The Longitudinal and Vertical Integration of Health Systems Science in an Undergraduate Medical Education Program: A Means to Support "Curricular Elasticity".

Although health systems science (HSS) has become increasingly included as requisite curricular content in undergraduate medical education (UME), educators have many implementation options for integrating HSS content into medical school training. Learning from medical schools' authentic experiences and lessons learned for the successful and sustainable implementation of HSS would be valuable. We share our experience with the longitudinal and vertical integration of HSS at the Sidney Kimmel Medical College (SKMC) at Thomas Jefferson University in Philadelphia over the past six years. We posit that our approach to curricular design has afforded us the "curricular elasticity" needed to keep our educational program current and flexible in the rapidly changing healthcare and geopolitical landscape.

Three-year evaluation of a program teaching social determinants of health in community-based medical education: a general inductive approach for qualitative data analysis.

BACKGROUND: Social determinants of health (SDH) are intricately intertwined with various social and economic factors. Reflection is essential for learning about SDH. However, only a few reports have focused on reflection in SDH programs; most were cross-sectional studies. We aimed to longitudinally evaluate a SDH program in a community-based medical education (CBME) curriculum that we introduced in 2018 based on the level of reflection and content on SDH in students' reports. METHODS: Study design: General inductive approach for qualitative data analysis. Education program: A 4-week mandatory clinical clerkship in general medicine and primary care at the University of Tsukuba School of Medicine in Japan was provided to all fifth- and sixth-year medical students. Students underwent a 3-week rotation in community clinics and hospitals in suburban and rural areas of Ibaraki Prefecture. After a lecture on SDH on the first day, students were instructed to prepare a structural case description based on encounters during the curriculum. On the final day, students shared their experiences in a small group session and submitted a report on SDH. The program was continuously improved and faculty development was provided. STUDY PARTICIPANTS: Students who completed the program during October 2018-June 2021. ANALYSIS: Levels of reflection were categorized as reflective, analytical, or descriptive. The content was analyzed based on the Solid Facts framework. RESULTS: We analyzed 118 reports from 2018-19, 101 reports from 2019-20, and 142 reports from 2020-21. There were 2 (1.7%), 6 (5.9%), and 7 (4.8%) reflective reports; 9 (7.6%), 24 (23.8%), and 52 (35.9%) analytical reports; and 36 (30.5%), 48 (47.5%), and 79 (54.5%) descriptive reports, respectively. The others were not evaluable. The number of Solid Facts framework items in reports were 2.0 ± 1.2, 2.6 ± 1.3, and 3.3 ± 1.4, respectively. CONCLUSIONS: Students' understanding of SDH deepened as the SDH program in the CBME curriculum improved. Faculty development might have contributed to the results. Reflective understanding of SDH might require more faculty development and integrated education of social science and medicine.

Admission into healthcare education in France: half-baked reform that further complicates the system.

France has undertaken the most ambitious reform of healthcare education in more than 10 years. It has resulted in a hybrid system with multiple pathways, granting admission into the healthcare professions after competitive exams. The reform continues the trend to increase the quotas limiting the number of second year healthcare students, and also creates new local access options to healthcare education. However, the heterogeneity in implementation has led, in conjunction with the difficulties caused by the Covid-19 pandemic, to great dismay among students and parents. This article seeks to outline the historical underpinnings of the reform program(s) and argues that the core question - selecting students from the very high number of candidates in a fair and effective manner - remains largely unresolved.

Feasibility and Acceptability of a US National Telemedicine Curriculum for Medical Students and Residents: Multi-institutional Cross-sectional Study.

