key: cord-0076844-8xcvw63m authors: Linganna, Regina E.; Starks, Victoria B.; Weiss, Stuart J; Feinman, Jared W; Augoustides, John GT; Patel, Saumil J title: Mid-Atlantic Cardiac Anesthesiology – Leveraging Virtual Technology to Advance Continuing Medical Education date: 2022-04-08 journal: J Cardiothorac Vasc Anesth DOI: 10.1053/j.jvca.2022.03.041 sha: 65fa44ed50f9e0739c88c2b816cb135d036eb5b4 doc_id: 76844 cord_uid: 8xcvw63m nan disease while maintaining the integrity of trainee education. This stressful and challenging situation has forced educators to innovate and rethink traditional educational paradigms. This article discusses how, in the midst of this devastating pandemic, graduate medical education has evolved and flourished, specifically utilizing technology to overcome traditional logistical barriers allowing for inter-institutional collaboration. 7 We present several programs that were created, developed, and adapted in response to the pandemic with a focus on inter-institutional programs. Lastly, we discuss how the pandemic inspired and facilitated the creation of a new, multi-institutional conference, the Mid-Atlantic Cardiac Anesthesiology Conference. In response to the sudden disruption to clinical volume, the pain fellowship at the University of Washington established the Inter-institutional Pain Learning Exchange (PLEX) in Spring 2020. 8 This multi-institutional program consisted of daily didactic sessions in the form of faculty lectures or fellow-led difficult case or journal club presentations via the online video platform Zoom 9 . The goals of the PLEX program were to continue fellow didactic learning despite reduced in-person sessions while simultaneously providing a space for networking and sharing of curricular content and practice styles. The program was quickly established to minimize the loss of educational opportunities for the fellows since there was an abrupt stop and significant decline in office visits and procedures. The program's success was measured by frequent participant satisfaction surveys. Over 90% of participants found the various sessions helpful, agreed that the program was valuable to their growth as a pain specialist, and indicated that continuation of the program would be beneficial beyond pandemic times. 8 Despite an uncertain clinical environment, this program was quickly created in a time of stress and change and has become a permanent component of its fellows' education due to the adaptability and flexibility of its structure and ability to harness the full capabilities of virtual conferencing software. Similarly, oral maxillofacial surgery educators from around the United States developed the "Collaborative OMS Virtual Interinstitutional Didactic" (COVID) Program, a combined didactic program intended to enrich current resident education and potentially fill any educational voids that an individual institution may have within its traditional curriculum. 10 Content was delivered online over the course of twenty weeks and consisted of three weekly lessons followed by an expert discussion and subsequent question and answer session with attendees. This collaboration highlights the benefits of the inter-institutional format, which includes shared responsibility of curriculum creation, widespread opportunities for networking, presentation experience, and the ability to engage in human and professional connection during the pandemic. Continuous program improvement was maintained through weekly meetings among founding representatives and intermittent feedback collected from both faculty and resident participants. Online Video Didactics (COViD) series that featured daily lectures from renown faculty around the world. 11 Trainees could view and listen to the lectures on their own time. The initiative became an important resource for urology education with over 50 institutions from around the world as part of the collaborative, providing a library of lectures for asynchronous learning. The National Surgery Resident Lecture Series (NSRLS) was created in March 2020, and featured lectures from expert faculty from around the country. Over fifty general surgery programs participated, and the program lasted for 8 weeks until surgical case volume had resumed in May 2020. 12 In April 2020, the Virtual Global Spine Conference (VGSC) was created by a multiinstitutional, multidisciplinary team of neurosurgeons and neuroradiologists to provide a virtual case-based conference series to deliver spine education to attendings and trainees. Over 1,000 surgeons, trainees, and other specialists were recruited from around the world and an early survey showed that 92% viewed the content to be highly valuable to their practice and 94% would continue to participate post COVID-19. 13 Lastly, within our own specialty, the instructors Prospective institutions were approached over e-mail and every department that was invited, accepted the invitation to participate. After the member institutions were finalized, 1-2 core representatives from each institution were identified as liaisons to the conference directors. The idea for an in-person conference had been discussed amongst some of the institutions in the past; however, it was the embrace of videoconferencing in graduate medical education that allowed the idea to bear fruit and flourish. The development and creation of the conference was done systematically and stepwise starting with the development of clear goals and objectives. The objectives of the conference were multi-faceted, geared towards not only education for Adult Cardiothoracic Anesthesiology (ACTA) fellows, but also cardiothoracic anesthesia faculty (see Table 1 ). After the objectives were agreed upon, the logistics of the conference were established. Initially, the founders wanted to create a quarterly conference; however, to allow time for new ACTA fellows to orient into their new roles, successfully prepare for their ABA