When the Association of American Medical Colleges issued guidance on March 17 recommending that medical schools suspend all student activities involving direct patient contact due to safety concerns, many medical students were left wondering how they might continue to build their competencies and also contribute to the COVID-19 response. A webinar explores key criteria for volunteer opportunities and gives examples of how medical students across the country are taking initiative to help increase capacity at hard-hit medical centers.
The webinar, “Deploying students in alternative roles during COVID-19: Preserving clinical educational objectives and supporting competency development,” was produced by the AMA’s senior medical education staff and featured speakers from the AMA Accelerating Change in Medical Education initiative.
Creating value-added roles
“Currently we're in the throes of unprecedented change in medical education that many if not most of us have never seen,” said Jed Gonzalo, MD, associate dean of health systems education at Penn State College of Medicine. "And the change spans from the suspension of clinical activities to remote learning to rethinking content, and it's all happening in the context of tragedy.”
The key to understanding how to move forward, Dr. Gonzalo said, is unifying two conceptual frameworks: health systems science—the understanding of how care is delivered, how health professionals work together to deliver that care and how the health system can work improve patient care and health care delivery —and value-added medical education, or how building student competencies can align with system goals, such as improving health outcomes and decreasing costs.
Dr. Gonzalo and his colleagues have developed three key criteria for evaluating volunteer opportunities in the context of the COVID-19 pandemic: remote capability, alignment with system needs and educational value. They then developed a list of opportunities that met all three criteria, some of which Penn State medical students are already doing. These include contact tracing, on-demand virtual COVID-19 screening and telehealth visits and COVID-19 outpatient follow-up.
By focusing on projects that are aligned with health system needs, the medical education mission is uninterrupted, Dr. Gonzalo said, noting that all the projects that met the three criteria have been approved by Penn State for curricular credit through health systems electives.
Why innovate now?
“As a student, there are a lot of decisions that are outside of our control, and I think for many of us, it can feel at times like we are hanging in the balance,” said Catie Havemann, a third-year medical student at Vanderbilt University School of Medicine. “And so, by all indications it would seem maybe like this is the wrong time [to innovate]. Although it might seem paradoxical, I actually think that this is the perfect moment … it has to do with who we are.”
With guidance from Vanderbilt deans and the Liaison Committee on Medical Education on how to ensure patient and student safety, Havemann, along with more than 250 volunteers at Vanderbilt and hundreds of other students across the country have put together at least 10 volunteer opportunities, including staffing COVID-19 hotlines, creating educational materials for patients and communities in multiple languages and helping patients set up telehealth capabilities.
Meanwhile, students at the University of Michigan Medical School have put together numerous volunteer opportunities in both community outreach and clinical care support. These include running a personal protective equipment collection center, assembling COVID-19 test kits and making phone calls to geriatric patients to provide social support. Medical students also played a crucial role in helping to set up a new prenatal care telemedicine service aimed at keeping pregnant patients safe during the outbreak.
“One of the most rewarding parts of working with pregnant patients is confronting uncertainty,” said Susan Carlson, the medical student lead on the project. “This is not the pregnancy they could have ever imagined, but I think we have a responsibility to maintain the humanity that underlies our care.”
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).
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.