BACKGROUND: Telemedicine use increased as a response to health care delivery changes necessitated by the COVID-19 pandemic. However, lack of standardized curricular content creates gaps and inconsistencies in effectively integrating telemedicine training at both the undergraduate medical education and graduate medical education levels. OBJECTIVE: This study evaluated the feasibility and acceptability of a web-based national telemedicine curriculum developed by the Society of Teachers of Family Medicine for medical students and family medicine (FM) residents. Based on the Association of American Medical Colleges telehealth competencies, the asynchronous curriculum featured 5 self-paced modules; covered topics include evidence-based telehealth uses, best practices in communication and remote physical examinations, technology requirements and documentation, access and equity in telehealth delivery, and the promise and potential perils of emerging technologies. METHODS: A total of 17 medical schools and 17 FM residency programs implemented the curriculum between September 1 and December 31, 2021. Participating sites represented 25 states in all 4 US census regions with balanced urban, suburban, and rural settings. A total of 1203 learners, including 844 (70%) medical students and 359 (30%) FM residents, participated. Outcomes were measured through self-reported 5-point Likert scale responses. RESULTS: A total of 92% (1101/1203) of learners completed the entire curriculum. Across the modules, 78% (SD 3%) of participants agreed or strongly agreed that they gained new knowledge, skills, or attitudes that will help them in their training or career; 87% (SD 4%) reported that the information presented was at the right level for them; 80% (SD 2%) reported that the structure of the modules was effective; and 78% (SD 3%) agreed or strongly agreed that they were satisfied. Overall experience using the national telemedicine curriculum did not differ significantly between medical students and FM residents on binary analysis. No consistent statistically significant relationships were found between participants' responses and their institution's geographic region, setting, or previous experience with a telemedicine curriculum. CONCLUSIONS: Both undergraduate medical education and graduate medical education learners, represented by diverse geographic regions and institutions, indicated that the curriculum was broadly acceptable and effective.

Medical studies in times of a pandemic - concepts of digital teaching for Orthopaedics and Trauma at german universities.

BACKGROUND: Due to the Covid-19 pandemic, on-site classroom teaching became limited at most German medical universities. This caused a sudden demand for digital teaching concepts. How the transfer from classroom to digital teaching or digitally assisted teaching was conducted was decided by each university and/or department individually. As a surgical discipline, Orthopaedics and Trauma have a particular focus on hands-on teaching as well as direct contact to patients. Therefore, specific challenges in designing digital teaching concepts were expected to arise. Aim of this study was to evaluate medical teaching at German universities one year into the pandemic as well as to identify potentials and pitfalls in order to develop possible optimization approaches. METHODS: A questionnaire with 17 items was designed and sent to the professors in charge of organising the teaching in Orthopaedics and Trauma at each medical university. A differentiation between Orthopaedics and Trauma was not made to allow a general overview. We collected the answers and conducted a qualitative analysis. RESULTS: We received 24 replies. Each university reported a substantial reduction of their classroom teaching and efforts to transfer their teaching to digital formats. Three sites were able to switch to digital teaching concepts completely, whereas others tried to enable classroom and bedside teaching at least for students of higher edcuational levels. The online platforms used varied depending on the university as well as the format it was supposed to support. CONCLUSION: One year into the pandemic significant differences concerning the proportions of classroom and digital teaching for Orthopaedics and Trauma can be observed. Simultaneously huge differences in concepts used to create digital teaching are present. Since a complete suspense of classroom teaching was never mandatory, several universities developed hygiene concepts to enable hands-on and bedside teaching. Despite these differences, some similarities were observed: the lack of time and personnel to generate adequate teaching material was reported as the leading challenge by all participants of this study.

Virtual medical education accreditation survey visits and viability for the future.

Coronavirus disease 2019 (COVID-19) drastically disrupted daily life and abruptly forced curricular modifications in undergraduate medical education. Despite level of preparedness, medical schools moved instruction online for students to access remotely. Similarly, accreditation visits by the Liaison Committee for Medical Education (LCME) were also moved from in-person to virtual formats during these chaotic times. Little guidance was available to transition to the new process. Medical schools that were scheduled for a virtual survey visit were required to pivot without tried experience on how to prepare for and conduct these high stakes online visits. New processes needed to be developed to successfully navigate a virtual accreditation visit. To date, there has been nothing in the literature from those who have participated on LCME teams nor from medical schools who have undergone a virtual survey visit. This article accounts for one medical school's experience from its 2021 LCME virtual visit and makes recommendations to consider when planning for such a significant event. The future of virtual visits is taken into account as this method has its benefits including elimination of travel and the associated time and cost. Yet, the perspectives from others who have participated in a virtual LCME accreditation visit should be studied. While the LCME will return to in-person visits in 2022-23, it is important for medical schools to share their experiences and lessons learned from their virtual accreditation visit should the need arise to reinstate virtual visits in the future.

Creation of an asynchronous faculty development curriculum on well-written narrative assessments that avoid bias.

