1. Knowledge & learning
1.1. What advantages did the E-Learning bring to the learning resources and conditions?
1.1.1. E-Learning seems to provide equality in education in some situations Overcrowded schools are an example for disparities in opportunities for access to educational resources in which E-Learning could be a solution to overcome those kinds of disparities
1.2. How do we usually learn the theory?
1.2.1. Classroom setting
1.2.2. Theoretical discussion during clinical sessions
1.2.3. Tutorials
1.2.4. Homework and personal reading
1.2.5. Wrap up sessions
2. Clinical skills & reasoning
2.1. What are clinical skills?
2.1.1. Physical examination
2.1.2. Interpretation of results
2.1.3. communication with patient
2.2. What are the issues now? What have we been doing around the world?
2.2.1. variability of outcomes
2.2.2. not very effective
2.2.3. we need more practice not moore knowledge
2.2.4. questionable quality of doctors
2.2.5. lack of feedback
2.2.6. evaluation is an issue
2.2.7. history taking is not the best (we cant take any right now)
2.2.8. virtual classrooms
2.2.9. online lectures and videos
2.2.10. training for volunteers
2.2.11. there isnt enough orientation on online problems
2.2.12. participation gets affected
2.3. How do we usually learn clinical reasoning?
2.3.1. bedside learning
2.3.2. case discussions
2.3.3. hands on training
2.4. What are the resources to learn clinical reasoning?
2.4.1. Online resources
2.4.1.1. InSimu
2.4.1.2. CyberPatient
2.4.1.3. Body interact
2.5. What are the resources to learn clinical skills?
2.5.1. Stanford 25
2.6. Can we learn clinical skills away from clinical practice?
2.6.1. some demonstrations
2.6.2. improve our skills during this time
2.6.3. demonstrations
2.6.4. simulations
2.6.5. added problems of ethics (too many students on one patient)
3. Patient-physician communication
3.1. What are the components of communication?
3.1.1. History taking
3.1.2. Patient physician communication
3.1.3. Verbal communication
3.1.4. Non-verbal communication
3.2. How do we usually learn patient-physician communication?
3.2.1. Simulated patients
3.2.2. Through courses
3.2.3. During residency
3.3. Can we learn patient-physician communication from a distance?
3.3.1. Resources
3.3.1.1. Online platforms
3.3.1.2. Books
3.3.1.3. Attending online consultations
3.3.2. What solutions are being used worldwide?
3.3.2.1. Online simulated patients
3.3.2.2. Book reading competition
3.3.2.3. Online clinical case study
4. Assessment
4.1. What are the components of assessment?
4.1.1. Assessing knowledge
4.1.2. Assessing practical skills & behaviours
4.1.3. Assessing clinical reasoning
4.1.4. Formative
4.1.4.1. E.g. continuous assessment after classes, helps you memorise and understand class materials
4.1.5. Summative
4.1.5.1. Actual assessment of the knowledge & skills that you acquired
4.2. What solutions are being used now?
4.2.1. Knowledge (theoretical exams)
4.2.1.1. Online exams
4.2.1.1.1. With or without a surveillance system to prevent cheating (e.g. Zoom)
4.2.1.1.2. Adding questions or shortening the time to prevent people from checking the answers
4.2.1.1.3. In some cases, was already done on a computer but in class -> exam simply done at home
4.2.1.1.4. Or formative assessment online, not included in the final grade -> final exams presential, respecting precautions
4.2.1.1.5. Open book exam: case-based exam, books are allowed but students need to find the answer with a limited time
4.2.2. Clinical skills & reasoning
4.2.2.1. Exams delayed until after the pandemic
4.2.2.2. Or added to next year's curriculum
4.2.2.3. Internships/rotations
4.2.2.3.1. Continued
4.2.2.3.2. Stopped temporarily, now resuming in COVID-free departments
4.2.2.4. (Teaching rather than assessment) Course materials provided but without face-to-face meetings
4.2.2.5. Open book exam: scenario-based cases, books are allowed but we need to find the answer with a limited time
4.3. What could be done better?
4.3.1. Clinical skills & reasoning could be assessed in different ways: online presentations of clinical cases -> students use their clinical reasoning to diagnose the disease. The best way to learn is to practice in a scenario
4.3.2. But even with open book and clinical reasoning assessment, you can chat with your friends
4.3.3. Participants' preference
4.3.3.1. Open books exams, because in the real clinical practice, you have resources (internet etc.). Also, doing clinical practice would help us remember => do open book exams based on clinical cases
4.3.3.2. But sometimes we won't have the opportunity to access internet, like if the patient is in front of us or in case of an emergency, there's some knowledge you should have -> there should be an in-between, not only assess the reasoning but also some amount of knowledge
4.3.4. About teamwork
4.3.4.1. Being assessed in a group could be interesting to evaluate the competence for teamwork, but everyone also needs to be competent on their own
4.3.4.2. You can prevent 1 person doing all the work if you're being supervised live, e.g a discussion, the evaluator can check if everyone is contributing
4.3.5. About teamwork
4.4. What are the resources?
4.4.1. Patient simulation apps: Body Interact, Insimu, Cyber patient
4.4.1.1. Online platforms for exams (variable from one university to another)
4.5. Assessment is a challenge. There is no current solution that would convince every party.
4.6. What would the best solution be currently, that would suit everyone?
4.6.1. Open book exams on an online platform could be a good solution right now, with a formative assessment beforehand
4.6.1.1. Should be a scenario-based exam so a book would help but not give you the answer straight away
4.6.1.2. We need to be careful because teachers tend to make the questions harder when we have access to resources, we need to make sure that they will make the questions clinically relevant, not just harder.
4.6.2. Not shortening the time and adding questions
4.6.3. About formative assessments
4.6.3.1. For a daily assessment: after every lecture, a quizz, 5-10 questions about the lecture which would help us summarise.
4.6.3.2. Chatboxes can be used so people can contribute, make contribution mandatory -> teachers can check the chatbox and see who's contributing and they can take it into account in the assessment
4.6.4. What about final medical exams for last year medical students who are graduating?
4.6.4.1. This is a big issue, because it's the final exam that says if you're competent enough to be responsible for a patient. These should be in person, they would have to schedule it on different days with less people and social distancing, they should be considered differently.
4.6.4.2. Some people are already starting to work and will be assessed later
4.6.4.3. In some cases, the final year medical students are already in the hospitals, they're being assessed on their sckills, they have their final exam in a clinical setting.
4.6.4.4. In the end, should the final exam matter that much? Even if someone is not competent and somehow managed to go through their years of medical school, professors will not block that person on 1 exam, they might have to take it again but they won't be more competent than the first time.