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Corvetto MA, Altermatt FR, Belmar F, Escudero E. Health Care Simulation as a Training Tool for Epidemic Management: A Systematic Review. Simul Healthc 2023; 18:382-391. [PMID: 36881436 DOI: 10.1097/sih.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
SUMMARY STATEMENT The objective of this research was to identify and review studies that have evaluated the impact of simulation-based training on health care professionals during epidemics.All studies in health care simulation-based training published during the last 5 epidemics with a global impact (SARS-CoV, H1N1, MERS, Ebola, SARS-CoV-2; through July 2021) were selected from a systematic search of PUBMED, EMBASE, and key journals.The search strategy identified 274 studies; 148 met the inclusion criteria and were included. Most of the studies were developed in response to SARS-CoV-2 infection (n = 117, 79.1%), used a descriptive approach (n = 54, 36.5%), and were used to train technical skills (n = 82, 55.4%).This review demonstrates a growing interest in publications related to health care simulation and epidemics. Most of the literature is marked by limited study designs and outcome measurements, although there is a trend toward the use of more refined methodologies in the most recent publications. Further research should seek the best evidence-based instructional strategies to design training programs in preparation for future outbreaks.
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Affiliation(s)
- Marcia A Corvetto
- From the Department of Anesthesiology (M.A.C., F.R.A.), Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Experimental Surgery and Simulation Center (M.A.C., F.B.), Department of Digestive Surgery, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; and Comité Académico de Fundación Garrahan (E.E.), Buenos Aires, Argentina
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Young A, Gilotra K, Jin MX, Raiker A, Dickson M, Ros P. A Review of COVID-19's Impact on Radiology Residents' Academics and Wellness in North America. J Am Coll Radiol 2023; 20:1135-1145. [PMID: 37716445 DOI: 10.1016/j.jacr.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/07/2023] [Accepted: 08/22/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND The COVID-19 pandemic caused major disruptions in radiology departments throughout North America. Radiology residency programs were forced to make dramatic changes to their training programs, which had major impacts on resident academics and wellness. The goal of this review is to evaluate the impact of COVID-19 on radiology residents' academics and wellness in North America, while also identifying effective measures taken by programs to mitigate the effects of the pandemic. METHODS The search strategy involved database search via PubMed, Embase, and Web of Science with specific key words related to COVID-19, radiology residents, education, wellness, and virtual learning. Studies discussing the education and wellness of radiology residents in North America published after 2020 were included. The data were analyzed using a narrative synthesis approach. RESULTS The three main domains affected by the pandemic include the residency curriculum, research, and resident wellness. The decline in case volume and diversity of cases had negative overall impact on education of radiology residents, but simulated cases and virtual learning proved its value during the pandemic and may have lasting implications for the postpandemic world. Research initiatives transitioned to a remote format with greater emphasis on quality improvement and COVID-19-related studies. Reduced face-to-face interaction opportunities made it difficult to establish strong and meaningful interpersonal connections and had a negative impact on resident wellness, mentorship, and professional development. Implementing mentorship programs and virtual "town hall meetings" were effective measures to maintain connections during times of social distancing. Finally, the COVID-19 pandemic introduced unprecedented stressors and challenges for radiology residents that negatively impacted their mental health and wellness. Incorporating wellness initiatives such as wellness hours and team-building activities and using social media were helpful in promoting wellness and mental health for radiology residents. CONCLUSION The COVID-19 pandemic has had a significant impact on the academics and wellness of radiology residents across North America but has taught us many lessons that can help us navigate the ongoing challenges of the pandemic, the postpandemic world, and future pandemics.
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Affiliation(s)
- Austin Young
- Medical Student, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York.
| | - Kevin Gilotra
- Medical Student, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Michael X Jin
- Radiology Resident, Department of Radiology, Stony Brook University Hospital, Stony Brook, New York
| | - Ashna Raiker
- Medical Student, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Maya Dickson
- Undergraduate Student, State University of New York at Stony Brook, Stony Brook, New York
| | - Pablo Ros
- Clinical Professor of Radiology and Pathology, Department of Radiology, Stony Brook University Hospital, Stony Brook, New York
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Khoo A, Ho C, Ballard DH, Gould JE, Marquis KM. Results of the 2021-2022 Survey of the American Alliance of Academic Chief Residents in Radiology. Acad Radiol 2023; 30:2050-2058. [PMID: 36813667 DOI: 10.1016/j.acra.2023.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 02/22/2023]
Abstract
RATIONALE AND OBJECTIVES An annual survey of chief residents in accredited North American radiology programs is conducted by the American Alliance of Academic Chief Residents in Radiology (A3CR2). Special topics surveyed for the 2021-2022 academic year were procedural competency and virtual radiology education in the COVID-19 pandemic. The purpose of this study is to summarize the 2021-2022 A3CR2 chief resident survey. MATERIALS AND METHODS An online survey was distributed to chief residents from 197 Accreditation Council on Graduate Medical Education-accredited radiology residency programs. Chief residents responded to questions regarding their individual procedural readiness and attitudes on virtual radiology education. A single chief resident from each residency answered programmatic questions including the use of virtual education, faculty coverage, and fellowship choices among their graduating classes. RESULTS We received 110 individual responses from 61 programs, yielding a 31% program response rate. Although the majority (80%) of programs maintained purely in-person attending readout throughout the COVID 19 pandemic, only 13% of programs reported purely in-person didactics and 26% converted to all virtual didactics. The majority (53%-74%) of chief residents perceived virtual learning (in read-out, case conference, and didactic formats) to be less effective than in-person learning. One third of chief residents reported decreased procedural exposure during the pandemic, and 7%-9% of chief residents felt uncomfortable with basic procedures (basic fluoroscopy examinations, basic aspiration/drainage procedures, and superficial biopsy procedures). The number of programs with 24/7 attending coverage increased from 35% in 2019 to 49% in 2022. Body, neuroradiology, and interventional radiology were the most popular advanced training options among graduating radiology residents. CONCLUSION The COVID-19 pandemic had a profound impact on radiology training, particularly in terms of virtual learning. These survey results suggest that although digital learning offers increased flexibility, most residents still prefer in-person readout and didactics. Despite this, virtual learning will likely remain a viable option as programs continue to evolve following the pandemic.
