reflective essay about covid 19 as a student

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Introduction

The global outbreak of COVID-19 has certainly taken an overwhelming toll on everyone. People have lost their jobs, their homes, and even their lives. There is no getting past the fact that the overall impact on the world has been negative, but it is important to realize that positive aspects of the pandemic have been overshadowed by the many negative ones. In an attempt to slow the spread of the disease, many governments made the decision to implement lockdowns, forcing billions to work and take classes from home, in many cases for the first times in their lives. Not only have these lockdowns altered the way that people work and go to school, but they have altered the mental health of everyone and the environmental health of the world around us.

Connection to STS Theory

The positive impacts of technology during the pandemic stems from the Modernization Theory, posing that there is a relationship between societal and technological advancements as societies shift to become updated as opposed to traditional. Technology has brought about lots of resistance to COVID that would not have been possible without the drastic advancements in science over the years. Thanks to these advancements, relationships can stay connected, students can continue to learn, jobs can stay open, and the environment can subtly improve. Our modernized world is well enough suited to take on the troubling times that COVID-19 has brought along.

Technology with School – Relates to College Students

Remote learning has allowed each of us to learn from the comfort of our homes. Working remotely has also allowed us to work from our living rooms. The perks of both are not having to wake up early to drive to work in the mornings, not having to sit at an office desk for eight hours a day, and not having to walk to class. Working remotely and remote learning has also been a time saver for many individuals.

According to Business Insider, there are a few tips that will help students be successful while being virtual. One tip is to clean your workspace. It is important to have a space, just like you would at a desk in a classroom, to ensure that you are paying attention to the professor. It is always important to engage with your professor. It is important to contact your professor outside of the class section to ensure that you are retaining the information. Another tip that the Business Insider recommends is to connect with your classmates. It is vital to build connections with your classmates that will help everyone have a comfortable environment to ask questions.

Personal Growth

In March 2020, the COVID-19 outbreak hit the United States. College students were forced to leave their beloved campuses and go home to finish their semesters online. For some, it meant their schoolwork load was lightened and they could sleep until noon. For others, it meant their plans of graduating and having a job for the summer were in jeopardy. Regardless of their situation, one thing was likely the same for all: lots of time alone. Students found things to do to pass the time. Some learned to cook, some started exercising at home, and others had more time to do what they already loved.

Ethan, a student at the University of South Carolina, used the time to start lifting weights in his home gym. In the United States, sales of home gym equipment doubled, reaching nearly $2.4 Billion in revenue. Store shelves were entirely sold out of exercise equipment. Many students like Ethan report that exercising was one of the biggest changes they made during COVID lockdown.

Other students, such as Cam, found an opportunity to get in a better place mentally. “I learned not to take things for granted. My relationship with my family has gotten better. I’m a much stronger person,” the Clemson student reported. Grayson, an athlete at Winthrop University, reported that it made him have a more positive outlook on being by himself. A student that elected to remain anonymous was just happy they could wake up later and not have to brush their teeth as much because of masks. Whether a dentist would approve of that habit or not, an improvement in mental health is a win in anyone’s book.

A select few students decided to challenge themselves in a world where all odds are stacked against them.  Dean, a freshman at the University of South Carolina, decided to start his own bracelet and T-Shirt business in a time when small businesses all over the country were facing a grave threat of going out of business. All the while, he learned to play the guitar and uploaded his songs to SoundCloud, he reported.

Whether college students decided to get a six-pack or learned how to sew, almost everyone found something constructive and positive to do with their extra free time. The college students of COVID-19 learned what it meant to make the best of an unfortunate situation. Things may have looked bleak and frightening, but they learned how to manage those feelings and make something positive out of it.

Change in Workforce

Before the pandemic, many companies did not allow employees to work from home. Also, many companies would not even allow employees to take home items, such as laptops, as a safety precaution. According to Stanford Medicine, rapid innovation and implementation of technology has allowed for the employees to navigate the challenges. It states that it is clear that technology has transformed our typical daily workflow. Technology has also made it easier to connect with the patients during the pandemic.

The Pew Research Center states “about half of new teleworkers say they have more flexibility now and that majority who are working in person worry about virus exposure.” In December 2020, 71% of the workers that were surveyed were doing their job from home all or most of the time. Of those workers, more than half said if they were given the choice that they would want to keep working from home even after the pandemic. Among those who are currently working from home, most say that it has been easy to meet deadlines and complete projects on time without interruptions.

Environmental Improvements

Before the COVID-19 outbreak, a typical day consisted of billions of people across the globe commuting to work or school, whether that be through public buses or trains, driving themselves in cars, or some other means of transportation. As all these vehicles were used, immeasurable amounts of gases and chemicals were released into the atmosphere. As infection numbers and the death toll increased, most nations began enforcing lockdown protocols, and these mandates affected almost 3 billion people (Rume & Islam, 2020). Businesses and factories shut down or people began working from home, meaning they no longer needed to drive to work. In an attempt to stunt transmission, the majority of international travel was halted, limiting tourism, which also had a great impact. Since industrialization has advanced in major cities across the globe, the amount of Greenhouse Gases that have been emitted is alarming. Cars, buses, trains, industries, factories all release harmful chemicals due to the burning of fossil fuels or other energy sources. When these pollutants enter the atmosphere, they cause a variety of issues. It decreases overall air quality and visibility, and can be dangerous to those inhali ng the m.

According to research performed by Shakeel Ahmad Bhat and a group of other scientists from India, China, and the United Kingdom, Delhi, India is one of the most polluted cities in the world (Bhat et al, 2021). The city is highly industrialized and densely populated, contributing to the elevated levels of particulate matter in the air. Particulate matter is small pollutant liquid droplets and solid particles in the air (Environmental Protection Agency, 2020). When inhaled, they can burrow deep into the lungs and even the bloodstream and cause serious damage to a person, “particularly respiratory ailments” (Bhat et al, 2021). The two types of particulate matter are PM10 and PM2.5, and their numbers correspond to the size of the particles (their diameters in units of micrometers). The smaller the particle, the more harmful they are. By National Ambient Air Quality Standards (NAAQS), the level of particulate matter in Delhi is well above the tolerable limits. In 2016 alone, the amount of deaths caused by the poor air quality in India “was approximately 4.2 million” (Bhat et al, 2021).

Lockdowns positively affe cted more than just the air quality around the world; additionally, water quality and beaches were a major beneficiary. Tourism for centuries has led to a significant overuse of beach resources such as fishing and leisure activities, and these in turn led to pollution of the water. If people are using jet skis and boating in lakes or oceans, the fuel and exhaust often leak into the water which can cause significant harm to the wildlife that lives in it. Restricting beach access has allowed them to recover and regain their resources, and has also decreased the pollution levels in the water. The water flowing in the Venice canals are cleaner now than they have been before (Bhat et al, 2021). pH levels, electric conductivity, dissolved oxygen levels, biochemical oxygen demand, and chemical oxygen demand have all decreased as a result of the lockdowns (Rume & Islam, 2020). These decreases all contribute to the fact that overall water quality levels have increased.

Noise pollution is an often-overlooked type of pollution that affects the world, especially in highly urbanized regions. Noise pollution is elevated levels of sound which are typically caused by human activities including transportation, machines, factories, etc. When the noise levels are elevated for extended periods of time, it negatively affects all organisms in the area. It leads to hearing loss, lack of concentration, high stress levels, interrupted sleep, and many other issues in humans. As for the wildlife, their abilities to detect and avoid predators and prey are hindered by noise pollution. It affects the invertebrates responsible for the control of many environmental processes that maintain balance in the ecosystem (Rume & Islam, 2020). When lockdowns were implemented, traveling and transportation stopped, industries shut down, flights were canceled, and people stayed home. The environment was able to recover and the people and organisms within the ecosystem enjoy a higher quality of life as a result.

Reflection Questions

• What kinds of positive experiences have you had during the pandemic?
• As stated in the chapter, there are many students who spent their time working out or picked up new hobbies. What new things were you able to focus on during the lockdowns?

Bhat, Shakeel Ahmad et al. “Impact of COVID-Related Lockdowns on Environmental and Climate Change Scenarios.” Environmental research 195 (2021): 110839–110839. Web. https://www-sciencedirect-com.libproxy.clemson.edu/science/article/pii/S001393512100133X?via%3Dihub.

DiDonato, S., Forgo, E., & Manella, H. (2020, June 5). Here’s how technology is helping residents during the COVID-19 pandemic . Scope Blog. https://scopeblog.stanford.edu/2020/06/04/how-technology-is-helping-residents-during-the-covid-19-pandemic/.

Environmental Protection Agency. (2020, October 1). Particulate Matter (PM) Basics. EPA. https://www.epa.gov/pm-pollution/particulate-matter-pm-basics.

Merkle, Steffen. “Positive Experiences During COVID-19.” Survey. 18 April 2021.

Parker, K., Horowitz, J. M., & Minkin, R. (2021, February 9). How Coronavirus Has Changed the Way Americans Work . Pew Research Center’s Social & Demographic Trends Project. https://www.pewresearch.org/social-trends/2020/12/09/how-the-coronavirus-outbreak-has-and-hasnt-changed-the-way-americans-work/.

Rume, T., & Islam, S. M. D.-U. (2020, September 17). Environmental effects of COVID-19 pandemic and potential strategies of sustainability. Heliyon. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498239/#bib42.

Shaban, Hamza. “The Pandemic’s Home-Workout Revolution May Be Here to Stay.” The Washington Post, WP Company, 8 Jan. 2021, www.washingtonpost.com/road-to-recovery/2021/01/07/home-fitness-boom/.

Thompson, K. L. (2021, February 2). I’m a college professor who’s teaching virtually during the pandemic. Here are 7 things my most successful students do on Zoom. Business Insider. https://www.businessinsider.com/tips-for-zoom-success-as-remote-student-professor-advice-2021-2.

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Community Reflections

My life experience during the covid-19 pandemic.

Melissa Blanco Follow

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Affiliation with sacred heart university.

Undergraduate, Class of 2024

My content explains what my life was like during the last seven months of the Covid-19 pandemic and how it affected my life both positively and negatively. It also explains what it was like when I graduated from High School and how I want the future generations to remember the Class of 2020.

Class assignment, Western Civilization (Dr. Marino).

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Blanco, Melissa, "My Life Experience During the Covid-19 Pandemic" (2020). Community Reflections . 21. https://digitalcommons.sacredheart.edu/covid19-reflections/21

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What Life Was Like for Students in the Pandemic Year

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In this video, Navajo student Miles Johnson shares how he experienced the stress and anxiety of schools shutting down last year. Miles’ teacher shared his experience and those of her other students in a recent piece for Education Week. In these short essays below, teacher Claire Marie Grogan’s 11th grade students at Oceanside High School on Long Island, N.Y., describe their pandemic experiences. Their writings have been slightly edited for clarity. Read Grogan’s essay .

“Hours Staring at Tiny Boxes on the Screen”

By Kimberly Polacco, 16

I stare at my blank computer screen, trying to find the motivation to turn it on, but my finger flinches every time it hovers near the button. I instead open my curtains. It is raining outside, but it does not matter, I will not be going out there for the rest of the day. The sound of pounding raindrops contributes to my headache enough to make me turn on my computer in hopes that it will give me something to drown out the noise. But as soon as I open it up, I feel the weight of the world crash upon my shoulders.

Each 42-minute period drags on by. I spend hours upon hours staring at tiny boxes on a screen, one of which my exhausted face occupies, and attempt to retain concepts that have been presented to me through this device. By the time I have the freedom of pressing the “leave” button on my last Google Meet of the day, my eyes are heavy and my legs feel like mush from having not left my bed since I woke up.

Tomorrow arrives, except this time here I am inside of a school building, interacting with my first period teacher face to face. We talk about our favorite movies and TV shows to stream as other kids pile into the classroom. With each passing period I accumulate more and more of these tiny meaningless conversations everywhere I go with both teachers and students. They may not seem like much, but to me they are everything because I know that the next time I am expected to report to school, I will be trapped in the bubble of my room counting down the hours until I can sit down in my freshly sanitized wooden desk again.

“My Only Parent Essentially on Her Death Bed”

By Nick Ingargiola, 16

My mom had COVID-19 for ten weeks. She got sick during the first month school buildings were shut. The difficulty of navigating an online classroom was already overwhelming, and when mixed with my only parent essentially on her death bed, it made it unbearable. Focusing on schoolwork was impossible, and watching my mother struggle to lift up her arm broke my heart.

My mom has been through her fair share of diseases from pancreatic cancer to seizures and even as far as a stroke that paralyzed her entire left side. It is safe to say she has been through a lot. The craziest part is you would never know it. She is the strongest and most positive person I’ve ever met. COVID hit her hard. Although I have watched her go through life and death multiple times, I have never seen her so physically and mentally drained.

I initially was overjoyed to complete my school year in the comfort of my own home, but once my mom got sick, I couldn’t handle it. No one knows what it’s like to pretend like everything is OK until they are forced to. I would wake up at 8 after staying up until 5 in the morning pondering the possibility of losing my mother. She was all I had. I was forced to turn my camera on and float in the fake reality of being fine although I wasn’t. The teachers tried to keep the class engaged by obligating the students to participate. This was dreadful. I didn’t want to talk. I had to hide the distress in my voice. If only the teachers understood what I was going through. I was hesitant because I didn’t want everyone to know that the virus that was infecting and killing millions was knocking on my front door.

After my online classes, I was required to finish an immense amount of homework while simultaneously hiding my sadness so that my mom wouldn’t worry about me. She was already going through a lot. There was no reason to add me to her list of worries. I wasn’t even able to give her a hug. All I could do was watch.

