Telegram Education for Surgical Learning and Application (TESLA): An exploratory study (Preprint)

BACKGROUND The COVID-19 pandemic disrupted medical education, shifting a huge portion of learning online. Social media platforms have long been well-integrated into medical education. However, Telegram’s role in medical education remains relatively unexplored. A Telegram channel titled “Telegram Education for Surgery Learning and Application (TESLA)” focusing on General Surgery education was created to supplement medical students’ learning. It encompassed weekly multiple-choice questions and resources such as illustrations and journal articles. OBJECTIVE This study explored students’ experience of TESLA and their views on the role of messaging apps in medical education. METHODS We invited thirteen medical students from Lee Kong Chian School of Medicine, Singapore who were in the TESLA channel for at least a month to participate in individual semi-structured interviews. The interviews were conducted via video conference using an interview guide. Interviews were transcribed and analysed by two researchers using inductive thematic content analysis. RESULTS Three themes were identified: (1) Learning as a medical student, (2) The role of mobile learning in medical education and (3) TESLA for surgical education. Students shared that pandemic-related safety measures such as reduced clinic allocations and the inability to cross between wards led to a decrease in clinical exposure. Students used a variety of messaging and study apps to aid their medical education. Telegram was preferred over other messaging apps. Concerning the use of TESLA, students felt that the questions were clinically relevant and of appropriate difficulty. Students offered suggestions for improvement relating to the organization, content and format of TESLA. CONCLUSIONS Medical students found TESLA useful as a supplementary learning instrument in surgical education. They were supportive of integrating TESLA into formal undergraduate education and using Telegram as an educational tool in other areas of medicine. In line with our findings, we outlined recommendations for the use of Telegram in medical education.

AMPATH Surgical App: Open Appendectomy

Background/Objective: Due to a geographic shortage of surgical providers within Kenya, doctors without surgical training are expected to complete emergency surgical procedures. The Academic Model Providing Access to Healthcare (AMPATH) surgical team is developing an education module, delivered via mobile phone app and self-made simulators, dedicated to the skills necessary to complete open appendectomy. We hypothesize that our model and curriculum will provide a low-cost method of effectively simulating the open appendectomy. Methods: After developing a step-based curriculum, an initial prototype of a model for the appendectomy was constructed. Expert academic surgeons from Indiana University were identified to test the prototype by performing an open appendectomy on the model. Feedback on both the model and the procedure was obtained via recorded video and REDCap. Results: A total of 8 expert surgeons were consulted on the model, each presented with an updated version of the appendectomy model and procedure based on feedback. Experts provided feedback on the model and each substep of the curriculum. Overall, the curriculum was clear with each substep receiving a median score of at least 82 out of 100 for clarity. While the model received lower scores in utility and “realism, expert feedback was incorporated in an iterative process such that latter models demonstrated net improvement in the realism and utility of several substeps, including “the appendectomy”. Conclusion: A low-cost appendectomy model with corresponding curriculum was developed, and refined with expert feedback, to facilitate this project’s transition to its next stage – testing on medical trainees. Additionally, the model and curriculum will enable the development of an AI algorithm to give the learner real-time feedback as they perform the simulation. Implications: Ultimately, this study may create a platform that increases access to best possible practice and improves outcomes in settings where surgical education is limited.