key: cord-0783409-59x750y7 authors: Loh, Chee Hoou; Ong, Felicia; Oh, Choon Chiat title: Teledermatology for medical education in the COVID-19 pandemic context date: 2022-01-10 journal: JAAD Int DOI: 10.1016/j.jdin.2021.12.012 sha: fb0d90933cac6167c25d4b4a7f55340179839b2d doc_id: 783409 cord_uid: 59x750y7 nan . We report six studies involving 897 participants, that provided 41 objective data on TD for educational purposes (Table 1) . 42 43 TD in residency programs prior to the pandemic were commonly used in academic medical 44 centres to deliver access to dermatology care to the underserved communities, including 45 residents of rural and remote areas such as the Amazonia. With the pandemic, the use of TD 46 has expanded into almost all areas of dermatology practice. 47 48 There has been a proliferation of virtual scientific meetings and faculty-led online teaching for 49 residents during the pandemic. 90.3% of scientific meetings were held face-to-face before the 50 pandemic, which drastically reduced to 8.3% during the pandemic 1 . More than 70% of 51 respondents are willing to attending virtual meetings and webinars, and those who did were 52 more likely to be utilising TD for clinical care 1 . 53 54 TD was reported to be beneficial for education of dermatology residents, who participated in 55 TD consultations followed by formulating an assessment and management plan, supervised by 56 an attending dermatologist. 91% of Canadian residents reported that TD had added to their 57 education in a positive and meaningful way 1 . TD provided high caseloads in a low-stress 58 learning environment, allowing opportunities to consider broad differential diagnosis while 59 developing visual diagnostic and triage skills 2 . 75% of UK dermatology residents reported that 60 the use of online educational modules was a suitable alternative to face-to-face teaching 3 , and 61 88% of residents agreed that this sufficiently supplemented their learning requirements 3 . . 62 J o u r n a l P r e -p r o o f 91% of Canadian dermatology residents would like to see tele-dermatology being incorporated 64 into their residency curriculum, an opinion concurred by 62% of their faculty members 4 . 65 Surprisingly, only 35% of faculty had incorporated TD into their resident teaching during the 66 pandemic. This is in direct contrast to a global survey which found that the majority of faculty 67 members had utilised webinars and virtual rounds to facilitate resident teaching 1 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 There has been a rise in trainee confidence levels with the use of TD, with 58% of residents feel slightly confident in managing TD, as compared to 15% from a previous survey pre-pandemic 5 . 74% of residents felt neutral or unprepared to virtual working during the pandemic. 61% of residents agreed that virtual working would also be beneficial for clinicians, even in the post-pandemic era. 100% of residents had conducted virtual consultations during the pandemic. Virtual consultations Use of TD was result in higher productivity (11.49 cases seen per hour) as compared to face-to-face clinics (4.55 cases seen per hour). TD provide a high caseload, a low-stress learning environment, and opportunities to consider a broad differential diagnosis while developing visual diagnostic and triaging skills. All the participants who responded to the survey provided positive narrative comments. 2 respondents used the word 'fun' to describe their TD experiences. 1 respondent commented that use of TD improved his visual diagnostic skills and 'obviates any awkwardness when discussing lesions in front of a patient and allows residents to ask detailed questions about morphology'. The authors concluded that survey respondents may have felt the need to provide positive reviews of the program. There may be limited generalisability be due to differences in electronic record systems and the costs of implementing and integrating TD across different healthcare settings. 75% of residents rated online educational modules combined with tutor-led virtual session were a suitable alternative to traditional face-to-face teaching. 62.5% of residents rated the online teaching slides as 'excellent'. 88% of residents also reported that the online modules were sufficiently supplemented their learning needs to cover the Dermatology JRCPTB curriculum, in addition to regular clinical training. Residents also reported that ease of accessibility and lower risk of infection as major benefits of TD. Main limitations include access to technology, internet connectivity and lower levels of direct engagement between tutor and learner in larger groups. J o u r n a l P r e -p r o o f 1. The COVID-19 pandemic had caused massive disruptions to medical education around the globe. 2. Tele Dermatology has enabled continuation of medication education for residents and fellow during the pandemic, manage patients remotely, engage in learning activities and communicate seamlessly with colleagues and faculty. Virtual 92 conferences and e-learning in dermatology during COVID-19 pandemic: Results of a web-93 based, global survey Resident Experience and Education Electronic Learning for Healthcare e-Dermatology 97 modules as a key educational tool for trainees during the COVID-19 pandemic: a regional 98 experience Utilization and Integration in Residency Training Over the COVID-19 Pandemic Med Surg A UK-wide survey looking at teaching and 103 trainee confidence in teledermatology: a vital gap in a COVID-19-induced era of rapid digital 104 transformation? A paradigm shift in trainee confidence in 106 teledermatology and virtual working during the COVID-19 pandemic: results of a follow UK-wide survey