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

Dear Sir,

We enjoyed the recent publication on the growth of high-quality webinar-based teaching from the Plastic Surgery Trainees Association (PLASTA) and would like to offer some reflections. We agree webinars have many advantages in terms of cost, accessibility, convenience as well as the ability to place experts in niche areas of Plastic Surgery right into the homes of trainees. Even illustrious educational institutions hark that web-based teaching is a welcome evolution of the humble lecture, but returning to this format after the war against coronavirus may seem like a step backwards. The exciting and high quality webinars that have been produced at speed by organisations including PLASTA, British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS), The British Society for Surgery of the Hand (BSSH) and the Pulvertaft Hand Centre amongst others is commendable and has been a welcome escape from the frustrations of cancelled teaching sessions, limited trainee-operating and re-deployment.

However, webinars are a single tool in a Plastic Surgeon's educational toolbox. Those who have delivered a web-based teaching session will appreciate the solitude of the connection: the software programmes give little back to speakers; most viewers watch with the camera off and the microphone muted; the nods, grimaces or confused faces of the audience are lost; the platforms do not facilitate question and answer freely, as in a traditional lecture theatre. Interaction between more than two people is challenging and the engaging ruckus of a live debate is numbed. Features like the survey function allow people to anonymously engage by voting, but clearly limits people to the choices in front of them.

Educational theory states that a multitude of teaching techniques can improve participant learning: some students prefer to read, some to listen, others to watch a video. This approach is likely an effective learning strategy to only a subset of learners, as those who prefer to learn through sequential or kinaesthetic methods can attain more using different techniques. Face-to-face meetings also offer a myriad of networking opportunities through the chance to meet with colleagues on the rotation, make new connections, or introduce yourself to your future boss!

Finally, and potentially the biggest flaw of webinars, is that they do not mandate reflection. Consider the last movie you watched with friends: do you remember the story, or your reflections afterwards? All of this can be lost with webinars, along with the non-verbal communication offered by the speaker and fellow meeting attendees. Let us not forget that ‘Man is, by nature, a social animal’: we have an innate need to connect with each other. A handshake, a nod, an appreciation of subtle facial movements, or an encouraging roar of laughter.

Can these be overcome? Of course. Through watching the webinars as a group, or discussing them post-hoc with peers we will deepen our educational experience. Furthermore, having a local consultant present to guide the discussion, and facilitate discussion between local trainees changes the potential passive nature of webinars to an active process, where knowledge can be readily applied to local circumstances. In the post-COVID-era, let us harness the value of webinars, and encourage educational authorities to do so also: but as part of the learning toolbox.

Declaration of Competing Interest

VG has organised the Imperial International Webinar Series.