When the COVID-19 pandemic began, fourth year medical students were in the process of preparing for their USMLE step 2CK exam. At this stage, usually they would also be in a clinical rotation with required patient experiences, and beginning applications for their residencies. Instead, they were all at home self-isolating while studying and dealing with much uncertainty.

At the University of Central Florida, College of Medicine (UCF COM), we offered an elective for three blocks over the Summer to assist them in prepping them for their exam. This served as an opportunity to encourage self-regulated learning and foster an online environment which nurtures dual communication, support, and encouragement. Below are some techniques which we found to be successful in navigating an online learning environment.

  1. Employing the 4MAT System
    Before the month-long course officially began, the class was broken up into small groups and given a pre-quiz to establish their standing and goals which helped in tailoring teaching to their specific needs. To further enforce this, one on one meeting appointments were also encouraged and the students appreciated having personalized time to discuss their areas which required further strengthening and study planning. We began with a lecture on clinical reasoning and assessing the student’s ability in the use of self-regulated learning techniques.

    The corpus of the elective was then based around the protégé effect where they picked areas they needed to strengthen, prepared PowerPoint presentations and taught their peers. The presentations followed a standard style of a case followed by a more in-depth look at the chosen topic. Two faculty facilitators were present to highlight and supplement the material and apply it to a clinical case. Once per week, faculty provided didactics employing the TPACK method.

    We used the platform Canvas to create our online space called Webcourses, which is unique to UCF. This allowed us to post course material, discussion prompts, communicate with students via announcements and update the course calendar. Here the students uploaded their weekly presentations and received their grades. Webcourses also allowed the exchange of messages between students and faculty.

    To encourage critical analysis, the students were tasked with reading weekly news and journal articles. They were invited to answer a series of questions relevant to patient care and previous patient encounters. We found this to be a successful way to supplement the removal of the patient experience, as students were able to answer clinical questions and discuss how to approach management by sharing their experiences. One of the most striking things was seeing how they were able to utilize textbook and evidence-based algorithms to work through real life clinical scenarios while also taking stock of their role in healing. The course emphasized not just being a good test taker but learning valuable knowledge for beyond the exam as well. We made available to them optional podcasts and videos on the art of humanism in medicine.
  1. Setting a clear syllabus, modules, expectations, and rubrics.
    Everyone appreciates clear expectations, communication, and instructions. A syllabus was sent out weeks before the course began, so the students were able to become familiar with the course content and what was expected of them. Grading, class times, rubrics and material was clearly stated and after some initial confusion on how to grade the presentations, it was decided evaluations would be based on topic relevance, communication and teaching style and their PowerPoint presentations content. Weekly discussion forum entries were graded on critical analysis, thoughtful responses to given prompts, and engagement.
  1. Communicating openly, often, and warmly.
    To ensure students and faculty were on the same page, weekly announcement roundups were implemented. These announcements, which were all communicated with warm greetings and endings, included commenting on the past week, updating class times, the topics which would be presented that week. Current events were acknowledged, helpful resources were shared and even some poetry was shared. Students were not only reminded but encouraged to take regularly scheduled breaks to do something for themselves. It was pertinent to provide timely responses to all email communication and to allow flexibility for life events. Presentations were all done using the Zoom platform and while professionalism was encouraged, students appreciated the freedom to mute themselves or stop their video if needed. Each class required engagement by faculty to keep the energy going but with that invitation students adopted a balance of staying on topic but also feeling comfortable enough to be themselves.
  1. Maintaining structure while creating room for flexibility
    While flexibility is important, the facilitator’s job is also to maintain structure. The students needed time for dedicated study so mandatory classes were limited to one per week. Here they delivered their presentations to the class via Zoom. Faculty developed a standard format to use for the presentation, by using a case presentation and elaboration on the topic with high yield exam specific details. These were then uploaded to Webcourses for all to share. There were clear deadlines in place for responses to discussion post prompts, one for the original post and one for a peer response.
  1. Collaborating between faculty and students
    As always, collaboration is key! It is pertinent that students are viewed as partners in cultivating a learning environment that is designed for their benefit. Fellow faculty and mentors serve as maintaining quality check-ins and providing different viewpoints in delivery of the art of pedagogy.


Did you know that the Harvard Macy Institute Community Blog has had more than 220 posts? Previous blog posts have explored topics including harnessing the power of zoom for teaching and learning, empowering residents to teach on the wards, and mastering adaptive teaching in the midst of COVID-19.

Sanjana Mathur

Sanjana Mathur, MD is a physician and Instructor in clinical skills and simulation. Sanjana currently holds an adjunct faculty appointment in the Department of Education at The University of Central Florida College of Medicine. Sanjana’s areas of professional interest include medical education, simulation, and global health. Sanjana can be followed on Twitter or contacted via email.