Int. Med. Educ., Volume 1, Issue 1 (September 2022) – 5 articles

In 2019, Showa University implemented a compulsory clinical English course for all 4th-year medical students that included a medical interview with an English-speaking standardized patient (ESSP), but since 2020 the interviews have been conducted online due to the novel coronavirus pandemic. These students reported difficulties with eye contact and reading body language/non-verbal cues of the ESSP. In this project report, we describe a telemedicine lecture that we included in the 2021 course and compare students’ reported difficulties during the online medical interview for two years. The 2021 cohort reported significantly less difficulties with eye contact than the 2020 cohort, and a similar trend was found for reading body language/nonverbal cues and creating rapport with the ESSP. While possible third variables, such as 2021 cohort’s greater comfort in using teleconference platforms, may limit the interpretation of these results, we conclude that Japanese medical students can clearly benefit from the inclusion of telemedicine education into the medical curriculum as online healthcare services become the “new normal” in Japan. Full article

Background: The COVID-19 pandemic caused medical education to shift unprecedentedly, leading medical schools to switch to virtual platforms and modify student-patient interactions. On top of educational changes, medical students adapted to their support network, finances, and mental and physical health changes. Objective: To understand the holistic impact of COVID-19 on medical students and medical education and identify how to distribute resources during future educational disruptions in a large medical university in the United States. Methods: An anonymous online survey was distributed to medical students at Sidney Kimmel Medical College, Philadelphia, in February 2021. Participants self-reported the impact of the COVID-19 pandemic on their medical education, family life, financial burden, mental health, and physical health. Results: 168 out of 1088 students at Sidney Kimmel Medical College completed the survey, with 58% (98/168) of the respondents identifying as female. The class breakdown was as follows: 38% (63/168) first years, 18% (31/168) second years, 21% (36/168) third years, 20% (34/168) fourth years, and 2% (4/168) were considered “other” (including research year, Master’s program). A total of 28% of respondents reported developing new mental illness, with second years having the highest incidence at 39%. In total, 42% said the pandemic affected a previous mental health condition. Further, 96% of third and fourth years reported COVID-19 affected their clinical rotations. In total, 68% of first years reported their entrance to medical school was severely affected. Moreover, 13% reported losing a family member due to COVID-19, and 7% reported personal sickness due to COVID-19. Additionally, 16% reported incurring a financial burden due to the pandemic. Conclusion: COVID-19 impacted the well-being of students by affecting their mental health and financial burdens. Clinical rotations and medical school entrance were the most problematic aspects. In the future setting of major educational disruptions, this study provides a starting point for where to focus resources, mental health support, financial support, and academic flexibility. Full article

Objectives: Demonstrate the feasibility and effectiveness of using the AirSim^® Bronchi airway simulator to teach anesthesia residents how to successfully troubleshoot and manage malpositioned double-lumen endotracheal tubes used for single-lung ventilation. Design: Prospective observational study. Setting: Simulation lab in a university-based anesthesiology residency training program. Participants: CA1 (PGY2) anesthesiology residents. Interventions: Each resident was initially tasked with troubleshooting a malpositioned double-lumen tube (DLT) on an AirSim^® Bronchi (Trucorp, Craigavon, UK) airway simulator in one of the three positions and was timed on their performance. This first simulation was followed by completion of a survey that assessed the resident’s level of confidence in repositioning a malpositioned DLT. Following the initial simulation, a didactic presentation was given to the residents on the management of malpositioned DLTs using a protocol, followed by a practice session. Two months later, each resident repeated the simulation exercise. A follow-up survey was conducted after each simulation, assessing the quality of the curriculum and subsequent level of confidence in performing the same tasks using a five-point Likert scale. Measurements and Main Results: Ten residents at the University of Mississippi Medical Center completed the simulation exercises and curriculum. The average time it took to troubleshoot the malpositioned DLT during the first simulation was 139 s, with only 30% of the residents correctly identifying the specific malposition and 40% correctly repositioning the DLT after initial malposition. The repeat simulation after two months showed significant improvement in efficiency, with the average time to complete the task decreasing from 139 s to 56 s. During the second simulation exercise, all 10 residents were able to correctly identify the DLT malposition and correctly reposition the DLT to the correct position. Additionally, residents’ confidence levels in managing a malpositioned DLT improved significantly. Initially, 70% of the residents reported a lack of confidence in identifying and correcting a malpositioned DLT, but after the didactic curriculum and simulation training, 100% of the residents reported confidence in completing the task. Conclusions: The AirSim^® Bronchi (Trucorp, Craigavon, UK) simulator can be used to effectively teach and evaluate residents on correctly identifying and repositioning a malpositioned DLT. The residents’ performance and level of confidence were evaluated before and after the simulation curriculum. The results reveal that simulation-based training is an effective educational tool for improving clinical performance and confidence in identifying and appropriately managing a malpositioned DLT. Full article