The Effects of COVID-19 on Teaching Practices in Medical Education

Main Article Content

H. Paul LeBlanc III, PhD

Abstract

Purpose: This study investigates the transition to online teaching modalities in U.S. medical schools as reported in publicly available datasets before and during the COVID-19 pandemic. The study examines the number and types of graduate medical education (GME) programs and their instructional methods that might be appropriate for continued online teaching modalities as compared to trends in higher education, and in particular, trends in health communication instruction, such as skills training in provider-patient and medical team consultations.


Materials & Method: Studies investigating or reporting trends in medical education were culled from PubMed, and additional studies regarding trends in higher education were culled from Web of Science and Communication Abstracts using search terms “COVID-19” and “education.” Publicly available data was collected from the Accreditation Council for Graduate Medical Education (ACGME) and Association of American Medical Colleges (AAMC) for years 2007-2021 (latest date available).


Results: Analysis of U.S. medical programs shows a clear trend toward modification of instructional methods to online modalities as a response to COVID-19 with some intent to continue utilizing these modalities post-COVID-19. Further analysis revealed a majority of utilized instructional methods which are adaptable to online teaching and learning, with certain instructional methods not easily adaptable comprising only 5.34% of the total. Growth in the number of graduate medical education programs and medical residents in the U.S. has steadily increased over the period, whereas the number of hours core medical faculty spend in teaching activities has decreased.


Discussion: Trends in medical education mirrored those in higher education in general during the period under investigation. Advances in instructional design can be applied to instructional methods used in medical programs. The greatest area of improvement gains could be attained in redesign of didactics.


Conclusions/Recommendations: Results indicate that medical schools were trending towards certain teaching methodologies which can be readily delivered in an online format prior to the COVID-19 pandemic. Given the development of new online teaching techniques resulting from the rapid transition to online teaching in 2020 throughout higher education institutions worldwide, it behooves medical societies and school to invest in research and development of online teaching methodologies for future-proofing of graduate medical education.

Keywords: COVID-19, graduate medical education, health communication

Article Details

How to Cite
LEBLANC III, H. Paul. The Effects of COVID-19 on Teaching Practices in Medical Education. Medical Research Archives, [S.l.], v. 10, n. 9, sep. 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3081>. Date accessed: 22 dec. 2024. doi: https://doi.org/10.18103/mra.v10i9.3081.
Section
Research Articles

