Implementation and Evaluation of a Formal Virtual Medical Student Away Rotation in Orthopaedic Surgery During the COVID-19 Pandemic: A Single Institution Pilot Experience

Students' Perceptions and Lessons Learned From Virtual APPE Rotations: A Multi-Institutional Perspective

Objectives: The COVID-19 pandemic caused disruption in pharmacy experiential learning as clinical practice sites restricted student access to onsite rotations. Therefore, colleges of pharmacy across the country likely included virtual advanced pharmacy practice experiences (APPEs) to fulfill experiential education requirements. The objective of this paper is to evaluate students' perceptions of virtual APPEs during the 2020-2021 academic year. Methods: Experiential directors and faculty at 3 colleges of pharmacy in the south Florida region developed a survey to assess students' perceptions of their virtual APPE rotations during the 2020-2021 academic year. Students who took at least one fully virtual APPE rotation were asked about their perceptions of these rotations. Results: A total of 349 students were invited to take the survey and 92 (26.3%) completed the survey. Of these, 77 students (83.7%) completed at least one virtual rotation. These students completed a total of 152 virtual rotations, with elective and ambulatory care rotations being the most frequent. Most students agreed that rotation objectives were clear, and preceptors offered resources needed to be successful during the rotation. Responses regarding engagement during virtual rotations, rotation expectations being met, and rotations expanding students' knowledge were mixed. Conclusions: Virtual rotations may present unique experiential opportunities for students. Colleges of pharmacy and preceptors can benefit from additional guidance regarding how to incorporate virtual rotations into the experiential curriculum. Best practices for virtual rotations include high frequency of interactions with preceptors, clear objectives and responsibilities, and the use of a rotation calendar.

Augmented Web-based applicant experiences for anesthesiology away audition rotations: A systematic review of the current literature

Objective

The objective of this paper is to evaluate Augmented Web-based Applicant Experiences in the field of Anesthesiology. We hope to advocate for Augmented Web-based Applicant Experiences rotations and address their limitations in case in-person rotations become restricted again.

Methods

A thorough search of articles from the years 1978 to 2023 was completed using the search phrases "Away Rotations Anesthesiology," "Away Rotations Anesthesia," "Audition Rotation Anesthesia" and "Audition Rotation Anesthesiology." These search phrases were used on both the PubMed (Medline) and Excerpta medica database (EMBASE) databases, and the number of total articles that appeared was 73. These articles were then filtered to gather relevant articles for our study.

Results

After the articles were filtered, there was one remaining article that was used for our study. To supplement this article, 29 additional sources were added using the worldwide web. However, these did not address rotations in Anesthesiology. Although these other sources did not involve Anesthesiology residencies, they still provide significant perspectives that can be applied to online rotations. A total of 30 sources were used for our manuscript.

Conclusion

Although in-person rotations are preferred, Augmented Web-based Applicant Experiences rotations are valuable as they give residency programs an opportunity to evaluate students. Augmented Web-based Applicant Experiences rotations also provide students with learning opportunities and also help familiarize them with the residency programs. There are limitations that come with Augmented Web-based Applicant Experiences rotations. However, addressing these shortcomings can help Augmented Web-based Applicant Experiences rotations become a proper substitution for in-person rotations if they become restricted again.

Graduating Medical Students' Experiences with Away (In-Person and Virtual) Rotations During COVID-19: Analysis of the Association of American Medical Colleges (AAMC) 2021 Graduation Questionnaire (GQ)

OBJECTIVE

The COVID-19 pandemic disrupted students' opportunities for away rotations (ARs). Schools and specialty organizations innovated by supplementing in-person ARs (ipARs) with virtual ARs (vARs). We sought to determine how ipAR and vAR completion varied by intended specialty among 2021 graduates.

DESIGN

Using de-identified Association of American Medical Colleges 2021 Graduation Questionnaire (GQ) data, we examined AR completion by specialty and community-based school attendance (among other variables) in univariate analysis and multivariable logistic regression models.

