COVID-19 Curriculum Disruptions and Future Preparedness in Iranian Medical Education: A National Mixed-Methods Study

COVID-19 disrupted clinical training, assessment, and student engagement in medical education worldwide. We aimed to identify the curriculum challenges faced by Iranian medical education during the pandemic and the modifications that stakeholders consider necessary for future public health emergencies.

In this sequential exploratory mixed-methods study, a literature review and 14 semi-structured interviews informed a 39-item questionnaire, which was distributed online to students, trainees, and faculty of Iranian medical schools.

The survey yielded 1095 valid responses (mean age 29.8±5.3 years; 61.5% women) from 58 medical schools. The lowest-rated experience items concerned compensation for lost clinical exposure through simulation and virtual patients (1.59±0.90 on a 5-point scale), regular quizzes or short assignments to monitor learning (1.60±0.98), timely feedback on assignments (1.73±1.06), and valid alternatives for assessing practical skills (1.80±1.07), whereas personal access to the internet and equipment scored highest (3.57±1.07). Between-institution differences were statistically significant but small in five of seven domains (η²H=0.018-0.053). All nine forward-looking reform items were endorsed (3.92±1.03 to 4.42±0.71). The assessment domain showed poor reliability, and the seven-domain confirmatory model fitted inadequately.

Difficulty concentrated in the components of training that depend on physical presence and supervision. Recalled experience differed between institutions, although this design cannot attribute that variation to institutional characteristics. Endorsement of reform was near-uniform, but because the items were positively keyed, it indicates the direction of stakeholder priorities rather than their intensity or feasibility. The questionnaire domains served as a reporting framework rather than validated scales and require revision before reuse.