Introduction: The first wave of the COVID-19 pandemic resulted in the closure of all Polish medical universities. Simultaneously, due to staff shortages and the Polish health-care system being seriously challenged, many students were eager to contribute to the fight against the outbreak. This study explores medial student volunteers’ (MSV) perspectives and their lived experiences during the COVID-19 pandemic in Poland. Material and Methods: Semi-structured interviews were conducted with twenty-one students. Results: A total of seven major themes emerged from the interviews: 1. students’ reactions to the COVID-19 pandemic, 2. students’ experiences of the outbreak, 3. motivations for volunteering, 4. students’ perceptions of the COVID-19 volunteering, 5. organization of students’ volunteering, 6. benefits and costs of volunteering during COVID-19, and 7. social perception of MSVs. Although students volunteering was an example of civic responsibility and created new learning opportunities, many students felt unprepared for the pandemic, lacked social skills and access to psychological support, and were the target of stigmatization and discrimination. Discussion: Because during the first wave of the COVID-19 pandemic medical universities were closed and classes were held online, students’ volunteering became an important part of service learning and created an opportunity for education. Consequently, while it benefited students, patients and the healthcare system, students’ involvement reinforced such important values of medical ethos as: altruism, public service, and  solidarity. However, some systemic approach should be undertaken that would prepare students better for future crises. The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 resulted in the closure of many segments of the national economy, a limitation on travel, the closing of public places, and the implementation of social distancing. However, it was the closure of hospitals and medical universities that seemed to disrupt society the most. Consequently, health-care systems in many countries, i.e., Italy, Spain, or Israel were seriously overburdened by the coronavirus disease 2019 (COVID-19), especially due to staff and personal protective equipment (PPE) shortages ,4,5. SimHowever, there was uncertainty about the involvement of clinical and preclinical medical students during the pandemic, and their role has been discussed more than ever before ,19,20. SOn the other hand, many insisted on letting students into the hospitals and argued that because healthcare staff are a finite resource and may become depleted as a result of illness, students’ commitment may play a significant role in supporting healthcare workers ,23,25,28Similar discussions occurred in Poland, where the first case of the COVID-19 infection was confirmed on 4 March 2020, the first case of the disease in Poznan was confirmed five days later, and the first COVID-19 victim in the country died on 12 March. Consequently, starting from 10 March, various lockdown-type control measures were imposed by the Polish government, including the closure of all universities, which was announced on 11 March. However, following a call from the Ministry of Health, Poznan University of Medical Sciences (PUMS), in collaboration with the university’s student organizations, started inviting its students to volunteer. The reason for this was that although even before the pandemic Poland suffered from healthcare workforce shortages—in 2017, there were 2.4 doctors and 5.1. nurses per 1000 population  —COVID-19Thus, on 13 March 2020 the rector of PUMS and the governor of the Wielkopolska province signed an agreement which made it possible for volunteers to work in various health care facilities, including hospitals, emergency units, hospital pharmacies, sanitary-epidemiological stations, and the university’s diagnostic laboratory. As a result of this, more than seven hundred students from the faculties of Medicine, Pharmacy, and Health Sciences volunteered during the first wave of pandemic alone.However, the problem was that in contrast to many other jurisdictions in the Polish law, student volunteering is not regarded as a mandatory form of experiential learning, such as internships. Consequently, although, medical students engage in various forms of volunteering, medical universities in Poland do not regard student volunteering as a part of university curricula, nor it is treated as a way of supporting student learning process .Thus, this study explores medical student volunteers’ (MSV) perspectives and their lived experiences of volunteering during the COVID-19 pandemic. Although knowing the perceptions of frontline healthcare workers is important, understanding medical students’ experiences with the pandemic is also of crucial importance, as it may help us to guide future practice and prepare them better for the next health crisis. In particular, many students felt unprepared for dealing with the pandemic, and for others, volunteering during the COVID-19 was a source of serious burden.Although earlier studies focussed on medical students’ attitudes, motivations, and willingness to volunteer during the COVID-19 outbreak, or the role of volunteering in the education of future healthcare professionals and formation of their professional identity, there is still a great shortage of research on the students’ lived experiences during the pandemic. Consequently, this study identifies the facilitators, barriers, and factors affecting medical students’ satisfaction with volunteering during the coronavirus outbreak. Moreover, while most previous studies were designed as quantitative research, this study used qualitative methods . Thus, sThus, semi-structured interviews with students who volunteered during the COVID-19 pandemic in Poznan, Poland, were performed. Because the study focussed on the students’ lived experiences, the meanings they gave to those experiences and the choices they made based on those meanings, an interpretative phenomenological approach was used for this study . The queBefore conducting the formal phase of qualitative research, a series of three pretest interviews were conducted to assess the instrumentation rigor and to formulate measures to address any limitations or threats to bias and management procedures. While it helped to reformulate four questions, it also enabled me to identify various obstacles and increase the methodological and social reliability of the questionnaire, which are central considerations to any qualitative research. The final version of the questionnaire was evaluated by three external reviewers: two medical students and one sociologist, and received approval from the University Student Council Board (USCB). Additionally, ethics approval and research governance approval were obtained from the PUMS Bioethics Committee (KB—831/20).Invitation to participate in the study was posted on an online platform. Students were included if they were directly involved in voluntary service during the pandemic and were eager to participate in the study. The recruitment process was continued until thematic saturation was achieved . All in Students were interviewed between January and March 2021. Due to safety reasons, nineteen interviews were conducted as telephone conversations, lasting between 40 and 75 min, and two were performed as written interviews. All interviews were digitally audio-taped and transcribed verbatim. For analytical purposes, any type of emotions, intonations, silences, or emphases were also transcribed.The data were analysed thematically, guided by Colaizzi’s approach . First, n = 8), nursing (n = 6), rescue medicine (n = 2), public health (n = 2), pharmacy (n = 1), and medical analytics (n = 1). Additionally, one PhD student was interviewed. The mean time of voluntary experience during the pandemic was 3.4 months (range: 1.5–12 months). There were ten participants who were already well established students , while six were first year students. Among the tasks performed during their voluntary service were: helping in local hospitals, emergency units, sanitary-epidemiological stations, or the university’s diagnostic laboratory, where they performed triage, cared for patients, conducted epidemiological interviews over the phone, took the medical history from those infected, helped in administrative work, gave telephone advice in call centres, translated English texts about COVID-19, or helped in the distribution of PPE. A total of sixteen respondents had earlier experiences with various forms of volunteering.A total of 21 student volunteers were interviewed: sixteen females and five males . They stOverall, seven key patterns emerged during the interviews: 1. medical students’ reactions to the COVID-19 pandemic, 2. medical students’ experiences of the outbreak, 3. motivations for volunteering, 4. medical students’ perceptions of the COVID-19 volunteering, 5. organization of medical students’ volunteering, 6. benefits and costs of volunteering during COVID-19, and 7. the social perception of MSVs .While describing their first reactions after hearing about the COVID-19 outbreak and restrictions imposed by the government, students evoked a wide range of emotions. However, the most common reactions were disbelief and fear. Some MSVs described their feelings of uncertainty and anxiety and recalled the apocalyptic visions of previous plagues and omnipresent death fuelled by the media.At the beginning it was fear. I thought it would be like a plague and that people would be dying on the streets, especially that the media were constantly showing images from Italy with the soldiers on the streets. There was also rumours that they would close the entire city, so I thought I would be cut off from the world. It was fear and insecurity.(MSV3)There was a lot of adrenaline. I had this feeling that a war was coming.(MSV10)Other respondents recalled their mistrust in the government’s assurance that the situation in the country was under control.When they [the government—JD] told us that it was going to last for two weeks only, I already knew that it would be much longer, as no epidemic lasts for two weeks.(MSV2)While I was thinking that in relation to the number of infections restrictions were too harsh, I also knew that it wouldn’t be as promising as the minister Szumowski [the Minster of Health—JD] was saying.(MSV8)Some students admitted being sceptical about the pandemic, as at the beginning they did not believe it was a real threat and were thinking about it in terms of fear mongering. Simultaneously, they recalled how their perception of the risk has changed over time.At the beginning I didn’t believe it was a real pandemic (…) Later when the number grew and the virus appeared in Italy and Poland, I was mad that so many people didn’t follow the restrictions.