The COVID-19 pandemic has re-written the rules of the world; for many people, it has restricted them to their homes and replaced every in-person interaction. For some learners, such as the clerks, they have been removed from clinical environments and are in virtual clerkships. Other learners, especially residents, have continued their rotations with certain modifications. With the stress of the pandemic consuming most of our attention, how do teachers ensure we remain supportive faculty during this time?
In 2011, I was a medical student at the University of Alberta and I spent my third year in the town of Slave Lake. Near the end of my time there, a devastating fire broke out, destroying most of the town and changing the medical landscape forever. In 2013, a flood affected High River, another rural town. In conversations with clinicians and students affected by this, we realized that we needed a framework to assist teachers in times of crisis like this (1). Although the COVID-19 pandemic is very different from a high impact natural disaster, there are many lessons we can employ to protect our students and ensure they have preserved learning opportunities.
- Safety is paramount
We need to ensure we protect the safety of our students. This entails psychological safety (i.e. ensuring they feel adequately supervised) to physical safety (making sure they have personal protective equipment (PPE) and know how to use it). Learners are less likely to be familiar with hospital specific protocols and may have less experience donning & doffing PPE. They may, therefore, be at higher risk when taking care of sicker patients. We need to make sure we are constantly protecting them. Similarly, check in regularly with your students to see how their stress level is doing. Do they have avenues of support? Are you aware of local resources to help support learners (i.e. resident affairs, mentorship/advisor programs, etc.)? (2)
- Keep them in the loop
Sharing knowledge is essential as uncertainty creates anxiety and stress. Where possible, keep your learners in the loop about what is happening and be honest about parts you do not know. Everyone can appreciate that a lot is unknown at this time. Sharing whatever you can helps people feel in control. Don’t forget to remain human and share with learners your own fears, anxieties and what you’re doing to remain calm and present.
- Create a defined point person
Your department is likely getting busy, and everyone is taking on additional responsibilities. Ensure learners know who the point of contact is for communication so that they feel supported. Similarly, if you have a group of learners, have them appoint a leader so that you don’t feel overwhelmed repeating the same message. If you have learners of different levels create a buddy system so that they can look after each other. Clinical teaching unit leaders would be natural leaders in this case, but it may also be prudent to have a resident leader.
These suggestions will help your learners feel more connected and secure during their rotations. Having a strong plan will also reduce your stress and reinforce a community mindset. For more tips, check out the papers below:
1. Myhre D, Bajaj S, Fehr L, Kapusta M, Woodley K, Nagji A. Precepting at the time of a natural disaster. Clin Teach. 2017;14(2):104–7. https://doi.org/10.1111/tct.12523
2. MacPFD Team Site - InspT-Supporting-Healthcare-Students in Times of Crisis [Internet]. [cited 2020 Apr 11]. Available from: https://sites.google.com/view/macpfd-team-site/content-pillars/inspired-teaching/inspt-supporting-healthcare-students-in-times-of-crisis
3. Carter FA, Bell CJ, Ali AN, McKenzie J, Wilkinson TJ. The impact of major earthquakes on the psychological functioning of medical students: a Christchurch, New Zealand study. N Z Med J. 2014 Jul 18;127(1398):54–66. PMID: 25146861
4. Kent GG, Kunkler AJ. Medical student involvement in a major disaster. Med Educ. 1992 Mar;26(2):87–91. DOI: 10.1111/j.1365-2923.1992.tb00131.x
Alim Nagji (@alimnagji) is an ER staff at Joseph Brant Hospital (JBH) & St. Joseph Healthcare Hamilton. He is the Director of Emergency Medicine Clerkship for McMaster University and the Director of Simulation Learning and Clinical Teaching Unit for JBH. He has interests in medical education, simulation and global health. Send him your favourite meme on Twitter @alimnagji