Webinars in plastic and reconstructive surgery training - a review of the current landscape during the COVID-19 pandemic.

Dear Sir,

The COVID-19 pandemic has resulted in cancellation of postgraduate courses and the vast majority of elective surgery. Plastic surgery trainees and their trainers have therefore needed to pursue alternative means of training. In the face of cross-speciality cover and redeployment there is an additional demand for COVID-19 specific education. The Joint Committee on Surgical Training (JCST) Quality Indicators for Higher Surgical Training (HST) in Plastic Surgery state that trainees should have at least 2 h of facilitated formal teaching each week. Social distancing requirements have meant that innovative ways of delivering this teaching have needed to be found. A seminar is a form of academic instruction based on the Socratic dialogue of asking and answering questions, with the word originating from the Latin word seminarium meaning "seed plot”. Fast and reliable internet and the ubiquitous nature of webcams has led to the evolution of the seminar into the webinar. Whilst webinars have been common place for a number of years, they represent an innovative and indispensable tool for remote learning during the COVID-19 pandemic, where trainees can interact and ask questions to facilitate deep and meaningful learning.

Speciality and trainee associations have traditionally used their websites and email lists to publicise training opportunities. However, the COVID-19 pandemic has seen a shift to social media; with people seeking constant updates and information from public figures, brands and organisations alike. Surgical education has mirrored this trend, and we have increasingly observed that webinars are being launched through speciality and trainee association social channels to keep up with the fast-paced demand for accessible online content. The aim of this study was to audit cumulative compliance of active publicly accessible postgraduate plastic surgery training webinar frequency and duration against JCST Quality Indicators.

We used the social listening tool Brand24™ (https://brand24.com). This tool monitors social media platforms for selected ‘keywords’ and provides analysis of search results. We used the search terms “Plastic Surgery Webinar”, “Reconstructive Surgery Webinar”, “Royal College of Surgeons”, “BAPRAS”, “BSSH”, “British Burns Association”, “PLASTA” and “BSSH”. There were 733 mentions of these terms from 6th May 2019 to 5th May 2020 and 727 of these were after 23rd March 2020, the date that lockdown began in the United Kingdom (UK). This represents an increase of 12,017% post-lockdown. We supplemented this search strategy by searching Google™ and YouTube™ with “Plastic and Reconstructive Surgery Webinar”. These search engines rank results in order of relevance using a relevancy algorithm, we therefore reviewed the first 100 results only. Additional webinars were identified through a snowballing technique where the host webinar webpage was searched for advertised webinars at other institutions. We included any educational webinar series aimed at trainees that was free to access, mirroring weekly plastic surgery HST teaching. Free webinars which required membership registration were also included. We excluded webinars aimed at patient or parent education, webinars with less than one video, any historic webinar that did not have an accessible link and webinars behind a paywall or requiring paid membership. We systematically reviewed the search results from Brand24™, Google™ and YouTube™ and identified webinar series currently in progress (Table 1 ) and historic webinar series (Table 2 ). Seven active webinar series and two historic webinar series were identified respectively. All were consultant or equivalent delivered. Of the active webinar series, 3 (43%) related to COVID-19, 2 (29%) related to aesthetic surgery, 1 (14%) related to pan-plastic surgery and 1 (14%) related to hand surgery. The weekly total running time for active webinars amounted to 8 h 30 min, with 4 h and 30 min plastic surgery specific. This was a surplus of 2 h 30 min to JCST Quality Indicators.

Table 1

Active plastic and reconstructive surgery webinar series in progress during COVID-19.

Host	Webinar series Theme	Frequency	Duration (minutes)	Registration and viewing details
Royal college of surgeons of England	COVID-19	Weekly	60	https://www.rcseng.ac.uk/news-and-events/events/covid-19-webinars/?_id=B3FC6CC4688A4A7E8A52FD0F81E50FDA&_z=z
Royal college of surgeons of Edinburgh	COVID-19; head and neck surgery	Weekly	60	https://www.rcsed.ac.uk/professional-support-development-resources/learning-resources/webinars
British association of plastic, reconstructive and aesthetic surgeons (BAPRAS)	COVID-19	Weekly	120	http://www.bapras.org.uk/professionals/training-and-education/bapras-events/COVID-19-webinars
Plastic surgery trainee Association (PLASTA) UK	Pan-plastic surgery	Weekly	60	https://www.plasta.org/education/resources/webinars.aspx
Pulvertaft hand centre	Hand surgery	Weekly	60	https://www.pulvertafthandcentre.org.uk/derby-on-line-teaching-programme/
International master course on aging science (IMCAS) academy	Aesthetic surgery	Weekly	90	https://www.imcas.com/en/academy/webinars
The international society of plastic surgery (ISAPS)	Aesthetic surgery	Weekly	60	https://www.isaps.org/webinars/

Table 2

Historic plastic and reconstructive surgery webinar series available online.

Host	Webinar Series Theme	Duration (minutes)	Achieve details
International Confederation of Plastic Surgery Societies (ICOPLAST) Confederation	Pan-plastic surgery	Variable	https://www.youtube.com/channel/UCcQQrZp97sAOZT2NLn8jw7w/videos
The Aesthetic Society	Aesthetic surgery	60	https://www.surgery.org/professionals/publications/webinars

Limitations of this study include us only identifying webinars advertised publicly. We are aware of training programmes in the UK running in-house webinar series to supplement training and therefore the total available for training is likely to be higher than we have identified. We have also not reviewed the quality of educational content. We acknowledge there are good quality webinar series that require paid for membership such as those provided by the British Association of Aesthetic Plastic Surgeons and American Society of Plastic Surgeons but it was not the aim of the study to present them here.

Innovation flourishes during times of crisis. The education of surgical trainees is of paramount importance and should be maintained, even during the difficult times we currently face. While operative skills will be difficult to develop, the use of technology can allow for the remote delivery of expert teaching to a large number of trainees at once. In this study we identify a number of freely available webinar series that provide a greater number of teaching hours than is recommended by the JCST. The training exists, it is up to trainees to make the most of it.

Conflict of Interest

None.