Virtual Rotation Research Articles

VoLearn

Conventional motion tutorials rely mainly on a predefined motion and vision-based feedback that normally limits the application scenario and requires professional devices. In this paper, we propose VoLearn, a cross-modal system that provides operability for user-defined motion learning. The system supports the ability to import a desired motion from RGB video and animates the motion in a 3D virtual environment. We built an interface to operate on the input motion, such as controlling the speed, and the amplitude of limbs for the respective directions. With exporting of virtual rotation data, a user can employ a daily device (i.e., smartphone) as a wearable device to train and practice the desired motion according to comprehensive auditory feedback, which is able to provide both temporal and amplitude assessment. The user study demonstrated that the system helps reduce the amplitude and time errors of motion learning. The developed motion-learning system maintains the characteristics of high user accessibility, flexibility, and ubiquity in its application.

Single-Center Evaluation of a Virtual Vascular Surgery Rotation in Retention of Knowledge and Skills

Virtual vascular surgery rotations are helpful in allowing students to explore their interests in the field of vascular surgery when they do not have in-person access. However, little is known about the retention of knowledge and manual skills learned from those virtual rotations and the subjective effectiveness of the activities during virtual rotations. We performed a long-term follow-up study of knowledge and skills retention after a virtual vascular surgery rotation and subjective effectiveness of the activities during a virtual rotation.

Evaluation of an interactive virtual surgical rotation during the COVID-19 pandemic.

ObjectiveTo evaluate medical student and attending surgeon experiences with a novel interactive virtual Otolaryngology ‐ Head and Neck Surgery (OHNS) medical student elective during the COVID‐19 pandemic.Study DesignA virtual OHNS elective was created, with three components: (1) interactive virtual operating room (OR) experience using live‐stream video‐conferencing, (2) telehealth clinic, (3) virtual didactics.SettingOHNS Department at the University of Pennsylvania (May 2020 to June 2020).MethodsSix medical students from the University of Pennsylvania; five attending otolaryngologists. Two surveys were designed and distributed to participating medical students and attending surgeons. Surveys included 5‐point Likert scale items, with 1 indicating “not at all” and 5 indicating “very much so”.ResultsResponse rate was 100% for both surveys. Students on average rated the educational value of the telehealth experience as 4.2 ± 1.2, and the virtual OR experience as 4.0 ± 0.6. Most students (n = 5, 83%) indicated that they had enough exposure to faculty they met on this rotation to ask for a letter of recommendation (LOR) for residency if needed, while attending surgeons had an average response of 3.0 ± 1.0 when asked how comfortable they would feel writing a LOR for a student they met through the rotation. A majority of students (n = 4, 67%) felt they connected enough with faculty during the rotation to ask for mentorship. Half the students (n = 5, 50%) indicated that the rotation allowed them to evaluate the department's culture either “extremely well” or “somewhat well”.ConclusionsOverall, participating students described this innovative virtual surgical rotation as an educationally and professionally valuable experience. With the continued suspension of visiting student rotations due to the COVID‐19 pandemic, this virtual model may have continued relevance to medical education.

Third year medical student knowledge gaps after a virtual surgical rotation

IntroductionThis study describes perceived knowledge gaps of third-year medical students after participating in a virtual surgical didactic rotation (EMLR) and shortened in-person surgery rotation during the COVID-19 Pandemic. MethodsOpen-ended and Likert questions were administered at the end of the virtual rotation and inperson-surgical rotation to medical students. Three blinded coders identified themes by semantic analysis. Results82 students (51% of all MS3s) participated in the EMLR. Semantic analysis revealed gaps in perioperative management (Post-EMLR:18.4%, Post-Inpatient:26.5%), anatomy (Post-EMLR:8.2%, PostInpatient:26.5%). and surgical skills (Post-EMLR: 43.0%, Post-Inpatient: 44.1%). Students also described gaps related to OR etiquette (Post-EMLR: 12.2%, Post-Inpatient: 8.8%) and team dynamics/the hidden curriculum (Post- Inpatient:26.6%). There was a significant improvement in perceived confidence to perform inpatient tasks after completing the inpatient clinical experience (p ≤ 0.01). ConclusionVirtual interactive didactics for cognitive skills development cannot replace a full clinical surgical experience for third-year medical students. Future curricula should address perceived gaps.