(MSV15)[i]n October I was very sceptical about it. I thought it would be like in the case of Ebola: they were scaring us that it would also come to Europe but nothing like that happened. When it came to Poland (…) I was scared that Poland would turn into a second Italy.(MSV17)Students described their feelings of insecurity, fear, frustration, and anger. However, while some MSVs worried over the negative impact the pandemic might have on society and the healthcare system, most respondents were confused because of not knowing when the crisis would end. They were also frustrated with the restrictions imposed on their personal freedom and were afraid about their future. In particular, they were concerned over the social distancing requirements, which enforced remote education and disrupted their daily activities.I was mad and furious. My anxiety over the future mixed with anger that my plans couldn’t be realized. I was sad and mad that my study trip to Summer School abroad was cancelled.(MSV6)I was very upset that all the classes were suspended. I thought it was unnecessary and exaggerated. I was mad that they took away my time from clinical classes.(MSV19)Respondents were also afraid over the health of their loved ones, including parents and grandparents.I was afraid over the health of my parents and grandparents.(MSV12)I was worried that my grandparents may be infected.(MSV20)As the pandemic progressed, all these negative feelings intensified and MSVs expressed concerns over the negative impact of the outbreak on the national economy, healthcare system, and the health of their families. Interestingly, most were not so preoccupied with contracting the virus as they were with the possibility of being asymptomatic carriers and transmitting the virus to others. This was especially the case for those MSVs who were still living with high-risk individuals, such as senior family members with co-morbidities.When the pandemic gained momentum I was scared over the health of my loved ones, my family.(MSV11)I was more afraid of being a carrier than of being infected. Because of my age and good physical shape I didn’t feel endangered. I was afraid that I might infect others.(MSV20)During the first wave of the pandemic, most MSVs were mainly focused on personal issues and worried about their education and professional futures.After two or three months I started wondering how it would affect my education. I worried that we didn’t have access to clinical classes and patients, and that online lectures and seminars were not enough, as we were unable to talk to the patients and examine them.(MSV1)I was afraid that I wouldn’t be able to finish my studies. As we have lost almost a year and a half now, I was wondering how we could catch up and how we would handle ourselves in the future job. I was afraid that we would have to learn everything in practice, at work. It was hard.(MSV15)Some MSVs remained stoical and argued that although the situation was difficult, they did not find it particularly disturbing. Moreover, some perceived the pandemic as a “learning opportunity”.I didn’t experience any special worries. (…) I thought it was an opportunity for me, a chance to gain extra knowledge.(MSV5)To be honest, I wasn’t scared, nor had any negative feeling about it because I knew that I wasn’t in the group of increased risk. So I tried not to panic. It didn’t affect me.(MSV19)However, there were respondents who reported that due to the pandemic and lockdown inconveniences, they experienced serious psychological distress, an increased level of anxiety, and depressive emotions.I was scared over my future and health, how I would handle the isolation. Such negative feelings affected me a lot. My relationship broke up, and weeks of isolation resulted in panic attacks.(MSV6)It was social isolation, a prohibition to leave home and an inability to realize my passions that were the hardest experience; and fear over my loved ones. These were the most dominant feelings.(MSV1)After hearing the news about the COVID-19 pandemic, all MSVs described their need to act and engage in the fight against the outbreak. Although students declared a variety of motives for volunteering, for the majority the prime motivator was the belief that studying at medical university was a unique vocation and that as future healthcare professionals it was their duty to engage and help whatever the risks. Thus, some recalled the feeling of the ‘sublimity of the situation’ and a sense of a ‘mission’ they had, which influenced their desire to be a part of ‘something ground-breaking’.I had a feeling of duty. Although I don’t study medicine or pharmacy, I thought that as a public health student I could help. I was thinking ‘Who else if not we’, at the medical university.(MSV4)It may sound naïve, but it was a kind of imperative: you must give something from yourself, especially as you have finished medical university. I wanted to do something, and not be the observer and commentator. I had the sense of vocation.(MSV7)Because I have chosen my studies to help people and I often wondered what would I do if a war started or something I thought that maybe this was the right time to step up. It was a sense of a mission, the feeling of solidarity with the medics and the desire to help the sick.(MSV17)Students who had previous experience with various forms of volunteering described their decision as ‘natural’ and declared that as full-fledged volunteers they were driven by the ideal of doing good and helping others, and wanted to give something back to the community.For me it was a natural decision, to continue my medical volunteering I have started a year before the pandemic.(MSV5)It wasn’t a difficult decision. I have been engaged in voluntary service from early high school. In high-school I was a member of the Red Cross. I’ve always liked such activity.(MSV6)On the other hand, some MSVs were more orientated toward personal goals such as having a personal feeling of satisfaction from helping others, the possibility of passing a summer internship, or simply believing that volunteering was better than sitting at home and studying or being bored. Some also suggested that volunteering helped them to cope with their psychological stress and emphasized its therapeutic dimension.Because I come from a small town, I was tired of sitting at home doing nothing apart from walking around or jogging. I wanted to help and engage in something.(MSV15)It had a therapeutic value, because due to the lockdown it was impossible to leave home, meet people or travel. It was difficult; so if I didn’t volunteer it would be an even harder experience, especially that I had moments when I felt helpless and very uncertain.(MSV17)My colleague posted a message that we can pass our summer internships as volunteers. I thought it was a good opportunity to observe how management in a state agency functions. I also wanted to escape a bit from my bad mood.(MSV21)Yet others believed that the pandemic was a chance to gain new knowledge and practical skills that could be useful in their future profession.I wanted to be closer to what was going on. I wouldn’t gain all that knowledge while sitting at home next to the computer.(MSV4)I thought it was an opportunity: being my age and working during the pandemic. I thought that it may not be the last pandemic and that this experience could benefit me in the future.(MSV5)However, most respondents revealed a unique mixture of altruistic and egoistical drives. Thus, even though most were orientated towards altruism and public service, personal enhancement motivations were equally important as they wanted to learn new skills and gain professional experience. However, personal motivations were not the main reason for becoming involved.Because I study at this faculty [rescue medicine—JD], I felt, I’ll say it a bit lofty, a moral duty to help. I was also afraid that the healthcare system wouldn’t handle it. I believed that even a freshman like me could help. It was also a kind of adventure. Finally, I was hoping that as our education switched online I could learn something.(MSV8)At the beginning it was the desire to help, but later I was also motivated by the possibility to pass my summer internship.(MSV20)Simultaneously, while all students had discussed the decision to volunteer with their parents, families, partners, friends, or teachers, they declared that it was their personal and autonomous choice. However, some suggested that they experienced some forms of external pressure, either from their academic teachers, fellow students, or society.There was a kind of social pressure, especially in the media, that we should volunteer.(MSV16)There was a kind of pressure, even from some professors. For example, one professor posted a message on Facebook saying: ‘Either you’d be with us or not’.(MSV17)Although most MSVs did not have any special expectations related to the voluntary service and often perceived it simply as a ‘job’ or ‘learning opportunity’, some mentioned that before starting it they imagined pessimistic scenarios, which influenced their feelings of security and safety.I had this image, like they showed it on the TV, that we would be placed in the military tents at the front of the hospitals, which would serve as a kind of ‘dying rooms’. I was expecting that I might get infected. I knew I was putting myself at risk.(MSV3)I was thinking that (…) we would be sent to covid wards where we would be caring for the sick and monitor their life functions. It made me scared. I thought it might be dangerous.(MSV17)Although all students were aware of the risk, it was not the fear of being infected that worried them the most. As already mentioned, most respondents were more afraid of bringing the virus from the hospital to their homes. Consequently, while fearing that they may pose a risk to their loved ones, MSVs felt responsibility for others and avoided contact with their relatives or decided not to go back to their family house. Moreover, some experienced great anxiety for many months, until they were vaccinated.I worried that I might infect somebody. I felt a great responsibility that some persons might be hospitalized because of me. Such worries accompanied me during my entire volunteering. Only when we all got vaccinated I felt secure enough I could visit my family at home.(MSV15)Soon after I made the decision I started to worry, and I’ve felt it for months, that I might infect others. My anxiety was intensified by the constant information that young people are mainly carriers.(MSV16)Additionally, respondents were afraid that due to their age they lacked the necessary knowledge, skills, and experience, and that they would not be able to perform many tasks.Back then I was studying for only six months, so I was worried that my knowledge was vague and that they could assign me things I was not familiar with.