An Emergency Medicine Virtual Clerkship: Made for COVID, Here to Stay.

Stephen Villa,Natasha Wheaton,Andrew Grock,Hannah Janeway,Jaime Jordan,Taylor James,James Murphy,Kian Preston-Suni,Ashley Vuong,Ignacio Calles

doi:10.5811/westjem.2021.11.54118

Abstract

IntroductionSafety concerns surrounding the coronavirus 2019 pandemic led to the prohibition of student rotations outside their home institutions. This resulted in emergency medicine (EM)-bound students having less specialty experience and exposure to outside programs and practice environments, and fewer opportunities to gain additional Standardized Letters of Evaluation, a cornerstone of the EM residency application. We filled this void by implementing a virtual clerkship.MethodsWe created a two-week virtual, fourth-year visiting clerkship focused on advanced medical knowledge topics, social determinants of health, professional development, and professional identity formation. Students completed asynchronous assignments and participated in small group-facilitated didactic sessions. We evaluated the virtual clerkship with pre- and post-medical knowledge tests and evaluative surveys.ResultsWe hosted 26 senior medical students over two administrations of the same two-week virtual clerkship. Students had a statistically significant improvement on the medical knowledge post-tests compared to pre-tests (71.7% [21.5/30] to 76.3% [22.9/30]). Students reported being exposed to social determinants of health concepts they had not previously been exposed to. Students appreciated the interactive nature of the sessions; networking with other students, residents, and faculty; introduction to novel content regarding social determinants of health; and exposure to future career opportunities. Screen time, technological issues, and mismatch between volume of content and time allotted were identified as potential challenges and areas for improvement.ConclusionWe demonstrate that a virtual EM visiting clerkship is feasible to implement, supports knowledge acquisition, and is perceived as valuable by participants. The benefits seen and challenges faced in the development and implementation of our clerkship can serve to inform future virtual clerkships, which we feel is a complement to traditional visiting clerkships even though in-person clerkships have been re-established.

Highlights

Safety concerns surrounding the coronavirus 2019 pandemic led to the prohibition of student rotations outside their home institutions
This resulted in emergency medicine (EM)bound students having less specialty experience and exposure to outside programs and practice environments, and fewer opportunities to gain additional Standardized Letters of Evaluation, a cornerstone of the EM residency application
We demonstrate that a virtual EM visiting clerkship is feasible to implement, supports knowledge acquisition, and is perceived as valuable by participants

Summary

Introduction

Safety concerns surrounding the coronavirus 2019 pandemic led to the prohibition of student rotations outside their home institutions. This resulted in emergency medicine (EM)bound students having less specialty experience and exposure to outside programs and practice environments, and fewer opportunities to gain additional Standardized Letters of Evaluation, a cornerstone of the EM residency application. We filled this void by implementing a virtual clerkship. Visiting clerkships provide Standardized Letters of Evaluation (SLOE) – crucial to the residency application – and allow for reciprocal exposure between the student and program.[6,7,8] In response to COVID-19 restrictions, many medical schools and residencies pivoted to online education and cancelled visiting rotations.[9,10] With the loss of in-person visiting clerkships, a novel virtual curriculum was urgently needed to fill this void

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