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There is a growing literature on how medical education adapts to the COVID-19 pandemic. However, there is a need to examine the facilitators and barriers of these adaptations. This study explores the strengths, weaknesses, opportunities, and threats (SWOT) of how Italian medical schools adapted their curricula to the COVID −19 pandemic. The authors conducted an online survey of directors of medical curricula in Italy. Free-text responses to open-ended questions about curricular adaptations and reflections on these adaptations were analysed using qualitative thematic analysis. Twenty out of 60 Italian medical school directors completed the survey. Strengths identified were rapid responses and a spirit of cooperation. Weaknesses included dependency on clinical facilities, teachers' limited skills to use technology, and lack of mental health support for staff. Opportunities highlighted were clear government rules, new ways of teaching and a renewed focus on underrepresented topics. Threats expressed included impaired relationships, difficulties related to online assessment, lack of IT access, and legal and insurance issues. This study, in documenting the curricular adaptations of Italian medical schools during an active global pandemic, and recording the perspectives of medical education leaders, offers important lessons for the future. [ABSTRACT FROM AUTHOR]

Phenomenon: Medical professionalism is a complex construct, based in social and cultural influences, yet little research has been done to show how culture influences the behaviors and attitudes of medical students. We presented Italian students with the same professional dilemmas used in a previous Canadian and Taiwanese cross-cultural study to look for similarities and differences and detect elements of Italian culture that influenced how students responded to dilemmas. The aim was to provide medical educators with some insights into students' behavioral strategies and feelings when faced with a professional dilemma. Approach: Using Giorgi's method, we performed a phenomenological analysis of 15 interviews of Italian medical students who responded to standardized video scenarios representing professional dilemmas. These videos were used in Canada and Taiwan and were translated into Italian. All students were from the same degree course, at Year 6, and were recruited on a voluntary basis at the beginning of the Internal Medicine course. Interview transcripts were anonymized before analysis. Findings: Scenarios were perceived as realistic and easy to envision in Italy. Four themes emerged: establishing priority among principles, using tactics to escape the dilemma, defending the self, and defending the relationships. When compared with previous studies, we noted that Italian students did not mention the principles of reporting inappropriate behavior, seeking excellence, or following senior trainees' advice. Insights: This is the first cross-cultural study of professionalism that involves a Mediterranean country and the observed differences could be interpreted as expressions of Italian cultural traits: distrust toward authority and a cooperative rather than competitive attitude. These findings have practical implications for educators to design and run curricula of professionalism with culturally appropriate topics. They highlight the need for more cross-cultural research. [ABSTRACT FROM AUTHOR]