Calibration of beam vector deviation for four-axis precision on-machine measurement using chromatic confocal probe

On-machine measurement based on chromatic confocal principle is an effective method for quality control in precision manufacturing. However, angular misalignment between the measurement axis and the optical axis of probe will introduce cosine error, and the probe offset will cause rotational deviation. These alignment errors, which negatively affect measurement accuracy, are represented by beam vector deviations. In this paper, the influence of the beam vector deviation is first quantitatively analyzed. Then, an effective calibration method using standrad parts is proposed. The accuracy of the calibration method is verified by measuring standard sphere profile, and the uncertainty considering indication error, random error, sampling strategy and fitting optimization algorithm is evaluated. The feasibility of the proposed method is demonstrated by practical on-machine measurement experiments of a typical high-gradient freeform surface. Trajectory deviation is corrected based on virtual rotation center planning. The results agree well with offline measurements.

Type Synthesis Based on Modular Combination with Virtual Rotation Center and Application

Type synthesis of mechanical structure is of great significance to the realization of mechanism target function, systematization, and stability of mechanical device. The type synthesis method of multilinkage robot has been given high demands with increasing number of degrees of freedom and high flexibility in special occasions. In order to improve the workspace and flexibility of mechanism, this paper studies the existing type synthesis theory and proposes a type synthesis method of modular combination with virtual rotation centers. Firstly, modular units are built. Secondly, modular units are expanded according to the needed paths. In the end, the expanded modular units are combined to form the kinematic linkages. Based on the proposed method, the configuration design of the aerial working platform and the self-adaptive levelling platform is completed. The stabilities of two platforms are checked by modal analysis. The prototype products are manufactured, respectively, for further verifying validity of the method. The designed aerial working platform with virtual rotation centers can achieve 360° rotating large workspace, more compact mechanical structure, and short arrival time at the same height than the common scissor-type and mast-type aerial working platforms. The designed adaptive levelling platform is tested that ensures the levelling of the upper surface at different inclinations. The method can provide new idea for the mechanism configuration and expand the application scope of new mechanisms.

A MEMS Rate-Integrating Gyroscope (RIG) With In-Run Automatic Mode-Matching

Toward the objective of eliminating the angle error and rate threshold of the rate integrating gyroscope (RIG) caused by stiffness asymmetry, a novel in-run automatic mode-matching method is presented in this paper. Although other manual mode-matching methods can reduce the stiffness asymmetry temporarily, the environmental factors will interfere the manual calibration. Combined with virtual rotation, the processing circuits obtain the resonant frequencies of RIG operation modes and a controller is used to reduce the frequency difference. Meanwhile, an innovative method is proposed for RIG angle error analysis, avoiding the drawbacks of the traditional analysis methods. An FPGA based platform using a MEMS disk resonator is tested and the angle error is reduced to 1 degree compared with the manual calibration result 6.1 degrees.

Live-streaming otolaryngology surgical procedures for virtual medical student rotations.

The coronavirus disease 2019 pandemic created challenges in surgical education that expedited the development of virtual learning. Virtual rotations have been one such solution. However, they require co-ordination and technological equipment to create a meaningful, interactive experience for students. Various otolaryngology surgical procedures were live-streamed during a two-week virtual rotation for medical students. A mobile audiovisual cart comprising a computer mounted with a webcam and microphone/speaker were utilised to live-stream from four sources: video-assisted telescope operating monitor ('VITOM') exoscope, microscope, endoscope and room camera. A dedicated faculty member, who was not the operating surgeon, was present to facilitate students' understanding of the procedure. A wide breadth of otolaryngology surgical procedures were live-streamed via a mobile audiovisual computer, including views of the room, endoscopic views, microscopic views and open views via an exoscope (video-assisted telescope operating monitor). This virtual rotation set-up, along with the dedicated faculty facilitator, reduced the burden on the operating surgeon and enhanced students' learning experience.