“The Way of Staying Sane”

By Lynda Feustel, 16

Entering year two of the pandemic is strange. It barely seems a day since last March, but it also seems like a lifetime. As an only child and introvert, shutting down my world was initially simple and relatively easy. My friends and I had been super busy with the school play, and while I was sad about it being canceled, I was struggling a lot during that show and desperately needed some time off.

As March turned to April, virtual school began, and being alone really set in. I missed my friends and us being together. The isolation felt real with just my parents and me, even as we spent time together. My friends and I began meeting on Facetime every night to watch TV and just be together in some way. We laughed at insane jokes we made and had homework and therapy sessions over Facetime and grew closer through digital and literal walls.

The summer passed with in-person events together, and the virus faded into the background for a little while. We went to the track and the beach and hung out in people’s backyards.

Then school came for us in a more nasty way than usual. In hybrid school we were separated. People had jobs, sports, activities, and quarantines. Teachers piled on work, and the virus grew more present again. The group text put out hundreds of messages a day while the Facetimes came to a grinding halt, and meeting in person as a group became more of a rarity. Being together on video and in person was the way of staying sane.

In a way I am in a similar place to last year, working and looking for some change as we enter the second year of this mess.

“In History Class, Reports of Heightening Cases”

By Vivian Rose, 16

I remember the moment my freshman year English teacher told me about the young writers’ conference at Bread Loaf during my sophomore year. At first, I didn’t want to apply, the deadline had passed, but for some strange reason, the directors of the program extended it another week. It felt like it was meant to be. It was in Vermont in the last week of May when the flowers have awakened and the sun is warm.

I submitted my work, and two weeks later I got an email of my acceptance. I screamed at the top of my lungs in the empty house; everyone was out, so I was left alone to celebrate my small victory. It was rare for them to admit sophomores. Usually they accept submissions only from juniors and seniors.

That was the first week of February 2020. All of a sudden, there was some talk about this strange virus coming from China. We thought nothing of it. Every night, I would fall asleep smiling, knowing that I would be able to go to the exact conference that Robert Frost attended for 42 years.

Then, as if overnight, it seemed the virus had swung its hand and had gripped parts of the country. Every newscast was about the disease. Every day in history, we would look at the reports of heightening cases and joke around that this could never become a threat as big as Dr. Fauci was proposing. Then, March 13th came around--it was the last day before the world seemed to shut down. Just like that, Bread Loaf would vanish from my grasp.

“One Day Every Day Won’t Be As Terrible”

By Nick Wollweber, 17

COVID created personal problems for everyone, some more serious than others, but everyone had a struggle.

As the COVID lock-down took hold, the main thing weighing on my mind was my oldest brother, Joe, who passed away in January 2019 unexpectedly in his sleep. Losing my brother was a complete gut punch and reality check for me at 14 and 15 years old. 2019 was a year of struggle, darkness, sadness, frustration. I didn’t want to learn after my brother had passed, but I had to in order to move forward and find my new normal.

Routine and always having things to do and places to go is what let me cope in the year after Joe died. Then COVID came and gave me the option to let up and let down my guard. I struggled with not wanting to take care of personal hygiene. That was the beginning of an underlying mental problem where I wouldn’t do things that were necessary for everyday life.

My “coping routine” that got me through every day and week the year before was gone. COVID wasn’t beneficial to me, but it did bring out the true nature of my mental struggles and put a name to it. Since COVID, I have been diagnosed with severe depression and anxiety. I began taking antidepressants and going to therapy a lot more.

COVID made me realize that I’m not happy with who I am and that I needed to change. I’m still not happy with who I am. I struggle every day, but I am working towards a goal that one day every day won’t be as terrible.

Coverage of social and emotional learning is supported in part by a grant from the NoVo Foundation, at www.novofoundation.org . Education Week retains sole editorial control over the content of this coverage. A version of this article appeared in the March 31, 2021 edition of Education Week as What Life Was Like for Students in the Pandemic Year

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Reflections from our Students on “A Day in my Life During Covid-19″

Here are some reflections from our students here at Xavier School in San Juan, Philippines as part of the Global Student Stories Project A Day in my Life: living under the Covid-19 Pandemic . We hope you enjoy reading them. 

A Day in my Life: Zachary 18, Xavier College San Juan, Philippines

The COVID-19 pandemic has definitely shaken our society, especially here in the Philippines. The country and government’s response to the sudden surge of cases in the Philippines was sluggish to say the least. Moreover, the distribution of supplies and food items to both ordinary citizens as well as frontliners continues to be inefficient. News of politicians choosing to label relief goods for their constituents with their names means that time was wasted instead of just handing out the relief goods as soon as possible. More than just being saddened by the cancelation of our graduation I recognize that there are many more concerns in our country that require our attention. The shut down of businesses has truly hit our country hard, as a whole. It especially affects blue collar workers and employees who generally live on a paycheck to paycheck basis. It is immensely frustrating that the government continues to respond late to the needs of the people during this troubling time. In my case I am very grateful that my family is not one that is greatly affected by non-essential businesses being shut down during the quarantine. I cannot begin to feel what the frontliners in our hospitals throughout the country are experiencing right now. I am thankful that I am at home safe and that all I need to do to stay safe is to follow the rules of the community quarantine. However, I have an uncle who is a doctor and is currently serving as a frontliner in PGH. Every day I pray for his well-being that he may be able to stay healthy until this pandemic ends and he is able to come home safely. In light of all the negative effects of this pandemic there have also been little acts of kindness by ordinary people which make their way into the news. People showing that despite what’s going on in the world right now we still need to stick together and lend each other a helping hand throughout this crisis. I see Jesus in the frontliners who sacrifice their health to help people recover from the virus. When thinking and reflecting about the future I am just flooded with emotions, namely relief, anxiety, and hopefulness. I am relieved to hear that the Philippines is starting to eliminate the COVID-19 virus, it’ll be like the light at the end of a dark tunnel. I will be overjoyed when the news comes that we may start to leave our houses again and attempt to live life as we did before the pandemic. However with this sense of relief may also come a sense of anxiety, countries like Singapore have experienced second as well as third waves of the virus and that may very well happen to the Philippines too. Lastly, the future makes me feel hopeful that from this pandemic we learn to be more prepared. Hopefully measures will be put in place to be able to help the less fortunate during the next pandemic. Our society should learn to be able to wrap our arms around one another in a time of crisis like this. Hoarding of supplies such as alcohol and masks should no longer be a practice the next time we encounter a virus similar to this. Instead we must help our neighbor and learn to look out for one another which indirectly helps you protect yourself from the virus as well. God is calling for us to exercise the Filipino quality of “bayanihan” so that we may be able to get through this pandemic together united as a country.

  A Day in my Life: Juancho 17, Xavier College San Juan, Philippines A month into the enhanced community quarantine, everything still feels so surreal. The situation at hand has severely crippled our nation, as there are currently more than 6500 Filipinos who have been diagnosed with the coronavirus, as well as around 500 deaths no thanks to the aforementioned pandemic. However, thanks to the frontline healthcare workers, there have been close to 650 recoveries as of writing.

The repercussions of COVID-19 are endless, with many families struggling financially as multiple companies have laid off several employees as a result of the economic strain which the pandemic has caused. Personally, I feel really lucky and blessed that I still have a roof over my head and get to eat three meals a day during a time when there are countless people who can only wonder where their next meal will come from.

When the lockdown was announced, I felt anger, annoyance, and anxiety. I was angry because my senior year was cut short, but primarily because I didn’t get the chance to march during the Graduation Rites, which was my main driving force for the whole year. I was annoyed because my plans for the long summer before college had suddenly gone down the drain. Finally, I feel anxiety because UP still hasn’t released the list of accepted applicants.

All of these emotions were heightened even further over the course of the past month, albeit for very different reasons. The slow government response to the pandemic is incredibly frustrating. Their failure to immediately address the issue as early as February exacerbated the spread of the virus in our nation, and today, some of our fellow countrymen are paying for this incompetence with their lives. This isn’t to say that all politicians are inept at leading the nation, as some local government officials have truly put the needs of their city above their own, which has truly been a glimmer of hope in this otherwise dark time.

The dark and uncertain times which we now live in has no doubt strained the faith of many people across the world, myself included. After all, why would God allow such suffering and sorrow to propagate amongst his people? It got to the point that I would question why my family prayed the rosary every night, or why we would say the prayers for COVID-19 at multiple times a day. Then at one point I realized, faith is what keeps us going in this time. Faith is directly related to hope, so by praying each night, we keep hoping for the future. God may have his own reasons for allowing this virus to augment and intensify, but it’s faith which keeps us sane as we hope for a future better than the present we are dealing with.

It’s scary to think of the future. Without a doubt, life will not be the same after this pandemic, but that’s okay. Our “normal” wasn’t working. That’s why it truly warms the heart to see several videos on social media which show strangers showing random acts of kindness towards the elderly, frontline workers, and other fellow citizens to ensure that we all get through this trying and turbulent time in the world. Hopefully after this is all over, that becomes the new normal. A world where we finally value what we have and act on a desire to be innately good as opposed to self-centered action.

  A Day in my Life: Drew 16, Xavier College San Juan, Philippines The current situation has affected my daily life to a significant degree. During the summer I would usually be able to visit my relatives and play games with my cousins. My family would usually go to our maternal-side’s house every Friday to be able to catch-up with them. Now we video call through messenger instead. This is so that our grandparents will be safe.

Aside from being stuck at home, I have to give more priority to my health and wellbeing. I’ve begun the habit of washing my hands more often, washing every other hour instead of washing my hands before eating.

Being stuck at home means that we all have a new type of life to live. All structure that we had beforehand are now nonexistent. This has been a blessing to me since now I can focus my time on exercising and other bucket lists that I have kept buried for a long time.

The epidemic has revealed a lot of the weaknesses of our society, as well as its strengths. We realize that our health system was not as effective as it seemed. In my own personal life, I begin to realize that much of my happiness has come from my social interactions with other people. Much of the things that I have looked forward to in the summer, like programmes, camps etc have been cancelled.

On the bright side I have given more priority to my studies and reviewing for the college entrance exams. I am lucky that time was given to me to reflect on my life and where I want to go.

I really hope that everyone else is safe and will find the best way to spend the time that this situation has given us.

A Day in my Life: Marcus 14, Xavier College San Juan, Philippines Ever since the outbreak of COVID-19, me and my family have not been able to freely go outside. One thing that I have changed in my daily lifestyle is that I have to reduce the amount of food I consume. One other change is that we are very focused on keeping our house and ourselves sanitized by regularly washing hands, disinfecting furniture, etc.

I would say that the biggest challenge in living within the outbreak of COVID-19 would be facing the fact that many of our fellow human beings, most especially our frontliners, are suffering amidst the pandemic. One other challenge would be the Enhanced Community Quarantine, where people are not allowed outside of their homes. However, the consolation of the situation is the lessons we would get from it. For example, it teaches us that we should always be prepared for a situation like this in the future. These have made me feel that the world is not perfect, but there are those people who can make it better and this is what society should learn.

My biggest concern regarding the pandemic is the consequences it causes, the death and suffering of many people, the economy, amongst others. My biggest hope is that the pandemic ends as soon as possible.

  A Day in my Life: Mat 16, Xavier College San Juan, Philippines We live in a time of unprecedented fear—merely going out of the house could start a descent into ill health, the social and economic systems we have set up are threatening to collapse, and political systems have shown their full deficiencies. In other words, the idea of community has sacrificed itself in service of individuality.

The full scale of that even rips apart the dynamic of families. Parents have more often than not lost their pay because of the global situation, but worse than this, children have become, in their eyes, even more “useless.” In this extraordinary time, ideas of filial duty and obligation break down and should no longer be fully accepted.

What people need to re-realize is that all our relationships have been built on love, the unconditional love of the most memorable Sacrifice, the perfect love of the Father. However, the love of the Father is meaningless without fear—fear that people will never return to him, fear that fear itself vanishes from us and makes us unafraid for others. Without fearing for the welfare of others, we cannot channel the ultimate Sacrifice on the cross. In this trying time, where communities have torn each other apart, fear for the loss of the communal good has vanished. Love for the fellow human has vanished. Contrary to expectations, the current situation has resulted into the deepest loss of the most fundamental unit of the community. The family has devolved into a sort of hateful contract of apparently one-way obligation. Fear for each other’s holistic welfare has been lost.

Now is the time to change that.

A Day in my Life: Richwynn 16, Xavier College San Juan, Philippines Disrupted routine.  Restrained movement.  Impersonal/Virtual communication.  These summarize my situation following the pandemic declaration and ECQ imposition.  As the world grapples with a powerfully-mutating disease, I have been riding on a roller coaster of emotions and realizations. My moments of desolation sporadically intersperse with a conscious, driven effort to dwell in a state of consolation.  Uncertainties and fear abound as I worry over drastic lifestyle adjustments and the duration of such while grieving over daily news of fallen frontliners and patients who were mostly deprived of their last farewell and/or receiving their last rites.  Meanwhile, this trying time proves human fallibility; and sheds truth that mankind’s scramble for recognition, power, wealth are seemingly worthless when what matters most now is safeguarding God’s gift of life – for self-survival or sharing this through saving others.

In light of Pope Francis’ message for the world to reconnect, I tend to tie this to the themes of Catholic social teachings by showing solidarity from simple acts of acknowledging our frontline warriors to inclusive participation of multi-ethnicities in medical research/clinical trials.  This pandemic effectively breaks man-made barriers stratified through GDP standing, gender, race and social stature; thus highlights that the very essence of human life/dignity is our responsibility to self in relation to our environment (care for God’s creation) and others (care for the needy and the vulnerable).

