COVID-19 School Simulation Study

Principal Investigators: M. Science, C. Matava

Co-Investigators: S. Anthony, et al.

The Hospital for Sick Children is leading a research study to learn more about ways to support or enhance the safety and well-being of students and faculty during the COVID-19 pandemic, and to better understand the impact of a modified environment and health and safety measures on potential infectious risks. A ‘return to school’ simulation study was conducted for two full days. Volunteer students and teachers from elementary and high schools were recruited to participate in the study in Toronto.


Student Perspectives from a School Simulation Study

Objectives: This study examined children’s perspectives about returning to in-person school following lockdown due to the pandemic and about mask-wearing in class, as well as the mental health of children and parents during the pandemic.

Methods: This cross-sectional study was part of a 2-day school simulation exercise that randomized students to different masking recommendations. Parent-report of mental health and post-simulation child-report of COVID-19-related anxiety and mask-wearing were analyzed using descriptive and multiple regression analyses. Semi-structured focus groups were conducted with older students to supplement questionnaire data.

Results: Of 190 students in this study, 31% were in grade 4 or lower 95% looked forward to returning to in-person school. Greater child anxiety about COVID-19 was predicted by increased parent/caregiver anxiety, and lower parental educational attainment. Older students were more likely than younger students to report that mask-wearing interfered with their abilities to interact with peers and understand the teacher. Students in the group that did not require masks were more likely than students in the masking group to report worries about contracting COVID-19 at school, and anticipated difficulty wearing a mask.

Conclusions: For children anxious about COVID-19, parental anxiety and education about COVID-19 may be targets for intervention. Future research should examine the impact of prolonged implementation of public health mitigation strategies in school on academic achievement and children’s mental health.

Knowledge Translation: Return to school and mask-wearing in class during the COVID-19 pandemic: Student perspectives from a school simulation study. Coelho SG, Segovia A, Anthony SJ, Lin J, Pol S, Crosbie J, Science M, Matava CT, Parekh RS, Caldeira-Kulbakas M, Carroll S, Greenwood JL, Panzera G, Imgrund R, Osokin K, Back to School COVID-19 Study Group, Korczak D. Pediatrics & Child Health, 2022:1-7.


Impact of COVID-19 Public Health Protocols on Teachers

Objective: As a result of the COVID-19 pandemic, public health agencies and school boards across Canada enacted new protocols, including face masks, physical distancing and enhanced hygiene, to support the safe reopening of in-person school. This study explored the experiences and perceptions of teachers instructing children and adolescents in person during a two-day school simulation.

Method: This study was part of a large school simulation exercise conducted in Toronto, Ontario. Kindergarten to grade 12 teachers taught in classrooms with either masked students, or students who were un-masked or only masked when physical distancing was not possible. A qualitative descriptive phenomenology approach was utilized, and data were collected via virtual focus groups. Qualitative data analysis involved multiple rounds of inductive coding to generate themes.

Results: The sample included 14 teachers (92.9% female; 85.7% White), with a median of 9.5 years teaching experience. Three primary themes emerged: 1) learning to navigate public health measures, 2) needing to adapt teaching strategies and 3) striving to manage conflicting priorities. The majority of teachers reported that mask-wearing and physical distancing impacted their classroom teaching, communication and connection with students.

Conclusions: As schools transition to in-person instruction, teachers will be required to play dual roles in education and public health, with implications on safety, teaching and professional identity. Public health agencies and school boards are encouraged to engage teachers in ongoing conversations regarding in-person school planning and operations. Furthermore, evidence-based interventions, including increased teaching development programs, are recommended to support teachers during the COVID-19 pandemic.

Knowledge Translation: Impact of COVID-19 Public Health Protocols on Teachers Instructing Children and Adolescents During and In-Person Simulation. Lin J, Pol SJ, Korczak DJ, Coelho S, Segovia A, Matava CT, Parekh RS, Science M, Caldeira-Kulbakas M, Crosbie J, Carroll S, Greenwood JL, Panzera G, Imgrund R, Back to School COVID-19 Study Group, Anthony SJ. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 2022;31(2):52-63.

COVID-19 School Study Infographic