# Studies in medicine during the COVID-19 pandemic in Kenya and germany: a cross-sectional pilot study

## TL;DR

This study compares how medical students in Kenya and Germany experienced changes in education and mental health during the COVID-19 pandemic.

## Contribution

The study provides a cross-national comparison of medical students' pandemic experiences, offering insights for global medical education policy.

## Key findings

- Kenyan and German students showed similar levels of depression and anxiety during the pandemic.
- Kenyan students found online learning more comfortable, though the difference was not statistically significant.
- Social support and hobbies were key coping mechanisms for students in both countries.

## Abstract

The COVID-19 pandemic disrupted global medical training and resulted in substantial alterations in the psychosomatic health of medical students. We conducted a comparative evaluation across diverse socio-cultural and economic settings in Kenya (LMIC) and Germany (HIC) to examine the changes wrought to students during the COVID-19 pandemic, their experiences and responses to ease the pandemic burden. We also assessed their attitudes towards the online training model that was introduced during the COVID-19 pandemic with an aim to develop effective educational approaches that could be adopted in learning institutions and offer support in future unpredictable events.

We conducted a retrospective cross-sectional web survey three years post the announcement of the first COVID case among undergraduate medical students at the University of Nairobi, Kenya (UoN) and at Charité – Universitätsmedizin Berlin, Germany. Questionnaires were used to assess COVID-19-specific changes in the learning situation, evaluation of mental burden, satisfaction with the online learning (OL), and coping mechanisms of the students. Binomial and multiple regression analyses were applied.

In total, 122 undergraduate medical students participated in our cross-sectional pilot study (response rate: 78.71%). Respondents were from the UoN (65.5%) and Charité (34.4%). Kenyan and German students experienced similar levels of depression (PHQ-2COVID) (M = 2.12; SD = 1.36 and M = 2.02; SD = 1.22, P = 0.960) and anxiety (GAD-2COVID) (M = 2.09; SD = 1.54 and M = 1.91; SD = 1.59, P = 0.540) during the COVID-19 pandemic. For Kenyan students (M = 3.12; SD = 0.60) the transition to OL during the COVID-19 pandemic seemed to be a more comfortable way of learning, compared to the German students (M = 2.91; SD = 0.61). However, the OL score difference was not statistically significant (P = 0.078). In regards to mental health during the pandemic, most students from both countries attributed social support from either family, friends, or religious institutions as a benefactor in coping (UoN: 50.0%, Charité: 59.5%). Most of the students from UoN (40.0%) identified with hobbies such as movies, reading, writing, and social media, while German students (33.3%) identified with sporting activities such as gym, walks and workouts.

There was significant negative impact on both medical training and the psychosomatic state of medical students in the survey. Such a comparative approach provides insights that isolated single-country studies cannot, thereby contributing to global medical education policy and guiding context-appropriate interventions for future crises.