Health professions education in pandemics and epidemics: A proposed framework for educators (original) (raw)

2021, Annals of the Academy of Medicine, Singapore

The COVID-19 pandemic has disrupted healthcare systems and health professions education (HPE). There are few frameworks to help educators manage HPE before, during and after pandemics and epidemics. We developed a crisis management framework which draws from diverse theories to emphasise preparedness, leadership, stakeholder perceptions and organisational learning to provide guidance. 1 Bundy et al. define crisis management in 3 stages: before, during and after a crisis. This allows detailed response planning. 1 We adapted it to derive a framework for HPE in pandemics and epidemics (HPEPE). This framework is relevant as it reminds educators to not only focus on the present pandemic, but also the steps to take before and after the crisis to learn and prepare further for the future. We performed a systematic literature review and identified 208 publications relevant to HPEPE. We distilled the key points, grouped them into 6 elements, reaffirmed representativeness, then mapped them back to the crisis management framework. 1 We describe 6 elements, comprising 6 Cs-curriculum, continuing professional development (CPD), communications, courage, communities and continuity-and demonstrate their relevance to HPEPE and crisis management stages. Table 1 illustrates how our proposed framework was applied during the COVID-19 pandemic in the Singapore context. Curriculum. Swift curriculum adaptation is essential in HPEPE. 2-4 Hybrid models, combining remote and onsite teaching and training could be adopted. Similarly, to minimise risk of exposure, alternatives could be used for assessments, such as electronic proctoring for written examinations, or use of simulated patients and videoconferencing for clinical assessments. Virtual selection interviews and even graduation ceremonies could be conducted online. Investing in technology resources (high-speed Internet access, video-production facilities, videoconferencing software and learning management systems 5) and upskilling faculty to thoughtfully use technology 5 are crucial for HPEPE. While technological innovations are welcome, educational principles should guide design and implementation, 5 with emphasis placed on programme evaluation. Context must be considered during implementation. Uptake of technology varies depending