SETTING

Students graduating from MD-degree granting U.S. medical schools were invited to complete the 2021 GQ, administered electronically on a confidential basis.

PARTICIPANTS

Our study included data for 15,451 GQ respondents (74% of all 2021 graduates).

RESULTS

Among GQ respondents, 18% (2,787/15,451) completed ARs: 8% (1,279/15,451) ipAR only, 8% (1,218/15,451) vAR only, and 2% (290/15,541) both. In univariate analysis, specialty and community-based school attendance (each p < 0.001), among other variables, were associated with ipAR and with vAR. In multivariable logistic regression, surgical specialties associated with greater odds of AR completion (vs. general surgery reference) included neurological surgery (ipAR: adjusted odds ratio [AOR]=1.9, 95% confidence interval [CI]=1.1-3.3; vAR AOR=3.1, 95% CI=1.9-4.9), ophthalmology (ipAR: AOR=2.3, 95% CI=1.6-3.3; vAR: AOR=2.5, 95% CI=1.7-3.7), orthopedic surgery (ipAR: AOR=2.5, 95% CI=1.8-3.4; vAR: AOR=12.4, 95%CI=9,2-16.5), otolaryngology (ipAR: AOR=1.8, 95% CI=1.2-2.8; vAR: AOR=4,8, 95% CI=3.4-6.9), plastic surgery (ipAR: AOR=2.1, 95% CI=1.2-3.5; vAR: AOR=13.9, 95% CI=9.3-20.7) and urology (ipAR: AOR=2,1, 95% CI=1.4-3.2; vAR: AOR=11.9, 95% CI=8.4-16.8). Community-based medical school attendance was also associated with greater odds of ipAR (AOR=4.6, 95% CI=3.1-6.7) and vAR (AOR=1.8, 95% CI=1.4-2.3).

CONCLUSIONS

The prevalence of AR completion was low. Differences we observed by specialty and medical school type aligned well with recommended circumstances for ipARs for the class of 2021. Substantial specialty-specific differences in vAR completion suggest that various surgical specialties were among the early innovators in this regard.

Assessing the Impact of COVID-19 on the 2021 Orthopaedic Surgery Match Outcomes

The purpose of this study was to assess the influence of the COVID-19 pandemic on the 2021 orthopaedic surgery residency match outcomes. Because in-person away rotations and interviews were canceled during the 2020 to 2021 application cycle, we hypothesized that applicants would match at their home program at a higher rate in 2021 than in previous years.

Methods

We queried allopathic orthopaedic surgery residency websites and social media accounts for names of residents and medical school information for cohorts matching from 2017 through 2021. To assess availability of and participation in virtual away rotations, we administered a survey to Accreditation Council for Graduate Medical Education-accredited allopathic orthopaedic surgery residency programs. The primary outcome was the annual proportion of applicants matching at the program affiliated with their medical school ("home program"). Subgroup analyses were stratified by Doximity reputation ranking and availability of a virtual away rotation.

Results

We identified 2,632 residents who matched between 2017 and 2020 and 698 residents who matched in 2021. Overall home program match rate and likelihood of home matching were higher in 2021 compared with 2017 to 2020 (28% vs. 20%; odds ratio [OR] = 1.51, 95% confidence interval [CI] 1.24-1.82, p < 0.001). The increase in the home match rate at programs ranked in the top 30 (27% vs. 20%, p = 0.034) was similar to the increase at programs ranked outside the top 30 (28% vs. 20%, p < 0.001). Of the 66 (48%) programs that responded to the survey, 16 (24%) offered a virtual away rotation. Programs with a higher Doximity ranking were more likely than lower-ranked programs to offer a virtual away rotation (OR = 6.75, 95% CI 1.95-23.4, p = 0.003). Home match rates did not differ significantly between programs that offered a virtual away rotation and those that did not (26% vs. 32%, p = 0.271).

Conclusions

A higher proportion of orthopaedic surgery residency applicants matched at their home program in 2021 compared with previous years. Limitations on in-person activities due to the COVID-19 pandemic may have contributed to this rise.

Level of Evidence

N/A.