Compassionate clinicians at the bedside, intrepid researchers at the bench, and steadfast staff behind the scenes have all played integral roles in Penn Medicine’s response to the ongoing pandemic, but another group has also rallied to combat the crisis while off campus — the driven medical students of the Perelman School of Medicine (PSOM) at the University of Pennsylvania.
When the coronavirus spread to the region earlier this spring, PSOM was forced to send its physicians-in-training home in order to minimize the spread of the virus. But while students couldn’t join the front lines, and some initially felt thrown by the transition to remote work and virtual learning, many quickly found ways to get involved, such as collecting PPE for staff, creating organizations to address needs among vulnerable communities, and sharing their peers’ COVID-19 experiences in a new student-run publication. For 80 rising fourth-years eager to play their part and return to their clinical rotations prepared, the path forward was clear — educate themselves on this ever-evolving pandemic, fast.
But with the news updating by the minute and their go-to experts and mentors also trying to catch up, where would they even begin?
Jennifer Kogan, MD, the associate dean for Student Success and Professional Development who oversees the development of the Module 5 elective course curriculum, was working with elective directors to translate their courses to an online platform when a group of students and residents came to her with a proposal for a new virtual class focused on COVID-19. Inspired by the open-source curriculum developed by students at Harvard Medical School, the group worked together with Kogan and Harvey Rubin, MD, PhD, a professor of Infectious Diseases, to co-create a course from scratch.
“I think that students often know what they need, and this offered a wonderful opportunity for us to think outside of the box and creatively deliver content that offered firsthand learning as the pandemic unfolded,” Kogan said. “It was completely new, and I think incredibly valuable.”
During four two-week sessions running from April to June, students dove deep into COVID-19’s basic science and basic virology, effects on different organs, epidemiology and mathematical modeling, new therapies, vaccine developments, and other related topics. The nature of the pandemic required a malleable syllabus that could change as quickly as the headlines, and there was a far smaller knowledge gap between the students and instructors than usual given that everyone was navigating the crisis together. For Rubin, the on-the-fly curriculum development was a bright spot of “great fun” amidst an often overwhelming time.
“This was by far the most interesting, challenging, and fulfilling course I’ve ever taught because we all had to be at the top of our game,” Rubin said. “Literally every day, things changed. Data is still emerging even now. The students had to combine all of their clinical and basic science knowledge in order to understand the impact of the pandemic, and they were flexible and fearless. And the teaching assistants? Remarkable! No question, I couldn’t have done it without them.”
Two of those TAs were rising fourth-years Hannah Schwennesen and Christina Bax. After taking the elective themselves, they stayed on to co-teach the next round. Rather than becoming overwhelmed by the deluge of new information emerging constantly, the TAs seamlessly integrated new readings and discussion topics into the curriculum with Rubin’s enthusiastic blessing. For example, Schwennesen expanded the syllabus to cover the social dimensions of COVID-19, such as health inequities and the disproportionate impact on Black and Hispanic communities. As a result, each iteration of the course got better and better as each round of students-turned-teaching-assistants wove in new priorities.
“One week, we were discussing hydroxychloroquine, and then a week later, we were talking about how we shouldn’t give that to anyone. It really reminded us that medicine isn’t set in stone — we’re always learning, and we always have to be open to new information,” Schwennesen said. “And in a situation where there aren’t really any true experts on the topic, it has been amazing to learn from one another.”
The course content further diversified when Rubin recognized the value of having students study patients, even if they couldn’t do so in person at the bedside. He started presenting COVID-19 cases at the start of each class, and each small group was assigned a patient to follow through their hospital stay. By diving into electronic medical records and sitting in on telemedicine visits, the class got a real-time understanding of how individual patients were affected by the virus differently. Not only did this unique combination of “synchronous and asynchronous learning” keep students engaged on even the most challenging online learning days, but it also kept patient care and the human impact of this disease at the forefront.
The class also split into groups to work on research assignments like investigating international pandemic responses that they’d then present to their peers in the afternoon. A variety of speakers also shared their perspectives. Kathryn Flack, MD, a Pulmonary and Critical Care fellow, graciously joined the class online multiple times after her long shifts in the ICU to share her front line experiences caring for patients who needed ventilators, for example, and P.J. Brennan, MD, chief medical officer and senior vice president of the health system, offered a comprehensive breakdown of Penn Medicine’s pandemic response.
Class after class offered rave reviews, praising Rubin’s expertise and the self-directed, evolving style of the course. Students were virtually lining up to vie for a spot in the next session, and after the demand exceeded the 20-student cap, the reading list was opened up to ensure those who weren’t able to take the course could also stay up-to-date. “We were all reading the news, but consolidating it and working through it with our peers really helped us to feel like we were taking action and preparing ourselves. One of my friends said the class really helped her talk to her family about the pandemic and answer their questions, which is a role a lot of med students find themselves in,” Bax said.
“We were teaching each other, then teaching our communities. We were learning in the moment. This course really was one of the best experiences I’ve ever had at Penn.”