key: cord-0791149-lr3wbt21
authors: Padley, Roxanne H.; Pace, Bruno Di
title: COVID-19 Lockdown Learning: The Revolution of Virtual Teaching
date: 2020-08-29
journal: J Plast Reconstr Aesthet Surg
DOI: 10.1016/j.bjps.2020.08.075
sha: 2fba8a2052e4a95e6989077a02932ac16021fadf
doc_id: 791149
cord_uid: lr3wbt21

nan

We commend the authors' recognition of the significance of continued professional development as well as the analysis of telehealth platforms as a means of communication among medical students, registrars and world-class surgeons. Indeed, what is most thoughtprovoking is that access to a wider variety of teaching surgeons across the globe may lead to even better trained students and registrars as they are exposed to a broader spectrum of surgical techniques being demonstrated by different surgeons drawing on the experience of different healthcare systems. In this sense, distance training for student doctors could be even more engaging due to this wider variety of remote instruction. 2 3 However, an area which could have been addressed in more depth is how the authors foresee the development and use of this technology in this current de-escalation period and beyond. Sleiwah et al. mention that webinars may indeed replace face-to-face lectures, but they failed to consider this transitional phase of the pandemic and the potential use of blended learning 3 whereby face-to-face instructional elements are in fact complemented by online modules.

Indeed, despite the undoubted benefits of having a wider access to surgical demonstrations via online platforms, in the long term it is unlikely that it would be feasible for doctors and particularly surgeons in training to acquire the necessary skills without an integration of hands-on practical and clinical elements. Evaluation and assessment of these same skills would also be near impossible. Therefore, a potential solution to this would be combining the two in the short to long-term post COVID-19 stages, while abiding by social distancing measures. This approach, if adopted, could also potentially increase access to remote surgical assistance, education and mentoring for resource-poor or conflict states.

A further valid point raised is most definitely that of security in the use of online platforms to maximise healthcare resources, the authors state the importance of safeguarding confidential information and suggest frequent updates of software. They also cite the use of specifically designed surgical platforms for secure storage and remote telesurgery among surgeons showing the example of free flap tissue transfer. However, what is not taken into consideration under this section is the need to potentially adapt patient consent in these cases. Generally speaking, a patient would consent to recordings being used for medical teaching but mention of consent to live streaming should also be considered and Sleiwah 4 and colleagues would have been prudent to consider not only the student doctor's perspective but the medical-legal perspective of patient consent.

This last point is also relevant as the question of security and privacy extends beyond providing remote learning opportunities but there is also much consideration of virtual consultations and clinics being used both in the public and private sectors and the question of patient privacy will as ever be at the forefront. 4 Proceeding with online consultations (also for teaching purposes), in order to maintain social distancing, opens up new considerations for all kinds of observers who would usually be present in a teaching hospital context (medical students, trainee healthcare practitioners, healthcare communication specialists, researchers) and thinking of ways for this to be developed represent the next stages in this new era of telehealth and learning.

In conclusion, although the authors' choice of "uprising in virtual teaching" in the title was certainly intentional, implying rebellion or revolt, we would assert that the correct term to coin would more likely be a revolution; namely a revolution for all parties involved.

COVID-19 Lockdown Learning: The uprising of Virtual Teaching

COVID-19 video conferencing: Preserving resident education with online meeting platforms

Teaching online: A practical guide

COVID-19 The Great Disrupter

The authors have no financial interest to declare in relation to the content of this article and have received no external support related to this article. No funding was received for this work.