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Affiliation(s)
- Allison Khoo
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Christopher Ho
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer E Gould
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Kaitlin M Marquis
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
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McBee MP, Agarwal A, Alexander LF, Bajaj G, Kelahan LC, Leake R, Richardson ML, Burns J. Teaching with Technology-Matching Pedagogy with Purpose in Radiology Education. Acad Radiol 2023; 30:359-369. [PMID: 35551855 DOI: 10.1016/j.acra.2022.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 01/11/2023]
Abstract
The response to pandemic-related teaching disruption has revealed dynamic levels of learning and teaching flexibility and rapid technology adoption of radiology educators and trainees. Shutdowns and distancing requirements accelerated the adoption of technology as an educational tool, in some instances supplanting in-person education entirely. Despite the limitations of remote interaction, many educational advantages were recognized that can be leveraged in developing distance learning paradigms. The specific strategies employed should match modern learning science, enabling both students and educators to mutually grow as lifelong learners. As panel members of the "COVID: Faculty perspective" Task Force of the Association of University Radiologists Radiology Research Alliance, we present a review of key learning principles which educators can use to identify techniques that enhance resident learning and present an organized framework for applying technology-aided techniques aligned with modern learning principles. Our aim is to facilitate the purposeful integration of learning tools into the training environment by matching these tools to established educational frameworks. With these frameworks in mind, radiology educators have the opportunity to re-think the balance between traditional curricular design and modern digital teaching tools and models.
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Affiliation(s)
- Morgan P McBee
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina.
| | - Atul Agarwal
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Gitanjali Bajaj
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Linda C Kelahan
- Department of Radiology, Northwestern University, Chicago, Illinois
| | - Richard Leake
- Department of Radiology, University of Utah, Salt Lake City, Utah
| | | | - Judah Burns
- Department of Radiology, Montefiore Medical Center, New York, New York
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Gaetke-Udager K, Sandstrom C, Robbins JB, Flemming DJ, Flink C, Catanzano T. Radiology Training Program Lessons Learned During the COVID-19 Pandemic. Acad Radiol 2023; 30:590-594. [PMID: 36746726 PMCID: PMC9841073 DOI: 10.1016/j.acra.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
The COVID-19 pandemic had major effects on radiology training programs throughout the country. Many of the challenges were shared, with some variation depending on the size and geographic location of each program. While some initial modifications, such as platoon-type scheduling and redeployment, have been abandoned, other changes such as home workstations and the option of remote conferences have become more permanently incorporated. Remote learning tools and virtual teaching are much more frequently used, although there is emphasis by many programs on preserving in-person training. Programs stressed the importance of communication and adaptability, and getting resident and faculty input is key in optimizing the educational experience.
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Affiliation(s)
- Kara Gaetke-Udager
- Michigan Medicine Radiology, University of Michigan, 1500 E Medical Center Drive, B1 D502, Ann Arbor, Michigan, 48103.
| | - Claire Sandstrom
- Department of Radiology, University of Washington, Seattle, Washington
| | - Jessica B Robbins
- Department of Radiology, University of Wisconsin, Madison, Wisconsin
| | | | - Carl Flink
- Department of Radiology, Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tara Catanzano
- Department of Radiology, UMass Chan Medical School - Baystate, Worcester, Massachusetts
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Artificial Intelligence-Driven Ultra-Fast Superresolution MRI: 10-Fold Accelerated Musculoskeletal Turbo Spin Echo MRI Within Reach. Invest Radiol 2023; 58:28-42. [PMID: 36355637 DOI: 10.1097/rli.0000000000000928] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
ABSTRACT Magnetic resonance imaging (MRI) is the keystone of modern musculoskeletal imaging; however, long pulse sequence acquisition times may restrict patient tolerability and access. Advances in MRI scanners, coil technology, and innovative pulse sequence acceleration methods enable 4-fold turbo spin echo pulse sequence acceleration in clinical practice; however, at this speed, conventional image reconstruction approaches the signal-to-noise limits of temporal, spatial, and contrast resolution. Novel deep learning image reconstruction methods can minimize signal-to-noise interdependencies to better advantage than conventional image reconstruction, leading to unparalleled gains in image speed and quality when combined with parallel imaging and simultaneous multislice acquisition. The enormous potential of deep learning-based image reconstruction promises to facilitate the 10-fold acceleration of the turbo spin echo pulse sequence, equating to a total acquisition time of 2-3 minutes for entire MRI examinations of joints without sacrificing spatial resolution or image quality. Current investigations aim for a better understanding of stability and failure modes of image reconstruction networks, validation of network reconstruction performance with external data sets, determination of diagnostic performances with independent reference standards, establishing generalizability to other centers, scanners, field strengths, coils, and anatomy, and building publicly available benchmark data sets to compare methods and foster innovation and collaboration between the clinical and image processing community. In this article, we review basic concepts of deep learning-based acquisition and image reconstruction techniques for accelerating and improving the quality of musculoskeletal MRI, commercially available and developing deep learning-based MRI solutions, superresolution, denoising, generative adversarial networks, and combined strategies for deep learning-driven ultra-fast superresolution musculoskeletal MRI. This article aims to equip radiologists and imaging scientists with the necessary practical knowledge and enthusiasm to meet this exciting new era of musculoskeletal MRI.
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Jaroonvanichkul V, Leksuwankun S, Vachatimanont S. Simulated daily readout for maintaining nuclear medicine education in residency training amidst declining case volume: evidence from the COVID-19 pandemic. Nucl Med Commun 2022; 43:1136-1142. [PMID: 36164718 DOI: 10.1097/mnm.0000000000001617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Simulated daily readout (SDR) is a teaching initiative in radiology and nuclear medicine developed to simulate a resident's experience during periods of case volume reduction. SDR was employed by many training centers during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate the perception of radiology residents on the effectiveness of SDR. METHOD The SDR was conducted in the nuclear medicine rotations from 2019 to 2020 during the shutdown of the radionuclide imaging facilities using a combination of strategies including case selection, assignment, reporting and feedback. A brief 8-item questionnaire with Likert scale values was completed by radiology residents who participated in the SDR-based nuclear medicine rotations. RESULTS Thirty-five of 54 residents returned the questionnaire. The majority of residents affirmed the negative impact of the reduction in case volume on their training experiences and perceived that SDR could alleviate the effects. The SDR strategies perceived as more effective were targeted case selection, in-advanced assignment, verbal interpretation and reporting, and verbal feedback. CONCLUSION The radiology residents perceived the SDR as an effective tool to preserve their training experiences. The SDR has the potential to be a useful initiative when teaching centers face the threat of declining case volume.
