COVID-19 and the medical education system in ophthalmology – Lessons learned and future directions

摘要

Dear Editor, COVID-19 pandemic has impacted not only the healthcare system but also the education system globally. In the process, medical teaching has also suffered. The conventional classroom teaching, bedside teaching, clinical grand rounds, and surgical training were completely stopped. The ophthalmology curriculum is an integral part of the undergraduate teaching program and imparts basic knowledge to promising doctors to serve the community in the future. It also forms the fundamental basis of future ophthalmology training if pursued at the postgraduate level.[1] All healthcare resources are channelled to combat this outbreak, largely affecting the teaching activities. Medical education and patient care must receive equal weightage and should continue simultaneously. To address these issues and to ensure that the students continue with their academics without losing precious time, there has been a paradigm shift toward online teaching classes, webinars, surgical video sessions, and interactive tutorial sessions. Furthermore, this is an opportunity for medical educators to plan various innovative methods that can help to ensure quality medical education during the crisis period and prepare for unpredictable outbreaks in the future. Technology should be leveraged and used to the maximum during the pandemic.[2] The traditional classroom lectures, where face-to-face interactions in large-group settings can potentially be the hotspots for the spread and transmission of the disease, cannot be conducted. There is a need for change in the mindset to transform in-person to online teaching, which is the new paradigm shift that has occurred recently and will stay in the future. With different e-learning platforms, weblinks and videoconferencing can be used to deliver lectures or conduct tutorials remotely with the students by using laptops and smartphone devices.[3] Furthermore, teleconsultation and teleconferencing can be adopted to demonstrate medical procedures and surgical techniques.[4] Thus, centralized teaching shall continue even with the cessation of in-person lectures and interhospital movements. Remote instruction via instructional videos or online webinars can be integrated into the training programs. The students may be followed by the faculty members with online discussions to assess their state of learning and progression. The study conducted by Chatziralli et al. has stated the significant increase of e-learning tools during the pandemic.[5] Challenges to online education reported in the medical literature so far include issues relating to time management, use of technology tools, students’ assessment, communication, and the lack of in-person interaction.[67] Grand rounds are conducted via online platforms. This has opened new facilities to invite national and international faculties to share their knowledge and discuss the cases at reduced cost and travel time. A variety of online teaching materials can be available in the e-library where students can access and learn at their convenient time. Time management and quality video-based teaching can be a valuable learning experience for the students. Furthermore, the use of digital tutorials shall enable the students to send live questions to their clinical tutors, who in turn shall explain to the entire group. Virtual conferences with online access to video teaching sessions can be attended both at the national and international level with reduced cost and have a positive impact on the students. A disadvantage is that it reduces the opportunity for residents to network with senior ophthalmologists, some of whom may become fellowship preceptors. In the future, models for massive online interactive conferencing, which will help students to make social connections, will be much encouraged. Ophthalmic surgery requires additional skills of hand–eye coordination compared to other surgical specialties. A study by Mishra et al. reported that 80.7% of the trainees experienced