Remote synchronous toenail procedure training using a sausage model

ABSTRACT

Objectives: Social distancing practices brought on by the COVID-19 pandemic have limited the ability of residency training programs to deliver procedure training via traditional in-person methods. Financial strains brought on by the pandemic also mean that fewer resources may be available to develop novel teaching processes. We sought to investigate a protocol meant to address the rising need for inexpensive procedure training that can be performed remotely or in a socially distanced manner.

Methods: We used a sausage model to train 11 family medicine residents in toenail procedures. The training was delivered via two-way video telecommunication as the residents were separated into small groups in separate rooms. Learners were given a cognitive skills evaluation and were asked to perform a self-assessment of their confidence with procedures using a scale of 1–10. These assessments were administered before and after the procedure and the results were compared using a paired t-test.

Results: The cognitive score improved from a pretest average of 73.6% to a posttest average of 86.0% (P = 0.022). The improvements in trainee self-assessment were significant for all performance characteristics of the procedure.

Conclusions: This evidence supports the use of synchronous video communication to train family medicine residents in toenail procedures using a sausage model.

KEYWORDS:

• Education
• curriculum
• community medicine
• procedures
• distance learning
• dermatology
• podiatry

Ethical approval

Under 45 CFR 46.101 (b) (Department of Health and Human Services (DHHS)) this research is exempt from IRB approval because the involvement of human subjects is in the following category:

(1) Research conducted in established or commonly accepted educational settings, involving normal educational practices, such as (i) research on regular and special education instructional strategies, or (ii) research on the effectiveness of or the comparison among instructional techniques, curricula, or classroom management methods.