key: cord-0860567-hyl9ev5l authors: Herrmann-Werner, Anne; Erschens, Rebecca; Zipfel, Stephan; Loda, Teresa title: Medical education in times of COVID-19: survey on teachers' perspectives from a German medical faculty date: 2021-06-15 journal: GMS J Med Educ DOI: 10.3205/zma001489 sha: 648aa546936d70484809ff0ec3ab74c2f2424fac doc_id: 860567 cord_uid: hyl9ev5l Background: Clinicians in their role as teachers and medical faculties were struggling to address the medical students’ needs regarding their medical education in times of COVID-19. They were especially confronted with several challenges regarding what medical training should look like and how to transfer medical training to integrate relevant skills like interpersonal or practical competencies. This study aimed to investigate the teachers’ perspectives on medical education and COVID-19 in general, including their distress level. Methods: This quantitative questionnaire study was distributed online among responsible lecturers of medical training at the Medical Faculty of Tuebingen. Teachers answered questions about the medical training, COVID-19 in general (on a seven point- Likert scale from “not at all” to “completely”) and their mental well-being (STAI). Descriptive data analysis and t-tests were performed. Results: The teachers reported being significantly (p<.01) more distressed regarding the medical training (M=4.63, SD=1.24) in comparison to their private lives (M=3.58, SD=1.38) or the clinical context (M=3.33, SD=1.95). They also felt significantly less informed about the medical training in times of COVID-19 (p<.001). They wished for more support and information from their medical faculty. When teachers were asked which teaching should be implemented in future, they reported the most the online lectures (87.5%), followed by collaborative working (75.5%), live broadcast (62.5%) and online chats (58.3%). Teachers also saw the current situation of COVID-19 as a chance for a digital transformation of the medical education (M=5.92, SD=0.95). Discussion: Teachers of the Medical Faculty of Tuebingen saw online-based teaching formats as a chance to meet the medical students’ needs regarding the medical education. Video-based formats like online lecturers and online chats with teachers might play a relevant role in order to impart knowledge. Furthermore, medical students should also be taught in digital formats like telehealth, including patient-physician distance interactions. The Coronavirus pandemic challenged medical education worldwide [1] . The start of the summer term 2020 was delayed at German medical faculties, and clinical clerkships and important exams were suddenly cancelled in order to minimise personal contact to mitigate the spread of COVID-19 [2] . The Association of American Medical Colleges even suggested in guidelines that medical schools should pause clinical rotations for medical students [https://www.aamc.org/]. Though the medical training was stopped at German medical faculties, medical students mobilised and were utilised to support the health care system in the combat against COVID-19 [3] , [https://www.bvmd. de/] . Regarding this support of medical students, physicians were especially challenged in their role as clinicians as well as teachers in times of COVID-19. Since keeping a distance is the current way to fight the pandemic of COVID-19, questions arose regarding what teaching could look like and how to ensure medical students' progress forward or graduation. The medical training had to be transferred into a digital format, though it has traditionally been structured as inperson learning [1] . Medical teachers needed to be innovative and creative to maintain the quality of medical training by combining technology-enhanced learning experiences with traditional ones [4] . Online video-conferencing platforms were used to implement lectures and small-group learning. However, Newman (2020) argued that these online teaching formats might comprise only a minor component of the previously existing curriculum before COVID-19 [5] . Sandhu & Wolf (2020) emphasised that the online formats need to be adapted to deliver teaching on clinical and practical skills that would have otherwise been developed during in-person courses. In the UK, final-year medical students were dramatically affected by COVID-19, as their medical