patient visit. The doctors of tomorrow will no doubt be using remote tools, and it is never too early for students to learn the utility and limits of virtual patient care.

Emphasize the Physical Examination

Telemedicine and social distancing always mean skipping parts of the patient physical examination. But there is a difference between eliminating steps out of necessity and rushing or cutting corners. When your student can’t be part of the physical examination process, they should still learn what the missing parts of the physical examination are and why these aspects of the physical exam are important.

Students need to hear which components of the physical examination would have been done if it were possible and what the different findings could be. They need to understand how information gained from the physical exam can change the patient care plan.

And while some medical schools may incorporate artificial mannequins for students to practice on, students need to be reminded that they will eventually have to guide real live patients through diagnostic tests that require touching or that might cause a small degree of pain. This is especially important given that when patients eventually return to more in-person care after the crisis is over, they might be skittish about the risks of physical contact for years to come.

Evaluate Diagnostic Tests Carefully

Diagnostic tests can carry more weight than usual when the risk of infection prevents patients from having these evaluations as often as would have otherwise been recommended. This means that medical decisions might be made with less information than in the past.

Students might not have the advantage of comparing changes in test results over time. So, each portion of a diagnostic test must be scrutinized carefully with an understanding that the results might have changed if the test could be easily repeated. And students may have more time to read official radiology reports and compare the reports to the original images, deepening their ability to interpret diagnostic tests.

Teaching is a challenge that most physicians welcome. But creating a valuable learning environment for medical students is especially challenging because the world differs so dramatically from when you were a “hands-on” student. It’s important to explore ways to maximize the experiences of medical students so they can face the challenges of the potentially different world that they will one day practice medicine in.