(MSV2)I had some worries, especially during my first meeting with the patients. I felt uncertain and tentative as I was not sure whether I was qualified to do all those things. I was anxious that I may not be gentle enough or even harm those people who were already suffering.(MSV14)MSVs were also asked about the organization of the COVID-19 volunteering. Most respondents argued that the volunteer induction they received was sufficient, as they were trained about all the responsibilities, procedures, and protocols. They also stressed that there was always someone who supported and advised them. Consequently, they felt safe, secure, and prepared for their service.We underwent basic training sessions on occupational hygiene, safety procedures and infectious diseases. (…) I was also trained in the patients’ personal data protection. Additionally, there were always persons who were watching and helping us.(MSV2)We underwent sanitary-epidemiological training: how to disinfect our hands and the workplace, wear masks and uniforms. We also knew exactly what to do during our volunteering; and someone was always helping us. I felt very safe and secure.(MSV17)However, some respondents complained about not being prepared properly for their functions. While some argued that their training was too short, others claimed that they did not receive training or information whatsoever, and said that students desperately lacked information on their responsibilities. Thus, some argued that they owed their preparation to their previous volunteering or to colleagues who explained everything to them.To be honest I felt like being thrown into deep water, without proper preparation. In fact, on the evening before I started someone called me and asked whether I could come the next day. However, I didn’t receive any type of training regarding safety or communication. I simply joined a nurse and was learning from her.(MSV14)We barely had any training and it was my colleagues who showed me everything.(MSV1).Although the majority of students declared that their personal safety and protection were taken care of, some complained that at the initial stage of the pandemic they had limited access to PPE. Simultaneously, they were aware that the primary reason for this was the shortages of PPE experienced in most of the countries struggling with COVID-19.It was well organized. I felt safe and secure. We were provided with the PPE, although at the beginning there were some problems, as there were only reusable masks. Later they gave us also FFP2s and FFP3s.(MSV5)At the beginning we didn’t have much protective equipment, there were very few masks or disinfectant liquid, but as it [the pandemic—JD] developed we were given the visors and dispensable aprons, and after a month it was much safer.(MSV2)Nevertheless, MSVs complained that volunteers’ well-being was not cared for enough as they did not have access to psychological support, especially during the first months when many students experienced stress and emotional burden, caused both by the pandemic and the volunteering itself. Respondents missed institutional support and the possibility of debriefing. Some suggested that it was the volunteers who supported each other.Although everyone was very supportive in technical issues, we didn’t have any psychological or emotional support. I missed the possibility of debriefing, and having a chance to share my experiences, anxieties and worries.(MSV6)We didn’t have any type of institutional support, and some persons needed such psychological help, especially those who volunteered at the beginning, as it was a hard, and stressful work. After eight, ten hours on a duty we experienced a psychological and emotional burden.(MSV16)Finally, students gave their opinions on the motivational system, which aimed to encourage students’ volunteering during the pandemic. Although most MSVs stressed being motivated by a strong sense of altruism and public service, some admitted that gaining a credit for a compulsory internship was an additional motivator. However, many suggested that it had negatively influenced the quality of volunteers, who were driven more by egoistic drives. Moreover, MSVs complained that as a result, volunteering “lost its spirit”. Additionally, some complained that the knowledge and skills acquired during volunteering were not compatible with those required by the program. There were also students who felt as if they were being used, and stressed that volunteers should receive regular pay.I see how it has changed. Now, when students include volunteering as part of their practice their motivations are much different than it used to be when it all began. It has lost its spirit. Back then we were all excited that we were taking part in it, but later many students lacked that commitment. They simply wanted to pass their summer internships. They became more mercenary.(MSV3)Because we do a normal job, I think that students could be offered a regular contract.(MSV5)Simultaneously, none of the respondents regretted their decision to join the fight with the pandemic and stressed that the university had made a good decision to call upon students to volunteer. MSVs felt satisfied that during the difficult situation experienced by the Polish healthcare system, they were able to help and relieve the system. Others stressed that it was a kind of a “test” and a chance to prove oneself as future health professionals.I think it was a good decision, especially at the beginning when the numbers were skyrocketing. There was a staff shortage and the system needed us.(MSV17)I think it was a good decision, because we are preparing ourselves for a profession which is a kind of sacrifice and it was a chance to prove oneself.(MSV14)Even though most MSVs were not involved in any direct patient care activities, all respondents considered their work as useful and believed that it was an important part of their medical education. Moreover, regardless of their age, gender, faculty, initial level of fear, the time of recruitment, or time spent on volunteering, all MSVs expressed a high level of satisfaction from volunteering and stressed the countless benefits that arose from it. Although for some it was a chance to leave home, spend their time in a useful way, make new friends, or pass a summer internship, most respondents emphasized that volunteering made them feel needed and useful, and made them sure that they had chosen the right studies.Now I see clearly that these studies have a purpose. Volunteering made me realize how great it is to work for such a great cause. It also helped me to develop self-confidence.(MSV3)The most satisfying was that I had the feeling that I didn’t waste that time. I was useful and I was doing something important. I wasn’t passive.(MSV7)Simultaneously, although value-based gratifications were highlighted, some MSVs stressed how volunteering had affected their psychological development and personal growth.I could test myself as I didn’t know how would I react in such a critical situation, whether I would go to the front line. Now I know I will, so I have proved this to myself.(MSV10)I felt great satisfaction each time I managed to do something I have learnt during the classes. It was very satisfying when the personnel called for help as they already knew that I could do something and they were treating me as a member of their team.(MSV2)Additionally, MSVs emphasized that as medical schools were closed and classes were held online, volunteering created an educational opportunity for learning new things, improving clinical and social skills, and gaining professional experience.It gave me a lot of practical knowledge and skills. I also developed many soft skills. I learnt how to communicate with people. I was able to work in a team, under pressure and to cope with difficult situations.(MSV4)I have learnt more than I would during regular classes. On the intensive care unit, I was allowed to assist in some procedures that otherwise I could observe only after specialization. I also performed some procedures done typically by physicians, I would never do these as a nurse.(MSV13)It helped me to develop compassion for the sick and dying patients and improved my communication skills. Now when we are on the ward during the classes I find it much easier to deal with toilet issues, wash the patient or change their diaper.(MSV14)Finally, volunteering was a chance for interprofessional collaboration, which helped MSVs to understand the peculiarities of other medical professions. Working with students from other faculties helped them “leave their own boxes”, “see them from the outside”, and appreciate the knowledge and skills of other healthcare professionals. This, in turn, strengthened the “professional integration” and “sense of cohesion”. Some also acknowledged that volunteering made them realize how the system works in critical situations.As a future physician I could observe and work with other healthcare professionals, i.e., nurses, and know their peculiarities. (…) It strengthened a solidarity between healthcare professionals.(MSV4)I could observe how the system works during the pandemic, how do hospitals work during this new situation. I could watch how the ward operates and how nurses, paramedics, physicians and technicians work.(MSV8)Simultaneously, MSVs admitted that volunteering during the pandemic was a source of serious burden. However, although all respondents were afraid of being infected and bringing the virus to their homes, it was especially students who worked with patients, either in hospitals, emergency units, or sanitary-epidemiological stations, who complained about the high pressure and stress they were dealing with, and stressed the emotional strain and “moral injury” which made them physically and emotionally exhausted. Especially, that psychological burden, feelings of helplessness, guilt, and frustration were coupled with the absence of psychological support.The hardest thing was conversations. Sometimes it was difficult to forget about them. I kept them in my head and I often thought that I should have said something else or differently. (…) I remember one conversation with a mother of a teenage girl who struggled with self-destructive behaviours: scarification, the ‘S thoughts’, overdosing paracetamol [silence]. This was the worst call. I was shaken emotionally and I reminiscenced about it for a long time and had flashbacks [silence]. After such calls I needed a day or two off to go through it.(MSV6)The most difficult were conversations with the patients. Sometimes I felt helpless, as no one knew back then what to do, how to respond to questions… We were so confused.