Pivot to online learning for adapting or continuing workplace-based clinical learning in medical education following the COVID-19 pandemic: A BEME systematic review: BEME Guide No. 70

Figures & data

Table 1. Quality assessment of the interventions.

Bias source	High quality	Unclear quality	Low Quality
Underpinning bias	Clear and relevant description of theoretical models or conceptual frameworks that underpin the development.	Some limited discussion of underpinning, with minimal interpretation in the context of the study.	No mention of theoretical underpinning.
Resource bias	A clear description of the cost/time/resources needed for the development.	Some limited description of resources.	No mention of resources.
Setting bias	Clear details of the educational context and learner characteristics of the study.	Some description, but not significant as to support dissemination.	No details of learner characteristics or setting.
Educational bias	A clear description of relevant educational methods employed to support delivery.	Some educational methods mentioned but limited detail as to how these were applied.	No details of educational methods.
Content bias	Provision of detailed materials (or details of access).	Some elements of materials presented or summary information.	No educational content presented.

Figure 1. PRISMA flow diagram for included studies.

Figure 2. Infographics of the key findings. (a) Month of publication. (b) Article and journal classification. (c) Origin of publication. (d) Stage of medical education. (e) Number of participants per primary study. (f) Discipline or specialty. (g) Education pivot. (h) Kirkpatrick's outcome. (i) Risk of bias assessment.

Table 2. Geographical origin of included studies.

Continent	Total	UGME	PGME	Mixed
Africa	1	0	0	1
Antarctica	0	0	0	0
Asia	5	3	2	0
Australia/Oceania	1	1	0	0
Europe	6	4	2	0
North America	40	30	9	1
South America	2	0	2	0
Total	55 (100%)	38 (69.1%)	15 (27.3%)	2 (3.6%)

UGME: undergraduate medical education; PGME; postgraduate medical education; Mixed: combination of UGME and PGME

Table 3. Discipline or specialty of deployed educational innovation or adaptation.

	Total	UGME	PGME	Mixed
Surgical
Cardiothoracic surgery	1	1	0	0
General surgery	2	1	1	0
Neurosurgery	4	1	2	1
Obstetrics and gynaecology	1	1	0	0
Otolaryngology	2	0	1	1
Urology	2	2	0	0
Vascular surgery	1	1	0	0
Medical
Cardiology	1	0	1	0
Dermatology	2	1	1	0
Emergency medicine	3	3	0	0
Infectious diseases	1	1	0	0
Internal medicine	4	4	0	0
Oncology	2	2	0	0
Neurology	1	1	0	0
Palliative care	1	1	0	0
Other
Inter-professional	1	1	0	0
Pathology	3	2	1	0
Radiology	12	8	4	0
Primary care	4	4	0	0
Paediatrics	5	3	2	0
Not stated	2	0	2	0
Total	55 (100%)	38 (69.1%)	15 (27.3%)	2 (3.6%)

Table 4. Focus of education adaptation or innovation.

	Total	UGME	PGME	Mixed
Online learning	33	26	7	0
Remote clinical interaction as an adaptation in response to a change in practice	9	7	2	0
Online simulation	8	3	5	0
Remote clinical interaction as an innovation to support COVID-19 service provision	6	6	0	0
Remote adaptation of multidisciplinary ward round	6	3	2	1
Remote adaptation of multidisciplinary team meetings	2	1	1	0
Live-streaming surgery or procedures	1	1	0	1
Remote clinical interaction as a replacement	1	1	0	0

Table 5. Risk of bias assessment for randomised-controlled trials.

Risk of bias	Pasricha 2020
Random sequence
Allocation concealment
Blinding of participants
Blinding of outcome assessment
Incomplete outcome data
Selective reporting
Other bias

Green – low risk of bias; amber – unclear risk of bias; red – high risk of bias

Pasricha ND, Haq Z, Ahmad TR, Chan L, Redd TK, Seitzman GD, Parikh N, Kim TN, Schallhorn JM, Ramanathan S. 2020. Remote corneal suturing wet lab: microsurgical education during the COVID-19 pandemic. J Cataract Refract Surg. 46(12):1667–1673.

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