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Affiliation(s)
| | | | - Sira Vachatimanont
- Division of Nuclear Medicine, Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Radiology training. What good looks like, now and in the future. Clin Radiol 2022; 77:902-903. [PMID: 36116969 PMCID: PMC9477647 DOI: 10.1016/j.crad.2022.08.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 11/22/2022]
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Omofoye TS, Leong LCH, Kalambo M, Teo SY, Lim WEH, Chew DCY, Lee SYS, Lane D, Kapoor MM, Martaindale S, Teichgraeber D, Moseley T, Phalak K, Srinivasan A, Sun J, Whitman G, Leung JW, Tan BS, Yang WT. Responsive Web-based Breast Imaging Core Curriculum for International Radiology Residents with Self-Assessment: A Pilot Study. Acad Radiol 2022; 29:919-927. [PMID: 34389260 DOI: 10.1016/j.acra.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/26/2021] [Accepted: 07/01/2021] [Indexed: 11/24/2022]
Abstract
RATIONALE AND OBJECTIVES Lack of uniformity in radiology resident education is partially attributable to variable access to subspecialty education. Web-based courses improve standardization, but with growing emphasis on competency based education, more evaluation of their effectiveness is needed. We created a responsive web-based breast imaging curriculum for radiology residents including self-assessment and a satisfaction survey. MATERIALS AND METHODS Two global academic institutions collaboratively developed a breast imaging curriculum to address radiology residents' educational needs. This virtual course comprised 11 video lectures, nine didactic (with attached pre-test and post-test assessments) and two case review sessions. In April 2020, this optional curriculum was made available to all 56 radiology residents in one residency program cluster in Singapore, to be accessed alongside the breast imaging rotation as a supplement. A voluntary anonymous satisfaction survey was provided upon completion. RESULTS A total of 39 of the 56 radiology residents (70%) completed the course. For the average score of nine lectures (maximum score 5), there was a significant increase in mean pre and post - test scores (mean = 2.2, SD = 0.7), p < 0.001. The proportion of residents with improvement between the pre-test score and the post-test score ranged from 74% to 100% (mean, 84%). Thirty three of the 39 participants (85%) completed the satisfaction survey, and all agreed or strongly agreed that the curriculum increased their knowledge of breast imaging. CONCLUSION This web based breast imaging curriculum supplement was viewed positively by participating residents and improved their self-assessed knowledge. Curriculum access could be expanded to improve global radiology education.
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Wong TY, Huang JJ, Cooke EA, Hoffmann JC, Donnelly EF. Adapting to the Era of Virtual Recruitment: Radiology Departmental Website Response to COVID-19 and Portrayal of the Resident Experience. Acad Radiol 2022; 29:771-778. [PMID: 35379478 PMCID: PMC8971923 DOI: 10.1016/j.acra.2021.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 11/09/2022]
Abstract
Rationale and Objectives The COVID-19 pandemic has transformed radiology recruitment into a virtual affair and placed an even stronger emphasis on the importance of departmental websites. In this study, we evaluate residency websites in detailing the response to COVID-19 as well as initiatives which help describe the resident experience. Materials and Methods Program websites for diagnostic radiology residencies listed in the 2022 Electronic Residency Application Service (ERAS) program list were evaluated for 31 criteria related to departmental response to COVID-19, online outreach, and resident wellness. Results Of 184 programs, 182 had functioning websites for review. One program was excluded from analysis as the website was almost entirely video-based. In response to COVID-19, ≤1% described resident redeployment, vaccination information, departmental response to ABR Core Exam changes, or regular administration updates. Six (3.3%) described revised read-out protocols, four (2.2%) mentioned supplementary non-clinical education, and 14 (7.7%) indicated changes to educational conferences. The majority of websites (122, 67.4%) offered an informational or tour video, while 44 (24.3%) described expectations for virtual interviewing, and 20 (11.0%) had virtual “open-houses.” Departmental social media, primarily Twitter, was linked for 60 (33.1%) programs. A total of 134 (74.0%) websites described community highlights. More than a quarter mentioned meal stipends (72, 39.8%), paid sick time (54, 29.8%) and healthcare resources (57, 31.5%). Although social activities were described by 44 (24.3%) programs, some specifically indicating changes to COVID-19, formal resident mentoring (25, 13.8%) and wellness committees (28, 15.5%) were less common. These criteria were found more commonly at the largest third of residency programs (chi square, p < 0.00625). Conclusion Programs rarely described work flow changes to COVID-19, and websites could improve in virtual outreach. Compared with prior literature, departmental websites have improved in describing wellness initiatives and related measures.
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Patil NS, Gunter D, Larocque N. The Impact of the COVID-19 Pandemic on Radiology Resident Education: Where Do We Go From Here? Acad Radiol 2022; 29:576-583. [PMID: 35033451 PMCID: PMC8610839 DOI: 10.1016/j.acra.2021.11.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/09/2021] [Accepted: 11/18/2021] [Indexed: 02/03/2023]
Abstract
The Coronavirus Disease of 2019 (COVID-19) pandemic caused a dramatic shift in radiology resident education. Primarily, physical distancing prompted a general transition to virtual learning. Common changes made by radiology residency programs included virtual rounds and readouts, the use of simulation technology, and case-based learning which utilized pedagogical approaches such as the flipped classroom for teaching residents. Virtual learning appears to be a suitable alternative to traditional, in-person learning, and may have a place post-pandemic as part of a blended curriculum with in-person and virtual components. The extent of disruption to radiology resident education varied based on the local impact of COVID-19 and the prevalence of redeployment, as did residents’ mental health and wellbeing. Accessibility of mental health resources for residents was highlighted as an issue that programs need to address during these difficult times. Moreover, the pandemic resulted in unavoidable reductions in procedural exposure which programs mitigated through the use of simulation technologies and virtual learning resources. Professional development activities such as mentorship and career planning were also dramatically impacted by the pandemic and remains a challenge that programs need to consider moving forward post-pandemic. The purpose of this review is to outline the changes made to radiology resident education as a result of the COVID-19 pandemic and suggest what changes may be worthwhile to continue.
