Grafton-Clarke, C, Uraiby, H, Gordon, M, Clarke, N, Rees, EL, Park, S, Pammi, M, Alston, S, Khamees, D, Peterson, W, Stojan, J, Pawlik, C, Hider, A and Daniel, M (2021) Pivot to online learning for adapting or continuing workplace-based clinical learning in medical education following the COVID-19 pandemic: A BEME systematic review. Medical Teacher. ISSN 0142-159X

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The novel coronavirus disease (COVID-19) was declared a pandemic in March 2020, which necessitated adaptations to medical education. This systematic review synthesises published reports of medical educational developments and innovations that pivot to online learning from workplace-based clinical learning in response to the pandemic. The objectives were to synthesise what adaptations / innovation were implemented (description), their impact (justification), and ‘how’ and ‘why’ these were selected (explanation and rationale).
The authors systematically searched four online databases and hand-searched MedEdPublish up to December 21, 2020. Two authors independently screened titles, abstracts and full-texts, performed data extraction, and assessed the risk of bias. Our findings are reported in alignment with the STORIES (STructured apprOach to the Reporting in healthcare education of Evidence Synthesis) statement and BEME guidance.
Fifty-five articles were included. Most studies (n=40) were from North America, and nearly 70% focused on undergraduate medical education (UGME). Key developments were rapid shifts from workplace-based learning to virtual spaces, including online electives, telesimulation, telehealth, radiology, and pathology image repositories, live-streaming or pre-recorded videos of surgical procedures, stepping up of medical students to support clinical services, remote adaptations for clinical visits, multidisciplinary team meetings and ward rounds. Challenges or barriers included lack of personal interactions, lack of standardised telemedicine curricula and need for faculty time, technical resources and devices. Assessment of risk of bias revealed poor reporting of underpinning theory, resources, setting, educational methods, and content.
This review highlights the response of medical educators in deploying adaptations and innovations from workplace-based to online learning during the COVID-19 pandemic in clinical settings. Whilst innovations and adaptations have ensured learning across the continuum, explicit reporting of operationalisation of education interventions requires additional focus. We would encourage future work to fully evaluate all outcomes and move towards reporting at Kirkpatrick levels 3 or 4.

Item Type: Article
Additional Information: � 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way
Uncontrolled Keywords: COVID-19; systematic review; clinical learning; online learning; remote learning
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Depositing User: Symplectic
Date Deposited: 13 Oct 2021 11:55
Last Modified: 11 Feb 2022 10:47

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