Negative effects on medical students' scores for clinical performance during the COVID-19 pandemic in Taiwan: a comparative study

Eunice Jia-Shiow Yuan; Shiau-Shian Huang; Chia-An Hsu; Jiing-Feng Lirng; Tzu-Hao Li; Chia-Chang Huang; Ying-Ying Yang; Chung-Pin Li; Chen-Huan Chen

doi:10.3352/jeehp.2023.20.37

Negative effects on medical students' scores for clinical performance during the COVID-19 pandemic in Taiwan: a comparative study

J Educ Eval Health Prof. 2023:20:37. doi: 10.3352/jeehp.2023.20.37. Epub 2023 Dec 26.

Authors

Eunice Jia-Shiow Yuan^{1

2

3}, Shiau-Shian Huang^{1

3

4}, Chia-An Hsu^{1

3

5}, Jiing-Feng Lirng^{3

6}, Tzu-Hao Li^{1

3

7}, Chia-Chang Huang^{1

3

8

9}, Ying-Ying Yang^{1

3

9}, Chung-Pin Li^{3

8

10

11}, Chen-Huan Chen^{1

3}

Affiliations

¹ Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.
² Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
³ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁴ School of Public Health, National Defense Medical Center, Taipei, Taiwan.
⁵ Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
⁶ Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
⁷ Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
⁸ Division of Clinical Skills Training, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.
⁹ Clinical Innovation Center, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.
¹⁰ Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
¹¹ Therapeutic and Research Center of Pancreatic Cancer, Taipei Veterans General Hospital, Taipei, Taiwan.

Abstract

Purpose: Coronavirus disease 2019 (COVID-19) has heavily impacted medical clinical education in Taiwan. Medical curricula have been altered to minimize exposure and limit transmission. This study investigated the effect of COVID-19 on Taiwanese medical students' clinical performance using online standardized evaluation systems and explored the factors influencing medical education during the pandemic.

Methods: Medical students were scored from 0 to 100 based on their clinical performance from 1/1/2018 to 6/31/2021. The students were placed into pre-COVID-19 (before 2/1/2020) and midst-COVID-19 (on and after 2/1/2020) groups. Each group was further categorized into COVID-19-affected specialties (pulmonary, infectious, and emergency medicine) and other specialties. Generalized estimating equations (GEEs) were used to compare and examine the effects of relevant variables on student performance.

Results: In total, 16,944 clinical scores were obtained for COVID-19-affected specialties and other specialties. For the COVID-19-affected specialties, the midst-COVID-19 score (88.513.52) was significantly lower than the pre-COVID-19 score (90.143.55) (P<0.0001). For the other specialties, the midst-COVID-19 score (88.323.68) was also significantly lower than the pre-COVID-19 score (90.063.58) (P<0.0001). There were 1,322 students (837 males and 485 females). Male students had significantly lower scores than female students (89.333.68 vs. 89.993.66, P=0.0017). GEE analysis revealed that the COVID-19 pandemic (unstandardized beta coefficient=-1.99, standard error [SE]=0.13, P<0.0001), COVID-19-affected specialties (B=0.26, SE=0.11, P=0.0184), female students (B=1.10, SE=0.20, P<0.0001), and female attending physicians (B=-0.19, SE=0.08, P=0.0145) were independently associated with students' scores.

Conclusion: COVID-19 negatively impacted medical students' clinical performance, regardless of their specialty. Female students outperformed male students, irrespective of the pandemic.

Keywords: COVID-19; Curriculum; Medical education; Medical student; Taiwan.

MeSH terms

COVID-19*
Education, Medical*
Female
Humans
Male
Pandemics
Students, Medical*
Taiwan / epidemiology