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Affiliation(s)
- Nikhil S Patil
- Michael G Degroote School of Medicine, McMaster University, Hamilton, ON, Canada.
| | - Dane Gunter
- University College Cork School of Medicine, Cork, Ireland
| | - Natasha Larocque
- Department of Diagnostic Imaging, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada
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Chen SZ, Kapral N, Dueck N, Gaskin CM, Bueno J, Hanley M. TeleResidents: Exploring the use of Resident Home Workstations During the COVID Pandemic. Acad Radiol 2022; 29:450-455. [PMID: 34865955 PMCID: PMC8639450 DOI: 10.1016/j.acra.2021.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/25/2021] [Accepted: 11/01/2021] [Indexed: 02/08/2023]
Abstract
RATIONALE AND OBJECTIVES Since the beginning of the COVID-19 pandemic, numerous strategies have been proposed to allow for continued resident education while following social distancing guidelines. Diagnostic radiology is largely electronic work, allowing for relatively easy transition to telehealth. Our institution deployed home workstations to interested upper level radiology residents and fellows in order to maintain high volume workload and education, while complying with CDC social distancing and quarantine guidelines. MATERIALS AND METHODS We deployed 28 home workstations with integrated PACS, electronic health record, and reporting system, supporting workflow that matched our on-site processes and allowing residents to work from home while on diagnostic rotations. Two months into the pilot, surveys were sent to trainees and faculty to assess satisfaction related to education, productivity, and wellness. A retrospective study count was performed for a sample of residents in order to assess productivity. RESULTS Residents perceived their remote productivity as unchanged or better than at the hospital, while faculty were more likely to perceive it as decreased, however, objective results showed no difference. Education was largely considered worse or unchanged with very few regarding it as improved. Those utilizing shared-screen signout platforms rated education better than those utilizing voice/telephone communications only. Trainees expressed improvement in wellness and quality of life. CONCLUSION Home workstations for trainees represent a feasible solution for implementing social distancing or even quarantine while maintaining operational productivity. There is the added benefit of scheduling flexibility, option to overcome space constraints, and improved quality of life.
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Grafton-Clarke C, Uraiby H, Gordon M, Clarke N, Rees E, Park S, Pammi M, Alston S, Khamees D, Peterson W, Stojan J, Pawlik C, Hider A, Daniel M. Pivot to online learning for adapting or continuing workplace-based clinical learning in medical education following the COVID-19 pandemic: A BEME systematic review: BEME Guide No. 70. MEDICAL TEACHER 2022; 44:227-243. [PMID: 34689692 DOI: 10.1080/0142159x.2021.1992372] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The novel coronavirus disease was declared a pandemic in March 2020, which necessitated adaptations to medical education. This systematic review synthesises published reports of medical educational developments and innovations that pivot to online learning from workplace-based clinical learning in response to the pandemic. The objectives were to synthesise what adaptations/innovation were implemented (description), their impact (justification), and 'how' and 'why' these were selected (explanation and rationale). METHODS The authors systematically searched four online databases up to December 21, 2020. Two authors independently screened titles, abstracts and full-texts, performed data extraction, and assessed the risk of bias. Our findings are reported in alignment with the STORIES (STructured apprOach to the Reporting in healthcare education of Evidence Synthesis) statement and BEME guidance. RESULTS Fifty-five articles were included. Most were from North America (n = 40), and nearly 70% focused on undergraduate medical education (UGME). Key developments were rapid shifts from workplace-based learning to virtual spaces, including online electives, telesimulation, telehealth, radiology, and pathology image repositories, live-streaming or pre-recorded videos of surgical procedures, stepping up of medical students to support clinical services, remote adaptations for clinical visits, multidisciplinary team meetings and ward rounds. Challenges included lack of personal interactions, lack of standardised telemedicine curricula and need for faculty time, technical resources, and devices. Assessment of risk of bias revealed poor reporting of underpinning theory, resources, setting, educational methods, and content. CONCLUSIONS This review highlights the response of medical educators in deploying adaptations and innovations. Whilst few are new, the complexity, concomitant use of multiple methods and the specific pragmatic choices of educators offers useful insight to clinical teachers who wish to deploy such methods within their own practice. Future works that offer more specific details to allow replication and understanding of conceptual underpinnings are likely to justify an update to this review.
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Affiliation(s)
- Ciaran Grafton-Clarke
- School of Medicine, University of East Anglia, Norwich, UK
- School of Medicine, University of Leicester, Leicester, UK
| | - Hussein Uraiby
- School of Medicine, University of Leicester, Leicester, UK
| | - Morris Gordon
- Department of Pediatrics, Blackpool Victoria Hospital, Blackpool, UK
- School of Medicine, University of Central Lancashire, Preston, UK
| | - Nicola Clarke
- Research Department of Medical Education, University College London, London, UK
| | - Eliot Rees
- Research Department of Medical Education, University College London, London, UK
- School of Medicine, Keele University, North Staffordshire, UK
| | - Sophie Park
- School of Medicine, University of East Anglia, Norwich, UK
| | - Mohan Pammi
- Section of Neonatology, Texas Children's Hospital, Houston, TX, USA
| | - Sebastian Alston
- Division of Clinical Sciences, Alabama College of Osteopathic Medicine, Dothan, AL, USA
| | - Deena Khamees
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | | | - Cameron Pawlik
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ahmad Hider
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Michelle Daniel
- University of Michigan Medical School, Ann Arbor, MI, USA
- San Diego School of Medicine, University of California, La Jolla, CA, USA
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Bastos RA, Carvalho DRDS, Brandão CFS, Bergamasco EC, Sandars J, Cecilio-Fernandes D. Solutions, enablers and barriers to online learning in clinical medical education during the first year of the COVID-19 pandemic: A rapid review. MEDICAL TEACHER 2022; 44:187-195. [PMID: 34608845 DOI: 10.1080/0142159x.2021.1973979] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
AIMS The COVID-19 pandemic has seen a major disruption to undergraduate and postgraduate clinical medical education. The aim of this rapid review was to identify and synthesize published literature relating to the solutions, enablers and barriers to online learning implemented in clinical medical education during the first year of the COVID-19 pandemic. METHODS All articles published before March 2021 in peer-reviewed journals, including MedEdPublish, that described authors' experience of online learning in response to the COVID-19 pandemic. A descriptive analysis of the solutions and a qualitative template analysis of enablers and barriers. RESULTS 87 articles were identified for inclusion. Face to face teaching was maintained with interactive approaches between learners and/or learners and teachers. Several innovative solutions were identified. The enablers were a readiness and rapid response by institutions, with innovation by teachers. The barriers were the lack of planning and resources, usability problems and limited interactivity between teachers and students. CONCLUSIONS Important and timely evidence was obtained that can inform future policy, practice and research. The findings highlighted the urgent need to use rapid design and implementation methods with greater explicit descriptions in published articles to ensure applicability to other contexts.
