What stance have organizations taken in response?

Organizations have tried to guide institutions and set new expectations. The Association of American Medical Colleges recommended that medical student clinical rotations be suspended for several weeks during the initial height of the pandemic (April 2020).⁷ The Accreditation Council for Graduate Medical Education has since released flexible guidelines in response to unpredictable workforce and clinical demands.^8,

The “DO”

How to balance medical student skills with clinical expectations?

Students may not be qualified or essential to our delivery of patient care but their future value as professionals cannot be underestimated: medical students are a precious resource and serve as the “doctors of tomorrow.”

Students may use their ingenuity to volunteer in other ways, but balancing the needs of clinical staff with the safety, learning, and wellness of students is imperative. Busy faculty must ethically attend to the needs of patients and satisfy patients above all else, often at the expense of learning and teaching opportunities. Additionally, students risk contracting illness and falling behind with other educational requirements. Students should be allowed to opt-out because of the current set of unique health circumstances.

Future Steps

An important goal of COVID-19 is learning how to educate amidst an unprecedented modern pandemic. Students are part of the knowledge translation process and may show up in the emergency department, provided there is sufficient PPE, in order to learn how to manage patients in the COVID era.

Safe learning is critical for students, although safety is not a guarantee. What if students are vectors for viral spread, or threats to themselves? What is the liability risk for programs? Society must continuously weigh the risk-benefit ratio of student learning amidst a rapidly evolving pandemic—a delicate balance that demands more data and consideration for all parties involved.

The ability of students to safely perform clinical work depends upon their knowledge, attitude, and skill set, especially pertaining to PPE donning and doffing. Emergency departments should prepare accordingly and further develop these areas to ultimately ensure student safety.

In conclusion, we submit that:

• KNOW: Medical students do not know how to use PPE properly
• CAN: Medical students can be taught how to use PPE properly.
• DO: Medical students do want to be part of the health care system’s effort to navigate and overcome this pandemic.

References

1. 1 Arandjelovic A, Arandjelovic K, Dwyer K, et al. COVID-19: considerations for medical education during a pandemic. MedEdPublish, 2020;9(1):87.
2. 2 John A, Tomas ME, Hari A, et al. Do medical students receive training in correct use of personal protective equipment? Med Educ Online. 2017;22(1):1264125.
3. 3 Christensen L, Rasmussen CS, Benfield T, et al. A randomized trial of instructor-led training versus video lesson in training health care providers in proper donning and doffing of personal protective equipment. Disaster Med Public Health Prep. 2020 Mar 30:1-15.
4. 4 Zach KM, Maloney LM, Praslick AD, et al. Medical student personal protective equipment training through simulated contamination. Med Sci Educ. 2016;26:517-518.
5. 5 Gallagher TH, Schleyer AM. “We signed up for this!” – student and trainee responses to the Covid-19 pandemic. N Engl J Med. 2020 Jun 18;382(25):e96.
6. 6 Klasen JM, Vithyapathy A, Zante B, et al. “The storm has arrived”: the impact of SARS-CoV-2 on medical students. Perspect Med Educ. 2020;9(3):181-185.
7. 7 Interim guidance for medical students’ participation in patient care during the coronavirus (COVID-19) outbreak. Association of American Medical Colleges website. Available at: https://www.aamc.org/news-insights/press-releases/updated-interim-guidance-medical-students-participation-patient-care-during-coronavirus-covid-19. Accessed Sept. 23, 2020.
8. 8 ACGME Reaffirms its four ongoing requirement priorities during COVID-19 pandemic. Accreditation Council for Graduate Medical Education Available at: https://acgme.org/Newsroom/Newsroom-Details/ArticleID/10188/ACGME-Reaffirms-its-Four-Ongoing-Requirement-Priorities-during-COVID-19-Pandemic. Accessed Sept. 23, 2020