BACKGROUND: The COVID-19 pandemic in parallel with concerns about bias in grading resulted in many medical schools adopting pass/fail clinical grading and relying solely on narrative assessments. However, narratives often contain bias and lack specificity. The purpose of this project was to develop asynchronous faculty development to rapidly educate/re-educate > 2000 clinical faculty spread across geographic sites and clinical disciplines on components of a well-written narrative and methods to minimize bias in the assessment of students. METHODS: We describe creation, implementation, and pilot data outcomes for an asynchronous faculty development curriculum created by a committee of volunteer learners and faculty. After reviewing the literature on the presence and impact of bias in clinical rotations and ways to mitigate bias in written narrative assessments, the committee developed a web-based curriculum using multimedia learning theory and principles of adult learning. Just-in-time supplemental materials accompanied the curriculum. The Dean added completion of the module by 90% of clinical faculty to the department chairperson's annual education metric. Module completion was tracked in a learning management system, including time spent in the module and the answer to a single text entry question about intended changes in behavior. Thematic analysis of the text entry question with grounded theory and inductive processing was used to define themes of how faculty anticipate future teaching and assessment as a result of this curricula. OUTCOMES: Between January 1, 2021, and December 1, 2021, 2166 individuals completed the online module; 1820 spent between 5 and 90 min on the module, with a median time of 17 min and an average time of 20.2 min. 15/16 clinical departments achieved completion by 90% or more faculty. Major themes included: changing the wording of future narratives, changing content in future narratives, and focusing on efforts to change how faculty teach and lead teams, including efforts to minimize bias. CONCLUSIONS: We developed a faculty development curriculum on mitigating bias in written narratives with high rates of faculty participation. Inclusion of this module as part of the chair's education performance metric likely impacted participation. Nevertheless, time spent in the module suggests that faculty engaged with the material. Other institutions could easily adapt this curriculum with provided materials.

The relationship of online pre-recorded neurology mini-lectures to medical student assessment: a pilot study.

INTRODUCTION: eLearning has become an essential part of medical education. However, there is a lack of published research on student engagement with online pre-recorded mini-lectures and its relation to assessment. The aim of this pilot study is to explore the relationship between newly introduced neurology pre-recorded mini-lectures and undergraduate medical students engagement and assessment. This may encourage the wider use of mini-lectures in undergraduate medical curricula. METHODS: The engagement of medical students with 48 online pre-recorded neurology mini-lectures was assessed through a Learning Management System. To measure engagement, data was stratified according to the number of watched/downloaded mini-lectures. A point system was used (out of 5): - 1 point = watching/downloading 0-10 mini-lectures, 2 points = watching/downloading 11-20 mini-lectures, 3 points = watching/downloading 21-30 mini-lectures, 4 points = watching/downloading 31-40 mini-lectures and, 5 points = watching/downloading 41-48 mini-lectures. The students' engagement was correlated with their neurology assessments [Objective Structured Clinical Examination (OSCE), and knowledge-based assessment 10 Multiple Choice Questions (MCQs) and one 10-mark Short Answer Question, (SAQ)], internal medicine grade and annual grade point average (GPA) using the Pearson correlation coefficient. RESULTS: The mean engagement of 34, Year 5, medical students is 3.9/5. There is a significant positive correlation between engagement and internal medicine grade (r = 0.35, p = 0.044). There is a moderate correlation between engagement and neurology OSCE (r = 0.23), annual Year 5 GPA (r = 0.23), neurology knowledge-based score (r = 0.22) and composite neurology knowledge/OSCE (r = 0.27). The knowledge-based assessment included SAQ and MCQs: there was a moderate correlation with SAQ (r = 0.30), but a weak negative correlation with the MCQs (r =-0.11). Sub-groups analysis comparing the top- and low- or non- engaging students made these weaker correlations stronger. CONCLUSION: This pilot study indicates a high rate of engagement with an online pre-recorded mini-lectures resource and evidence of moderate correlation between engagement and assessment. Online pre-recorded mini-lectures should be used more in delivering the curriculum contents of the clinical clerkships. Further studies are needed to evaluate the relation and the impact of the mini-lectures on assessment.

Undergraduate Students' perceptions of online assessment during COVID -19 pandemic at faculty of medicine for girls, Al-Azhar University, Cairo, Egypt: Journal of the Association for Programmed Learning

The Corona virus-19 pandemic has forced universities globally to shut down and shift their educational and assessment activities to online platforms. This study explores the perception of undergraduate preclinical medical students about online assessment during the ongoing pandemic. A cross-sectional study based on a semi-structured online self-administered questionnaire was conducted on 654 preclinical medical students following the final online exams at Faculty of Medicine for Girls, Al-Azhar University. Perception was investigated using a 3-point Likert scale. The overall mean score of students' satisfaction with the quality of online assessment was (31.7 ± 3.1), and they agreed that online exams create a sense of security. However, 69.7% of students preferred paper-based exams to online exams. Furthermore, high cost, lack of ability to concentrate and only knowledge-based exams were some of the reported drawbacks. These findings highlight the importance of students' perception through online assessment for promoting successful educational processes.

