Randall Zachary D, Ganapathy Aravinda, Kuhn Andrew W, Silverman Richard M, Inclan Paul M, Aleem Alexander W
School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri.
JB JS Open Access. 2023 Aug 1;8(3). doi: 10.2106/JBJS.OA.23.00034. eCollection 2023 Jul-Sep.
COVID-19 forced surgical resident training programs to adapt to meet educational requirements within the constraints of various guidelines. Some of the changes implemented during the pandemic have imparted a lasting effect on orthopaedic education. As such, the purpose of this article was to review how orthopaedic training and education were affected during the COVID-19 pandemic.
The published literature was queried using search strategies devised by a medical librarian, according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Studies eligible for inclusion were studies related to COVID-19, orthopaedic surgical training, and medical education. Studies were excluded if they (1) were abstracts, conference proceedings, letters, perspective pieces, reviews, or editorials; (2) evaluated medical student education; (3) included other specialties; or (4) were unrelated to COVID-19 and/or orthopaedic training.
Eighty-three (n = 83) studies were included. Five themes emerged including (I) Fellowship Application, Interview, and Match Processes; (II) Social Media and Websites for Program Information; (III) Changes in Trainee Surgical Volume; (IV) Trainee Mental Health and Well-being; and (V) Innovations in Education. The pandemic decreased opportunities for medical students to gain exposure to orthopaedic surgery. Social media use, particularly Instagram, among orthopaedic residencies increased during the pandemic. Between the cancellation of away rotations and in-person interviews, applicants saved over $6,000; however, both residency applicants and interviewers preferred in-person interviews. The pandemic led to decreased surgical volume and in-person didactics for trainees, thus relying more on virtual learning. Orthopaedic trainees had mixed feelings regarding online virtual education. Although some respondents reported that they preferred the convenience of online learning, others expressed dissatisfaction with the quality of virtual education.
The shift to virtual learning affected how applicants learned about residency programs, with many relying on virtual away rotations and social media to compare different programs. The pandemic also highlighted issues of diversity and accessibility within orthopaedic surgery, with cost savings from virtual interviews and canceled away rotations potentially benefiting applicants from lower socioeconomic backgrounds. Although some innovative approaches and adaptations to orthopaedic education and training have shown promise and may continue to be used in the future after the COVID-19 pandemic, the role of others, such as virtual interviews, is less clear.
新冠疫情迫使外科住院医师培训项目做出调整，以在各种指南的限制下满足教育要求。疫情期间实施的一些变革对骨科教育产生了持久影响。因此，本文旨在回顾新冠疫情期间骨科培训与教育受到了怎样的影响。
根据系统评价与荟萃分析的首选报告项目指南，由医学图书馆员设计检索策略，对已发表文献进行查询。纳入的研究为与新冠疫情、骨科手术培训及医学教育相关的研究。若研究属于以下情况则被排除：（1）摘要、会议论文、信函、观点文章、综述或社论；（2）评估医学生教育；（3）涵盖其他专科；或（4）与新冠疫情和/或骨科培训无关。
共纳入83项研究。出现了五个主题，包括：（I）专科住院医师申请、面试及匹配流程；（II）用于获取项目信息的社交媒体和网站；（III）住院医师手术量的变化；（IV）住院医师的心理健康与幸福感；以及（V）教育创新。疫情减少了医学生接触骨科手术的机会。疫情期间，骨科住院医师中社交媒体的使用，尤其是照片墙（Instagram）的使用有所增加。取消外地轮转和现场面试后，申请者节省了超过6000美元；然而，住院医师申请者和面试官都更倾向于现场面试。疫情导致住院医师的手术量和现场教学减少，因此更多地依赖虚拟学习。骨科住院医师对在线虚拟教育看法不一。尽管一些受访者表示他们更喜欢在线学习的便利性，但另一些人则对虚拟教育的质量表示不满。
向虚拟学习的转变影响了申请者了解住院医师项目的方式，许多人依靠虚拟外地轮转和社交媒体来比较不同项目。疫情还凸显了骨科手术中的多样性和可及性问题，虚拟面试和取消外地轮转节省的成本可能使社会经济背景较低的申请者受益。尽管一些骨科教育和培训的创新方法和调整已显示出前景，并且在新冠疫情之后未来可能会继续使用，但其他一些方法，如虚拟面试的作用尚不明朗。
