Teaching healthcare during Covid-19 – a marathon and not a sprint

Health professions’ providers have faced as turbulent a time as any higher education institution over the last few months.

However, it’s fair to say that we’ve had one major advantage to meeting the demands of a global healthcare crisis – the expert knowledge of our people.

So what happens during a pandemic when your staff and students have a collective understanding of viruses, epidemiology, and public health?

Early warning systems

At RCSI Dublin, one immediate advantage was the early warning our microbiology and infectious disease faculty gave us on the emergence of the new virus. They highlighted its existence, but also shared their concerns, interpreting the gravity of the clinical picture for less experienced eyes. This in-house expertise also meant that when events unfolded, advice came from trusted friends and colleagues, rather than unknown sources.

Strategies to manage the pandemic were led by staff and underpinned by the science, meaning that we knew the “why” behind the “what” in our plans. Perhaps most important of all was our proximity to the Covid-19 frontline. With many RCSI staff working in hospitals, or supporting those that did, our teaching became infused with “news from the wards”. Compassion and understanding, already important values for health professions’ educators, became central to how we worked. Our struggles with virtual classrooms and recording lectures came with perspective.

We are not alone in these experiences. A recent BEME (Best Evidence Medical Education) rapid review which screened over 7,000 studies has outlined the challenges faced by health professions’ universities this year. As with other higher level institutions, there was a rapid transition to online learning, and a wide range of remote teaching approaches emerged. This was just one part of the puzzle, however, and, as at RCSI, it was common for teaching staff to be diverted from clinical education into urgent patient-care and Covid-19 training roles within hospitals. As a result, many clinical learning opportunities for students evaporated overnight.

The bright side

Although the findings of the review are cautionary, they are not without optimism. Innovation in remote teaching has seeded opportunities for new forms of learning environments which are likely to persist beyond the pandemic. Authors of the study recommend that our focus now should be on supporting learner engagement and maintaining opportunities for learners’ clinical exposure through use of telehealth, PPE, and physical distancing.

To achieve all of this, we must adopt a new mindset. The new mantra amongst medics is “it’s a marathon, not a sprint”. As our outlook on coronavirus becomes more long-ranging so too must our outlook on teaching. At RCSI we’ve been fortunate to have the mandate and resources to implement an extensive faculty development programme. Through a collaboration between the university’s Health Professions’ Education Centre (HPEC), IT and Library departments, we’ve been able to upskill and support teaching staff on a wide range of technologies throughout the summer months.

What this means, however, is that educators have lost their usual end-of-year sense of closure. There has been little time for reflection, or the usual review of programmes and research work. With that in mind, it’s important that institutions and educators change pace and approach as we continue to teach in the time of coronavirus. On the basis of what we’ve learned so far this year at RCSI, we have come to some important conclusions.

Complexity and control

In this time of complexity, we are trying to simplify as much as we can. Learning will look very different this year so we are focussing on what’s important. If we can build a pleasant, inviting learning environment, and help our students to achieve the learning outcomes, we think we’ll be on the right track.

We are trying to recognise that there are things that we can control, and things that we cannot. External influences may trigger a switch from hybrid teaching to online, or from synchronous to asynchronous, events that are not under our control. What we can influence, however, is our relationship with our students, by reaching out, connecting, and being a welcoming face.

We are trying to build flexibility into our teaching approach. There will be hitches and glitches, so taking ten minutes to consider what we might do if a session doesn’t go to plan becomes important. Can we support our students’ learning another way, e.g. through an alternative asynchronous approach?

Connections and space

Taking time to connect with our colleagues is crucial. Remote and physically distanced work impacts on our interpersonal relationships, an essential part of our capacity to cope with adversity. How we might replicate that “waiting for the kettle to boil” moment in the staff room is an important question. Could we arrange a regular, online (and informal) catch up with a small group of colleagues is another.

We are trying to ring-fence “space” in our weekly schedules. Where possible, that involves the creation of buffers against long periods of back-to-back teaching. Online teaching can be taxing and “Zoom fatigue” is an emerging topic of interest for cyber-psychologists. Taking regular breaks from the screen and from sitting is important too.

Reflecting on what we enjoy most about our work is also a big part of it. It’s natural to go on “auto-pilot” when under pressure, but if a sense of meaning and enjoyment is missing, motivation can wane. We are trying to ask ourselves questions like – what did we used to enjoy about our teaching, and can we find that again in this new format? Or, are there aspects of online teaching that we like a lot and can do more of?

We are attempting to remind ourselves that it’s common to feel overwhelmed by the technology at times. We are educators first and much of the knowledge, skills and attitudes required for the job remain unchanged. Quality and Qualifications Ireland reminds us that the “technology is in the service of pedagogy”.

Finally, we should all take time to feel proud of what we have achieved so far. It hasn’t been an easy year and the educational community has pulled together in an unprecedented fashion. Adopting a perspective of compassion for ourselves and for our students, we can continue to meet the challenges of this new landscape.