Medical Students Rise to the Occasion: How KSAM Has Helped Fight the COVID-19 Pandemic

2022/06/20

Amid the COVID-19 pandemic, with clinical hospital training forced to a halt, some students at the Keio University School of Medicine rose to the occasion to play their part as the Keio University School of Medicine Student Ambassadors (KSAM). Formed at the end of 2019, KSAM consists of 12 fourth- to sixth-year students.

Here, we sat down with Masayuki Sato (sixth-year student, former co-chair), Kaworu Takatsuna (fifth-year student), Kensei Oya (fourth-year student), and Itsuki Yamamoto (fourth-year student), who shared what KSAM has been doing to help fight the spread of COVID-19.

─ You launched the website, COVID-19 Vaccine Information for University Students, ahead of student vaccinations in June 2021. How did you come up with that idea?

Sato: While Keio University was one of the first large universities in Tokyo to offer “workplace vaccinations,” we were unsure how many students would actually want to be vaccinated. As you can tell from the reaction to the human papillomavirus (HPV) vaccine, many people in Japan are apprehensive due to perceived adverse reactions and side effects of vaccines in general. Thus, vaccination rates in Japan remain lower than other developed countries. That is why the faculty members of the executive board of Keio University School of Medicine asked KSAM to come up with a way to encourage students to get vaccinated.

We wanted each student to understand the risks and benefits of vaccination and to consider their decision to get vaccinated carefully. We thought that this information would lead to a higher vaccination rate, so we launched the Vaccine Information Website Project to deliver accurate information somewhere available to anyone.

We medical students had been vaccinated in January and felt that adverse reactions were more severe in people in their 20s. Subsequent reports and papers have also shown that adverse reactions vary by age. The Ministry of Health, Labour and Welfare (MHLW) provides general information on their website, but we thought it would be beneficial to provide information specifically for young people and explain the principles of vaccines in detail for students who want to know more.

─ What were some of the difficulties you faced, and what did you keep in mind when creating the website?

Sato: The primary difficulty was the tight deadline. Keio’s faculty members approached us on June 3rd, but the vaccination rollout was scheduled for the 16th, so we had less than two weeks, which meant we would have to work very efficiently. Four KSAM members (one fourth-year student and three fifth- and sixth-year students) helped prepare the guidelines. Following approval from an infectious disease specialist, we finally launched the guidelines on June 14th.

Takatsuna: It was also challenging to convey information in a way that was easy for students to understand. For example, would a literature student know what an "RNA vaccine" is, or would we have to explain it? I checked my high school biology textbook and consulted with my advisor as I tried to write this kind of science-based information in a more accessible way.

Sato: Throughout the whole process, we tried to remain objective. Even among KSAM members, there were varying opinions on vaccines, so we were very careful to ensure that the website wouldn't be biased against people who decided not to get vaccinated. That is why the homepage reads: "Vaccination is a choice."

─ What kind of response have you received after launching the website?

Sato: The site launched on June 14th, and we saw significant traffic during the first round of Keio’s workplace vaccinations, from the start of reservations on the 16th through the start of vaccinations on the 21st. Traffic again increased during the second round, so I think people looked to our website as a reliable source. In total, close to 10,000 people accessed the site.

As a result, 80% of students at Keio University were vaccinated. Research has shown that in the case of COVID-19, herd immunity can be achieved when 80% of a population has immunity, so we can say that we reached our target. In fact, Keio experienced spikes in infection every time there was a new wave of infection in Japan, but we did not see any spikes after July. We feel that the vaccine was very effective, and we are happy that KSAM could contribute to improving the vaccination rate at Keio.

─ In 2020, you created the Infection Prevention Guidelines for School of Medicine Students. Could you walk us through your process?

Sato: When COVID-19 first began to spread throughout Tokyo in April 2020, healthcare-associated infections occurred at several medical institutions, including the Keio University Hospital. In light of this unprecedented situation, the hospital scaled back medical treatments and postponed clinical training for medical students.

