Internal Medicine Resident Perspectives on Format of Didactics during the COVID-19 Pandemic.

Background: The COVID-19 pandemic necessitated the virtualization of medical education. While there is increasing guidance available on the various methods and strategies for this online pivoting, there is limited data about the learners' perspective. The easement of social distancing restrictions has necessitated innovative delivery of education in hybrid formats (a mix of in-person and virtual). Methods: An anonymous voluntary survey was distributed to all internal medicine (IM) residents at an academic medical center assessing resident perspectives on the transition from in-person didactics (IPD) prior to March 2020 to virtual didactics (VD) prompted by COVID-19 related limitations from March 2020-June 2022. This was followed by an evolution to a hybrid format didactics (HD) in July 2022 after social distancing guidelines were lifted. In January 2023, a follow-up survey was distributed to all IM residents to assess perspectives of VD as compared to HD. The surveys assessed trainee impact on education, quality of content and interaction with the speaker, use of interactive tools, content accessibility, technical difficulties, and comparison to prior formats (IPD). Results: 45 PGY-1s (interns) and PGY2-4s (senior residents) responded to the June 2021 survey (comparing IPD and VD; 30.8% response rate) and 30 interns and senior residents responded to the January 2023 survey (comparing HD to both previous formats; 18.3% response rate). Most interns were dissatisfied with the quality of educational content, with only 35% (9 out of 26) rating it as high or very high quality in 2021, and a similar rating in the January 2023 survey (7 out of 20). Interns also reported subpar interaction with speakers, with 19% (5 out of 26) rating it as high or very high quality in 2021, and 35% (7 out of 20) in 2023. Senior residents had similar views on content quality, with 45% (8 out of 18) giving it a high or very high rating in 2021, and a lower rating of 20% (2 out of 10) in 2023. They also reported suboptimal speaker interaction, with 28% (5 out of 18) in 2021 and 20% (2 out of 10) in 2023 rating it as high or very high quality. Despite the ease of use and accessibility of digital platforms, with over 70% of both interns and senior residents in both 2021 and 2023 surveys expressing satisfaction, a notable 54% (14 out of 26) of interns indicated an interest in returning to in-person didactics post-pandemic, compared to 25% (4 out of 16) of senior residents. Conclusions: Our single center study demonstrated dissatisfaction in IM residents across various domains of virtual as well as hybrid format didactics despite reported ease of access. As innovations in delivery of resident education continue to occur, an ongoing assessment of the impact on learner satisfaction and knowledge acquisition is advised to ensure effective delivery.