JTCVS Open (Dec 2021)

Maintaining technical proficiency in senior surgical fellows during the COVID-19 pandemic through virtual teachingCentral MessagePerspective

  • Justin C.Y. Chan, MBBS, MPhil,
  • Thomas K. Waddell, MD, PhD,
  • Kazuhiro Yasufuku, MD, PhD,
  • Shaf Keshavjee, MD, MSc,
  • Laura L. Donahoe, MD, MSc

Journal volume & issue
Vol. 8
pp. 679 – 687

Abstract

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Background: The novel coronavirus (COVID-19) pandemic has resulted in a severe reduction in operative opportunities for trainees. We hypothesized that augmenting independent practice with a bench model of vascular anastomoses using regular videoconferences and individual feedback would provide a meaningful benefit in the maintenance of technical skills in senior lung transplant surgical fellows. Methods: A lung transplantation virtual technical skills course was developed, and surgical fellows were provided with a bench model and surgical instruments. Using a virtual communication platform, teaching sessions were held twice weekly, and fellows performed an anastomosis on camera. Video recordings were reviewed and critiqued by attending staff. At the end of the 3-month course, participants were surveyed about their experience. Warm ischemic time was compared between the fellows' 5 most recent cases before and after the pandemic. Results: Seven senior surgical fellows participated and provided feedback. The fellows had graduated medical school an average of 14 years before fellowship, and spent an average of 5 hours (range, 1.3-15 hours) of home practice. Five of the 7 participants (71%) reported improvement in their technical skills and increased confidence in performing lung transplantation. No significant difference in average warm ischemic time in procedures performed by fellows was identified (70.3 minutes prepandemic vs 68.3 minutes postpandemic; P = .68). Conclusions: A program of virtual technical skills teaching, individual video coaching, and independent practice has provided a benefit in maintaining technical skills in lung transplant surgical fellows during the COVID-19 pandemic, when equivalent operative experience was unavailable. Lessons learned from this exceptional time can be used to create simulation curricula for senior trainees.

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