Coronavirus outbreaks including COVID-19 and impacts on medical education: a systematic review

Kelly Kelly(1*), Lie Rebecca Yen Hwei(2), Gilbert Sterling Octavius(3)

(1) Faculty of Medicine, University of Pelita Harapan, Karawaci, Banten, Indonesia
(2) Faculty of Medicine, University of Pelita Harapan, Karawaci, Banten, Indonesia
(3) Faculty of Medicine, University of Pelita Harapan, Karawaci, Banten, Indonesia
(*) Corresponding Author


Since the beginning of 2020, the world has been affected by the novel coronavirus COVID-19 pandemic. The virus’ infectious nature pushed all sectors to implement social distancing measures in an effort to limit its transmission, including the education sector. We searched PubMed and Science Direct on June 12th and found 24 papers that are relevant to our review. After the World Health Organization announced that COVID-19 is a global threat, various countries took a variety of measures to limit the disease spread such as social distancing, self-quarantine, and closing public facilities that hold large gatherings, including universities and schools. Hospitals started to prioritize services for COVID-19 cases. Medical education programs are also affected by this disease, but not continuing in-person classes outweighs any benefit from traditional teaching methods. The previous Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) pandemics have shown ways to shift medical education to online platforms. In the current pandemic, online meetings are being used to hold lectures, classes, laboratory practices, and clinical skills classes. For clerkship students, online platforms might not be feasible because this eliminates patient-doctor relationships, but it appears for now to be the only option. Some institutions have involved medical students in the frontlines altogether. We encourage all parties to constantly evaluate, review, and improve the efforts of continuing medical education, especially during this pandemic. Further research is needed to evaluate students’ performance after adopting e-learning and to discover the best methods in medical education in general and clerkship education in particular.


COVID-19; Medical Education; MERS; SARS

Full Text:



