Abstract:

Background:
COVID-19 has had significant repercussions on current final year medical students at Imperial College London (ICL). A significant portion of their clinical placements in their penultimate year rescheduled to take place in their current final year, with current placements still being impacted. We sought to gather data on how students feel this has impacted their learning, particularly with regards to the clinical aspects of medicine, such as history taking and physical examinations.

Summary of Work:
A questionnaire covering perceived impact of COVID-19 including history taking and examination opportunities, safety concerns, obstacles, and impact on student motivation/wellbeing, was created. 30 students undertaking a virtual mock clinical examination responded. The results were analysed to identify trends and common themes. We also searched the literature to see if identified themes had been mirrored elsewhere.

Summary of Results:
Most students strongly agree that COVID-19 has impacted their history taking (80%) and examination opportunities (63%), with a significant correlation between the two (p<0.05). There was also a significant correlation between impact of COVID-19 on examination opportunities and confidence in eliciting signs on patients (p<0.005). PPE concerns were also significantly associated with opportunities to practice history/examination skills (p<0.005). Key themes surrounding obstacles to preparation for final examinations included lack of structure in placements, inability to practice clinical skills with friends due to lockdown, and lack of patient exposure. COVID-19 has also negatively impacted motivation/well-being and confidence, divided attention, and increased uncertainty and feelings of isolation.

Discussion and Conclusions:
As well as doctors in training, COVID-19 has negatively impacted clinical skill acquisition in current final year medical students at ICL. The fact that students who have had fewer opportunities to take histories also had fewer opportunities to examine patients dispels the idea that it is only examination skills which have been impacted.
Mitigation strategies to curb COVID-19’s impact on this cohort of medical students remain to be explored.

Take Home Messages:
Clinical skill acquisition in medical students have been adversely affected by COVID-19, which has also negatively impacted student motivation and wellbeing.

Keywords:

COVID-19, Medical Education, Finals, Examination, Isolation, Uncertainty, Medicine, Education, London.