Friday, October 2, 2020

First- and Second- Year Medical Students’ Responses to Remote Learning

From the 10/2/2020 newsletter


First- and Second- Year Medical Students’ Responses to Remote Learning


by Eileen Peterson and Anna Visser


MCW Students Eileen Peterson and Anna Visser organized a student survey to better understand how their colleagues adjusted to the remote learning environment, and lessons learned moving forward that can connect to well- being efforts ...



While online degree programs have existed for decades, they made up a small minority of degree programs in the United States until 2020, when remote learning became the norm, forcing students and faculty members to adapt to its benefits and challenges.

The Medical College of Wisconsin was just one of the many institutions affected once the threat of disease spread materialized during the spring semester of this past academic year. In-person lectures for first- and second-year medical students (M1s and M2s, respectively) stopped for the rest of the spring semester, and third- and fourth-year medical students were pulled from the clinics and hospitals during their rotations. As we all learned more about COVID-19 and how to safely bring students back to campus, things have slowly shifted to a “new normal.” The third- and fourth-year students were allowed back at their rotations. However, the path to this “new normal” has been a bit rockier for first- and second-year medical students.

As the first- and second-year medical school curriculum is largely lecture- based, many changes have had to occur to transition to mostly-virtual learning.

During the spring semester, virtual learning for first- and second-year medical students consisted of watching lectures that had been recorded the previous year. This fall, we have transitioned back to live lectures that are given on campus by masked faculty members and clinicians behind Plexiglass. Attendance is capped at 50 students, and everyone must sit 6 feet apart with their masks on. This is certainly not the same pre-COVID experience of cramming into Kerrigan with friends. We are not able to roll our chairs closer together to discuss which lunch talk might have the best food that day. We no longer make the trek to anatomy lab with all 200 fellow first-year medical students. We understand that it would not be safe for things to be like they were pre-COVID. Even with all the terms that fall under this “new normal,” being able to watch live lectures again, from home or at school, has been a great improvement from this past spring.

We wanted to know: How has this transition affected students? We sought out answers from first- and second-year medical students at MCW through a voluntary survey distributed at the beginning of September. Within mere days, we garnered 53 responses. Selected data are presented below, along with free responses published anonymously with permission.


Ease of Transition


The transition to mostly-remote learning this semester has been easy for me:



There was a wide variety in thoughts about the ease of transition to online learning. We postulate that this variety may be based on class year; since current M2s experienced remote learning last spring, they may have already formulated schedules and study habits that work well for them, whereas remote learning may be new to current M1s. Here are a couple free responses related to the ease of transition:

“The hardest part is not being able to separate school and studying from home and relaxing. There is no barrier between my desk and my bed, so work and life have meshed into one thing.”

“The transition was relatively easy as I had already been watching lecture and studying from home 99% of the time. I suppose the most difficult aspect has been not seeing many people. As introverted and painfully shy as I am, humans are largely social creatures. Not being able to seefamiliar faces after a while began to take its toll.”


Has mostly-virtual learning and/or COVID-19 affected how/where you are living this year?


For the majority of students who responded to our survey, their living arrangements were not impacted by the transition to mostly-remote learning or COVID-19. For those whose living arrangements have been impacted, there are many reasons why this could be the case. At the start of the pandemic, in the spring, many students chose to go back home for some time. There was also much uncertainty about how we would be coming back to school in the fall. 

Some students weighed in on their experiences:

“As an M1, I waited as long as possible to sign a lease because I was unsure of whether or not I would have any in-person classes this semester. As a result, I’m now living alone and have little to no interaction with my classmates. It’s made the transition significantly more difficult...”

“I had been planning to live at home with my parents this year. Both of my parents are older, and I was worried that somehow, I would be bringing COVID home by going back to school and clinic. I quickly found and moved into a new apartment so that I wouldn’t be putting my parents at increased risk.”


I have more time to study or enjoy recreational activities now that my learning is largely remote:



When asked for their favorite part of remote learning, many students discussed their schedule’s increased flexibility, including getting more sleep, avoiding the commute to school, and being able to watch lectures at their own pace. A student explained,

“I enjoy not needing to drive to campus for class. Even though I live close, it saves at least 30 minutes every day and instead I can continue studying from my desk, watching lectures at my own pace, while still getting a quality education.”

However, not all students feel this way, especially those with families and other commitments at home. One student was frustrated with the increase in assignments given the remote nature of medical courses:

“It seems that we have more work to do now more than ever. It appears faculty are concerned we have a lot of free time, but we have the same amount of time, if not less, now that we are home. For instance, many people have children they now have to help out with school.”


Faculty and Staff

It is easy to reach out to faculty and staff remotely when I have questions or concerns:



Though our responses to this question were fairly neutral, the majority of responses were positive. Seventeen students chose Somewhat agree, Agree, or Strongly agree; while only ten students chose Disagree or Somewhat disagree. No students strongly disagreed with this statement. Though we have not been able to have as many face-to-face interactions with faculty as we were able to pre-COVID, it has still been fairly easy to reach out to faculty and staff with questions and concerns in this mostly-virtual age. However, there is certainly still room for improvement in the format of mostly-remote learning.

