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Background  An innovative medical student elective combined student-directed, faculty-supported online learning with COVID-19 response field placements. This study evaluated students’ experience in the course, the curriculum content and format, and its short-term impact on students’ knowledge and attitudes around COVID-19.    Methods  Students responded to discussion board prompts throughout the course and submitted pre−/post-course reflections. Pre−/post-course questionnaires assessed pandemic knowledge and attitudes using 4-point Likert scales. Authors collected aggregate data on enrollment, discussion posts, field placements, and scholarly work resulting from course activities. After the elective, authors conducted a focus group with a convenience sample of 6 participants. Institutional elective evaluation data was included in analysis. Authors analyzed questionnaire data with summary statistics and paired t-tests comparing knowledge and attitudes before and after the elective. Reflection pieces, discussion posts, and focus group data were analyzed using content analysis with a phenomenological approach.    Results  Twenty-seven students enrolled. Each student posted an average of 2.4 original discussion posts and 3.1 responses. Mean knowledge score increased from 43.8 to 60.8% ( p  <  0.001) between pre- and post-course questionnaires. Knowledge self-assessment also increased (2.4 vs. 3.5 on Likert scale,  p  <  0.0001), and students reported increased engagement in the pandemic response (2.7 vs. 3.6,  p  <  0.0001). Students reported increased fluency in discussing the pandemic and increased appreciation for the field of public health. There was no difference in students’ level of anxiety about the pandemic after course participation (3.0 vs. 3.1,  p  = 0.53). Twelve students (44.4%) completed the institutional evaluation. All rated the course “very good” or “excellent.” Students favorably reviewed the field placements, suggested readings, self-directed research, and learning from peers. They suggested more clearly defined expectations and improved balance between volunteer and educational hours.    Conclusions  The elective was well-received by students, achieved stated objectives, and garnered public attention. Course leadership should monitor students’ time commitment closely in service-learning settings to ensure appropriate balance of service and education. Student engagement in a disaster response is insufficient to address anxiety related to the disaster; future course iterations should include a focus on self-care during times of crisis. This educational innovation could serve as a model for medical schools globally.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12909-021-02616-9.

Global health on the front lines: an innovative medical student elective combining education and service during the COVID-19 pandemic