training stopped, and there was discussion regarding whether they should fast-track through their studies independently if they felt able to take on this responsibility [1] , [6] . Core competencies for medical doctors, like communication or interpersonal skills, must be integrated into online teaching formats to ensure the development of empathic behaviour in patient-physician encounters [7] , [https:// www.acgme.org/Newsroom/Blog/Details/ArticleID/ 10281/ACGME-e-Communication-May-26-2020]. Previous literature focussing on COVID-19 and medical education offers a broad variety of suggestions when recommending digital teaching possibilities, e.g. implementing virtual reality settings [2] , [8] . In particular, they all agreed on the point that medical training needs a digital transformation in general and that single interventions won't be enough [1] , [9] , [10] . Therefore, the following questions arose regarding medical training in times of COVID-19: • What should medical training look like in times of COVID-19? • How to transfer classes -particularly teaching interpersonal and practical skills -best into online teaching? What did the medical training look like in its practical implementation in summer term 2020, and how did the teachers experience this challenge? This survey aimed to investigate the medical training, including stressors and expectations from the perspectives of teachers at one medical faculty in Germany during the 2020 summer term. Furthermore, we asked them for their mental well-being and their attitude concerning COVID-19. This survey presents a quantitative study that was performed at the Medical Faculty of Tuebingen. The assistant lecturers of this faculty were invited via email to participate in the online survey, which started in May 2020 and lasted four weeks. The survey was approved by the Ethics Committee of Tuebingen Medical Faculty (no. 314/2020BO2). Participation was voluntary, and the data acquisition was kept anonymous. All participants gave their written consent. Demographic data like age and gender were assessed. Furthermore, teachers were asked for their teaching experience and their qualifications. Teachers were asked about their current distress level in times of COVID-19 regarding issues of their private lives, clinical work and teaching. Furthermore, they rated their level of knowledge about COVID-19 in general, as well as in the medical and teaching contexts. All questions were rated on a seven-point Likert scale ranging from 1 ("not at all") to 7 ("completely"). Last, they reported if they had COVID-19, how much they were afraid of it and what they estimate as their risk of getting infected with COVID-19 (0% to 100%). Teachers rated their desired and expected course content for the summer semester 2020 as well as possible longterm changes in their medical education due to the cir-cumstances of the pandemic (i.e. multiple-option items). Furthermore, they ranked their expectations to students in this summer term. Using a seven-point Likert scale from 1 ("not at all") to 7 ("completely"), they rated how much the COVID-19 crisis presented a chance for a digital transformation in the medical faculties. In open questions, participants reported their stressors regarding medical education in the COVID-19 pandemic and what they expected from their medical faculty. They could also add comments regarding medical education in times of COVID-19. For measurement of mental well-being, the State-Trait Anxiety Inventory (STAI) [11] questionnaire was used to assess the teachers' distress levels, particularly, the "state anxiety" dimension was used to measure the degree to which they felt distressed, using a four-point scale, from 1 ("not at all") to 4 ("very much so"). They also rated their wish for recommendations on how to cope with distress, for relaxation techniques or psychotherapy. Additionally, they rated their ability to handle a crisis in general. These questions were rated on a seven-point Likert scale, ranging from 1 ("not at all") to 7 ("completely"). Data were normally distributed as tested by the Kolmogorov-Smirnov test. Descriptive data like mean values (M), standard deviations (SD), sum scores, frequencies and percentages of relevant factors were calculated. Missing data were replaced by mean. In order to compare the results, independent samples t-test and