Implementation and Evaluation of a Formal Virtual Medical Student Away Rotation in Orthopaedic Surgery During the COVID-19 Pandemic

Category:OtherIntroduction/Purpose:Away rotations are a valuable experience for medical students when applying for residency. However, in light of the ongoing coronavirus disease 2019 (COVID-19) pandemic, traditional in-person away rotations were largely suspended during the 2020-2021 residency application cycle. As such, there has been significant interest in the development of virtually-based substitutes. The purpose of this study is to evaluate the utility of a formal virtual fourth year medical student away rotation in orthopaedic surgery by surveying student, resident, and faculty participants.Methods:A two-week virtual orthopaedic elective was offered to fourth-year medical students from outside institutions in lieu of a traditional in-person away rotation. The course was conducted via online video conferencing and consisted of multiple components including nightly subspecialty case-based didactics, weekly social events with residents, assigned resident mentors, student case presentations, and the ability to attend the residency's daily conferences. Following course completion, anonymous surveys were administered to students as well as resident and faculty participants to evaluate the rotation. 23 of 24 participating students (96%) completed the student survey and 22 of 24 participating faculty and residents (82%) completed the resident/faculty survey.Results:Most students were very (87%) or somewhat satisfied (9%) with their experience and found the virtual rotation to be a very (35%) or somewhat useful (61%) substitute for in-person rotations. Students indicated the virtual rotation very (91%) or somewhat positively (9%) influenced their perception of the residency. All students indicated the rotation was very educational. Most students (91%) reported the rotation was very useful for learning about the program and culture, with the subspecialty didactics and happy hours being the most useful. Faculty and residents indicated the virtual rotation was useful for getting to know the students, with resident mentoring and case presentations most useful. Faculty and residents reported the rotation was useful for assessing student characteristics such as knowledge base and interpersonal communication skills. Students' qualitative responses highlighted the small group size, educational value, quality of interactions with residents/faculty, and opportunities for participation as positive features of the rotation.Conclusion:A well organized, formal virtual orthopaedic surgery away rotation can be a valuable experience for medical students that provides educational value, insight into a program's culture, and an opportunity to demonstrate interest in the program. Virtual rotations can also be useful tool for residencies to share information about their program and learn more about prospective applicants. Features such as dedicated subspecialty case-based didactics, resident social events and mentoring, student case presentations, and small group formats are recommended to maximize value.

Selecting the Next Class: The "Virtual Orthopaedic Rotation".

Introduction:When the COVID-19 pandemic forced the cancellation of visiting subinternships, we pivoted to create a virtual orthopaedic rotation (VOR). The purpose of this study was to assess the effect of the VOR on the residency selection process and determine the role of such a rotation in the future.Methods:A committee was convened to create a VOR to replace visiting orthopaedic rotations for medical students who are interested in pursuing a career in orthopaedic surgery. The VOR was reviewed and sanctioned by our medical school, but no academic credit was granted. We conducted three 3-week VOR sessions. During each session, virtual rotators participated in regularly scheduled educational conferences and attended an invitation-only daily conference in the evenings that was designed for a medical student audience. In addition, students were paired with faculty and resident mentors in a structured mentorship program. Students' orthopaedic knowledge was assessed using prerotation and postrotation tests.Results:From July to September 2020, 61 students from 37 distinct medical schools participated in the VOR. Notable improvements were observed in prerotation and postrotation orthopaedic knowledge test scores. In postrotation surveys, both students and faculty expressed high satisfaction with the curriculum but less certainty about how well they got to know each other. In the subsequent residency application cycle, 27.9% of the students who participated in the VOR were selected to interview, compared with 8.7% of the total application pool.Discussion:The VOR was a valuable substitute for in-person clinical rotations during the COVID-19 pandemic. Although not likely to be a replacement for conventional away rotations, the VOR is a possible adjunct to in-person clinical rotations in the future.

