March’s blog was written by Amanda Bolderston and Kim Meeking.
The COVID-19 pandemic has affected the delivery of undergraduate education, both for university-based coursework (including exams) and clinical placements. We asked diagnostic and therapeutic radiography students on Twitter to tell us what the experience has been like for them. We posted a tweet from the @MedRadJClub account with a link to a Google form and after a week we had 23 replies from 4 countries (UK, Canada, Ghana and Malta) The main themes of the responses have been summarised in this blog.
Part One: The University Experience
We first asked about learning experiences at university (lectures, exams, coursework etc.) All students had shifted to learning online (e.g. through Zoom or Microsoft Teams) and many saw positive elements to this. Online learning was seen as more flexible and efficient for some. On-demand videos could be watched in the student’s own time or re-watched if needed. Travel time was less, and some students appreciated having more control of their work and timelines:
With my lectures being pre-recorded it has given me the opportunity to get lectures done earlier than in the timetable, which gives me more time to revise.“
Support and flexibility from universities was appreciated. Students mentioned laptops being supplied, exams being changed to open book or courses being graded without exams which suited people who suffer from exam anxiety. Finally, some students mentioned faculty support has been invaluable:
Having the choice of a virtual chat during difficult times has had a positive impact on many students.“
There were many more comments detailing negative experiences, or problems with online learning. Students missed the support from fellow students and faculty, both socially and in learning situations. Having to be extremely self-motivated was a challenge and some felt that they didn’t learn best online and needed face to face teaching and support. Some felt that peers who didn’t fully participate impacted the learning of others and that (for example) group work was more difficult online:
Students will often log into lectures to get a tick for attendance and turn the volume down and go back to sleep/watch TV. When it comes to ‘breakout rooms’, many will stay silent or leave to avoid speaking on a mic.“
There were comments about “screen fatigue” and technical issues that can hinder learning. Some people mentioned privacy issues with online learning and difficulties balancing children at home or living with others:
I have a large family, so having exams at home was a very stressful event for me, as all throughout the duration of an exam, I was praying that they keep silence.“
Finally, there were numerous comments about variability in the quality of materials used and the readiness of teaching faculty to teach online.
Online lectures are not as good as they should be, tutors don’t understand or make poor use of technology, the technology platform isn’t designed for a healthcare course and much of the content delivered is often of mediocre standard. Interaction with material has dropped, attendance has dropped…“
A few people felt that universities would take advantage of the shift to online learning and provide less value for money. However, some expressed that faculty were also learning and needed support.
Part Two: The Clinical Environment
Although most students had experienced delays in accessing clinical teaching/placements the comments in this section were generally more positive. One person commented that “clinical has been less impacted compared to academic”. An overriding concern was that of diminishing time to achieve competencies or complete assignments in the clinical environment (or a possible delay in graduation). One student called for a change in the traditional way of clinical evaluation:
Some competencies have had to be deferred piling on yet more pressure on students, some of us have competencies for year 1 that we will feasibly not have signed off until we’re third year … Progression through the course needs to be based on safety and clinical skill/knowledge, how someone can be deemed competent to be a third year doing “third year-type work” when they haven’t actually passed first year due to deferring one or two competencies? This makes a mockery of the competency system and shows how much work needs to be done to improve the way students are assessed on placement moving to a more sustainable (and sensible) model such as continuous assessment. End-point or staging type assessments are outdated“
Some clinical tutors have been providing support remotely, but many students mentioned that clinical staff (radiographers or medical radiation technologists) have stepped up and provided additional support and learning opportunities:
Perhaps the best change introduced is the 'extra sessions' which are delivered by radiographers to a small group of 2-3 students at a time (taking them away from the department if 2 students are both timetabled on a single machine) and delivering a sort of seminar - covering things such as difficult scenarios, first-day chats, IR(ME)R, anatomy refreshers etc.“
Thankfully many students said they felt safe and have been included in staff screening and access to PPE, although getting used to working and learning in PPE has been challenging. There was also a sense of appreciation, both for the learning opportunities available and for resilience learned during the pandemic:
"It has provided us with a lot of learning opportunities and has put us in the ‘worst’ situation, which helps us get through the easier aspects of placement in the future. We have been able to learn and work through an entire pandemic, I personally don’t think it could get worse than that.“
Changes made in the clinical environment to accommodate physical distancing and safety have included staggered start times and/or study days as well as access to study space, lockers or staff rooms.
In some cases, patient numbers in clinics have dropped, and some patient groups have been unavailable (for example, brachytherapy access has been limited for radiation therapy students). However there have also been unexpected opportunities:
I don’t think I would have had the chance to do as many portable chest x-rays pre-covid that’s for sure!“
Finally, some students mentioned that they had a better awareness of the difficulties faced by patients (e.g. having to come alone for appointments) as well as a better grasp of patient communication:
I feel that covid has made me more aware of my communication with patients - facing difficulties with masks and extra patient anxiety involved etc.“
It’s clear that students have faced many challenges and uncertainties in the last year and will continue to do so. MedRadJClub would like to thank the students whose honest responses have helped illustrate how COVID-19 has impacted undergraduate learning. Although comments have been anonymized, several students left their names, so we’d like to mention Astrid, Andie, Samantha, Samuel, Kathryn, Sahar, Vanessa, Lauren, Keith, Charli, Izzy, Millicent, Anne, Clara and Rebecca.