Continuity interrupted: exploring discontinuity of education and mitigation strategies in family medicine.

Abstract

BACKGROUND: Continuity of education (CoE) is a growing area of interest in health professions education, both for its impacts on learning (continuity of curriculum and continuity of supervision; CoS) and for its influence on patient care (continuity of patient care; CoPC). The COVID-19 pandemic offered an opportunity to examine discontinuity of education and the potential impacts of interruption to CoE, a knowledge gap in medical education research. METHODS: We conducted 14 semi-structured qualitative interviews involving participants from a Canadian family medicine programme. We recorded and transcribed interviews conducted on Zoom that were then analysed iteratively using reflexive thematic analysis to identify major themes. RESULTS: We identified three themes. Theme 1: Changed relationships: an alteration due to mitigation strategies. Theme 2: Preparedness for practice: a decrease despite mitigation strategies. Theme 3: Adaptivity in the face of change: a consequence of mitigation strategies. CONCLUSION: This study suggests that there are three main implications resulting from the impacts of disruption to CoE. Faculty development and curricular design are needed to support interrupted relationships, including finding ways to help faculty and residents nurture changed relationships. Physicians in their first 5 years of practice who have experienced disruption in their training may benefit from additional support to address the negative impact on their sense of preparedness for practice. Finally, the positives learned from this study can be used to face future disruptions to CoE.