Virtual arthroplasty training during the COVID-19 era: Is this the way forward?

14 Apr 2020

by Mazin Ibrahim and Andrew Poole
London Health Sciences Centre, University Hospital, London Ontario, Canada

Published 14 April 2020

The coronavirus pandemic has surprised us and drastically changed our training plans for the rest of the year. As post T&O training fellows in a foreign country, we want to invest every single minute to learn and operate before embarking on our future consultancy career. This pandemic affected all of our plans as elective work has temporarily vanished. We are left vying for emergent cases amongst ourselves while sharing limited operating room resources with other surgical specialties. This results in minimum operating time and less training.

As a fellow of the London Health Sciences Centre (Rorabeck-Bourne arthroplasty institute) in London, Ontario in Canada, we receive regular weekly teaching covering all aspects of arthroplasty with a focus on complex cases. Social distancing and the restrictions imposed, to avoid the spread of the virus, has introduced virtual arthroplasty training to compensate for the loss of the teaching opportunities. Online conferences via Zoom have introduced a new era of training and teaching, which we have found more efficient than face to face training as you can do it at your convenience away from peak productive time during a busy work day. The amount of teaching and discussion in the last week alone are testament to the effectiveness of these virtual conference rooms. Professor Richard McCalden, the director of our fellowship program, has launched this initiative. He is dedicating his time to discuss very complex cases in a systematic way similar to the usual teaching we receive, but in a virtual fashion. These conferences will be held regularly with each meeting lasting for at least 2 hours to cover a variety of complex lower limb arthroplasty cases supported by evidence based discussions. Additionally, the American Association of Hip and Knee Surgeons (AAHKS) have launched an initiative for fellows named the FOCAL Initiative: Fellows Online COVID-19 AAHKS Learning granting free access to anyone. This is an excellent experience in which we have the opportunity to spend one to two hours daily discussing a variety of topics presented with renowned North American surgeons who dedicated their time to teach. We have spent numerous hours sitting through these meetings where we have discussed a large number of complex cases covering numerous arthroplasty topics.

We have found this to be an extremely successful experience, which made us think, is this the way forward for the orthopaedic training? Will this help to avoid rushing and moving from one hospital to another to attend teaching sessions and will this be more applicable for trainees and residents? In discussions with co-fellows it appears the difficult challenge of having educational lectures at one facility while also having clinical responsibilities across town at a different campus are the same regardless if you train in London, UK or Greenville, SC. The coronavirus era could help reshape training and teaching in the future as we now recognize the value of online technology in Orthopaedics. We appreciate that it can help us gather for teaching, training, and believe it or not, even a happy hour party with friends. Ultimately this pandemic may have single handily sped up the incorporation of technology into Orthopaedic education.

We hope that everyone stays safe and we hope that this will end soon, but in the interim, there are many lessons to learn from this extraordinary time.

Mazin Ibrahim is a post CCT fellow from London, UK who completed his training from the Northeast Thames London training program (University College London).

Andrew Poole is a post-training fellow from Greenville, South Carolina who completed his residency training from Greenville Health System (Prisma Health).

The Transient Journal