Pearson correlations were conducted. The level of significance was p<.05. IBM SPSS Statistics version 26 was used for data analysis. Twenty-four out of 42 teachers finished the survey (response rate=57.1% Teachers reported being distressed regarding issues in their private lives with 3.6 (SD=1.4) and clinical work with 3.3 (SD=2.0). However, they were significantly more distressed with 4.6 (SD=1.2) regarding medical education, (t(45)=-2.77, p<.01). Their wishes for psychotherapy and relaxation techniques were low with 2.0 (SD=1.1) for psychotherapy and 2.1 (SD=1.3) for relaxation techniques. Their wishes for recommendations on how to cope with distress were higher with 2.6 (SD=1.4), but this difference was not significant. When regarding their current level of information, they felt well informed about COVID-19 in general with 6.0 (SD=1.0) and in the clinical context with 5.9 (SD=1.0). However, they felt significantly less informed with 3.9 (SD=1.4) regarding the medical training in times of COVID-19 (t(41)=6.29, p<.001). Twenty-one (87.5%) reported not having been infected with COVID-19, and two participants (8.33%) did not provide any information. The fear of getting infected was 17.1%, and the participants estimated the probability of getting infected at 34.6%. Teachers reported the following stressors triggered by COVID-19: lack of information, lack of interaction with students, transfer to online teaching, double burden by combining clinical work and teaching, and home office without childcare. Teachers rated desired and expected content for the COVID-19 summer semester as well as possible long-term changes in medical education. Please see table 1 for results. Furthermore, they reported seeing the COVID-19 crisis as a chance for a digital transformation in medical training, with 5.9 (SD=1.4). They also expected the medical faculty to show more transparency, make clearer announcements and be more open in dialogue. They also wished for licences for rugged video-based conferences and for more support regarding the digitalisation. In addition, they ranked their expectations to the students. Please see figure 1 for more details. The current distress level of the teachers was high when regarding the STAI (cut-off >43), with 44.3 (SD=5.9). Simultaneously, they reported being able to handle the crisis, with 5.3 (SD=1.0). This survey aimed to assess teachers' perspectives on medical training and their current distress levels in times of COVID-19. With regard to the content of medical education during the COVID-19 pandemic, teachers ranked online lectures as highest, followed by collaborative working, live broadcast, and online chats. Teachers reported being significantly more distressed about medical education compared to issues in their private lives or clinical work. However, they generally reported being able to cope with the distress. Participating teachers reported being highly distressed regarding providing medical training, but felt less distressed in their private lives about COVID-19 in general. These high levels of distress represented a fact several authors have already addressed: teachers have needed to adapt their teaching formats in a very short period of time while simultaneously maintaining a high quality of medical training [2] , [5] , [8] . Thus, teachers were especially challenged. Additionally, they wished for more information on how COVID-19 might impact their medical training in the summer term. They expected faculty members to have more transparency on the topic. They also wished for more support in transferring their teaching to a digital format, mirroring the general notion of unpreparedness in use of modern technologies for teaching. Similar to other studies, the teachers in this study expected that traditional teaching formats like lectures would easily transfer into digital formats, like online lectures [1] , [8] , [9] , [12] . Moreover, they saw independent collaboration as an important method to impart knowledge in times where in-person contact was not possible [2] . Thus, teachers sought to implement online chats with their students to keep personal contact despite social distance. In general, the results showed that teachers considered the COVID-19 crisis as a potent opportunity for a digital transformation of medical training. Medical students also needed to be