Deans, faculty and students in health professions education call for fundamental change in how we train doctors, nurses and other health care providers to advance equity, prevent burnout and prepare for the next crisis
New York, NY—With a set of sweeping recommendations published today in Academic Medicine, more than 50 health professions education leaders, faculty and students from across the country outline transformative changes in medical and nursing education based on the lessons learned from the COVID-19 pandemic. The COVID-19 pandemic exposed the many ways that our health care system is unprepared for a major health crisis. It also laid bare the inequities and disparities that are rife within health care and health professions education. Reforms to health professions education (HPE) are essential so that it is more flexible and responsive, achieves equity for all, and enriches the human experience of giving and receiving care, say the authors.
While the recommendations call for a wide variety of action steps, highlights include:
- Learners must be included in the design and improvement of their own education and training. In response to the pandemic, learners initiated and directed innovative efforts to address urgent challenges in clinical and community-based health care environments. They also helped ignite action within their institutions around racial justice, showing that they have much to teach leadership and faculty on this issue. Learners’ voices should be sought out and valued.
- Anti-racism curriculum, policies, and procedures must be adopted to achieve diversity, equity and inclusion in HPE learning environments. There are myriad examples of racism and other forms of discrimination in HPE that have created inequities among learners of color. The pandemic magnified these inequities. All HPE learners should have opportunities to advance, thrive, and achieve their potential.
- Learning environments must support learners in resolving ethical challenges. During the pandemic, learners faced ethical conflicts, such as accessing personal protective equipment, and allocating patient beds and ventilators. These challenges have always been present in health care, but they were more numerous and severe during the pandemic. It takes training and support to navigate these difficult decisions, particularly during a crisis.
- Providers’ mental health and well-being are crucial to building a stable and effective health care workforce. During the first waves of the pandemic, health care clinicians and HPE faculty and learners across the country provided high-quality patient care in facilities overwhelmed by acutely ill patients and experienced death, dying, and grief among patients and their families on a massive scale. Norms and practices that foster a dangerous focus on perfectionism, individualism, self-sacrifice, and heroism—all of which can result in emotional depletion and contribute to burnout—must be eradicated.
“Many of the pandemic’s most difficult challenges existed long before COVID-19, but inertia inhibited progress, requiring many lessons to be learned again and more forcefully,” said conference co-chair Allison Whelan, MD, Chief Academic Officer of the Association of American Medical Colleges. “We have learned much from the practical and logistical challenges encountered during the pandemic and from the innovative solutions that were tested in response.”
The World Health Organization declared COVID-19 a global pandemic in March 2020. Recognizing society’s obligation to examine and learn from its early pandemic experiences not just in preparation for the next global health crisis but to reconsider the status quo more broadly, the Macy Foundation convened 50 health professions experts in June 2021, culminating in the recommendations published today.
“The pandemic highlighted the urgent need for medical and nursing schools to at long last address the root causes of health disparities and gaps in quality of care,” said conference co-chair Lepaine Sharp-McHenry, DNP, RN, Dean of the College of Natural, Behavioral, and Health Sciences at Simmons University. “But the pandemic has also shown us that we are in fact capable of flexibility, responsiveness and profound change.”
As the pandemic extends into its third academic year, new challenges are developing as the goal of defeating the pandemic morphs into managing it. The politicization of public health has prompted a slow vaccination rate and backlash against other measures shown to prevent the spread of COVID-19, meaning patients continue to contract and be treated for the disease. An increasing number of patients are also suffering with long-term, COVID-related symptoms. These challenges underscore the urgency of implementing meaningful changes in the system that trains tomorrow’s doctors, nurses, and other health care professionals—those who will be delivering increasingly excellent care, improving the public’s health, and guiding the nation through the next global health crisis.
“Having taught and trained during the worst global pandemic in more than a century, our health professions faculty, students, and trainees are emerging from a life-altering, career-defining experience,” said Holly J. Humphrey, MD, MACP, President of the Josiah Macy Jr. Foundation. “We owe it to them, and to those who come after them, to make lasting changes that improve learning, health care quality and patient outcomes. We can no longer delay.”
About the Josiah Macy Jr. Foundation
Since 1930, the Josiah Macy Jr. Foundation has worked to improve health care in the United States. Founded by Kate Macy Ladd in memory of her father, prominent businessman Josiah Macy Jr., the Foundation supports projects that broaden and improve health professional education. It is the only national foundation solely dedicated to this mission. Visit the Macy Foundation at macyfoundation.org and follow on Twitter at @macyfoundation.