Clinical support during COVID-19: An opportunity for service and learning? A cross-sectional survey of UK medical students

Abstract

Purpose

Medical students providing support to clinical teams during Covid-19 may have been an opportunity for service and learning. We aimed to understand why the reported educational impact has been mixed to inform future placements.

Methods

We conducted a cross-sectional survey of medical students at UK medical schools during the first Covid-19 ‘lockdown’ period in the UK (March–July 2020). Analysis was informed by the conceptual framework of service and learning.

Results

1245 medical students from 37 UK medical schools responded. 57% of respondents provided clinical support across a variety of roles and reported benefits including increased preparedness for foundation year one compared to those who did not (p < 0.0001). However, not every individual’s experience was equal. For some, roles complemented the curriculum and provided opportunities for clinical skill development, reflection, and meaningful contribution to the health service. For others, the relevance of their role to their education was limited; these roles typically focused on service provision, with few opportunities to develop.

Conclusion

The conceptual framework of service and learning can help explain why student experiences have been heterogeneous. We highlight how this conceptual framework can be used to inform clinical placements in the future, in particular the risks, benefits, and structures.

Practice points

• There was a benefit for most students who provided clinical support compared to those who did not during Covid-19.

• Most students found clinical support roles more beneficial than clinical placements and most final years wanted their final year clinical placements replaced by a formal role within a clinical team.

• Not every student’s experience of clinical support was equal. The conceptual framework of service and learning can help explain this heterogeneity.

• The most beneficial roles for students complemented the curriculum and provided opportunities for clinical skill development, reflective practice, and meaningful contribution to the health service.

• There is an added benefit of combining service and learning if done correctly, and we can use this to inform the structure of clinical placements going forwards. However, there are risks, and we discuss principles of good practice and provide our own considerations.

Keywords:

• Covid-19
• coronavirus
• SARS-CoV-2
• medical school
• medical education
• curriculum
• disaster medicine
• pandemic influenza
• service-learning
• volunteering
• interim-foundation year one
• FiY1
• preparedness for practice
• clinical placement

Acknowledgements

PubMed citable MedEd Collaborative authors can be found in supplemental Appendix A. We would like to thank the UK Medical Schools Council, the Royal Society of Medicine Student Members Group, IncisionUK, and the ADAPT Consortium for their support in developing this study.

Author contributions

The writing group (supplemental Appendix A) contributed to study conception, protocol development, data collection, data interpretation, and critical revision of the manuscript. The survey development group (supplemental Appendix A) contributed to protocol development, survey development, and critical revision. The Dissemination group (supplemental Appendix A) contributed to data collection and critical revision. All authors (supplemental Appendix A) have read and approved the manuscript. RA is the guarantor.

Ethical approval

Ethical approval for this study was obtained from the University of Oxford Medical Science Interdivisional Research Ethics Committee (Reference: R74003/RE001).

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Matthew H. V. Byrne

Matthew H. V. Byrne is an NIHR Academic Clinical Fellow in Urology at the Nuffield Department of Surgical Sciences, University of Oxford, UK.

Laith Alexander

Laith Alexander is an Academic Foundation Doctor at Guy’s and St Thomas’ Hospital London, UK.

Jonathan C. M. Wan

Jonathan C. M. Wan is an Academic Foundation Doctor at Guy’s and St Thomas’ Hospital London, UK.

Megan E. L. Brown

Megan E. L. Brown is a post-doctoral researcher in medical education at the Medical Education Innovation and Research Centre, Imperial College London, UK and Senior Lecturer in Medical Education at the University of Buckingham.

Anmol Arora

Mr Anmol Arora is a final year medical student at the University of Cambridge, UK.

Anna Harvey

Anna Harvey Bluemel is an Academic Foundation Doctor at The Cumberland Infirmary, UK.

James Ashcroft

James Ashcroft is an NIHR Academic Clinical Fellow in General Surgery at Cambridge University Hospitals Trust, UK.

Andrew D. Clelland

Andrew D. Clelland is an Academic Foundation Year two doctor at Cambridge University Hospitals Trust, UK.

Siena Hayes

Siena Hayes is an intercalating year medical student at Cardiff University School of Medicine, Cardiff University, UK

Florence Kinder

Florence Kinder is a 5th year medical at Leeds University, UK

Catherine Dominic

Catherine Dominic is a 4th year medical student at Barts and the London, UK.

Aqua Asif

Aqua Asif is a 5th year medical student at the University of Leicester, UK.

Jasper Mogg

Jasper Mogg is an Internal Medical Trainee at Oxford University Hospitals NHS Foundation Trust, UK.

Rosie Freer

Rosie Freer is a junior doctor at the Royal Free Hospital, London, UK.

Arjun Lakhani

Arjun Lakhani is a junior doctor at Chelsea and Westminster Hospital, London, UK.

Samuel Pace

Samuel Pace is a junior doctor at Newham University Hospital, London, UK.

Soham Bandyopadhyay

Soham Bandyopadhyay is an Academic Foundation Year two doctor at the Nuffield Department of Surgical Sciences, University of Oxford, UK.

Nicholas Schindler

Nicholas Schindler is a tutor at the Institute of Continuing Education at the University of Cambridge and a consultant paediatrician at Norfolk and Norwich University Hospitals Foundation Trust, UK.

Cecilia Brassett

Professor Cecilia Brassett is the Teaching Professor of Human Anatomy, Department of Physiology, Development and Neuroscience, University of Cambridge.

Bryan Burford

Bryan Burford is a Lecturer in Medical Education at Newcastle University, UK.

Gillian Vance

Professor Gillian Vance is Professor of Medical Education at Newcastle University, UK.

Rachel Allan

Rachel Allan is Deputy academic lead for undergraduate primary care teaching, MedEd Collaborative is a trainee and student led medical education research collaborative.