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Affiliation(s)
- Rodrigo Almeida Bastos
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | | | | | | | - John Sandars
- Edge Hill University Medical School, Edge Hill University, Ormskirk, UK
| | - Dario Cecilio-Fernandes
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, Brazil
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15
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Patel V, Li CH, Rye V, Liu CSJ, Lerner A, Acharya J, Rajamohan AG. A Comparison of WebRTC and Conventional Videoconferencing for Synchronized Remote Medical Image Presentation. J Digit Imaging 2022; 35:68-76. [PMID: 34935095 PMCID: PMC8691158 DOI: 10.1007/s10278-021-00544-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 10/18/2021] [Accepted: 11/11/2021] [Indexed: 10/26/2022] Open
Abstract
DICOM viewers must fulfill roles beyond primary diagnostic interpretation, including serving as presentation tools in teaching and multidisciplinary conferences, thereby enabling multiple individuals to review images collaboratively in real time. When in-person gathering is not possible, a variety of solutions have been deployed to maintain the ability for spatially separated users to view medical images simultaneously. These approaches differ in their backend architectures, utilization of application-specific optimizations, and ultimately in their end user satisfaction. In this work, we systematically compare the performance of conventional screensharing using a videoconferencing application with that of a custom, synchronized DICOM viewer linked using Web Real Time Communications (WebRTC) technology. We find superior performance for the WebRTC method with regard to image quality and latency across a range of simulated adverse network conditions, and we show how increasing the number of conference participants differentially affects the bandwidth requirements of the two viewing solutions. In addition, we compare these two approaches in a real-world teaching scenario and gather the feedback of trainee and faculty radiologists, who we found to favor the WebRTC method for its decreased latency, improved image quality, ease of setup, and overall experience. Ultimately, our results demonstrate the value of application-specific solutions for the remote synchronized viewing of medical imaging, which, given the recent increase in reliance on remote collaboration, may constitute a significant consideration for future enterprise viewer procurement decisions.
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Affiliation(s)
- Vishal Patel
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, 2025 Zonal Ave, Los Angeles, CA, 90033, USA.
| | - Charles H Li
- Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, 2nd Floor, Los Angeles, CA, 90033, USA
| | - Van Rye
- Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, 2nd Floor, Los Angeles, CA, 90033, USA
| | - Chia-Shang J Liu
- Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, 2nd Floor, Los Angeles, CA, 90033, USA
| | - Alexander Lerner
- Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, 2nd Floor, Los Angeles, CA, 90033, USA
| | - Jay Acharya
- Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, 2nd Floor, Los Angeles, CA, 90033, USA
| | - Anandh G Rajamohan
- Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, 2nd Floor, Los Angeles, CA, 90033, USA
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16
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Chen D, Ayoob A, Desser TS, Khurana A. Review of Learning Tools for Effective Radiology Education During the COVID-19 Era. Acad Radiol 2022; 29:129-136. [PMID: 34799258 PMCID: PMC8542451 DOI: 10.1016/j.acra.2021.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has significantly disrupted medical education around the world and created the risk of students missing vital education and experience previously held within actively engaging in-person activities by switching to online leaning and teaching activities. To retain educational yield, active learning strategies, such as microlearning and visual learning tools are increasingly utilized in the new digital format. This article will introduce the challenges of a digital learning environment, review the efficacy of applying microlearning and visual learning strategies, and demonstrate tools that can reinforce radiology education in this constantly evolving digital era such as innovative tablet apps and tools. This will be key in preserving and augmenting essential medical teaching in the currently trying socially and physically distant times of COVID-19 as well as in similar future scenarios.
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Affiliation(s)
- David Chen
- University of Kentucky College of Medicine, Lexington, Kentucky
| | - Andres Ayoob
- Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St, HX 316, Lexington, KY 40536
| | - Terry S Desser
- Department of Radiology, Stanford University, Stanford, California
| | - Aman Khurana
- Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St, HX 316, Lexington, KY 40536.
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17
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Zamora E, Moadel RM, Song N, Zuckier LS. Remote Reading and Teaching of Nuclear Medicine in the Era of COVID-19. Semin Nucl Med 2022; 52:71-78. [PMID: 34301376 PMCID: PMC8293558 DOI: 10.1053/j.semnuclmed.2021.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Community SARS-CoV-2 has profoundly affected traditional elements of learning and teaching in nuclear medicine and diagnostic radiology departments. The response of the nuclear medicine community to the challenges imposed by the COVID-19 pandemic can be described in 3 phases: accommodation, consolidation and optimization, and a return towards normalcy. Adoption of virtual communication platforms has emerged as the crucial interim tool for preservation of trainee supervision and diagnostic imaging education. Development of supplemental teaching materials, refocusing research interests, and relaxation of requirements have all contributed toward stabilization of the residency programs. As we embark on a gradual return to normalcy, many of the virtual solutions that were employed have gained a degree of enduring popularity and may find a place in the postpandemic period.
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Affiliation(s)
| | | | | | - Lionel S. Zuckier
- Address reprint requests to Lionel S. Zuckier, MD, MBA, Division of Nuclear Medicine, Department of Radiology, Montefiore Medical Center, Bronx, NY 10467
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18
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Bass RZ, Smith AD, Langston MC, Frazier MB, Tridandapani S. Trainee and Faculty Perceptions of Remote PACS Workstations and Next Steps in a Large US Academic Medical Institution. Curr Probl Diagn Radiol 2021; 51:146-151. [PMID: 34844828 PMCID: PMC8619642 DOI: 10.1067/j.cpradiol.2021.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/02/2021] [Accepted: 09/19/2021] [Indexed: 11/22/2022]
Abstract
Objective Remote workstations were rapidly deployed in our academic radiology practice in late March 2020 in response to the COVID-19 pandemic. Although well-received by faculty, there were concerns for the impact on resident education. Materials and Methods Surveys of the radiology trainees and faculty were conducted online seven- and thirteen-months following workstation deployment as a part of a quality improvement project to assess the impact on radiology education and faculty wellness, as well as assess the desired trajectory of remote work in an academic setting. Results The majority of trainees (52%) reported the implementation had negatively impacted resident education, greatest among lower level residents (p < .001). This perception did not change despite interventions and perceived improvement in teleconferencing. Greater than 75% of radiologists with remote workstations reported improved wellness and lower stress levels compared to the onsite radiologists. The majority of all respondents voted to continue or expand remote work following the COVID-19 pandemic in both surveys. Conclusions Onsite teaching is important for the education of residents, particularly for lower-level residents. However, the adoption of a hybrid model in an academic setting may prove beneficial for faculty wellness and recruitment of the next generation.
