Underhill Jennifer, Poulose Benjamin K, Harzman Alan, Huang Emily
Department of Surgery, The Ohio State University Wexner Medical Center, 410 W 12th Ave, Columbus, OH 43210 USA.
Global Surg Educ. 2023;2(1):17. doi: 10.1007/s44186-022-00093-2. Epub 2022 Dec 27.
The COVID-19 pandemic disrupted many aspects of personal and professional life for surgeons, with resulting suspension of many in-person educational opportunities in favor of virtual education programs. Adapting to these new challenges, we developed, implemented, and evaluated a novel approach to Department of Surgery Grand Rounds to meet the educational needs of residents.
At the outset of COVID-19-related restrictions, educational leadership performed a needs assessment of resident education, leading to a quick pivot to video-based programming. We developed "What Would You Do?" (WWYD), a virtual case-based educational session. Junior residents worked with senior residents, fellows, and faculty to develop disease-specific cases and questions, which were then presented to a panel of invited national subject experts. Feedback was collected from attendees after each grand rounds session via electronic survey, and the panel logistics and "flipped classroom" style of questioning iteratively adapted based on survey responses, verbal feedback, and educational principles. A department-wide survey was conducted at the end of the first year of virtual sessions to assess faculty and trainee perceptions of virtual vs. in-person didactics.
While COVID-19 educational materials were widely available, needs assessment found that surgical educational programming for trainees was dramatically reduced. Over a period of 24 months, we hosted twelve WWYD sessions with 20 internal faculty and 22 national virtual guest panelists. WWYD covered core surgical topics, such as hernia, colorectal, trauma, endocrine, vascular, foregut, and transplant. Weekly attendance ranged from 40 to 100, including faculty, trainees, and students. Attendees at WWYD grand rounds reported more strong agreement that speakers communicated effectively (93.7% vs. 79.8%, p < 0.0001), and that topics were engaging (92.4% vs. 78.5%, < 0.0001) and relevant (91.5% vs. 79.7%, < 0.0001), when compared to didactic virtual grand rounds. Department-wide survey noted differences in faculty vs. trainee priorities for didactic sessions, with faculty both finding virtual didactics more convenient (92.1% vs. 71.4% strong agreement, = 0.004) and more highly valuing convenience (89.7% vs. 69.1% highly value, = 0.005).
During an isolating time, the WWYD format leveraged affordances of a virtual platform to bring diverse content experts together for disease-specific discussions, aligning with problem-based, active learning pedagogical approaches which have proven more effective than lectures. Attendees found the format more engaging than virtual didactic lectures, but department-wide survey revealed a dichotomy of didactic priorities between faculty and trainees, with faculty more strongly favoring attendance convenience. WWYD is well-positioned to deliver a didactic educational experience with both engagement and convenience.
新冠疫情扰乱了外科医生个人生活和职业生涯的诸多方面，导致许多面对面教育机会暂停，转而青睐虚拟教育项目。为应对这些新挑战，我们开发、实施并评估了一种新颖的外科大查房方法，以满足住院医师的教育需求。
在与新冠疫情相关的限制措施开始时，教育领导层对住院医师教育进行了需求评估，从而迅速转向基于视频的课程安排。我们开发了“你会怎么做？”（WWYD）这一基于虚拟病例的教育课程。低年资住院医师与高年资住院医师、研究员和教员合作，制定特定疾病的病例和问题，然后提交给受邀的全国学科专家小组。每次大查房结束后，通过电子调查收集参会者的反馈，并根据调查回复、口头反馈和教育原则，对小组讨论流程和“翻转课堂”式提问进行迭代调整。在虚拟课程的第一年结束时，进行了一次全科室调查，以评估教员和学员对虚拟教学与面对面教学的看法。
虽然新冠疫情教育材料广泛可得，但需求评估发现，针对实习生的外科教育课程大幅减少。在24个月的时间里，我们举办了12次“你会怎么做？”课程，有20名内部教员和22名全国虚拟客座小组成员参与。“你会怎么做？”涵盖了核心外科主题，如疝气、结直肠、创伤、内分泌、血管、前肠和移植。每周的参会人数在40至100人之间，包括教员、学员和学生。与传统虚拟大查房相比，参加“你会怎么做？”大查房的参会者更强烈地认同演讲者沟通有效（93.7%对79.8%，p < 0.0001）、主题引人入胜（92.4%对78.5%，p < 0.0001）且相关（91.5%对79.7%，p < 0.0001）。全科室调查指出了教员和学员在教学课程优先事项上的差异，教员既认为虚拟教学更方便（强烈认同率为92.1%对71.4%，p = 0.004），也更看重便利性（高度看重率为89.7%对69.1%，p = 0.005）。
在隔离期间，“你会怎么做？”这种形式利用虚拟平台的优势，将不同的内容专家聚集在一起进行特定疾病的讨论，符合基于问题的主动学习教学方法，已被证明比讲座更有效。参会者发现这种形式比虚拟教学讲座更有吸引力，但全科室调查显示教员和学员在教学优先事项上存在二分法，教员更强烈地倾向于参会便利性。“你会怎么做？”在提供既有吸引力又方便的教学教育体验方面具有优势。
