Teaching Surgery Online: Making The Impossible Possible

Surgical practice has evolved over the centuries, more so in past 2 decades. However, continuing surgical education practices remain antique.

Strongly dependent on hands-on-training, surgeons limitations of travel and time dedication, affects access to learning. Newer technologies for adaptive and immersive learning, including virtual reality and augmented reality has evolved over the past 5 years. It’s use might help to improve reach and quality of professional surgical education.  But some key questions to be answered are access to technology, adaptability and behaviour change.

As an experiment, one year skill development program, Diploma in Minimal Access Surgery, with 80% of learning happening online and 20% offline was introduced for the first time in India to train surgeons on minimal access surgery. Online included the use of smart learning management system with AI, virtual reality, augmented reality, real time app based logbook, live surgery streaming and scheduled mentor interactions. Offline training included over the shoulder learning, hands-on and interactive class room learning over one week. Program enrolled 70 students in the first batch.

In total 67/70 accessed the course (Ongoing). Over the period of 8 months, 34 video modules, 8 live interactions, including surgery streaming and one in person session with faculty, were conducted. Course received 100% attendance, with 3 or less reminders. A survey conducted at half time, to evaluate the effectiveness and net promoter,  73% responded (49/67). Average rating for the course stood at 4.35/5. Majority felt ‘Live Surgeries’ and ‘Virtual Contact Sessions’ were the most helpful ones. Ninetysix percent (96%: 47/49) said they either ‘agree/strongly agree’ that faculty provided all the necessary information during live surgeries and video lectures. When asked about ‘How likely are you to recommend the course to your peers?’, 47/49 rated either =or>7/10, and 26 responded 10/10. Providing the course a net promoter score of 77.55% (More than 70% is considered as ‘world class’).

Access to internet was not a limitation, and surgeons were quick to adopt. Feedback and survey responses indicate a blended learning approach, with didactic lectures delivered online and key surgical skills trained in-person, would increase the skilled surgeon base at a faster pace in India.

To date, the fourth batch is ongoing with 500+ surgeons getting trained online.

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