A Novel Interactive Virtual Medical Student Clinical Rotation for Ophthalmology

Abstract Objective This article describes a novel clinical rotation that uses technology to create a remote ophthalmology learning experience with the goal of improving virtual exposure to medical and surgical ophthalmic training for medical students. Methods Our unique curriculum incorporates mobile-mounted tablets which allow students to virtually participate in inpatient consults, clinic, and ophthalmic surgery. An adaptable mounting device attached to the slit lamp allows students to observe examinations in real time, enhancing recognition of ocular pathologies. Students participate in a robust curriculum that includes independent learning modules, video lectures, interactive modules, podcasts, and surgical video rounds. Students engage with residents and faculty in interactive-guided lectures and case-based discussions that focus on the American Academy of Ophthalmology white paper teaching objectives. Students are mailed surgical instruments and participate in surgical modules and faculty-led virtual wet laboratories. Results Our unique virtual curriculum combines didactic learning, interactive content, and novel technology applications such as mobile tablets, slit lamp-mounted devices, and faculty-led virtual wet laboratories. Conclusion Virtual technologies can be utilized to enhance ophthalmology medical student education in a safe and effective way during the coronavirus disease 2019 pandemic, and to improve educational access in the future.

Connected and automated vehicle distributed control for on-ramp merging scenario: A virtual rotation approach

This study proposes a rotation-based connected automated vehicle (CAV) distributed cooperative control strategy for an on-ramp merging scenario. By assuming the mainline and ramp line are straight, we firstly design a virtual rotation approach that transfers the merging problem to a virtual car following (CF) problem to reduce the complexity and dimension of the cooperative CAVs merging control. Based on this concept, a multiple-predecessor virtual CF model and a unidirectional multi-leader communication topology are developed to determine the longitudinal behavior of each CAV. Specifically, we exploit a distributed feedback and feedforward longitudinal controller in preparation for actively generating gaps for merging CAVs, reducing the voids caused by merging, and ensuring safety and traffic efficiency during the process. To ensure the disturbance attenuation property of this system, practical string stability is mathematically proved for the virtual CF controllers to prohibit the traffic oscillation amplification through the traffic stream. Moreover, as a provision for extending the virtual CF application scenarios of any curvy ramp geometry, we utilize a curvilinear coordinate to model the two-dimensional merging control, and further design a local lateral controller based on an extended linear-quadratic regulator to regulate the position deviation and angular deviation of the lane centerlines. For the purpose of systematically evaluating the control performance of the proposed methods, numerical simulation experiments are conducted. As the results indicate, the proposed controllers can actively reduce the void and meanwhile guarantee the damping of traffic oscillations in the merging control area.

Cross-Sectional Survey of Students and Instructors on Virtual Dermatology Teaching in a Competency-based Format

Background
 Due to the COVID-19 pandemic in the Spring of 2020, the dermatology rotation at the Penn State College of Medicine was converted into a 4-week virtual format. Given these rapid changes, we aimed to assess student and instructor satisfaction to the virtual course and if the course fulfilled the six ACGME core-competencies for medical student education required in a traditional teaching format.
 
 Methods
 We conducted a cross-sectional study to assess PSCOM student and instructor satisfaction to the elective. Surveys specifically inquired about course learning objectives, interaction, and teaching in the virtual setting based on a 5-point Likert scale and asked to provide qualitative feedback.
 
 Results
 Medical students (n=15, response rate=52%) were satisfied with learning objectives geared towards the ACGME core competencies in five of the six competencies. Instructors (n=7, response rate=58%) reported satisfaction with convenience, university support, and technical training, but less with student-to-student interaction, gauging comprehension, and fostering critical thinking. Qualitative feedback reflected these results.
 
 Conclusions
 From our survey data, students and instructors were generally satisfied with the virtual rotation’s dermatology teaching during the uncertain times of the COVID-19 pandemic and holds potential to expand dermatology education, with a future focus on improving student engagement in a virtual format.

Plastic Surgery Away Rotations During the Coronavirus Disease Pandemic: A Virtual Experience.

Plastic surgery has traditionally been a specialty that places a strong emphasis on away rotations during the final year of medical school. These rotations allow the program and residency candidates to become better acquainted and are often crucial, as a large portion of applicants match at programs where they rotated. The coronavirus disease 2019 (COVID-19) pandemic forced many institutions to modify their educational curriculums when away rotations were canceled. We present our experience creating and implementing a virtual plastic surgery rotation. Our virtual program was designed to mirror the in-person away rotations as much as possible. Prerotation and postrotation surveys from the students as well as feedback interviews with the students, residents, and faculty were used to gather information on the experience. We created a 2-week curriculum including approximately 20 hours of lecture time, 28 hours of operating room time, 2.5 hours of one-on-one mentorship, and 3 hours of social opportunities. Students reported that they learned more about plastic surgery and the residency program, but in contrast to this, some found it difficult to make an impression. We developed a novel 2-week virtual curriculum that provided visiting medical students from across the country an opportunity to learn more about plastic surgery and our residency program. Virtual learning is becoming a vital part of education, and our study provides pearls and pitfalls when structuring these experiences.

