Interactive Virtual Surgical Education During COVID-19 and Beyond

To the Editor: The COVID-19 pandemic put unprecedented limitations on surgical education. All medical students and many residents were essentially barred from participating in the operating room to mitigate disease exposure and transmission. While many curricular components can be translated into virtual learning, such as telemedicine encounters, online didactics, and video review, it is difficult to recreate the educational experience of the operating room.1 Exclusion from live surgery denies learners the opportunities to ask questions about the procedure, understand case flow, and develop team rapport. This is problematic for medical students and residents who have a limited window to make a specialty or subspecialty decision.2 To address this need, we developed an interactive virtual surgical experience for undergraduate and graduate medical education. For most surgical specialties, video is already an integral part of many procedures, including endoscopic, robotic, laparoscopic, and microscopic surgery. However, open surgeries, particularly those requiring narrow operative fields with limited ability for visualization by an observer, can be challenging to capture.3 We used commercially available head-mounted video recording devices (HERO7 Black, GoPro, San Mateo, California) with modified lenses (Peau Productions, Mapir Inc., San Diego, California) to produce high-definition first-person point-of-view videos. These videos were then livestreamed through a Health Insurance Portability and Accountability Act–compliant institution-supported videoconferencing platform, providing remote learners with a superb view of the surgical field and simultaneous audiovisual communication with the operative team. We believe that an operating theater such as the one we described is a critical educational experience that should be a component of any virtual medical student surgical rotation or surgical resident curriculum while in-person participation in the operating room is restricted. It is simple, economical, and safe for patients and trainees. We anticipate that interactive virtual surgical education platforms will continue to have a role in undergraduate, graduate, and continuing medical education beyond the COVID-19 pandemic, enhancing existing curricula and improving access to comprehensive surgical education in the United States and abroad.