(MSV10)Sometimes I felt irritated because there were so many patients and due to staff shortages they were not cared for enough. It was very frustrating because I often couldn’t devote them more time and answer all their questions. I often left the zone embittered, irritated and felt sorry for the patients.(MSV5)Although all MSVs claimed that the tasks performed during their service were adjusted to their qualifications, many complained over a lack of social skills and stressed how unprepared they felt for dealing with offensive or aggressive patients. Moreover, while complaining about the lack of a protocol on how to deal with such situations, students stressed how difficult and emotionally challenging it was to talk to patients.Especially during the first month patients were very against us. They associated us with restrictions in entering hospital and called us many bad words. We faced many negative emotions, especially when they gathered together, were tired and didn’t understand why we let some persons in and others not. Frequently we met with insults.(MSV16)Although during the first year we had some humanities, pedagogy or psychology, the studies didn’t prepare me for that: meeting people face-to-face, when they were often mad or aggressive while waiting for such a long time at the front of the hospital. Sometimes it was a bit dangerous.(MSV15)Some MSVs felt unappreciated or suggested that students could have been used better. Especially medical students and those in their final years stressed that they could have performed more demanding tasks so they could relieve the staff.Some of us could have been used better. Being a PhD student myself, I graduated from biotechnology and I am familiar with all those laboratory things like isolation, and PCR. I would be more useful in the COVID Lab.(MSV7)I still have this feeling that we were not being used properly. There were hundreds of volunteers, but they didn’t recognize properly our potential and didn’t used us properly. People were very eager to work but our potential was wasted.(MSV16)Among other burdens, MSVs stressed that constant performing of the same simple tasks was monotonous and boring. Others found it difficult to reconcile volunteering and studying. Some also admitted that volunteering had a negative impact on their social relations.After performing the same tasks for two months I was a bit tired and bored. It was so monotonous and non-developing.(MSV1)The hardest thing was to reconcile volunteering and studies.(MSV19)It negatively affected my social relations.(MSV16)MSVs reflected on how they were perceived by others and what reactions they faced during their voluntary service. Most respondents admitted receiving positive feedback from their families, including pride and support. However, at the beginning, parents and relatives were often ambivalent about it and tried to discourage them.My family was very supportive and proud. However, my extended family was like: ‘Why do you need it’, ‘Give it a break’. They were telling me I risk a lot and that I put relatives at risk. They discouraged me. But it was only at the beginning. Later they were proud and supportive.(MSV2)My entire family was against it. My parents were afraid and they tried to discourage me. Now they are proud and I have become a ‘family star’.(MSV8)Some students mentioned positive reactions from the university authorities who acknowledged the importance of their service.On the University’s web page I saw videos describing our work. It stressed that not only professionals work in the laboratory but also the volunteers. I saw their gratitude. I felt appreciated and it made me very happy.(MSV17)A dean came to us several times to see how we work and to show his appreciation. We even received an email from the hospital’s director who acknowledged our work.(MSV16)Moreover, the healthcare professionals also appreciated the students’ help, showing their support and respect. Others recalled the gratitude expressed by patients and their families.Healthcare professionals were very supportive and they often expressed their gratitude and told us how they appreciate our presence and help.They often called us ‘heroes’.(MSV1)Medical personnel appreciated us a lot. They were very thankful and stressed that thanks to us those, who worked at the front line were much safer. Nurses and receptionists were calling us ‘our angels’.(MSV16)Although similar positive reactions were expressed by students who did not volunteer, it was the peers, including university colleagues, who were often sceptical about the whole idea of students’ volunteering. Thus, although some respondents were admired by their friends, most MSV suggested that peers’ reactions were often negative and discouraging: some believed that volunteering was irresponsible as they might pose a risk to others, while others argued that volunteers were being used as a cheap workforce. Consequently, MSVs complained about the hate on the Internet and did not understand why some medical students were so aggressive about it.My friends from the university who didn’t know that I had volunteered were saying it was for the idiots; that one might get infected, that there was no equipment, one wouldn’t get paid and that it was not worth it as they wouldn’t let us do anything important.(MSV8)My colleagues tried to discourage me and said I shouldn’t do it; and on Facebook ‘the swamp’ spilled. I saw the discussion on the web saying that they were trying to use us as a cheap workforce. They were mad at the University that it asked us to volunteer. It really irritated me. I couldn’t understand their need to comment on my decision and being so negative and aggressive about it.(MSV3)For some students, volunteering was a source of discriminatory behaviours, including social exclusion within the student community, from teachers, or neighbours. Even though they perceived such prejudices as “small things”, still they felt stigmatized, marginalized, and discriminated against. They stressed that being perceived as an ‘infection risk’ and a threat rather than as individuals who were offering their service to society made them feel sad and disappointed.Once, when I returned to my apartment after a twelve or eighteen hours of service I found a note stuck in the door saying that my neighbours were asking me to leave my apartment immediately because I was a possible ‘source of the plague’. I felt bitterness and disbelief.(MSV8)In the summer time, when I was wondering whether I should come to a party, some friends told me ‘No, no, you don’t have to come. We know you are at work, you know’. It was such small things. Also some teachers, at another university where I also study, who knew about it, were afraid of letting me into the classes.(MSV10)The COVID-19 pandemic has resulted in the increased demand for healthcare workers worldwide. A similar situation occurred in Poland, which for years has had difficulty in retaining its health professionals and struggles with an inadequate number of practicing physicians or nurses. Consequently, the question of whether students’ involvement in the pandemic should be allowed or restricted provoked heated debate ,28,29,30Interestingly, although previous studies in the United States ,23,25, tInterestingly, students pointed to various benefits stemming from volunteering, which included the normative ones , personal enhancement , career  and social . However, most respondents suggested that the pandemic was a unique teaching moment and active involvement in volunteering created new learning opportunities, especially in the field of competency-based medical education and project problem-based learning ,50,51,52Simultaneously, in accord with Kalet et al.  this stuWhat is also important is that most respondents experienced a mix of an obligation to join in the fight against the COVID-19 pandemic, and fear ,25,56,57Another important finding is that the major concern regarding volunteering was related to perceived insufficient medical knowledge and skills . EspeciaAlthough respondents emphasized that their involvement in voluntary service during the pandemic had received positive feedback, they mentioned that many students who did not volunteer felt they were being exploited as a free workforce. Moreover, although all participants emphasized the voluntary character of their service, some suggested that as it lasted over time and the jobs they performed were ordinarily waged, they should be drafted a formal employment contract and have regular payment. Similar concerns were found among Danish students who believed that for many receiving a salary would be an important additional motivational factor . SimilarThis study has some limitations. First, only twenty-one MSVs were interviewed. However, despite the small sample, thematic saturation was achieved. Second, the study has a local dimension as only responses from one Polish medical university were analysed. Consequently, it would be desirable to compare the findings from other locations in the country. Third, because five students resigned, the results represent solely the opinions of those MSVs who agreed to participate in the study and cannot be generalised for the entire population of MSVs either in Poznan or in Poland as a whole. Fourth, there was a predominance of female participants (F:M 16:5), which limits the results’ transferability to male students, although this imbalance is representative of the female predominance within the medical studies in Poland. Finally, as the analysis was performed by one author alone, there was a higher risk of subjectivity that might have influenced both the choice of the themes and the interpretation of the data.However, despite these limitations, some advantages of this study should also be acknowledged. Most importantly, as there is a scarcity of previous work on the topic, this research fills the gap in the literature regarding the experiences of MSVs facing the COVID-19 pandemic in Poland. Indeed, while previous studies discussed students’ attitudes, motivations, or willingness to volunteer, to the best of my knowledge this is the first study that explores students’ lived experiences during the COVID-19 pandemic in Poland. Additionally, while previous studies often focused on medical students, this research highlights the experiences of students from various faculties enrolled in an interprofessional project. Moreover, it describes the experiences of not only final year students but also those in their early years of training, who are typically not immersed in clinical settings. Thus, while emphasizing the role of students during the current health crisis, this study provides new insights into how individualized the students’ response to COVID-19 was. Finally, it enabled the MSVs to share their experiences, which might have a therapeutic value.This study