How to Adapt Surgical Education on COVID Time - Repercussions and Solutions
An interview with Professor Steven D. Wexner by Zoe Garoufalia
ESCP dedicated this month to the next generation of colorectal surgery education.
Interview with Professor Steven D. Wexner, Director of the Digestive Disease Center at Cleveland Clinic Florida @SWexner
The COVID pandemic has taken a toll on physical, emotional and mental health of healthcare-workers. Residents and fellows are uniquely positioned as both physicians and trainees, pursuing specialty training while providing patient care. Although much attention has been focused on pandemic response, surgical leaders have had to also consider the pandemic’s impact on postgraduate surgical education. Traditional ways of training have been transformed in this new reality.
Professor Steven D. Wexner, a world-famous colorectal surgeon and researcher, pioneer and mentor to many colorectal surgeons all around the world, shared his insights with ESCP audience on the new reality of surgical education in these difficult and unprecedented times.
Dr Wexner notes that COVID has had an adverse impact on in person surgical education in his institution in many ways-student medical rotations went away, as well as observers’ rotations, while markedly reduced case volumes affected residents and fellows training. In comparison to 2020, he notes, 2022 seems to be a recovering period in terms of patients’ volumes.
In order to continue education despite the COVID restrictions, Dr Wexner highlights the new central role of video-based education. As he shares with ESCP, whilst this is something that he was doing and promoting for years, now it became much more mainstream. “So, meetings that traditionally were all in-person, like Grand Rounds, like visiting professors, like the national graduation program for rectal cancer, weekly multidisciplinary, tumour board, and so on, were held remotely, so everybody could participate from their office or from their home. And although the in-person interaction isn't quite as spontaneous, it did allow far more people to routinely participate in; we found out that education, not only locally but nationally, transcends boundaries”, he says. He foresees that this is probably a new training reality that is here to stay despite the changes in COVID restrictions. He notes: “There are all these meetings, if hybrid remains available, you can tap into sessions you want to see. And as we have done with American College of Surgeons (ACS), materials are archived and you can look at them for up to a year. So typically, at the ACS, for example, there might be three or four concurrent sessions, which interests an attendee…well, now with meetings being recorded and housed in the cloud, or online, you can see all of them at different times”.
He advises trainees and fellows to use the time spared from traditional surgical education, such as operating rooms, to expand their knowledge through textbooks, online videos, reading papers and working on their research projects. “If you're given lemons, make lemonade, right?” he remarks. Therefore, he encourages trainees and fellows to try and make the most of these adverse circumstances; of course he notes the importance of advising your program director and/or other faculty and or mentors. The other advice he gives to trainees and fellows is to network with people from other parts of the world. He continues: “And one of the great, perhaps, patterns we've become inculcated with during COVID is remote mentoring. Now more than ever, because we as mentors have more time in front of our computers than we ever did in the past, more time not traveling. So we are more accessible and I think the combination of video-based education, as well as social media, allows trainees and fellows to reach out to faculty and mentors. One of my greatest joys as a mentor is that I get to work with people who I've never trained on site. Some cases, people I've never met, other than through social media. And before I know it, I'm collaborating with them”. Regarding platforms and media that could be utilised for this cause, again, he recommends the use of social media, video based education, hybrid-meetings and remote meetings for participation. As he very optimistically notes “There's an infinite number of educational opportunities, it's impossible for any person to keep up with the myriad of opportunities out there. Look at what is available and what interests you the most”.
Finally, he advises to utilise these opportunities to make the most of this new situation, while highlighting the importance of efficient time management. “Worse than saying ‘no, I can't do this’, is saying, ‘yes, I can do this’ and then not doing it well or not doing it on time. Now, don't say no on a routine basis, or people are going to stop asking. So try to figure out what interests you the most…and then if you don't have a mentor, at your own institution, reach out across the electronic expanse of social media and find somebody with your interests”.
He further advises all Young ESCP members: “So by all means, take advantage of this pandemic to appreciate the restructuring of surgical education and realize that education is no longer limited to in-person at your particular place of employment, but it is a global opportunity, which will involve many, many more people that are present in your ‘immediate’ environment”.