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Background\ud The novel coronavirus disease (COVID-19) was declared a pandemic in March 2020, which necessitated adaptations to medical education. This systematic review synthesises published reports of medical educational developments and innovations that pivot to online learning from workplace-based clinical learning in response to the pandemic. The objectives were to synthesise what adaptations / innovation were implemented (description), their impact (justification), and ‘how’ and ‘why’ these were selected (explanation and rationale).\ud Methods\ud The authors systematically searched four online databases and hand-searched MedEdPublish up to December 21, 2020. Two authors independently screened titles, abstracts and full-texts, performed data extraction, and assessed the risk of bias. Our findings are reported in alignment with the STORIES (STructured apprOach to the Reporting in healthcare education of Evidence Synthesis) statement and BEME guidance.\ud Results\ud Fifty-five articles were included. Most studies (n=40) were from North America, and nearly 70% focused on undergraduate medical education (UGME). Key developments were rapid shifts from workplace-based learning to virtual spaces, including online electives, telesimulation, telehealth, radiology, and pathology image repositories, live-streaming or pre-recorded videos of surgical procedures, stepping up of medical students to support clinical services, remote adaptations for clinical visits, multidisciplinary team meetings and ward rounds. Challenges or barriers included lack of personal interactions, lack of standardised telemedicine curricula and need for faculty time, technical resources and devices. Assessment of risk of bias revealed poor reporting of underpinning theory, resources, setting, educational methods, and content. \ud Conclusions\ud This review highlights the response of medical educators in deploying adaptations and innovations from workplace-based to online learning during the COVID-19 pandemic in clinical settings. Whilst innovations and adaptations have ensured learning across the continuum, explicit reporting of operationalisation of education interventions requires additional focus. We would encourage future work to fully evaluate all outcomes and move towards reporting at Kirkpatrick levels 3 or 4.

Background\ud COVID-19 has fundamentally altered how education is delivered. Gordon et al. previously conducted a review of medical education developments in response to COVID-19, however, the field has rapidly evolved in the ensuing months. This scoping review aims to map the extent, range and nature of subsequent developments, summarizing the expanding evidence base and identifying areas for future research.\ud \ud Methods\ud The authors followed the five stages of a scoping review outlined by Arskey and O’Malley. Four online databases and MedEdPublish were searched. Two authors independently screened titles, abstracts and full texts. Included articles described developments in medical education deployed in response to COVID-19 and reported outcomes. Data extraction was completed by two authors and synthesized into a variety of maps and charts.\ud \ud Results\ud One hundred twenty-seven articles were included: 104 were from North America, Asia and Europe; 51 were undergraduate, 41 graduate, 22 continuing medical education, and 13 mixed; 35 were implemented by universities, 75 by academic hospitals, and 17 by organizations or collaborations. The focus of developments included pivoting to online learning (n=58), simulation (n=24), assessment (n=11), well-being (n=8), telehealth (n=5), clinical service reconfigurations (n=4), interviews (n=4), service provision (n=2), faculty development (n=2) and other (n=9). The most common Kirkpatrick outcome reported was Level 1, however, a number of studies reported 2a or 2b. A few described Levels 3, 4a, 4b or other outcomes (e.g. quality improvement).\ud \ud Conclusions\ud This scoping review mapped the available literature on developments in medical education in response to COVID-19, summarizing developments and outcomes to serve as a guide for future work. The review highlighted areas of relative strength, as well as several gaps. Numerous articles have been written about remote learning and simulation and these areas are ripe for full systematic reviews. Telehealth, interviews and faculty development were lacking and need urgent attention.

We investigated whether a brief geriatric assessment (GA) would identify important patient deficits that could affect treatment tolerance and care outcomes within a sample of older cancer patients rated as functionally normal (80%–100%) on the Karnofsky performance status (KPS) scale.