suggests that although medical students’ involvement in volunteering during the COVID-19 pandemic was intended to prevent shortages of healthcare workers and relieve the system before it reached a personnel crisis, it was also a self-satisfying and career-related experience. Although being committed gave students the feeling of taking part in the fight against the pandemic, MSVs emphasized that in times when medical universities were closed and classes were held online, students’ volunteering became an important part of the service learning and created an opportunity for education. Thus, while it benefited students, patients, and the healthcare system, students’ involvement reinforced such important values of medical ethos as: altruism, public service, and  solidarity.To ensure that medical students can effectively volunteer in future disasters, policymakers and university authorities should not overlook the potential force of medical students as a support to the health system;There is an urgent need for promoting the idea of volunteering among all medical students;Students’ participation should always be voluntary, and free of any type of external, formal, or informal pressure;Students volunteering should be treated as a way of supporting the student learning process and incorporated into university curricula;Medical universities should integrate global health and disaster medicine to the medical curricula;There is a need for special preparation courses that would improve students’ communication skills and handling of difficult situations;Dedicated university courses on emergency decision making, coping, and leadership during a crisis should be integrated into the medical curricula;To minimize the risk of litigation, students should always receive proper induction and be trained about their responsibilities, procedures, and protocols;All tasks performed by MSVs should be safe, adjusted to their capabilities and level of training, and performed under supervision and institutional medico-legal protection;When engaging MSVs, special attention should be paid to the risks of infecting the patients and students as well as to the PPE shortages;Because MSVs may perform some tasks remotely, telemedicine should be further developed;Because volunteering during the pandemic was physically and emotionally challenging, MSVs must be provided with mental health support in physically or emotionally challenging roles.However, although this research confirms the view that medical students are willing to contribute in the response to health disasters and emergencies and that their involvement helped to relieve the healthcare system, it also shows that in order to promote the idea of students volunteering, improve the healthcare’s organization, enhance the students’ safety, and better prepare them for next health crisis, some systemic approaches should be undertaken:


Spuling, Verena Klusmann, Catherine E. Bowen, Anna E. Kornadt and Eva-Marie Kessler., was originally published electronically on the publisher’s internet portal on 09 October 2020 without open access. With the author(s)’ decision to opt for Open Choice the copyright of the article changed on 05 January 2021 to © The Author(s) 2021 and the article is forthwith distributed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit


The New Zealand government has been globally praised for its response to Covid-19. Despite the global accolades, little attention has been given to the swift and innovative Māori response to Covid-19. This paper will detail some of this rapid Māori response to Covid-19 in Aotearoa New Zealand and argue the response can be understood as key examples of Māori exercising tino rangatiratanga (self-determination), independent of the government’s measures and policies. We suggest that this exploration of tino rangatiratanga during Covid-19 demonstrates central aspects of Māori well-being that move beyond a government focus on statistics as the key measure of well-being and how tikanga Māori  are being used to develop successful responses to the global pandemic. Like many people and places around the world, 2020 has required significant changes to the way we work, socialise and carry out our day to day lives due to the ongoing impacts of Covid-19. Indigenous communities from around the world have had to make significant adaptations to cultural practices in order to protect the health and well-being of their communities. This article discusses some of the actions that Māori the Indigenous peoples in Aotearoa New Zealand have taken to protect their communities, while also maintaining and promoting tino rangatiratanga (self-determination).In March 2020, with only 183 cases of Covid-19 the New Zealand government moved the entire country into a lockdown under level four restrictions. The decisive action taken by the New Zealand government has been heralded around the world as one of the most effective solutions to limiting the reach and impact of Covid-19. Since the reduction in alert levels, there has been a small swell in cases, but most are traced and controlled, with social distancing measures in place across the country. The measures taken by the New Zealand government has meant that the devastation that has been caused by Covid-19 throughout the world, has not been felt in the same way in our country.A number of Māori communities throughout Aotearoa, also took swift and rapid action to the pandemic, which in many ways built on and exceeded actions taken by the New Zealand government.This article explores those actions and the ways in which there is a cyclical and inter-dependent link between tino rangatiratanga and well-being. In this article, the authors argue that tino rangatiratanga enables positive well-being, and equally, the positive well-being of individuals and communities enables the exercise of tino rangatiratanga. In other words, despite the impacts of colonisation, Māori communities have maintained and built strong levels of tino rangatiratanga, to both protect and enable tino rangatiratanga to thrive. We suggest that an important way of understanding the actions taken by certain Māori communities, is through an analysis of tikanga Māori , which provide an Indigenous lens for understanding partially why and how communities responded as they have to Covid-19.This article will begin by providing a contextual discussion of the New Zealand governments responses, before a brief on the importance of intergenerational storytelling. This is followed by a brief analysis and explanation of tino rangatiratanga, tikanga  and hauora, before discussing five examples of Māori responses to Covid-19. Finally, we make some recommendations which we hope will provide a basis for how governments and Indigenous peoples alike can strengthen responses to Covid-19 while also supporting well-being and Indigenous self-determination. Responses to Covid-19 have not only shown the strength of Māori leadership, but more broadly Indigenous leadership, and the potential for Indigenous-led solutions, such as a values-driven holistic health approach. This could positively shape the global Covid-19 responses and impact the health of all.“We have a window of opportunity to stay home, break the chain of transmission, and save lives,” , making the total number of confirmed and probable cases 1,815. Sadly, there have been 25 deaths related to Covid-19, with 71 active cases remaining . Of releTino rangatiratanga can mean self-determination, sovereignty, independence, autonomy. The term itself is rooted in a Māori worldview, and there is no one English term which fully encapsulates its meaning. Tino rangatiratanga refers to Māori control over Māori lives, and the centrality of mātauranga Māori (Māori knowledge). While focused on a Māori worldview, tino rangatiratanga also has a close association with the challenges that have come from the loss of Māori control through colonial practices, and has been used as a framework from which Māori have continued to challenge governments for recognition of our individual and collective self-determination.The term “rangatira” makes up the term, and is the Māori word for leader, again this English term does little to inform about the worldview through which Māori leadership is understood. The term can be broken into two parts “ranga” and “tira.” Ranga derives from the term “raranga” which means to weave, and “tira” refers to a group or community. In essence, leadership from a Māori perspective, is dependent upon a leader’s ability to weave a community together, while recognising the different strands which exist within a group . For MāoIn some cases, actions toward tino rangatiratanga has involved overt and direct challenges to the Crown, such as protests, hīkoi (protest marches), sit ins, or utilising legal avenues, all tools through which Māori have sought to maintain and regain some level of tino rangatiratanga . HoweverThe Māori responses to Covid-19 demonstrate numerous ways through which Māori expressed tino rangatiratanga directed at protecting and supporting local communities that happened irrespective of the actions being taken by the New Zealand government. These actions show how tino rangatiratanga is enacted as independent Māori decision-making. We suggest that this independent decision-making and indeed the exercise of tino rangatiratanga was partially made possible through adherence and respect of tikanga Māori.Tikanga are the rules and values that are founded within a Māori worldview. According to Tikanga are also often viewed as a Māori legal framework, but as Mana – this is power, authority, or prestige and can be understood also as Māori political authority and control. Both individuals and groups can exercise mana, and for an iwi and hapū to be recognised as the authority over their lands and resources, it is considered that they have mana , over the last 30 years allowed for a swift, culturally tailored, Māori health response, as well as an acute awareness of factors that could lead disparate health outcomes ; Treaty of Waitangi claims and the organisation of hapū and iwi organisations allowed for economic self-determination and a coordinated care response. While significant struggles still exist for Māori, we have continued to reaffirm our tino rangatiratanga in diverse ways, which have helped us to respond proactively to Covid-19.The following section provides five case studies of how Māori responded to Covid-19. We clearly demonstrate the link between tino rangatiratanga and well-being and how the responses were informed by tikanga Māori.Oral traditions and intergenerational storytelling practices are a fundamental part of Māori culture and communities and played an important role in the rapid Covid-19 response by Māori communities. Māori cultural practice of remembering our