trained in telehealth, including technological aspects and professional models of physician-patient distance interactions [13] . Moreover, teachers might have to support medical students in finding their role in the medical community, as it will likely be challenging to evolve and integrate themselves due to missed clinical rotations and collaborative experiences in times of COVID-19 [2] . This optimistic attitude of teachers involved some expectations of medical students in order to successfully implement online teaching modules in the summer term. They expected medical students to be lenient and patient and to demonstrate that they are prepared for online medical education. Loda et al. (2020) also questioned students regarding their expectations of medical training under COVID-19 [14] . Similar to teachers, students felt less informed about their medical training in times of COVID-19 compared to private or general information. Additionally, they also felt stressed by their medical studies. However, they were also optimistic that their teachers will enhance their digital competencies during the pandemic. Moreover, teachers were challenged in their role as clinicians. They reported on the double burden of combining teaching with clinical work, which was very stressful for them. Future potential stressors were lack of information from the government and their bosses as well as working at home without childcare. Interestingly, teachers did not express a need for relaxation techniques or psychotherapy to manage their stress. This may be due to different concepts and understandings of terms. Based on the results, some implications may be gleaned. Medical faculties should strive to improve communication in a clear and transparent way so that teachers feel sufficiently informed. Furthermore, training on how to conduct online teaching courses should be offered to teachers. Such trainings would help teachers to learn how to use digital learning platforms or video conference systems as well as the various features (such as interactive whiteboards) that these tools have. Simultaneously, medical students should also be trained in order to establish clear communication with their teachers in online courses. Such training will very likely help teachers and students transfer their medical education into the digital world. Most online experiences in response to the COVID-19 pandemic are not sufficiently adaptable to medical school training and need to be improved for future online teaching [15] . We are aware that our results are limited as they represent teachers from only one medical facility, and the numbers of participants was limited to 24. However, we think that it might be of interest to explore how medical training could be implemented in times of COVID-19. With regard to data analysis, we need to consider that the mean imputation might lead to a bias of variance. However, the overall mean of missing values was estimated at 1.28%, which is very low. This survey aimed to assess teachers' perspectives on medical education during the COVID-19 pandemic. In line with previous literature, participating teachers saw a need for medical schools to continue classes, and new ways of teaching were developed through online-based learning platforms that facilitate online lecturers, live broadcasts, and online chats with students [1] , [5] , [8] . The results of this study present a practical implementation of various teaching formats in medical education in times of COVID-19. Furthermore, stressors, expectations, and the mental well-being of teachers in this unique situation due to COVID-19 were assessed showing an additional stressor with regards to teaching but generally a feeling of good situational coping. AHW and TL were responsible for the design and conduction the study, as well as acquisition, analysis and interpretation of data. AHW and TL drafted the first version of the manuscript. RE was involved in data analyses and interpretation and revised the manuscript critically. SZ made substantial contributions to the study design and revised the manuscript critically. All authors approved the final version of the manuscript and agreed to be accountable for all aspects of the work. Ethical approval for the study had been given by the Ethics Committee of Tuebingen's Medical Faculty. Students signed their consent