Four Strategies for Plastic Surgery Education amid the COVID-19 Pandemic.

Abstract

Sir: It was with great interest that we read Kania et al.’s Viewpoint article proposing strategies for preserving and promoting plastic surgery training during the current health care crisis.1 Their recognition of the importance of striking the correct balance between the necessities of social distancing and fostering the progress of future plastic surgeons is laudable. Their first strategy for the involvement of said residents is to include them in decision-making surrounding patient care through daily briefings followed up with administrative tasks. This is undoubtedly an extremely effective strategy demonstrating a wise use of hospital resources by keeping residents constantly engaged with “normal” hospital activities, and could even perhaps be extended to a broader spectrum, such as online hospital multidisciplinary meetings (e.g., breast multidisciplinary teams). The second strategy adopted recognizes the need for surgical and manual abilities to be maintained and developed through a more hands-on approach and is likely based on the assumption that distance training would not cut the mustard.2 We commend the introduction of a dedicated resident space for such practice but would suggest that there are further ways in which this specifically designed task could be complemented by online tools. Indeed, despite the current use of video conferencing, we would offer that the current crisis calls for a more articulated learning approach most commonly referred to as blended learning.3 The current strategies adopted by Kania et al. propose asynchronous offline activities (assignments and a surgical laboratory) with the addition of synchronous online activities (daily briefings, online teaching, and lectures in the form of virtual grand rounds), which in our opinion could be even further enhanced to the benefit of the residents. Therefore, we propose the addition of the following: Offline asynchronous activities could also be accompanied by online asynchronous tasks. We believe this would be most beneficial for the surgical laboratory, whereby residents could be encouraged to use a “plastic surgery resident forum” (provided by the teaching hospital) to engage in discussion and, most importantly, the sharing of the skills acquired and difficulties encountered. This forum could even be monitored by senior consultants and professors who could provide input and surgical tips that would be specifically tailored to the residents’ learning needs. Introduce more team learning during synchronous didactics, whereby Zoom “breakout rooms”4 could be used to create smaller discussion groups, allowing professors to move among the rooms offering feedback and support, much like in a real-life classroom. A final consideration while looking toward the evolution of surgeons in training is the careful choice of the online software for security reasons, of particular importance from a medical perspective. Despite the undisputed benefits of Zoom, there have been concerns regarding so-called “bombing” facilitated by the meeting link being shared without caution. In this sense, we encourage the integration of blended learning to the current platforms in use but also call for prudence and perhaps the adoption of “closed” groups within organizations, such as those found in Microsoft Teams, with the aim of maintaining patient privacy. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication and have received no external support related to this communication. No funding was received for this work. Roxanne H. Padley, M.A.Department of HumanitiesPhD School of Literary, Linguistic, and Historical StudiesUniversity of SalernoSalerno, Italy Bruno Di Pace, M.D.Department of Medicine, Surgery, and Dentistry “Scuola Medica Salernitana”PhD School of Translational Medicine of Development and Active AgingUniversity of SalernoSalerno, ItalyPlastic and Reconstructive Surgery DepartmentAddenbrooke’s HospitalCambridge University HospitalsNational Health Service Foundation TrustCambridge, United KingdomAnglia Ruskin School of MedicineAnglia Ruskin UniversityCambridge and Chelmsford, United Kingdom