The transition to clerkshIps bootcamp: Innovative and flexible curriculum strategies post COVID-19 adaptation

Abstract

As in many other countries, Vietnam was severely affected by the COVID-19 pandemic in 2020 and 2021. The transition from traditional face-to-face instruction to remote learning amid social distancing measures propelled educators to develop new delivery methods to adapt to the new circumstances.¹ At VinUniversity, medical students experienced gaps in their clinical skills due to the shift to remote learning and deferred hands-on training. These gaps included insufficient exposure to hospital settings, challenges in interpersonal communication, limited opportunities for history-taking and physical examinations. These deficiencies necessitated the development of an intensive preparatory course to bridge these gaps before students entered their clerkships.

In response to the above situation, a 4-week “Transition to Clerkship Bootcamp” was implemented to equip the students with both knowledge and skills to overcome the disparity. This bootcamp was organized in the summer of the pre-clerkship year, comprising three main themes: (i) Introduction to Clinical Medicine, focusing on refining skills in history-taking, physical examination and communication; (ii) Hospital Preparation, providing practical training in hospital orientation, infection control and patient care; and (iii) Differential Diagnosis, emphasizing symptom-based diagnosis. The course summative assessment, including case presentations of actual patients seen during hospital visits (30%), completion of illness scripts (30%) and an Objective Structured Clinical Examination (OSCE) exam (40%), established a baseline for evaluating students' readiness for clerkships.

In its inaugural implementation, 49 students completed the bootcamp, with an 85.7% response rate to the course-end survey. The course received a mean satisfaction score of 4.2 out of 5 on Likert scale, indicating a significant increase in students' confidence and preparedness for their clerkships.

The Transition to Clerkship Bootcamp addressed important gaps in medical education imposed by remote learning during the pandemic, including clinical skills such as physical examination and communication, as well as clinical reasoning in the differential diagnosis modules leading to high performance on the OSCE, written examination of illness scripts and feedback from students on course evaluations. However, several key insights emerged from the implementation process. First, the lowest evaluation grade, mean 4.1 out of 5, was given to the course workload due to the intensive coverage of three themes within a 4-week period. This suggests a need for balancing content delivery with manageable student workload. Second, qualitative feedback revealed student concerns regarding the fairness and clarity of assessments, particularly due to limited familiarity with certain evaluation methods. One of the most valuable lessons learned was the importance of faculty development in the success of such an intensive program. Clinical preceptors played an essential role in shaping the curriculum, aligning hospital preparation modules with real-world clinical settings and providing students with practical exposure to clinical environments. However, the experience highlighted the need for structured faculty development programs that prepare instructors not only to deliver content but also to mentor students effectively. As many of the preceptors were relatively new to teaching in a bootcamp format, it became evident that faculty training should include guidance on active learning strategies, assessment calibration and providing constructive feedback to students.

In conclusion, the successful integration of the bootcamp into the medical curriculum has provided a model for not only for facilitating the transition to clerkship but also for addressing post-pandemic educational challenges in clinical training, with potential applications in other settings where similar disruptions have occurred.

Thuy Minh Ha: Conceptualization; writing—original draft; methodology; project administration. Quang Thanh Nguyen: Conceptualization; investigation; writing—original draft. Siaw Cheok Liew: Conceptualization; methodology. Jeffrey Mayne: Investigation; data curation; supervision. Phuoc Van Le: Conceptualization; supervision; project administration.