Lessons from innovation in medical education during the COVID-19 pandemic: student perspectives on distributed training

Introduction: Can the forced adaptation brought about by COVID-19 inform the future of clinical education? This study brings a low- and middle-income country perspective to this question. Most studies of the impact of COVID-19 on medical students' training have been conducted in high-income countries, where the infrastructure to convert to alternative virtual or COVID-19-friendly training platforms (online teaching or case discussions and skill development centres) is more established than in low- and middle-income countries. In South Africa, Stellenbosch University instead chose to move substantial components of clinical training away from the traditional city tertiary campus and into smaller district hospitals. The main objective of this study was to ascertain the perspectives of these student interns regarding the quality of their restructured training at distributed health facilities during the COVID-19 pandemic and compare the perspectives of rural-site students with those of metropolitan (metro)-site students. Methods: A cross-sectional study was conducted by REDCap survey. Quantitative data were analysed by SPSS Statistics by doing descriptive and inferential statistics. The statistical significance of associations was determined by a p-value of <0.05. Likert-scale questions were analysed as ordinal variables to determine distribution of the responses, and non-parametric Mann-Whitney tests were used to compare distributions between rural and metro groups. Qualitative questions were analysed thematically by identifying common themes. Ethical approval was obtained for the study. Results: There were 155 respondents (62% response rate). Although 74.6% of participants indicated that they developed approaches to undifferentiated problems and illnesses, rural-site students were more likely to perceive that they learnt new procedures (p=0.006) and improved their ability to perform procedures previously learnt (p=0.002) compared to metro-site students. Rural-site students reported that they saw more patients independently than during previous training (p<0.001) and felt that they took more responsibility for patient management (p<0.001) than metro-site students. Students at rural sites were more likely to agree that training during the pandemic provided good learning opportunities (p<0.001) and that medical students form a necessary part of the pandemic response. Overall, students at both distributed sites felt that their training gave them more confidence for their future internship than previous training at central teaching hospitals (median=2 (agree)). Conclusion: The COVID-19 pandemic provided challenges for the continuation of quality medical training. It also provided the opportunity for innovative changes. This study demonstrates the successful outcomes, even during the pandemic, of distributed-site training, where students are immersed in the healthcare team, take responsibility of patient management and report that they improve their skills. Students at rural sites tended to report a more positive perspective on their clinical training. Rather than seeing the end of the pandemic as a time to revert to the previous status quo, the students in this study suggest to us that the lessons learnt from this forced innovation in distributed learning can now inform a better approach to clinical education for the future

First Image of the Sun with MeerKAT Solar Observations: Opening a New Frontier in Solar Physics

Solar radio emissions provide several unique diagnostics to estimate different physical parameters of the solar corona, which are otherwise simply inaccessible. However, imaging the highly dynamic solar coronal emissions spanning a large range of angular scales at radio wavelengths is extremely challenging. At GHz frequencies, the MeerKAT radio telescope is possibly globally the best-suited instrument at the present time and can provide high-fidelity spectroscopic snapshot solar images. Here, we present the first images of the Sun made using the observations with the MeerKAT at L-band (856 -- 1711 MHz). This work demonstrates the high fidelity of the MeerKAT solar images through a comparison with simulated radio images at the MeerKAT frequencies. The observed images show extremely good mophological similarities with the simulated images. A detailed comparison between the simulated radio map and observed MeerKAT radio images demonstrates that there is significant missing flux density in MeerKAT images at the higher frequencies of the observing band, though it can potentially be estimated and corrected for. We believe once solar observations with the MeerKAT are commissioned, they will not only enable a host of novel studies but also open the door to a large unexplored phase space with significant discovery potential.Comment: Preparing for submission, 14 pages, 9 figure