Experience of a Medical School in the Philippines on the Sudden Shift to Online Learning amidst COVID-19

Introduction. The COVID-19 pandemic forced educational institutions to adapt to a full online learning environment. Medical schools in particular were disrupted by this shift since the majority of the learning objectives, skills, and necessary competencies are learned through classroom and hospital face-to-face activities. Objective. The purpose of this paper is to describe the experiences of a medical school in the country as it navigated the sudden shift to full online learning vis-à-vis a framework on the barriers and solutions to online learning. Method. This is a descriptive paper written from the perspective and observations of an administrator who participated in crafting the immediate response of the school to the sudden shift to online delivery and who worked with the stakeholders of the Ateneo School of Medicine and Public Health (ASMPH). Results. To address concerns on time, skills and infrastructure, the school reprioritized its learning objectives for the remainder of the school year. It conducted in-service sessions for faculty while also immediately setting up a learning management system and a technical support team that was available on demand. Strategies employed included a deliberate switch to asynchronous learning, curation of content and creativity in delivery and assessment, and the reshaping of the management and public health activities into the online platform. To manage attitudes and provide institutional support, the school worked collaboratively with stakeholders and transformed its traditional support services of campus ministry, counselling, formation, and physical and mental health to be readily available online. Conclusion. We described the experience of ASMPH when medical schools were forced to completely shift to online delivery of their programs because of the pandemic. We identified the barriers and solutions of online learning in medical education. The unique context of the ASMPH for having a dual degree in medicine and management;having an inter-disciplinal, non-departmentalized set-up at each year level;and, possessing the traditions of Jesuit education were instrumental in the school's ability to navigate this sudden shift. © 2022 University of the Philippines Manila. All rights reserved.

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

OBJECTIVE: To 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 DESIGN: A 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. SETTING: OHNS Department at the University of Pennsylvania (May 2020 to June 2020). METHODS: Six 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". RESULTS: Response 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". CONCLUSIONS: Overall, 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.

"We Need More Practice": Evaluating the Role of Virtual Mock OSCES in the Undergraduate Programme During the COVID Pandemic.

Background: Feedback collated at University College London Medical School (UCLMS) during the COVID pandemic identified how many students felt unprepared for their summative Objective Structured Clinical Examinations (OSCEs) despite attending mock face-to-face OSCEs. The aim of this study was to explore the role of virtual mock OSCES for improving student's sense of preparedness and confidence levels for their summative OSCEs. Methods: All Year 5 students (n=354) were eligible to participate in the virtual mock OSCEs and were sent a pre- and post-survey for completion. Hosted on Zoom in June 2021, each circuit comprised six stations, assessing history taking and communication skills only, in Care of the Older Person, Dermatology, Gynaecology, Paediatrics, Psychiatry and Urology. Results: Two hundred and sixty-six Year 5 students (n=354) participated in the virtual mock OSCEs, with 84 (32%) students completing both surveys. While a statistically significant increase in preparedness was demonstrated, there was no difference in overall confidence levels. In contrast, between specialties, a statistically significant increase in confidence levels was seen in all specialties barring Psychiatry. Despite half of the participants highlighting how the format did not sufficiently represent the summative OSCEs, all expressed interest in having virtual mock OSCEs incorporated into the undergraduate programme. Conclusion: The findings of this study suggest that virtual mock OSCEs have a role in preparing medical students for their summative exams. While this was not reflected in their overall confidence levels, this may be due to a lack of clinical exposure and higher anxiety levels among this cohort of students. Although virtual OSCEs cannot replicate the "in-person" experience, considering the logistical advantages, further research is required on how these sessions can be developed, to support the traditional format of face-to-face mock OSCEs within the undergraduate programme.

Medical student flourishing before and during the COVID-19 pandemic at one U.S. institution.

