American Council of Academic Plastic Surgeons
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University of Pittsburgh Plastic Surgery Virtual Sub-Internship: An Evolutionary Response to the Pandemic
Francesco M. Egro, MBChB, MSc, MRCS; Samyd S. Bustos, MD; J. Peter Rubin, MD; Jesse A. Goldstein, MD; Joseph E. Losee, MD; Vu T. Nguyen, MD
University of Pittsburgh Medical Center, Pittsburgh, PA,USA

Background: Plastic surgery programs ceased to offer in-person sub-internships due to the COVID-19 pandemic. To overcome this hurdle, the University of Pittsburgh developed a virtual sub-internship (vSub-I) to provide an overview of plastic surgery and insight into the residency program. This study aims to present the vSub-I program and objectively assess its impact on student education and satisfaction.
Methods: The vSub-I program consists of a virtual two-week experience, in which the student attends education and simulation sessions as well as one-on-one meetings with representative faculty/residents. Educational sessions include core conferences, grand rounds, journal clubs, indications conferences (head and neck, hand, breast, and pediatric plastic surgery), and case-review sessions discussing the breadth of plastic surgery including aesthetic surgery, breast surgery, pediatric plastic surgery, hand surgery, facial trauma, head and neck, and general reconstruction. Simulation sessions include cleft lip and palate, breast reduction, and flap markings. The student also participates in virtual social events with residents. Each student gives a 15-minutes talk during grand rounds about their journey and research/clinical interests. To assess this innovative program, student satisfaction was evaluated using an 8-question survey rated with a five-point Likert scale. Self-reported level of knowledge was assessed before and after the vSub-I using a 16-question survey rated with a five-point Likert scale.
Results: The vSub-I program was attended by 20 students distributed into five consecutive two-week blocks (four students per block) between August-October. The program included 50% males and 50% females, 25% underrepresented minorities and 10% international medical graduates. The mean overall level of knowledge before and after completion of the vSub-I was 2.84 (SDą0.98) and 3.78 (SDą0.77), respectively, and mean level of improvement was +1.10 (SDą0.82, p<0.0001). Mean overall satisfaction was 4.83 (SDą0.44). Importantly, all students felt they gained plastic surgery knowledge, insight of the culture and clinical breadth/volume, and insight of the faculty and residents of the residency program.
Conclusion: The vSub-I emerged as a response to the challenges of this new era. This study suggests that vSub-I offers a highly satisfactory experience by allowing direct involvement with our training program, and easy and effective incorporation of plastic surgery concepts.

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