Technology has transformed educational programs and has created an inexhaustible source of information and communication accessible to anyone worldwide. Leveraging technology for trainee orientation in the COVID-19 pandemic is alluring; however, published literature describing the safety and effectiveness of virtual education for resident and fellow integration into a sponsoring program is limited. 14 Our manuscript highlights the value of this unique approach to learner onboarding.
In a recent report, Schwartz et al.4 describe their orthopedic residency program's education and training strategies during the current pandemic.4 They divided the residents into two cycling groups: the "active duty" and the "working remotely" groups, with the former maintaining in-person surgical training. The "working remotely" group only took part in virtual educational activities. The two teams transitioned every two weeks to reduce COVID-19 exposure. Although this approach was successful and preserved the resident workforce, adopting this strategy in GME orientation may not be practical considering the large number of learners.
Resident and fellow trainees entering our Medical Center's GME training programs participate in an institutional GME orientation to acclimate them to the unfamiliar learning environment. Before the COVID-19 pandemic, we performed GME onboarding in an in-person, small-group station-based, active learning approach to critical principles and procedures applicable to all specialties in GME. However, the COVID-19 pandemic prevented our standard in-person orientation process because of the absolute need for social distancing. As a result, we creatively pivoted to a virtual GME orientation process in 2020.
After considerable planning, educational/training modules were designed using similar content from our traditional in-person approach and uploaded into our LMS. We maintained the in-person curriculum, even around procedural safety techniques and understanding the clinical learning environment, yet successfully transitioned to an online delivery platform to comply with the CDC and WHO recommendations to reduce the risk of COVID-19 transmission. Our analysis of the trainee feedback data suggests that virtual GME orientation using CarmenCanvas is practical and provides residents and fellows with the information needed to adjust to their new clinical learning environment. The trainees overwhelmingly appreciated the ability to complete the modules remotely, described the contents as beneficial to their education and training, and had little difficulty accessing and navigating relevant content. They appreciated the virtual orientation organization and the flexibility that the virtual platform provided.
Lessons Learned
Our strategy did not require changing our orientation materials' content, but only the delivery platform. We did not encounter any barriers to implementing virtual orientation. The virtual CarmenCanvas platform enabled the provision of GME orientation to late-arriving residents and eliminated the scheduling of makeup lectures as occurs with the in-person format. Based on survey responses, we found this change to be very successful. Of note, specific modules that were traditionally hands-on (i.e., invasive procedures) were presented as video recordings to emphasize the procedures' key aspects.
The VIDEO study helped us identify areas for improvement using this novel virtual orientation format using trainee respondents' comments. A few trainees expressed that despite the lecture format's informative nature (PowerPoint slides with voiceover recordings), an interactive design such as videoconferencing would be more helpful, especially for questions and answers, and we intend to use this approach in the future. Second, we also had variability in the modules' duration. The respondents requested standardization of the length of modules (the majority preferred shorter, concise lectures of ~ 30 minutes duration) to improve trainee engagement.