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 Table of Contents  
INVITED EDITORIAL
Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 3-4

Post-COVID-19: Looking back to move forward in health professions education


Department of Oral Pathology and Dean, Penang International Dental College, Penang, Malaysia

Date of Submission19-May-2022
Date of Decision20-May-2022
Date of Acceptance20-May-2022
Date of Web Publication23-Jun-2022

Correspondence Address:
Dr. Ajay Telang
Penang International Dental College, Penang
Malaysia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/amhs.amhs_114_22

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How to cite this article:
Telang A. Post-COVID-19: Looking back to move forward in health professions education. Arch Med Health Sci 2022;10:3-4

How to cite this URL:
Telang A. Post-COVID-19: Looking back to move forward in health professions education. Arch Med Health Sci [serial online] 2022 [cited 2022 Dec 7];10:3-4. Available from: https://www.amhsjournal.org/text.asp?2022/10/1/3/347950

Dealing with COVID-19 has been the most challenging public health crisis in recent times. Because the WHO declared it a pandemic in March 2020, over 514 million confirmed cases and more than six million deaths have been reported globally as of May 8, 2022.[1] As this emerging infection gripped the whole world, strict safety measures were introduced globally, and with this, many professions including the Health Professions Education (HPE) went through a difficult phase while finding ways to reduce its impact. The intriguing part though was that regardless of how the learning was delivered previously, rapid adjustments to maintain educational progress were made, and academic chaos and disruptions were evaded.[2] Thanks to the advancement in technology and connectivity, the impact of this disruption in HPE seemed manageable. As we crawl into the post-COVID-19 era, it is imperative that we reflect on the challenges, adaptations, and lessons learned along the way to prepare ourselves for a better future.


  Challenges Top


One of the greatest challenges faced due to the COVID-19–led disruption has been its economic impact. This has not spared HPE, with both public and private institutions experiencing far-reaching cascading effects at every level of the organization. The most evident effect however was the cancellation or indefinite postponement of elective procedures and shift of entire focus only on to critical care. Many nonemergency care service providers experienced a sharp decline in revenue leading to pay cuts, furloughing, and layoffs.[3] The decline in funding affected HPE faculty and students alike exacerbating mental health issues in addition to the challenges of increased cognitive load and work from home (WFH) challenges. In addition, educators were forced to rapidly shift their entire curricula online and get creative to maintain clinical engagement concurrently, while also coping with increased family responsibilities at home.

Moving forward from 2020 to 2021, the WFH balance got better as more organizations accepted the “new norm” of flexible work culture. However, mental health issues continued to rise leading to resignations as a result of exacerbated burnout due to the pandemic.[4] Overall, COVID-19 created a “syndemic” with synergistic interactions between socioecological factors and biological factors, resulting in adverse health outcomes.[5] Existing issues such as poor nutrition, ethnic inequalities, isolation, information overload about COVID-19, financial instability, inequality in access to health care, poor Internet connectivity, and reduced social interactions had led to poorer outcomes in HPE. Thus, the pandemic had exposed the vulnerabilities of global health care and HPE at the same time.


  Adaptations Top


Any new change always meets with resistance in HPE; be it a new curriculum, teaching method, assessment, or quality assurance. However, in the case of the COVID-19 pandemic, the rapid change was inevitable and came to be accepted due to the TINA (There is No Alternative) factor under the restriction imposed globally. The most significant adaptation phenomenon was the acceptance of online mode as a formal teaching and learning method including its acceptance for assessments of certain components in HPE. This acceptance of online flexible synchronous or asynchronous learning has provided students and faculty the much-needed catch-up time to focus on the face-to-face interaction for clinical teaching that was to follow later. A hybrid approach to continue delivery of HPE curricula serves to prevent overload and improves self-directed learning skills. As technology advancement in the Fourth Industrial Revolution (4IR) is happening all around us, harnessing digital technology, and improving 4IR skills promise to prepare HPE students for secure jobs in the future.[6]

The second most significant adaptation was the WFH culture. Virtually, unheard of in the prepandemic era within the HPE, the faculty could have never imagined that WFH would be a possible option in their profession. Although clinical training and face-to-face patient interactions cannot be replaced entirely, online learning delivered by faculty working from home can certainly be used for training in communication skills,[7] small group discussions, mentoring sessions, flipped classroom sessions, problem-based learning, case-based learning, online electives, telesimulation, telehealth, radiology image discussions, and pathology image repositories, live-streaming or prerecorded videos of lectures/surgical (medical/dental) procedures, adaptations of clinical visits, multidisciplinary team meetings, and ward rounds among many other methods to continue delivery of content and support the teaching and learning progress.[2],[8],[9]

The pandemic has blurred the line between work and home molding us all to be flexible. This adaptation has to come with leadership and governance being empathetic and agile. This approach only can bring down work-related stress and mental health concerns for clinicians, faculty, and students as well as improve engagement, retention, and positive outcomes in the time to come.


