Implementation and Evaluation of a Formal Virtual Medical Student Away Rotation in Orthopaedic Surgery During the COVID-19 Pandemic

Abstract

Introduction: Away rotations are a valuable experience for medical students when applying for residency. In light of the coronavirus disease 2019 pandemic, there has been significant interest in the development of virtually based substitutes. This study evaluates the utility of a formal virtual fourth-year medical student away rotation in orthopaedic surgery by surveying participants and provides recommendations for success. Methods: A 2-week virtual orthopaedic elective was offered to fourth-year medical students in lieu of traditional in-person away rotations. The course consisted of multiple components such as subspecialty case-based didactics, “happy hours” with residents, assigned resident mentors, student case presentations, and observation of resident lectures. After course completion, anonymous surveys were administered to participants to evaluate the rotation. Results: Twenty-three of 24 participating students (96%) completed the student survey, and 22 of 24 participating faculty and residents (82%) completed the resident/faculty survey. Most students were very (87%) or somewhat (9%) satisfied with their experience and found the rotation to be a very (35%) or somewhat useful (61%) substitute for an in-person rotation. Students indicated that the rotation very (91%) or somewhat positively (9%) influenced their perception of the program. All students indicated that the rotation was very educational. Most students (91%) reported that the rotation was very useful for learning about the program and culture, with subspecialty didactics and happy hours most useful. Faculty and residents indicated that the rotation was useful for getting to know the students (17% “very useful” and 83% “somewhat useful”) and for assessing student characteristics, such as knowledge base and communication skills. Conclusions: A formal virtual orthopaedic surgery away rotation can be a valuable experience for medical students which provides educational value, insight into program culture, and an opportunity to demonstrate interest in the program. The curriculum and recommendations presented in this study can be used as a preliminary template for others interested in creating successful virtual rotations.

Graduating Medical Students’ Experiences with Away (In-Person and Virtual) Rotations During COVID-19: Analysis of the Association of American Medical Colleges (AAMC) 2021 Graduation Questionnaire (GQ)

“…The substantial differences we observed across all specialties in vAR suggest that early innovators regarding vRs represented a discrete set of specialties. 6 , 7 , 8 , 9 , 10 , 11 , 12 Aligned with recent literature on vRs largely targeting potential applicants (e.g., fourth year students) in the specialty, our observations indicate that selected surgical specialties were well-represented among these early innovators, in both multi-institutional and single-institution innovations. In mid-2020, the Society of Academic Urologists developed the first standardized virtual sub-internship in urology, which was subsequently implemented in 19 programs across the country.…”

“… 9 Descriptions of single-institutional experiences with vR implementation in surgical specialties include (among others), experiences in urology, 20 plastic surgery, 21 , 22 , 23 vascular surgery, 24 , 25 otolaryngology, 26 and orthopaedic surgery. 8 Based on published reports to date about surgery specialty vRs, there is substantial variation in duration of vRs, ranging from 1-4 weeks 24 , 26 and content of the vRs. 19 , 24 Furthermore, these vRs may or may not meet requirements for participants to receive credit from their home institutions.…”

“…During the 2020-2021 academic year, schools and specialty organizations supplemented in-person away rotations (ipARs) with innovative, new virtual rotations (vRs). 6 , 7 , 8 , 9 , 10 , 11 , 12 We sought to describe the characteristics of participants in each of ipARs and vARs among students who graduated in the 2020-2021 academic year and to identify the extent to which specialty was independently associated with AR participation.…”

Assessing the Impact of COVID-19 on the 2021 Orthopaedic Surgery Match Outcomes

“…Indeed, program directors ranked virtual rotations in the 2020 to 2021 cycle as a less important selection criterion than away rotations in the previous cycle 14 . Programs were also less likely to invite back virtual away rotators for an interview compared with in-person rotators in prior years 11 , 12 . It remains unclear how student performance on virtual away rotations will factor into the orthopaedics applicant evaluation process as in-person away rotations resume.…”

“…The Doximity system was chosen because it reflects the opinions of orthopaedic surgeons; accordingly, it must be interpreted in light of its inherent subjectivity. In addition, this study considered formal virtual away rotations as a single entity, but the components of virtual away rotations—such as duration, didactic sessions, and interaction with attending physicians—may have varied between programs 12 , 13 . The findings related to virtual away rotations may also be subject to response bias due to the survey response rate of 48%.…”