Résumés
Abstract
The COVID-19 pandemic disrupted academic life worldwide for students as well as educators. The purpose of this study is to shed light on the collective adversity experienced by international medical students and bioethics educators caused by the COVID-19 pandemic in relation to both personal and academic life. The authors wrote their subjective memoirs and then analyzed them using a collective autoethnography method in order to find the similarities and differences between their experiences. The results reveal some consistent patterns in experience that are captured in two metaphors: Falling apart and Bouncing back. “Falling apart” involves the breakdown of daily lives during the initial stages of the pandemic, shown through subjective quotes contextualized through the authors’ commentary. The consensus is that returning home and the transition to remote education were the two main reasons for the breakdown. “Bouncing back” encompasses the authors’ recovery after the initial breakdown, achieved by acquiring new information about the virus, discovering how to continue their hobbies at home, such as working out or dancing, and learning to adjust exam expectations. At the educational level, the bioethics course, which guided students through the ethical dilemmas of the pandemic, played an important role in the recovery/bouncing back process. For that reason, we report on how it was to learn about and teach this subject during the pandemic, and how bioethics knowledge was applied for better understanding and coping with some of the moral dilemmas related to the pandemic. The study testifies to the importance of bioethics education during a pandemic and explains how this can contribute to shaping the moral resilience of future medical practitioners.
Keywords:
- autoethnography,
- bioethics,
- COVID-19,
- infodemic,
- medical education,
- online education,
- public health,
- moral resilience
Résumé
La pandémie de COVID-19 a perturbé la vie universitaire dans le monde entier, tant pour les étudiants que pour les éducateurs. L’objectif de cette étude est de mettre en lumière l’adversité collective vécue par les étudiants internationaux en médecine et les éducateurs en bioéthique, causée par la pandémie de COVID-19, tant sur le plan personnel que sur le plan académique. Les auteurs ont rédigé leurs mémoires subjectives et les ont ensuite analysées à l’aide d’une méthode d’auto-ethnographie collective afin de trouver les similitudes et les différences entre leurs expériences. Les résultats révèlent des schémas cohérents dans l’expérience qui se traduisent par deux métaphores : s’effondrer et rebondir. « S’effondrer » désigne l’effondrement de la vie quotidienne au cours des premières phases de la pandémie, illustré par des citations subjectives mises en contexte par les commentaires des auteurs. Le consensus est que le retour au pays et la transition vers l’enseignement à distance ont été les deux principales raisons de l’effondrement. Le terme « rebondir » englobe le rétablissement des auteurs après la rupture initiale, grâce à l’acquisition de nouvelles informations sur le virus, à la découverte de moyens de poursuivre leurs passe-temps à la maison, tels que l’entraînement ou la danse, et à l’apprentissage de l’adaptation des attentes en matière d’examens. Au niveau éducatif, le cours de bioéthique, qui a guidé les étudiants à travers les dilemmes éthiques de la pandémie, a joué un rôle important dans le processus de récupération et de rebond. C’est pourquoi nous expliquons comment il a fallu apprendre et enseigner cette matière pendant la pandémie, et comment les connaissances en bioéthique ont été appliquées pour mieux comprendre et faire face à certains des dilemmes moraux liés à la pandémie. L’étude témoigne de l’importance de l’éducation à la bioéthique pendant une pandémie et explique comment elle peut contribuer à former la résilience morale des futurs praticiens médicaux.
Mots-clés :
- autoethnographie,
- bioéthique,
- COVID-19,
- infodémie,
- enseignement médical,
- enseignement en ligne,
- santé publique,
- résilience morale
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Parties annexes
Remerciements / Acknowledgements
Nous remercions nos réviseurs et l’éditeur en chef de la revue pour leurs commentaires qui nous ont permis d’améliorer ce document. Nous remercions Mary Graham pour la révision de cet article.