References

1. Webb A, McQuaid RW, Webster CWR. Moving learning online and the COVID-19 pandemic: A university response. World Journal of Science Technology and Sustainable Development. 2021;18(1):1-19. doi:10.1108/wjstsd-11-2020-0090
2. Watermeyer R, Crick T, Knight C, Goodall J. COVID-19 and digital disruption in UK universities: Afflictions and affordances of emergency online migration. Higher Education. 2021;81(3):623-641. doi:10.1007/s10734-020-00561-y
3. Adedoyin OB, Soykan E. Covid-19 pandemic and online learning: The challenges and opportunities. Interactive Learning Environments. 2020;doi:10.1080/10494820.2020.1813180
4. Cheng X. Challenges of “School’s out, but class’s on” to school education: Practical exploration of Chinese schools during the COVID-19 pandemic. Science Insights Education Frontiers. 2020;5(2):501-516. doi:10.15354/sief.20.ar043
5. Aristeidou M, Cross S. Disrupted distance learning: the impact of Covid-19 on study habits of distance learning university students. Article. Open Learning. 2021;36(3):263-282. doi:10.1080/02680513.2021.1973400
6. Kinsky ES, Merle PF, Freberg K. Zooming through a Pandemic: An Examination of Marketable Skills Gained by University Students during the COVID-19 Crisis. Article. Howard Journal of Communications. 2021;32(5):507-529. doi:10.1080/10646175.2021.1965927
7. Raptis PR. Teaching Online During COVID-19: Lessons Learned About Creating Connection Through Trauma-Informed Teaching and Communicating Social Presence. Article. Ohio Communication Journal. 2022;60:180-186.
8. Kulikowski K, Przytula S, Sulkowski L. Emergency forced pandemic e-learning – feedback from students for HEI management. Article. Open Learning. 2021;36(3):245-262. doi:10.1080/02680513.2021.1942810
9. Vittorini P, Galassi A. From blended to online due to the COVID outbreak: the case study of a data science course. Article. Open Learning. 2021;36(3):212-230. doi:10.1080/02680513.2021.1973399
10. Trust T, Whalen J. Emergency remote teaching with technology during the COVID-19 pandemic: using the whole teacher lens to examine educator's experiences and insights. Article. Educational Media International. 2021;58(2):145-160. doi:10.1080/09523987.2021.1930479
11. Sturgis I, Lamb YR. Pivot! Teaching Communications Online During COVID-19. Article. Journalism & Mass Communication Educator. 2022;77(1):123-139. doi:10.1177/10776958211038152
12. Phillips RLJ, George BC, Holmboe ES, Bazemore AW, Westfall JM, Bitton A. Measuring graduate medical education outcomes to honor the social contract. Acad Med. 2022;97(5):643-648. doi:10.1097/acm.0000000000004592
13. Simons-Rudolf AP, Lilliott-González L, Ringwalt CL, Achoki T. COVID-19 and international efforts to reduce harmful drinking. Med Res Arch. 2022;10(5). doi:10.18103/mra.v10i5.2794
14. Abid K, Qureshi AL, Yasmin R. Continuum of medical education: Objectivity in instructional method, learning and assessment. J Pak Med Assoc. Apr 2010;60(4):262-264. Accessed June 21, 2022. https://www.jpma.org.pk/article-details/1994
15. Liras A. Computer-assisted instruction and scientific method in medical schools. Acad Med. Nov 1990;65(11):687. doi:10.1097/00001888-199011000-00008
16. Cook DA, Gelula MH, Dupras DM, Schwartz A. Instructional methods and cognitive and learning styles in web-based learning: Report of two randomised trials. Med Educ. Sep 2007;41(9):897-905. doi:10.1111/j.1365-2923.2007.02822.x
17. Gabard DL, Lowe DL, Chang JW. Current and future instructional methods and influencing factors in anatomy instruction in physical therapy and medical schools in the U.S. J Allied Health. Summer 2012;41(2):53-62. Accessed June 22, 2022. https://www.proquest.com/docview/1348257253/D976380CEC7742A9PQ/3?accountid=7122
18. Kao YS, Beeler MF, Strong JP. Comparison of the conventional lecture method and the self-instruction method for teaching clinical pathology. Am J Clin Pathol. Dec 1978;70(6):847-50. doi:10.1093/ajcp/70.6.847
19. Mason JL, Barkley SE, Kappelman MM, Carter DE, Beachy WV. Evaluation of a self-instructional method for improving doctor-patient communication. J Med Educ. Aug 1988;63(8):629-35. doi:10.1097/00001888-198808000-00007
20. Liu T-H, Sullivan AM. A story half told: a qualitative study of medical students’ self-directed learning in the clinical setting. BMC Med Educ. 2021/09/15 2021;21(1):494. doi:10.1186/s12909-021-02913-3
21. Mohd Saiboon I, Jaafar MJ, Ahmad NS, et al. Emergency skills learning on video (ESLOV): A single-blinded randomized control trial of teaching common emergency skills using self-instruction video (SIV) versus traditional face-to-face (FTF) methods. Med Teach. Mar 2014;36(3):245-50. doi:10.3109/0142159x.2013.857013
22. Peine A, Kabino K, Spreckelsen C. Self-directed learning can outperform direct instruction in the course of a modern German medical curriculum - results of a mixed methods trial. BMC Med Educ. Jun 3 2016;16:158. doi:10.1186/s12909-016-0679-0
23. Lee BR, Moore R. International telementoring: A feasible method of instruction. World J Urol. Sep 2000;18(4):296-8. doi:10.1007/s003450000136
24. Qayumi AK, Kurihara Y, Imai M, et al. Comparison of computer-assisted instruction (CAI) versus traditional textbook methods for training in abdominal examination (Japanese experience). Med Educ. Oct 2004;38(10):1080-8. doi:10.1111/j.1365-2929.2004.01957.x
