The American College of Surgeons (ACS) Academy of Master Surgeon Educators has had its hands full during the coronavirus (COVID-19) pandemic, as evidenced in a Special Session Monday, October 25, Surgery Residency Training Beyond the COVID-19 Pandemic: Perspectives from the ACS Academy of Master Surgeon Educators.
Membership in the Academy “is more than honorific recognition,” said L.D. Britt, MD, MPH, DSc(Hon), FACS, FSACME, MAMSE, Past-President of the ACS, and Co-Chair of the Academy. “It is a living, working body that continually develops the science of education.”
Throughout the pandemic, a Special Committee of the Academy has been charged with studying COVID-19 and its effects on surgical residency, noted Ajit K. Sachdeva, MD, FACS, FRCSC, MAMSE, Director, ACS Division of Education. The lessons learned over the last 18 months were discussed by representatives of the Academy’s various subcommittees. To hear more from Dr. Britt and Dr. Sachdeva, watch this Clinical Congress Daily Highlights video interview.
Kathryn Spanknebel, MD, FACS, senior associate dean of academic and faculty affairs and associate professor of surgery, New York Medical College School of Medicine, NY, spoke on behalf of the Survey Subcommittee, which sought to assess the pandemic’s impact on surgical education and resident wellness. The subcommittee conducted a longitudinal survey of surgeon educators—including faculty, program directors, and so on—to determine how they believed their institutions responded during various phases of the pandemic.
Initially, only 26 percent of the respondents said the pandemic had a severe impact on their education program, but by early winter 2020−2021, when COVID-19 cases were spiking, that percentage increased to 45 percent. Likewise, respondents indicated that the surges had a deleterious affect on their institutions’ ability to recover their educational programs and on learner well-being, Dr. Spanknebel said.
“The most surprising finding was that the respondents said programs were doing nothing, not doing enough, or they were uncertain” about whether programs were providing enough resources to safeguard resident safety and well-being, she said.
The subcommittee also surveyed trainees to determine the degree to which institutions responded to their needs. “Virtual education was a standout in helping to sustain program activity during the pandemic,” Dr. Spanknebel said. Moving forward, residents will expect more hybrid learning opportunities, she added.
Mohsen Shabahang, MD, PhD, FACS, MAMSE, chair of the Geisinger Surgery Institute, Danville, PA, and the director of general surgery residency, spoke on behalf of the Subcommittee on Novel Teaching and Assessment Methods and Innovative Educational Resources. The objective of the subcommittee is to “use the lessons learned from the COVID-19 pandemic pertaining to surgical education to inform innovation in the future,” he said.
Key activities of the subcommittee include disseminating information, mentoring, highlighting past educational material, and obtaining perspectives from all fields of surgery on important topics and opportunities for collaboration, Dr. Shabahang said. For example, the subcommittee established a Listserv for sharing information and used virtual technology to bring together the House of Surgery, including offering Virtual Grand Rounds on robotics; diversity, equity, and inclusion; disparities in health care; and the Delta variant.
Dr. Shabahang said that moving forward, the subcommittee will be focused on the role of virtual technology in the post-COVID era, asking, “What have we learned, and how can apply this in the future?”
A second area of focus for the subcommittee has been mentoring, he said. To fill this need, the Academy has offered Fireside Chats, in which preeminent surgeon leaders and surgeon educators offer career advice.
In addition, the subcommittee has been highlighting past educational material, including previously given Named Lectures from the ACS Clinical Congress, through the Encore Series. At present, the subcommittee is obtaining perspectives on telemedicine, virtual interviews for resident selection and for obtaining a job, and practice management and financing of surgical education, according to Dr. Shabahang.
“Where do we see this going in the future?” he asked, stating that he foresees greater emphasis on virtual technology and its role in education and patient care, practice management, novel educational methods, and collaboration.
Brenessa Lindeman, MD, MEHP, FACS, assistant professor of surgery and associate designated institutional official for the clinical learning environment, University of Alabama at Birmingham, spoke on behalf of the Task Force for Response to COVID-19, which has developed a new portal called the Cutting Edge in Surgical Education. The portal is dedicated to the following three categories of content: practical advice on the direct response to the pandemic, human interest pieces, and virtual education resources.
“What we were seeing was that there was an unmet need among surgical educators,” Dr. Lindeman said. “We came up with the tenets that we felt were necessary and put together four goals of a portal for education resources.” The four goals are as follows:
- Provide a singular repository for high-quality, peer-reviewed surgical education tools
- Promote interdisciplinary collaboration
- Equip surgical educators across the continuum with selected, effective educational resources to improve surgical training and, ultimately, patient care
- Disseminate curricula and tools in a peer-reviewed manner to give educators necessary materials to apply for promotions
Jeffrey B. Matthews, MD, FACS, MAMSE, Dallas B. Phemister Professor of Surgery and chair, department of surgery, University of Chicago Medicine, IL, provided an update from the Disaster Planning for Surgical Education Subcommittee. Dr. Matthews said the subcommittee reviewed institutional and Accreditation Council for Graduate Medical Education guidelines for disaster planning for training programs. The subcommittee “identified seven common themes for disaster planning for surgical education: communication, safety and wellness, clinical experience, curriculum, telemedicine, redeployment, leadership, and preparedness.”
The subcommittee then developed “A checklist framework for surgical education disaster plans,” which was published in the July 2021 issue the Journal of the American College of Surgeons, and is being prepared for submission to the Cutting Edge as a practical roll out to the surgical education community, Dr. Matthews said.
“We clearly found that there is no ‘one size fits all’ approach” to disaster planning because of such variables as patient population, institution location, size of the training program, and other considerations, he said. That said, the target audience for the checklist is program directors, department chairs, and other key education leaders. These individuals can use the checklist for self-assessment, including a focus on lessons learned—“what went well, what could be improved”; strategic planning, sharing best practices, and more.
Looking ahead, “We need to look beyond the general surgery perspective, and ask how this can be adapted for surgery subspecialty training programs into an integrated strategy for all surgical learners,” Dr. Matthews said.
“Education leaders are encouraged to use the checklist, document the process, and share outcomes in a scholarly way,” he added.
This and other Clinical Congress 2021 sessions are available to registered attendees for on-demand viewing for a full year following Congress on the virtual meeting platform.