Advanced exam or critical care board exam, the conference is held thrice per year -Fall, Winter, and Spring. The directors polled representatives from each institution and after discussion, it was determined that Saturday mornings from 9AM-11AM would likely garner the most attendance. The conference is two hours in duration, and consists of 3 presentations, from either an ACTA Fellow or faculty member. After a ~20 minute presentation, at least 25 minutes of discussion are allowed. Fellows were asked to have a faculty mentor for their presentations who would act as a moderator during the discussion. To prevent interruption, participants were asked to submit As of January 2022, four meetings have taken place with 45-60 attendees per meeting. We continue to receive positive feedback from participants, generate fantastic discussion, and have even helped change practice in one institution, which started to incorporate regional anesthesia into minimally invasive procedures. This conference is specifically not a didactic lecture series geared towards ACGME topics. It provides a unique, society meeting-like venue for trainees and faculty to develop high-level presentations on advanced topics. By leveraging virtual conferencing technology, fellows not only learn as presenters, but also by engaging with faculty and content experts as participants. This conference provides a unique venue for discussion, collaboration, and debate by pooling faculty and content experts from multiple institutions. In the future, the conference will likely continue to grow and include more member institutions. We hope participants utilize the conference as a platform for collaboration for research and other scholarly activities, invited lectures or grand rounds, inter-institutional mentorship, and junior faculty career development. The COVID-19 pandemic has challenged the feasibility of traditional graduate medical education and has necessitated the creation and implementation of novel modalities of delivering didactic content to physician learners. The natural solution has been the utilization of virtual platforms, which have not only allowed for safe and rapid dissemination of information, but have even more impressively, cultivated means of inter-institutional educational collaborations that may not have otherwise come to fruition. A major shift has been from inperson didactic sessions to virtual learning. 15 Virtual meeting software has allowed for conferences and seminars at all levels, from intra-departmental to national society meetings and international conferences. Software, such as Microsoft Teams 16 and Zoom 9 , are now in the vernacular of most medical trainees. Online learning platforms have enabled faculty at other clinical sites to contribute to graduate medical education, whether that be within the same institution or from another one. 17, 18 Furthermore, traditional barriers to in-person attendance, such as off-site rotations, operating room clinical duties, post-call or duty hour restrictions that may prevent in-person attendance are overcome with virtual meetings that can be recorded and catalogued for asynchronous learning. Although this new paradigm is readily utilized at the departmental level, we presented several unique programs that maximized the benefits of virtual conferencing platforms and created multi-institutional educational initiatives. Combining educational resources and faculty experts from multiple institutions maximizes the educational experience of our trainees and offers academic opportunities for junior faculty. The authors, who founded the new, Mid-Atlantic Cardiothoracic Anesthesiology Conference, strongly believe it can be readily replicated in other geographical regions to further ACTA fellow education, promote faculty development and enrichment, allow for cross-institutional networking and Table 1 A professional and an academic opportunity for Cardiothoracic Anesthesiology faculty and fellows Venue for discussion and presentation of new and/or important topics in perioperative cardiovascular medicine and transesophageal echocardiography Venue to discuss trends and variability of institutional practice seeking to improve clinical practice, patient outcomes and efficiency Opportunity to develop professional relationships, collaboration and enhance academic careers COVID-19) Dashboard Fellowship Training in Adult Cardiothoracic Anesthesiology: Navigating the New Educational Landscape as a Result of the Coronavirus Crisis Interruption of the European Association of Cardiothoracic Anaesthesiology (EACTA) Pandemic: Consequences and Solutions Survey Says… The Effects of the COVID-19 Pandemic on Graduate Medical Education Anesthesiology Training in the Time of COVID-19: Problems and Solutions Resident Education and Redeployment During a Disaster Impact of the COVID-19 pandemic on ophthalmic specialist training in Virtual Opportunities for Learning and Collaboration in Chronic Pain Fellowships During the COVID-19 Pandemic and Beyond Resident Education in the Time of a Global Pandemic: Development of the Collaborative OMS Virtual Interinstitutional Didactic (COVID) How We Do It: Implementing a Virtual, Multi-Institutional Collaborative Education Model for the COVID-19 Pandemic and Beyond Virtual Spine: A Novel, International Teleconferencing Program Developed to Increase the Accessibility of Spine Education During the COVID-19 Pandemic Learning at home during COVID-19: A multi-institutional virtual learning collaboration Our education, our concerns: The impact on medical student education of COVID-19 Redesigning Fellowship Curriculum Amidst The Covid-19 Pandemic: Our Shared Experiences Reinforcing Cardiology Training During a Pandemic: An Open Letter to Our Leaders The authors would like to acknowledge the following individuals and their respective institutions for being part of the original MACA cohort: All authors declare no conflict of intertest.