to participate. The datasets used and/or analysed during this study are fully available without restriction. Die Studie wurde von der Ethik-Kommission der Medizinischen Fakultät Tübingen genehmigt (Nr. 314/2020BO2). Die Teilnahme war freiwillig und die Datenerhebung erfolgte anonymisiert. Alle Teilnehmer gaben ihre schriftliche Einwilligung. Es wurden demographische Daten wie Alter und Geschlecht erhoben. Darüber hinaus wurden die Dozierenden nach ihrer Lehrerfahrung und ihren Qualifikationen gefragt. Die Dozierenden wurden zum Maß der Belastung befragt, welche sie zu COVID-19-Zeiten im privaten Bereich, im klinischen Bereich und durch ihre Lehrtätigkeit empfanden. Ferner stuften sie ihren Wissensstand zu COVID-19 im Allgemeinen sowie im medizinischen und im Lernkontext ein. Alle Fragen wurden anhand einer siebenstufigen Likert-Skala mit Punkten von 1 ("überhaupt nicht") bis 7 ("sehr") eingestuft. Abschließend gaben die Dozenten an, ob sie bereits an COVID-19 erkrankt waren, wie groß ihre Angst war, daran zu erkranken und wie hoch sie ihr Risiko einschätzten, sich mit COVID-19 zu infizieren (0% bis 100%). Die Dozierenden gaben ihre gewünschten und erwarteten Kursinhalte im Sommersemester 2020 an, sowie mögliche langfristige Veränderungen in ihrer medizinischen Lehre, ausgelöst durch die Bedingungen während der Pandemie (Mehrfachoptionen). Darüber hinaus gaben sie ihre Erwartungen an ihre Studierenden in diesem Sommersemester an. Anhand einer siebenstufigen Likert-Skala von 1 ("stimme überhaupt nicht zu") bis 7 ("stimme voll und ganz zu"), stuften die Dozierenden ein, inwieweit die COVID-19-Krise eine Chance für eine digitale Transformation in den medizinischen Fakultäten darstellte. In offenen Fragen nannten die Teilnehmer ihre Stressfaktoren während der COVID-19-Pandemie und was sie sich von ihrer medizinischen Fakultät erhofften. Darüber hinaus konnten sie weitere Anmerkungen oder Kommentare zur Lehre in COVID-19-Zeiten notieren. Zur Bemessung des psychischen Wohlergehens wurde das Maß der Belastung der Dozierenden anhand des STAI-Fragebogens (State-Trait Anxiety Inventory) [11] bemessen, insbesondere des "Angstzustandes", um das Maß der gefühlten Belastung festzustellen. Die Einstufung erfolgte mithilfe einer vierstufigen Skala von 1 ("überhaupt nicht") bis 4 ("sehr"). Die Teilnehmer stuften auch ein, inwieweit sie sich Empfehlungen zum Umgang mit Stress, Entspannungstechniken oder Psychotherapie wünschten. Darüber hinaus stuften sie ihre Fähigkeiten ein, mit Krisen im Allgemeinen umzugehen. Diese Fragen wurden anhand einer siebenstufigen Likert-Skala mit Punkten von 1 ("überhaupt nicht") bis 7 ("sehr") eingestuft. Es Die Dozierenden stuften ihre Belastung im privaten Bereich mit 3,6 (SD=1,4) und im klinischen Bereich mit 3,3 (SD=2,0) ein. Mit einem Wert von 4,6 (SD=1,2) stuften sie ihre Belastung in ihrer Lehrtätigkeit jedoch signifikant höher ein, (t(45)=-2,77, p<0,01). Ihr Wunsch nach Psychotherapie und Entspannungstechniken war gering, mit einem Wert von 2,0 (SD=1,1) für die Psychotherapie und von 2,1 (SD=1,3) für Entspannungstechniken. Ihr Wunsch nach Empfehlungen für den Umgang mit Stress war mit 2,6 (SD=1,4) größer, dieser Unterschied war jedoch nicht signifikant. In Bezug auf ihren aktuellen Wissensstand fühlten sie sich gut informiert über COVID-19 allgemein mit einem Wert von 6,0 (SD=1,0) und im klinischen Kontext mit einem Wert von 5, 9 (SD=10) . In Bezug auf ihre Lehrtätigkeit unter COVID-19 fühlten sie sich jedoch mit einem Wert von 3, 9 (SD=1, 4) Die Dozierenden gaben ihre gewünschten und erwarteten Kursinhalte für das COVID-19-Sommersemester 2020 an, sowie mögliche langfristige Veränderungen in ihrer medizinischen Lehre. Die Ergebnisse sind Tabelle 1 zu entnehmen. Darüber hinaus gaben sie mit einem Wert von 5,9 (SD=1,4) an, die COVID-19-Krise als Chance für eine digitale Transformation der medizinischen Ausbildung zu sehen. Ferner wünschten sie sich von der medizinischen Fakultät mehr Transparenz, klarere Ansagen und einen offeneren Dialog. Zudem wünschten sie sich Lizenzen für stabile Videokonferenzen und mehr Unterstützung bei der Digitalisierung. Darüber hinaus gaben sie ihre Erwartungen an die Studierenden an. Abbildung 1 enthält dazu nähere Einzelheiten. In der STAI-Bemessung (Cut-off-Wert >43) war das aktuelle Maß der Belastung der Dozierenden mit einem Wert von 44,3 (SD=5, 