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19
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Giordano L, Cipollaro L, Migliorini F, Maffulli N. Impact of Covid-19 on undergraduate and residency training. Surgeon 2021; 19:e199-e206. [PMID: 33248923 PMCID: PMC7659986 DOI: 10.1016/j.surge.2020.09.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/21/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The covid-19 pandemic has dramatically changed lives of residents and medical students. In particular, the learning process has undergone widely changes, especially due to the rules of social distancing which have forced universities and various institutes to modify lessons, work shifts and internships. PURPOSE The purpose of our review is to evaluate how the various institutes have faced the covid-19 emergency and guaranteed the perpetuation of the learning process of resident and students. METHODS A comprehensive search of the medical literature in PubMed and Google Scholar was performed including all the works explaining how the institutes have reorganized teaching for resident and undergraduate students. MAIN FINDINGS The use of internet for the dissemination of teaching material and educational meetings has built bridges, albeit virtual, between resident and teachers. New techniques for teaching and conducting exams have been introduced. The rotating team system allowed the continuation of the teaching activity in safety. CONCLUSION Thanks to remodulation of the teach modalities, the massive use of internet platforms, a wise distribution of work shifts, and others, universities and hospitals have not only reduced the impact on the learning process of resident and students but also turn this pandemic into a moment of personal and professional growth for the new generation of healthcare professionals.
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Affiliation(s)
- Lorenzo Giordano
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy; Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy
| | - Lucio Cipollaro
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy; Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy
| | - Filippo Migliorini
- Department of Orthopaedics, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy; Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy; Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, 275 Bancroft Road, London, E1 4DG, England, UK; School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Thornburrow Drive, Stoke on Trent, England, UK.
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20
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Geanacopoulos AT, Sundheim KM, Greco KF, Michelson KA, Parsons CR, Hron JD, Winn AS. Pediatric Intern Clinical Exposure During the COVID-19 Pandemic. Hosp Pediatr 2021; 11:e106-e110. [PMID: 33863816 PMCID: PMC8650022 DOI: 10.1542/hpeds.2021-005899] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Pediatric health care encounters declined during the coronavirus disease 2019 (COVID-19) pandemic, and pediatric residency programs have adapted trainee schedules to meet the needs of this changing clinical environment. We sought to evaluate the impact of the pandemic on pediatric interns' clinical exposure. METHODS In this retrospective cohort study, we quantified patient exposure among pediatric interns from a single large pediatric residency program at a freestanding children's hospital. Patient encounters and shifts per pediatric intern in the inpatient and emergency department settings were evaluated during the COVID-19 pandemic, from March to June 2020, as compared with these 3 months in 2019. Patient encounters by diagnosis were also evaluated. RESULTS The median number of patient encounters per intern per 2-week block declined on the pediatric hospital medicine service (37.5 vs 27.0; P < .001) and intensive care step-down unit (29.0 vs 18.8; P = .004) during the pandemic. No significant difference in emergency department encounters was observed (63.0 vs 40.5; P = .06). The median number of shifts worked per intern per 2-week block also decreased on the pediatric hospital medicine service (10.5 vs 9.5, P < .001). Across all settings, there were more encounters for screening for infectious disease and fewer encounters for respiratory illnesses. CONCLUSIONS Pediatric interns at the onset of the COVID-19 pandemic were exposed to fewer patients and had reduced clinical schedules. Careful consideration is needed to track and supplement missed clinical experiences during the pandemic.
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Affiliation(s)
| | | | | | - Kenneth A Michelson
- Department of Pediatrics
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts
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21
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Alhasan AS, Alahmadi SM, Altayeb YA, Daqqaq TS. Impact of COVID-19 Pandemic on Training and Well-Being in Radiology Residency: A National Survey of Diagnostic Radiology Trainees in Saudi Arabia. Acad Radiol 2021; 28:1002-1009. [PMID: 33893029 DOI: 10.1016/j.acra.2021.03.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To understand and report the perceived impact of the COVID-19 pandemic on radiology residents in Saudi Arabia with respect to their education, clinical activities, and personal well-being. METHODS The survey questionnaire was designed by a team of experts based on a review of the literature and was distributed electronically through the Saudi Commission for Health Specialties to residents registered in all radiology residency training programs in Saudi Arabia during the academic year 2019 to 2020. Categorical variables were presented as counts and percentage. Numerical variables were presented as mean and standard deviation if normally distributed. Chi-square testing was used to compare categorical variables with the perceived impact of the COVID-19 pandemic. Spearman correlation was used to correlate numerical variables at the level of significance p-value < 0.05. RESULTS A total of 109 residents completed the online survey during the study period, with a response rate of 32.2% (109/337). The mean age was 27.3 years (standard deviation, 1.86). The majority of respondents (71.5%, 78/109) reported either a severe or moderate negative impact on educational activities. Also, the majority (73.4%, 80/109) reported either a minimal or moderate negative impact on clinical activities. Residents training in the western province perceived a statistically higher negative impact on educational activities compared to their peers in other regions (p = 0.01). Residents in their second year of residency training perceived a statistically higher negative impact on their participation in clinical activities (p = 0.014). Less than half of the respondents (45.9%, 50/109) reported that they were redeployed to work in another department. The majority (80%, 40/50) reported a negative impact on their well-being. CONCLUSION The majority of radiology residents in Saudi Arabia reported a negative impact of the COVID-19 pandemic on their education, clinical activities, and personal well-being. Our study also identified and explored some of the innovative solutions and strategies implemented by the training programs and the SCFHS to mitigate the negative effects on trainees.
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Affiliation(s)
- Ayman S Alhasan
- Department of Radiology, College of Medicine, Taibah University, P.O.Box 7295, Zip Code 42361, Madinah, Saudi Arabia.
| | - Shahad M Alahmadi
- College of Medicine, Taibah University, Madinah, Kingdome of Saudi Arabia
| | - Yara A Altayeb
- College of Medicine, Taibah University, Madinah, Kingdome of Saudi Arabia
| | - Tareef S Daqqaq
- Department of Radiology, College of Medicine, Taibah University, P.O.Box 7295, Zip Code 42361, Madinah, Saudi Arabia
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22
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Lanier MH, Wheeler CA, Ballard DH. A New Normal in Radiology Resident Education: Lessons Learned from the COVID-19 Pandemic. Radiographics 2021; 41:E71-E72. [PMID: 33939548 PMCID: PMC8103952 DOI: 10.1148/rg.2021210030] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- M Hunter Lanier
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110 (M.H.L., D.H.B.); and Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (C.A.W.)
| | - C Austin Wheeler
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110 (M.H.L., D.H.B.); and Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (C.A.W.)
| | - David H Ballard
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110 (M.H.L., D.H.B.); and Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (C.A.W.)
