ABSTRACT
Introduction: Virtual classroom training (VCT) is a novel educational method that permits accessible, distanced interactive expert instruction. We aimed to evaluate the efficacy of VCT in comparison to face-to-face training (FFT) and non-interactive computer-based learning (CBL) for basic surgical skills training. Method: 72 participants recruited from five London medical schools underwent stratified block randomisation into three equal intervention groups based on subjective and objective suturing experience. VCT was delivered via the BARCO weConnect platform and FFT was provided by expert instructors. Optimal student-to-teacher ratio was used, 12:1 for VCT and 4:1 for FFT. The assessed task was interrupted suturing with hand-tied knots. The primary outcome was post-intervention Objective Structured Assessment of Technical Skills (OSATS) score, adjudicated by two blinded experts and adjusted for baseline proficiency. Results: VCT was non-inferior to FFT (adjusted difference 0.44, 95% CI: -0.54 to 1.75, delta 0.675), VCT was superior to CBL (adjusted difference 1.69, 95% CI 0.41 to 2.96) and FFT was superior to CBL (adjusted difference 1.25, 95% CI 0.20 to 2.29). FFT alone was associated with student travel expenses (mean £4.88, SD 3.70). Instructor hours used per student for VCT and FFT were 0.25 and 0.75, respectively. Conclusions: VCT has a similar educational benefit to FFT and is a suitable modality of high-quality surgical skills education. VCT provides greater accessibility and resource efficiency compared to FFT. VCT satisfies the requirement for social distancing during the COVID-19 pandemic and is better than non-interactive CBL. VCT has the potential to improve global availability and accessibility of surgical skills training.
ABSTRACT
Background: In response to the COVID-19, the NHS has implemented significant workforce changes to manage the increased and changing demand on healthcare services. We aimed to investigate the impact of such changes on the wellbeing of redeployed doctors. Method: We conducted a survey at three NHS trusts over 2 weeks during the peak of the pandemic, asking redeployed doctors to rate their morale, work-life balance, perceived support and safety, and to voice concerns. Results: 172 redeployed doctors responded to the survey. On exploring morale, 114 (66.3%) respondents felt confident in their new role, 113 (65.7%) felt satisfied or neutral with their new role and only 54 (31.4%) felt stressed at work. 114 (66.3%) doctors felt valued by their team and 136 (79%) felt valued by the general public. 111 (64.5%) had noticed an increase in the length of breaks and 153 (89%) felt that their rotas provided sufficient respite. 95 respondents (55.2%) did not feel confident in the Public Health personal protective equipment (PPE) guidance and similarly 94 (54.7%) did not feel safe while wearing PPE. The three most common concerns were training opportunities-105 (61%), PPE-99 (57.6%) and family health-95 (55.2%). Conclusions: Our findings suggest that, among the doctors surveyed, morale is higher than might be expected, with doctors feeling valued, confident, and well rested in their new role. Concerns about training opportunities/career progression, PPE and family safety need to be addressed to minimise the adverse effects on doctor's wellbeing due to redeployment.