Coronavirus in the lungs. Image:selvanegra/iStock/Getty Images
This article is part of Harvard Medical School’s continuing coverage of medicine, biomedical research, medical education and policy related to the SARS-CoV-2 pandemic and the disease COVID-19.
For Harvard Medical School students, and thousands of other physicians-in-training around the world, the COVID-19 pandemic may prove to be the most meaningful lesson of their nascent careers: a crash course in the pathophysiology of a formidable disease, involving diagnosis, treatment and prevention, and an evolving tutorial in epidemiology, public health response and ethics.
When the pandemic prompted HMS to shutter classrooms and labs in mid-March, transitioning to virtual learning and remote work, dozens of HMS students quickly gathered online to determine how they could respond to the crisis in the most constructive way.
For one group, the answer was clear: they needed to educate themselves and quickly. What they had no way of knowing was that by doing so they would soon be helping medical students around the nation and the world learn about the disease.
“It’s spread beyond all our initial dreams and hopes, and it’s amazing to see the impact we’ve been able to make,” said HMS student Michael Kochis who, together with a group of about 25 to 30 fellow HMS students, set about creating a COVID-19 curriculum. It was initially conceived as a resource to be shared with fellow classmates or other local health care providers.
“We viewed this as a real need,” said Kochis, a graduating HMS student with a master’s degree in education who had just matched in general surgery at Massachusetts General Hospital.
“We were trying as best we could to keep up with the material … with what we should know as health care providers,” he said.
Within five days the students had divided the labor and drafted a curriculum that, at first, was stored on a shared Google doc that all HMS students could access and distribute to friends and colleagues.
Their goal, said Kochis, was to “provide accurate information, and to help people feel they’re empowered in a very challenging time.”
The curriculum, as it stands now, contains seven modules covering a range of topics, from bench to bedside content, to the epidemiological principles used to describe the spread of COVID-19. One module seeks to “develop technical know-how in preparation for roles that medical students may play in a clinical setting,” while two other modules cover medical ethics and global collaboration.
What the student group did not anticipate was the reception the open-source curriculum has received. In one month’s time it has been adopted at medical schools and by health care professionals in 96 countries on six continents. It has been translated into 12 languages, including Georgian, Kiswahili and Vietnamese.
“I don’t think anyone had that expectation,” said Wolfram Goessling, HMS professor of medicine and chief of gastroenterology at Mass General. “In the beginning it was really made for ‘home use.’”
With the help of a student at another Harvard school, the team moved the curriculum to a free, online platform accessible anywhere in the world. The students invite feedback and are updating the curriculum weekly.
Goessling, who is also co-director of the Harvard-MIT Division of Health Sciences and Technology, and advisory dean for the Irving M. London Society, had been in contact with specialists in virology and immunology at HMS to assemble a knowledge base on COVID-19 for HST students. His interest and action led to his becoming the faculty mentor to the student curriculum team and to assisting them in getting their content vetted by a host of HMS faculty experts.
“First, the students did peer review of the material,” Goessling said. “The reason to involve faculty was that many of the faculty reviewing the modules had direct frontline experience in a field that was developing in real time, offering additional perspectives and input.”
HMS is fortunate, he said, to be able to convene top-ranked experts from among its 11,000-member faculty on a range of topics and to be able to share that information through the students’ curriculum.
“There are so many places [globally] where they’re facing the same problems, but they don’t have the knowledge,” he added
The students immediately began getting feedback from other MD students worldwide.
“Thank you so much for this!” wrote a student in the Philippines. “The city I live in was just placed under enhanced community quarantine, which is pretty much the equivalent of a lockdown. They’ve encouraged graduating medical students, like myself, to try to study this as much as we can, because it is likely we will be deployed very soon to the hospitals due to lack of health workforce. Learned a lot from your modules, am very grateful.”
Another wrote, “Hello, as a 6th-year medical student in Spain (a country which is in ‘quite a pickle’ at the moment regarding the COVID-19 pandemic) I am particularly interested in the upcoming 5th module and hope this can be part of my autonomous preparation for the likely chance I'll have to take a medical role in the following weeks. Thank you for this initiative!”
An attending physician in Angola wrote, “Until now, only 4 cases of COVID-19 have been diagnosed in Angola. With the trend of contamination overseas, the medical community want to learn more about this pandemic, from the medical community and not from the social media, in order to be well prepared to face it. I particularly appreciate your contribution. Thank you.”
The contributions of translators were key to reaching international students. Lorena Tora, a physician-scientist in the HMS Cancer Research Program, helped translate the curriculum into Spanish, and said it is a much-needed tool that will have a significant impact.
“Information has always been a very powerful tool, but specifically with this pandemic, and since the very beginning of this outbreak, it has played a key differentiator role, for better or for worse, in fatality rates and outcomes,” Tora wrote in an email from Mexico City.
“During this time of human crisis, as well as a challenging time for science,” she added, “this carefully curated, updated, evidence-based, and well-integrated content is an extraordinary effort for an urgent need … and an absolute example of global unity.”
Some 60 HMS students are now working on the content, and less than a month after publishing it, the curriculum website has already attracted more than 19,000 unique users and more than 100,000 page views, according to Kochis, who expects those numbers to continue to grow. He said he knows of at least a dozen other medical schools that are now incorporating the material into their curricula.
Kochis credits his fellow HMS students for coming together in extraordinary way to produce a much-needed resource.
“This was an amazing project to be a part of, to experience the combined enthusiasm, dedication and energy of the students to contribute something for the benefit of their peers, first here at Harvard, and now elsewhere in the world. It has been truly inspiring,” said Goessling.
“It is also interesting because, in this field the knowledge gap between learners and teachers was almost nonexistent; we were all learning together at lightning speed. It may serve as a model for self-directed learning in other fields, too,” he added.