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Caring for the self and others: a reflection on everyday commoning amid the COVID-19 pandemic

• Reflective Essay
• Published: 24 August 2020
• Volume 2 , pages 243–251, ( 2020 )

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• Chun Zheng 1  

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In this essay, I share my experiences and reflection on fighting the COVID-19 pandemic from the perspective of a Chinese student residing in Pittsburgh, USA. Three examples of “commoning”—acts of managing shared resources by a group of people—reveal the importance of care and collaboration in the time of uncertainty. First, when COVID-19 posed a threat to the food supply chain, community gardens and home gardening ensured food security and enhanced mutual support. Second, the emergence of online activities of teaching, learning, and collaborating presented an opportunity of having more collective, equitable, and diverse formats of virtual communities. Lastly, volunteering in the distribution of “Healthy Packs,” I witnessed the nurture of a sense of belonging and a connection with home in the student community. These examples suggest that facing the crisis, care-driven commoning activities at the individual, everyday level lay the foundation for large-scale collaborative systems.

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1 Commoning in a crisis

The COVID-19 pandemic is sweeping the planet. We, as individuals in the extended human family, are living through a crisis together. Within the vast and daunting global crisis are changes to every person’s daily life. These changes reveal the normally hidden human needs of care and collaboration and force us to re-invest in ourselves and our communities. In this essay, I share my personal experiences since the beginning of the pandemic and my observations of care-based everyday commoning activities over this period from the perspective of a Chinese student residing in Pittsburgh, USA (Fig.  1 ). Commoning, as defined by Gibson-Graham et al. ( 2013 ), takes place when a group of people is motivated by an ethic of care for a flourishing and sustainable common future and decides to manage shared resources in a collective manner. After discussing three examples of everyday commoning: gardening as commoning, online sharing as commoning, and volunteering as commoning, I reflect on the potential of expanding the sentiment of care for ourselves and others into larger-scale collaborative networks.

Spatial pattern of COVID-19 cases in Pittsburgh neighborhoods. Locations mentioned in this paper are highlighted. The map was created by the author based on the open data accessed on July 28 from Allegheny County Public Health Department ( https://www.alleghenycounty.us/Health-Department/Resources/COVID-19/COVID-19.aspx ) and Esri ArcGIS Database ( https://www.esri.com/en-us/arcgis/products/arcgis-online/resources )

2 From one epicenter to another

January 23rd, the day before the Chinese Lunar New Year’s Eve, the news that Wuhan and three other surrounding cities were going into lockdown Footnote 1 struck all TV channels in China. While words of the spread of a new type of pneumonia had been circulating for days (Wee and Wang 2020 ), Wuhan’s lockdown marked the start of an unprecedented national struggle and later, a global crisis.

Although physically stranded overseas, I could hear the worry in my family and friends’ voices over the phone. The anticipated joy of the annual family reunion was completely overwhelmed. In the following month, tracking the number of confirmed cases and the death toll became my daily routine. Watching more and more cities turn into darker colors Footnote 2 on the color-coded live COVID-19 tracking map put me into fear and homesickness.

Subsequently, I observed, in Pittsburgh, USA, personal protective equipment (PPE) in nearby pharmacies were almost sold out by February (Fig.  2 ). I collected 80 masks from over 10 shops in our region, most of which were the last bundles left for sale, to mail to a police friend working at the frontline in China. By the time I was ready to mail out the package, all flights to and from China had been banned (Corkery and Karni 2020 ). The travel ban not only meant the package would not have guaranteed delivery in the foreseeable future, but also put me into the mentality of being cut off from my homeland. Throughout February, via WeChat, Footnote 3 family and friends shared stay-home updates, cheered up each other, and even guided me to prepare for a potential COVID-19 outbreak in Pittsburgh. Geographical separations and time differences didn’t prevent us from caring for and supporting each other.

Last of N95 masks left in a Home Depot, 13 miles away from central Pittsburgh (February 2, 2020. Photography provided by the author)

On March 16, when most students were in the spring break, Pittsburgh officially reported its first two cases, Footnote 4 which meant educational entities had to make different decisions. Pittsburgh heavily relies on its education industry. The student population takes up 27% of the total population of the city. Footnote 5 Therefore, schools, preceding other public and private sectors in the city, responded to the outbreak first by switching to online classes, which lowered the risk of infection and spreading of the virus in the city that might be caused by students’ domestic and international travel. Still, I believe more earlier actions could have been implemented citywide and nationwide, including social distancing, encouragement to wear masks, and cancellations of large gatherings, to name a few. Nonetheless, what seemed so obvious to me, or to any Chinese citizen living in the USA, turned out to be invisible to most Americans, especially politicians and decision makers. The US government was overly optimistic about the epidemic and focused its resources on political rivalries, thus missing early opportunities to contain the outbreak. Compared with the constant and rolling media coverage of self-help prevention measures in China, the American people were given confusing and sometimes contradictory information, which blurred the severity of the pandemic. The rest of the story is well known. The malfunction of the government, the partisan differences, the sacrifices of healthcare workers, the hoarding of living essentials and weapons, etc., have become new abnormal norms in the USA. In these selfish, divisive and confusing situations, it is inevitable for many to find alternatives to self-help.

The duality of my experiences in two epicenters—the USA and China—has inspired me to recognize and cherish the spirit of mutual support and sentiment of care from others, as well as rethink where we can individually begin to act upon and contribute to forming a more collaborative and interconnected world. It took a long time for the majority of the world to realize that “the well-being of the group is endangered by indifferent individuals, and that community means originally simply a pooling of duties” (Jones 2020 , para 9). As individuals, we are incapable of changing the irreversible crisis; our duties lie simply in small everyday commoning actions.

3 Care and commoning

Commoning is the act of managing and sharing material and non-material resources, of creating things together, and of cooperating to meet shared goals among a group of people (Bollier and Helfrich 2015 , p. 17; Džokić and Neelen 2015 , p. 15; Bollier 2014 , p. 15). The participants in commoning processes are people who prioritize care for one another. Volunteering, altruism, selflessness, peer-assistance, mutual support, and so on can all be considered synonyms of commoning (Bollier 2020 , para 10). Prior to the pandemic, the logic of commoning can be found in cooperatively managed forests, social currencies, open-source software, citizen-managed urban spaces, community gardens, cooperative housings, and more. Commoning has been and is prevalent around the world as an essential survival strategy, especially in challenging times (Troncoso 2020 ; Baibarac and Petrescu 2017 , p. 229). We can, moreover, note that when governmental or market systems fail in the crisis, more people are finding their ways to support others through commoning—for instance, in the USA, crowdsourcing masks and ventilators, and mobilizing food bank resources for the elderly living alone amid the COVID-19 pandemic. A critical emotional motivation behind these commoning activities is care.

Our perception of care often draws on the traditional imaginaries of the parents’ domestic responsibility of taking care of children and the housework, or the healthcare workers’ job of providing service in the medical sphere. On the one hand, the ongoing pandemic has brought these traditional imaginaries of care into the spotlight. Healthcare workers who haven’t been paid enough appreciation are now deemed essential and thus regarded with greater value than before (Fig.  3 ). Households are forced to devote increasing time in domestic caregiving during physical distancing. On the other hand, the current crisis also triggers our rethink of alternative ways of caring beyond these formats (Morrow and Parker 2020 ; Thackara 2015 ; Petrescu and Trogal 2017 ). Here, I argue that care, manifesting in ways of verbal encouragement, physical gestures like waving and hugging, a sense of responsibility, commoning activities, etc., is a more inclusive concept than the traditional perception of care. It is a deep-rooted ability of human beings to resonate and connect with others. As Sennett claims, “Buried in all of us is the infantile experience of relating and connecting to the others who took care of us” (Sennett 2012 , p. 9). The pandemic is a catalyst for awakening people’s innate ability to care. We can all find ways to care for the self and others. The following examples aim at sharing my encounters of care-driven everyday commoning activities during the COVID-19 pandemic. They manifest that commoning is one of the most efficient ways of caregiving and is essential for not only our current survival but also a collective caring future.

“Heroes at work” slogans were displayed in the garden and on the building façade of the University of Pittsburgh Medical Center (UPMC) Shadyside Hospital in Pittsburgh, USA (May 5, 2020. Photography provided by the author)

4 Gardening as commoning

The top priority for individuals in quarantine is food. The food supply chain, including food production, processing, distribution, consumption, and disposal, needs to be operational for all of us to survive. However, the current food supply chain is severely compromised by COVID-19. According to the Washington Post (Telford and Kindy 2020 ), over 30 meat plants across the country owned by major American meat processing companies reported coronavirus outbreaks in their factories. The plants were forced to shut down because of growing numbers of confirmed cases and lack of PPE. Meanwhile, the transportation and distribution links on the supply chain also face unprecedented challenges. High demands for food delivery services put drivers and distributors at risk, as the virus can stay viable on cardboard boxes or plastic bags for a few days. Footnote 6 Both the processing and distribution links on the food supply chain are weakened, which has turned tons of milk, vegetables, and meat into waste.

Recognizing the vulnerability of a long food supply chain, many individuals and nonprofit organizations, such as community gardens, community farms, and home gardeners, have made contributions to shorten the food supply chain. By securing their own and local food supplies, they reduce the reliance on processing and transportation links on the chain (Fig.  4 ). In the Pittsburgh neighborhood of Garfield, the Garfield Community Farm, despite suffering from a large loss of financial income and voluntary labor during COVID-19, decided to donate all their sales to restaurants to the poor and healthcare workers in the neighborhood (Fig.  5 ). On the other side of the globe, the Knowledge and Innovation Community (KIC) Garden in Shanghai initiated a SEEDING campaign to facilitate community trust-building amid the pandemic (Jian 2020 ). The campaign encouraged people to develop a self-sufficient lifestyle at home and to share their home-grown produce and seeds with neighbors in non-contact ways. Many creative participants designed, modeled, and built small exchange stations in their local communities. Conversations among neighbors were triggered upon the implementation of these stations. Several weeks ago, I joined the SEEDING group and started to share the progress of my own home seeding project. Quick growing herbs, like basil and oregano, are optimal for apartment dwellers like me. My project is still gradually expanding with handmade hydroponics of onions, green onions, and garlic (Fig.  6 ).

Food supply chain infographic (Source: Sandia Seed Company. https://www.sandiaseed.com/blogs/news/shorten-your-food-chain-infographic . Accessed by the author on May 5, 2020)

On March 25, the first donation was made by Garfield Farm since the stay-at-home order was placed in Pittsburgh (Source: Garfield Community Farm Facebook page. https://www.facebook.com/GarfieldCommunityFarm . Accessed by the author on April 25, 2020)

The author’s home planting project on the windowsill (June 26, 2020. Photography provided by the author)

Gardening as a commoning practice has both ecological and social benefits. Growing and eating locally reduces the energy consumed in processing and transportation and rebuilds the connection between people and nature, which is a way to care for the environment. At the same time, less consumption of processed food lowers the risk of exposure for workers in food processing and transportation industries. Gardening also brings people together, either by engaging people in the farm work or by allowing people to share their gardening knowledge with others. When sharing updates of my home gardening project in the SEEDING group, I received detailed guidance and encouragement from other home gardeners. The communication, care, and enlightenment from others in this turbulent time have become an indispensable source of life motivation. That is to say, gardening as a commoning activity is also a way to care for our social well-being. It creates connections among people with diverse social and cultural backgrounds in the time of physical separation.

5 Online sharing as commoning

Currently, the majority of family networks, businesses, and schools depend on online video communication technology. Many online activities of working, teaching, learning, collaborating, and sharing have emerged. The heavy reliance on the online video conference platforms (e.g., Zoom, one of the most widely used Apps) raises the question of how technology might contribute to a more inclusive and equitable future for knowledge exchange and socialization.

Even when the world comes to a halt, intellectual flows and simulations do not. Professor Jeffrey Hou from the University of Washington, Seattle, initiated a platform named disCO-commons: Distance Collaboration Commons in Support of Design for Social Change, Footnote 7 on which scholars, students, educators, and practitioners in architecture, design, and planning could contribute to a collection of academic resources. Discussions and debates around design thinking are also continued with Design Baithak, Footnote 8 a weekly Zoom event organized by Ahmed Ansari, an assistant professor at New York University. The discussants come from all parts of the country and across continents. Besides, many international conferences in academia have also switched to free online formats. Distance, time, and financial concerns are no longer barriers. In pre-pandemic times, academic collaborations at such scales would take months to plan and coordinate. COVID-19 and technology have miraculously pushed the progress of remote knowledge sharing and collaborations.

Concurrently, online social activities are taking place exponentially. Figure  7 shows a screenshot of our 2018 Carnegie Mellon Master of Urban Design alumni reunion, held on Zoom. Two years after graduation, friends from five different countries, across three continents, managed to meet virtually. Some of us are foreigners staying in the USA, some traveled home before the outbreak, and some are in their homeland but separated from the family. The moment we saw each other, memories of us being physically together were recalled. Technology shortened the geographical distance between us. Figure  8 shows an online yoga class that I joined. The teacher just completed her yoga training in Portland, Oregon, and kindly provided free online classes. In such a time of uncertainty, spending some time each day doing yoga, meditation, or stretching is a good way to relieve the anxiety and despair that the mainstream social media is trying to render. When the body is relaxed, the mind becomes composed.

Virtual alumni reunion (April 10, 2020. Screenshot provided by the author)

Remote yoga class (April 26, 2020. Screenshot provided by the author)

Despite the challenge of video bombs and internet interferences, online sharing has brought genuine excitement for the possibilities afforded by unique forms of information caregiving. With careful application and management of new technology, virtual communication has shown outstanding efficiency in (re)connecting people and promoting more accessible ways of education and socialization. Now that we have a firmer grasp on the planning, coordination, and execution of these online activities, we may start to imagine a network of virtual commoning.