ancestors - their lives, experiences, characteristics, their passing - meant that Māori were acutely aware of the potentially devastating impacts that Covid-19 could have on their communities. Throughout history, epidemics and introduced diseases have had a devastating impact on Māori communities. European colonisers brought new diseases such as measles and flu to New Zealand and because Māori lacked natural immunity to these diseases, many died. From the first European contact to 1840, Māori lost an estimated 30% of our entire population, mostly to epidemics . A furthToday, Māori continue to tell stories about the impact these infectious diseases had on their population, language, culture and community. Māori immortalise these stories in physical reminders, such as pictures and carved pou, to ensure they speak about and remember the devastating disproportionate impact epidemic’s such as the Spanish Flu had on Māori communities. This is deliberate “We keep our ancestors close, their memories live on with us, and their lives become our lessons” , p.1. BeIwi checkpoints were perhaps the most well-known action undertaken by iwi throughout the country. As the Covid-19 threat became ever more present in Aotearoa, a number of iwi took it upon themselves to protect local communities by establishing monitored entry and exits from their communities. These actions complimented decisions made by the New Zealand government, who had made nationwide rules to restrict movement, however as the history of pandemic devastation in Māori communities is still being felt, this extra measure taken by Māori communities sought to provide an extra layer of protection. These checkpoints saw iwi members organising to stop travellers from entering their communities- unless they were residents- to avoid any risk of spreading Covid-19. The iwi checkpoints were essentially about protecting the well-being of entire communities, Māori and non-Māori, and represent clear sites of iwi exercising tino rangatiratanga. The communities where such checkpoints were established were towns with high Māori populations, As such, some iwi rūnanga  effectively mobilised in ways that demonstrated a capacity to protect well-being due to strong systems of governance that were already in place. Iwi such as those in Te Tai Tokerau, Te Whānau a Apanui, Tūhoe and Taranaki iwi all set up various checkpoints which were guided by both a need to protect the health of communities, but also responses that were driven through tikanga. Numerous media reports covering the iwi checkpoints and interviews with iwi leaders throughout the country demonstrates the centrality of tikanga and rangatiratanga in informing the rapid responses. Co-ordinator of the Northland iwi checkpoints for example stated that their decision to close off communities was based on their position as kaitiaki (guardians) which was supported by iwi rangatiratanga; “If we have this kaitiaki status and our own rangatiratanga, we have to step up and participate in serious issues like this,”  and the responsibility that iwi have to protect the health of their environments, which is inseparable from the health of their people. In turn, these kaitiaki responsibilities are also driven through manaakitanga  and that care for communities is essential and could be practically protected through monitoring travel in and out of communities. These tikanga also come hand in hand with the exercise of mana , in that iwi mana is reconfirmed through actions that are taken to support the health of a community. These instances demonstrate the continued importance of whanaungatanga, in that social relationships are embedded in these communities as being essential to the way that iwi operate. Protecting relationships and utilising those iwi relationships to develop a planned and coordinated response was central to iwi checkpoints. Understood through a tikanga lens provides important lessons on how Aotearoa could develop well-being frameworks and structures that are underpinned by tikanga Māori. Many other Indigenous communities, such as Aboriginal Australians also identified themselves as being at risk of infection and death from COVID-19. They also enacted sovereign actions and moved quickly to keep COVID-19 out of their communities in remote regions by restricting access to both outsiders and returning Aboriginal community members .Iwi checkpoints provide important examples of how current iwi governance structures are in a position to mobilise in situations that require rapid responses. These are clear examples of how iwi understand their tino rangatiratanga and that an essential part of maintaining tino rangatiratanga is to protect and promote the well-being of local communities.A lesser publicised example, which equally demonstrates Māori enacting tino rangatiratanga during the Covid-19 crisis, was the decision made by Te Kōhanga Reo National Trust advising all kōhanga reo (Māori language preschool’s) to remain closed during alert level 3, this despite the New Zealand Government lifting restrictions and recommended early childhood programmes could go back at full capacity.While the New Zealand Government had announced that Education providers and children could return to schools, Te Kōhanga Reo National Trust made an independent decision for children to remain at home. This decision was made as a matter of caution and protection for Māori communities beyond the national standards. Trust chief executive, Angus Hartley stated, “The Trust believes whānau should take an extra precautionary approach and not risk the health and well-being of our vulnerable pakeke (adults), kaumātua (elders) and mokopuna (grandchildren)”. “Further, stating that the”. The advice from the ministries of education and health is not consistent with the risk profile that exists at kōhanga reo”  support, as well as Māori specific business pages all developed during this period which simultaneously advanced Māori knowledge as it did promote whanaungatanga in absence of physical contact. These can all be considered as actions taken to enhance tino rangatiratanga as they were aimed at essentially promoting the well-being of Māori communities through sharing Māori knowledge and Māori expertise.For example, outside of targeted actions to protect local communities, the Covid-19 alert level restrictions and the resulting limited social interactions led to various online initiatives. Online karakia (prayer), tangihanga , research conferences, medical and psychology advice, health messaging, cultural workshops, educational resources, and pages dedicated to supporting Māori businesses through the economic downturn, are just a few of the many examples of the online innovation Māori individuals and communities showed during the lockdown. It is clear from these few examples, that Māori were not only reacting in the space but actively innovating, sharing knowledge, and supporting others.New grassroots organisations also emerged. During the pandemic, Māori knew that Māori specific health messaging was essential to ensure effective and relevant communication of important health information to Māori communities. Therefore, a grassroots organisation started an online communication strategy and hashtag #Protectourwhakapapa see .Due to Covid-19 restrictions preventing gathering, some normally in-person cultural practices were moved to an online format. This included several people and organisations hosting online karakia (prayer) over Zoom and Facebook, as well as some tangihanga proceedings moving online. While we do not go into significant detail in this article about the process in which these practices were adapted, the important point here is that a significant adaptation to our cultural practices took place. Karakia and even more so tangihanga processes are not common online and indeed in many ways center on face to face interaction. However, Māori recognised the importance of both of these cultural processes for spirituality and emotional health during Covid-19 (as well as the long-term impact of these practises for well-being). Therefore, kaumātua, and those with in-depth knowledge of tikanga and mātauranga Māori, came together to adapt tikanga and create online tangihanga guidelines and also host online karakia. Again this shows the adaptive capacity of our tikanga, when we understand the underlying mātauranga and values guiding our tikanga practices - and this in and of itself demonstrates how tino rangatiratanga and well-being are linked.These case studies provide examples of how tino rangatiratanga can be enacted through novel and diverse measures which are underpinned by tikanga Māori. In these cases, Māori values and holistic well-being was the key motivation, as Māori responded to the physical, mental, emotional, social, spiritual and economic challenges of Covid-19, in a culturally appropriate manner.The holistic Covid-19 responses worked to ensure that not only were mortality rates low, but also protected wider well-being of Māori communities and in line with the World Health Organization which describes health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” , p. 1. T1. Tikanga Māori positioned at the center of decision-making across all political decision-making. Presently, while there are some policies and even fewer laws which mention tikanga Māori, there needs to be greater acceptance of tikanga Māori as key values which can benefit all of Aotearoa New Zealand. As adaptable and flexible values, tikanga have effectively informed key Māori responses to the Covid-19 pandemic.2. Māori leadership in the responses to Covid-19 and overall health and well-being. This could take the form of an independent Māori health board at the national, regional or local levels, iwi led responses with more decision-making powers. However, whatever the structure that Māori leadership takes, it must be resourced sufficiently and given full control over how resources are used. Several governance groups have already proposed partnership with the government on Covid-19 issues such as the Māori Reference Group, Māori Monitoring Group, Iwi Chairs Forum, and Te Tumu Whakarae. The government has also eventually released a Māori Covid-19 response plan including the formation of a Māori Touchstone Group and almost $NZ50 million in assistance for Māori health providers , These a3. Supports the establishment of an independent Māori Health Authority which also allows capacity and space for Iwi-specific response, as seen as effective during Covid-19 .4. Provide opportunity and resources for Māori to continue to explore the underlying nature of tikanga so that tikanga can continue to inform the future of Aotearoa.5. Greater collaboration between Māori communities and police. The iwi checkpoints in particular required some level of Māori and police engagement which was largely successful. This was a result of Māori being given support by the police for Māori led initiatives. This could provide a framework for developing Māori and police relationships.6. 