Nobody really saw it coming. A pandemic on this scale caused huge challenges for those of us involved in medical education; we’re still seeing the impact of redeployment on our junior colleagues, in terms of training progression, fatigue and so forth. Educational supervisors no longer had time to meet with trainees, and when they did meet, all they’d ever seen were people with COVID-19, which didn’t make for a very well-rounded discussion at the time.
Annual Reviews of Competence Progression (ARCP) were all done remotely, or in absentia, or simply didn’t happen. That led to a lot of ill feeling among trainees. It was very disrupted, spaces would be repurposed at short notice, and we just didn’t have enough time or environment to be able to teach them properly. There were no operations, no clinics. None of the usual rules applied.
In the end, it was the lack of patient contact that got to us all. We were physically separated, wearing masks – communication was very difficult. There’s something lost in conversation over a virtual platform. We were doing far more consultations over the phone, with lots of office-based decision making, and patients themselves were reluctant to come into hospital because of the risk of catching COVID-19.
However, now I’m hearing that medical students and junior doctors crave that face-to-face contact. They want to see patients and experience bedside teaching. Patients want to be back in clinic, interacting with their healthcare professional: now there’s choice. We tend to see every new patient face to face the first time, then offer them telephone follow-up if appropriate. There’s a cost- and time-saving element for patients to virtual follow-up when it works.
Of course, there are benefits to Teams and Zoom; it allows you to reach a wider audience, to help people access education in different ways. It gave us time to create new online content and allowed flexibility in the way people access their education. Technology also gave us new ways to disseminate knowledge; we spent a lot of time during the height of the pandemic working out the best way to get important information out to a wide audience quickly.
There were times we surprised ourselves and achieved things that in normal times you’d say couldn’t be done – like educating hundreds of nurses in the space of a couple of weeks on how to use continuous positive airway pressure (CPAP) machines. Some of the digital tools and innovative solutions will definitely stay with us, especially in a geographically dispersed healthcare environment like BCUHB. We’re really focusing on how we get it right, especially as we develop plans for the new medical school in Bangor.
Dr Daniel Menzies
Consultant respiratory physician
Clinical director for medical education
Betsi Cadwaladr University Health Board
