On March 6th 2020, I wished our first year medical students good luck on their Physiology exam, and told them I hoped I would see them on Monday. Alas, on March 8th, the dreaded (but expected) email arrived. Due to COVID19, all in person classes were suspended immediately. With one day's notice, and with no preparation, we all moved to a world of Zoom.
As course director, I quickly learned the basic features of Zoom, created meeting links, and began to lecture and facilitate small groups from my apartment. That, it turned out, was the easy part. It soon became clear that there was a much bigger need to address: the mental health and well-being of our students. For many, class time is an integral part of their social life and gives their day purpose and structure. Now, as they were sheltering in place, with many returning to homes across the country, they were far removed from their study buddies and the camaraderie that infuses a medical school class. Moving lectures online is a matter of technology. How do we replace the “we’re all in this together” spirit of the lecture hall and small group room?
Much has been said and written on best practices for online medical education. A large part of our mission as medical educators is to ensure our students have mastered pre-clinical content. However, I would argue that we have an equal responsibility to foster teamwork and support our students through the daunting landscape of medical school. In those early days of the pandemic – when it was becoming clear that our NYC medical center was at the epicenter of the crisis; as our hospital lobbies were being converted into patient wards; and the endless wailing of ambulance sirens pervaded our city – our students were paralyzed by fear and foreboding. To be honest, so was I. As soon as my course responsibilities were over, I was to be deployed to the hospital, which terrified me.
I quickly realized that we needed to make our Zoom classroom as inviting and fun as our actual classroom so that all of us –myself included – could have respite from a world that felt increasingly out of control. I began to start lectures with a silly poll to diffuse the tension. As an example:
Are you wearing:
- A) Day pajamas
- B) Night pajamas
- C) Clothes
- D) Clothes?
Between lectures on complex physiologic topics, we would pause to do a daily “Pet Roll Call,” where students would introduce their pets. Like many great ideas, this one happened serendipitously, following the unexpected appearance of someone’s dog on camera. It soon blossomed into something we looked forward to daily, and students who were living far from their furry family would instead show off photos of their beloved pets. Others unveiled their favorite stuffed animals. Students would show up in silly hats and animal onesie pajamas, lightening the mood, which inspired us to celebrate the last day of class with a costume contest, complete with voting and prizes. Outside our Zoom room, the world was terrifying. Inside, we were -- to the surprise of all of us -- having fun, building community, and ensuring psychological safety to learn.
I began to send daily emails; initially they were to inform students about Zoom links and additional office hours. Often, I shared my own fears about the virus and the future, partly as an outlet for my own apprehensions and partly to normalize their own feelings. Eventually, they became cathartic for many of us, with students telling me that in a very uncertain and tumultuous world, it gave them comfort to know that they would wake up to instructions and encouragement from their Physiology professor. Maintaining and strengthening their sense of community was key. I offered to set up Zoom study groups for students without Zoom accounts, so that they could continue to study together, even when apart.
COVID-19 disrupted the world of education in ways that are likely to persist. The classroom was now our Zoom room, giving us an intimate look into people’s homes and private spaces. The boundaries between the personal and professional had become hazier, and by embracing that, we were able to support each other in a manner that surprised and comforted all of us. As we move into the fall semester with new challenges inherent in onboarding first year medical students from a distance, a critical component will be to develop and sustain their sense of belonging. By allowing our own humanity to shine through and sharing our vulnerabilities, we can help achieve this.
Did you know that the Harvard Macy Institute Community Blog has had more than 225 posts? Previous blog posts have explored topics including training with mental practice during COVID-19, the Hy-Flex option, and engaging students virtually.
Staci Leisman
Staci Leisman, MD, FASN is a medical educator and nephrologist. Staci currently is an Associate Professor of Medicine/Nephrology and Medical Education and a co-director of the curriculum at the Icahn School of Medicine at Mount Sinai. Her professional areas of interest include undergraduate medical education and curricular development. Staci can be followed on Twitter.