Telementoring, Surgery training, Rural surgery, Breast cancer

Abstract
Telementorship allows an expert surgeon to mentor another surgeon through an advanced procedure from a remote location via 2-way audio-visual communication. The current article was planned to review the existing literature and evaluate the utility of telementorship regarding educating rural surgeons in Pakistan about multidisciplinary breast cancer care. Publications from 2016 to 2020 were searched on PubMed and GoogleScholar and 10 most recent publications were selected. Review of literature revealed that even though telementorship in this context might be comparable to onsite mentorship, multiple concerns need to be addressed before its implementation. These include lack of concrete evidence regarding its effectiveness, legal, security and financial issues. Thus, a pilot project evaluating the efficacy of telementorship needs to be conducted for rural breast surgeons working in Pakistan. If these studies show promise and an affordable, convenient and effective method of telementorship is devised, then it may become the future of breast surgery training in far-flung regions of Pakistan.

Virtual learning in global surgery: current strategies and adaptation for the COVID-19 pandemic

Modern surgical education has shifted to include technology as an integral component of training programs. The onset of the COVID-19 pandemic highlights the need to identify currently training modalities in global surgery and to delineate how these can be best used given the shift of global surgical training to the virtual setting. Here, we conducted a rapid review of the MEDLINE database examining the current status of training modalities in global surgical training programs and presented a case study of a virtual learning course on providing safe surgical care in the time of a pandemic. Our rapid review identified 285 publications, of which 101 were included in our analysis. Most articles describe training in high income country environments (87%, 88/101). The principal training modality described is apprenticeship (46%, 46/101), followed by simulation training (37%, 37/101), and virtual learning strategies (14%, 14/101). Our focused case study describes a virtual course entitled “Safe Surgical Care: Strategies During Pandemics,” created at the University of British Columbia by E.J., published 1-month postdeclaration of the pandemic. This multimodal course was rolled-out over a 5-week period and had significant engagement on an international level, with 1944 participants from 105 countries. With in-person training decreased as a result of the pandemic, virtual reality, virtual simulation, and telementoring may serve to bridge this gap. We propose that virtual learning strategies be integrated into global surgical training through the pursuit of increased accessibility, incorporation of telementoring, and inclusion in national health policy.