Table 5 Student quotations representative of views expressed by multiple students regarding thematic content of free response questions

I. Structure: Flexibility and Efficiency

a. “I do not learn well in the physical lecture session bc I cannot pause and address confusion right away.”

b. “I appreciate having all the block’s lectures at the beginning so I can watch them at my own pace and get ahead if I choose.”

c. “I am an early riser so I do like being able to wake up early and start on lectures by 6 AM.”

d. “The ability to learn more or less depending on the energy level of the day is absolutely massive. And has been the STRONGEST addition to my education, regardless of the circumstance.”

e. “More freedom to productively use my time (research/STEP studying).”

f. “I also commute to school so remote learning is saving me a lot of money and time, which I am very happy about.”

g. “The biggest killer in remote learning is time self management... I sleep in more than I should and do less work than I should. I would like help keeping myself accountable by having more assignments with more set due dates. If the assignments are there, I will do them.”

h. “At grad housing, my neighbors above have children who are persistently loud and while at home my large family are all working and always on calls. Many students feel that it’s difficult to focus, be engaged, and be placed in an environment conducive to learning. As such, a student like myself who used to never struggle with having motivation to get to work is having more difficulties now than ever to simply be a student.”

II. Remote Learning Format: Digital Fatigue and Participation

i. “Zoom classes feel much longer online than in person.”

j. “POM [Practice of Medicine] for 4 h straight is impossible. Many of the activities are difficult to do over Zoom. Honestly, the past few weeks after logging off the 4 h POM zoom call, I have been so discouraged that I couldn’t focus for the rest of the evening. Four hours on a Zoom call is physically and emotionally draining.”

k. “Interaction with faculty and students is simply not the same. It’s a bit hard to describe, but as someone who is very much an “in person” and “tangible” learner, going to lecture and seeing the faculty, speaking with peers, and interacting with everyone in person is more conducive to my learning style.”

l. “It’s very hard to do any sort of group studying. It’s very hard to find a quiet place to study. It’s very hard to learn doctoring skills … There is no way to practice your skills/ask questions.”

III. Content: Lab Classes and Clinical Skills Learning

m. “As someone who learns best through hands on methods, I’m struggling with anatomy and POM and really missing the opportunity to practice patient interviewing/physical exams during ACA. I do not feel prepared for an OSCE at the end of the year.”

n. “As of now I do not feel prepared for step style questions, or comfortable trying to apply my knowledge in relevant clinical settings.”

o. “It has also been hard not having clinical experiences, since that was my favorite part of medical school.”

p. “Anatomy is extremely difficult to learn remotely - and I know a lot of students who have just resigned to not learning pelvic anatomy given the circumstances.”

q. “(Telehealth participation) has been very valuable and a great learning experience and is helping me stay grounded and connected to my role as a med student.”

r. “Telehealth... Was a great learning experience, practiced taking a hx, presenting to attending, writing a note.”

s. “(Telehealth participation) has been hugely helpful for my motivation and keeping up with my interviewing skills.”

IV. Mental Health: Anxiety and Isolation

t. “Being more or less alone for the past ~ 2 months has showed me the importance of connection and social interaction in my own mental well-being and the role that our in-person classes served in meeting that need for me. I miss in-person class for that reason the most. And I would be worried that if the SOM switched to more remote learning permanently after COVID-19, a lot of student’s mental health would decline due to isolation and lack of relationships with classmates. “

u. “It’s an incredibly isolating experience... mental health is more so a challenge than ever with all of this, and it is impacting all facets of our student life: academic performance, extracurricular commitments, socializing, etc. “

v. “Some of us are being hit more by the complete psychological lack of interaction, that can’t really be remedied by looking at boxes on a computer with friends and mentors faces in them.”

w. “In addition to family issues and regular coursework, it’s more difficult to go about daily activities, such as grocery shopping or exercising; some of us do not have access to a quiet study space with reliable internet; some of us are managing free clinic responsibilities, where more administrative duties are falling on students. Some of us have had a known exposure to COVID-19 ourselves or have responsibilities to our communities outside of school. “

x. “I also wish I knew what was going on—I get so many emails from the school and UC San Diego Health that I don’t know what to open for actual information about my own curriculum, etc.”