Exploring the transition to virtual care in surgery and its impact on clinical exposure, teaching, and assessment during the COVID-19 pandemiec

ABSTRACT

Background: The COVID-19 pandemic resulted in a rapid shift from in-person to virtual ambulatory care delivery for surgical residencies across Canada. This transition has necessitated changes to clinical encounters for surgery residents within the competency-based medical education model. The purpose of this study was to explore the lived experiences of surgery residents and faculty related to teaching, learning, and assessment during virtual ambulatory care encounters. Methods: Residents (n = 10) and faculty (n = 9) were recruited from the Department of Surgery at Queen's University to participate in this phenomenological study. Interviews and focus groups were conducted to understand participants' experiences related to the transition to virtual ambulatory care. Interviews and focus groups were audio-recorded and transcribed verbatim. Qualitative data were analyzed thematically. Results: Four themes emerged from the data teaching/learning, assessment, logistical considerations, and recommendations. Barriers to teaching included the lack of direct observations and ability to perform physical exams, while barriers to assessment included an absence of clinic-specific entrustable professional activities (EPAs) and lack of feedback focused on virtual-care-related competencies. Faculty and residents highlighted logistical challenges and limited time for clinic-related learning in comparison to resident responsibilities on in-patient wards and operating rooms. Recommendations included access to video-conferencing technology and development of virtual-care-specific EPAs in surgery. Conclusion: Surgical faculty and residents highlighted challenges related to the transition to virtual ambulatory care during the COVID-19 pandemic. Specific suggestions were offered for improving the teaching and learning during virtual care, given its ongoing role in medical education and practice.