A Student in My Pocket: Development of a Virtual Internal Medicine Hospital Rotation During the COVID-19 Pandemic.

Purpose: It is imperative for physician assistant (PA) students to be exposed to hospital medicine as 40% of practicing PAs identify the hospital as their principal clinical practice setting. 1 Many of these rotations were canceled due to the COVID-19 pandemic, negatively impacting the 70% of PA programs not affiliated with an academic medical center. 2 To address this need and provide a comparable experience for PA students, medical educators at the University of Chicago created a Virtual PA Rotation (VPAR). The purpose of this project was to develop a high-yield clinical rotation for private PA programs negatively impacted by COVID-19 by implementing and evaluating a 4-week-long VPAR comprising (1) direct patient care, (2) medical educator-facilitated breakout sessions, and (3) asynchronous learning. Approach: Five students worked with 3 preceptors for the VPAR and were assigned 3–6 patients daily. Direct patient experiences included virtual interviews using FaceTime, preceptor staffing via Zoom, and completion of daily progress notes. This was augmented with medical educator-facilitated breakout sessions and didactic sessions. Evaluation of the VPAR included: (1) comparison of virtual vs traditional in-person rotation patient logs, (2) postcurriculum survey of students and medical educators’ satisfaction and self-efficacy, and (3) student pass rate on the end of rotation (EOR) examination. Outcomes: Diagnoses and patient encounter logs were collected from the 5 virtual rotation students and compared with 4 students who completed traditional in-person rotations in 2019–2020. Mean diagnoses logged per virtual student was 206 (standard deviation [SD] = 155), compared with mean 414 diagnoses (SD = 130) for traditional students (t = 2.14, P = .07). Mean patient encounters logged per virtual student was 34.2 (SD = 20.7), compared with 80.8 (SD = 29.5) for traditional students (t = 2.79, P = .03). One hundred percent of students responded to a survey. Interactive patient interviews, preceptor group, case presentations, and electronic health record review were rated as the most useful educational experiences. Students felt most prepared in ability to review hospital charts, analyze results, and obtain a patient history. All 5 students felt this rotation provided an adequate experience to understand Internal Medicine in a hospital setting. Fifty-nine percent (13/22) of medical educators responded to the postrotation survey. Eighty-five percent (11/13) were moderately or extremely satisfied with their participation in teaching in the rotation, 77% (10/13) were moderately or extremely likely to recommend the rotation to other medical educators, and 100% felt it made them more open to future interprofessional education experiences. Discussion: We were able to create an innovative, high-yield hospital medicine rotation to meet the need for PA students negatively impacted by COVID-19. The VPAR overall was a success as measured by 100% EOR examination pass rate, high student ratings, and comparable patient encounters and diagnoses. The VPAR was also well received by medical educators, though most felt it was more time-consuming, proving to be the biggest limitation to this model. Lessons learned from the preceptors included limitations of technology such as decreased device battery life, need for troubleshooting, and loss of organic educational experiences for students. They also highlighted concerns regarding increased time dedicated to logistics of the rotation while managing highly complex patients. Strengths of the VPAR include its feasibility, low cost of implementation, and ease of application of this model to other practice settings, specialties, and professions. The VPAR also has the capability to adjust for different rotation lengths of time. Significance: We believe the results above showcase that this innovative model of education can meet the needs of PA students negatively impacted by COVID-19. Therefore, as COVID-19 continues and health systems respond, a VPAR is a reasonable alternative to in-person clinical rotations. Beyond COVID, this pilot rotation’s success demonstrates that VPARs or a hybrid of a virtual and in-person rotation may be an interesting addition to PA education, particularly for unaffiliated programs with a significant need for access to inpatient rotations and tertiary care centers. Furthermore, this model could easily translate to other professional disciplines similarly impacted by visiting student restrictions.

