key: cord-291525-yjhgj438
authors: Nic Dhonncha, E.; Murphy, M.
title: Learning New Ways of Teaching and Assessment – The Impact of Covid‐19 on Undergraduate Dermatology Education
date: 2020-07-03
journal: Clin Exp Dermatol
DOI: 10.1111/ced.14364
sha: 
doc_id: 291525
cord_uid: yjhgj438

Covid‐19 has resulted in unprecedented global disruption. As this global pandemic persists with no end in sight, we must not ignore its impact on undergraduate medical education. Dermatology undergraduate exposure is variable, limited and often suboptimal. It has been shown that medical students and qualified doctors are not adequately confident in their ability to assess and manage skin conditions, and many feel that their undergraduate dermatology teaching was not satisfactory.

In March 2020, Irish Universities were closed and clinical rotations suspended. This presented us with an immediate need to adapt our teaching methods to limit the negative impact on undergraduate dermatology exposure. We report our experience of undergraduate dermatology teaching during this extraordinary time.

We adopted the platform Microsoft Teams to deliver online teaching to medical students.

This collaboration tool facilitated video lectures with active participation from students, real time discussion, and document sharing. Teaching sessions included didactic lectures, interactive tutorials, and student-led case and topic presentations.

Remote assessment is challenging, as all online assessments from home are essentially openbook. We sought to devise a rigorous tool to assess students' dermatology knowledge. We designed an online 30-question multiple-choice question examination using the online learning management platform, Canvas, with each question based on a clinical image. We felt that the use of clinical images would offset any potential benefit of additional information resources available to students in the home environment, and a maximum time of 30 minutes was allocated to complete the exam. Students were allowed to take the exam at any 30-minute period over a 24-hour window, in order to accommodate time differences for overseas students, who had returned home upon closure of the university.

Studies have demonstrated that university students have experienced increased symptoms of anxiety and depression due to the Covid-19 pandemic, which may in part be attributable to the effect on their studies. 1, 2 In an effort to alleviate anxiety related to their dermatology rotation, we allocated a specialist registrar in dermatology as a point of contact and encouraged students to reach out with any concerns related to their rotation.

On reflection, we successfully substituted scheduled in-person teaching and assessments with online alternatives, but didn't implement a suitable alternative to clinical patient interaction. As we slowly return to a new-normal with video-consultations, virtual clinics and a gradual increase in in-person consultations, we must consider how best to incorporate our dermatology students into this new clinical setting. Social distancing is likely to dictate our practice, with a significant impact and reduction in clinical rotations likely for the months and potentially years ahead.

In addition to our current teaching methods as outlined above, we will invite medical students to participate in our virtual weekly journal club, departmental clinical and multidisciplinary meetings, which are now established on Zoom. We plan to upload short videos on Canvas demonstrating surgical techniques and procedures. We also plan to develop dermatology podcasts for medical students. In order to protect the invaluable experience of patient encounters whilst facilitating the requisite social distancing, participation of medical students' in video consultations and virtual patient visits via online applications will also be explored.

While virtual learning cannot replace hands-on clinical experience and patient exposure, the unique circumstances of Covid-19 have promoted innovation in medical education. We must continue to develop alternative learning streams to the best of our ability to ensure adequate preparation of the next generation of doctors in an era where clinical rotations are likely to be limited for the foreseeable future.

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Accepted Article