6 Volunteering as commoning

It seems that our hands are tied because of the limitation of face-to-face contact with others. However, challenges always prelude opportunities. Coronavirus interrupts our normal socialization but offers unique volunteering opportunities that call for reciprocity among strangers. In April, the Carnegie Mellon University (CMU) Chinese Students and Scholars Association (CSSA) were planning to distribute packs of personal protective supplies sent by the Consulate General of PR China in New York to CMU Chinese students. I signed up to be the volunteer and was assigned to be the driver and distributor for our apartment building and several surrounding blocks (Fig.  9 ). Myself and 20 other volunteers collectively coordinated the transportation and distribution of over a thousand “Health Packs” with the assistance of CSSA staff, brainstorming and deciding the best timing, location, and method of distribution. The quick reaction and organization were all from the bottom-up. Two other volunteers and I took advantage of the fact that the foyer of my apartment building is separated from the lobby by a glass door. We placed the bags in the foyer and waited in the lobby (Fig.  10 ). Remaining mindful of social distancing rules, recipients came and lined up on the sidewalk outside the foyer. Each person who entered the foyer showed us their student ID against the glass door to confirm the pickup. For residents in the building, a digital signup sheet was circulated for them to fill in their apartment numbers. Based on the signup sheet, we left the bags directly in front of their apartment doors. Volunteering in this distribution, I witnessed the nurture of a sense of belonging and a connection with home in the Chinese student community.

The author picking up two boxes of “Health Packs” from the post office (April 17, 2020. Photography provided by the author)

A box packed with 24 “Health Packs” to distribute to Chinese students (April 17, 2020. Photography provided by the author)

Recent anti-Chinese rhetoric in the USA and around the world has put many Chinese citizens overseas in trepidation. Incidents of racism are on the rise, as President Donald Trump “continues to stoke xenophobia by using a racist name for the virus and associating it with Asian Americans” (Zhou 2020 , para 6). Now more than ever, Chinese students are questioning our identities and trying to find a sense of belonging, both physically and mentally. Physical isolations have also worsened the situation as the feelings of uncertainty and fear are internalized. Apart from providing material security, more importantly, “Health Packs” sent a signal of being cared for by others and were catalysts for commoning practices. In this case, each one of the volunteers and recipients was fulfilling his/her duty in connecting these worried and isolated individuals. Volunteering as a way of commoning demonstrates that, by carrying out small acts of care for others, we, regardless of ethnicity, religion, gender, or age, have the agency to overcome physical isolation and dismantle the difficulties posed by the crisis.

7 From a current me to a future we

As I put this paper together, the death toll of COVID-19 across the world has surpassed 650,000, Footnote 9 casting an even larger shadow of uncertainty over the future. The harder the crisis hits us, the more we have to look for the positive changes that it facilitates. The above-mentioned experiences and examples are personal and quotidian. However, what is personal and present allows us to imagine what is collective and future.

The three commoning examples that I have discussed are all manifestations of how care has connected us, which forms the premise for systematic changes. Because of care for the Earth, home gardeners and community farmers will contribute to building more sustainable food production and consumption systems. Because of care for our minds, online sharing will connect into global knowledge systems. Because of care for ourselves and each other, volunteering activities and mutual support will continue building more supportive, inclusive, and equitable social systems. We need to recognize that the scaling from individual commoning activities to larger neighborhood, local, and regional collaborative systems may require much more efforts, education, and time. Nonetheless, we can still continue fulfilling our own duties as connecting dots in the systems, weaving the collective networks.

The COVID-19 pandemic can be the most effective moment in which we disrupt unhealthy norms and validate new possibilities. Care-based commoning can be one of these possibilities. The emphasis on giving rather than taking, on solidarity rather than individuality, on care rather than indifference is what I would like to reflect on when engaging in and discussing everyday commoning experiences. Taking everyday commoning practices as the starting point, it is necessary to start imagining a new collaborative future that is no longer constrained by geospatial boundaries and physical contacts. In fact, since the beginning of the COVID-19 outbreak, care has been ubiquitous; we have all sensed it in the formats “of responsibility, of sharing, of reciprocity, of democratic organization, and of welfare” (Petrescu and Trogal 2017 , p. 194). As we remain physically apart, let us see this as an opportunity to practice our muscles of commoning and build the strength to care for ourselves and others.

Coverage on Wuhan lockdown can further be found on South China Morning Post ( https://www.scmp.com/news/china/society/article/3047278/wuhan-goes-shutdown-china-tries-contain-deadly-coronavirus ).

Larger numbers of confirmed cases are presented in darker colors in most COVID-19 live tracking maps, for instance, Baidu COVID-19 live data ( https://voice.baidu.com/act/newpneumonia/newpneumonia ) and Sina News COVID-19 live tracking ( https://news.sina.cn/zt_d/yiqing0121 ).

WeChat is the most widely used multi-purpose messaging, social media and mobile payment app in China.

The information of Pittsburgh’s first two COVID-19 cases is available on TribLIVE ( https://triblive.com/local/pittsburgh-allegheny/allegheny-county-to-announce-1st-coronavirus-cases/ ).

Student population percentage is calculated based on data provided by the US Census Bureau ( https://www.census.gov/quickfacts/pittsburghcitypennsylvania ).

The information is acquired from the study of coronavirus survival time on surfaces by US National Institutes of Health ( https://www.nih.gov/news-events/nih-research-matters/study-suggests-new-coronavirus-may-remain-surfaces-days ).

More information on the Distance Collaboration Commons in Support of Design for Social Change can be found on their Facebook page ( https://www.facebook.com/groups/880415052397554 ).

The time, guests and topics of Design Baithak can be found on the website ( https://sites.google.com/view/designbaithak/ ).

The COVID-19 death toll number is acquired from the Johns Hopkins Coronavirus Resource Center ( https://coronavirus.jhu.edu/map.html ).

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Zheng, C. Caring for the self and others: a reflection on everyday commoning amid the COVID-19 pandemic. Socio Ecol Pract Res 2 , 243–251 (2020). https://doi.org/10.1007/s42532-020-00062-3

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Medical student wellbeing during COVID-19: a qualitative study of challenges, coping strategies, and sources of support

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Medical students face challenges to their mental wellbeing and have a high prevalence of mental health problems. During training, they are expected to develop strategies for dealing with stress. This study investigated factors medical students perceived as draining and replenishing during COVID-19, using the ‘coping reservoir’ model of wellbeing.

In synchronous interactive pre-recorded webinars, 78 fourth-year medical students in the UK responded to reflective prompts. Participants wrote open-text comments on a Padlet site. Responses were analysed using reflexive thematic analysis.

Analysis identified five themes. COVID-19 exacerbated academic pressures, while reducing the strategies available to cope with stress. Relational connections with family and friends were affected by the pandemic, leading to isolation and reliance on housemates for informal support. Relationships with patients were adversely affected by masks and telephone consultations, however attending placement was protective for some students’ wellbeing. Experiences of formal support were generally positive, but some students experienced attitudinal and practical barriers.

Conclusions

This study used a novel methodology to elicit medical students’ reflections on their mental wellbeing during COVID-19. Our findings reinforce and extend the ‘coping reservoir’ model, increasing our understanding of factors that contribute to resilience or burnout. Many stressors that medical students typically face were exacerbated during COVID-19, and their access to coping strategies and support were restricted. The changes to relationships with family, friends, patients, and staff resulted in reduced support and isolation. Recognising the importance of relational connections upon medical students’ mental wellbeing can inform future support.

Peer Review reports

Medical students are known to experience high levels of stress, anxiety, depression and burnout due to the nature, intensity and length of their course [ 1 ]. Medical students are apprehensive about seeking support for their mental wellbeing due to perceived stigma and concerns about facing fitness to practice proceedings [ 2 ], increasing their vulnerability to poor mental health.

Research has identified that the stressors medical students experience include a demanding workload, maintaining work–life balance, relationships, personal life events, pressure to succeed, finances, administrative issues, career uncertainty, pressure around assessments, ethical concerns, and exposure to patient death [ 3 , 4 ]. In March 2020, the COVID-19 pandemic introduced additional stressors into medical students’ lives. These included sudden alterations to clinical placements, the delivery of online teaching, uncertainty around exams and progression, ambiguity regarding adequate Personal Protective Equipment (PPE), fear of infection, and increased exposure to death and dying [ 5 , 6 ]. Systematic reviews have reported elevated levels of anxiety, depression and stress among medical students during COVID-19 [ 7 ] and that the prevalence of depression and anxiety during COVID-19 was higher among medical students than in the general population or healthcare workers [ 8 ].

While training, medical students are expected to develop awareness of personal mental wellbeing and learn healthy coping strategies for dealing with stress [ 9 ]. Developing adaptive methods of self-care and stress reduction is beneficial both while studying medicine, and in a doctor’s future career. Protecting and promoting psychological wellbeing has the potential to improve medical students’ academic attainment, as well as their physical and mental wellbeing [ 10 ], and it is therefore important for medical educators to consider how mental wellbeing is fostered. Feeling emotionally supported while at medical school reduces the risk of psychological distress and burnout, and is related to whether students contemplate dropping out of medical training [ 11 ]. In their systematic narrative review of support systems for medical students during COVID-19, Ardekani et al. [ 12 ] propose a framework incorporating four levels: policies that promote a supportive culture and environment, active support for students at higher risk of mental health problems, screening for support needs, and provision for students wishing to access support. This emphasis on preventative strategies aligns with discussions of trauma-informed approaches to medical education, which aim to support student learning and prevent harm to mental wellbeing [ 13 ]. Dunn et al. [ 14 ] proposed a ‘coping reservoir’ model to conceptualise the factors that deplete and restore medical students’ mental wellbeing (Fig.  1 ). This reservoir is drained and filled repeatedly, as a student faces demands for their time, energy, and cognitive and emotional resources. This dynamic process leads to positive or negative outcomes such as resilience or burnout.

Coping reservoir model– adapted from Dunn et al. [ 14 ], with permission from the authors and Springer Nature

At present we have limited evidence to indicate why medical students’ mental wellbeing was so profoundly affected by COVID-19 and whether students developed coping strategies that enhanced their resilience, as suggested by Kelly et al. [ 15 ]. This study therefore sought to conceptualise the challenges medical students experienced during COVID-19, the coping strategies they developed in response to these stressors, and the supportive measures they valued. The ‘coping reservoir’ model [ 14 ] was chosen as the conceptual framework for this study because it includes both restorative and depleting influences. Understanding the factors that mediate medical students’ mental wellbeing will enable the development of interventions and support that are effective during crises such as the pandemic and more generally.

Methodology

This research study is based on a critical realist paradigm, recognising that our experience of reality is socially located [ 16 ]. Participant responses were understood to represent a shared understanding of that reality, acknowledging the social constructivist position that subjective meanings are formed through social norms and interactions with others, including while participating in this study. It also draws on hermeneutic phenomenology in aiming to interpret everyday experienced meanings for medical students during COVID-19 [ 17 ]. The use of an e-learning environment demonstrates an application of connectivism [ 18 ], a learning theory in which students participate in technological enabled networks. We recognise that meaning is co-constructed by the webinar content, prompts, ‘coping reservoir’ framework and through the process of analysis.

The multidisciplinary research team included a psychologist working in medical education, two medical students, and two Foundation level doctors. The team’s direct experience of the phenomenon studied was an important resource throughout the research process, and the researchers regularly reflected on how their subjective experiences and beliefs informed their interpretation of the data. Reflexive thematic analysis was chosen because it provides access to a socially contextualised reality, encompasses both deductive and inductive orientations so that analysis could be informed by the ‘coping reservoir’ while also generating unanticipated insights, and enables actionable outcomes to be produced [ 19 ].

Ethical approval

Approval was granted by the University of Liverpool Institute of Population Health Research Ethics Committee (Reference: 8365).

Participants

Fourth-year medical students at the University of Liverpool were invited to participate in the study during an online webinar in their Palliative Medicine placement. During six webinars between November 2020 and June 2021, 78 out of 113 eligible students participated, giving a response rate of 69%. This was a convenience sample of medical students who had a timetabled session on mental wellbeing. At the time, these medical students were attending clinical placements, however COVID-19 measures in the United Kingdom meant that academic teaching and support was conducted online, travel was limited, and contact with family and friends was restricted.

Students were informed about the study prior to the synchronous interactive pre-recorded webinar and had an opportunity to ask questions. Those who consented to participate accessed a Padlet ( www.padlet.com ) site during the webinar that provided teaching on mental wellbeing, self-care and resilience in the context of palliative medicine. Padlet is a collaborative online platform that hosts customisable virtual bulletin boards. During this recording, participants were asked to write anonymous open-text responses to reflective prompts developed from reviewing the literature (Appendix 1 ), and post these on Padlet. The Padlet board contained an Introduction to the webinar, sections for each prompt, links to references, and signposting to relevant support services. Data files were downloaded to Excel and stored securely, in line with the University of Liverpool Research Data Management Policy.

The research team used the six steps of reflexive thematic analysis to analyse the dataset. This process is described in Table  1 , and the four criteria for trustworthiness in qualitative research proposed by Lincoln and Guba [ 20 ] are outlined in Table  2 . We have used the purposeful approach to reporting thematic analysis recommended by Nowell et al. [ 21 ] and SRQR reporting standards [ 22 ] (Appendix 2 ).

Five themes were identified from the analysis:

COVID-19 exacerbated academic pressures.

COVID-19 affected students’ lifestyles and reduced their ability to cope with stress.

COVID-19 changed relationships with family and friends, which affected mental wellbeing.

COVID-19 changed interactions with patients, with positive and negative effects.

Formal support was valued but seeking it was perceived as more difficult during COVID-19.

COVID-19 exacerbated academic pressures

‘Every day feels the same, it’s hard to find motivation to do anything.’

Many participants reported feeling under chronic academic pressure due to studying medicine. Specific stressors reported were exams, revision, deadlines, workload, specific course requirements, timetables, online learning, placement, and communication from University. Some participants also reported negative effects on their mental wellbeing from feelings of comparison and competition, feeling unproductive, and overthinking.

Massive amounts of work load that feels unachievable.

COVID-19 exacerbated these academic stresses, with online learning and monotony identified as particularly draining. However, other students found online learning beneficial, due to reduced travelling.

I miss being able to see people face to face and zoom is becoming exhausting. My mental wellbeing hasn’t been great recently and I think the effects of the pandemic are slowly beginning to affect me.

I also prefer zoom as it is less tiring than travelling to campus/placement.

Clinical placements provided routine and social interaction. However, with few social interactions outside placement, this became monotonous. A reduction in other commitments helped some students to focus on their academic requirements.

Most social activity only taking place on placement has made every day feel the same.

Some students placed high value on continuing to be productive and achieve academically despite the disruption of a pandemic, potentially to the detriment of their mental wellbeing. Time that felt unproductive was frustrating and draining.

Having a productive day i.e. going for a run and a good amount of work completed in the day.

Unproductive days of revision or on placement.

COVID-19 affected students’ lifestyles and reduced their ability to cope with stress

‘Everyone’s mental well-being decreased as things they used for mental health were no longer available’.

Students often found it difficult to sustain motivation for academic work without the respite of their usual restorative activities challenging.

Not being able to balance work and social life to the same extent makes you resent work and placement more.

The competing demands medical students encounter for their time and energy were repeatedly reported by participants.

Sometimes having to go to placement + travel + study + look after myself is really tough to juggle!

However, removing some of the boundaries around academic contact and structure of extracurricular activities heightened the impact of stressors. Many participants focused on organising and managing their time to cope with this. Students were aware that setting time aside for relaxation, enjoyment, creativity, and entertainment would be beneficial for their wellbeing.

Taking time off on the weekends to watch movies.

However, they found it difficult to prioritise these without feeling guilty or believing they needed to ‘earn’ them, and academic commitments were prioritised over mental wellbeing.

Try to stop feeling guilty for doing something that isn’t medicine. Would like to say I’d do more to increase my mental wellbeing but finals are approaching and that will probably have to take priority for the next few months.

Medical students were generally aware that multiple factors such as physical activity, time with loved ones, spiritual care, nourishment and hobbies had a positive impact on their mental wellbeing. During COVID-19, many of the coping strategies that students had previously found helpful were unavailable.

Initially it improved my mental well-being as I found time to care for myself, but with time I think everyone’s mental well-being decreased as things they used for mental health were no longer available e.g. gym, counselling, seeing friends.

Participants adapted to use coping strategies that remained available during the pandemic. These included walks and time spent outdoors, exercise, journaling, reflection, nutrition, and sleep.

'Running’. ‘Yoga’. ‘Fresh air and walks'.

A few students also reported that they tried to avoid unhelpful coping strategies, such as social media and alcohol.

Not reading the news, not using social media.

Avoiding alcohol as it leads to poor sleep and time wasted.

Many participants commented on increased loneliness, anxiety, low mood, frustration, and somatic symptoms.

Everyone is worn out and demotivated. Feel that as I am feeling low I don’t want to bring others down. ‘Feel a lot more anxious than is normal and also easily annoyed and irritable.’

However, not all students reported that COVID-19 had a negative effect on wellbeing. A small minority responded that their wellbeing had improved in some way.

I think covid-19 has actually helped me become more self reliant in terms of well-being.

COVID-19 changed relationships with family and friends, which affected mental wellbeing

‘Family are a huge support for me and I miss seeing them and the lack of human contact.’

Feeling emotionally supported by family and friends was important for medical students to maintain good mental wellbeing. However, COVID-19 predominantly had a negative impact on these relationships. Restrictions, such as being unable to socialise or travel during lockdowns, led to isolation and poor mental wellbeing.

Not being able to see friends or travel back home to see friends/family there.

Participants frequently reported that spending too much time with people, feeling socially isolated, being unable to see people, or having negative social experiences had an adverse effect on their mental wellbeing. Relationships with housemates were a key source of support for some students. However, the increased intensity in housemate relationships caused tension in some cases, which had a particularly negative effect.

Much more difficult to have relationships with peers and began feeling very isolated. Talk about some of the experiences I’ve had on placement with my housemates. Added strain on my housemates to be the only ones to support me.

Knowing that their peers were experiencing similar stressors helped to normalise common difficulties. The awareness that personal contacts were also struggling sometimes curtailed seeking informal support to avoid being a burden.

Actually discussing difficulties with friends has been most helpful, as it can sometimes feel like you’re the only one struggling, when actually most people are finding this year really difficult. Family and friends, but also don’t want to burden them as I know I can feel overwhelmed if people are always coming to me for negative conversations.

COVID-19 changed interactions with patients, with positive and negative effects

‘With patients there has been limited contact and I miss speaking to patients.’

Some students reported positive effects on relationships with patients, and feeling a sense of purpose in talking to patients when their families were not allowed to visit. Medical students felt a moral responsibility to protect patients and other vulnerable people from infection, which contributed to a reduction in socialising even when not constrained by lockdown.

Talking to patients who can’t get visitors has actually made me feel more useful. Anxiety over giving COVID-19 to patients or elderly relatives.

Students occasionally reported that wearing PPE made interactions with patients more challenging. Students’ contact with patients changed on some placements due to COVID-19, for example replacing in-person appointments with telephone consultations, and they found this challenging and disappointing.

Masks are an impediment to meaningful connections with new people. GP block when I saw no patients due to it all being on the telephone.

Formal support was valued but seeking it was perceived as more difficult during COVID-19

‘Feel a burden on academic and clinical staff/in the way/annoying so tend to just keep to myself.’

Many participants emphasised the primary importance of support from family and friends, and their responses indicated that most had not sought formal support. While staff remained available and created opportunities for students to seek support, factors such as online learning and increased clinical workloads meant that some students found it harder to build supportive relationships with academic and placement staff and felt disconnected from them, which was detrimental for wellbeing and engagement.

Staff have been really helpful on placement but it was clear that in some cases, staff were overwhelmed with the workload created by COVID. Even though academic staff are available having to arrange meetings over zoom rather than face to face to discuss any problem is off putting.

A few students described difficulty knowing what support was available, and identifying when they needed it.

It’s difficult to access support when you’re not sure what is available. Also you may feel your problems aren’t as serious as other people’s so hold off on seeking support.

Formal support provided within the University included meetings with Academic Advisors, the School of Medicine wellbeing team, and University counselling service and mental health advisory team. It was also available from NHS services, such as GPs and psychological therapies. Those who had accessed formal support mostly described positive experiences with services. However, barriers to seeking formal support, such as perceived stigma, practicalities, waiting times for certain services, and concern that it may impact their future career were reported by some participants.

It is good that some services offer appointments that are after 5pm- this makes it more accessible to healthcare students. Had good experience with GPs about mental health personally. Admitting you need help or asking for help would make you look weak. Reassurance should be provided to medical students that accessing the wellbeing team is not detrimental to their degree. If anything it should be marketed as a professional and responsible thing to do.

Some students preferred the convenience of remote access, others found phone or video impersonal and preferred in-person contact.

Students expressed that it was helpful when wellbeing support was integrated with academic systems, for example Academic Advisors or placement supervisors.

My CCT [primary-care led small group teaching] makes sure to ask how we are getting on and how our placements are going, so I think small groups of people with more contact with someone are more useful then large groups over zoom. Someone to speak to on palliative care placement, individual time with supervisor to check how we are doing (wellbeing, mental health) - would be a nice quick checkup.

Participants typically felt able to share openly in an anonymous forum. Reading peers’ comments helped them to see that other students were having similar experiences and challenged unhealthy comparisons.

I definitely shared more than I would have done on a zoom call. I loved this session as it makes you feel like you’re not alone. Reassuring to know that there are others going through similar things as you.

Our findings demonstrate that the COVID-19 pandemic exacerbated the stressors medical students experience, and removed some rewarding elements of learning, while reducing access to pre-existing coping strategies. The results support many aspects of the ‘coping reservoir’ framework [ 14 ]. Findings corroborate the restorative effects of psychosocial support and social/healthy activities such as sleep and physical activity, and the depletion of wellbeing due to time and energy demands, stress, and disruptions relating to the pandemic such as online teaching and limited social interaction. Feeling a sense of purpose, from continuing studying or interactions with patients for example, was restorative for wellbeing. Mentorship and intellectual stimulation were present in the responses, but received less attention than psychosocial support and social/healthy activities. Internal conflict is primarily characterised by Dunn et al. [ 14 ] as ambivalence about pursuing a career in medicine, which was not expressed by participants during the study. However, participants identified that their wellbeing was reduced by feeling unproductive and lacking purpose, feeling guilty about taking time for self-care, competing priorities, and comparison with peers, all of which could be described as forms of internal conflict. Different restorative and draining factors appeared to not be equally weighted by the participants responding to the prompts: some appear to be valued more highly, or rely on other needs being met. Possible explanations are that students may be less likely to find intellectual stimulation and mentorship beneficial if they are experiencing reduced social support or having difficulty sleeping, and internal conflict about pursuing a career in medicine might be overshadowed by more immediate concerns, for example about the pandemic. This prioritisation resembles the relationship between physiological and psychological needs being met and academic success [ 23 ], based on Maslow’s hierarchy of needs [ 24 ]. A revised ‘coping reservoir’ model is shown in Fig.  2 .

Coping reservoir model - the effects of COVID-19 on restorative and depleting factors for medical students, adapted from Dunn et al. [ 14 ], with permission from the authors and Springer Nature

Relational connections with family, friends, patients, and staff were protective factors for mental wellbeing. Feeling emotionally supported by family and friends is considered especially important for medical students to maintain good mental wellbeing [ 11 ]. These relationships usually mitigate the challenges of medical education [ 25 ], however they were fundamentally affected by the pandemic. Restrictions affecting support from family and friends, and changes to contact with patients on placement, had a negative effect on many participants’ mental wellbeing. Wellbeing support changed during the pandemic, with in-person support temporarily replaced by online consultations due to Government guidelines. Barriers to seeking formal support, such as perceived stigma, practicalities, and concern that it may impact their future career were reported by participants, reflecting previous research [ 26 ]. Despite initiatives to increase and publicise formal support, some students perceived that this was less available and accessible during COVID-19, due to online learning and awareness of the increased workload of clinicians, as described by Rich et al. [ 27 ]. These findings provide further support for the job demand-resources theory [ 28 , 29 ] where key relationships and support provide a protective buffer against the negative effects of challenging work.

In line with previous research, many participants reported feeling under chronic academic pressure while studying medicine [ 3 ]. Our findings indicate that medical students often continued to focus on achievement, productivity and competitiveness, despite the additional pressures of the pandemic. Remaining productive in their studies might have protected some students’ mental wellbeing by providing structure and purpose, however students’ responses primarily reflected the adverse effect this mindset had upon their wellbeing. Some students felt guilty taking time away from studying to relax, which contributes to burnout [ 30 ] , and explicitly prioritised academic achievement over their mental wellbeing.

Students were aware of the factors that have a positive impact on their mental wellbeing, such as physical activity, time with loved ones, spiritual care, nourishment and hobbies [ 31 ]. However, COVID-19 restrictions affected many replenishing factors, such as socialising, team sports, and gyms, and intensified draining factors, such as academic stressors. Students found ways to adapt to the removal of most coping strategies, for example doing home workouts instead of going to the gym, showing how they developed coping strategies that enhanced their resilience [ 15 ]. However, they found it more difficult to mitigate the effect of restrictions on relational connections with peers, patients and staff, and this appears to have had a particularly negative impact on mental wellbeing. While clinical placements provided helpful routine, social interaction and a sense of purpose, some students reported that having few social interactions outside placement became monotonous.

Our findings show that medical students often felt disconnected from peers and academic staff, and reported loneliness, isolation and decreased wellbeing during COVID-19. This corresponds with evidence that many medical students felt isolated [ 32 ], and students in general were at higher risk of loneliness than the general population during COVID-19 lockdowns [ 33 ]. Just as ‘belongingness’ mediates subjective wellbeing among University students [ 34 ], feeling connected and supported acts as a protective buffer for medical students’ psychological wellbeing [ 25 ].

Translation into practice

Based on the themes identified in this study, specific interventions can be recommended to support medical students’ mental wellbeing, summarised in Table  3 . This study provides evidence to support the development of interventions that increase relational connections between medical students, as a method of promoting mental wellbeing and preventing burnout. Our findings highlight the importance of interpersonal relationships and informal support mechanisms, and indicate that medical student wellbeing could be improved by strengthening these. Possible ways to do this include encouraging collaboration over competition, providing sufficient time off to visit family, having a peer mentor network, events that encourage students to meet each other, and wellbeing sessions that combine socialising with learning relaxation and mindfulness techniques. Students could be supported in their interactions with patients and peers by embedding reflective practice such as placement debrief sessions, Schwartz rounds [ 35 ] or Balint groups [ 36 ], and simulated communication workshops for difficult situations.

Experiencing guilt [ 30 ] and competition [ 4 ] while studying medicine are consistently recognised as contributing to distress and burnout, so interventions targeting these could improve mental wellbeing. Based on the responses from students, curriculum-based measures to protect mental wellbeing include manageable workloads, supportive learning environments, cultivating students’ sense of purpose, and encouraging taking breaks from studying without guilt. Normalising sharing of difficulties and regularly including content within the curriculum on self-care and stress reduction would improve mental wellbeing.

In aiming to reduce psychological distress among medical students, it is important that promotion of individual self-care is accompanied by reducing institutional stressors [ 11 , 29 ]. While the exploration of individual factors is important, such as promoting healthy lifestyle habits, reflection, time management, and mindset changes, this should not detract from addressing factors within the culture, learning and work environment that diminish mental wellbeing [ 37 ]. Heath et al. [ 38 ] propose a pro-active, multi-faceted approach, incorporating preventative strategies, organisational justice, individual strategies and organisational strategies to support resilience in healthcare workers. Similarly, trauma-informed medical education practices [ 13 ] involve individual and institutional strategies to promote student wellbeing.

