The Renewal of Medical Education in the Era of the COVID 19 Pandemic

Professor John Sandars

The COVID 19 pandemic has seen unprecedented disruption in how we all live, learn and work; medical education has been no exception. 

The global impact has fallen mainly on clinical training, especially for medical students and junior doctors.  Traditional opportunities for clinical training, including general practice and hospital, initially became impossible due to the high workload of teachers since they were responding to the enormous demands created by a surging wave of seriously ill patients. Training via the ‘laying on of hands’ also became problematic.

Despite these initial challenges however, new and innovative approaches have been developed and implemented.  Medical students are now actively engaged in patient consultations through phone and video-links. Operations can be live-streamed to medical students and junior doctors and followed up by an associated online discussion with the surgeons.  Consultations and practical clinical skills can be practiced using the latest virtual reality techniques using personal headsets and mobile device apps.  

Medical students have also provided a vital contribution to healthcare, especially for raising awareness about the prevention of COVID-19 infection in the community and supporting the increasing number of testing and vaccination schemes. Through these activities, medical students have gained wide variety of skills that will be of great value for both their future personal and professional lives.

There are also increasing concerns about a global divide in medical education during the present uncertain times, particularly as many medical schools with low resources are also in some of the poorest countries of the world with the highest number of COVID-19 infections and other health challenges.

It is therefore essential that the initial creativity and innovation to medical education in response to the COVID-19 pandemic continues. Moreover, medical schools will need to continue sharing their expertise and innovations, particularly between schools with higher and lower resources.  Without practical help to implement some of the innovations, such as consultations by video or clinical training using virtual reality, future graduating medical students may not have the clinical knowledge and skills to ensure that they are adequately trained to work as junior doctors.

Rapidly conducting research and evaluation of the implementation of innovations, along with rapid dissemination, will also be essential to ensure that the important lessons learned can inform transfer and further refinement in other contexts, without a major time delay.  This is a challenge for current publishing opportunities, such as peer-reviewed journals. New free open access opportunities for widely disseminating research and evaluation related to medical education innovations in response to the COVID-19 pandemic will need to be developed.

Renewal of medical education has, and will continue to be a global challenge, in the wake of the COVID-19 pandemic. Now is the time to act to ensure that we have a skilled future global workforce of doctors.

Prof John Sandars is Professor of Medical Education at Edge Hill University.

He recently gave an Edge Talk on this topic at the Edge Hill Festival of Ideas. This can be viewed here.

Merseyside Health – why is it worse than elsewhere?

In 2014 the Margaret Westhead Inquiry Panel into Health Equity in the North of England delivered their report. The Due North Report revealed that the North of England suffers from significantly lower investment in public health and poorer health outcomes compared to other English regions.

Whilst the North of England is home to about 30% of the English population, the region contains around half of the poorest neighbourhoods in England. Liverpool, in particular, is a metropolitan area in the North of England that has some of the worst health outcomes, for adults as well as children.

On the 21st May 2018 we invited three experts in public health to a round table discussion with a public audience as part of the Festival of Ideas at Edge Hill University.  This public event was hosted by the Institute for Public Policy and Professional Practice (I4P), in association with PGMI and the Faculty of Health and Social Care.

Participants were Prof David Taylor-Robinson (Professor of Public Health and Policy at University of Liverpool), Susan Forster (Director of Public Health at St Helens Council) and Andrew Woods (Lead of the Statutory Accountability Service for Merseyside CCGs).

They each gave a presentation on the main challenges of public health for both adult and children populations in the Merseyside area and then elaborated on the difficulties the region faced in improving health care outcomes.

In a question and answer with the audience, several touchpoints of agreement emerged. The first one was that local authorities had taken a significant cut in public spending over the last decade which had impacted on population health and the capacity of public services to respond adequately to the needs of patients.

The second point of agreement was around the need for long term service planning to improve health, in particular the positive effects of investing in children’s health at an early stage. Last but not least, there was a consensus that the problems had to be tackled in partnership with all relevant organisations, with services collaborating to deliver effective and timely care to patients. As local authorities and the NHS are looking towards the next decade, new solutions to the persistent health problems of the region have to be found.

Watch the discussion event here: YouTube

Dr Axel Kaehne is Reader in Health Service Research and I4P Associate Director (Operations) here at Edge Hill University.