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23
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Larocque N, Shenoy-Bhangle A, Brook A, Eisenberg R, Chang YM, Mehta P. Resident Experiences With Virtual Radiology Learning During the COVID-19 Pandemic. Acad Radiol 2021; 28:704-710. [PMID: 33640229 PMCID: PMC7883720 DOI: 10.1016/j.acra.2021.02.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/03/2021] [Accepted: 02/06/2021] [Indexed: 12/12/2022]
Abstract
Rationale and Objectives COVID-19 has disrupted radiology education and forced a transition from traditional in-person learning to a virtual platform. As a result of hospital and state mandates, our radiology residency program quickly transitioned to a virtual learning platform to continue dissemination of knowledge, maintain resident engagement, and ensure professional development. The goal of this study is to assess the strengths and weaknesses of the virtual learning platform at our institution using resident ratings. Materials and Methods This institutional IRB-exempt study involved a survey of 17 questions which was electronically distributed to 45 radiology residents using SurveyMonkey. Questions encompassed resident satisfaction with teaching and professional development, scheduling changes, and engagement with the virtual platform. Answers to most questions were submitted on a Likert scale. Results A total of 31 of 45 respondents completed the survey (response rate = 69%). Most residents were satisfied with the virtual platform with teaching activities identified as a strength and the incorporation of professional development as a weakness. The most frequent barriers to attending the virtual curriculum were technical difficulties (43%) and childcare (36%). Residents who reported experiencing barriers were less likely to adhere to the virtual curriculum (p = 0.004). Most respondents (81%) reported a desire to maintain elements of the virtual learning practice postpandemic. Conclusion The majority of residents reported high satisfaction with virtual learning during the COVID-19 pandemic. Teaching activities are a curricular strength. Weaknesses identified include the incorporation of professional development and extrinsic barriers, such as technical difficulties and family obligations, which require further support for trainees.
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Affiliation(s)
- Natasha Larocque
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts.
| | - Anuradha Shenoy-Bhangle
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts
| | - Alexander Brook
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts
| | - Ronald Eisenberg
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts
| | - Yu-Ming Chang
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts
| | - Pritesh Mehta
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts
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24
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Impact of COVID-19 on radiology training: Royal College of Radiologists Junior Radiologists Forum national survey. Clin Radiol 2021; 76:549.e9-549.e15. [PMID: 33879321 DOI: 10.1016/j.crad.2021.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/22/2021] [Indexed: 11/20/2022]
Abstract
AIM To obtain a national snapshot of radiology trainees' experience during the first wave of the pandemic. MATERIALS AND METHODS A 25-item questionnaire was disseminated to representatives from all training regions across the UK in July 2020. Each representative collated the collective experiences of trainees in their training programme in key domains, including redeployment, shielding, training, and teaching. RESULTS Ninety-five percent (38 of 40) of representatives completed the questionnaire. Trainees in up to 76% of training programmes were redeployed to wards and some trainees were shielding in 81% of programmes. Only 27% of programmes enabled remote reporting for isolating or shielding trainees. Sixty-two percent of respondents felt their well-being needs were supported. There was an overall increase in the attendance, volume, and quality of teaching and training nationally due to improved accessibility via remote-learning methods. Significant challenges were described with reporting, interventional procedures, and multidisciplinary team meeting attendance, although 62% of programmes noted an increase in service provision. Less in-person feedback was reported with in-person training still deemed necessary for practical skills. The Royal College of Radiologists Junior Radiologists Forum webinars were well received by all trainees with continuation of the series recommended. CONCLUSION The COVID-19 pandemic has had a clear impact on many areas of radiology training in the UK. Early strategies have been adopted to mitigate the challenges faced by trainees and opportunities for future improvement are highlighted.
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25
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Daniel M, Gordon M, Patricio M, Hider A, Pawlik C, Bhagdev R, Ahmad S, Alston S, Park S, Pawlikowska T, Rees E, Doyle AJ, Pammi M, Thammasitboon S, Haas M, Peterson W, Lew M, Khamees D, Spadafore M, Clarke N, Stojan J. An update on developments in medical education in response to the COVID-19 pandemic: A BEME scoping review: BEME Guide No. 64. MEDICAL TEACHER 2021; 43:253-271. [PMID: 33496628 DOI: 10.1080/0142159x.2020.1864310] [Citation(s) in RCA: 120] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND COVID-19 has fundamentally altered how education is delivered. Gordon et al. previously conducted a review of medical education developments in response to COVID-19; however, the field has rapidly evolved in the ensuing months. This scoping review aims to map the extent, range and nature of subsequent developments, summarizing the expanding evidence base and identifying areas for future research. METHODS The authors followed the five stages of a scoping review outlined by Arskey and O'Malley. Four online databases and MedEdPublish were searched. Two authors independently screened titles, abstracts and full texts. Included articles described developments in medical education deployed in response to COVID-19 and reported outcomes. Data extraction was completed by two authors and synthesized into a variety of maps and charts. RESULTS One hundred twenty-seven articles were included: 104 were from North America, Asia and Europe; 51 were undergraduate, 41 graduate, 22 continuing medical education, and 13 mixed; 35 were implemented by universities, 75 by academic hospitals, and 17 by organizations or collaborations. The focus of developments included pivoting to online learning (n = 58), simulation (n = 24), assessment (n = 11), well-being (n = 8), telehealth (n = 5), clinical service reconfigurations (n = 4), interviews (n = 4), service provision (n = 2), faculty development (n = 2) and other (n = 9). The most common Kirkpatrick outcome reported was Level 1, however, a number of studies reported 2a or 2b. A few described Levels 3, 4a, 4b or other outcomes (e.g. quality improvement). CONCLUSIONS This scoping review mapped the available literature on developments in medical education in response to COVID-19, summarizing developments and outcomes to serve as a guide for future work. The review highlighted areas of relative strength, as well as several gaps. Numerous articles have been written about remote learning and simulation and these areas are ripe for full systematic reviews. Telehealth, interviews and faculty development were lacking and need urgent attention.
