Efficacy of vascular virtual medical student education during the coronavirus disease 2019 pandemic

On March 17, 2020, Emory University School of Medicine temporarily suspended student–patient contact to minimize the risk of exposure to coronavirus disease 2019, representing an unprecedented disruption to medical education. In response, virtual electives were expeditiously created to supplement existing curricula and keep students on track for their scheduled graduation dates. The Emory University School of Medicine Department of Surgery faculty and students created the ViSEG (virtual surgical education group) to design virtual electives in eight surgical specialties for third-year medical students. All students, including those not previously enrolled in a surgical clerkship, were encouraged to enroll. Seven students chose the virtual vascular surgery elective.

The week-long vascular surgery curriculum, goals, and objectives were based on the American College of Surgeons prerequisite competencies and U.S. Medical Licensing Examination (USMLE) content outline^{1 , 2} (Table ). The topics included aortic, carotid, and peripheral arterial disease, vascular trauma, venous disease, and dialysis access. The daily schedule included ∼4 hours of lectures, assigned reading of landmark vascular surgery publications, and video instruction of physical examinations or relevant surgical procedures. A virtual skills laboratory proctored by a faculty mentor offered basic suturing instruction using materials distributed in advance. The use of webcams afforded opportunities for real-time feedback, a feature that greatly enhanced the experience. These sessions included no more than four students per session.

Table.

Learning goals and objectives of the course

Learning goals

Improve knowledge of standard clinical presentations, diagnosis, and management of common vascular problems, including, but not limited to, carotid artery stenosis, abdominal aortic aneurysm, and peripheral artery disease

Gain an understanding of the various modalities of noninvasive vascular imaging

Practice basic suturing on vascular prosthetic materials

Learning objectives

Describe the components of the vascular physical examination

Demonstrate knowledge of basic vascular anatomy through question and answer sessions with faculty

Demonstrate knowledge of common vascular surgery problems on multiple-choice question quizzes and post-test

Describe indications for open vs endovascular management of common vascular pathologies, including abdominal aortic aneurysm and peripheral artery disease

Present a “postoperative day 1” patient case as a 5-minute teaching topic or a formal oral patient presentation to peers and faculty

Describe indications for anticoagulation therapy and vascular access

The students completed a nonvalidated, objective 25-question pre- and postcourse assessment. All the students showed improved performance after the elective, with an overall significantly improved mean score (from 11.6 ± 3.5 to 16.6 ± 3.4; P < .03). In addition, students indicated an overall positive response to the course and increased interest in pursuing vascular or other surgical specialty as a career.

The result from our pilot project have demonstrated the successful remote delivery of a vascular surgery curriculum to medical students and could prove to be a vital adjunct to traditional clerkships. Virtual technologies can enhance surgical education, are increasingly relevant, and deserve further investigation as supplementary teaching platforms.