Students favoured formal support that was responsive, individualised, and accessible. For example, integrating conversations about wellbeing into routine academic systems, and accommodating in-person and remote access to support. There has been increased awareness of the wellbeing needs of medical students in recent years, especially since the start of the pandemic, which has led to improvements in many of these areas, as reported in reviews by Ardekani et al. [ 12 ] and Klein and McCarthy [ 39 ]. Continuing to address stigma around mental health difficulties and embedding discussions around wellbeing in the curriculum are crucial for medical students to be able to seek appropriate support.

Strengths & limitations

By using qualitative open-text responses, rather than enforcing preconceived categories, this study captured students’ lived experience and priorities [ 4 , 31 ]. This increased the salience and depth of responses and generated categories of responses beyond the existing evidence, which is particularly important given the unprecedented experiences of COVID-19. Several strategies were used to establish rigour and trustworthiness, based on the four criteria proposed by Lincoln and Guba [ 20 ] (Table  2 ). These included the active involvement of medical students and recent medical graduates in data analysis and the development of themes, increasing the credibility of the research findings.

Potential limitations of the study are that participants may have been primed to think about certain aspects of wellbeing due to data being collected during a webinar delivered by medical educators including the lead author at the start of their palliative medicine placement, and the choice of prompts. Data was collected during the COVID-19 pandemic, and therefore represents fourth year medical students’ views in specific and unusual circumstances. Information on this context is provided to enable the reader to evaluate whether the findings have transferability to their setting. Responses were visible to others in the group, so participants may have influenced each other to give socially acceptable responses. This process of forming subjective meanings through social interactions is recognised as part of the construction of a shared understanding of reality, and we therefore view it as an inherent feature of this methodology rather than a hindrance. Feedback on the webinar indicated that students benefitted from this process of collective meaning-making. Similarly, researcher subjectivity is viewed as a contextual resource for knowledge generation in reflexive thematic analysis, rather than a limitation to be managed [ 19 ]. The study design meant that different demographic groups could not be compared.

Padlet provided a novel and acceptable method of data collection, offering researchers and educators the potential benefits of an anonymous forum in which students can see their peers’ responses. The use of an interactive webinar demonstrated a potential application of connectivist pedagogical principles [ 18 ]. Researchers are increasingly using content from online forums for qualitative research [ 40 ], and Padlet has been extensively used as an educational tool. However, to the authors’ knowledge, Padlet has not previously been used as a data collection platform for qualitative research. Allowing anonymity carried the risk of students posting comments that were inappropriate or unprofessional. However, with appropriate guidance it appeared to engender honesty and reflection, provided a safe and collaborative learning environment, and student feedback was overwhelmingly positive. It would be useful to evaluate the effects of this reflective webinar on medical students’ mental wellbeing, given that it acted as an intervention in addition to a teaching session and research study.

Students were prompted to plan what they would do following the webinar to improve their mental wellbeing. A longitudinal study to determine how students enacted these plans would allow a more detailed investigation of students’ self-care behaviour.

While we hope that the stressors of COVID-19 will not be repeated, this study provides valuable insight into medical students’ mental wellbeing, which can inform support beyond this exceptional time. The lasting impact of the pandemic upon medical education and mental wellbeing remains to be seen. Nevertheless, our findings reinforce and extend the coping reservoir model proposed by Dunn et al. [ 14 ], adding to our understanding of the factors that contribute to resilience or burnout. In particular, it provides evidence for the development of interventions that increase experiences of relational connectedness and belonging, which are likely to act as a buffer against emotional distress among medical students.

Data availability

The datasets generated and analysed during the study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Dr P Byrne for providing guidance, Mrs A Threlfall and Professor VCT Goddard-Fuller for commenting on drafts, and the medical students who participated in the webinars.

This study was unfunded.

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Authors and affiliations.

Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK

Helen M West

Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK

School of Medicine, University of Liverpool, Liverpool, UK

Rowan M Davies, Benjamin Shelley & Oscar T Edginton

Salford Royal NHS Foundation Trust, Manchester, UK

Rowan M Davies

Calderdale and Huddersfield NHS Foundation Trust, West Yorkshire, UK

Benjamin Shelley

Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK

Oscar T Edginton

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Contributions

HMW conceptualised the study and collected the data. HMW, LF, RMD, BS and OTE conducted data analysis. HMW, LF, RMD and OTE wrote the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Helen M West .

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West, H.M., Flain, L., Davies, R.M. et al. Medical student wellbeing during COVID-19: a qualitative study of challenges, coping strategies, and sources of support. BMC Psychol 12 , 179 (2024). https://doi.org/10.1186/s40359-024-01618-8

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Student essays reflect Covid-19 struggles

What’s on the minds these days from students at Como Park Senior High School?

Here are essays from juniors Jude Breen, Keira Schumacher and Logan Becker who wrote these essays in late February for English teacher Elizabeth Boyer’s CIS Writing Studio class.

What A Blessing

by Jude Breen

When I reflect on the 2020 football season, I always find myself concurring with the word gratitude.

Every day at practice, Coach Scull would have us take a minute. We would sit there in perfect silence and bask in the opportunity and blessing that we were given in being able to have a season. Not only because it was nice to be doing something normal, but also for the chance to build these lifelong friendships and memories that we all will still think back on decades down the road.

I am constantly thinking back to our game against Johnson. Como hasn’t beat Johnson in football for over 10 years and Johnson likes to let us know that. There was a lot of pressure going into the game. We knew we were a good team with many weapons, but we really had to prove ourselves in this matchup.

The game was on a Saturday morning, and it was the first real cold day we had all year. The type of cold where your toes are numb and your snot is frozen inside of your nose . . . not very pretty.

Despite the crisp wind on our faces, we were fired up.

Our Cougars scored first. I threw a corner route in the end zone to Stone who tracked the rock-hard, bruising football for a touchdown. There’s no feeling quite like your first touchdown. The defense stood strong all game and only allowed one touchdown.

We went into overtime tied 6-6. The strong bodies of our defensive lineman protected the tie, then out came our offense. We direct snapped the ball to Stone and he follows his bodyguard blockers into the end zone, reaching with every inch he has to get the ball over the goal line.

And then, pandemonium ensues. We stormed the field in a sea of black. Johnson players were on their knees questioning how in the world they let Como beat them. The adrenaline running through my body made me forget all about the blistering wind chill, as Coach Scull did his victory dance in our team circle.

Once the celebration is over, the grind started all over again in preparation for the upcoming game. The next Monday we were back on our beautiful turf, again in perfect silence, processing how grateful we are for what we have done so far and what is to come.

I will never forget this season. Hard work truly does pay off, and I have unconditional gratitude for my brothers on my team, and the role models I found in the coaching staff.

A Little Bit of Happiness

By Keira Schumacher

Quarantine has been a hard, boring, slow and tiring time for every­one. Being stuck in the same place day after day has made every moment feel the same. It’s almost been a year now since quarantine has started, so I’m sure that everyone has felt this repetition of days just like I have.

By now it’s very hard to find things that can separate the days for me to make them different or unique. I have hobbies that I can do at home. I draw and paint, play video games. But at some point you get sick of those too.

After months of everything being the same, I knew I had to do something to make my time in quarantine a little bit better. I didn’t think that doing little things, like cleaning my room, walking my dogs, or even just taking time to listen to music would make such an impact on my days.

Taking time for yourself and doing something solely for you and no one else have made my days a little better. When your days start to melt together without being able to separate them, you can get stuck in a rut without being able to get out. That’s happened to me a few times. Sometimes the rut lasts only a few days, but sometimes it can last weeks.

When I’m stuck in this place of repetition it demotivates me to do anything. It feels that anything I do doesn’t really matter because everything will be the same the next day and the day after that. It can be very hard for me to clear my head and start to actively do things rather than just floating through the days.

Some things that have helped me get through these ruts are making a good cup of coffee in the morning, or doing some laundry to be able to wear your favorite sweatshirt again.

I’ve been lucky enough to be able to go downhill skiing this winter, which is the biggest factor for helping me clear my mind and resetting. Being able to breath the cold crisp air on the hills as I’m speeding down. Being able to enjoy skiing with my friends has been one of the main reasons I’m not in a constant rut.

You have to work to find happiness and fulfillment in the little things.

Struggles with online learning

By Logan Becker

Onerous and loneliness are two words I would use to describe the past nine months each and every one of us has experienced. Our main issue, and quite frankly the most obvious one, would be the coronavirus.

It’s been exceptionally difficult on most of us, and the days feel as if they just keep getting worse and worse. Hearing about a vaccine was a lighthearted and a very hopeful sign that everything will turn out okay.

But, social distancing at this point has been nothing but repetitive. I fully understand it’s a safety precaution to keep everyone safe from this pandemic, but it still hurts to know I’m unable to see my friends daily.

I go through my day expecting the same thing consistently over and over again through this pandemic. It’s quite literally the same: Wake up, brush my teeth, take a shower, eat some breakfast, feed my dogs, check in on my little brother, take out the trash, make some lunch, do the dishes, do my laundry, spend time with family and go to sleep. It seems as if spending time at home has been more time consuming than my regular day life before the pandemic. And it’s not entirely easy using my precious free time to focus on school.

Online schooling is more distracting than one might think, surrounded by things you love to do, and having to ignore it to get the things more important done. I’ve always had a difficulty during normal school to get my homework done when I get home from school because I get distracted and it’s really my only time during the day to do what I want to do. But it seems as if that’s how my daily routine has wound up to be. It’s unfortunate to say the least, and overall has been stressful.

I’ve talked with other students about this over Google meets, and we’ve all come to the same consensus that we lack tons of motivation when doing school at home.

Additionally, I find nearly no time to step away from this and haven’t given myself much time to just relax and enjoy myself without the weight of school on my chest. . . . I’m quite fully sure there are hundreds of more students who have dealt with this monstrous difficulty, and it’s been a very strenuous position to be in.

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COVID-19 reflections: the lessons learnt from the pandemic

by Alana Cullen , Lucy Lipscombe 03 February 2021

Imperial researchers reflect on the lessons they will take away from the pandemic.

Over the past 12 months the Imperial College London community has devoted an intense amount of time and research to COVID-19. Members of the community have been making fundamental scientific contributions to respond to coronavirus , from advising government policy to critical therapy research. A year on, Imperial researchers reflect on what lasting impact the pandemic has left on them. 

Watch the clip above to hear the researchers’ insights. 

A global contributor

Before I felt like just a person in the world, and now I feel like I’m one of those important people in the world! Dr Kai Hu

The first lesson is how fast- moving science is at this time. It is exciting to have been “on the forefront of vaccine discoveries” said Dr Anna Blakney, Assistant Professor at the University of British Columbia, formally a Research Fellow in Imperial’s Department of Infection and Immunity . Imperial has also been key in finding optimal treatments for COVID-19, with clinical academics such as Anthony Gordon , Professor of Anaesthesia and Critical Care and Intensive Care consultant, caring for critically ill patients in intensive care units as well as leading clinical trials. Findings from these trials include the effective use of an arthritis drug in reducing mortality in COVID-19 patients.

The science doesn’t stop there. Outside of the lab Imperial academics have been informing UK government policy. Since the emergence of coronavirus the team from the MRC Centre for Global Infectious Disease Analysis and Jameel Institute (J-IDEA) at Imperial have been predicting the course of the pandemic and informing policy. The team have also been supporting the COVID-19 response in New York State. Furthermore, Imperial academics including Professor Charles Bangham and Professor Wendy Barclay continue to advise the government as part of the Scientific Advisory Group for Emergencies (SAGE). 

In total the Imperial community has contributed nearly 2,000 key workers to essential services and research, from biomedical engineers developing rapid COVID-19 tests to health economists, generating a wealth of knowledge about the science behind the pandemic.

“This is the first time where I feel like what I have learnt is very useful” said Dr Kai Hu, Research Associate in the Department of Infectious Disease. “Before I felt like just a person in the world, and now I feel like I’m one of those important people in the world.” Dr Kai Hu is part of Professor Robin Shattock’s COVID-19 vaccine team, who continue to develop an RNA vaccine .

Watch our full COVID reflections video below, including researchers sharing their hopes for the future.

Collaboration is key

Another key lesson learnt is how much stronger we are when we work together. Vaccine development, production and delivery have all been achieved in under 12 months – an unprecedented timeframe for any disease prevention tool. This goes to show that collaborative efforts with the  right funding will go a long way in biomedical science. “I can work even harder than I thought I could work because we can come together as a team” says Dr Paul McKay , Senior Research Fellow in the Department of Infectious Disease. “Science is a competitive endeavour, but a collaborative endeavour too.” 

Something that will leave a lasting impression is the kindness of community, family and friends. Kindness at this time has been “unparalleled” said Sonia Saxena , Professor of Primary Care and General Practitioner. From providing free meals to NHS workers to educational materials for homeschooling there has been a feeling of togetherness, even when apart, throughout these difficult times. Going forward, we can bring these lessons into science, bringing more collaboration and kindness into the everyday. 

Article text (excluding photos or graphics) © Imperial College London.

Photos and graphics subject to third party copyright used with permission or © Imperial College London.

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A qualitative analysis of third-year medical students' reflection essays regarding the impact of COVID-19 on their education

Affiliations.

• 1 Department of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Curtis Building, Suite 400, Philadelphia, PA, 19107, USA. [email protected].
• 2 Department of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Curtis Building, Suite 400, Philadelphia, PA, 19107, USA.
• PMID: 34496820
• PMCID: PMC8425993
• DOI: 10.1186/s12909-021-02906-2

Background: The COVID-19 pandemic fundamentally changed every aspect of healthcare delivery and training. Few studies have reported on the impact of these changes on the experiences, skill development, and career expectations of medical students.