We thank our reviewers and the journal Editor-in-Chief for their comments that helped us to improve this paper. We thank Mary Graham for editing this paper.
Bibliography
- 1. Delgado J, Siow S, de Groot J, McLane B, Hedlin M. Towards collective moral resilience: the potential of communities of practice during the COVID-19 pandemic and beyond. Journal of Medical Ethics. 2021;medethics-2020-106764.
- 2. Rushton CH, Thomas TA, Antonsdottir IM, et al. Moral Injury and moral resilience in health care workers during COVID-19 pandemic. Journal of Palliative Medicine. 2022;25(5):712-9.
- 3. Rushton CH. Moral resilience: a capacity for navigating moral distress in critical care. AACN Advanced Critical Care. 2016;27(1):111-9.
- 4. WHO. Infodemic. 2020.
- 5. Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Academic Medicine. 1994;69(11):861-71.
- 6. Jagiellonian University Medical College. School of Medicine in English. Academic Program in English. 2023.
- 7. Myser C. How bioethics is being taught: a critical review. In: Bioethics Around the Globe. Oxford: Oxford University Press; 2011.
- 8. Gillam L. Teaching ethics in the health professions. In: Kuhse H, Singer P, editors. A Companion to Bioethics. 2nd Ed. Blackwell Publishing; 2009. p. 584-93.
- 9. Russell DC. Aristotle on cultivating virtue. In: Snow NE, editor. Cultivating Virtue: Perspectives from Philosophy, Theology, and Psychology. Oxford: Oxford University Press; 2015. p. 17-48.
- 10. WHO. Novel Corona Virus Update. 1 Feb 2020.
- 11. PA Media. Heart disease deaths soar in England during Covid pandemic. The Guardian. 14 Nov 2020.
- 12. Thakur V, Jain A. COVID 2019-suicides: A global psychological pandemic. Brain, Behavior, and Immunity. 2020;88:952-3.
- 13. Nelson-Becker H, Victor C. Dying alone and lonely dying: Media discourse and pandemic conditions. Journal of Aging Studies. 2020;55:100878.
- 14. Adedoyin OB, Soykan E. Covid-19 pandemic and online learning: the challenges and opportunities. Interactive Learning Environments. 2023;31(2):863-75.
- 15. Khalil R, Mansour AE, Fadda WA, et al. The sudden transition to synchronized online learning during the COVID-19 pandemic in Saudi Arabia: a qualitative study exploring medical students’ perspectives. BMC Medical Education. 2020;20:285.
- 16. Fishbane L, Tomer A. As classes move online during COVID-19, what are disconnected students to do? Brookings Institute. 20 Mar 2020.
- 17. Martin R, Piedmont-Palladino S, Sturlaugson B, et al. Field Notes on pandemic teaching: 1. Places. April 2020.
- 18. Kala PS, Thapliyal N, Pandey HS, Piyush AR, Maheshwari S, Chaudhary VS. Medical students’ perspective on online teaching during pandemic: Experience from a government medical college in Uttarakhand, India. Journal of Education and Health Promotion. 2021;10:473.
- 19. Hodges CB, Moore S, Lockee BB, Trust T, Bond MA. The difference between emergency remote teaching and online learning. Educause. 27 Mar 2020.
- 20. Rajab M, Gazal A, Alkattan K. Challenges to online medical education during the COVID-19 pandemic. Cureus. 2020;12(7):e8966-76.
- 21. Cutri RM, Mena J, Whiting EF. Faculty readiness for online crisis teaching: transitioning to online teaching during the COVID-19 pandemic. European Journal of Teacher Education. 2020;43(4):523-41.
- 22. Good BJ. Medicine, Rationality and Experience: An Anthropological Perspective. Cambridge: Cambridge University Press; 1994.
- 23. Denshire S. On auto-ethnography. Current Sociology. 2014;62(6):831-50.
- 24. Lapadat JC. Ethics in autoethnography and collaborative autoethnography. Qualitative Inquiry. 2017;23(8):589-603.
