When the COVID-19 pandemic hit the U.S., the attending uncertainty wreaked havoc on undergraduate and graduate medical education programs across the country. Almost overnight, medical schools removed students from clinical rotations and health systems redeployed residents. Meanwhile, the professional development of medical educators ground to a halt.
A scholarly perspective published in Academic Medicine summarizes lessons the AMA’s medical education leaders learned in 2020 and 2021 as they developed a new model to facilitate ongoing collaboration and respond to the needs of overwhelmed medical educators.
While the peak disruption of the COVID-19 pandemic has passed, these lessons continue to be applied and may serve as vital points of references when another pandemic hits.
There’s no replacing community
When the pandemic emerged, it threw the AMA Accelerating Change in Medical Education Consortium into a scramble. A predecessor to the AMA ChangeMedEd Initiative, the consortium was launched in 2013 and included 37 medical school members working to transform undergraduate medical education and 11 grant projects promoting systemic change in graduate medical education.
Leaders in the AMA’s medical education unit initially responded by canceling consortium events and reducing the workload of consortium activities in deference to the other demands on its members, “but it quickly became clear that the consortium needed additional strategies,” wrote the perspective’s authors, who include Kimberly Lomis, MD, vice president for undergraduate medical education innovations at the AMA.
“The constituents needed resources, support and community,” they wrote, adding that the top-line goal was to find new ways for stakeholders to remain connected in the absence of in-person events.
To facilitate ongoing collaboration, the team implemented a four-phase model that spanned assessing needs, mining experts, convening people and generating products, such as two virtual discussion series for consortium members. The first focused on crisis management. AMA staff designed the second series to help combat structural racism in undergraduate and graduate medical education.
AMA staff were also able to sustain the attention of partners to complete products initiated before the pandemic, including publishing a new instructor-directed textbook, Value-Added Roles for Medical Students, and the second edition of the Health Systems Science textbook. In fact, consortium members published more than 50 manuscripts detailing their innovations.
“Whether educators are pursuing innovation in the training of physicians or other health care professionals and whether in times of extreme stress or stability, the model provides a pathway for maintaining community,” the authors wrote.
3 things to focus on
“This model demonstrated the centrality of trusting relationships and cross-institutional collaboration that must be continually fostered to address future disruptions,” the authors noted.
For other medical education professionals looking to continue driving improvements in a hybrid in-person and virtual world, the authors offered these three key recommendations.
Embrace ambiguity and be flexible. “Tolerance for ambiguity is a critical skill for health care professionals, and the COVID-19 pandemic challenged even the nimblest,” the authors wrote. “In an uncertain situation, we provided certainty where possible but remained humble and flexible.”
The AMA looked for the best experts it could find among older and newer relationships and then convened these contacts to coproduce solutions.
“An important element of the model was a feedback cycle of following up with constituents to assess effectiveness and glean lessons,” they added. “Acknowledging that we were all learning together enabled agility as we experimented with numerous online collaboration tools.”
Effective virtual events must be designed differently from in-person events. Virtual events have the advantage of eliminating travel time, but they “should be shorter and more frequent than in-person events,” the authors wrote, adding that “conveners and attendees must master technical tools to promote engagement and interaction.”
Be intentional. “The model developed early in the pandemic guided our work,” the authors wrote. “It promoted agility in a rapidly evolving situation and maintained focus on urgent needs.”
To address future disruptions, medical educators must continually foster trusting relationships and cross-institutional collaboration.
“Although we do not know how successful the virtual interactions would have been in the absence of strong preexisting relationships,” they noted, “we know our efforts maintained the consortium at a time of crisis when in-person opportunities to connect were put on hold, projects were paused and participant bandwidth was limited.”
