COVID-19 is now a part of everyday language. Of those who have survived the infection, there is emerging evidence that there will be long-term effects on their physical health. Psychological wellbeing should not go unmentioned.
The pandemic has generated concern, fear, and stress in the population at large, as observed in numerous studies. From anecdotal evidence at the start of the pandemic, medical students seemed particularly affected. However, no formal research had been done to assess the psychological effects of the COVID-19 pandemic on medical students and interim foundation year (FiY1) doctors across the UK, and the support they received and sought. Alongside a team of medical students and doctors from across the country, we were keen to design and run a prospective, observational, multicentre study.
2075 medical students from across the UK participated which meant the effects of the pandemic could be studied on a national scale, with statistically significant results. Both medical students and FiY1 doctors self-reported a decrease in their mood since the start of the pandemic. Social distancing and more time at home or with family were the factors that negatively and positively impacted respectively the mood of the greatest number of participants.
All areas of life surveyed in the study were found to have been more negatively impacted than positively impacted. The negative impact of COVID-19 on participants’ lives and their mental wellbeing might explain why nearly half of all participants indicated that they would like more support from their universities and, to a lesser extent, their foundation schools. These results were sent to relevant bodies to assist medical schools, foundation schools, and hospital trusts with their decision and policy making, signposting medical schools to the most affected student groups, and facilitating the developments of interventions designed to obviate the impact of the pandemic on mental health and wellbeing.
Collaborating and co-creating research ensures studies are closer to the needs and experiences of the participants.
During a period where medical students and FiY1 doctors were subjected to recruitment for different studies on almost a daily basis, it is worth noting the large number of individuals that participated in this study. We believe one factor behind this was the study being co-developed by medical students and FiY1 doctors.
We started at the University of Oxford by conducting an initial qualitative data-gathering exercise of 170 medical students or FiY1 doctors that had graduated from the university. Based on the concerns and thoughts raised by medical students and FiY1 doctors, a questionnaire was created. However, data from a sample of medical students and FiY1 doctors in one medical school in the country were not sufficiently generalisable for us to be confident that we were capturing all the necessary views and needs of medical students nationally.
To address this, we sent the questionnaire to medical students across the country for their input into its design, content, and usability. Feedback was received from at least one individual at all 34 medical schools in the UK. Based on their experiences, the questionnaire was updated to improve clarity, objectivity, and more accurately capture the needs of our participants. This collaborative approach also meant that the survey caught our participants’ attention, as we actively explored the issues that they most cared about.
An added benefit of involving the target audience for our study at the conception and design stage was the establishment of regional leads for this study at a national scale. Having medical students and FiY1 doctors champion this study locally allowed us to gain buy-in from local stakeholders, such as local medical schools and foundation schools, and ensure that they were formally engaged at an early stage of this study.
This also minimised a duplication of efforts, with the faculty at local medical schools agreeing to partner with us rather than running their own single-centre study. The study could therefore be disseminated more widely and reach individuals that would otherwise have not been accessible to an external body trying to recruit participants independently.
Our regional leads were constructive in many aspects of the study, and we were able to share fundamental skills in study design and delivery with them. We believed it was equally important to take a participatory approach to co-create the manuscript with our target audience to better understand the implications of the data generated. This meant the advice produced was geared to medical students and their needs, and medical schools could respond appropriately.
Collaborating and co-creating research ensures studies are closer to the needs and experiences of the participants. This not only ensures buy-in from participants, but greater buy-in from bodies that can action recommendations. The philosophies of collaboration also need to extend beyond research. As a community, we all succeed whenever any of us succeeds. We need to ensure collaboration is built into the system early so future healthcare practitioners do not lose sight of that.