Plastic Surgery Lockdown Learning during Coronavirus Disease 2019: Are Adaptations in Education Here to Stay?

Remote Real-Time Training for Sustainable Cleft Operation in Rural Region of West Africa: Effective Webinar in the COVID-19 Pandemic

INTRODUCTION

The surgical requirement for cleft lip and palate repair remains unmet in many developing areas of the world, including remote regions of Ghana. This article reviews the utilization of Internet education and online consultation for cleft lip and palate surgical training in Sunyani Regional Hospital (SRH), Ghana.

METHODS

The cleft lip and palate treatment was promoted to patients in remote areas of Sunyani, Ghana region, through a charitable outreach program. These basic designs and settings were managed by local participants such as doctors, residents, nurses, and staff in SRH, Ghana.

RESULTS

From November 2014 to December 2020, the authors collaborated in surgical treatment for 84 cases that were diagnosed with unilateral cleft lip, bilateral cleft lip, hard and soft palate cleft, and microstomia. The type of surgery has varied and has included cheiloplasty, palatoplasty, and others. The average scores of esthetic outcome evaluation were nasal form=2.4, symmetry of the nose=2.9, and vermillion border=2.9. Through the program, the surgeons and residents became significantly more proficient at cleft lip and palate surgery. The seminar topics have covered essential and sustainable topics based on SRH's current needs and showed the effectiveness in the current coronavirus disease-19 pandemic situation.

CONCLUSIONS

The shortage of orofacial cleft surgeons working in rural areas like Sunyani, Ghana, remains an obstacle that poses a challenge to any effort to improve health care quality in these rural communities. Sustainable remote education is essential for the training of local cleft surgeons to fill this local need; our collaborative and charitable program could be a recommended education design for cleft surgeons and institutes for their sustainable education.

Development of Competencies in Oral and Maxillofacial Surgery Training

The goal of graduate surgical education is to ensure that the graduate is competent to practice in his or her chosen specialty. Traditionally, surgical learning has been based on an apprenticeship model; that is, the long-term observation and assessment of the trainee over a prolonged period of time. Patient expectations, work hour restrictions, and expectations of increased faculty oversight have led to decreased resident autonomy and independence. Graduates completing surgical training with less surgical autonomy may have lower clinical competence, which may affect patient safety, patient outcomes, and career satisfaction. This will require the modification of current assessment and training methods.

Impact of the Virtual Format on Plastic Surgery Residency and Fellowship Interviews: A National Cross-Sectional Study

BACKGROUND

The 2020-2021 residency and fellowship application cycles were profoundly affected by the introduction of virtual interviews (VIs). The authors investigate the impact that the virtual format (VF) had on plastic surgery residency and fellowship interviews from the perspectives of program directors (PDs).

METHODS

Surveys were sent to PDs of integrated plastic surgery residency (RPD) and fellowship (FPD) programs to ascertain their perspectives regarding the VF's impact on residency and fellowship interviews. PDs were stratified into residency and fellowship cohorts, and comparative analysis was performed.

RESULTS

A total of 92 PDs, 28 RPDs and 64 FPDs, completed our survey (35%). When compared to in-person interviews, VIs were reported to be more economical and time efficient by RPDs (100% and 46%, respectively) and FPDs (97% and 48%, respectively). Consequentially, 36% and 47% of residency and fellowship programs were able to interview more applicants, respectively. RPDs and FPDs reported that VIs hindered their ability to assess applicants' fit with the program (75% and 63%, respectively), personality and communication skills (75% and 64%, respectively), and commitment to the field along with their ability to function as a trainee (57% and 50%, respectively). Overall, 71% of RPDs and 58% of FPDs preferred in-person interviews. The majority of residency (71%) and fellowship (56%) programs intend to conduct both in-person and VIs in future application cycles (p=0.12).

CONCLUSIONS

Despite preferring in-person interviews, PDs intend on hosting both in-person and VIs in future application cycles. It remains to be seen how VIs will be employed moving forward.

Plastic Surgeons and their Financial Relationships with the Industry in the era of COVID: Insights from the Physician Payments Sunshine Act

BACKGROUND

The impact of the COVID-19 pandemic on physician relationships with industry and subsequent financial implications has not been previously assessed. The aim of this study is to compare pre- and post-COVID-19 payments between industry and medical providers for all plastic surgeons.

METHODS

Payment information was collected for the 2019 and 2020 reporting periods from the Open Payments Program (OPP) database for plastic surgeons and plastic surgeon subspecialists. An analysis was performed of trends and comparison of payments for each year for all plastic surgeons and each subspecialty cohort.

