RESIDENTS & FELLOWS COMMITTEE The Future of Virtual Education for the Urology Trainee: A Standardized Curriculum in the Post-COVID-19 Era
By: Miyad Movassaghi, MD | Posted on: 01 Apr 2022
The COVID-19 pandemic has changed all of our lives, and the impact on surgical training and education has been substantial. Trainees, students and faculty have met these changes with flexibility and resilience, all while stepping up to provide patient care on the front lines. In these trying times, there has been a silver lining: programs across the country have been pushed to find new ways of educating residents. These efforts have resulted in a multitude of cross-institutional collaborations to put together virtual didactic programs.
The original Halstedian approach to surgical education sought to develop surgeon clinicians, teachers and researchers through apprenticeship and learning by doing, with graded responsibility granted to the trainee over time. From this model evolved more formal educational practices taking place outside of the operating room, including a combination of bedside rounds, faculty lectures, tumor board didactics, morbidity and mortality conferences, and independent textbook-oriented learning. This process has relied heavily on each institution designing its own curriculum, resulting in significant heterogeneity across programs.
The rapid adoption and implementation of virtual education platforms commanded by the pandemic has changed the landscape of surgical education altogether. At the onset of the pandemic, half of surveyed U.S. urology program directors reported a significant negative impact of the pandemic on resident surgical and didactic education.1 As a response, urological educators from across the world came together and created daily topic-, guideline- and case-based didactic lectures, expert panels and surgical video reviews. The New York Section of the AUA (EMPIRE [Educational Multi-Institutional Program for Instructing Residents]), Albany Medical College (Urology Teaching Collaborative), University of Southern California (Urology 60 Minutes), Endourology Disease Group of Excellence Consortium (EDGE Talks), University of California, San Francisco (COViD [Collaborative Online Video Didactics]) and many other groups answered the call and brought together experts in the field to give live video lectures. Social media and word of mouth quickly popularized these platforms, which soon had hundreds of daily views. In response, for both the COViD2 and EMPIRE3 series, feedback from viewers reported over 90% positive impressions, with nearly 100% of viewers reporting a desire to have the lectures continue in the future.
It’s time for professional urology societies to bring together the best from all of these independent lecture series to centralize and optimize a virtual learning platform: a platform that provides a virtual curriculum to be accessed and used by all trainees. All of the virtual lectures should be peer reviewed, curated and organized based on guidelines, cases, surgical techniques and practice updates into a standardized curriculum. Tabakin et al have made a similar proposal: a national virtual curriculum created by expert groups that supplements, rather than replaces, individual resident educational programs. The benefits of such a comprehensive, expert-reviewed curriculum would be long lasting. Furthermore, it would allow us to combine and complement existing AUA resources including the AUA Core Curriculum, AUA University Surgical Video Library, Fundamentals in Urology Course, Annual Board Review and Oral Board Review courses.4
We are in a new era of graduate medical education in urology. There is no doubt that we have made strides. For medical educators who have made “lemonade out of lemons” during the pandemic and created the best possible circumstances for learners to continue to succeed, we thank you. But if we are to capitalize on the innovative advances during the pandemic, we need to channel our current momentum to optimizing a virtual platform; a platform that incorporates all the content available to trainees into a single standardized curriculum. The time is now.
- Rosen GH, Murray KS, Greene KL et al: Effect of COVID-19 on urology residency training: a nationwide survey of program directors by the Society of Academic Urologists. J Urol 2020; 204: 1039.
- Li Y, Chu C, de la Calle CM, et al: Multi-institutional collaborative resident education in the era of COVID-19. Urol Pract 2020; 6: 425.
- Smigelski M, Movassaghi M, Small A: Urology virtual education programs during the COVID-19 pandemic. Curr Urol Rep 2020; 21: 50.
- Tabakin AL, Patel HV and Singer EA: Lessons learned from the COVID-19 pandemic: a call for a national video-based curriculum for urology residents. J Surg Educ 2021; 78: 324.