Takatsuna: At the time, I remember wondering what medical education would look like going forward. Lack of proper medical education could lead to a shortage of doctors, both in terms of quality and quantity. I also thought it was important for the medical students going into clinical practice as doctors to learn about proper protection against COVID-19.

Sato: The goal was to resume educational and research activities such as clinical training while guaranteeing the safety of medical facilities. To do so, it was essential for us to learn proper infection prevention measures on our own and master them before teaching them to other students. Although there were materials for treating medical personnel and guidelines for the general public at that point, there were no practical manuals that took into account the risks and circumstances unique to medical students.

That is when KSAM, with the help of other School of Medicine volunteers, began to create a manual under the supervision of an infectious disease specialist. The manual was published online in April 2020 as the “Infection Prevention Guidelines for School of Medicine Students” and consists of the following sections: Pathogens and Clinical Imaging; Basics of Infection Prevention among Medical Students; Basic Principles for COVID-19 Infection Prevention for Medical Students; COVID-19 Prevention Measures Outside the Hospital; and Pre-Clinical Practice Checklist for COVID-19 Prevention.

Takatsuna: During the uncertainty at that time, I felt that the guidelines served as a roadmap for how we could resume clinical training at the hospital. I started my training in January 2021 and am happy to report that the School of Medicine has successfully resumed all of its training programs.

─ It seems the Infection Prevention Guidelines have been widely used outside of Keio University as well.

Sato: That’s right. We had hoped that the site would be utilized not only within Keio University but also throughout Japan. So at the beginning of the guidelines, we stated that we had published the site under a Creative Commons licenese that allows it to be freely modified and shared. And thanks to the generous support of Dr. Toshiaki Kadokawa, who has been guiding KSAM, the Infection Prevention Guidelines have been used by medical school students, faculty, and staff, and at nursing and pharmacy faculties throughout Japan. We received thank you messages via email and social media and heard from friends at other universities that they were using the guidelines.

─ You then modified the Infection Prevention Guidelines for use on your website “An Encouragement of COVID-19 Measures.

Sato: We created that website after being asked by the All Keio Student Senate to provide students with basic knowledge about COVID-19 and general infection control measures. KSAM was in charge of creating the content, and students outside of the School of Medicine, Faculty of Nursing and Medical Care, and Faculty of Pharmacy were in charge of creating the website.

In recognition of our project, volunteer medical students, including the members of KSAM, were awarded the 2020 President's Award. I am very honored that this project, which started out as a desire to contribute something as a medical student, was officially acknowledged by the university.

─ Fourth-year students who joined KSAM during the pandemic must have found the activities to be quite different from what they had expected.

Yamamoto: Yes, definitely. I joined in hopes of contributing to the organization by giving tours to researchers and guests from Japan and abroad, so I would be lying if I said I wasn’t disappointed. But when I saw how the Infection Prevention Guidelines my classmates made were being used, I realized KSAM’s impact and its future potential. Without COVID-19, I never would have been involved in activities like building the vaccination information website, so I view this different experience in a positive light.

Oya: I, too, obviously felt disappointed but pushed forward, and creating the vaccine information website to share information with those outside of the School of Medicine was also a great experience for me. I feel that through this experience, I have gradually acquired the ability to communicate with people with different perspectives and levels of understanding. I believe this is very important in being able to see things from the patient’s point of view, and I want to always be aware of that when I enter clinical practice as a doctor.

─ KSAM has also interviewed researchers who have been awarded the Keio Medical Science Prize.

Sato: That’s right. I’ve been interviewing Keio Medical Science Prize recipients since 2020. The trouble is that there are already countless articles and videos with these acclaimed researchers, so we try to make our interviews stand out by focusing on their lives as students and how they built their careers.

It’s a great opportunity because we typically wouldn’t have access to such esteemed researchers, but you have to remember that they, were once university students just like us and have endured many challenges to get to where they are today. Their stories are very inspiring. We make all of our interviews available on YouTube in hopes that many people will watch them!

