Medical students’ preference for returning to the clinical setting during the COVID‐19 pandemic

Compton, Scott; Sarraf‐Yazdi, Shiva; Rustandy, Felicia; Kumar Radha Krishna, Lalit

OBJECTIVES: The Covid‐19 pandemic has led to widespread disruptions in the clinical education of medical students. In managing students’ return to the clinical setting, medical schools face the challenge of balancing education, service, and risk considerations. To compound this challenge, medical students may prefer not to re‐enter during a period of great uncertainty, leading to substantive downstream sequelae on individual, institutional, and national levels. Understanding students’ views on resuming clinical experiences, therefore, is an important consideration. The purpose of this study was to assess medical students’ preference for re‐entering the clinical setting during a pandemic, and to explore personal and environmental characteristics associated with that preference. METHODS: We conducted an electronic survey of currently enrolled medical students of Duke‐NUS Medical School in Singapore, less than a month into the pandemic. Survey items were aligned with a conceptual framework related to medical students’ preference for returning to the clinical setting. The framework consisted of three domains: 1) non‐modifiable demographic information, 2) factors thought to be modifiable through the course of medical education, including burnout, tolerance for ambiguity, motivation, and professionalism, and 3) students’ perception of Covid‐19 infection risk to self. RESULTS: Approximately one third of 179 students preferred not to return to the clinical setting. Results of a multivariable analysis indicated that compared to this group, the two‐thirds of students favouring return showed evidence of greater autonomous (or internal) motivation, a greater sense of professional responsibility, and a lower self‐perception of harbouring risk to patients. CONCLUSIONS: Students’ preference regarding return to the clinical environment stems from the interplay of several key factors, and is substantively associated with perceptions of professional responsibility and their own potential risk to the healthcare system. Mindfully considering and addressing these issues may help medical schools in their preparation for returning students to the clinical setting.