One student commented,

“I don't like the email barriers to asking questions - I'd much prefer to get real-time answers to questions. I don't like Panopto - it’s clumsy and lags.”


I feel supported by faculty and staff, even though my learning has been largely remote:



Based on our personal experiences and our survey responses, is clear that the faculty and staff are still here for students during this time. A large majority of students who answered our survey feel supported by MCW faculty and staff. In an effort to improve their medical school experience, several students offered suggestions for faculty, staff, and MCW as a whole:

“I would love if MCW offered more free virtual workout classes for us to stay mentally and physically healthy, especially if we aren’t comfortable using gyms or wearing masks when working out in more public spaces.”

“I wish that [student organizations] would be able to do outdoor activities/more online events... I'm disappointed by the lack of community especially having just moved here from far away.”

“Brightspace is very clunky - it takes 7-8 clicks to find one thing. I also wish there were more ARS questions instead of professors droning on. It feels very removed watching a lecturer in a mask behind a glass screen and the audio is not always good. I'd rather professors broadcast from home.”

“I really, really wish they could change the scratch paper rule during tests.”

“Send us something once in a while, a joke, a song, something to keep us connected.”

“Be supportive when we have illnesses or injuries. We are students, but we are patients too.”

“Be receptive to changes especially with the [Black Lives Matter] movement sweeping the nation. We finally feel open to talking about these hot topics. It may seem like an attack or uncomfortable but imagine decades of that for [people of color].”


Connectedness to Peers


I feel connected to my peers, even though my learning has been largely remote:


When asked about the hardest parts of their transition to mostly-virtual learning, many students discussed their feelings of disconnectedness from peers and challenges with social isolation. Compared to students from the Milwaukee area or those who knew each other from undergraduate experiences, these feelings of isolation are exacerbated in first-year students who moved here from out of town and may not have already developed those previous friendships with other medical students. One student expands upon this challenge:

“I just moved to a new city, I’m living by myself, and have little to no interaction with my classmates. I find virtual learning to be significantly more difficult because it requires way more self-discipline than if we were to be attending lectures in person. So.... it’s been not only a tremendous adjustment in terms of just finding my footing as a med student, but I also feel incredibly disconnected from my peers. I worry that I may somehow be missing the opportunities to meet people just because I’m out of the loop somehow.”



Adaptability and Growth

Whether their mostly-remote learning experience has been smooth or rocky, freeing or isolating, or otherwise, students have learned a lot about themselves. They discussed their resilience and adaptability: 

“I can overcome obstacles and still have a meaningful experience.”

“Being flexible and ready to adapt to new changes and plans is the key to success.”

“Nothing will stop me from reaching my goal, not even a pandemic.”


Because of the various challenges associated with being a medical student during a pandemic, many students advocated for prioritizing mental health and other efforts to promote wellness:

“It has been further cemented into me that I alone am in charge of my wellness. With nearly all learning being remote, the days of the week blend together and a weekend is almost no different than a weekday. Taking the necessary time to unwind and take a break from studying needs to be an intentional act, and deciding when enough studying is enough on any given day is also important to prevent burning out. I’ve learned that spending time alone, whether it be reading a book or playing guitar, is a great and fulfilling alternative to hanging out in big groups when trying to enjoy some time away from school work, given the circumstances.”

“I’ve learned that I need to keep myself accountable for my work by keeping checklists and to do lists so I can do my school work, keep the house chores under control as well as think about eating right and staying social.”

Being a medical student is notoriously challenging, much less during a pandemic. From technological hiccups on Brightspace to feelings of isolation, students discussed struggles that are shared by many of their classmates. Amidst the difficulties, it has been inspiring to witness the resiliency, adaptability, and courage of learners, faculty, and staff as we navigate our “new normal.” Until handshakes, coffee shop meetings, and large-group gatherings return, we encourage you to continue promoting wellness for yourself and others, one small step at a time. 


If you or anyone you know is struggling, you are not alone. Below are some resources for students, shared via Dr. Cassie Ferguson and the REACH curriculum:

MCW Student and Resident Behavioral Health Services

- Referral Coordinator: Carolyn Bischel, MS, LPC

- (414) 955-8933

- Referral Hours: 8:00 am-4:30 pm, Monday-Friday

- After-hours Emergency Contact: (414) 805-6700


24/7 Suicide Helplines

- National Suicide Prevention Lifeline: 1-800-273-8255

- Crisis Textline: Text the word "Hopeline" to 741741


Columbia Suicide Severity Rating Scale (research-based screening tool for

assessing suicide risk in individuals)

https://cssrs.columbia.edu/the-columbia-scale-c-ssrs/cssrs-for-

communities-and-healthcare/#filter=.general-use.english


Milwaukee Health Department/Office of Violence Prevention

- Blueprint for Peace:

https://city.milwaukee.gov/ImageLibrary/Groups/healthAuthors/O

VP/Reports/20171117OVP-Report-MKEBlueprintforPeace-Low-

Res.pdf


Eileen Peterson and Anna Visser are students at the Medical College of Wisconsin with interests in Diversity and Inclusion, Medical Humanities and Student Wellness. They are both Associate Editors of the Kern Transformational Times newsletter. 

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