The Schrödinger’s cat stage of the pandemic

What I’m about to describe is very much focused on the United Kingdom. However, readers in countries across the world who are not currently facing the same situation will quite possibly be doing so sometime soon if they haven’t already.

Currently, the United Kingdom finds itself in a position not dissimilar to Schrödinger’s cat [1]. At the time of writing, the British Broadcasting Corporation (BBC) tells us that one in 65 of our population is estimated to have coronavirus, which equates to approximately 1 million people. And the weekly death toll up to 27 May 2022 is running at 455 coronavirus-associated deaths [2], which means that more people are still dying from coronavirus every month than died because of road traffic accidents in any one year in the UK throughout 2011–2021 [3].

Yet, in a situation akin to Schrödinger’s cat which found itself simultaneously both dead and alive in Erwin Schrödinger’s well-known thought experiment [1], the UK is, therefore, still in the midst of the pandemic, whilst most people within the UK are thinking and behaving as though the pandemic is over.

Setting aside the obvious health concerns this raises, what are the implications of this duality for the education of healthcare professionals?

For me, the epicentre of this question is the effect this new normal is having on student–patient, student–educator and educator–educator interactions.

Patient consultations have become more variable and less predictable than ever. In any given environment, which sometimes includes the patient’s home in UK family medicine, mask wearing, for example, might be mandated, optional or no longer be seen at all as the general population seems to have little appetite for any ongoing virus-related restrictions.

Yet mask wearing is just one factor, add in the changes to patient triage, the increase in remote consulting, and the changes in onward passage of selected patients to secondary care, and it becomes apparent how much variability has been introduced into a previously relatively stable, reasonably homogenous primary healthcare system.

Inevitably, such variability has a consequential effect on, amongst other things, the full breadth of clinical skills development that normally takes place in the family medicine setting at a time when learners are already playing catch up as a result of the impact of the pandemic in previous years.

The intrusion of IT, even where it has brought local enhancements, has also altered the student–patient and student–educator dynamics, which again makes it harder to predictably implement clinical experience aspects of curricula in consistent ways for a large number of students.

In educator–educator interactions, we are also having to learn anew how to move forwards as, for example, conferences embrace the virtual space entirely or offer hybridised virtual and face-to-face events. Whilst the resultant reduction in travel is undoubtedly better for our planet, the sequential nature of online networking interactions requires more deliberate action and organisation, and lacks the serendipity and spontaneity of meeting new colleagues face to face.

It is important then that educators are mindful of the influence of the multiple pandemic-related changes, which are now present and still evolving in the learning environment, and the consequences of these for learning itself if our learners are going to flourish whilst pandemic-related uncertainty persists.