9) hoch. Gleichzeitig gaben sie mit einem Wert von 5,3 (SD=1,0) an, mit der Krise umgehen zu können. Diese Befragung hatte zum Ziel, die Sichtweisen der Dozierenden hinsichtlich der medizinischen Ausbildung und des Stresslevels in Zeiten von COVID-19 zu untersuchen. Auf die Frage, was die Lehre in Zeiten von Covid-19 beinhalten sollte, lagen Online-Vorlesungen an vorderster Stelle, gefolgt von kollaborativem Arbeiten, der Live-Übertragung von Lehrinhalten und Online-Chats. Die Dozierenden gaben an, dass sie sich durch ihre medizinische Lehrtätigkeit signifikant mehr belastet fühlten als durch Probleme in ihrem Privatleben oder bei ihrer klinischen Tätigkeit. Allerdings gaben sie generell an, mit der Belastung umgehen zu können. Die Teilnehmer gaben an, von ihrer medizinischen Lehraufgabe sehr gestresst zu sein, in ihrem Privatleben hingegen fühlten sie sich durch COVID-19 allgemein weniger gestresst. Dieses hohe Maß an Belastung spiegelte eine Tatsache wider, der sich bereits einige Autoren gewidmet haben: Dozierende mussten ihre Lehrformate innerhalb sehr kurzer Zeit anpassen und dabei gleichzeitig eine hohe Qualität der medizinischen Ausbildung aufrechterhalten [2] , [5] , [8] Wir sind uns darüber bewusst, dass unsere Ergebnisse begrenzt sind, da sie Dozierende nur einer medizinischen Fakultät repräsentieren und sich die Anzahl der Teilnehmer auf 24 beschränkte. Dennoch denken wir, dass es von Interesse sein könnte zu untersuchen, wie die medizinische Ausbildung in Zeiten von COVID-19 implementiert werden könnte. Bei der Datenanalyse ist zu berücksichtigen, dass die Zurechnung des Mittelwertes zu Verzerrung/Varianz führen kann. Der Gesamt-Mittelwert der fehlenden Daten wurde jedoch mit 1,28% beziffert, was sehr niedrig ist. Diese Befragung hatte zum Ziel, Perspektiven von Dozierenden hinsichtlich der medizinischen Ausbildung zu Zeiten der COVID-19-Pandemie zu untersuchen. Übereinstimmend mit der bereits bestehenden Literatur sahen die teilnehmenden Dozierenden die Notwendigkeit, weiterhin in der ärztlichen Ausbildung Lehrveranstaltungen durchzuführen und es wurden neue Wege des Lehrens über Online-Lernplattformen entwickelt, welche Online-Vorlesungen, Live-Übertragungen und Online-Chats mit Studierenden ermöglichten [1] , [5] , [8] . Die Ergebnisse dieser Studie zeigten praktische Implementierungen verschiedener Lehrformen in der medizinischen Ausbildung in COVID-19-Zeiten auf. Ferner wurden Stressfaktoren, Erwartungen und das psychische Wohlergehen der Dozierenden in dieser nie da gewesenen, durch COVID-19 bedingten Situation untersucht, wobei zusätzlicher Stress durch die Lehrtätigkeit festgestellt wurde, welcher jedoch im Allgemeinen mit dem Gefühl einherging, die Situation gut bewältigen zu können. COVID-19 and medical education The Impact of COVID-19 on Medical Education Medical Student Mobilization During a Crisis: Lessons From a COVID-19 Medical Student Response Team Pandemics and Their Impact on Medical Training: Lessons From Singapore Coalition for medical education-A call to action: A proposition to adapt clinical medical education to meet the needs of students and other healthcare learners during COVID-19 Covid-19: medical schools are urged to fast-track final year students General Medical Council -Outcomes for Graduates. London: General Medical Council Medical Education Amid the COVID-19 Pandemic Twelve tips for rapidly migrating to online learning during the COVID-19 pandemic Transformation to learning from a distance The Spielberger statetrait anxiety inventory (STAI): the state scale in detecting mental disorders in geriatric patients Our Education, Our Concerns: Medical Student Education Impact due to COVID-19 COVID-19: Challenges and Opportunities for Educators and Generation Z Learners Medical education in times of COVID-19: German students' expectations -A cross-sectional study The difference between emergency remote teaching and online learning COVID-19 and medical education The Impact of COVID-19 on Medical Education Medical Student Mobilization During a Crisis: Lessons From a COVID-19 Medical Student Response Team Pandemics and Their Impact on Medical Training: Lessons From Singapore Coalition for medical education-A call to action: A proposition to adapt clinical medical education to meet the needs of students and other healthcare learners during COVID-19 Die