─ Would you mind sharing some memorable moments from your interviews?

Takatsuna: I interviewed 2020 laureate Dr. Atsushi Miyawaki, a graduate of the Keio University School of Medicine who developed molecular imaging technology. When I asked him why he went into this field, he replied, "As a medical student, I spent a lot of time in the Kitasato Memorial Medical Library, reading amazing books and journals on engineering, biology, and physics. It was during this time that I discovered photobiology, which has been a focus of my research ever since." This story of how he found his research topic was really inspiring.

Dr. Aviv Regev, the other 2020 laureate, has developed an analysis technique for understanding gene expression and cellular conditions at the single-cell level. During her session with students, she took questions from undergraduate students, and when asked about how she maintains work-life balance, she told us: "Follow your heart, follow your compass," and urged us to stay true to ourselves. That message has stuck with me ever since.

─ You also produce a popular newspaper column that introduces various information about the School of Medicine.

Takatsuna: Every month, the Keio School of Medicine Newspaper publishes its column “Tell Me! Ambassador” (Oshiete! Ambassador). In one issue, we wrote about a small gate on the northeast side of campus. The gate was created by late Professor Emeritus of Neurophysiology, Motoichi Kato, so that he could spend every minute of his day on his research, as the other gates were too far from his laboratory, which was located where the JKiC building now sits. This is just one example of the deep, obscure trivia that we uncover and share in the column.

Oya: The column is interesting because there are hidden stories in things that you wouldn’t usually pay attention to. In a recent issue, I shared a map of food trucks and bento shops around Shinanomachi Campus. Even though we have to eat alone to help prevent the spread of COVID-19, I hope that these kinds of stories can help people enjoy their lunchtime a little more.

─You have also started a new interview project this year.

Takatsuna: Indeed, we have. We have started a series called "My Blueprint," where we look at what School of Medicine faculty were like as students, using photos from their time at university. I hope that this series will be informative for people both inside and outside of Keio and highlight the inspiring stories of our professors. We have posted interviews with Prof. Masaya Nakamura (Orthopaedic Surgery) and Prof. Katsunori Masaki (Pulmonary Medicine) and will be publishing articles on Prof. Takeshi Arimitsu (NICU) and Prof. Hiroaki Miyata (Data Science), with more to come.

KSAM is in a position to share what makes the School of Medicine great, and I feel my own love for the school growing as I learn more about it from our professors. I hope that others will feel the same way when they read the “My Blueprint” series.

─ The fourth-year students will soon be the leaders of KSAM. Are you planning any new initiatives, and what is your vision for the future? Mr. Sato, could you share some words of encouragement as a sixth-year student?

Yamamoto: There are many things I would like to do once the COVID-19 pandemic is under control. One of them is to make the Keio School of Medicine more appealing to younger students in the Keio community. I am a graduate of Keio Senior High School, and when I was a student there, professors from various departments came to information sessions at the school. I think that if KSAM members could visit high schools to talk with students, it would be easier for them to ask questions and learn more about life as a medical student, including club activities. This would hopefully lead to more students applying to the School of Medicine. I have studied at Keio since elementary school, and sharing what makes the School of Medicine great with younger students is the best way I can think of to say thank you for everything I have learned during my time at Keio.

Oya: I think the first thing KSAM needs to do is further raise its profile within Keio and become a more influential organization. Eventually, we would like to collaborate with other medical schools to create a network that enables us to do projects that are much broader in scope. I’m also hoping to expand this network with other medical schools overseas.

Sato: KSAM was created to be the face of the School of Medicine and a bridge that connects students with the university. Although the pandemic has limited our activities, we have been able to communicate well with the university and act quickly when needed. I hope that the next generation of KSAM will think of new and innovative projects without feeling obligated to repeat the past. And I hope that their achievements will inspire more students to become a part of KSAM.