Medical students have been trained to investigate COVID-19 outbreaks with an intensive workshop provided by Western Sydney Local Health District (WSLHD), the University of Notre Dame Australia and Western Sydney University.
As the number of COVID-19 cases started to rapidly rise in late February, health services had to explore ways to expand the number of trained health professionals capable of managing the volume of case investigations that were needed.
“An important part of the ‘containment phase’ when managing an infectious disease, like COVID-19, is identifying cases and anyone with whom they may have been in contact,” explains Professor Lynne Madden, professor of Population and Planetary Health at Notre Dame.
“Currently every person in NSW who has a positive swab for coronavirus has a very careful detailed history taken to identify the places they have been and the people with whom they have been in recent contact. The people who they identify as contacts are then followed up to check if they are well. Anyone who has symptoms is tested for coronavirus – as you can imagine, this is an essential but hugely time-consuming process.”
In response to the crisis, the WSLHD Public Health Unit and Research and Education Network approached the medical schools at Notre Dame and Western Sydney universities to work with them to develop a course to train staff and medical students in case investigation and contact tracing to help meet the anticipated demand.
The ambition was to develop a standardised core training that might also be adapted for use across NSW and develop surge capacity in the event of successive waves of COVID-19 or indeed, any other form of communicable disease.
“We were very conscious that the course could not just be theory based. The training would need to prepare them to step into a role in a public health unit, and after observing a couple of investigations, start working straight away – so it needed to be very active and practical,” said Dr Kate McBride, from the School of Medicine at Western Sydney University.
Dr McBride said it was apparent that students and medical professionals needed to quickly become ‘disease detectives’ who are skilled at interviewing.
“There is quite a skill involved in speaking to people over the phone and being able to make them feel comfortable about opening up.
“Medical students have been taking clinical histories since year one, but case investigation is much more detailed. You need to ask probing questions. You need to know everything that they have done, and every person that they have had recent contact with. When these people are unwell, they might not be comfortable disclosing their multiple trips to Woolworths – but it’s essential that they do so.”
On 20 April a pilot of a day of training was delivered online to a group of 19 people, including health services staff and final-year medical students.
The eight-hour session comprised presentations by expert speakers and practice sessions for communication skills, and was complemented by two days of on-site training at public health units including the WSLHD department.
“This pilot training program was a rapid, responsive and successful cross-institutional initiative that addressed an immediate need and has provided an avenue for further training that will ensure we are prepared to manage potential outbreaks in the future,” says Christine Newman, WSLHD Population Health deputy director.
Following this training, four medical students from Notre Dame’s Sydney School of Medicine have been placed in public health units to assist with efforts to continue containing the spread of COVID-19.
Final-year medical student Michael Berger was placed at South Eastern Sydney PHU based in Randwick and says the insights he gained during placement have complemented what he’s learnt about population and public health at university.
“This program was presented to me as an opportunity to not only learn about public health medicine and gain a unique insight into the local management of the pandemic of our generation, but also as a way to help and make a meaningful contribution to public health and safety,” Michael said.
“My role in the PHU was mainly helping with investigating clusters of cases and looking for possible connections or unidentified routes of transmission by digging through the data and re-interviewing COVID-19 cases. I found it an amazing privilege to be able to investigate the spread of COVID-19 in the area I lived my entire life, and I am delighted that I was able to take part in this unique placement and learning opportunity.”
Professor Madden said she was proud to have been part of Australia’s successful public health response to this global pandemic.
“This is a fine example of how university medical programs and health services can work together to respond to community needs.”