ABSTRACT
Introduction As more specialists become dual accredited in internal medicine, non-gastroenterology specialists have greater exposure to gastroenterology patients over the course of their training, especially via the acute take. Simultaneously, the COVID pandemic has meant most regular local teaching has moved online with varying quality. This project aimed to evaluate 1) whether a standardised protocol can be used to successfully deliver large scale digital gastroenterology teaching that 2) is non-inferior when compared with traditional face to face teaching. Methods Teaching was delivered to internal medical trainees on the acute management of ulcerative colitis and chronic liver disease. Two sessions were delivered a year apart, initially regionally, and then nationally. This was delivered via Zoom, using a standardised protocol based on guidelines to ensure consistency, with live-polled multiple-choice questions to encourage interaction. Each session was followed by Q&A related to that topic. Feedback was taken after each session. Outcome measures analysed were: number in attendance, whether viewers would recommend this teaching to others, whether they thought it ran smoothly, and how they felt about it when compared with face-to-face teaching as measured on a Likert scale. Given the subjective nature of our hypotheses, we accept that these are surrogate markers. Results 171 trainees attended the initial regional teaching session and 469 the subsequent session. Following the first session, 98.9% of trainees would recommend the teaching to others, rising to 99.7% after the second session. 99% and 99.5% respectively agreed or strongly agreed with the statement the initial session ran smoothly, while 84.5% and 88.8% agreed or strongly agreed that digital teaching was as effective as face to face. The benefits of digital teaching were no travel (90%) ability to watch later (86%), whereas the downsides were loss of social interaction (60%) and harder to get study leave (39%). Conclusions Gastroenterology teaching for non-specialists can be delivered successfully at a large scale using a standardised protocol for digital teaching. The vast majority of trainees felt that digital sessions were as effective as face-to-face teaching with a lack of travel and flexibility on viewing time the main reported benefits.
ABSTRACT
Aim: Infection control during COVID-19 has prevented trainees from attending clinical teaching in person. Lectures have been easily digitalised with video conferencing, but bedside teaching has not made the transition. This study's aim was to assess whether a mixed reality (MR) headset can feasibly be used to deliver remote bedside teaching;and to measure the reduction in exposure time and use of PPE. Method: Senior registrars conducted two MR bedside sessions wearing the HoloLens™ headset, allowing bi-directional video and audio communication between trainer and attendees. Trainees' conceptions of bedside teaching and the session's technical success were evaluated using pre- and post-session questionnaires with 1 ('strongly disagree' or 'never') to 7 ('strongly agree' or 'always') Likert scales. Clinician exposure time and use of PPE were also recorded. Results: Pre-questionnaire respondents (n=24) strongly agreed that bedside teaching is key to educating clinicians (7, IQR 6-7). It was also clear that bedside teaching had become very infrequent during COVID-19 (2, IQR 2-4). Session 1 feedback (n=6) was affected by a technical fault. With the issue corrected for session 2 (n=4), respondents strongly agreed that they felt like they were present in-person (7, IQR 6.75-7). MR teaching led to a 79.5% reduction in cumulative clinician exposure time and 83.3% reduction in PPE use. Conclusions: This study is proof of principle that HoloLens™ is a feasible tool to deliver high-quality remote bedside teaching. This novel platform confers significant advantages in terms of: minimising exposure to COVID-19;economising PPE;facilitating greater attendance;and providing accessible real-time clinical teaching.