Lessons from the Effective Implementation of a Hybrid Virtual Clinical Model for Surgical Clerkships during the Covid Pandemic: Impact on Academic Performance, Burnout and Surgical Interest

Abstract

Objective: Determine the academic and psychosocial impact of a hybrid-virtual surgical clerkship in medical students during the Covid Pandemic.Background: The Covid-19 pandemic has forced universities to modify their academic curriculum to adapt and overcome never before seen adversities. Herein we present the implementation of a Hybrid Virtual Clinical Model for Surgical Clerkships and its comparison against traditional face-to-face learning.Methods: We surveyed 47 medical students prior to their first-ever clerkship using Maslach’s Burnout Inventory and a questionnaire regarding their interest in surgery as a career path before and after their clerkship. Burnout rates, clinical exposure, academic performance, and surgical interest were analyzed and compared against results from prior year students on a traditional program.Results: Baseline burnout was significantly lower in the hybrid model (15.4% vs. 2.6%, p=0.048). The same was seen on alternate burnout rates (33.3% vs. 10.3%, p=0.02), differences remained after three months of clerkship (23.1% vs. 5.1%, p=0.023). When comparing different domains such as professional fulfillment, depersonalization, and fatigue, the hybrid model did overall better. Clinical exposure hours were statistically significant between both groups (954.32 vs. 276.33, p=0.001), however, when considering virtual clinical hours, no significant differences were found. Despite the hybrid group having a lower midterm exam score (68 vs. 77.49, p=0.001), final exam scores were similar between groups (74.97 vs. 75.89, p=0.662).Conclusion: We believe our model may be useful for other programs to maximize clinical exposure while minimizing the risk of exposure, maintaining maximum academic performance, and preserving the surgical interest of rotating alumni.ACGME Competencies: Practice-Based Learning and Improvement