How to Virtually Become a Doctor

Jarell Catlett’s eyes narrowed on the large intestine, a shiny, shiny stick-like object, whose color matched the stools stored inside it. He chose to separate the limb, and it expanded on his screen as the surrounding body parts were refilled – the gall bladder bright green with bile, the ribs white and curved like half moons.

“My old boss told me how complicated I would make the human body when I did it.” Gesture to a body image on your laptop screen. “But it seems that something is missing from the experience right now.”

For generations, medical students were initiated as a ritual for their training because it was awe-inspiring: cadaver amputation. Since at least the 14th century, physicians have respected their understanding of human anatomy by examining carcasses. But amidst the coronavirus epidemic, cadaver amputations – such as multiple hands-on aspects of the medical curriculum – became virtualized using three-dimensional simulation software.

Most of the nation’s 155 medical schools converted at least part of their first and second year curriculum to distance education during the epidemic. According to a survey by the Association of American Medical Colleges, nearly three-quarters offered lectures, and 40 percent used virtual platforms to interview students about their symptoms and teach them how to pick up their medical history. . Although cadaver amputation presented a difficult challenge, about 30 percent of medical schools, including Mount Sinai, used online platforms to teach anatomy.

Although medical students in many states are eligible and able to receive vaccines, some have not yet fully returned to in-person learning, with school administrators saying they prefer to wait until Kovid’s case declines further. We do. Some in-person training, practicing clinical skills, has resumed to a large extent.

Medical schools adapted in the previous year with an inventive approach to medical training. Case Western Reserve University School of Medicine and Stanford used virtual reality technology to teach anatomy. Vagelos College of Physicians and Surgeons at Columbia University gave students the opportunity to stay away from doctors, who sat in tele-medicine work. Dr. Nadia Ismail, associate dean of course Drs. According to Nadia Ismail, in Boiler College of Medicine, the students had given physical examination through video to assess what kind of actions they would take. Part of the knee and this is the reflex I will see. “

The KK School of Medicine at the University of Southern California opted to dissect the cadres by wearing body cameras to allow faculty members to watch from afar. The cadre was also imaged using a three-dimensional scanner, so that students could manipulate the type of images produced by magnetic resonance imaging and CT scans.

Dr. Donna Elliott holds Dr. for medical education at KK. Donna Elliott said, “I felt good when the faculty came in, ‘This is my goodness, this is amazing.” “These scanned, three-dimensional images approximate the type of imaging you would use as a physician.”

Teachers know that for all the promise of new technologies, there is a sense of loss for students who are not capable of dissecting laboratories in hospitals, classrooms and in person. “The medical school’s classroom is a clinical environment, and it’s just too long,” said Lisa Hawley, Senior Director for Strategic Initiatives and Partnerships at AAMC. “

The students said that they felt some frustration, as they helped to pressurize the frontline providers without any capacity. “We know more than the average person, but we generally feel powerless,” said 28-year-old Saundra Albers, a Columbia second-year student.

Both faculty members and students find that moving the viewing organs on a laptop screen is not the same as removing them one by one from the human body. “A cadaver’s body parts look as smooth and perfect as they do on a screen,” Mr. Catlett said. “Assuming the cadaver was an alcoholic, you can see the liver and head with cirrhosis covering the liver.”

He and his classmates know that they missed a medical rite of passage: “We don’t have to feel what tissues are, or how hard the bones are.”

Mr. Kellett and his classmates have now been offered the vaccine, and are resuming some in-person activities, including meeting with patients for the first time this month. His lectures are still online.

Sara Serrano Callow, 26, is a second-year student at Massachusetts Medical School who introduced a mix of in-person and virtual learning last semester. Since the beginning of medical school, Ms. Callow was keen to practice interacting with patients – taking her medical history and reporting the diagnosis – so the transition to learning clinical skills at Zoom was a lethargy. was.

She was assigned to interview a medical actor, referred to as a standardized patient, about her financial troubles, an emotional conversation she found virtually awkward to conduct.

“When you’re on the zoom, you can’t tell if the person is holding their hands or shaking their legs,” he said. “For some of my classmates, the response was that we had to show more sympathy. But how can I recognize my sympathy through a computer screen? “

Medical schools were often unable to arrange for students to practice their skills over medical actors in the final semester, as these actors come from older, retired populations who are at risk for Kovid-19. In some schools, including the University of Massachusetts, students had practiced physical exams on their classmates, for parts of the exam, including opening the mouth and looking into the nose.

For Ms. Kelloway, it was challenging to assess her physical exam skills because she could only prepare by watching videos, whereas in any other year she had a week in-person practice.

“Generally, you will hear lung wheezing, feel the enlarged liver, find the edges of the abdominal aorta,” she said. “Listening to a heart murmur online is different from listening in person.”

Nevertheless, she praised the school’s efforts to check in with herself and her classmates as to how they were moving forward, partly as being conducive to distance education.

Some students pointed to a silver lining in their virtual medical training: they have become adept at speaking with patients about sensitive issues on video, a lesson that is likely to prove essential in the field of tele-medicine Spreads. Through remote clerkships at schools such as Sydney Kimmel Medical College at Thomas Jefferson University, medical students assisted hospital staff, who worked with patients discharged earlier than usual due to the epidemic.

“Other doctors threw in the deep end, but we find practice using this technique,” said second-year student Ernesto Rojas at the University of California San Francisco School of Medicine. “We learned how to build rapport and ask the patient, such as, ‘Are you a place where you can talk in private?”

The students also stated that they felt particularly motivated to complete their training amid the epidemic. According to the AAMC, this time there has been an increase of 18 percent in medical school applications as compared to last year.

For 22-year-old Prerna Katiyar, a first-year medical student in Columbia, the first few months of medical school saw nothing like she had anticipated. He served in Fairfax, Va. Began the semester living in his childhood home, where he shared lessons with his family from anatomy classes over dinner. “When my dad said he had a stomach injury, I was able to talk to him about the abdominal quadrant,” Ms. Katiyar said.

In half a semester, he was an exciting update to his parents. “My skull finally hit the mail,” he said. Ms. Katiyar’s anatomy ordered each student a plastic model of the skull.

“Now I can see the bony landmarks and where the nerves are,” he continued. “I am a very visual person so it is useful to trace it with my finger.”

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