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Internal Medicine Clerkship Amidst COVID-19 Pandemic: A Cross-Sectional Study of the Clinical Learning Experience of Undergraduate Medical Students at Makerere University, Uganda

Authors Bongomin F, Olum R, Nakiyingi L, Lalitha R, Ssinabulya I, Sekaggya-Wiltshire C, Ocama P, Byakika-Kibwika P

Received 3 January 2021

Accepted for publication 4 March 2021

Published 12 March 2021 Volume 2021:12 Pages 253—262

DOI https://doi.org/10.2147/AMEP.S300265

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Balakrishnan Kichu Nair


Felix Bongomin,1,2 Ronald Olum,1 Lydia Nakiyingi,1 Rejani Lalitha,1 Isaac Ssinabulya,1,3 Christine Sekaggya-Wiltshire,1,4 Ponsiano Ocama,1 Pauline Byakika-Kibwika1

1Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; 2Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda; 3Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda; 4Directorate of Medicine, Mulago National Referral Hospital, Kampala, Uganda

Correspondence: Pauline Byakika-Kibwika
Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
Email [email protected]

Background: The coronavirus-2019 (COVID-19) pandemic continues to impose a significant impact on medical education. We aimed to describe the clinical learning experience of undergraduate medical students undertaking internal medicine clerkship during the COVID-19 pandemic at Makerere University, Uganda.
Methods: A descriptive, cross-sectional study among medical students in clinical years of study pursuing the Bachelor of Medicine and Bachelor of Surgery undergraduate degree program was conducted in November 2020. Only 3rd (junior clerks) and 5th (senior clerks) year medical students whose internal medicine clerkships were interrupted by the COVID-19 pandemic were studied.
Results: Data of 188 (95%) eligible clinical year students; junior (101, 54.0%) and senior (86, 46.0%) were analysed. Median age was 24 (range: 22– 42) years. Majority (70.1%) were male and Ugandan nationals (94.1%). Sixty-four (30.3%) students reported inadequate personal protective equipment, 152 (81.7%) felt at risk of contracting COVID-19, and 127 (67.9%) said it was difficult to observe COVID-19 standard operating procedures. Twenty-two students (11.9%) were discouraged from pursuing a career in internal medicine. Overall, most students reported good or excellent clinical experience pre-COVID-19 era compared to during the COVID-19 era (4.0 vs 3.5, p< 0.0001). Senior clerks significantly believed that the time allocated for the rotation was adequate (p< 0.0001) and they were able to complete their study objectives (p< 0.001), compared to the junior clerks. Senior clerks believed that learning was difficult when combined with junior clerks (p=0.013). About half of the students (51.4%, n=95) reported clinical teaching should remain as it was in the pre-COVID-19 era.
Conclusion: The COVID-19 pandemic has had a significantly negative effect on the clinical learning experience of the students. There is need to review the current teaching and learning methods to suit teaching and learning during pandemics of highly infectious diseases to ensure safe and effective learning experience.

Keywords: clinical learning experience, COVID-19, internal medicine, Makerere University

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