Introduction: Medical education research often focuses on measuring negative mental states like burnout, rather than focusing on positive states like well-being. Flourishing - a state that includes domains of happiness and mental health - is a way of thinking about well-being that may be relevant to education and research. The purpose of this prospective, observational study was to compare the relationship among flourishing, other well-being measures, and burnout in medical students via a survey administered at two time points.    Methods: We surveyed medical students at one U.S. institution about their flourishing, satisfaction with work-life balance, quality of life, empathic concern, and burnout (emotional exhaustion and depersonalization) before and after the onset of the COVID-19 pandemic. Flourishing was measured using two scores, the Flourish Index (FI) and Secure Flourish Index (SFI), with higher scores indicating greater flourishing. Pre- and post-scores for both measures were compared. Results: 107/585 (18%) medical students responded to the survey and 78/107 (73%) participated in the post survey. At the first time point, respondents reported both a mean FI and SFI 6.7 (SD=1.3); higher levels of flourishing correlated with higher satisfaction with work-life balance (p<.001), higher quality of life (p<.001), and lower levels of burnout (emotional exhaustion p<.001; depersonalization p=.021). SFI scores were higher at the second time point (M=7.1, SD=1.2) than the first (M=6.7, SD=1.3, p=.026). FI, satisfaction with work-life balance, quality of life, empathic concern, and burnout were unchanged at the second time point. Discussion: Like past findings in medical residents, we found medical students' flourishing-as measured by FI and SFI scores-correlated with greater satisfaction with work-life balance, higher quality of life, and lower burnout. In this limited sample, we found flourishing remained largely unchanged after the COVID-19 pandemic onset.

Practical tips for moving your patient panel online.

Patient panels are an inspiring, highly rated educational tool to complement course goals and objectives for students in medical education programs. The COVID-19 pandemic brought challenges on the ability to successfully host in-person patient panels. These challenges resulted in the need to pivot in-person patient panels to online platforms, while still ensuring the quality and intimacy of patient narratives. In this 12 tips article, we share lessons learned in transitioning patient panels in our health systems science curriculum to an online experience for students enrolled in a pre-clinical medical education program.

Radical reform of the undergraduate medical education program in a developing country: the Egyptian experience.

Medical educators are in a continuous quest to close the gap between the needs of medical practice and the rising expectations of the communities in their countries. During the past two decades, competency-based medical education has been evolving as an appealing strategy to close this gap. In 2017, the Egyptian medical education authorities mandated all medical schools to change their curricula to comply with revised national academic reference standards, which changed from outcome-based to competency-based. In parallel, they also changed the timeline of all medical programs for six years of studentship and one-year internship to five years and two years, respectively. This substantial reform involved the assessment of the existing situation, an awareness campaign for the proposed changes and an extensive national faculty development program. Monitoring the implementation of this substantial reform was performed through surveys, field visits and meetings with students, teaching staff and program directors. In addition to the expected challenges, the COVID-19-associated restrictions presented a significant further challenge during the implementation of this reform. This article presents the rationale for and steps of this reform, the challenges faced and how they were addressed.

Reimagining Undergraduate Medical Education in a Post-COVID-19 Landscape.

Online education due to the COVID-19 pandemic caused many medical schools to increasingly employ asynchronous and virtual learning that favored student independence and flexibility. At the same time, the COVID-19 pandemic highlighted existing shortcomings of the healthcare field in providing for marginalized and underserved communities. This perspective piece details the authors' opinions as medical students and medical educators on how to leverage the aspects of pandemic medical education to train physicians who can better address these needs.

Dyad pedagogy in practical anatomy: A description of the implementation and student perceptions of an adaptive approach to cadaveric teaching.

Prior to the challenges imposed by the Covid-19 pandemic, anatomy practical sessions at Trinity College Dublin involved eight to 10 students per donor station, rotating between digital learning, anatomical models/osteology, and dissection activities for three hours weekly. To maintain cadaveric participation in the anatomy laboratory while adhering to distancing guidelines, a transition to dyad pedagogy was implemented. This mode of delivery allowed two students per donor station to spend one hour per week in the anatomy laboratory with all digital learning elements transferred to the virtual learning platform Blackboard as pre- and post-practical session learning activities. Dyad pedagogy has been explored in clinical settings and simulation procedural-based training but is yet to be fully verified in anatomy education. To determine the effectiveness of hybrid practical sessions and reduced donor to student ratios, the opinions of first year medical students were examined using an online questionnaire with a 51% response rate. Although students recognized the merits of more time in the anatomy laboratory, including opportunities for self-directed study and exposure to anatomical variation, they felt that having two students per station enabled sufficient hands-on time with the donor body and fostered learning opportunities that would not be possible with larger groups. Strong preferences for quality time with the donor body supported by online resources suggests this modality should be a key consideration in course design for anatomy curricula and emphasizes the importance of gauging students' preferences to optimize satisfaction and learning output when pivoting to blended learning strategies in anatomy education.