Implementing Live Virtual Surgery in the COVID Era: Overcoming Medicolegal, Technical, and Educational Hurdles.

Due to current health concerns related to the coronavirus disease of 2019, remote learning has been adopted at every academic level. In congruence with policies drafted by academic surgical societies, a majority of medical schools nationwide have decided against accepting visiting medical students.1,2 As such, there has been an emergence of virtual adaptations of educational sessions and clinical rotations across a variety of medical specialties.3,4 Because surgical education occurs primarily in the operating room, adopting a virtual model for surgical education presents distinct challenges. At the Yale School of Medicine, we designed the first virtual surgical rotation format to center around livestream plastic surgeries across key areas of the specialty.5 Successfully implementing this teaching modality required overcoming medicolegal challenges, the logistical and technical details involved in the creation of this educational modality, and educational hurdles. In coordination with the Yale School of Medicine and the Yale Graduate Medical Education office, the virtual rotation was registered as a formal course for credit through the Association of American Medical College’s Visiting Student Application Service, identical to in-person visiting electives. By formally registering for the virtual rotation through the Visiting Student Application Service, virtual rotators met the same medical malpractice liability coverage and Health Insurance Portability and Accountability Act requirements as in-person rotating subinterns. Many of the participating students used the virtual rotation toward clinical credit for their graduation requirements. In addition, patients completed written consent forms for the hospital and university, giving permission to livestream surgery. (See Document, Supplemental Digital Content 1, which shows the photographic consent form for patients agreeing to participate in the livestream surgery, https://links.lww.com/PRS/E735.) These steps enabled clinical information to be shared freely with students in a remote learning environment. The technical challenges included high-quality visual capture of the surgery, real-time transmission to enrolled students, and real-time interactive communication between students and the surgical team. For image capture, we utilized a high-definition resolution, loupe-mounted camera with two-times and three-times magnification options. Loupe magnification enabled optimal macro image transmission for viewing of detailed surgical anatomy. For more macroscopic surgeries, a nonmagnified camera would be preferable. The high-definition camera captured images onto a computer that livestreamed images to the virtual participants using a Zoom platform (Zoom Video Communications, San Jose, Calif.) with password protection. To enable real-time two-way communication, speakers were strategically placed in the operating room to allow faculty and students to continuously discuss the case (Figs. 1 and 2).Fig. 1.: Setup of the live-stream surgery, with images transmitted to participants via Zoom, with password protection and communication between surgeon and applicants in real time.Fig. 2.: High-definition resolution, loupe-mounted camera was used for the video streaming of the procedures from the surgeon point of view.The virtual surgery curriculum included one live surgery per day spanning the breadth of plastic surgery, which replicated many of the benefits of being physically present in the operating room. Students could view a surgery step by step from the attending’s viewpoint. In addition, a multitude of students can simultaneously participate in the same case, unlike with in-person rotations. Participants were able to reference case-relevant study materials during the operation, which may enhance understanding of the procedure. The development of live virtual surgery poses some initial challenges, but ultimately it can be replicated with ease to create a surgical rotation more authentic to the in-person experience as pandemic restrictions continue. By elucidating the process by which we implemented livestreamed surgeries, other interested institutions will be able to easily traverse the necessary medicolegal and technical aspects of constructing similar models.

