The Impact of COVID-19 on the Medical Student Emergency Department Clinical Experience
Learning Objective: Describe the impact of COVID-19 related restrictions in the clinical learning environment on the patients and chief complaints evaluated by students.
Background: In March 2020, medical students across the nation were removed from the clinical learning environment in response to novel coronavirus. Upon returning, students found new precautions and restrictions around patient care to avoid exposure and curb PPE shortages. These restrictions often impacted which patients students could see, potentially changing their experience in comparison to students in typical years.
Objectives: With the restrictions placed on medical students on their return to the clinical learning environment, we anticipate that their experience would differ from students in the prior year. Specifically, we hypothesize that students would see fewer patients with respiratory or infectious symptoms as their presenting complaint.
Methods: Through a query of the electronic medical record, we obtained de-identified information for all patients seen in the Emergency Department at our large academic medical center for June 1 – October 31 in 2019 and 2020, including age, chief complaint, and if the patient was seen by a medical student. Investigators categorized chief complaints into one of twelve categories and calculated the total number of student shifts during the study time period using the published student schedule. We calculated the average number of patients seen by students in each category per shift for 2019 and 2020.
Results: In 2020, students saw on average fewer patients with respiratory, constitutional, and cardiac presenting complaints per shift. Students saw slightly fewer patients per shift overall in 2020 in comparison to 2019.
Conclusions: Restrictions placed on medical students in the Emergency Department during the COVID-19 pandemic have had a significant impact the student clinical experience during their clerkships. Although the intent of these restrictions was to protect learners from the risks posed by caring for COVID patients, these restrictions had unintended consequences on which patients students evaluated.