Method: Using 59 responses to a short reflection essay prompt, 3rd year medical students in Philadelphia described how the COVID-19 pandemic affected their education in mid-2020. Using conventional content analysis, six main themes were identified across 14 codes.

Results: Students reported concerns regarding their decreased clinical skill training and specialty exposure on their career development due to the loss of in-person experience during their family medicine clerkship. A small number felt very let down and exploited by the continued high cost of tuition while missing clinical interactions. However, many students also expressed professional pride and derived meaning from limited patient and mentorship opportunities. Many students developed a new sense of purpose and a call to become stronger public health and patient advocates.

Conclusions: The medical field will need to adapt to support medical students adversely impacted by the COVID-19 pandemic, from an educational and mental health standpoint. However, there are encouraging signs that this may also galvanize many students to engage in leadership roles in their communities, to become more empathetic and thoughtful physicians, and to redesign healthcare in the future to better meet the needs of their most vulnerable patients.

Keywords: COVID-19; Clinical training; Undergraduate medical education; Workforce development.

© 2021. The Author(s).

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Conflict of interest statement

The authors declare that they have no competing interests.

Summary of codebook refinement and…

Summary of codebook refinement and final theme determination

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The psychosocial impact of the covid-19 pandemic on italian families: the perception of quality of life and screening of psychological symptoms.

1. Introduction

2. materials and methods, 2.1. participants, 2.2. procedure, 2.3. instruments, 2.3.1. sociodemographic questionnaire, 2.3.2. revised children’s manifest anxiety scale—second edition, 2.3.3. chia, 2.3.4. pedsqol 3.0 multidimensional fatigue scale, 2.4. plan of statistical analyses, 3.1. perceptions of anxiety, anger, and quality of life of children and adolescents compared to norms, 3.2. comparison of quality of life scores between parents and children, 3.3. what are the factors that influence anxiety symptoms in children and adolescents, 3.4. what are the factors that influence the perceived quality of life of children and adolescents, 4. discussion, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, acknowledgments, conflicts of interest.

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Incardona, R.M.; Tremolada, M. The Psychosocial Impact of the COVID-19 Pandemic on Italian Families: The Perception of Quality of Life and Screening of Psychological Symptoms. Pediatr. Rep. 2024 , 16 , 519-529. https://doi.org/10.3390/pediatric16020043

Incardona RM, Tremolada M. The Psychosocial Impact of the COVID-19 Pandemic on Italian Families: The Perception of Quality of Life and Screening of Psychological Symptoms. Pediatric Reports . 2024; 16(2):519-529. https://doi.org/10.3390/pediatric16020043

Incardona, Roberta Maria, and Marta Tremolada. 2024. "The Psychosocial Impact of the COVID-19 Pandemic on Italian Families: The Perception of Quality of Life and Screening of Psychological Symptoms" Pediatric Reports 16, no. 2: 519-529. https://doi.org/10.3390/pediatric16020043

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Quinnipiac Today

Students experience an immersive visit to New Haven courthouse

May 03, 2024

Quinnipiac students have had the opportunity to visit the Richard C. Lee Courthouse in New Haven, Connecticut, providing first-hand experience of the judicial process in action.

For the last semester, students enrolled in LE-101 course have been learning about the foundation of the American legal system. As an addition to their course curriculum, students were provided the opportunity to visit the New Haven Courthouse to witness a sentencing proceeding, engage in a post-proceeding discussion and participate in a Q&A with Judge Robert M. Spector.

This opportunity provides students with an exclusive and unique experience that offered a deeper understanding of the legal environment.

“Law courses are about learning a system that impacts all of us,” said Experiential Learning Coordinator Sally Anastos. “It is important to realize how the system works so that people are empowered to enforce their rights. Experiential learning is a key component of the legal studies program and it is ingrained into the major, minors and every class.”

Following this experience, students were assigned to write a reflective essay on what they learned and how the trip contributed to the curriculum they learned. 

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Nursing students' reflections on vaccine administration during the COVID-19 global pandemic

During the COVID-19 pandemic, many nursing schools limited in-person clinical instruction to lower the risk of student exposure to SARS-CoV-2. Some U.S. state boards of nursing authorized virtual learning experiences to attempt to fill this void. The effects of restricting such hands-on training are not fully understood, but we believed it could be detrimental to student development and saw partnering with local COVID-19 vaccination clinic as a promising alternative. Between January and April 2021, second semester pre-licensure nursing students assisted at the clinic and submitted reflections on the experience. The aim of this study was to assess the effectiveness of this educational encounter.

One hundred seventy-one students submitted reflections on their experience, which were de-identified and uploaded to a HIPAA- and FERPA-compliant cloud storage system using SAFE desktop and coded for thematic analysis.

Analysis revealed five major themes: community, socializing, perceived confidence, impact, and professional role.

This study demonstrated the viability of instruction at a COVID-19 vaccination clinic as an alternative learning experience for nursing students encountering restricted face-to-face clinical training. It suggests that schools can develop other novel clinical experiences to increase students' perceived confidence, provide opportunities to practice skills, and gain insights into nursing practice.

Graphical abstract

Introduction

During the start of the global COVID-19 pandemic, nursing education delivery was forced to change. Many nursing schools around the world had to reduce the number of face-to-face classes and hospital clinical rotations due to government restrictions to reduce the risk of student exposure to the SARS-CoV-2 virus. Additionally, many healthcare partner institutions stopped allowing student nurses access to their facilities for training, to attempt to reduce the risk of students inadvertently exposing their staff or patients to COVID-19.

These constraints created numerous challenges for nursing education in the United States. Due to social distancing and other restrictions, nursing students were forced to learn remotely and had limited opportunities to practice hands-on clinical skills. Some state boards of nursing authorized use of virtual learning experiences to try to fill the void of in-person learning; while some schools of nursing took advantage of this change ( NCSBN, 2020 , NCSBN, 2020 ), the effects of such training are not yet known.

Recognizing the potential implications of the pandemic for the readiness of future nurses to practice safely and effectively, the Maryland Nurses Association (MNA) called on nursing faculty to become innovative and flexible in experiences that would meet course objectives and program outcomes ( Watties-Daniels, 2020 ). This call led our school of nursing to explore alternative educational opportunities that would permit hands-on learning in a safe, innovative fashion.

Literature review

Reflections and experiences of student nurses during the COVID-19 pandemic were limited at the time of this study's inception but suggested complex interactions between students' own lived experiences of the pandemic and their attempts to train to become nurses when faced with numerous constraints on their coursework. Savitsky et al. (2020) stated that over half of Israeli nursing students in their study screened positive for moderate to severe anxiety during the lockdown. In Sweden, Langegård et al. (2021) found that many students preferred in-person learning, with some reporting decreased motivation with the online format. Hamadi et al. (2021) reported that nursing students at a private university reported higher stress levels during the COVID-19 pandemic than before it; interestingly, the highest increase in stress was in the category “lack of professional knowledge and skills” (p. 631). Students at five schools of nursing across the U.S., meanwhile, felt that it was difficult to connect with their student peers and instructors due to the virtual learning format, with some reporting that the loss of student peer socialization was the hardest part of the pandemic. Notably, though, the authors found that these students nonetheless felt the pandemic strengthened their desire to become nurses ( Michel et al., 2021 ).

Clinical experience in nursing education provides opportunities for students to learn critical thinking and judgement, build confidence, improve nursing skills, act as a member of the clinical team, and model the professional nurse role. When such training is lacking, recent evidence suggests that students may suffer both personally and professionally, yet when it is present—particularly during periods of great morbidity and mortality—students may find it especially gratifying. Dickel (2021) , for example, expressed frustration, anger, and hopelessness that she and her fellow students were given “subpar” virtual experiences in place of contributing to the health of patients, despite the risks of infection, and wished that she and her peers could be utilized like student nurses were in Great Britain and Australia (p. 334). Indeed, Casafont et al. (2021) reported that Spanish nursing students were permitted to work in hospitals, including with COVID-19 patients; students in their study expressed feelings of helpfulness and pride from contributing to the pandemic response. Townsend (2020) , meanwhile, reported that an optional, extended experience in a hospital in Great Britain during the pandemic helped him grow emotionally and mature professionally and that he felt useful, proud, and privileged to participate in nursing care during such challenging times, though he confessed that the experience created anxiety for his family, who worried about his well-being. This student reflected on feeling useful, proud and privileged to participate in providing nursing care during unprecedented times ( Townsend, 2020 ). Limiting in-person experiences for students has the potential to slow the growth of clinical reasoning, reduce or delay skill development, and decrease confidence in pre-licensure nursing students ( Noh, 2021 ).

These articles also suggest the benefit of searching for new educational opportunities that balance student nurses' involvement in the pandemic response with minimizing risks to students and others, to attempt to mitigate these possible barriers to their professional development. One attempt at such a solution involved the use of nursing students to assist with COVID-19 vaccination efforts. The National Council of State Boards of Nursing (NCSBN), which oversees the examination and licensing of nurses in the U.S., encouraged partnerships between schools of nursing and medical and health institutions to assist with their COVID-19 vaccination efforts. It is unclear how many institutions heeded this suggestion, though St. Luke's University Health Network (2021) enlisted nursing students to help provide vaccinations and found that their students stressed the desires to be productive members of the healthcare team, give back to their local community, and therefore actively participate in the global effort against COVID-19. Towson University provided a similar experience for their nursing students to provide an opportunity to interact and engage with people and provide the chance to apply their injection skills ( Boteler, 2021 ).

The project

For this project, second-semester master's entry-to-practice nursing students spent time assisting at a COVID-19 vaccination clinic as part of a foundational adult medical-surgical clinical course from January through April 2021. The purpose of this experience was to not only provide additional clinical experience and increase confidence in the skill of giving an intramuscular injection, but to give students an opportunity to promote patient education, assist in vaccination efforts, model inter-professional teamwork and to encourage self-reflection. Following the vaccine clinic, students were asked to reflect on this activity using the “What? So, what? Now what?” framework originally described by Rolfe, Freshwater & Jasper in 2001.

The occupational health vaccination clinic served students and staff at a large, metropolitan health system in the United States. The clinic stocked the Pfizer-BioNTech COVID-19 Vaccine that was granted Emergency Use Authorization in August 2020, for use in the prevention of COVID-19 in individuals 16 and older ( Federal Drug Administration, 2022 ). The safety protocols for the vaccination clinic required face coverings and social distancing for all people at the clinic. The students and vaccinators also donned face shields. Employees and students with appointments were pre-screened for COVID-19 symptoms and were re-screened upon arrival at the clinic. If they had symptoms, they were instructed to either stay home or leave the clinic immediately and follow up with testing for COVID-19.

Small groups of students rotated through the vaccination clinic for one assigned clinical day during the semester. Prior to the clinic, students completed an educational module about SARS-CoV-2 and the newly approved vaccines, which was created by one of the course instructors. The prework activity culminated in a post-module quiz to assess content knowledge. Designated student activities at the vaccination clinic consisted of rotating through four stations to help with check-in, administer vaccines, and perform post-vaccine observation for employees and students.

On the day of the clinic, students reviewed proper intra-muscular administration technique using an injection pad made of rolled gauze and saline in a needleless syringe. During the four-hour rotation, student responsibilities included (1) assisting with patient check-in and document verification before escorting patients to injection stations, (2) observing vaccine dosing with pharmacy and delivery of the prepared syringes to vaccinators, (3) confirming eligibility and administering vaccines under the supervision of experienced nurses, and (4) assisting Emergency Medical Technicians (EMTs) monitor for post-vaccination side effects. Following the experience, the students submitted a reflection on the activity by answering twelve free-text survey questions ( Fig. 1 ). Reflections were submitted to a learning management system and graded by the course coordinators. The activity was created by a course coordinator and used the “What? So, what? Now what?” framework originally described by ( Rolfe et al., 2001 ).

Free text survey questions that students answered following the clinic experience.

The unique clinical activity utilized a combination of virtual and tactile instruction to limit potential for disease exposure for students and staff. This method allowed students to learn vaccine theory content through an asynchronous, virtual format and then apply this knowledge through hands-on clinical practice. The goal of this project was to review students' reflections on their experiences participating in the vaccination effort during the pandemic. The aims were to analyze the student reflections and identify common themes.

Methods and materials

The project authors used the reflection responses to perform a retrospective analysis. These data were downloaded from a learning management platform and did not capture protected health information (PHI). No demographic data were collected, to minimize participant risk. For this reason, informed consent was not required, because no ethical concerns existed. Data collection and access were limited to the research team members. The project was awarded an IRB exemption waiver by the home institution.

One hundred seventy-one students provided reflections, which were the principal data sources. Data were de-identified by one researcher, who then exported them to a Microsoft Excel spreadsheet. The spreadsheets were then uploaded to a HIPAA- and FERPA-compliant cloud storage system using SAFE desktop; only members of the project team had access to the data. The reflections were divided evenly among the research team, then coded using Microsoft Word. The members of the team rotated through each batch of reflections as an independent double-check. While reading responses, each reviewer made note of comments that were similar among multiple respondents. If two or more respondents had a similar response to the question, the team member noted this on a Word document and kept count of all similar responses. Once the preliminary review was conducted, all project team members deliberated to identify common themes and sub-themes. Results were coded for thematic analysis, and a quantitative approach was used to analyze the number of responses for each theme.

Analysis of the data revealed 5 major themes, as well as various sub-themes ( Table 1 ). The major themes that were identified are community, socializing, perceived confidence, impact, and professional role. The theme of community was discussed 157 times in the reflections, with sub-themes of local and state communities and hospital/school of nursing community. Socialization was mentioned in 56 reflections; sub-themes included employee-patient socialization as well as professional/teamwork socialization. The perception of confidence was the most common theme, with 201 comments, and it included sub-themes of perceived lack of confidence and/or gain in confidence. Impact was the third-largest theme, with 103 responses, and it included sub-themes of being a part of history and impacting the end of the pandemic. Lastly, the professional role theme was present in 87 comments and contained sub-threads of pride in nursing/choosing the right profession and professional skills as a nurse.

