The COVID-19 pandemic is forcing medical schools to innovate to keep their third- and fourth-year students on track. Learn about the many ways medical schools are achieving their goals for clerkships even though students are unable to see patients in person.

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A recent AMA webinar, “Clinical Education and Return to Clerkships in the World of COVID-19: Principles, Alternative Models and Assessing Competence,” was produced by the AMA Accelerating Change in Medical Education initiative and features speakers from medical school leadership and the AMA’s senior medical education staff.

Getting back in touch with patients

With this pandemic causing removal of students from clinical sites, medical schools quickly developed curriculums for their clinical students,” said Brenda Roman, MD, associate dean for medical education at the Wright State University Boonshoft School of Medicine and president of the Alliance for Clinical Education. “Certainly COVID-19 electives are important at this time, and population health electives have also been popular options.”

Following are examples of clinically oriented online electives already underway.

A teaching hospital affiliate at the University of Minnesota Medical School created a database of about 1,400 patients at risk of SARS-CoV-2 infection. Each morning, the hospital system sends an email to every patient asking about symptoms, such as fever, cough and shortness of breath. Any patient who reports one or more of the symptoms then receives a call from a third- or fourth-year medical student. The student then takes a history and staffs the patient with the supervising resident.

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At the Boonshoft School of Medicine, the psychiatry clerkship director partnered with the chair of geriatrics to create an elective called “Psychiatric considerations of the older adult population,” in which students work through online modules on psychological first aid and behavioral activation. Each student is then paired with an isolated older adult in the community with whom they make weekly virtual social visits to ensure the patient has access to food, water, shelter and medications and is able to pay bills. Specific medical concerns are then referred to licensed health professionals.

Members of the Association of Professors of Gynecology and Obstetrics (APGO) at the University of Vermont Larner School of Medicine have developed a two-week elective using APGO’s medical student educational objectives and vast library of basic science videos. Students complete about six video cases per day in obstetrics and gynecology, sexuality, intimate partner violence and sexual assault, each requiring them to think critically and develop differential diagnoses. Assessment is done through APGO-developed quizzes.

The Larner School of Medicine has also developed an asynchronous, online two-week elective using the “Telemedicine: A Practical Guide for Incorporation into your Practice” module developed by the American College of Physicians. It features more than 40 short sessions focused on key aspects of telemedicine, which align with the Association of American Medical Colleges’ target telehealth competencies. It also includes a virtual journal club on telemedicine topics, and as well as training on virtual visits—followed by a remote simulated patient encounter.

Learn more about planning clerkships during COVID-19.

Dr. Roman also summarizes remote internal medicine rotations at Cleveland Clinic Lerner College of Medicine, virtual neurology patient rounds at Johns Hopkins School of Medicine and an online interviewing OSCE project created by the psychiatry clerkship director at University of Texas Medical Branch’s Galveston campus. Slides and an audio recording of the webinar are available in the “Resources” section of the AMA Accelerating Change in Medical Education digital community (registration required).

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Planning clerkships during COVID-19: Notes from the field

The AMA has developed a COVID-19 resource center as well as a physician’s guide to COVID-19 to give doctors a comprehensive place to find the latest resources and updates from the Centers for Disease Control and Prevention and the World Health Organization. The AMA has also curated a selection of resources to assist residents and medical students during the COVID-19 pandemic to help manage the shifting timelines, cancellations and adjustments to testing, rotations and other events.  

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