Objective
Grand rounds are a central component of medical education across specialties, with demonstrated benefits.
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Obstetrics and gynecology (OB-GYN) departments across the country transitioned from in-person grand rounds (IPGR) to virtual grand rounds (VGR) during the COVID-19 pandemic.Knowledge gaps exist around OB-GYN educators’ and trainees’ perceptions of VGR. Single-center studies of faculty perspectives in other specialties have shown positive correlations with improved attendance.
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This multicenter observational study sought to explore the OB-GYN experience with VGR and to assess perceptions by role (educator vs trainee).Study Design
After institutional review board exemption, a cross-sectional survey comparing VGR and IPGR was developed de novo using themes from the literature, and then reviewed and edited by subject matter experts.
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Likert-style questions asked about satisfaction, engagement, learning, and multitasking (Supplemental Material). The e-survey was deployed in May 2021 to all members of 5 academic OB-GYN departments, with a 2-week reminder email.Data were analyzed in aggregate. Trainee (resident or fellow) and educator responses were then compared, excluding research staff and emeritus faculty respondents. We used bivariate statistics and regression to control for confounders that were significant in bivariate analyses.
Results
Of the 591 potential participants, 306 (52%) responded. Among respondents, 69% were faculty, 21% residents, 7% fellows, and 3% others (research staff or emeritus faculty).
Compared with IPGR, 91% felt satisfied with VGR; 90% reported being more likely to attend VGR. Presentation quality was assessed as the same or better by 91%, and 93% described presenter caliber as the same or better; 48% reported learning the same amount. However, 90% were more likely to multitask; 69% felt the sense of community was worse.
The secondary analysis included 297 respondents. Response rates were 45% (86/193) for trainees and 53% (211/397) among educators. Compared with educators, trainees were more likely to be dissatisfied, less likely to attend, and reported learning less during VGR (Table). Almost all trainees were more likely to multitask (Table). After controlling for gender and institution, compared with educators, trainees remained less satisfied, less likely to attend, and perceived worse learning with VGR (Table).
TableComparison of educator and trainee (resident and fellow) perspectives on virtual grand rounds
| Perspectives | Educators N=211 (%) | Trainees N=86 (%) | P value | aOR (95% CI) |
|---|---|---|---|---|
| Overall unsatisfied with virtual grand rounds | 11 (5.3) | 16 (18.8) | .001 | 0.14 (0.05–0.40) |
| Less likely to attend VGR than in-person grand rounds | 14 (5.7) | 18 (20.9) | <.001 | 0.17 (0.07–0.43) |
| Learned less during VGR than during in-person grand rounds | 38 (18.1) | 26 (30.6) | .03 | 0.42 (0.22–0.82) |
| Felt a loss of sense of community with VGR compared with in-person grand rounds | 142 (67.6) | 64 (74.4) | .19 | — |
| More likely to ask questions in VGR than in in-person grand rounds | 105 (50.5) | 38 (44.2) | .37 | — |
| More likely to multitask during VGR than during in-person grand rounds | 185 (88.9) | 80 (93.0) | .29 | — |
aOR, adjusted odds ratio; CI, confidence interval; VGR, virtual grand rounds.
Dotters-Katz. Obstetrics and gynecology perspectives on the transition to virtual grand rounds. Am J Obstet Gynecol 2022.
a P values obtained by nonparametric bivariate statistics; Kruskal–Wallis and Wilcoxon rank-sum tests, as appropriate
b adjusted for gender and site.
Conclusion
This multicenter study of academic OB-GYN educators and trainees found that VGR was well-received. However, improved attendance and presentation quality must be weighed against increased multitasking and lost sense of community. Perceptions varied greatly by role; trainees were more likely to be dissatisfied, were less likely to attend, and perceived worse learning.
Lack of connection during virtual learning is well-described.