RESULTS

For all plastic surgeons, there was a decrease in industry payments between 2019 and 2020 (- 30.5%). All plastic surgery subspecialties had a decrease in payments with general plastic and reconstructive surgery affected the most (- 56%) and craniofacial surgery affected the least (- 9%). Payments for almost all categories for plastic surgeons decreased along with compensation as faculty or as speakers. Total charitable contributions and grant payments increased by 61 and 273%, respectively.

CONCLUSION

Analysis of industry-physician payments available through the Sunshine Act shows that the COVID-19 pandemic has significantly impacted industry payments to plastic surgery and its subspecialties. While this study demonstrates the economic impact of the current pandemic, only time will tell whether these trends will persist in the coming years.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Impact of COVID-19 Pandemic During Lockdown on the Veterinary Profession in Romania: A Questionnaire-Based Survey

The lockdown period in Romania lasted for 60 days and had the purpose of limiting the spread of SARS-CoV-2 virus outbreak and manage its consequences through emergency measures on many important areas of activity. This study aimed to gather, assess, analyze and disseminate relevant social, economic, and medical aspects on the impact of COVID-19 pandemic during lockdown on the veterinary profession in Romania. A survey was created using an online questionnaire platform, and disseminated. The survey was completed by a total of 409 individuals. A high number of respondents (71.64%; n = 293) felt exposed to medium or high risk of infection with SARS-CoV-2 at their workplace and many (56.97%; n = 233) felt that their professional environment was more stressful than usual during lockdown. Almost all respondents (89.73%; n = 367) declared the implementation of several control measures recommended by FECAVA and FVE (e.g., social distancing, wearing protective equipment, hand washing), but few mentioned the opportunity of remote work or visiting restrictions. Overall, the results show that the impact of lockdown lies directly on four main categories of importance on veterinarian professional's life—human resource, activity management, relationship between veterinarian and authorities, and continuing education.

Comparing Virtual to In-Person Delivery of Continuing Medical Education in Dementia Care: Which Is Preferred?

OBJECTIVES

There is limited understanding of learners' perceptions of virtual learning during the COVID-19 pandemic, as well as the use of virtual modalities for interprofessional education (IPE) in primary care. Four of 7 in-person annual "Booster Day" IPE sessions for health professionals working in primary care-based memory clinics in Ontario, Canada, were canceled when the pandemic was declared; these sessions were replaced with 2 sessions delivered via live-streamed videoconferencing. This study compares Booster Day session participants' perceptions of the in-person and virtual sessions and assesses their preferences for in-person or virtual sessions in the future.

DESIGN

Survey methodology.

SETTING AND PARTICIPANTS

Interprofessional primary care-based memory clinic team members attending 1 of 5 annual IPE events, 3 delivered in-person immediately prior to the COVID-19 pandemic and 2 subsequently delivered virtually via videoconferencing.

METHODS

Chi-squared test and analysis of variance was used to identify significant differences in reaction, attitude, and preference ratings between delivery modalities.

RESULTS

There were no significant differences in satisfaction, relevance, knowledge acquisition, and intentions to apply new knowledge between delivery modalities. Although attendance via videoconferencing was perceived as useful, enjoyable, engaging, and as more feasible to attend, it was rated as less enjoyable and perceived as having fewer opportunities for networking than in-person sessions. Most participants preferred in-person sessions.

CONCLUSIONS AND IMPLICATIONS

Quality engagement and networking, as afforded by in-person IPE, are highly valued by health professionals attending dementia-related education. IPE on complex health issues of the older people requiring interprofessional perspectives may be best suited to in-person formats.

The Experience of Virtual Interviews in Resident Selection: A Survey of Program Directors in Surgery

BACKGROUND

MATCH 2021 was short of the classic "in-person" component. Herein, we assess the impact of virtual interviews (VIs) on resident selection, from the perspectives of program directors (PDs) across all surgical specialties.

MATERIALS AND METHODS

We conducted a cross-sectional survey-based study of ACGME-accredited US residency program directors (PDs) of all surgical specialties. The survey was designed based on a review of relevant literature and inquired about the strengths, limitations, and overall utility of VIs.