6. Finally, tino rangatiratanga needn’t be considered as a threat. The Covid-19 pandemic has shown that is Māori exercising tino rangatiratanga has in fact led to greater well-being for Māori and non-Māori alike. If encouraged outside of a pandemic, the potential would be even greater.The Covid-19 pandemic is still unfolding and presenting the world with unprecedented challenges and questions around how to best manage the ongoing uncertainty and response.From the actions undertaken by Māori and highlighted in this article, there are a number of key lessons that could be implemented to inform future plans. With these case study examples in mind, and in line with a Kaupapa Māori research methodology which suggests that research should lead to transformational change we suggest a number of recommendations for how Aotearoa can plan for a future that enhances both tino rangatiratanga and well-being . We offeThe Covid response in New Zealand, both by the New Zealand Government and Māori, has highlighted the need for systemic change in health. The case study examples provided in this article and discussion show clearly that Māori need to be given leadership roles in health and well-being plans. While this right to have control over well-being is a central part of tino rangatiratanga, there remain significant challenges around the New Zealand government's willingness to fully accept Māori tino rangatiratanga which is often seen as a threat to governments. However, Covid-19 has and will continue to require innovative and shared responses in order to ensure that the health and well-being of all individuals and groups are protected and enhanced. Māori experience of disease coupled with our continued expressions of tino rangatiratanga, have shown that we are prepared as well as any colonial government, if not more so, to promote the well-being of our communities. Furthermore, the examples have shown how well-being for Māori has been able to thrive in both the numbers of people who contracted Covid-19, as well as well-being that has been enabled through the adaptation of our tikanga to promote social well-being and community learning.The New Zealand response to Covid-19 is being heralded internationally as an economic and health success . But thiIn analysing the Māori response to Covid-19 it is clear that Māori communities reacted with innovative, decisive, and robust decision making, that enacted tino rangatiratanga which was driven in part by tikanga Māori. Furthermore, these Māori philosophical perspectives which resulted in swift and concise actions, demonstrate the close links between tino rangatiratanga and well-being. In other words, each is necessary for the other, and that the health of our communities is dependent on the health of our tino rangatiratanga.“I would like to see an Aotearoa moving forward, which gives more cognisance to the systems and structures that we have as Māori. What I think we require, is a system in this country which allows us, or gives us more flexibility to do things in a way in which we know work for our people” (2020).The response to Covid-19 to protect communities and ensure holistic well-being meant for the first time ever, Māori were not disproportionately negatively impacted by an endemic reaching the shores of Aotearoa. We echo the calls from It is clear that there are parallels across the indigenous community lead responses, who showed strong leadership and a value- driven response to Covid-19. By examining the Covid-19 response in New Zealand, as well as that of other Indigenous peoples around the world, it is clear that Indigenous-led solutions can positively impact the Covid-19 response for all.CC and ATO both made an equal contribution to preparing and writing this manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


This paper presents a cross-sectional study that demonstrates how King Abdulaziz University has responded to the lockdown imposed by the Ministry of Education in Saudi Arabia due to the Covid-19 pandemic. The purpose of this study was to examine the perceptions of students and faculty towards assessment that had to take place online due to physical or social distancing rules and lockdowns. A descriptive mixed-method study was conducted with two different self-administered questionnaires that were developed for students and faculty, respectively. A total of 547 responses were received from undergraduate students and 213 from faculty. The main finding suggests the need for a multilevel approach to the problems of cheating and plagiarism, including raising student awareness and ethics, training teachers to detect cheating methods, and institutions activating their code of practice and applying severe sanctions on those who engage in such practices. The year 2020 started with a new virus that crossed the lines between human and animal and caused a worldwide pandemic. In a matter of months, everything was affected, and the world as we knew it changed. Physical distancing rules, government-mandated masks, and shut-downs, as well as partial and total lockdowns, were taking place in almost every country. The health sector was affected, as well as trade, the economy, the environment, and, certainly, education. As of March 9th, Saudi Arabia’s Ministry of Education (MoE) closed schools, universities, and colleges and moved learning completely online as Al-Samiri , p.148 eDespite the situation being far from ideal, “Saudi universities were naturally better prepared to transition to the online learning environment, as most Saudi universities had already implemented digital communication and learning tools” , the move to online teaching and learning was at the beginning of their fourth and final quarter. This study was designed after the MoE-mandated closures started, and data were collected between April and May 2020 towards the end of the second semester. As a descriptive mixed-method study, it was conducted on both male and female campuses at KAU, where undergraduate students of all levels, as well as academic staff with different rankings, participated by filling out online questionnaires for students and faculty, respectively. The questionnaires were designed to look at the online learning and teaching experience from three different angles or axes, namely (1) teaching and learning, (2) assessment, and (3) social and technical aspects. However, this paper will only focus on results from the second perspective, namely the assessment axis. The study is dedicated to exploring and answering the following questions:As a result of the COVID-19 pandemic, learning has migrated online in most classrooms, colleges, and universities around the world. This has removed the alternative of combining informal learning with formal education as a choice from both students and teachers. Online learning and networking became the new standard, replacing conventional classroom teaching, and online testing has also been shifted. This happened with little preparation due to the new World Health Organization (WHO)-recommended physical distance rules that refused any group presence in a closed physical space, such as a classroom where the novel virus could spread. Hence, it was important “to make a transformational shift in [our] approach to teaching from one of disseminating information to one of creating learning environments where students [could] co-construct knowledge through interactions” Vaughan . This idResearch has shown that teachers are engaged in assessment-related tasks for as much as one-third to half of their time Stiggins . PractitVirtual Learning Environments  can make it easier to present assessment tasks to students  and to track and record student progress (e.g. automatic time logging of activities and assignment submissions).Moving assessment from a physical classroom environment to an online one is challenging because “often the temptation or commonly used approach is to mirror face-to-face strategies and practices”  was completed in 1964. It found that 75 percent of the students had engaged in one form or another of academic dishonesty” Chace , p.12. KIn their research, Baijnath and Singh  looked aMcCabe and Treviño  provided their university emails. At the beginning of both questionnaires, a short paragraph explaining the study’s aims and objectives was provided to assure potential participants of anonymity or confidentiality. This was followed by a question of consent, where participants were asked to confirm that they were either students or academic staff at KAU and that they agreed to participate in this study, and answering “No” to either option resulted in the termination of the questionnaire and no data being collected. The sampling was purposeful; (n = 547) students participated in the research, as well as (n = 213) faculty members. Any postgraduate, diploma, paid or executive degree students were either not contacted or excluded and a small pilot was carried out with students to check understanding and with faculty to ensure translation was accurate.To collect data to answer this study’s research questions, two online questionnaires were designed, created using Google Forms, and distributed to students and faculty via WhatsApp, email, and Blackboard®. Undergraduate KAU students were randomly contacted through their instructors via university emails, LMS communication channels, and student-teacher WhatsApp groups, as well as the university’s MyKAUApp. A similar sampling procedure was applied to faculty, who were randomly selected utilizing official university emails and shared staff mobile chat applications. All responses were anonymous and confidential; however, faculty were given the option to provide their email addresses, and just under 40% , as shown in Table A 5-point Likert-scale questionnaire was presented to faculty both in Arabic and English . The questionnaire included 47 questions and, like the student questionnaire, was divided into three main sections preceded by an introductory section gathering faculty demographic data, such as gender, discipline, ranking, teaching experience (in years), and email address , as shown in Table change in assessment practices, (2) nature of this change, (3) effect of this change upon workload, skill-based subjects or applied sciences, GPA, and psychological well-being, (4) perception of this change, (5) cheating—opportunities, actual cheating, reasons, methods—and (6) overall online experience.The student questionnaire had 15 closed questions, five of which had an open-ended option . All 15 questions were related to student perceptions of assessment practices, which