Development of an Online SARS-CoV-2/COVID-19 Elective Course for Fourth-Year Medical Students.

As a result of the COVID-19 pandemic, the Paul L. Foster School of Medicine incorporated supplementary online learning for 4th year medical students who were unable to participate in clinical activities due to clinical site restrictions to reduce SARS-CoV-2 transmission. An online elective was developed aimed to increase student knowledge of COVID-19: "COVID-19: Utilizing basic sciences to implement what you need to know as a physician." This course required students to further their understanding of SARS-CoV-2 and COVID-19 through directed self-study to identify and summarize the latest scientific literature followed by presenting an online seminar to peers and faculty.

Implementation and Assessment of an Informal Virtual Elective for Medical Student Radiation Oncology Exploration During the COVID19 Pandemic: a Brief Report.

Subspecialty exposure during medical school can be limited. Moreover, the COVID19 pandemic prevented most onsite elective medical student (MS) rotations during 2020. Therefore, we sought to create and assess the efficacy of an informal virtual elective (IVE) for MSs to explore radiation oncology (RO) at our institution. We created IVE activities including invitations to resident didactics, a faculty lecture series, and interactive virtual events with residents and faculty. MSs were offered RO resident and faculty mentors and the opportunity to deliver a lecture. Pre- and post-IVE evaluation surveys were sent to 27 4th year MSs. Surveys utilized importance ordering (1=most important; reported as median (interquartile range), free response, and Likert-type questions (5 = extremely, 1=not at all). Our IVE, held from July to October 2020, had a median of 11 students (range 7-18) attend each activity. Pre- and post-IVE surveys were completed by 22/27 (81%) and 20/27 (74%) MSs, respectively. In pre-IVE, MSs reported participating in the IVE for faculty/resident interaction (1.5 [1, 2]), networking (3 [2, 3]), and learning (4 [3-5]). In post-IVE, MSs reported benefit from faculty mentors (5 [4, 5]), delivering a presentation (5 [3-5]), and faculty lectures (4.5 [4, 5]). In post-IVE, MSs preferred a full onsite away elective (16, 80%) over an official virtual elective (1, 5%) or IVE (3, 15%). Overall, MSs reported that the IVE provided an adequate introduction to RO at our institution (4 [4, 5]). Alternative virtual elective experiences allow MSs to informally evaluate medical subspecialties and could be offered even if formal elective opportunities are available.

Transforming the "SEAD": Evaluation of a Virtual Surgical Exploration and Discovery Program and its Effects on Career Decision-Making.

OBJECTIVE: The abrupt cessation of in-person education due to the COVID-19 pandemic has made it difficult for preclerkship students to explore a career in surgery. To supplement the lack of exposure, the Surgical Exploration and Discovery (SEAD) program was transitioned to an entirely virtual format. This study aims to describe the virtual SEAD program and evaluate its effectiveness as a career decision-making (CDM) intervention. DESIGN: The week-long program was delivered on Microsoft Teams, featured 11 surgical specialties, and comprised four activities: live demonstrations, virtual operating room observerships, career talks, and technical skills workshops. The program was evaluated using the four levels of the Kirkpatrick model: (1) reactions, (2) knowledge, (3) CDM behaviors - assessed using the Career Decision-making Difficulties Questionnaire (CDDQ) - and (4) results. The latter was indirectly assessed using CDDQ scores from an in-person SEAD program, where lower CDDQ scores indicate less difficulty with CDM. SETTING: Faculty of Medicine at the University of Ottawa in Ontario, Canada. PARTICIPANTS: Forty pre-clerkship students (27 first and 13 second year students) at the University of Ottawa RESULTS: Level 1: 97.5% of participants rated the program as good or very good. Live demonstration and technical skills workshops were the highest rated activities. Level 2: participants' scores on knowledge-based questions about a surgical career significantly increased following the program (pre: 9/25 vs post: 15/25, p = 0.008). Level 3: overall mean CDDQ scores (±SD) decreased difficulties with significantly following the program (pre: 45.6 ± 10.5 vs post: 38.8 ± 10.9, p < 0.001), which indicates decreased CDM difficulties. Level 4: Except for one sub-category, the difference in mean CDDQ scores between the virtual and in-person programs were not significantly different. CONCLUSION: The program received the positive reactions and significantly increased participants' knowledge. The change in CDDQ scores following the virtual program suggests it may reduce career decision-making difficulties in the short-term. In-person surgical exposure remains important; however, a hybrid model may be valuable in resource limited settings. WC: 300.