LAUSR

INTRODUCTION: The arrival of the novel coronavirus SARS-CoV-2 to the United States and ensuing outbreaks of COVID-19 had significant impacts on medical education Learners stratified as ?high-risk? were removed from the bedside, leading training programs to create alternate models We report a model used to continue Surgical Critical Care (SCC) education for a high-risk learner at our institution and discuss the successes, shortcomings, and essential aspects of a virtual training model METHODS: The program is an SCC fellowship at a Level I Trauma Center in Charlotte, NC All Surgical Trauma Intensive Care Unit (STICU) rooms were already equipped with cameras for a Virtual Critical Care (VCC) platform The fellow's home workstation included multiple screens for simultaneous viewing of applications including Cerner Millennium® for the electronic medical record, Philips IntelliSpace PACS Enterprise, Philips PIIC iX for real-time vital signs, halo™ and Microsoft® Teams for communication, and Philips eCareManager for camera access to patient rooms A structured process was developed to allow the fellow to lead rounds with physical examinations performed by STICU team members under the fellow's supervision Additional preparation included an apprenticeship with VCC intensivists and plan dissemination to the STICU team The model was reviewed and modified weekly RESULTS: Identified weaknesses included camera downtime, camera-related ?tunnel-vision? of the fellow limiting team management and teaching, and inability to perform physical examinations and procedures Strengths included improved real-time data access and error detection which streamlined care plan creation Modifications included adding an iPad with Facetime for improved communication, transitioning to mobile camera carts, and deliberate inclusion of the fellow in presentations and physical examinations There was no solution that could authentically replicate procedural skill acquisition CONCLUSIONS: The consensus is that the model successfully enabled a critical care fellow to continue training in a meaningful manner Cooperation from the in-hospital team was crucial to overcome limitations Though procedural experience remains a barrier, this model could be applied more broadly to engage learners needing to work remotely for a defined period