- Franck Rolland: UVSQ, Inserm, CESP, équipe recherches en éthique et en épistémologie (R2E), université Paris-Saclay, 94807 Villejuif, France.
Objectives: In France, during the first wave of the COVID-19 pandemic, all care workers have been mobilized. Despite this, the strong demand for care has put the health system under great strain. To overcome this overload of world, 86 medical students of Paris-Saclay University came to help some hospital services. They replaced caregivers, nurses or stretcher bearers under "degraded care" conditions. At the university level, the closure of the faculty due to generalized lockdown disrupted the training of these future doctors who were in second, third or fourth year of training (pre-clinical). This exploratory study proposes to collect the impact of the experience of these students during the first wave of the pandemic in order to better understand the difficulties they encountered, as well as the resources they exploited during this period.
Materials and methods: Using a mixed approach, both quantitative on the one hand and qualitative on the other hand, medical students from Paris-Saclay were interviewed through a retrospective questionnaire distributed in December 2020. The quantitative part of the questionnaire assessed their psychological distress (6-item Kessler scale) and their resilience (Brief Resilience Scale). The qualitative part of the questionnaire included various open questions concerning the motivations to participate, the difficulties encountered, the impact of the situation on their interpersonal relationships or their university course.
Results: A total of 46 responses from medical students from the University of Paris-Saclay were collected. This constitutes a response rate of 55%. Half of them were second or third year medical students. They were assigned to emergency departments, resuscitation or units dedicated to the care of patients with COVID-19. The average psychological distress score is 7.13. The average resilience score is 3.14. From these results, several categories of students were analyzed according to the elements found in their answers to the open questions. Almost all the students reported wanting to contribute to the collective effort and help hospital services. For some students, it was also a way of making themselves useful while escaping lockdown. The students were exposed to difficult working conditions, the distress of families and the deaths of numerous patients. Their involvement also had an impact on their relationships with their families: they could feel more isolated, or be afraid of infecting them. Their university work was very disrupted by their investment in the hospital: fatigue, concentration problems, lack of motivation could lead them to a form of dropping out of university.
Conclusions: The results of this study are part of the context of a particular health crisis. They show medical students exposed to significant psychosocial risks in a period of stress. It seems important to identify what leads some students to develop good resilience capacities. The COVID-19 pandemic acts as an indicator of difficulties that were already present but that it is exacerbating: the link between the faculty, the student and the hospital, mentoring, supervision, support, university workload, hospital working conditions, psycho-pedagogical support for students and support for most struggling students… These results invite us to rethink the educational engineering of medical studies so that they make it possible, even in a health crisis, to ensure the quality of training and the quality of life of medical students.