FACE TO FACE OR VIRTUAL, THAT IS THE QUESTION: VA WOMEN'S HEALTH MINI-RESIDENCY EXPERIENCE WITH VIRTUAL LEARNING

SETTING AND PARTICIPANTS: Over 400 VA primary care providers (PCPs) attending one of three virtual Women's Health Mini-Residencies (WHMR) held during the summer of 2021 DESCRIPTION: The VA WH-MR is a three-day faculty development conference aimed at ensuring VA PCPs have the clinical knowledge needed to provide gender-specific care to women Veterans. The face-to-face (F2F) program incorporates both large-group didactic, small group case-based discussion sessions, and hands-on breast and pelvic clinical skills. The WHMR has been shown to improve provider comfort with gender specific care and has been associated with improved PCP retention. Secondary to the COVID19 pandemic, the WH-MR was converted to virtual program (VP) utilizing a flipped classroom model in which providers watched recorded didactic lectures prior to attending 4 half-day virtual conference sessions. Each half-day session began with a recap of key material, followed by small group case-based discussions sessions. Clinical instruction on the breast and pelvic exams were reviewed using video presentations. The WH-MR was presented in the VP format 3 times during the summer of 2021. EVALUATION: Similar to the traditional F2F conference, the VP was evaluated using an immediate post survey to assess participants' self-reported acquisition of new knowledge and skills and satisfaction. When comparing 2019 F2F data with that from the VP, we found that average scores were acceptably high, but uniformly lower. This was particularly true for subject matter related to physical exam skills: breast and pelvic exam 4.64 vs 4.36, F2F program vs VP respectively. A similar trend was noted in satisfaction scores when comparing F2F and VP data: overall satisfaction 4.72 vs 4.41 and training environment was effective 4.66 vs 4.20. Within free-text responses on VP evaluations, providers indicated their preference for F2F learning for many reasons including: 1) frequent interruptions as a result of clinical demands, 2) timing challenges related to dissemination across multiple times zones, and 3) the desire for hands on training DISCUSSION / REFLECTION / LESSONS LEARNED: As we emerge from the COVID-19 pandemic, there will be questions about how best to optimize and deliver clinical training. While virtual learning does provide benefits, including reduced cost and easier access, F2F education appears preferable for skills-based training. Additionally, F2F conferences allow for opportunities to network and build community, which are thought to attribute to improved job satisfaction and reduced attrition. Regardless of the modality, it is critical to ensure that attendees have dedicated time away for clinical demands so that they can fully engage in the training. Though virtual learning will have a place after the pandemic remits, it will be up to the medical education community to use our collective experiences to help determine when F2F versus virtual learning environments are most appropriate.

STING. steroid injections during covid-19. a cross speciality call

Introduction: An important clinical question during the Covid-19 pandemic is the safety of steroid use. Guidelines published by rheumatology, physiotherapy, orthopaedic and pain medicine societies have advised on the restricted use of corticosteroids for musculoskeletal and rheumatic conditions. For clinicians across the specialities there is a challenge to safely conducting best practice, yet ensuring patients have access to the significant functional benefits of steroid injections. Methods: The STING prospective service evaluation will collect data on steroid injections undertaken during this part of the pandemic. Clinicians will be able to input information on patient demographics, background Covid risk and steroid injection specifics. At follow up at 4-6 weeks complications and Covid specific outcomes will be recorded, as well as patient perceived symptom improvement. Each unit collecting data will have assigned collaborator(s), with a senior consultant validating the data. Data will be collected and managed using Research Electronic Data Capture (REDCap). Data collection and management will adhere to Caldicott II principles and GDPR. Results: Results will be analysed through RedCap and compared to national Covid incidence. Local complication and patient reported outcomes will be compared between specialities, environments and steroid specifics (volume, location etc.). Conclusion: A pan-speciality look at steroid injection use during the pandemic will be useful primarily to contribute to understanding the safety of steroid use. Secondarily to look at cross speciality differences in administration, PROMs and to appreciate patient groups who may be excluded from steroid treatment.