Experiences of Faculty and Learners During the Rapid Conversion from In-Person to Interactive Video-Based Clinical Education During the COVID-19 Pandemic

Kristina Dzara, PhD, MMSc
Department of Brigham Education Institute
Division of Brigham Education Institute
Poster Overview

The COVID-19 pandemic rapidly disrupted medical education, necessitating an abrupt transition to interactive video-based clinical education. Taking into account change management processes, we studied this shift in clinical education at the Brigham and Women’s Hospital. In April and May of 2020 – about 8 weeks after the onset of COVID-19 – we interviewed 30 practicing physicians (teachers) as well as residents and medical students (learners) using Zoom with questions we developed. Using the interview data, we employed a well-known data analysis approach to review, organize, and understand their experiences. We identified six themes which show how they navigated the transition. First, they had to define necessary tasks. Second, they had to determine challenges and barriers. Third, they had to enable ways of efficiently changing existing educational processes. Fourth, they had to manage and adapt to change. Fifth, they had to identify and ensure meaningful educational outcomes of their efforts. Finally, they had to decide which educational initiatives would be worthwhile to maintain. Our findings indicate that while disruptively introduced, interactive video-based clinical education was largely successful, and positively received by both teachers and learners. They noted some increased educational value and anticipated keeping some educational initiatives after COVID- 19.

Scientific Abstract

Purpose: The COVID-19 pandemic rapidly disrupted medical education, necessitating an abrupt transition to interactive video-based clinical education. Applying a change management framework, we studied this shift to understand how an educational community adapts to maintain its clinical skills mission under such circumstances.

Methods: We performed a constructivist grounded theory investigation of the COVID-19 disruption to clinical skills learning at our academic medical center, using semi-structured interviews with teachers and learners throughout the medical training continuum. Interviews occurred from April – May 2020, approximately 8 weeks following disruptive change, via zoom utilizing a semi-structured guide. Data were analyzed following a thematic analysis coding process.

Results: 30 teachers and learners were recruited, representing the continuum of pre-clinical to clinical and undergraduate to graduate training. Six themes result: a) defining the task of conversion, b) determining challenges and barriers, c) identifying enablers to bring efficiency to change, d) managing change and adapting to the continual adaptation process, e) identifying tangible outcomes, and f) implementing sustainable educational initiatives.

Conclusions: While disruptively introduced, interactive video-based clinical education proved sustained and successful. These findings provide insight into an educational community’s adaptations, identifying barriers and facilitators while describing value-added propositions likely sustained into the future.

Clinical Implications
These findings will help clinician-educators impacted by disruptive change, as they move to effectively introduce and utilize interactive video-based clinical education to further their educational environment. They demonstrate barriers to expect, and facilitators to cultivate, likely to facilitate successful learning.
Research Areas
Authors
Kristina Dzara, PhD, MMSc; Martin Pusic, MD, PhD; Narath Carlile, MD, MPH, Dipl Clinical Informatics; Edward Krupat, PhD; Erik K. Alexander, MD
Principal Investigator
Erik K. Alexander, MD

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