Virtual versus in-person didactic modalities: A national survey of emergency medicine residencies

Following the widespread shift from in-person to virtual delivery of didactics during the COVID-19 pandemic, some emergency medicine (EM) residency programs have retained virtual didactic time while others have returned exclusively to in-person didactics. In this national survey of EM residency programs, we explored the current national distribution of virtual versus in-person didactic time and the circumstances and motivators for use of each.

A cross-sectional survey with branched logic was designed via Qualtrics. Distribution was via a Council of Residency Directors in Emergency Medicine (CORD) listserv; nonresponding programs were emailed directly with subsequent reminders. Analysis and descriptive statistics were calculated via Microsoft Excel. All authors performed thematic analysis of narrative comments.

We received responses from 174 of 281 programs (61.9%). "Hybrid" programs utilizing both in-person and virtual time represented 51.7% of respondents, and the remaining 49.3% used in-person didactics only. Among hybrid programs, 77.3% utilized in-person conferences greater than 75% of the time. Simulation (100%) and procedural teaching (99%) were most strongly preferred in person, and oral boards practice (30.2%) was supported virtually. The most common motivations for in-person delivery were perceived impact on resident and/or faculty learning (86.8%), perception of resident engagement (79.3%), community building (74.7%), type of learning sessions (70.1%), and perceived impact on resident and/or faculty wellness (59.8%). Top reasons for choosing virtual didactics were perceived convenience for residents (75.6%) or faculty (60.0%) and perceived impact on resident and/or faculty wellness (43.3%).

Nationwide, EM residency programs spend most didactic time in person. Modality choice is influenced by didactic content as well as sociocultural considerations. Future investigation into the validity of perceptions that participants are more engaged and learn better with in-person didactics is warranted.