A Framework to Support Medical Students’ Professional Development During Large-Scale Societal Events

Large-scale societal events affect the general public at a local, regional, national, or international level and may substantially impact the daily lives and interpersonal interactions of many people. These events are acute with potential for long-lasting effects. They may cause significant disruptions, as in the case of pandemics, military conflicts, terrorism, widespread natural disasters, mass shootings, and other violent events discussed in the media. Large-scale societal events may also serve as a catalyst for positive change and empowerment, for example, the call for racial justice by the Black Lives Matter (BLM) movement or for gender equity with the #MeToo movement. Some events may both disrupt and empower groups; for instance, the pandemic disrupted medical students’ education because of safety concerns, but also led to a heightened sense of duty and advocacy in many. In fact, societal events that disrupt medical education significantly impact how medical students think about and act out their roles as students and future physicians [1–3]. Largescale societal events such as the COVID-19 pandemic and the BLM movement changed not only medical school curricula and operations, but also medical students’ daily lives, professional development, and interactions with patients and faculty, and how they view their role in the medical community and society [4–10]. As the impact of these societal events on students’ professional development and well-being has only begun to be described in the short term, long-lasting and possible permanent changes as to how future physicians will envision their profession are unknown. What is known now though is that medical schools have an obligation to adapt, to respond to students’ needs, and to support students’ professional growth and mental health. Perhaps the greatest challenge will be for medical schools to realize the need for change in the face of societal disruptions. In a recent commentary about the pandemic, Jansen notes that to fully support students, medical schools must recognize the need to “unfreeze” by critically reflecting about how the event transformed individuals and how the organization must then be willing to transform accordingly [1]. Medical schools need guidance on how to transform during and after large-scale societal events to support learners’ professional development; however, there is a dearth of literature that provides a framework to do so. A recent publication provides a model for institutional pandemic response describing zones of crisis, adaptation, and growth [11]. While the model wholly focuses on graduate medical education, it recognizes the need for transparent communication between leaders, faculty, and learners and emphasizes continued professional development during uncertainty [11]. Less described are specific “how to” steps for gaining understanding of the learners’ perspectives, supporting learners’ psychosocial needs to further their professional development, and a mechanism for evaluation to determine if changes were successful, need adaptation, or should continue or end [11]. In response to the pandemic, one academic medical center developed a response model in which students’ perspectives and participation in a response team and task forces developed opportunities for students to contribute meaningfully to the community, healthcare system, and school when traditional clinical activities were suspended [12]. While this framework may well be transferrable to future events and focuses on value-added education and coproduction activities [12], it does not provide mechanisms for critical evaluation of endeavors, including the impact on the professional development of students. Medical schools need a flexible framework to keep students’ professional development at the forefront including a step-by-step implementation process and guidance for critically evaluating the impact of the school’s response while simultaneously dealing with logistics and operation disruptions. * Christine Sullivan [email protected]