The Challenges of Visualisation During Delivery and Assessment of Clinical Teaching Under COVID-19: A Reflective Account of Problem Solving.

Whilst the in-person clinical immersion of students in their final years of medical programmes was relatively protected from the impact of COVID-19, the ability to deliver in-person clinical teaching was restricted or heavily altered for early-year students. Our challenge as a 3-year BSc (Hons) in Medicine programme at the University of St Andrew's School of Medicine was to continue to immerse and engage students in their clinical training when in-person access to the authentic environment was impossible, restricted, or completely altered from the original image held by students.In this chapter, we aim to discuss the problems faced, the solutions considered within the contextual restraints and then reflect on the successes and failures of the approaches we took in aiding students to visualise themselves in the clinical environment, or when using altered delivery modes that introduced radically different optics on the learning experience.Whilst there were some limits on what could be practically achieved (specifically remote learning of "hands-on" clinical skills requiring specialist models or equipment), either sole- or hybrid-use of virtual platforms to provide both real-time and student-led mixed-media visualisations provided effective means to ensure appropriate delivery and assessment throughout varying levels of restrictions. In some cases, this mirrored adaptations in the clinical environment (e.g. virtual consultations).Whilst online delivery of teaching and assessment provided some mitigation of COVID-19 impact upon teaching, given the nature of a medical curriculum these cannot offset the lack of hands-on practical experience students require. However, some adaptations made by necessity (e.g. teleconsultations) have mirrored the advances in patient care and have arguably better-equipped students. The full positive and negative impacts of the pandemic on medical education remain to be seen.