The World Health Organization declared the Corona Virus Disease (COVID-19) a pandemic on March 11th. As this unprecedent situation deteriorated all universities have stopped all types of lectures and changed to online methods.1,2 The first activities suspended were medical students’ clinical clerkships and elective opportunities.3,4 Surgical residents faced a great challenge during the pandemic. Elective surgeries for benign diseases were postponed and the urgent or emergency surgeries were performed by more experienced surgeons. This reduced the number of learning opportunities for surgical residents.1
During the global crisis, social media platforms (Twitter, Facebook, WhatsApp) and also applications for videoconferencing (Google Hangouts, Skype, Zoom, WebEx) have played a prominent role.1 Surgery Departments were able to implement activities such as journal clubs, case discussions and lectures to provide adequate surgical education to medical students, residents and attendings. Surgical societies tried to mitigate the scientific damage imposed by the pandemic. Many surgical meetings were postponed or cancelled this year due to the pandemic. Others had online editions at a low cost or free of charges. The same phenomenon happened with hands-on courses, lectures and social meetings.
Hernia U steps upThe Hernia U team realized the need to strengthen surgical education online during this difficult time. Hernia U (www.herniau.com) was created in 2016 by hernia specialists with the objective to expand the abdominal wall surgery (AWS) educational landscape and make it available for surgeons who wanted to revisit their hernia education. It is an online platform where surgeons can register with no cost and subscribe for different activities: Hernia A to Z Fundamentals, Advanced, Live surgeries, and Hernia U library which is a depository for high quality lectures, cases and the Hernia U podcast. Some courses (Hernia A to Z Fundamentals and Advanced) are available in other languages: Chinese, Spanish, French or Arabic. Currently, more than 15,000 professionals from 157 countries have already participated in one of the courses available in the platform since its beginning.
A new modality of live lectures was created after March 11th. Not just exclusivelyour team perceived the need to strengthen surgical education online, but also surgeons around the globe. In 2019, 1709 new surgeons registered in the platform from March 11th to the end of September. In 2020, this number increased more than 3 times: 5523 new surgeons registered in the same period. In the last 6 months, Hernia U has broadcasted 28 live events (21 lectures and 7 surgeries) against 7 live surgeries in the same period last year. (Table 1) There were not just hernia-related topics. Specialists also discussed what surgeons should know during the pandemic (lecture in English and Spanish) and the importance of social media. Furthermore, Hernia U has joined forces with the Americas Hernia Society (AHS), the European Hernia Society (EHS) and the International Hernia Collaboration (IHC) from Facebook to proportionate scientific activities. Hernia U didn’t just offer more activities, but they offered activities that surgeons were eager to participate in Table 1.
Hernia U attendants from March 11th to October in 2019 and 2020.
| Hernia U | 2019 | 2020 | p-Value |
|---|---|---|---|
| New Surgeons registered (March 11-oct.) | 1709 | 5523 | |
| Live Surgeries (March 11-oct.) | 7 | 7 | |
| Live Surgeries surgeon attendance (March 11-oct.)a | 803 | 1202 | |
| Logins/surgery (March 11-oct.) | 114.7 | 195.6 | 0.021 |
For statistical analysis, IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, N.Y., USA).
Despite the pandemic, Hernia U team managed to have the same number of live surgeries as in the same period of 2019. To our surprise, the number of surgeons who attended these live cases was higher (1202 versus 803) and the logins per surgery was significantly higher: 195.6 versus 114.7 logins/surgery (p=0.021). It is important to note the 1202 was the number of different surgeons who watched the live surgeries, but to calculate the audience (logins/surgery), the same surgeon could be counted more times, depending on how many events he was present.
We are living in a time where social distancing can mitigate the spread of the disease. This cannot stop us from sharing knowledge and experiences which will improve healthcare worldwide. We have the tools that allow us to make it available to everyone and Hernia U is part of this arsenal.
FundingThere was no funding for this research project.
Conflicts of interestDL Lima and RNCL Lima have no conflict of interests.
Drs DL Lima, RNCL Lima, SMConde reports consulting fees from BD Bard, Medtronic, Ethicon, Stryker, Storz, Olympus, Baxter, Dipro, BBraum, Gore, outside the submitted work.
EPDavila discloses consulting fees from Bard Davol, outside the submitted work.
Dr. Malcher discloses consulting fees from BD & Medtronic, outside the submitted work.
Dr. Cavazzola discloses consulting fees from Strattner and Intuitive, outside the submitted work.
We’d like to thank Jennifer Petrie for helping with the manuscript.
