What has medical school been like in the age of Zoom? Before I was a student doctor, I was an undergraduate student pining after the halls of medicine and the truthfully looking forwards to the rigors of medical school. Upon acceptance to medical school at the University of California, San Diego, I celebrated via Zoom with family. Orientation week was a hybrid model of Zoom and on-campus socially distanced activities. Our white coat ceremony was also held through Zoom, which was quite painful for a few of us but ultimately necessary to comply with the public health guidelines. What I did not foresee was how much my peers and I would experience Zoom fatigue.
Zoom fatigue started creeping in around the second week of my medical school education. I noticed that I had been subconsciously relying on the atmosphere of a traditional classroom to remain engaged in my learning. Zooming at home, I am distracted by the comfort within reach, the ease of access to food, and the noises of other media in the background. Tiktok. I have never hated an app so much until the present moment for the ease of entertainment it affords and how I gravitate towards it when I feel disengaged during a Zoom lecture. I overcame this during my third week by simply deleting the app and willfully engaging in my online lectures and pre-recorded lectures. Nevertheless, the other symptoms (if I may use this word) of Zoom fatigue persisted. These included emotional withdrawal, lack of focus, and even eye strain from looking at a computer screen for around 6 to 8 hours per weekday.
Sensory deprivation and the hybrid model
The model at UCSD School of Medicine is a hybrid one that incorporates Zoom live lectures plus pre-recorded lectures. Our anatomy classes are in person, and we are placed in cohorts to limit the possibility of an outbreak occurring and disseminating within the student body. This hybrid model works as we are learning smoothly. It also gives flexibility to the students to re-organize their schedules for when they want to see lectures that are pre-recorded and when they want to focus on other extra-curriculars. The model, however, lacks the culture and engagement that comes with being present in a traditional classroom full of your peers. This is my grave concern; there is sensory deprivation in the age of Zoom for medical students.
Sensory deprivation is going to impact the medical education of the entering class of 2020. Some medical schools in the University of California system have anatomy classes online. Anatomy is one such subject that is best learned in person. As Mark Whitehead, PhD, of UCSD stated to my class, the cadaver is our first patient. This is key in anatomy as we learn from the sacrifices of our donors. The sight of the body and the sensation of touching, smelling, and even hearing are all irreplaceable educational opportunities. This study stated that various literature that reference behavioral and neuroimaging studies found that learning is effective in multimodal and multisensory interactions. The engagement of the senses is critical in medical education to become not only a scientifically adept physician but also a compassionately humanistic one.
The counter-argument to that is neural plasticity, and it has been raised in discussion with some of my peers through Zoom of all places. While the brain is remarkable at adapting to different scenarios, adaptation does not necessarily equate to efficiency. Additionally, there are hardly any peer-reviewed studies that have provided data regarding the effects of education over a web platform for a long period of time. By contrast, however, some studies show a negative impact on memory recall of a subject due to the reduction of multimodal sensory in learning that specific subject. We can anticipate that the reduction to hyper-focused visual/auditory learning via Zoom will inevitably yield results that we will observe within the coming years as we enter the workforce.
Another argument is that the COVID19 pandemic is affecting only a small portion of our medical education. I believe this entirely contextual as some schools are completely remote learning, while others are employing a hybrid model. Each medical school is adapting as best they can, but the quality and quantity of education are impacted regardless of how long the pandemic lasts. The New Yorker magazine names education through Zoom what it truly is, a great experiment. In similarity, medical education through Zoom is an experiment, and those learning through Zoom in the pre-clinical years will be a unique cohort.
Onward with this great experiment
Every great experiment has a thematic research question. In this case, I believe a research question one could posit is how medical students who have trained over zoom compare with those who have trained in the traditional classroom. Given that this learning experiment is ongoing, the coming years will yield results that may show how the patient care we provide is positively or negatively impacted.
Zachariah Tman is a medical student. The views expressed here are my own and do not represent the University of California San Diego’s positions, strategies, or opinions.
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