  1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
  2. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet [Internet] 2020;395(10224):565–74. Available from:
  3. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–33.
  4. Aji W, Dewi F, Kristen U, Wacana S. Dampak Covid-19 Terhadap Implementasi Pembelajaran Daring Di Sekolah Dasar. Edukatif J Ilmu Pendidik [Internet] 2020;2(1):55–61. Available from:
  5. Purwanto A, Pramono R, Asbari M, Santoso PB, Wijayanti LM, Choi CH, et al. Studi eksploratif dampak pandemi COVID-19 terhadap proses pembelajaran online di Sekolah Dasar. J Educ Psychol Couns [Internet] 2020;2(1):1–12. Available from:
  6. WHO. Coronavirus disease 2019 (COVID-19) Situation Report-10 [Internet]. 2020. Available from:
  7. Djalante R, Lassa J, Setiamarga D, Sudjatma A, Indrawan M, Haryanto B, et al. Review and analysis of current responses to COVID-19 in Indonesia: pof January to March 2020. Prog Disaster Sci. 2020;6(April):100091.
  8. Windhiyana E. Dampak COVID-19 terhadap kegiatan pembelajaran online di Perguruan Tinggi Kristen di Indonesia. Perspekt Ilmu Pendidik. 2020;34(1):1–8.
  9. Kemdikbud RI. Edaran Tentang Pencegahan Wabah COVID-19 di Lingkungan Satuan Pendidikan Seluruh Indonesia. 2020;1–5.
  10. Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al. School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. Lancet Child Adolesc Heal. 2020;4(5):397–404.
  11. Jackson C, Mangtani P, Vynnycky E. Impact of school closures on an influenza pandemic: scientific evidence base review. [Internet] Public Health England: 2014. United Kingdom. Available from:
  12. Maudiarti S. Penerapan e-learning di Perguruan Tinggi Santi Maudiarti Sekolah Tinggi Pariwisata Trisakti. Perspekt Ilmu Pendidik. 2018;32(1):53–68.
  13. Rose S. Medical student education in the time of COVID-19. J Am Med Assoc. 2020;323(21):2131–2.
  14. Miller DG, Pierson L, Doernberg S. The role of medical students during the COVID-19 pandemic. Ann Intern Med. 2020;M20-1281.
  15. Belingheri M, Paladino ME, Riva MA. Beyond the assistance: additional exposure situations to COVID-19 for healthcare workers. J Hosp Infect. 2020;105(2):353.
  16. Whelan A, Prescott J, Young G. Interim guidance on medical students’ participation in direct patient contact activities: principles and guidelines [Internet]. Assoc. Am. Med. Coll.Available from: on 31 March 2020
  17. Guidance on Medical Students’ Participation in Direct Patient Contact Activities [Internet]. Assoc. Am. Med. Coll.Available from:
  18. Academic integrity for assessments affected by COVID-19 [Internet]. Assoc. Am. Med. Coll.Available from:
  19. Emanuel EJ. The inevitable reimagining of medical education. J Am Med Assoc. 2020;323(12):1127–8.
  20. Rieder MJ, Salvadori M, Bannister S, Kenyon C. Collateral damage: the effect of SARS on medical education. Clin Teach. 2004;1(2):85–9.
  21. Lim E, Oh V, Koh DR, Seet R. The challenges of “continuing medical education” in a pandemic era. Ann Acad Med Singapore. 2009;38:724–6.
  22. Liu M, Jiang C, Donovan C, Wen Y, Sun W. Middle east respiratory syndrome and medical students: letter from China. Int J Environ Res Public Health. 2015;12(10):13289–94.
  23. Al-Rabiaah A, Temsah MH, Al-Eyadhy AA, Hasan GM, Al-Zamil F, Al-Subaie S, et al. Middle East Respiratory Syndrome-Corona Virus (MERS-CoV) associated stress among medical students at a university teaching hospital in Saudi Arabia. J Infect Public Health. 2020;13(5):687–91.
  24. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLoS Med. 2009;6(7):e1000097.
  25. Sahi PK, Mishra D, Singh T. Medical education amid the COVID-19 Pandemic. Indian Pediatr 2020;57:652-7.
  26. Ashokka B, Ong SY, Tay KH, Loh NHW, Gee CF, Samarasekera DD. Coordinated responses of academic medical centres to pandemics: sustaining medical education during COVID-19. Med Teach. 2020;42(7):762-771.
  27. Singh K, Srivastav S, Bhardwaj A, Dixit A, Misra S. Medical education during the COVID-19 pandemic: a single institution experience. Indian Pediatr. 2020;57(7):678-679.
  28. Kanneganti A, Lim KMX, Chan GMF, Choo S, Choolani M, Ismail‐Pratt I, et al. Pedagogy in a pandemic – COVID‐19 and virtual continuing medical education (vCME) in obstetrics and gynecology. Acta Obstet Gynecol Scand. 2020;99(6):692–5.
  29. Almarzooq ZI, Lopes M, Kochar A. Virtual learning during the COVID-19 pandemic: A disruptive technology in graduate medical education. J. Am. Coll. Cardiol. 2020;75(20):2635–8.
