A Systematic Review of Virtual Subinternships in Surgical Education: Impact on Curriculum Delivery and Learner Outcomes.

The COVID-19 pandemic forced an abrupt reevaluation of traditional subinternship models in surgical education, with the adoption of virtual subinternships (VSIs) emerging as a prominent response. This review assesses VSIs as a cost-effective, equitable alternative, especially as virtual education continues since the end of the Federal COVID-19 Public Health Emergency and may be crucial in future crises. Our research question asks how curriculum delivery, learner outcomes, and interpretation of program fit occur within the VSI model. A thorough systematic review was conducted across multiple databases, including PubMed, Web of Science, Google Scholar, and Embase, adhering to PRISMA guidelines, and spanning publications in English from January 2020 to June 2023. Studies were selected based on review of VSI curriculum content, delivery formats, evaluation techniques, and student outcomes. Exclusion criteria encompassed non-original research or articles lacking comprehensive curriculum descriptions and associated outcomes. We assessed bias in study selection through independent double review and synthesized findings using thematic analysis. Of 1436 articles, 13 met the inclusion criteria. They encompassed a range of surgical fields and highlighted the diverse approaches to VSI implementation. Key themes included the integration of interactive learning sessions, balance between imparting knowledge and program familiarization, and mixed methods of program evaluation. Despite high student satisfaction reported, faculty feedback indicated it was difficult to provide an evaluation of student skills in this context and more challenging to assess students' fit for residency programs. VSIs were effective in delivering curriculum and engaging learners, highlighting diverse implementation approach challenges in assessing student skills and program fit.