SciELO - Scientific Electronic Library Online

vol.23 número2Neuronews Universal: el periódico online creado por estudiantes de la asignatura de neuropatología índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados




Links relacionados

  • En proceso de indezaciónCitado por Google
  • No hay articulos similaresSimilares en SciELO
  • En proceso de indezaciónSimilares en Google


FEM: Revista de la Fundación Educación Médica

versión On-line ISSN 2014-9840versión impresa ISSN 2014-9832

FEM (Ed. impresa) vol.23 no.2 Barcelona abr. 2020  Epub 04-Mayo-2020 


A new age for medical education after COVID-19

Manuel João Costa1  , Marco Carvalho-Filho2 

1Life and Health Sciences Research Institute; School of Health Sciences; Universidade do Minho; Braga, Portugal.

2Center for Education Development and Research in Health Professions, CEDARS; University Medical Center Groningen; Groningen, Países Bajos.

'The decisions people and governments take in the next few weeks will probably shape the world for years to come' (Yuval Noah Harari).

Medical education is not immune to the distresses of abrupt contemporary changes in our world like the COVID-19 pandemic. Unexpectedly and with a very short notice, people can no longer teach or learn next to other people. The impact on the heart of health professions educational processes is unprecedented.

Suddenly the status quo of undergraduate or graduate medical education was challenged, maybe for good. Yesterday's key concerns like the need to enhance learning at the patient physical bedside or of improving students experience at the physical clinical workplace, have a different meaning. While in some countries shadowing clinical teachers, observing how doctors care for patients within multidisciplinary teams in clinical environments was abandoned, in others, senior medical students were invited to collaborate in the frontline. 'Stay home!' if you are a citizen, 'be safe' if you are a health professional. How can medical education proceed ensuring that students develop into competent health professionals?

The immediate answer was the enhancement of remote learning experiences of medical students. Swiftly, online instruction rose sharply in virtually all universities with the technological conditions to do so. Distance education works when it comes to teaching and assessing the dimensions of medicine unrelated to human touch, such as scientific knowledge or clinical reasoning algorithms. Distance education was already, fortunately, well developed for academic learning.

In contrast, distance education is still rudimentary to support holistic professional learning. With clerkships being suspended at schools, medical educators need to be creative to offer meaningful alternatives. Although, virtual patients are not universally available and teaching clinical procedures online is not feasible yet, clinical teachers can take advantage of the changes we are witnessing in the healthcare to adapt to the COVID-19 crises. For instance, virtual consultations were considered a taboo for a long time, but, now, most of the elective consultations are moving to an online environment. Involving students in these activities is challenging but not impossible. Also, this crisis is an opportunity to support the identity development of medical students; an opportunity to discuss with students the social contract of medicine and derived responsibility. Small group identity discussions could be conducted online with clinical teachers, who could reflect on the values that feed the moral courage of doctors to become first responders and feel comfortable in the front line. Clinical teachers could elaborate on what doctors should expect from the society in return: adequate work conditions in the context of an equitable healthcare system. Crises are also opportunities to define our priorities and focus on them.

Still, COVID-19 might dictate that doctors become unavailable to teach as a consequence of intense clinical workload. The implications of such a prolonged situation are very worrisome. We might not be equipped with the tools to respond effectively. It is therefore important to plan ahead so that such impacts can be minimized in the future. Developments must facilitate effective students interaction with peers, patients, health professionals, within healthcare environments. Some key ingredients are at our disposal to do so. Multimedia including videos are already extensively used to support the development of clinical skills. Students are comfortable with technology-based solutions to support learning and assessment and with peer to peer communication tools. The pandemic circumstances have made many teachers comfortable with using online platforms to teach and meet students, as never before. We are now missing patients and the professional care environment. Extensive work is necessary to ensure privacy of participants, compliance with data protection regulations, quality, inclusiveness and equity, support for students and faculty, among other key issues. Those issues can be solved effectively by intra- and inter-institutional co-operation, preferentially at an international scale.

The COVID-19 emergency will, eventually, come to an end. By then, the whole medical education concept and system will have been reinvented, after having served as a live experiment. For the moment, it is clear that universities and health care institutions need to collaborate and potentiate new forms of distance professional education experiences. The COVID-19 will have made all more aware and keen to participate in this process.

Creative Commons License Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons