Master Series: Microsurgery for Residents
After 4 weeks of preparation, the MSMR was held on the 15th and 16th of May, along
with the COVID-19 pandemic. It was entirely developed and executed by three plastic
surgery residents and coached by the senior author (Eric Santamaria). It comprised
a 2-day course set in the Mexican GMT-5 time zone and broadcasted live through ZOOM
Premium (San Jose, CA, USA). The platform was configured in the webinar mode and had
the capacity for 3,000 simultaneous unique users connected. The official language
was English. The advertising campaign was performed using a Facebook page and an Instagram
profile where promotional videos, biographies and selffaculty invitations were posted.
We found no need for an official webpage or hiring a professional-paid advertiser.
No investment in Facebook Ads or paid promotion was made.
The academic program consisted of 31 lectures that were divided into two modules.
Each of them was split into different sections: basic principles and workhorse free
flaps harvesting for day 1, and microsurgical reconstruction according to anatomical
regions for day 2. The faculty was composed of 29 worldwide renowned speakers from
all across the world (Dr. JP Hong, Dr. Peter Neligan, Dr. Bohdan Pomahac, Dr. Scott
Levine, senior author Dr. Eric Santamaria, among others).
Lectures were recorded several days before the event, using the ZOOM platform to adjust
the talks to the previously published official schedule. Videos were then edited,
adding interactive introductions to create smooth transitions and professional-looking
performance.
After every section of lectures, live discussions were performed between two moderators
(one senior moderator: reconstructive microsurgeon and one junior moderator: plastic
and reconstructive surgery resident) and the respective faculty members. Back-up questions
were previously arranged and others were read from the Q&A ZOOM’s tool. More than
350 questions were registered between days 1 and 2.
The total number of unique participants during the 2-day course was 3,317 from 92
countries and every continent ([Fig. 1 ]). The average number of simultaneous online users was 1,178 people, with a peak
of 1,298 users for day 1 and 1,132 with a maximum of 1,286 for day 2. The transmission
did not experiment any interruption, and it lasted 507 minutes on day 1 and 493 minutes
on day 2 ([Fig. 2 ]).
Fig. 1. Country of origin of the Master Series: Microsurgery for Residents (MSMR)’s attendees.
Only the top 10 are lightened.
Fig. 2. Master Series: Microsurgery for Residents (MSMR). Lower limb flaps online discussion.
Official certificates of participation were given to all the users that reached at
least 60% of attendance, according to the log-in database, and completed an after-course
survey. The results of 1,111 completed questionnaires showed that 55.8% of the interviewees
were residents. The impact was assessed with the following results: 93.9% of attendees
would pursue a microsurgery career while 98.9% showed an increased interest after
watching the course. The overall score (from 0 to 10 scale) of the MSMR was 9.06 ±
0.9.
While some researchers have published the role of teamwork and their experience in
establishing an effective course, to the best of our knowledge, none of them has yet
examined the implementation of reproducible steps to deliver a successful online course
[5 ]
[6 ].
This study aims to summarize our model of an effective microsurgery online webinar
and present a seven-step reproducible approach that could be used to deliver a successful,
low-cost, and effective online course. We have shared our reflections to help illustrate
the effectiveness of various strategies implemented by our team.
Seven-step pathway
The following sequence will help plastic surgeons build a successful online course.
It is mainly based on the authors’ experience managing online webinars empathizing
the popularity gained after the MSMR ([Fig. 3 ]).
Fig. 3. Online course organization: seven-step pathway.
Step 1. Have an original idea
Being creative is the first condition to deliver a successful online course. The term
innovation is described as introducing something new, including a concept, process,
or mechanism [7 ]. Innovation is key in plastic surgery since it has been acknowledged as a specialty
for evolutionary procedures and products [7 ]. Most innovations are the result of a conscious and purposeful search for opportunities
producing breakthrough ideas [8 ].
The first step towards developing a successful online course is to implement an innovative
and original idea that should focus on the educational needs of the plastic surgery
society. An attractive title is key. A careful analysis of the situation is required,
and some circumstances must be considered:
(1) Special known situations: COVID-19 pandemic or any other worldwide condition affecting
surgical activities, new striking discoveries, mass global controversies.
(2) Potential target groups: plastic surgeons working in developing countries, specific
societies, residents, fellows, even medical students.
(3) A precise date choice: consider your primary population target group and set the
date by time zone according to that choice. If a webinar is best conducted during
the week or the weekend, it has not yet been established.
(4) HOT topics: social media trending topics, survey results and every online information
can be used to determine which subjects may be the most interesting for the audience.
Step 2. Create a trustful teamwork
Teamwork is a process that describes interactions among team members who combine collective
resources to resolve task demands [9 ].
Developing a diverse organization team consisting of members with compatible skill
sets is imperative to the team’s success. The members and roles of the team must be
carefully considered and selected to fill necessary skill gaps. The importance of
a mentoring leadership relies on the fact that a most experienced team member should
guide the whole group and take crucial decisions, even in times of uncertainty [10 ].
Team members should know how to cope with failures, be flexible in changing directions,
and maintain a positive attitude [11 ]. Teamwork allows people to experience sophisticated and large-scale projects which
cannot be completed individually [12 ].
Functions of the team are:
(1) Set specific goals.
(2) Work collaboratively.
(3) Share responsibilities: create a group of moderators
(4) Make collective decisions.
(5) Evaluate the whole experience despite the result.
(6) Accept difficulties and adversity.
Step 3. Develop an attractive program
To catch a big audience, maintain high levels of connectivity and high-rate feedback,
an attractive program must be delivered. The attractiveness of the course is based
on the optimization of content and design.
(1) Content: consider creating a faculty crew composed of renowned and fluent speakers,
preferably experts of specific areas. Topics must be distributed according to an underlying
intention: from simple to complex, from general to specific, from basic to advanced.
A state-of-the-art structure must be followed. Consider recording the lectures in
advance, to allow video editing avoiding incidentals.
(2) Design: a professional-looking course layout is crucial to keep users engaged.
An expert designer is not a formal requirement. Nowadays, friendly applications for
image and video editing exist, encouraging the team to create high-quality audiovisual
content (e.g., Wondershare Filmora, iMovie, Canvas, OBS studio).
Regarding the design, we recommend the following considerations:
(1) Attractive artwork: create a logo that represents your webinar. Use an appealing
font style and broaden your mind when considering the name of the course.
(2) Colors: maintain a constant color base for your social media posts, logo and font
styles. Use basic color theory and avoid common mistakes when choosing your colors
like using light fonts over a pale background.
(3) Photo and video quality: low-quality pictures are often seen and remain unnoticed.
Always use high-quality pictures. Avoid overlapping and basic photographic edition
mistakes like cropped or pixelated edges. They suggest a rudimentary appearance rather
than the desired professional look. We recommend a minimum resolution of 1,080 × 720
pixels.
(4) Verify your grammar.
(5) Video transitions: a 5-second introductory video can be added to the beginning
of a lecture. It produces a delightful moment and takes off the monotony.
(6) Promotional videos: if needed, they can be placed during the pauses between live
streaming. You can use looped promotional videos regarding sponsors or non-paid advertisers
(e.g., further webinars and upcoming congresses).
(7) Music and sound: they are a complement to the overall design strategy. Free sources
of non-copyrighted audios can be found on the internet.
Step 4. Choose a friendly platform
The best platform choice is the one that you feel more familiar within a short period.
It is mandatory to make tests and simulations to discover every tool and feature that
can be modified according to the meeting’s requirements.
As it has been already used for plastic surgery education, we consider ZOOM as an
excellent choice for online learning [13 ].
ZOOM webinars let you easily host significant online events with video, audio, and
screen sharing with up to 100 video participants and 10,000 attendees. Features in
this mode are tailored for large audiences with registering features, full host controls,
polls, questions and answers, attendees raise hand option, chat and record function.
We recommend the following basic/advanced settings to optimize ZOOM’s platform:
(1) Choose webinar mode.
(2) Send the registration form with adequate demographic questions (e.g., age, country
of origin, educational status).
(3) Disable annotations.
(4) Disable microphones and cameras for all the attendees.
(5) Disable screen sharing for all the participants.
(6) Apply an adequate role for each member (panelists and moderators).
Step 5. Deliver and effective and targeted communication strategy
Social media advertising campaigns are feasible. However, a new communication scheme
with visual impact and targeted grouping can be introduced to save the budget. Among
the many social media platforms the world has to offer, the two that reign supreme
are Facebook and Instagram [14 ].
Facebook allows for multiple pictures per post, videos over an hour-long, and detailed
text descriptions. On the other hand, Instagram allows photos with a small amount
of descriptive text, short video segments of 59 seconds or less. Hashtag indexing
of posts tends to be more important on Instagram, as many users search for and follow
not just individual accounts, but new posts on hashtag subjects of interest [15 ].
For these reasons, educational or explanatory posts may be fit more naturally on Facebook
than other current platforms. Regarding the demographic distribution, Facebook tends
to encompass adults, while Instagram is oriented to younger users [15 ].
E-mails have lost value due to increasing Spam filtering, but some software like Mailchimp
can create massive new sharing or keep everyone updated. ZOOM also provides an e-mail
alert feature that can be useful when the start date of the course is closed.
Recommendations:
(1) To promote the course, use animated videos.
(2) Share updated Bios of the faculty.
(3) Self-introducing videos.
(4) Interactive posts: use open questions to increment the number of interactions.
(5) Use Facebook related-private groups to share invitations.
(6) Use WhatsApp/Telegram related groups to share invitations.
(7) Follow Instagram users who have similar accounts and interests.
(8) Use common and popular hashtags.
(9) One official Facebook and Instagram account are enough. Do not divide the potential
audience.
Step 6: Perform an accurate and impeccable execution
The first measure to guarantee a successful performance is to prevent any threats
that may disrupt the course:
(1) Difficulties during faculty signing-in.
(2) Stable and powerful internet connection availability.
(3) Potential failure of the master control computer and lack of back-up.
(4) Unexpected time delays.
(5) External sources of noise.
Test meetings are critical because they minimize errors that may occur during the
event. Providing an efficient channel of communication (WhatsApp/Telegram) with the
entire organizational team is crucial for exchanging valuable information at the time
of the event and for the prevention and resolution of any possible issues. Webinars
can be delivered virtually anywhere.
Documentation of the whole process is a determining factor for success. By documenting,
you can ensure efficiency, consistency and feedback for the member’s team group. To
optimize the execution the following steps are essential:
(1) Reliable computer (processor of at least 2.4 GHz, and more than 8 GB of RAM)
(2) Reasonable internet upload speed (at least 15 Mbps)
(3) Proper and fluid interaction with participants.
(4) Smooth transitions between recorded lectures and live discussions.
(5) Put your effort towards adjusting to the schedule at all time.
Step 7: Make a comprehensive evaluation of your work
Evaluating results is vital to recognizing performance, finding shortcomings, and
moving towards quality improvement. Efficient and ineffective approaches may be assessed
for progress. A pre- and postcourse evaluation or survey can be done to obtain viable
feedback from the attendees and faculty members. This will be useful to improve the
development of future events. However, the learning process is not directly observable
and evaluating it is out of the goals and beyond the scope of a webinar.
Extra step: Be prepared for the unpredictable
Despite your efforts to be prepared and develop the best online course, you need to
give space for the unexpected. Sometimes things that are beyond your control may occur
and have devastating effects on your project. Electricity could shut down, Wi-Fi could
stop running, hardware inconveniences. Be prepared and have a plan B. The person in
charge of the platform needs the have knowledge and experience to use the software
as intended, requiring to have spend additional time learning the software.
