Online Dermatology Curriculum Experiences among U.S. Dermatology Residents and Faculty

An electronic Qualtrics survey was distributed during January-April 2021 addressing experiences with online dermatology curricula to the Association of Professors of Dermatology listserv and program coordinators for the 2020-2021 academic year. Study participation was voluntary and informed consent was obtained. Institutional review board approval was obtained through the IRB of the University of Texas Health Science Center Houston. Survey results were analyzed using Microsoft Excel.

Sixty-five individuals responded, including 21 faculty members and 44 residents from at least 20 ACGME-accredited dermatology residency programs (some respondents kept their program anonymous). Most of the represented programs implemented virtual, online curricula in March of 2020 (Table 1). Fifty-one (78%) respondents reported that 75-100% of their curriculum was virtual by January of 2021. Zoom was the most common platform utilized by 43 respondents (65%). Ninety percent of participants reported both clinical dermatology and dermatopathology were online during the initial peak of the pandemic.

Twelve (20%) participants reported they always had their personal video feed on during virtual learning, while 20 (33%) reported they rarely did. Thirty-five (67%) respondents felt that their education in non-procedural dermatology was not limited or only slightly limited by the COVID-19 pandemic (Figure 1). Seven (16%) participants felt online education was more effective. Thirty-eight (74%) respondents felt that their education in dermoscopy and twenty-five (50%) respondents believed that their education in dermatopathology was not limited or only slightly limited by the COVID-19 pandemic (Figure 2, Figure 3). Open-ended responses on advantages to the online learning included flexibility with driving to distant clinical sites and opportunities to hear from speakers outside of their local program. Twenty-two (49%) of faculty members and PGY3+ residents who had experienced live curriculum prior to the pandemic reported that the virtual curriculum had a similar level of effectiveness, while 16 (36%) reported it to be less effective (Supplemental Table 1). Open-ended responses as to why the pandemic curriculum was less effective included themes of “too many distractions,” “lack of human feature,” and “less spontaneous feedback.” Twenty-four of 29 (83%) PGY-3 residents and above were either satisfied or very satisfied with the curriculum prior to the pandemic while thirty-one of 41 (76%) were satisfied or very satisfied with curriculum after pandemic-related changes. Seven of 41 (17%) were neutral about the virtual curriculum and three (7%) were dissatisfied. Thirty-two (49%) residents reported difficulty staying engaged as the greatest educational challenges attributed to the pandemic. When asked what pandemic-related educational changes participants would like to sustain, responses ranged from making virtual attendance optional, continuing online-learning only, offering a combination of virtual and in-person didactics, and increasing guest lectures.

One limitation to this study is the sample convenience survey design, making the results less generalizable. A strength of this survey is the open-ended feedback from participants. Interestingly, the level of dissatisfaction prior to the curriculum change was consistent with the level after (7%), suggesting that the educational experience was not worsened. Regarding why 76% of responders thought the virtual didactics were satisfactory or very satisfactory when 49% reported difficulty staying engaged, we hypothesize that despite people having difficult staying engaged, other benefits (flexibility, ability to record lectures, less commuting, etc.) of virtual education outweighed the cons. Outside of didactic training, decreased procedures were a large challenge secondary to the pandemic for 26 (40%) of respondents (Supplemental Figure 1). Overall, there is wide variation in responses to experiences with online dermatology curriculum. Programs may benefit from seeking detailed feedback from their residents to meet the unique individual learner needs and preferences.