RESULTS

A total of 365 PDs responded to our survey. Almost all respondents (90%) found VIs to be less expensive than in-person interviews, while only 34% agree that VIs were less time-consuming. Only a median of 5% of interviews was complicated by technical difficulties. Most PDs found it more challenging to assess applicants' fit (75%), personality and communication skills (71%), and commitment to specialty (60%). Only 14% found VIs to be overall better for assessing residency applicants. In future cycles, most PDs are planning to host both virtual and in-person interviews (57%), while 35% and 8% will host exclusive in-person and virtual interviews, respectively.

CONCLUSIONS

VIs are a novel way of dealing with the restrictions imposed by COVID-19. Despite their cost and time benefit, they present particular challenges in evaluating residency applicants. A combination of both virtual and in-person interviews will likely be implemented in the coming cycles.

Experimental Performance Evaluation of Enhanced User Interaction Components for Web-Based Collaborative Extended Reality

COVID-19-related quarantine measures resulted in a significant increase of interest in online collaboration tools. This includes virtual reality (VR) or, in more general term, extended reality (XR) solutions. Shared XR allows for activities such as presentations, training of personnel or therapy to take place in a virtual space instead of a real one. To make online XR as accessible as possible, a significant effort has been put into the development of solutions that can run directly in web browsers. One of the most recognized solutions is the A-Frame software framework, created by Mozilla VR team and supporting most of the contemporary XR hardware. In addition, an extension called Networked-Aframe allows multiple users to share virtual environments, created using A-Frame, in real time. In this article, we introduce and experimentally evaluate three components that extend the functionality of A-Frame and Networked-Aframe. The first one extends Networked-Aframe with the ability to monitor and control users in a shared virtual scene. The second one implements six degrees of freedom motion tracking for smartphone-based VR headsets. The third one brings hand gesture support to the Microsoft HoloLens holographic computer. The evaluation was performed in a dedicated local network environment with 5, 10, 15 and 20 client computers. Each computer represented one user in a shared virtual scene. Since the experiments were carried out with and without the introduced components, the results presented here can also be regarded as a performance evaluation of A-Frame and Networked-Aframe themselves.

Perception among ophthalmologists about webinars as a method of continued medical education during COVID-19 pandemic

PURPOSE

To ascertain ophthalmologist's perceptions about webinars as a method of continued medical education during the COVID-19 pandemic.

METHODS

In a cross-sectional study, a 21-question survey was circulated using digital media platform to approximately 1400 ophthalmologists in India between 16th August 2020 to 31st August 2020. The questionnaire focussed on the quality and usefulness of webinars based on the Bloom's taxonomy. The responses (on 4- or 5-point Likert scale) were analyzed among three professional groups- ophthalmologists in-training, consultants in public sector, and private practitioners.

RESULTS

393 ophthalmologists participated in the survey, with a response rate of 28%. The mean age was 34.6 ± 9.7 years, and males constituted 49.6% (199/393) of the respondents. Forty-seven percent of the respondents perceived the quality of webinars as good or excellent (185/393), 72.8% reported knowledge gain from webinars (286/393), and 63.9% felt that webinars are important in clinical practice and should continue post-COVID-19 pandemic (251/393), with distinct responses among the professional groups. The drawbacks perceived were overt number of webinars (371; 94.4%), confusion regarding which webinars to attend (313; 79.6%), repetition of the information (296; 75.3%), limited opportunity for participant interaction (146; 37.2%) and disparate weightage to the core disciplines of Ophthalmology.

CONCLUSION

Most respondents had favorable perceptions of Ophthalmology webinars happening during the COVID-19 pandemic. However, there is need for improvisation in the volume of webinars, target-audience-based delivery, and participant interaction to add value to this new dimension of teaching-learning.

Virtual Rotations During COVID-19: An Opportunity for Enhancing Diversity

The COVID-19 pandemic has presented unique challenges to medical education. With the lack of in-person away rotations for the 2020-2021 residency application cycle, virtual rotations have surfaced as an alternative. The virtual rotations that the authors participated in allowed for active participation in various resident educational activities such as journal club, grand rounds, and morning conferences. One critical aspect of virtual rotations was the one-on-one meetings with the program leadership. In addition to a virtual tour of the hospital and campus, many programs offered virtual social hours with the residents to converse about the program, the city, and the match process. A few programs even allowed applicants to attend virtually live-streamed surgeries. These rotations offer students, especially those without a corresponding home program, an invaluable opportunity to express their interest in a particular program and gain foundational knowledge about the specialty. Virtual rotations also provide underrepresented minorities and international medical graduates with clinical exposure, mentorship, and networking opportunities, mitigating some of the challenges presented by COVID-19.