25. Godfrey M, Rosser AA, Jung SA, Crandall M, Nathan M, Greenberg JA. Instructional methods of attendings as exhibited during intraoperative takeovers: A pilot study. Surgery. Aug 2021;170(2):446-453. doi:10.1016/j.surg.2021.02.022
26. Chojniak R, Carneiro DP, Moterani GS, et al. Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil. Radiol Bras. Jan-Feb 2017;50(1):32-37. doi:10.1590/0100-3984.2015.0223
27. Holden MS, Xia S, Lia H, et al. Machine learning methods for automated technical skills assessment with instructional feedback in ultrasound-guided interventions. Int J Comput Assist Radiol Surg. Nov 2019;14(11):1993-2003. doi:10.1007/s11548-019-01977-3
28. Roehr M, Wu T, Maykowski P, et al. The feasibility of virtual reality and student-led simulation training as methods of lumbar puncture instruction. Med Sci Educ. Feb 2021;31(1):117-124. doi:10.1007/s40670-020-01141-6
29. Kelly K. An opportunity for change in medical education amidst COVID-19: Perspective of a medical student. Journal of Pediatric Rehabilitation Medicine. 2020;13(3):345-347. doi:10.3233/prm-200733
30. Saoji MB, Ahirwar AK, Kaim K, Ahirwar P. Continuing medical education in Covid-19 pandemic. Hormone Molecular Biology and Clinical Investigation. 2022;doi:10.1515/hmbci-2021-0102
31. Dias MC. COVID-19 and psychiatric education: From postgraduate to continuous medical education. European Psychiatry. Apr 2021;64:S42-S42. doi:10.1192/j.eurpsy.2021.141
32. Hamamoto PT, Bicudo AM, Cecilio-Fernandes D. Preserving cornerstones of student's assessment in medical education during COVID-19. Frontiers in Psychology. Apr 2021;12591152. doi:10.3389/fpsyg.2021.591152
33. Sami M, Farrah N, Iqbal H. Medical students and COVID-19: final-year medical students' perspective. Postgraduate Medical Journal. Mar 2022;98(E2):E102-E102. doi:10.1136/postgradmedj-2021-140999
34. Ashiq K, Bajwa MA, Ashiq S. COVID-19 pandemic and its impact on pharmacy education. Turkish Journal of Pharmaceutical Sciences. Apr 2021;18(2):122-123. doi:10.4274/tjps.galenos.2020.39024
35. Murthy AK, Fontan CT, Trikantzopoulou MF, et al. Impact of the COVID-19 pandemic on otolaryngology resident rhinology education. International Forum of Allergy & Rhinology. 2021;doi:10.1002/alr.22956
36. Lavercombe M. Changes to clinical education during the COVID-19 pandemic: Challenges and opportunities. Respirology. Feb 2022;27(2):112-113. doi:10.1111/resp.14201
37. Gelineau-Morel R, Dilts J. Virtual education during COVID-19 and beyond. Pediatric Neurology. Jun 2021;119:1-2. doi:10.1016/j.pediatrneurol.2021.02.008
38. Mallineni SK, Nuvvula S, Goyal V, Seymen F. COVID-19 effect on education in pediatric dentistry. Frontiers in Pediatrics. Sep 2021;9666501. doi:10.3389/fped.2021.666501
39. Quaranto BR, Lamb M, Traversone J, et al. Development of an interactive remote basic surgical skills mini-curriculum for medical students during the COVID-19 pandemic. Surg Innov. 2021/04/01 2021;28(2):220-225. doi:10.1177/15533506211003548
40. Coe TM, Jogerst KM, Sell NM, et al. Practical techniques to adapt surgical resident education to the COVID-19 era. Annals of Surgery. Aug 2020;272(2):E139-E141. doi:10.1097/sla.0000000000003993
41. Haji FA. Simulation in neurosurgical education during the COVID-19 pandemic and beyond. Canadian Journal of Neurological Sciences. Mar 2021;48(2):152-154.
Pii s0317167120002346. doi:10.1017/cjn.2020.234
42. Watson A, McKinnon T, Prior SD, Richards L, Green CA. COVID-19: Time for a bold new strategy for medical education. Medical Education Online. Jan 2020;25(1)1764741. doi:10.1080/10872981.2020.1764741
43. Brotherton SE, Etzel SI. Graduate Medical Education, 2019-2020. JAMA. 2020;324(12):1230-1250. doi:10.1001/jama.2020.14635
44. Brotherton SE, Etzel SI. Graduate Medical Education, 2020-2021. JAMA. 2021;326(11):1088-1110. doi:10.1001/jama.2021.13501
45. Association of American Medical Colleges. LCME Annual Medical School Questionnaire Part II, 2019-2020 through 2020-2021: Changes implemented based on the COVID-19 pandemic. AAMC.org. n.d. Accessed June 8, 2022. https://www.aamc.org/data-reports/curriculum-reports/interactive-data/covid-19-pandemic-changes-curriculum.
46. Association of American Medical Colleges. LCME Annual Medical School Questionnaire Part II, 2012-2013 through 2013-2014 and 2017-2018 through 2019-2020: Teaching Formats by Topic in Required Courses/Clerkships. Accessed June 8, 2022. https://www.aamc.org/data-reports/curriculum-reports/interactive-data/teaching-formats-topic-required-courses/clerkships
47. Association of American Medical Colleges. AAMC Curriculum Inventory, 2012-2013 through 2019-2020: Use of instructional methods. AAMC.org. n.d. Accessed June 8, 2022. https://www.aamc.org/data-reports/curriculum-reports/interactive-data/instructional-methods-used-us-and-canadian-medical-schools.
48. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2010-2011. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2010-2011_acgme_data_resource_book.pdf
49. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2011-2012. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2011-2012_acgme_databook_document_final.pdf
50. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2012-2013. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2012-2013_acgme_databook_document_final.pdf
51. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2013-2014. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2013-2014_acgme_databook_document.pdf
52. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2014-2015. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2014-2015_acgme_databook_document.pdf
53. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2015-2016. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2015-2016_acgme_databook_document_locked.pdf
54. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2016-2017. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2016-2017_acgme_databook_document.pdf.
55. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2017-2018. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2017-2018_acgme_databook_document.pdf
56. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2018-2019. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2018-2019_acgme_databook_document.pdf
57. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2019-2020. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2019-2020_acgme_databook_document.pdf
58. Accreditation Council for Graduate Medical Education. Data resource book, academic year 2020-2021. ACGME.org. n.d. Accessed June 8, 2022. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2020-2021_acgme_databook_document.pdf
59. Chiasson RM, Henningsen MLM. Emergency remote instruction versus face-to-face instruction: precursors and outcomes of online teaching self-efficacy during COVID-19. Article. Communication Research Reports. 2022;39(3):171-180. doi:10.1080/08824096.2022.2076664
60. Kositanurit W, Vivatvakin S, Kaikaew K, et al. Asynchronous online lecture may not be an effective method in teaching cardiovascular physiology during the COVID-19 pandemic. BMC Medical Education. 2022/03/09 2022;22(1):162. doi:10.1186/s12909-022-03217-w
61. Guo PJ, Kim J, Rubin R. How video production affects student engagement: An empirical study of MOOC videos. Proceedings of the first ACM conference on Learning at Scale; 2014; Atlanta, Georgia, USA. doi:10.1145/2556325.2566239
62. Le K. Pre-recorded lectures, live online lectures, and student academic achievement. Sustainability. 2022;14(5):2910. doi:10.3390/su14052910\
63. Metz CJ, Metz MJ. The benefits of incorporating active learning into online, asynchronous coursework in dental physiology. Advances in Physiology Education. 2022;46(1):11-20. doi:10.1152/advan.00110.2021
64. Deslauriers L, McCarty LS, Miller K, Callaghan K, Kestin G. Measuring actual learning versus feeling of learning in response to being actively engaged in the classroom. Proceedings of the National Academy of Sciences of the United States of America. 2019;116(39):19251-19257. doi:10.1073/pnas.1821936116
65. Choe RC, Scuric Z, Eshkol E, et al. Student satisfaction and learning outcomes in asynchronous online lecture videos. CBE—Life Sciences Education. 2019;18(4):ar55. doi:10.1187/cbe.18-08-0171
66. Dodson S, Roll I, Fong M, Yoon D, Harandi NM, Fels S. An active viewing framework for video-based learning. Proceedings of the Fifth Annual ACM Conference on Learning at Scale; 2018; London, United Kingdom. doi:10.1145/3231644.3231682
67. Spertus E. Interactive asynchronous online computer architecture education. Proceedings of the ACM/IEEE Workshop on Computer Architecture Education; 17 June 2021; Valencia, Spain. doi:10.1109/WCAE53984.2021.9707150
68. Louten J, Daws LB. Interdisciplinary differences in hybrid courses: A study in biology & communication. The Internet and Higher Education. 2022;53:100847. doi:10.1016/j.iheduc.2022.100847
69. Johnson HA, Barrett LC. Your teaching strategy matters: How engagement impacts application in health information literacy instruction. Journal of the Medical Library Association. Jan 2017;105(1):44-48. doi:10.5195/jmla.2017.8
70. Faiz T, Kamel MK, Shebrain S, Ghanem M, Blebea J. Options of surgical curriculum structure and objects during COVID-19 pandemic. Surg Innov. Apr 2021;28(2):249-250. doi:10.1177/1553350620979825
71. Kirschner J. Transparency in Online Pedagogy: A Critical Analysis of Changing Modalities. Article. Journalism & Mass Communication Educator. 2021;76(4):439-447. doi:10.1177/10776958211022485
72. Morreale SP, Thorpe J, Westwick JN. Online teaching: Challenge or opportunity for communication education scholars? Communication Education. Jan 2021;70(1):117-119. doi:10.1080/03634523.2020.1811360
73. Pohl A, Klass LG, Kleinsorgen C, et al. Integration and potential of teaching communication skills in tree study of veterinary medicine in Germany. GMS Journal for Medical Education. 2021;38(3)Doc53. doi:10.3205/zma001449
74. LeBlanc HP. COVID-19 effects on Communication course and faculty evaluations. Journalism & Mass Communication Educator. 2021;76(4):469-476. doi:10.1177/10776958211034116
75. Billings-Gagliardi S, Barrett SV, Mazor KM. Interpreting course evaluation results: Insights from thinkaloud interviews with medical students. Med Educ. 2004;38(10):1061-1070. doi:10.1111/j.1365-2929.2004.01953.x