  30. Akers A, Blough C, Iyer MS. COVID-19 implications on clinical clerkships and the residency application process for medical students. Cureus 2020;12(4):e7800.
  31. Calhoun KE, Yale LA, Whipple ME, Allen SM, Wood DE, Tatum RP. The impact of COVID-19 on medical student surgical education: implementing extreme pandemic response measures in a widely distributed surgical clerkship experience. Am J Surg. 2020;220(1):44-47.
  32. Sahu P. Closure of universities due to coronavirus disease 2019 (COVID-19): impact on education and mental health of students and academic staff. Cureus. 2020;12(4):e7541.
  33. Lapolla P, Mingoli A. COVID-19 changes medical education in Italy: will other countries follow? Postgrad. Med. J.2020; 96(1137):375-376.
  34. Tabari P, Amini M, Moosavi M. Lessons learned from COVID-19 epidemic in Iran: the role of medical education. Med Teach. 2020;1–1.
  35. Franchi T. The impact of the COVID‐19 pandemic on current anatomy education and future careers: a student’s perspective. Anat Sci Educ. 2020;13(3):312–5.
  36. Longhurst GJ, Stone DM, Dulohery K, Scully D, Campbell T, Smith CF. Strength, Weakness, Opportunity, Threat (SWOT) analysis of the adaptations to anatomical education in the United Kingdom and Republic of Ireland in response to the COVID-19 pandemic. Anat Sci Educ. 2020;13(3):301–11.
  37. Gonzales-Zamora JA, Alave J, De Lima-Corvino DF, Fernandez A. Videoconferences of infectious diseases: an educational tool that transcends borders. A useful tool also for the current COVID-19 pandemic. Le Infez Med. 2020;28(2):135–8.
  38. Brand PLP. COVID-19: a unique learning opportunity if the well-being of learners and frontline workers is adequately supported. Perspect. Med. Educ.2020; 9: 129-131.
  39. Wang S, Dai M. Status and situation of postgraduate medical students in China under the influence of COVID-19. Postgrad Med J. 2020;1–3.
  40. Hofmann H, Harding C, Youm J, Wiechmann W. Virtual bedside teaching rounds with patients with COVID‐19. Med Educ. 2020;14223.
  41. Shih KC, Chan JCH, Chen JY, Lai JSM. Ophthalmic clinical skills teaching in the time of COVID-19: A crisis and opportunity. Med Educ. 2020; 54(7).
  42. Roskvist R, Eggleton K, Goodyear-Smith F. Provision of e-learning programmes to replace undergraduate medical students’ clinical general practice attachments during COVID-19 stand-down. Educ Prim Care. 2020;1–8.
  43. Abi-Rafeh J, Azzi AJ. Emerging role of online virtual teaching resources for medical student education in plastic surgery: COVID-19 pandemic and beyond. J Plast Reconstr Aesthetic Surg. 2020; 73(8): 1575-1592.
  44. Singal A, Bansal A, Chaudhary P. Cadaverless anatomy: darkness in the times of pandemic COVID-19. Morphologie. 2020;3–6.
  45. Pitt MB, Li S-TT, Klein M. Novel Educational responses to COVID-19: what is here to stay? Acad Pediatr. 2020;120.
  46. Gill D, Whitehead C, Wondimagegn D. Challenges to medical education at a time of physical distancing. Lancet. 2020;396(10244):77–9.
  47. Park SW, Jang HW, Choe YH, Lee KS, Ahn YC, Chung MJ, et al. Avoiding student infection during a Middle East respiratory syndrome (MERS) outbreak: a single medical school experience. Korean J Med Educ. 2016;28(2):209–17.
  48. Sherbino J, Atzema C. “SARS-Ed”: severe acute respiratory syndrome and the impact on medical education. Ann Emerg Med. 2004;44(3):229–31.
  49. Dedeilia A, Sotiropoulos MG, Hanrahan JG, Janga D, Dedeilias P, Sideris M. Medical and surgical education challenges and innovations in the COVID-19 Era: A Systematic review. 2020;34(3):1603–11.
  50. Darras KE, de Bruin ABH, Nicolaou S, Dahlström N, Persson A, van Merriënboer J, et al. Is there a superior simulator for human anatomy education? How virtual dissection can overcome the anatomic and pedagogic limitations of cadaveric dissection. Med Teach. 2018; 40(7): 752–3.
  51. Ghosh SK. Cadaveric dissection as an educational tool for anatomical sciences in the 21st century. [Anat Sci Educ. 2017;10(3):286–99.
  52. Villela EF de M, Oliveira FM, Leite ST, Bollela VR. Student engagement in a public health initiative in response to COVID‐19. Med Educ. 2020;medu.14199. A
  53. Lim ECH, Oh VMS, Koh DR, Seet RCS. The challenges of “continuing medical education” in a pandemic era. Ann Acad Med Singapore. 2009;38(8):724–6


Article Metrics

Abstract views : 6955 | views : 4559


  • There are currently no refbacks.

Copyright (c) 2020 Journal of Community Empowerment for Health

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.