Forced by the Pandemic to Move Online, Students Excel at Virtual Surgical Instruction

Moving a hands-on laboratory course online is no small feat, particularly for surgical skills training. However, in response to the COVID-19 pandemic, last fall UW School of Veterinary Medicine instructors teaching the surgery lab for third-year veterinary medical students had to get creative in their approach, utilizing a video conferencing platform.

Clinical professor Robert Hardie demonstrates surgical knot tying while a student, seen on the laptop, practices the same suturing skills remotely and receives real-time feedback
Clinical professor Robert Hardie demonstrates surgical knot tying while a student, seen on the laptop, practices the same suturing skills remotely and receives real-time feedback.

Robert Hardie, clinical professor of small animal general surgery, spearheaded the course’s transition to the virtual platform, Blackboard Collaborate, in coordination with fellow surgeons and instructional specialists.

Students learn technical surgery skills such as instrument handling, suturing, and knot tying in this lab. Pre-pandemic, the class of 96 students was split into small groups in one of the school’s large teaching lab spaces to practice various skills in person with an instructor.

When COVID-19 caused many classes to go entirely online in fall 2020, the lab moved from workstations to webcams. Rather than practice their surgical abilities face-to-face in the lab, students practiced at home in this rendition of the course. Then they met remotely with an instructor and fellow students via the virtual platform.

The school provided each student with individual surgery kits. In addition, instructional specialists McLean Gunderson and Tina Wahl worked tirelessly to make teaching models for students and ensure students had the necessary supplies to practice at home.

Groups of 10 to 12 students would meet online to work one-on-one with an instructor and receive direct feedback on their skills. By tilting their laptop or tablet camera down to show their hands, students could demonstrate their surgical technique in real time and receive commentary from their instructor.

“In the remote format, the students actually got more one-on-one, face-to-face contact than they would have in the other environment,” Hardie notes. In the traditional in-person labs, the instructors divide their attention between 12-14 students at their station; then, after about 20-30 minutes, the students rotate to another station. “In the end, the amount of direct one-on-one interaction with an instructor was increased remotely, even though the number of lab sessions was approximately the same,” he says.

Instructional specialists McLean Gunderson and Tina Wahl created surgery kits and handmade surgical teaching models for students to practice with remotely, including this model of the female reproductive tract to rehearse spay surgeries
Instructional specialists McLean Gunderson and Tina Wahl, left to right, created surgery kits and handmade surgical teaching models for students to practice with remotely, including this model of the female reproductive tract to rehearse spay surgeries.

An additional asset of the virtual lab format was that students could hear, watch, and learn from feedback given to other students in their group, which was not easily done in the traditional lab setting.

“Prior to COVID, students would practice in a large circle with ready access to the instructor but not be able to easily see what other students were doing,” Hardie explains. “Online, the ability to watch your peers practice was very beneficial because students could pick up on the nuances of the skills and learn from others’ struggles and successes.”

According to Hardie, the biggest challenge for instructors was managing students’ expectations and perceptions going into the online learning environment. “The initial impression of many students, I think, was ‘how can we possibly learn surgery online?’” he recalls.

“Online, the ability to watch your peers practice was very beneficial because students could pick up on the nuances of the skills and learn from others’ struggles and successes.”

As the course got underway, he says, many students took it on as a challenge — their concern for being proficient in surgical skills motivated them to work hard and test their perceptions of remote learning.

In general, student feedback on the remote skills training portion of the course was positive, and the majority of students felt very prepared for their in-person surgical labs. From the faculty’s perspective, students performed very well, and in many ways, were more efficient than in previous years.

“When we eventually moved to the in-person labs with animals, things went very smoothly and students had very few of the same types of struggles we saw in the past with traditional teaching methods,” Hardie notes.

Given the success of the online surgical lab, the teaching team is considering keeping a virtual component of the course in future semesters. Hardie foresees one challenge to this will be managing expectations again but in reverse. “Everyone will be expecting everything to be in-person, assuming that’s the gold standard, not realizing the benefits we witnessed this year,” he says.

Considering the students’ performance when taught online and the advantages of a more collaborative format, the instructors hope to teach parts of the course in a hybrid manner in the fall.

Maddie Arthur

This article appears in the summer 2021 issue of On Call magazine.

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