- 25. Dyson M. My story in a profession of stories: auto ethnography - an empowering methodology for educators. Australian Journal of Teacher Education. 2007;32(1):36-48.
- 26. Van der Geest S, Gerrits T, Singer Aaslid F. Introducing ‘ethnography and self-exploration’. Medische Antropologie. 2012;24(1):5-21.
- 27. Wald HS, Monteverde S. COVID-19 era healthcare ethics education: Cultivating educational and moral resilience. Nursing Ethics. 2021;28(1):58-65.
- 28. Delamont S. The only honest thing: Autoethnography, reflexivity and small crises in fieldwork. Ethnography and Education. 2009;4(1):51-63.
- 29. Wear S. Teaching bioethics at (or near) the bedside. Journal of Medicine and Philosophy. 2002;27(4):433-45.
- 30. Johnson C. Declaration of Geneva now includes doctors’ own health. Australian Medicine. 2017;29(21):30.
- 31. Chłoń-Domińczak A, Sowa-Kofta A, Szarfenberg R. European Social Policy Network Thematic Report: Social protection and inclusion policy responses to the COVID-19 crisis. Poland. European Commission; 2021.
- 32. Spilg E, Rushton C, Phillips J, et al. The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic. BMC Psychiatry. 2022;22:19.
- 33. Holtz H, Heinze K, Rushton C. Interprofessionals’ definitions of moral resilience. Journal of Clinical Nursing. 2018;27(3-4):e488-e94.
- 34. Berg S. Virtual resilience rounds help physicians navigate moral distress. AMA Physician Health. 25 Jun 2020.
- 35. Yazdankhahfard M, Haghani F, Omid A. The Balint group and its application in medical education: A systematic review. Journal of Education and Health Promotion. 2019;8:124.
- 36. Brodar C, Muller C, Brodar KE, Brosco JP, Goodman KW. Ethics education in COVID-19: Preclinical medical students’ approach to ventilator allocation. Cureus. 2021;13(8):e16976.
- 37. Steiner-Hofbauer V, Grundnig JS, Drexler V, Holzinger A. Now, I think doctors can be heroes … Medical student’s attitudes towards the COVID-19 pandemic’s impact on key aspects of medical education and how the image of the medical profession has changed due to the COVID-19 pandemic. Wien Med Wochenschr. 2022;172(3-4):90-9.
- 38. Lempp H, Seale C. The hidden curriculum in undergraduate medical education: qualitative study of medical students’ perceptions of teaching. BMJ. 2004;329(7469):770-3.
- 39. Lin YK, Lin C-D, Lin BY-J, Chen D-Y. Medical students’ resilience: a protective role on stress and quality of life in clerkship. BMC Medical Education. 2019;19:473.
- 40. Cyrulnik B. Resilience: How Your Inner Strength Can Set You Free from the Past: Penguin Publishing Group; 2011.
- 41. Jupina M, Sidle MW, Rehmeyer Caudill CJ. Medical student mental health during the COVID-19 pandemic. Clinical Teacher. 2022;19(5):e13518.
- 42. Christophers B, Nieblas-Bedolla E, Gordon-Elliott JS, Kang Y, Holcomb K, Frey MK. Mental health of US medical students during the COVID-19 pandemic. Journal of General Internal Medicine. 2021;36(10):3295-97.
- 43. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA. 2016;316(21):2214-36.
- 44. Moxham L, Fernandez R, Lord H, Halcomb E, Middleton R. Life during lockdown: Coping strategies used by preregistration nursing students during COVID-19. Nurse Education in Practice. 2022;63:103388.
- 45. Halperin SJ, Henderson MN, Prenner S, Grauer JN. Prevalence of anxiety and depression among medical students during the Covid-19 pandemic: a cross-sectional study. Journal of Medical Education and Curricular Development. 2021;8:2382120521991150.