Bridging the preclinical-clinical divide in response to COVID-19.

Abstract

The COVID-19 pandemic posed unique challenges to educational institutions throughout the world, especially medical education programs. The usual demands of residency were heightened by increased patient volume and need for intensive care. Many hospitals, including Hackensack University Medical Center, enacted administrative changes including modifying staffing models to minimize disease exposure and remodeling hospital floors to increase the capacity of intensive care units. Many of these changes were enacted to allow for greater focus on patient care and social distancing, but they came at the expense of medical education, as traditional practices such as in-person lectures and participation in group clinical rounds were suspended to accommodate these changes. At a time when new information about SARS-CoV-2 and various treatment modalities was emerging rapidly, there was an urgent need for providing factual, relevant, concise educational materials to resident and attending physicians whose time was limited by the volume and urgency of COVID-19 patient care activities. This opened up an opportunity for students in our new medical school associated with the Hackensack Meridian Health network to provide this much needed informational resource. In March through June of 2020, first- and second-year students and medical science faculty at the Hackensack Meridian School of Medicine collaborated with resident and attending physicians at Hackensack University Medical Center via online web-conferencing. Each week, residents and attending physicians sent clinical questions to the medical school faculty that students would then research and convert into an educational presentation. The topics centered around actionable clinical queries. Students gathered relevant clinical studies and critically evaluated the methods, procedures, findings and conclusions of each report. Studies from hospitals and institutions around the world were emerging rapidly, most as preprints prior to peer-evaluation and often with a broad range of quality. Critical appraisal of data-gathering methods was essential to provide hospital staff with accurate information. Student presentations were supported by medical science faculty using standard evidence-based medicine methodology to ensure that a high-quality review had been conducted. After presentations concluded, residents and attendings posed further questions, reflected on what they were seeing clinically, and suggested new topics for discussion. This process allowed medical students to increase their skills in public speaking, critical appraising data and methodology, and presenting research in a concise, clear manner. These presentations also allowed frontline workers to receive up-to-date information in a setting of rapidly evolving knowledge of epidemiology, clinical presentation and disease management of COVID-19 patients. This innovative response to the pandemic provided a powerful opportunity to bridge medical education's preclinical-clinical divide. This example should serve as a prototype for sustained collaboration as different strains of SARS-CoV-2 emerge as a threat, as well as in post-pandemic times. This learning model can be applied to emerging diseases and is particularly useful for cutting-edge, novel research topics which significantly impact patient care.