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In this time of emotional stress and isolation, trainees, who rely on IPGR as a time to connect, may be disproportionally affected. Mind wandering and multitasking are well-described limitations to virtual learning and may more significantly affect trainees, especially those who are fatigued.4
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This multicenter survey included several departments across the country; thus, the results are generalizable. However, the survey only included tertiary academic centers, had only a 52% response rate, and was subject to recall bias. Given that there have been limited data on satisfaction with VGR in OB-GYN, these findings can reassure department leaders that OB-GYN educators and trainees perceive advantages to VGR. A hybrid (virtual and in-person) grand rounds model may be best for meeting the needs of all department members.
Appendix
Virtual Grand Rounds
Q9 You are being asked to complete a brief anonymous survey designed to better understand the pros and cons of virtual grand rounds. The survey should take less than 5 minutes to complete and is completely voluntary. You may skip any questions you do not wish to answer.
By clicking to the next section below, you will be taken directly to the survey. Please answer each question carefully. No personal or health information will be collected or linked to your survey results. For questions about the study, or if you have concerns, questions or suggestions about the research, contact Dr. Dotters-Katz at (919) 681-5220 during regular business hours. For questions about your rights as a research participant, or to discuss problems, concerns or suggestions related to the research, or to obtain information or offer input about the research, contact the Duke University Health System Institutional Review Board (IRB) Office at (919) 668-5111.
- Q1 In general, how satisfied are you with virtual grand rounds?
Tabled
1Q2 For the following questions, please ask yourself: compared to in person grand rounds...
| A lot more likely ( 1 ) | Somewhat more likely ( 2 ) | Less likely ( 3 ) | A lot less likely ( 4 ) | |
|---|---|---|---|---|
| How likely are you to attend virtual grand rounds? ( 1 ) | o | o | o | o |
| How likely are you to multitask during virtual grand rounds? (this is anonymous) ( 2 ) | o | o | o | o |
| How likely are you to ask a question of the presenter during virtual grand rounds? ( 3 ) | o | o | o | o |
| How likely are you to give kudos without asking a question in virtual grand rounds? ( 4 ) | o | o | o | o |
Dotters-Katz. Obstetrics and gynecology perspectives on the transition to virtual grand rounds. Am J Obstet Gynecol 2022.
Tabled
1Q3 Compared to inperson grand rounds, how would you rate the following with respect to virtual grand rounds?
| A lot better with virtual ( 1 ) | Somewhat better with virtual ( 2 ) | No difference ( 3 ) | Somewhat worse with virtual ( 4 ) | A lot worse with virtual ( 5 ) | |
|---|---|---|---|---|---|
| The sense of community ( 1 ) | o | o | o | o | o |
| The quality of the presentations ( 2 ) | o | o | o | o | o |
| The amount you learn ( 3 ) | o | o | o | o | o |
| The caliber/prominence of presenters ( 4 ) | o | o | o | o | o |
Dotters-Katz. Obstetrics and gynecology perspectives on the transition to virtual grand rounds. Am J Obstet Gynecol 2022.
- Q7 What do you see as the biggest advantage of virtual grand rounds?________________________________
- Q8 What do you see as the biggest disadvantage to virtual grand rounds?________________________________
- Q4 What is your gender?
- Q5 What is your position?
- Q6 When we come out of COVID-19 restrictions, what would the ideal grand rounds look like for you?
References
- A retrospective analysis of grand rounds in continuing medical education.J Contin Educ Health Prof. 1989; 9: 257-266
- Rebooting medical education with virtual grand rounds during the COVID-19 pandemic.Future Healthc J. 2021; 8: e11-e14
- Excellence available everywhere.Am J Clin Pathol. 2021; 156: 839-845
- Optimizing e-learning in oncology during the COVID-19 pandemic and beyond.Radiat Oncol J. 2021; 39: 1-7
- Left to their own devices: medical learners’ use of mobile technologies.Med Teach. 2014; 36: 130-138
Article info
Publication history
Published online: August 02, 2022
Accepted:
July 21,
2022
Received in revised form:
June 27,
2022
Received:
April 3,
2022
Footnotes
The authors report no conflict of interest.
The findings in this research letter were presented as an oral presentation at the 2022 annual meeting of the Council on Resident Education in Obstetrics and Gynecology and the Association of Professors of Gynecology and Obstetrics, Orlando, FL, March 9–12, 2022.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
