PLASTA National Webinar Series: A developing model for remote surgical education.

Dear Sir,

The increasing popularity of web-based learning in plastic surgery over the last 5 years has been driven by convenience, cost, use of portable devices, and the rise of remote communication platforms , . The delivery of regional plastic surgery teaching programmes in the UK is variable, and the centralisation of services makes gaining experience in the entirety of the broad curriculum challenging. The Plastic Surgery Trainees Association (PLASTA) recognised the need for additional educational resources to supplement trainees’ preparation for the FRCS(Plast) examination. To this end, we designed a national webinar series based on the current 2016 Plastic Surgery curriculum.

Commencing in March 2019, we have hosted monthly webinars - web-based presentations or lectures delivered in real time via the internet – using the Zoom™ platform . This allows for video and audio conferencing, screen-sharing, live text chat and submission of questions. Participants are invited by e-mail (mean open rate 65%) through the PLASTA mailing list which currently has 732 subscribers. Participant demographics are collected via an automated registration process, and they are sent a unique link to log into the webinar. The webinars are advertised on social media, on WhatsApp™ via our network of regional representatives, and through the BAPRAS membership e-mail bulletin. Reminders are e-mailed to all registered attendees at one week, two days and one hour prior to the webinar.

Each webinar is structured around a Consultant-led presentation lasting 45 minutes, with an FRCS(Plast) exam focus, followed by a facilitated question and answer session lasting 15 minutes. At the conclusion of each session, participants are automatically redirected to a SurveyMonkey™ feedback form. Speakers, whom are all Consultant Plastic Surgeons and experts in their webinar topic, are provided with a certificate and a summary of feedback for use in appraisals and revalidation. All webinars are recorded, edited, and uploaded onto the PLASTA website for members only to access on-demand following speaker review.

We appointed a webinar co-ordination team in January 2020 to manage and develop the webinar series. We have found that the presence of a facilitator is essential to introduce the speaker, lead the Q&A session by eliciting questions and encouraging interaction, and ensure time-keeping.

Thirteen webinars have been held to date (Table 1 ). The mean number of registrants per webinar is 175 (range:58-469), with 101 (range:41-373) attending live. These attendance rates were initially consistent between 41-73 attendees, with a significant recent increase to between 162-373 per webinar over the last 2 months. Participants are of all training grades ranging from medical students to Consultants, with ST5-6 representing the largest group, potentially as an adjunct to their concurrent exam preparation. Participants represent every training region in the UK (Fig. 1) , in addition to increasing numbers of international trainees.

Table 1

Summary of Webinar Topics with Number of Attendees

Webinar Topic	Number of Attendees
Craniofacial Plastic Surgery for FRCS (Plast)	73
Brachial Plexus Surgery for FRCS(Plast)	63
Breast Reconstruction for FRCS(Plast)	41
Facelift for FRCS(Plast)	61
Neck Dissection for FRCS(Plast)	67
Hypospadias for FRCS(Plast)	51
Facial Palsy for FRCS(Plast)	64
Mandibular Reconstruction for FRCS(Plast)	52
Congenital Hand Surgery for FRCS(Plast)	63
Oncoplastic Breast Reconstruction for FRCS(Plast)	70
Flap Reconstruction of the Hand for FRCS(Plast)	162
Aesthetic Breast Surgery for FRCS(Plast)	174
Free Flap Breast Reconstruction for FRCS(Plast)	373

Fig. 1

Distribution of Attendees by Region

The webinar series has received positive feedback for quality of content, educational value, and relevance with a mean overall rating of 93/100. Trainees have consistently highlighted the utility of the Q&A session. When asked about webinar logistics, 90% opt for email as their preferred method of contact, 54% favour webinars on Tuesday evenings and 64% favour a start time of 7pm. 73% of participants suggest an ideal webinar duration of 45-60 minutes whilst 16% prefer 60-90 mins. Over 98% of attendees state they benefit from access to recordings.

The webinar format provides unparalleled accessibility for participants, unrestricted by location, venue requirements or cost. The webinars cost the association less than £1/trainee/webinar to facilitate, which is advantageous in the current era of growing training costs and diminishing study leave budgets. In addition, trainees have access to specific teaching in areas of the FRCS(Plast) syllabus that might not be experienced in their region, for example Craniofacial and Hypospadias.

We are currently building working collaborations with the International Confederation of Plastic Surgery Societies (ICOPLAST) and the Pulvertaft Hand Centre, to expand the webinar series further. We also work closely with the BAPRAS Education Committee to theme our webinars around the BAPRAS Advanced Educational Course Series, and are developing our repertoire of webinars to support junior trainees in ‘preparation for ST3’ and managing plastic surgery cases whilst on call.

The unprecedented situation of the COVID-19 pandemic, with inevitable loss of plastic surgery training opportunities, has resulted in an increasing demand for remote training. This is supported by the significantly increased attendance at our most recent webinars, which we have responded to by increasing the frequency of webinars to weekly, to provide trainees with ongoing learning opportunities in the absence of normal clinical practice throughout the pandemic.

The PLASTA Webinar series is proving a reliable, cost-efficient and convenient learning tool that can enhance surgical training by engaging trainees through remote, yet collaborative, learning. We recommend use of this model to other surgical training programmes to supplement, but not replace, clinical training and face-to-face learning opportunities.

Declaration of Competing Interest

None