37 COVID-19 and Medical School Curriculum: Can Emergency Medicine Successfully Adapt to a Virtual Format of Teaching?

Kristensen, A. J.; Williams, N. M.; Finch, C.; Graber, M. N.

Background: Emergency medicine has historically been taught with a combination of didactic and bedside learning;however, the COVID-19 pandemic pushed emergency medicine programs to quickly resort to an online curriculum. Our novel online curriculum included reading, direct teaching, and interactive “patient walk-throughs” utilizing Google Forms. The “walk-throughs” consisted of case presentations in which the students were prompted to provide differential diagnoses, labs and imaging, and were given feedback on their decisions. We sought to evaluate how fourth year medical students' comfort level with common emergency medicine scenarios would change after completing the virtual curriculum. We also sought to evaluate how well the virtual curriculum prepared students for the end of rotation exam, the COMAT. Study Objectives: 1. Evaluate students’ perceptions on emergency procedures, assessing an ED patient, and the limitations of evaluating a patient in the ED. 2. Evaluate the student’s pre and post-rotation comfort level in evaluating a patient with abdominal pain, altered mental status, chest pain, suspected sepsis, and shortness of breath. 3. Evaluate how the virtual curriculum affected EM students’ COMAT scores compared to the national average, and to the scores of prior students from the same university who had a standard, in-person curriculum. Methods: 24 students participated in a one-month rotation in the virtual EM curriculum between March-May 2020 Pre-rotation surveys were conducted prior to the start of their rotation Post-rotation surveys were conducted within three days following the last day of the students’ respective rotations Results: Primary outcome: Evaluate students’ perceptions on ability to perform key aspects of emergency medicine following a one-month virtual curriculum. 24 students completed the pre-rotation survey and 20 students completed the post-rotation survey assessing comfort level with common emergency medicine scenarios. In total, there was a statistically significant improvement in students’ comfort level in a majority of scenarios (8/14) Secondary outcome: Evaluate virtual-EM students’ COMAT scores compared to prior students’ scores from the same university in years prior. All 24 students attended the same DO program and sat for the COMAT exam at the end of the rotation. Data is being analyzed comparing the performance of the 24 students participating in the virtual curriculum. Conclusions: Students’ comfort level significantly improved between the pre and post rotation survey in many emergency medicine aspects. This included the comfort in assessing abdominal pain, altered mental status, SEPSIS, and shortness of breath. A statistically significant improvement was found in students’ comfort in EKG interpretation and airway management. The inability to rotate in-person for emergency medicine likely impacted the learning experience for medical students. Our study found that students’ comfort level in key procedural aspects of emergency medicine was not significantly higher than prior to the rotation. Our current academic year COMAT score data is in the process of being analyzed. [Formula presented]