Multi-Institutional Virtual Medical Student Clerkship in Radiation Oncology

<h3>Purpose/Objective(s)</h3> Medical student education in radiation oncology traditionally takes place in-person during 3^rd or 4^th year of medical school. Due to the COVID-19 pandemic, onsite clerkships were placed on hold, leading to virtual medical student clerkships in radiation oncology which incorporated didactics and hands-on learning. We sought to implement this virtual medical student clerkship in radiation oncology at multiple institutions and analyze the impact and utility of this platform. <h3>Materials/Methods</h3> An IRB-approved virtual clerkship was created and implemented at 7 institutions. Students enrolled in home or away rotations. Clerkships offered general and disease subsite-specific oncology topics through recorded didactics geared towards medical students on www.radoncvirtual.com, as well as clinical vignettes, telehealth visits, chart rounds, contouring, and capstone presentations. Surveys were given pre- and post-clerkship to assess baseline comfort and knowledge. At the end of each clerkship, a course exam was given consisting of 48 questions. Clerkship directors were given a survey to assess comfort and ease of implementing the virtual clerkship. Surveys and course exams were analyzed using Wilcoxon Signed rank test and t-test, 2-sided. <h3>Results</h3> Seventy-two (72) students enrolled at 7 institutions between 4/2020 and 2/2021. Survey response rates were 100% pre- and post-clerkship as well as from course directors. The majority of students were MS4 (57%) and MS3 (33%) with equal distribution in gender. Each institution's median number of total medical students doing an away rotation was 4 (range 3-9) and home rotation number of students 2 (range 0-36). The median length of each virtual rotation was 2.5 weeks (range: 1-4 week). 71% (n = 51) of medical students had never previously enrolled in a radiation oncology elective. Improvements in the overall knowledge of radiation oncology, as well as specific knowledge in the scope of radiation oncology, roles of radiation physicist, dosimetrist and therapist, contouring, treatment planning, and training path to the field (all <i>P</i> < 0.001). There was no significant difference in course final exam scores between students who had attended a radiation oncology elective before enrollment and those who had not (<i>P</i> = 0.27). Course directors reported spending an additional 5-10 hours per week with students. The survey revealed 100% were satisfied with content and delivery of this virtual elective, and 83% (n = 6) indicated they would utilize the material for future rotations. <h3>Conclusion</h3> Implementation of a multi-institutional virtual radiation oncology elective was successful at improving knowledge for medical students at all levels, even those that had exposure previously. This virtual elective platform can be utilized to improve access to multiple institutions, resources, mentors, and networking opportunities. Resources in the virtual rotation platform can also be integrated into traditional educational paradigms to increase exposure in the field.

Multi-Institutional Outcomes and Perspectives From Medical Students After Virtual Radiation Oncology Electives

<h3>Purpose/Objective(s)</h3> Applications in radiation oncology residency have been on the decline in the past 3 years. This was attributed in part due to limited exposure to the field. We hypothesize that improving medical student enrollment into radiation oncology electives through virtual clerkships will increase interest and knowledge in the field. <h3>Materials/Methods</h3> IRB-approved surveys were distributed via a data collection web application to medical students who attended virtual radiation oncology clerkships offered at 7 academic institutions. The surveys consisted of a series of fixed-response, checkboxes, and open-ended questions. The open-ended responses were grouped into common themes. Surveys were analyzed with 2-sided t-tests and Wilcoxon rank test. <h3>Results</h3> Seventy-two (72) medical students from 7 institutions were sent a survey 1-7 months after completing the clerkship. Response rate was 54.1% (n = 39). 69.2% (n = 27) of respondents were MS4 and 30.8% (n = 12) were MS3 with equal distribution in gender. The median length of the elective rotation was 2 weeks (range 1 to 4). 69.2% (n = 27) of the respondents attended one virtual elective, 10.3% (n = 4) attended 2 virtual electives, and 20.5% (n = 8) more than 2 virtual electives. Majority (88.9%) of students attended the elective entirely virtually and 11.1% a combination of virtual and on-site rotation. 30.8% (n = 12) of the respondents, all of whom were MS4, planned on or applied for radiation oncology residency to an average of 59.5 (range 40-89) programs. 92% (n = 11) of these radiation oncology applicants were interviewed in at least one of the programs in which they attended a virtual away rotation. Students who applied to radiation oncology residency attended a median of 3 electives (range 2-4) while those who did not apply, a median of 1 elective (<i>P</i> < 0.001). There was a significant increase in interest in the field after the rotation among the students who applied or planned to apply (<i>P</i> = 0.002) and all respondents (<i>P</i> < 0.05). None of the MS3 respondents planned to apply to radiation oncology and 55.6% (n = 15) of MS4 respondents also did not apply or plan to apply to the field. 93% (n = 37) of respondents stated the elective was valuable for their future practice. 100 % (n = 39) of medical students indicated they were likely or most likely to recommend the virtual elective to other medical students. <h3>Conclusion</h3> Virtual radiation oncology electives have increased access to home and away rotations for medical students. The number of electives attended correlated with the interest of the student in the field and residency applications. Although a majority of medical students who took a virtual elective did not apply in radiation oncology, all recommended the elective and felt that the elective added valuable knowledge to their future practice, even outside of radiation oncology. Virtual elective platforms can improve education, awareness, exposure in radiation oncology as well as augment in-person rotations for medical students.