Major themes and sub-themes of students' reflections.

Theme of community

The theme of community was represented in many responses and included sub-themes of connection to and impact on the local community, such as city and state. Many of the respondents came to the school from out of state and had limited in-person interactions with fellow students or others in the area before this experience, so it is unsurprising that the experience helped them feel more a part of the local community, while giving them the opportunity to serve. The students respondents also mentioned how this experience allowed them to feel like a member of the hospital/school of nursing community of students and healthcare workers, which had been lacking due to restricted personal and professional interactions. Community outreach was another common sub-theme throughout the reflections, including the desire to volunteer with further public health efforts throughout the region. This echoes what was present in the literature; students crave safe, innovative clinical learning experiences, even amid a global pandemic, that help provide a sense of belonging ( Townsend, 2020 ; Casafont et al., 2021 ; Dickel, 2021 ).

Theme of socializing

Having the opportunity for socializing during the pandemic seemed to have a substantially positive impact on the participants; it was mentioned in over fifty responses. Students reflected favorably on having the ability to interact and socialize with employee-patients, peers, and other staff members at the clinic. They expressed that this opportunity to interact with others in this clinical setting helped them feel connected to the healthcare team, which was lacking prior to the experience. During the uncertainty that overwhelmed the early stages of the pandemic, respondents reported appreciating any opportunity to meet with their peers for social learning interactions.

Theme of perceived confidence

The perception of confidence was the most frequently mentioned theme in the student reflections. 33 % (n = 58) of respondents expressed a perceived lack of confidence prior to the experience regarding IM injection skills, medication administration procedures, patient interactions, multi-disciplinary interactions, and even their understanding of the nursing professional role. After completion of this experience, 83.6 % (n = 143) of respondents expressed a perceived gain in confidence. One respondent reflected that nursing school is full of first times, but this experience helped show them that they are prepared for the ever-changing profession of nursing. According to their reflections, participant perception of confidence improved not only in their understanding of the nursing professional role, but also in their decision to pursue a career in nursing.

Theme of impact

Discussion of the impact of this experience was present in many of the student reflections. The personal impact of the COVID-19 pandemic was a major component in their reflections in which they discussed how the pandemic impacted them, their families, and communities in many ways. Students expressed that they, as well as their families and home communities, were negatively impacted—both emotionally and economically—by the pandemic. On the other hand, many respondents mentioned the historical impact they will have by participating in public health measures during a once-a-century pandemic (n = 68). One student reflected on how the experience will contribute to their career, and that being a part of the vaccine clinic team was life changing. Another impactful outcome mentioned by the respondent was that they appreciated being able to help the community get back to normal (n = 35). The respondents' comments expressed that they felt honored to have an impact on the health outcomes of the hospital community and in turn, the local community.

Theme of professional role

Lastly, there emerged the theme of the professional role. Of the students surveyed, over half (n = 87) expressed pride in their future profession as a nurse. Many students stated the importance of gaining competence in clinical skills to prepare for the nursing role and were worried they would not get enough practice, due to the pandemic. The experience allowed students to reflect on the nursing role in multidisciplinary community health initiatives. One shared that the experience will help the clinical group be a more cohesive and responsible members of the care team. One student commented that the experience impacted how they intend to approach the profession by striving to foster teamwork and inclusivity in their future work environment, modeled after the vaccine clinic experience. In general, this theme showed that the students felt the novel clinical experience positively contributed to their understanding of the professional role of nurses.

The results of this project show that this structured, alternate clinical learning experience helped to increase students' perception of confidence in performing fundamental nursing skills while providing a better understanding of and appreciation for interdisciplinary roles and teamwork. Students had the perception of strengthened interpersonal communication skills with the healthcare team, their peers, and employee-patients. Importantly, this clinic-based educational experience demonstrated the feasibility of a safe, effective alternative to virtual learning formats for skills development during a pandemic. Based on respondent reflections, it seems that enhanced experiences like these are what students want and expect from their nursing programs. In this setting, students were able to strengthen their skills, be important members of a major public health initiative, and feel a sense of pride in the profession of nursing.

Strengths and limitations

There were several strengths and limitations to this project. First, it was a retroactive analysis, so data were readily available from a previously submitted reflection assignment. Second was the ability to partner with a medical institution that is affiliated with the school of nursing, which meant clinical site compliance requirements were already completed. Third, the educational format has an easily reproducible design, which could motivate other schools of nursing to continue studying how student learning is affected by novel clinical experiences.

There were also three limitations to this study. The first is incomplete or incorrectly formatted reflection submissions (for example, one student in the cohort did not submit the reflection assignment and some others did not use the relevant framework). A second limitation was the short duration of time that each group spent in the vaccine clinic; this was due largely to scheduling constraints with the clinic and also to the perceived fear of a few students of exposure to SARS-CoV-2, limiting some students' participation in this activity. Third is the uniqueness of the COVID-19 pandemic; it is impossible to know if vaccines with new Emergency Use Authorization will be used in mass vaccination efforts for future pandemics, as they were during COVID-19. The use of commonly used vaccines may result in changes to themes derived from student reflections.

Overall, the student respondents expressed their desire to be an active participant in the COVID-19 pandemic response and community outreach efforts, which echoed the literature findings ( Casafont et al., 2021 ; Dickel, 2021 ; Townsend, 2020 ). One comment noted feeling more of a part of the nursing profession and mentioned having pride in their ability to help. One participant noted they felt pride in helping on the “front lines”. Another student focused on the community impact they might have, hoping community members will recognize that the students want to be of service. These reflections suggest an area for future student nurses' involvement in projects or initiatives in the surrounding community.

Schools of nursing can utilize other novel clinical experiences, not only to increase students' perceived confidence by providing the opportunity to practice skills, but also to offer insight and knowledge of interdisciplinary teamwork in community events. One participant noted the level of teamwork that was needed to deliver exceptional patient care. Without this experience, this cohort of nursing students may not have had the opportunity to witness the impact nurses can have on individual and community health outcomes.

These findings have many implications for nursing education and practice. Ultimately, the project shows that it is possible to achieve positive learning outcomes that align with course objectives by offering non-traditional clinical experiences. It may also be possible for students to gain insight that is not afforded in traditional teaching and learning environments by participating in such guided experiences. Providing a structured activity with a medical/institutional partner allows nursing students to collaborate with other professionals to better understand their professional role. Nurse educators have an opportunity to be creative with other non-traditional opportunities that may help students achieve competence, improve perceived confidence, and further professional development while providing the opportunity to improve public health outcomes.

Nursing students require participation in hands-on experiences to achieve competence in clinical skills and knowledge of professional practice. The theme of confidence showed these students felt their perception of confidence improved with patient/staff interaction, and implementation of learned skills. In addition to the contribution to student development, medical institutions benefit from having nursing students assist with public health efforts. Schools of nursing play an important role in their communities, and nursing students are a valuable presence within health care systems—this is even more evident during times of crisis. The students in this study reported how important it was for them to have an impact and feel a part of an important moment in history as members of the healthcare community. It is the responsibility of schools of nursing to provide safe, effective opportunities for student learning even when the traditional methods of in-person learning are not possible.

While there have always been many challenges to providing adequate competency-based learning for nursing students, the COVID-19 pandemic brought unprecedented barriers. The ability of an entry-level nursing program to maintain teaching and learning standards during times of crisis is more essential now than it may have ever been before. Future students could be entering the nursing profession in times of turmoil and doubt, with circumstances that are ever-changing and seemingly unconquerable.

This study showed that providing nursing students with learning experiences that not only help strengthen skills but also facilitate their connection to the profession (and community) is vital to providing quality care with equitable access to all. The themes of community, socialization and professional role seen in this study show that nursing students continue to be stakeholders in the health and wellness of their community. They are resilient enough to prioritize their learning during the uncertainty of a global pandemic and will certainly be resilient enough to take on the next inevitable global (or local) challenges that come their way. By offering experiences outside of the typical clinical learning environment, schools of nursing can help to contribute to the resilience and endurance of future new nurses.

Declaration of competing interest

Acknowledgements.

The authors thank the editor and two anonymous reviewers for extremely helpful feedback on previous versions of this paper.

Funding sources

There were no funding sources or individuals who contributed to the conduct of the manuscript. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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What Happened When Brooklyn Tried to Integrate Its Middle Schools

A new report found that many schools enrolled more racially and socioeconomically diverse groups of students without sparking a major exodus of families from public schools.

By Troy Closson

Seeking to solve a problem that has vexed public schools around the country for decades, one progressive section of New York undertook an ambitious plan to better integrate middle schools that were among the most homogenous in the city.

Selective admissions were scrapped. Every child got a lottery number instead. Schools adopted targets to admit certain numbers of disadvantaged children. And unlike in many places where integration attempts faced fierce opposition, parents led the effort.

Now, five years later, the plan appears to be working.

Middle schools in a section of northwest Brooklyn that stretches from Sunset Park to Cobble Hill went from being the second most socioeconomically segregated to 19th out of the city’s 32 local districts. Teachers and students say friendships are emerging across income lines.

And while opposition to integration efforts is often focused on concern that middle-class and white families will abandon public schools, the area — District 15 — has not seen a major exodus. The city’s public school enrollment has dropped as families leave New York or move to charters, but the district’s declines have been less extreme than elsewhere.

Across American public schools, more than a third of all students attend a school where most of their peers share the same race or ethnicity. But the Supreme Court has also limited how schools can use race to sort students among schools, and efforts to address racial segregation have mostly stalled.

Instead of using race, the district employed other categories to diversify student bodies and bring students with different life experiences and resources together. Specifically, schools prioritized students who are homeless, learning English or from low-income families — factors that are often correlated to race but that do not pose the same legal challenges.

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• The army-backed establishment in Thailand goes after its enemies

Thaksin Shinawatra’s case is just one of many

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I N ONE of a handful of politically charged cases passing through courts in Bangkok on June 18th, Thaksin Shinawatra, a former prime minister who was ousted in an army coup in 2006, was formally indicted for insulting the monarchy. In ordinary circumstances, that ought not to be surprising. The conservative establishment close to the monarchy and the army is notorious for reaching for Thailand’s harsh lèse-majesté law, with sentences of up to 15 years in prison, to hound perceived enemies.

Even during long years in exile Mr Thaksin, at the head of his populist Pheu Thai movement, has been enemy number one. The charge has to do with a claim he made nearly a decade ago that the king’s powerful Privy Council was complicit in yet another coup, in 2014, when his sister was prime minister.

But the indictment is striking because only last year both sides made a grubby-looking pact, following a general election in May 2023. The ex-generals then running the country hoped to manage the election. But a more liberal movement than Pheu Thai, the Move Forward Party, easily won the most seats on a platform of breaking up monopolies, ending conscription and reforming the lèse-majesté law. Pheu Thai came second, and the main army-backed party a distant third.

Yet the army-controlled senate blocked Move Forward’s bright and progressive leader, Pita Limjaroenrat, from forming a government. Instead, the prime minister who emerged was Pheu Thai’s Srettha Thavisin, a businessman-turned-politician with close ties to the Shinawatras. In August 2023 Mr Thaksin himself returned from exile to a rapturous reception. Rather than go to prison to serve a long sentence for previous convictions for corruption, he was allowed to move to a posh Bangkok hospital with service on par with a resort. Within months Mr Thaksin was out. The bane of the establishment had become its ally.

The deal made with Mr Thaksin has not been divulged. But his indictment suggests that he has since crossed a line. Perhaps the establishment thought he would steer clear of politics. Instead, he has eagerly re-entered political life, travelling about the country as if campaigning. Meanwhile, a separate case heard on the same day by the constitutional court was against his ally, Mr Srettha, brought by a group of conservative senators. They claim that Mr Srettha broke the law by appointing a convicted man (and another Thaksin ally) to his cabinet. They call for the prime minister’s removal.

In the event, the courts granted Mr Thaksin bail and called for another hearing on Mr Srettha for July 10th. That puts off, for now, an immediate political crisis. Yet the cases, at the least, represent a warning to Mr Thaksin and his allies that they should not take for granted the political space they have carved out.

The outcome of a third case, against Move Forward, is perhaps the most predictable, yet it offers the greatest reflection on the future of Thailand’s dismal politics. In this case the election commission is seeking to dissolve the party, on the grounds that its call to change the lèse-majesté law was treason.

On June 18th the constitutional court appeared to agree. It is likely to rule in the coming weeks. Move Forward faces dissolution. That would be the same fate as its predecessor, Future Forward Party, following a strong showing in the previous election, in 2019. Mr Pita faces the possibility of a lifetime ban from politics. Other members of his party could also be banned.

Dissolution would be a slap in the face for over 14m voters. The ban on Future Forward was the catalyst for widespread student-led protests that lasted months. Since then, democracy advocates have been hounded. Some 2,000 Thais have been charged or prosecuted, among them over 270 for lèse-majesté . If not in prison, many activists lie low or have fled abroad. Even so, others Banyan spoke to said they would continue to fight, largely through grassroots campaigns for greater democracy and representation.

The establishment’s waging of “lawfare” is wearing for many of the targets, says Mr Pita. The risks of taking peacefully to the streets are high when protests become “an excuse for another military coup”. Yet, Mr Pita insists, supporters of democratic, more accountable government are far from giving up. Thais now have a taste of the ballot box. There is no going back—a lesson a reactionary establishment going after its enemies has yet to take on board. ■

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This article appeared in the Asia section of the print edition under the headline “The king’s men waging lawfare”

Asia June 22nd 2024

Vladimir putin’s dangerous bromance with kim jong un, thailand legalises same-sex marriage, why india should create dozens of new states.

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