included: (1) n = 217), the majority with 20.3% stated the difficulty of understanding lessons online as their reason, with ‘ease of cheating online’ (18.9%) and ‘general anxiety of the situation’ (18%) as other reasons. Using WhatsApp for cheating online was their number one method (27.4%) and the phone as their least chosen method (1.3%). Finally, 47% believed their overall online experience was successful despite the challenges, while 32.75% stated that the experience was equally positive and negative.As demonstrated in Table n = 188, 34.4%), it was deemed an important theme , students explained the nature of change that took place during the pandemic lockdown. Some of these changes involved the type of assessment or homework required. For example, some students said that they were asked to send videos or submit a commentary on a YouTube video or simply send the work electronically. One student explained: “We were asked to shoot a video from home while working on a project,” while another stated that “[practical assessment] was replaced by theoretical assignments and discussions.” However, some students clarified that there were no changes to their skill-based subjects’ assessment, as “all laboratory work was completed before the lockdown,” and their “grades up until the lockdown were considered enough, and [they] had no more assessments,” or they did not have such subjects as part of their learning.When asked about their perception of the best assessment solution during the pandemic (Q8), Four distinct themes emerged: faculty-related issues, MoE’s decisions, exam-related issues, and grade-related issues, with grades being their biggest area of concern. Students seemed to expect faculty to “help,” “assist,” “cooperate,” and make things “easy” for them due to the lockdown and the uncertain times they were living in. They believed that the faculty should “help students and alleviate pressure for [them],” “help and make it easier for students and this did not happen,” and “be lenient with marks to raise student GPA.” Students also wanted faculty “to increase homework while easing and facilitating exams.” In addition to suggesting that faculty helped them with assessment issues as a solution to the changes taking place, the majority believed the MoE’s decisions regarding grades were the best solution and were acceptable to them. The MoE decided that 80 marks were awarded to assignments, homework, and projects and 20 for the final exams, thereby adopting a more formative assessment approach as a solution to the unplanned complete move online during the crisis. Students agreed that that was the best approach to handle the change. One student commented that the best solution was “[t]o follow the decision of the Minister of Education. I felt the most appropriate thing was what the university did,” while another stated that “[t]he issue was resolved by the Ministry of Education,” and another claimed that “[t]he Ministry’s system is very fair.” The rejection of the proposed adoption of the first semester grades at the beginning by the university was reiterated, as one student explained: “The best way is the current way—online assessment. I believe that the adoption of first semester grades is a great injustice; please do not do that. This semester will increase my GPA, God willing.” Canceling final exams was the most commonly proposed solution to the assessment issue. Specifically, some students believed that they should get the final 20 marks by submitting a small project or homework online, whereas the majority believed that they deserved the remaining 20 marks and should be awarded to them without submitting any work or taking a final exam due to the circumstances. The best solutions, in their opinion, were “[t]o replace final exams with short tests or assignments,” “[t]o cancel the final and adopt 80 for pass and 40 for fail,” and “[t]o cancel the final exam and grant students the remaining 20 marks.” However, one student remarked that the best solution was “[t]o postpone the semester or transfer the exams to after the end of the crisis because the grades [were] not fair, and the reason is students’ cheating.”However, students’ biggest grievance was their grades and GPAs , students provided 10 explanations, including religion (for not cheating), exam time limit, difficulty of cheating online, type/features of exam, combination of reasons, stress and anxiety, ease of tests, ability to cheat, teacher complacency, and necessity/self-preservation.When asked about the most common cheating method, (Q14), they mentioned using “a combination of methods,” “reference to textbook,” and “WhatsApp and the internet.”In the final question (Q15) about overall online learning experience during the crisis, students either perceived it as a negative experience citing several reasons  or viewed it as a positive experience that could be developed into something permanent because there was no need for physical attendance, which created an ease of attending lectures, while a few saw it as an experience with equally positive and negative aspects .The faculty Likert-scale questionnaire had 13 questions related to online assessment that revolved around the following three major areas or themes, as shown in Table As seen in Table n = 78) responses in that section; (n = 14) of them revolved around assessment (18%). Faculty qualitative data surrounding assessment yielded three major themes: perceptions of assessment, cheating , and teacher power, flexibility, and knowledge . Their comments and suggestions were translated from Arabic where necessary  regarding finding ways to deal with cheating on exams and assessments, which, according to many teachers, had increased during this period. This could be achieved, in their opinion, by giving instructors more flexibility concerning assessment methods. One quote reads, “I faced difficulty on how to control the amount of plagiarized works as well as grading them fairly. Many would believe that zeros are the cure, but I think that [there] must be other solutions for this ethical issue.” Due to social and cultural restrictions, by default, webcams were not used neither by the staff nor by the students at the tertiary level, which made verifying student identity harder, as one faculty member wrote: “Everything was perfect in terms of teaching and curriculum delivery, but parts of the assessment were problematic not because they are problematic but because the university refuses to employ security measures, such as using CAMs [cameras] that will make the experience totally different, and I, of course, mean better, here.”However, preventing cheating and plagiarism was a primary concern for faculty. There were several comments (This study attempted to answer three questions related to online assessment during the COVID-19 pandemic lockdown: (1) How did the university handle assessment online? (2) What did students think of online assessment? and (3) What did faculty think of online assessment practices?Students who might otherwise complete their work honestly observe this phenomenon and convince themselves they cannot afford to be disadvantaged by students who cheat and go unreported or unpunished. Although many find it distasteful, they too begin cheating to “level the playing field.”As of March 8th, 2020, the university moved all learning and teaching online, using the LMS Blackboard® at the start of the government-mandated lockdown due to the COVID-19 pandemic. Online assessment became a major debate point until the MoE decided that all testing was going to be online and courses were to follow a more formative approach to assessment, with most grades awarded as coursework, projects, and short quizzes. This was perceived differently by both faculty and students because it increased both their workloads but was in the best interest of student grades and marking. This is in line with the literature, where Heberling  states tOne reason behind student cheating and academically dishonest practices could be due to internal pressure as well as external pressure as McCabe, Treviño and Butterfield , p.220 aNot only students’ workload increased due to emergency move to online teaching and learning, but faculty found themselves doing more. Alvarez et al.  argue thFew students are ignorant of the prevailing ethical standards of their home institutions. Should those standards be strong and consistently enforced, and should those institutions provide example after example of moral courage, students who cheat do so with the knowledge that they are violating a code of honor that has substance.Finally, this study has several pedagogical implications, especially regarding assessment online and combatting cheating, which affects score meaning and, therefore, validity. Eaton and Dressler  argue thOlt  suggestsTo overcome the problems associated with online assessment, such as cheating and plagiarism, we need to adopt a multilevel approach. Therefore, building on the results of the present study, we recommend applying such an approach to include the cultural and institutional context as well as policy regarding academic dishonesty. This is echoed by Olt , who offFirst, students need to be made aware of the severity of this practice on a moral and ethical level, and faculty could emphasize moral and/ religious teachings reflected in the data as a deterrent from cheating even when students have the opportunity. As Chace Second, faculty and administration should eliminate and reduce opportunities for students to cheat through employing certain exam features as suggested by Olt  and ReedAssuming that something should be done, one response could be to stiffen the apparatus of policing. Internet sites such as "Turnitin," to which students and teachers can submit student work to see if it contains material from essays already on electronic file, could be employed by more and more teachers to track down those who misuse the material. Penalties could be increased;Finally, faculty and those responsible for administering exams should be given extensive training on cheating methods and techniques employed by students as well as on what ignoring the practice may lead to. Furthermore, this training “must be renewed and adapted to the current and real needs of university teachers and university education”  with both students and faculty might yield a more comparable view. Thirdly, the current study focused on student and faculty perspectives; future research could focus on the institutional level and methods for raising student moral and ethical standards is a matter worthy of future research as well. Comparison with similar surveys done later in the pandemic, when the shift did not feel quite so much as an emergency and students got settled into the ‘new normal’, could prove interesting.