medizinische Ausbildung in Zeiten von COVID-19 Covid-19: medical schools are urged to fast-track final year students General Medical Council -Outcomes for Graduates. London: General Medical Council Medical Education Amid the COVID-19 Pandemic Twelve tips for rapidly migrating to online learning during the COVID-19 pandemic Transformation to learning from a distance The Spielberger statetrait anxiety inventory (STAI): the state scale in detecting mental disorders in geriatric patients Our Education, Our Concerns: Medical Student Education Impact due to COVID-19 COVID-19: Challenges and Opportunities for Educators and Generation Z Learners Medical education in times of COVID-19: German students' expectations -A cross-sectional study The difference between emergency remote teaching and online learning Medical education in times of COVID-19: survey on teachers' perspectives from a German medical faculty We would like to thank Lea Herrschbach, B.Sc. for her study assistance. We acknowledge support by Deutsche Forschungsgemeinschaft and Open Access Publishing Fund of University of Tuebingen. Available from https://www.egms.de/en/journals/zma/2021-38/zma001489.shtml 1. Attachment_1.pdf (65 KB)Numbers of teachers' specialty The authors declare that they have no competing interests.Abbildung 1: Erwartungen der Lehrenden an das Verhalten der Studierenden in einer virtuellen Lernumgebung ihrer Lehrinhalte in ein digitales Format. Hier spiegelte sich die allgemeine Wahrnehmung wider, wie unvorbereitet man beim Lehren und Lernen auf den Gebrauch moderner Technologien war. Ähnlich wie in anderen Studien erwarteten auch die teilnehmenden Dozierenden dieser Studie eine einfache Umstellung von traditionellen Lehrformen wie Vorlesungen auf digitale Formate wie Online-Vorlesungen [1] , [8] , [9] , [12] . Darüber hinaus sahen sie eigenständige Arbeitsgemeinschaften als wichtige Methode an, um in Zeiten, in denen ein persönlicher Kontakt nicht möglich ist, Wissen weiterzugeben [2] . Deshalb strebten die Dozierenden die Implementierung von Online-Chats mit ihren Studierenden an, um trotz der sozialen Distanz den persönlichen Kontakt aufrechtzuerhalten. Im Allgemeinen zeigten die Ergebnisse, dass die Dozierenden die COVID-19-Krise als große Chance ansahen, um eine digitale Transformation in der medizinischen Ausbildung herbeizuführen. Ferner sollten Medizinstudierende auch in der Telemedizin ausgebildet werden, einschließlich der technischen Aspekte und professioneller Fern-Interaktionsmodelle zwischen Arzt/Ärztin und Patient/-in [13] . Darüber hinaus könnte eine Unterstützung der Medizinstudierenden seitens der Dozierenden von Nöten sein, wenn es darum geht, ihre Rolle in der medizinischen Gemeinschaft zu finden, da es wahrscheinlich schwer sein wird, ohne vollständige Rotation durch die verschiedenen klinischen Bereiche und die entsprechenden Erfahrungen in der Zusammenarbeit, bedingt durch COVID-19, die eigene Aufgabe zu finden, sich weiterzuentwickeln und zu integrieren [2] . Zur optimistischen Haltung der Dozierenden gehörte auch eine gewisse Erwartung an ihre Medizinstudierenden, um die Online-Lernmodule im Sommersemester erfolgreich implementieren zu können. Von ihren Medizinstudierenden erwarteten sie Nachsicht, Geduld und Bereitschaft zur Online-Ausbildung. Loda Auf Grundlage der Ergebnisse lassen sich einige Implikationen ableiten. Medizinische Fakultäten sollten Verbesserungen anstreben hinsichtlich einer klaren und transparenten Kommunikation, damit sich die Dozierenden ausreichend informiert fühlen. Darüber hinaus sollte den Dozierenden angeboten werden, sich in der Durchführung von Online-Lehrformaten schulen zu lassen. Solche Schulungen könnten Dozierende dabei unterstützen, die Nutzung digitaler Lernplattformen und Videokonferenzsysteme zu erlernen und deren verschiedene Funktionen (wie interaktive Whiteboards) kennenzulernen. Gleichzeitig sollten auch Medizinstudierende geschult werden, um in Online-Kursen mit ihren Dozierenden eine klare Kommunikation etablieren zu können. Mit sehr großer Wahrscheinlichkeit wird eine solche Schulung Dozierende und Studierende bei der Überführung des medizinischen Lehrens und Lernens in die digitale Welt unterstützen. Die meisten Online-Erfahrungen, die infolge der COVID-19-Pandemie gemacht wurden, lassen sich nicht ausreichend mit der medizinischen Ausbildung vereinen und