Peer-assisted Virtual Learning in Basic Surgical Skills for Medical Students in Malaysia during the COVID-19 Pandemic
Authors: Chandrasagran Raymen Arviin , Siew Lim Yee , Rahim Muhammad Zulkarnain Abd , Xian Lim Woei , Rajendra Abiramy , Chooi Wen Han , Lyn Goh June , Ng Yuki Julius 
Published: April 2024

Abstract

Introduction:
During the coronavirus disease 2019 pandemic, all in-person teachings were suspended. This includes opportunities to learn surgical skills among undergraduate medical students in Malaysia. Virtual learning became the prime modality of medical education for all Malaysian universities. InciSioN Malaysia designed and conducted an online suturing workshop to increase medical students’ exposure to surgical skills. This workshop aimed to evaluate the feasibility and the reception of such workshops for undergraduate medical students in Malaysia.

Methods:
All participants received a preworkshop handbook covering the basic techniques of knotting and suturing. The online workshop was 2 h and peer-led. We conducted the suturing workshop through Zoom and using a unique set-up to provide real-time skills sharing with immediate feedback. This involved connecting on Zoom with two devices from both the tutor and the participant. A smartphone to show the suturing and knotting skills and a laptop to provide tutor-to-participant feedback. Participants were divided into small peer-to-peer (PTP) teaching groups where tutors demonstrated the basic surgical skills according to the handbook.

Results:
All tutors’ reported challenges in orientating their equipment set-up to ensuring that their technique was visible to the participants. Few participants faced difficulties understanding the tutor’s instruction on the knotting technique. Variations in the participants’ and tutors’ camera angles and Internet connectivity issues hindered effective real-time feedback. All participants were satisfied with the knotting and suturing skills session and 80% of participants rated a score of higher than 4/5 on the overall workshop and the quality of the lecture. In the perspective of long-term outcome, participants were motivated to practice more on the knotting and suturing technique which was taught on the event day.

Discussion:
Online PTP surgical skills workshops can reduce the time, travel, and costs to deliver and receive surgical skills teachings. This increases the learning opportunities for medical students, especially within social distancing limitations. This can provide workshops to upskill health-care providers in remote areas. However, Internet connectivity, technical issues with meeting platforms, and camera angles limited the effectiveness of online suturing workshops. These issues can be tackled by prior testing of the orientation of the phone and checking for the speed of Internet connectivity. Participants enjoyed the small group PTP teaching as it provided a comfortable environment for immediate questions and feedback.

Conclusion:
Virtual skills workshop has the potential to continue surgical education and can develop an interest in surgery. More importantly, this model has the potential to reach remote areas where workshops like this are usually conducted in the cities.