Reply

Abstract

We would first like to thank the students from the University of Manchester for their response to our letter and would also like to thank you for the opportunity to respond to their comments.1Akbari A.R. Sunmola O. Chillingworth J. Khan B. Exploring the benefits of virtual education for medical students.J Vasc Surg. 2021; 73: 1111-1112Google Scholar We will address as many of their concerns as possible. In response to the concern raised regarding the assessment, we acknowledge the inherent limitations of using an unvalidated assessment and agree that a recognized, validated, assessment would have been preferred. However, the circumstances rendered any alternative impossible at the time. The course had been assembled within a matter of weeks in response to the COVID-19 (coronavirus disease 2019) crisis in which U.S. medical students were temporarily, albeit immediately, barred from clinical duties. However, validating a formal assessment within that period was simply not feasible. In addition, we are unaware of any recognized, validated vascular surgery objective assessments (or multiple-choice question examination) we could have used as an alternative. Regarding their questions about the circumstances under which the students had completed the assessment, we trusted our students to adhere to the university honor code, which prohibits the use of study materials during any formal examination. Regarding the inquiry about the assessment content, we have attempted to include as much detail as is reasonable. The assessment consisted of 25 multiple-choice, board-style questions. The vast majority were accompanied by clinical vignettes and covered board-eligible material. The questions were written and approved by senior vascular surgery faculty to cover an appropriate breadth of content at an appropriate difficulty level for third-year medical students. The topics covered included the diagnosis and management of aortic dissection, acute limb ischemia, peripheral arterial disease, venous insufficiency, abdominal aortic aneurysm, and carotid atherosclerosis. In addition, several questions without clinical vignettes were included purely to assess the students' knowledge of vascular anatomy. In conclusion, our pilot project resulted from necessity and was not intended to provide any broad, definitive conclusions but, rather, to contribute the findings from a small cross-sectional study to the increasing reported data examining the efficacy of virtual medical education. Despite the limitations, we believe our experience in conducting virtual vascular surgery education has demonstrated feasibility, the aim of pilot projects, and is a useful starting point for other institutions requiring feasible, accessible, and creative solutions for continuing surgical education. Because this challenge is not unique to our institution, we would be more than happy to collaborate with students and faculty around the world to ensure virtual surgical education is implemented as effectively as possible in these times of global crisis.