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On May 8, 2020, Texila American University (TAU) had organized the second panel discussion on COVID-19 preparedness on the topic “Medical Education During COVID- 19.” The discussion was conducted on the TAU’s virtual platform that had seen attendance from students, staff, and the faculty.
This was the second panel discussion of the series planned by TAU’s COVID task force team.
- Dr. Navin Rambaran, Chairman of Medical Council of Guyana
- Dr. Dheeraj Bansal, Dean, College of Medicine, TAU
- Dr. Hugh Duckworth, Chief Academic Officer, TAU
The discussion started with Dr. Rambaran’s update on the current status of COVID-19 in Guyana. He announced that:
- Guyana has 82 positive cases with 10 deaths.
- Guyana has faced some technical issues in Coronavirus tests; however, this issue has been rectified, and hence, the country has seen the spike in cases.
- GPHC has been identified as the main hospital for treating critically ill patients infected with COVID-19 and required intensive care.
- Tests are being conducted on patients in the transition ward.
- Private labs have also been insisted on conducting the COVID-19 test.
- Guyana is looking to implement broad-based testing to test more samples and identify positive ones faster.
Dr. Rambaran also indicated that Guyana had commenced its preparations to have isolation wards and intensive units several weeks before the first case had been recorded. He further insisted that the country would require to enforce its team to conduct more testing and identify hotspots.
Dr. Dheeraj thanked Dr. Rambaran for a compressive update on the current situation in Guyana.
Dr. Navin indicated that they are using two types of testing to ensure the positive cases: (1) real-time PCR that checks RNA, which is of gold standard, and (2) rapid testing that checks for the antibodies.
Besides these updates, the team had discussed how we foresee medical education in the future.
A question had been raised to Dr. Hugh. On the view of basic science medical education, what kind of change do you see happening in the USA and now evolving worldwide?
Dr. Hugh answered that based on the webinar conducted by LCME, TAU is on par with all the schools in the USA with the commencement of its online classes.
Dr. Dheeraj indicated that technology would have a big part in medical education going forward. He gave a brief on steps taken by TAU in light of the present pandemic. He also stated that TAU had already moved all its classes to an online platform for MD 1 to MD 4. The major challenge will be on conducting the Mid-Term Examinations online.
Future Chances for Some Online Teaching That Will Continue
Dr. Rambaran stated that this is the stimulus of bringing classes online and electronic interfaces. He stated that this would allow us to move out of our comfort zones and adapt to a new normal.
Dr. Hugh said that these are very acute challenges we have to adapt. We are adhering to technology that is appearing on the scene slowly over the years in medical education. We have started adapting these changes and remote technologies.
These are very rough times for students and faculty to adapt to these new normal and use these remote tools to impact medical education positively.
Mr. Syam questioned Dr. Dheeraj on how he sees some of the medical schools handling lab sessions that is not possible online.
Many institutions are revisiting the number of lab sessions needed. Dr. Dheeraj stated that many schools are recording lab sessions and sharing the videos with students. The challenging part of this issue would be a real-time experience.
Dr. Rambaram said that one of the main limitations is the real-time experience that may be required to a certain extent where it cannot be done virtually. We may be faced with a situation where we have to maximize the use of virtual interfaces and plan more select sessions or practical attendance and interaction with models or patients. It is adaptable.
Dr. Hugh agreed to the general discussion on virtual learning and technology. The first answer for hands-on clinical training was the use of standardized patients. Dr. Hugh also stressed that we would see more and more use of standardized patients.
What Do We Do with Clinical Rotations?
Dr. Dheeraj exclaimed that clinical rotations rely solely on hands-on training. How do we address this challenge? What can be and cannot be done to keep students engaged?
Dr. Rambaran stated that the use of standardized patients for training, recognizing the limitations on hands-on, real-time experience, the transition of learning, and developing the skills may not be there. What we are doing in the interim is the use of online training with standardized patients. A virtual interface for clinical training can do done in a research setting with all the necessary checks and balances in place.
Dr. Hugh asked, “How do we fill in the gaps in the lockdown, and how do we adapt once hospitals reopened?” And said, “we will have to adapt to didactics and other types of virtual learning to fill in the gaps.”
Dr. Dheeraj also asked, “many hospitals are recording the rounds by residents. Is this something that can happen at GPHC?”
Dr. Rambaran said that the major issue would be maintaining patients’ confidentiality. Once the privacy and confidentiality of patients are assured, there will be no other legal hurdles or ramifications.
Plans are also there to do didactics classes upfront, which is accepted by all clinicians.
Dr. Dheeraj stated that the new normal for students restarting clinical rotations would have to be dressed in full PPE gears. Dr. Rambaran and Dr. Hugh echoed this sentiment. Students will have to be more careful and cautious and be in full PPE at all times.
A question had been raised. Can the Objective Structured Clinical Examination (OSCE), a clinical exit exam, be conducted online?
Dr. Dheeraj stated that this option is doable once we have a panel of doctors online following the same matrix we follow during face-to-face exams and requested Dr. Rambaran and Dr. Hugh to share their views. Dr. Rambaran also agreed that this is doable with the necessary safeguards in place. Students have to progress, and on the other hand, systems have to ensure that there is no compromise in quality treatment to patients.
Having said that, how do you fulfill these requirements? This is quite debatable. How do we safeguard the competency levels bear in mind that there is justice for the students, patients, and health system globally?
Dr. Rambaran stressed that globally, the majority of the schools had extended the timeline to conduct examinations and pushed back graduations. He stated that this is totally in the hands of the universities. Dr. Rambaran indicated that we should not comprise the competency of the graduates.
Dr. Hugh said, “before pandemic days, we would have never considered having OSCE online. We will defiantly have to discuss the way forward. We will try our best to train our students in the best competency level.”
Dr. Rambaram again stressed that all stakeholders would have to put their heads together to come up with a plan on the way forward.
Dr. Dhreeraj concluded by saying that we are all in this together as we have never faced a pandemic before, and we will be up to the challenges to make adjustments given the uncharted waters we are in at this moment. We are going to keep exploring without comprising the quality of education that every student deserves.
Dr. Dheeraj thanked panel members for taking the time to participate in the discussion.