Innovative methods of remote teaching during the COVID-19 pandemic
JA Gilmour, J Holman, A Hindocha, A Donald, R Curnock, H Manning, D Pask, L Turnbull, R Ranganna.

In March 2020, Coronovirus hit the UK and caused huge changes to the NHS. Aside from the clinical challenges; educational and training opportunities were cancelled which significantly impacted on both training and trainee wellbeing. As a team based at Royal Manchester Children’s Hospital we rapidly established a virtual paediatric teaching programme, improving trainee unity during such upheaval, supporting emotional wellbeing providing a virtual meeting place when social restrictions prevented face to face. This also acted as a pilot to shape the future of our regional teaching. Here we share our experience and our advice as we consider how COVID-19 accelerated the transformation of educational practices for the better.
Prior to the COVID-19 pandemic, our teaching programme was held face to face. An annual survey of regional teaching for ST4-8 trainees disappointingly revealed only 20% of trainees reached the desired attendance rate of 50% over 2018-2019, predominantly due to service provision commitments. Trainees unable to attend due to clinical commitments, those out of programme, or on sick or parental leave, had no means to “catch up” or access teaching remotely. Steps to increase accessibility via virtual/recorded platforms were in progress pre-COVID, but the attempts of teaching committees to secure funding were halted by the onset of the pandemic.

At the onset of lockdown, the trainee committee merged Local and regional teaching sessions within the North West to form a virtual teaching programme. We chose Zoom© as the platform, as we felt it was the most intuitive and accessible. We arranged speakers, both consultant and trainees, to deliver 40-60 minute talks mapped to curriculum relevant topics. Topics ranged from COVID-specific updates, general/speciality paediatrics, mental health and well-being, and topical peripheral interest areas such as trends in domestic violence during the COVID-19 pandemic. This maintained variety, allowing trainees to still engage with the curriculum and helped keep us all up to date with specialities which we are not experiencing presently via outpatient or elective work, supplementing currently unmet training needs.
The committee run a minimum of two sessions per week, utilising the post-graduate education team to advertise links via email and on relevant trainee social media platforms. The sessions are designed to be interactive or evoke post-talk discussions amongst the group. We have had impressive engagement from the consultant body and have found it invaluable having such a diverse range of experts to contribute, who would likely not have been present at previous face-to-face sessions.
To ensure ongoing teaching engagement, quality, and relevance we have involved trainees in shaping the programme, seeking feedback on each session and prospectively surveying trainees to elect preferred future topics (encouraging learner-driven teaching(3). We have found this responsive and flexible approach has engaged trainees and empowered them to take a lead in their teaching and training goals.
Initially we faced some technological difficulties. Our solution was to allocate a host for each session alongside the guest speaker. Prior to the lecture the host arranges a “tech-check” with the speaker, checking their camera, microphone, and ability to screen share. They also remind the speaker of governance and patient confidentiality to ensure that there is no patient identifiable information in slides. Another member of the teaching committee asks attendees to identify themselves by naming their devices and records a register. After the meeting, the host facilitates questions by unmuting participants or reading out audience input from the chat function, allowing optimal engagement from the group and maintaining order in the virtual platform. Lastly, as our sessions are recorded to be watched at a later date. These are shared with trainees via email and are available for two months, ensuring content remains relevant.
We have been able to quickly adapt our teaching during the pandemic in a way that maintains social distancing, maximises participation, and increases accessibility to all. Our peak attendance at virtual teaching has reached 140 devices on Zoom© with the average regional attendance increasing from 29 participants pre-COVID-19 (range 18-42) to 57 post COVID-19 (range 32-140). It has enabled access for all, regardless of rota patterns, self-isolation, shielding, and those trainees out of programme or on personal leave (e.g. maternity leave).
Instigating this innovative and responsive virtual teaching programme has acted as a pilot programme, allowing us to test and gain feedback on the approach to shape future training. Feedback on this interim approach, through trainee surveys, has shown >98% of trainees felt that virtual sessions have already positively impacted their training and educational needs; an area which was previously identified as “in need of improvement” in trainee surveys. These improvements will hopefully result in making Greater Manchester and Lancashire an even more desirable location for specialty training.

References
Royal College of Paediatric and Child Health, Trainee charter, your charter what to expect from each training unit. https://www.rcpch.ac.uk/education-careers/training-assessment
Royal College or Paediatrics and Child Health, Progress Curriculum https://www.rcpch.ac.uk/education-careers/training/progress/curriculum
Malcom S, Knowles. Andragogy:Adult Learning theory in Perspective, 1978