Abstract
What if I were to tell you that you do not have to leave your home for medical education? You can stay at home and still learn how to save patients and alleviate ailments. COVID-19 gave medical students insight into e-learning as medical schools shut down in-person classes due to the pandemic. We want to share our experience with e-learning and discuss some implications of “Zoom burnout” or “Zoom fatigue” during our medical education.
We were excited at the beginning of the pandemic to have everything associated with school be online. Our thoughts included having increased efficiency and time for self-directed learning, giving us more time to study for the boards and ultimately higher exam scores. Initially, we did not fully note the importance of social structure, seclusion, or being away from direct contact with our professors and how these precedented structures influence our learning. We would soon find out the full impact of COVID-19 as the year progressed. We also learned the downsides of e-learning and resources to overcome its challenges.
Online learning has had many advantages for students during the pandemic, including continuing medical education during these unprecedented times. 1 By executing online learning, medical students finished the grueling 4 years of medical school without interruption. However, e-learning created unforeseen stressors on students. 2 The fast turnaround of transitioning from an in-person format to an all-online platform proved to be challenging. This process left students confused and wondering what tasks needed to be done while also searching for more review content to cover the gaps in the curriculum. Students in undergraduate programs complained about assessment methods, student–instructor communication, fairness of examination, and difficulty understanding online learning concepts. 3 We believe these defects stemmed from the unpolished system placed to aid students not to have a gap in their education. At the beginning of the pandemic, most students did not have high hopes for e-learning, as showcased in a cross-sectional study from Libya to gauge medical student engagement. 4 We found that e-learning had many strong potentials because we were very motivated and directly learned classroom content by using outside resources from our school.
Having increased Zoom sessions without interacting with our colleagues on the other end began to take an enormous toll on us. This phenomenon has been termed “Zoom burnout” or “Zoom fatigue”. The fatigue comes from the need for attentiveness to nonverbal cues and the constant awareness of what a person is doing while the Zoom camera is on. 5 Quoting Morris, a researcher on the topic: “Zoom technology can disrupt our normal intricate human communication methods that have been finely tuned over centuries to help humans survive”. 6 The taxing, seemingly never-ending Zoom calls made us tired of staring at our computer screens because of the claustrophobic format. I recall a time where we had multiple Zoom sessions per day leading to back pain from sitting in a chair too long. Other students reported neck pain from having desks and coffee tables not designed to support the hours of screen time in the Zoom age. These mental and physical aches further exacerbated the Zoom burnout dilemma, creating an endemic condition in the medical school within the context of a worldwide pandemic. As time progressed, we began to find fixes for our growing discomforts, such as standing desks, treadmill desks, or taking constant breaks to rest one’s eyes, as examples. These fixes began to alleviate the repetitiveness of Zoom. Although, more questions came about when we saw that our physical exam practice sessions for the heart and lung examinations were held over Zoom. We remember being instructed to place our stethoscopes on the wall of our homes to practice auscultating a patient. We knew we had to continue our education somehow and this new way of learning was the best way of progressing, even though odd at first.
We, however, began to maneuver Zoom with a high proficiency after understanding the ins and outs of how it functioned. The new platform allowed us to multi-task on an unprecedented level. We had a Zoom call for required sessions while simultaneously writing research papers or doing flashcards to enhance our learning. By the time our proficiency took shape, we had started utilizing Zoom in the clinic for telehealth visits where patients had sought attending physicians in the comfort of their own homes. Zoom began to expand the definition of medical access and brought about ease of access as well. With most meetings being on Zoom, many other individuals and we were accessing multiple seminars. By participating in Zoom calls from home, we took away the time needed to commute and reallocated the time to taking more breaks and self-reflecting to keep our sanity during a pandemic. Zoom reinvented the definition of education and the way information can be broadcasted to the world. The broadcasting of information most likely did not occur as readily in third world countries because they did not have access to computers. Still, since the pandemic put many different countries in the spotlight, international aid can now be integrated into securing more computers for the youth. This will limit social inequity through ease of access to education in third world countries by reducing the amount of money required for in-person meetings of big international aid organizations. 7
The pandemic has, without a doubt, created many challenges to medical education. Although we had to navigate these obstacles, we found ways to combat the monotony of Zoom while simultaneously excelling. Zoom burnout most likely reaches beyond medical training, but there are ways to combat Zoom burnout, including using different technology rather than just a computer such as virtual reality, creating an authoritative presence by directly looking at the camera, and staggering the Zoom meetings to limit screen time. 8 Human interactions remain a crucial part of human development and learning. We have evolved to interact and absorb new information through physical contact and real-life experiences. Although Zoom has become an invaluable tool in times where social distancing became necessary, with better control of the pandemic and better access to vaccination, medical education can regain some physical presence and continue taking advantage of the pandemic e-learning tools.
