Education in spine care during COVID-19

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Jonathan Rasouli (Cleveland Clinic, Cleveland, USA) details discussions at the Virtual Global Spine Conference (May 5), which hosted key opinion leaders to discuss the impact of COVID-19 on national education initiatives in spine care.

The ongoing COVID-19 pandemic has had wide-ranging implications on both micro and macro- healthcare policy and delivery. Hospitals have increasingly diverted resources to combat the crisis, and as a result, patients with spine ailments have been severely impacted due to rescheduling and cancelling of elective cases. Furthermore, resident and fellow education in spinal surgery has been effectively placed “on hold” as major societal meetings have been cancelled and surgical residents are being reassigned to treat COVID-19 patients. These recent developments in tandem with the implementation of widespread social distancing measures, have led to the rapid rise and popularity of teleconferencing platforms to effectively and quickly disseminate information amongst healthcare providers.

With this in mind, the Virtual Global Spine Conference (VGSC) was developed in April 2020 as a multi-institutional, multi-disciplinary effort to increase the accessibility and availability of spine education during the COVID-19 pandemic. The founders: Ali Baaj (Cornell University, New York, USA), John Shin (Harvard University, Cambridge, USA), Khoi Than (Duke University, Durham, USA), Wende Gibbs (Mayo Clinic, Rochester, USA), Griffin Baum (Lenox Hill Hospital, New York, USA) and Jonathan Rasouli, (Cleveland Clinic, Cleveland, USA) created this novel teleconferencing platform with the mission of providing high-quality, engaging, case-based sessions to spine providers, residents/fellows, medical students, and advanced care providers around the world.

On 5 May, the VGSC hosted a special session examining the “Impact of COVID-19 on national educational initiatives in spine” with key opinion leaders of the Spine Section (DSPN), Scoliosis Research Society (SRS), AO Spine (AOS), North American Spine Society (NASS), and the American Society of Neuroradiology (ASNR). Main highlights from each speaker are detailed below (in order of presentation):

Spine Section (Michael Steinmetz, Cleveland Clinic, Cleveland, USA): DSPN educational content has been delivered largely through annual meetings (Spine Summit 2020, March 5‒8, Las Vegas, USA). While the meeting was able to proceed, many speakers needed to cancel and the nationwide travel ban was instituted on 9 March. Since then, there has been renewed efforts to expand online and virtual educational content (online grand rounds, case presentations, update on COVID-19 impact for practicing spine surgeons). In general, it is still unclear how COVID-19 will impact future societal meetings this year. Institutions are increasingly barring academic travel with large healthcare systems behind budget due to pausing of elective spine cases. It is unclear how industry partners will be affected moving forward as they have suffered a tremendous financial impact as well. There will be increased reliance on teleconferencing/virtual meetings as there have been significant innovations in the quality and delivery of the platforms.

North American Spine Society (William Sullivan, Vanderbilt University, Nashville, USA): The cancellation of major societal meetings will have long-lasting implications on education, networking, and the structure and organisation of future meetings. NASS has been particularly affected as the Coding, Trauma, Deformity, and International meetings have been cancelled. Many national and international meetings have been cancelled and it is too early to see if meetings scheduled later this year will be able to proceed as scheduled. Teleconferencing platforms have demonstrated potential in addressing gaps created by conference cancellations. The key NASS meetings still planned are the Board meeting in July (Nashville, USA) and Annual Meeting in October (San Diego, USA).

Scoliosis Research Society (Rajiv Sethi, Virginia Mason, Seattle, USA): COVID-19’s devastating impact on the ability of trainees and physicians to network in-person at societal meetings is immeasurable. The SRS is currently examining the possibility of hybrid in-person/virtual sessions at the upcoming SRS meeting in September. SRS has also developed member-only webinars and a message board to address COVID-19. There has also been a public webinar examining the Leveraging of technology in the era of COVID-19. One of the difficulties currently being faced is the ability to encourage cross-institutional and nationwide mentorship in light of major meetings being cancelled and limitations of teleconferencing platforms.

American Society of Neuroradiology (Joshua Hirsch, Harvard University, Cambridge, USA): The upcoming ASNR 2020 meeting in May (Las Vegas, USA) has been converted to an entirely virtual event. There are over 3,000 registered attendees, 40 partner exhibits, and 1,200 invited lectures planned for the meeting. ASNR will now have pre-recorded sessions broadcast in a “simulated live” format with live faculty and attendee chat, e-posters, virtual exhibit halls, and networking opportunities via live chat. In addition, the ASNR has responded to the COVID-19 pandemic by creating a Task Force that has developed advocacy efforts, a webinar series, and business/financial resources for members (www.asnr.org/asnr-covid-19-resources).

AO Spine (Greg Grabowski, University of South Carolina, Columbia, USA): AOS has cancelled several upcoming meetings and courses in the interest of the health and wellbeing of the faculty and members: Principles and Treatment in Spinal Disorders for Residents,  Banff Fellows Forum, and the Fall cadaver course. The AOS Oral Board Review Course will likely move to a virtual format. The upcoming Complications Course is still tentatively scheduled for October, but that may change pending nationwide conditions. The AOS educational webinars for fellows and residents will continue as planned.

In summary, the COVID-19 crisis has elicited widespread response and advocacy for spine providers around the world. The adoption of teleconferencing platforms has enabled continuation of spine education and collaboration both nationally and internationally. A recording of the meeting can be found here.

Jonathan J Rasouli, is a neurosurgeon at the Cleveland Clinic (Cleveland, USA).


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