  Lessons Learned Top


Important lessons learned from the COVID-19 pandemic:

  • We have an opportunity to advocate redesigning of future workspace or learning spaces to ensure adequate cross air ventilation or adequate amount of air exchange ventilation. As it stands as the hallmark for transmission of infection, now that learning spaces return to full capacity
  • Hybrid/blended learning is an effective method of delivery of content and should be incorporated into all HPE curricula. This should also make us reflect on future designs of learning spaces where large lecture halls can be reduced in number to have smaller/smarter discussion rooms for better interactive learning
  • Flexible learning for students and WFH for faculty on a need basis will help build a culture of care, supplement coping strategies, and improve productivity and innovation in the time to come
  • To continue the learning journey of students during a crisis, educators need to think out of the box, while accreditors need to be pragmatic with the requirements. Together, we will need to come up with nontraditional ways to achieve the most important HPE outcome which is “to train component future graduates”
  • It is a fact that during the COVID-19 pandemic, health-care personnel across boundaries of medicine, dentistry, nursing, and other allied health care were deployed for various purposes including sample collection, testing, health promotion, and vaccination program delivery. This stresses the need for future HPE curriculums to incorporate interprofessional educational experience. A diverse learning exposure across science and engineering for HPE students and faculty will bring forth more collaboration, innovation, and respect for each other's work.


Compared to the rapid pace of scientific discovery, HPE has grown very little since the first educational model was proposed in 1765 by Benjamin Franklin.[5] HPE today is at a “turning point,” and the challenges and adaptations from our collective COVID-19 pandemic experience will lead to a transformation of the HPE system thus training health-care graduates with a diverse skill set in the future.



 
  References Top

1.
WHO. Weekly Epidemiological Update on COVID-19. Emergency Situational Update; 2022. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---11-may-2022. [Last accessed on 2022 May 15].  Back to cited text no. 1
    
2.
Grafton-Clarke C, Uraiby H, Gordon M, Clarke N, Rees E, Park S, et al. Pivot to online learning for adapting or continuing workplace-based clinical learning in medical education following the COVID-19 pandemic: A BEME systematic review: BEME Guide No. 70. Med Teach 2022;44:227-43.  Back to cited text no. 2
    
3.
Kaul V, de Moraes AG, Khateeb D, Greenstein GW, Jcnhsnqns D. Medical education during COVID-19 Pandemic. Chest 2021;159:1949-60.  Back to cited text no. 3
    
4.
Perna G. 'The Great Resignation' in Health Care: Five Solutions to the Problem. Health System Resilience; 2021. Available from: https://www.healthevolution.com/insider/the-great-resignation-in-health-care-five-solutions-to-the-problem/. [Last accessed on 2022 May 15].  Back to cited text no. 4
    
5.
National Academies of Sciences, Engineering and M 2021. In: Lessons Learned in Health Professions Education During the COVID-19 Pandemic, Part 1: Proceedings of a Workshop. Washington, DC: The National Academies Press; 2021.  Back to cited text no. 5
    
6.
Framing Malaysian Higher Education 4.0- Future Proof Taletnts. Putrajaya: Ministry of Higher Education Malaysia; 2018.  Back to cited text no. 6
    
7.
Wittenberg E, Goldsmith JV, Chen C, Prince-Paul M, Capper B. COVID 19-transformed nursing education and communication competency: Testing COMFORT educational resources. Nurse Educ Today 2021;107:105105. Epub 2021 Aug 19.  Back to cited text no. 7
    
8.
Mays KA. Coronavirus disease 2019 pandemic: An opportunity for transformation, innovation, and advocacy. J Dent Educ 2022;86:285-7.  Back to cited text no. 8
    
9.
Telang A. COVID-19drives innovation using free online resources. J Dent Educ 2021;85(Suppl 1):936-8:10.1002/jdd. 12421.  Back to cited text no. 9
    




 

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