The Development of a Virtual Sub-internship in Plastic Surgery during the COVID19 Pandemic

INTRODUCTION: The COVID19 pandemic forced many institutions to modify their educational practices and experiences, including halting visiting rotations for senior medical students. These rotations provide opportunities for both programs and students to meet one another, and allow for students to gain clinical and didactic knowledge in a subspecialty field. A number of previous studies have shown that a large portion of medical students match at an institution at which they rotated.1–3 However, with social distancing and travel restrictions, outside medical students were unable to visit our institution. In light of this, our section felt it was necessary to develop a virtual curriculum to provide a similar experience. The aim of this study was to share our experience and feedback from students, residents, and faculty. METHODS: The virtual rotation design mirrored that of our in-person rotation and included a mix of lectures, operative cases, case discussions, and social events. Students completed HIPAA training prior to the rotation, and specific consent was obtained from patients whose surgical cases would be live streamed for teaching. Feedback was obtained via prerotation and postrotation surveys on Qualtrics, as well as interviews with students, residents, and faculty. RESULTS: Twelve students participated (3 rotations, 4 students each). The curriculum included approximately 19 hours of lecture, 29 hours of live operating room time, and 8 hours of informational, mentor, or social events. Eight students (75%) completed the pre-rotation survey, and five (42%) completed the post-rotation survey. Overall, visiting students enjoyed the virtual rotation and found it useful and informative. When asked if virtual rotations should be kept as an option next year, 60% answered “yes” and 40% responded “maybe.” Notably, students reported feeling like that they knew more about the University of Chicago program after the rotation, and they answered an average of 3.20 and 3.37 points higher in the post survey to “On a scale from 1 to 10 how much do you feel like you know about the University of Chicago Program- Faculty” and “Residents,” respectively. Students reported that they enjoyed interacting with the team and the learning opportunities, but some noted that it was difficult to make an impression. CONCLUSIONS: We developed a two-week virtual curriculum that provided medical students from across the country an opportunity to learn more about plastic and reconstructive surgery and about the University of Chicago program. As virtual learning is becoming an increasingly vital part of medical education, our experience provides important insights on how we can best structure these opportunities moving forward. REFERENCES: 1. Drolet BC, Brower JP, Lifchez SD et al. Away rotations and matching in integrated plastic surgery: applicant and program director perspectives. Plast Reconstr Surg. 2016;137(4):1337–1343. 2. Janis JE, Hatef DA. Resident selection protocols in plastic surgery: a national survey of plastic surgery program directors. Plast Reconstr Surg. 2008;122(6):1929–1939. 3. Sergesketter AR, Glener A, Nguyen VT, et al. Abstract 9: The association between sub-internships and match rank order for integrated plastic surgery programs. Plast Reconstr Surg Glob Open. 2020;8(5S):5–6.

Implementation and Effectiveness of a Completely Virtual Pathology Rotation for Visiting Medical Students.

ObjectivesCoronavirus disease 2019 (COVID-19) upended in-person medical education, relocating many activities online. We designed a completely virtual pathology rotation to replace our traditional visiting rotation.MethodsThe virtual away rotation was listed in the Visiting Student Application Service (VSAS) and advertised on social media as well as various medical student mailing lists. Nine students were selected to participate in three month-long rotations. The virtual curriculum mirrored our typical in-person clerkship with didactic lectures and daily signout but also included activities exclusive to the virtual rotation such as digitally scanned slide trays and small-group problem-based learning. Anonymous surveys were conducted in which both participants and instructors rated their experiences.ResultsPostrotation feedback was overwhelmingly positive from both participants and instructors. Students considered virtual slide sessions as the most effective teaching tool and did not feel hindered overall by lack of in-person experiences. Volunteer trainee instructors indicated the experience improved their teaching and diagnostic skills and expressed interest in teaching future virtual courses.ConclusionsThe success of the virtual away rotation raises consideration for applications beyond the pandemic era and may provide a more level playing field for medical students from underrepresented groups.