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Affiliation(s)
- Michelle Daniel
- Emergency Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Morris Gordon
- Blackpool Victoria Hospital, Blackpool, UK
- School of Medicine, University of Central Lancashire, Lancashire, UK
| | | | - Ahmad Hider
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Cameron Pawlik
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | | | - Sebastian Alston
- Division of Clinical Sciences, Alabama College of Osteopathic Medicine, Dothan, AL, USA
| | - Sophie Park
- Primary Care and Population Health, University College London Medical School, London, UK
| | - Teresa Pawlikowska
- Health Professions Education Centre (HPEC), Royal College of Surgeons University of Medicine and Health Sciences, Dublin, Ireland
| | - Eliot Rees
- Primary Care and Population Health, University College London Medical School, London, UK
- School of Medicine, Keele University, Keele, UK
| | - Andrea Jane Doyle
- Health Professions Education Centre (HPEC), Royal College of Surgeons University of Medicine and Health Sciences, Dublin, Ireland
| | - Mohan Pammi
- Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA
| | - Satid Thammasitboon
- Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Mary Haas
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Madelyn Lew
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Deena Khamees
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Nicola Clarke
- Primary Care and Population Health, University College London Medical School, London, UK
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26
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Simon MJK, Regan WD. COVID-19 pandemic effects on orthopaedic surgeons in British Columbia. J Orthop Surg Res 2021; 16:161. [PMID: 33637100 PMCID: PMC7908008 DOI: 10.1186/s13018-021-02283-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/08/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND COVID-19 was declared a global emergency in the first quarter of 2020. It is has resulted in and continues in over a million deaths worldwide and halted medical systems and particularly elective surgeries worldwide. The aim of this study was to identify the effect of the initial COVID-19 pandemic months on orthopaedic surgeons in British Columbia. METHODS The study surveyed (June until August 2020) 187 orthopaedic surgeons in British Columbia affiliated with the University of British Columbia or the British Columbia Orthopaedic Association using an online survey to help identify the impact of COVID-19 on patient care, work and personal life. RESULTS Eighty-seven out of 187 (46.5%) orthopaedic surgeons participated in the online survey. All types of surgeries were completely cancelled for 23 respondents. Elective surgeries were cancelled for most respondents (in-hospital n = 38 and/or ambulatory n = 32). Trauma cases were reduced according to 35 respondents. Outpatient clinics were stopped initially and transferred in virtual clinics (telemedicine). Approximately 40% of respondents were afraid of infecting others (patients, family) and 25% admitted to drink more heavily. Ninety percent of respondents reported an income loss of > 15% (range 0-100%). CONCLUSION Orthopaedic surgeons and their patients have been significantly affected by the COVID-19 pandemic. Cancellation of surgeries has created an increased backlog of 32,400 orthopaedic surgeries in British Columbia. However, the COVID-19 pandemic has expedited the implementation of telemedicine, which will be a long-lasting benefit in providing healthcare.
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Affiliation(s)
- Maciej J K Simon
- Department of Orthopaedics, Chan Gunn Pavilion, Allen McGavin Sports Medicine Clinic, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T1Z3, Canada
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - William D Regan
- Department of Orthopaedics, Chan Gunn Pavilion, Allen McGavin Sports Medicine Clinic, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T1Z3, Canada.
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Coppola F, Faggioni L, Neri E, Grassi R, Miele V. Impact of the COVID-19 outbreak on the profession and psychological wellbeing of radiologists: a nationwide online survey. Insights Imaging 2021; 12:23. [PMID: 33595747 PMCID: PMC7887566 DOI: 10.1186/s13244-021-00962-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/04/2021] [Indexed: 01/08/2023] Open
Abstract
Background The COVID-19 outbreak has played havoc within healthcare systems, with radiology sharing a substantial burden. Our purpose is to report findings from a survey on the crisis impact among members of the Italian Society of Medical and Interventional Radiology (SIRM). Methods All members were invited to a 42-question online survey about the impact of the COVID-19 outbreak on personal and family life, professional activity, socioeconomic and psychological condition. Participants were classified based on working in the most severely affected Italian regions (“hot regions”) or elsewhere. Results A total of 2150 radiologists joined the survey. More than 60% of respondents estimated a workload reduction greater than 50%, with a higher prevalence among private workers in hot regions (72.7% vs 66.5% elsewhere, p = 0.1010). Most respondents were concerned that the COVID-19 outbreak could impact the management of non-COVID-19 patients and expected a work overload after the crisis. More than 40% were moderately or severely worried that their professional activity could be damaged, and most residents believed that their training had been affected. More than 50% of respondents had increased emotional stress at work, including moderate or severe symptoms due to sleep disturbances, feeling like living in slow motion and having negative thoughts, those latter being more likely in single-living respondents from hot regions [log OR 0.7108 (CI95% 0.3445 ÷ 1.0770), p = 0.0001]. Conclusions The COVID-19 outbreak has had a sensible impact on the working and personal life of SIRM members, with more specific criticalities in hot regions. Our findings could aid preserving the radiologists’ wellbeing after the crisis.
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Affiliation(s)
- Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Faggioni
- Department of Translational Research, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
| | - Emanuele Neri
- Department of Translational Research, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.,SIRM Foundation, Italian Society of Medical and Interventional Radiology, Milan, Italy
| | - Roberto Grassi
- Department of Precision Medicine, University of Campania, Naples, Italy
| | - Vittorio Miele
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Poyiadji N, Klochko C, LaForce J, Brown ML, Griffith B. COVID-19 and Radiology Resident Imaging Volumes-Differential Impact by Resident Training Year and Imaging Modality. Acad Radiol 2021; 28:106-111. [PMID: 33046369 PMCID: PMC7528904 DOI: 10.1016/j.acra.2020.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 01/23/2023]
Abstract
Rationale and Objectives The COVID-19 pandemic has greatly impacted radiology departments across the country. The pandemic has also disrupted resident education, both due to departmental social distancing efforts and reduced imaging volumes. The purpose of this study was to assess the differential impact the pandemic had on radiology resident imaging volumes by training year and imaging modality. Materials and Methods All signed radiology resident reports were curated during defined prepandemic and intrapandemic time periods. Imaging case volumes were analyzed on a mean per resident basis to quantify absolute and percent change by training level. Change in total volume by imaging modality was also assessed. The number of resident workdays assigned outside the normal reading room was also calculated. Results Overall percent decline in resident imaging interpretation volume from the prepandemic to intrapandemic time period was 62.8%. R1s and R2s had the greatest decline at 87.3% and 64.3%, respectively. Mammography, MRI and nuclear medicine had the greatest decline in resident interpretation volume at 92.0%, 73.2%, and 73.0%, respectively. During the intrapandemic time period, a total of 478 resident days (mean of 14.5 days per resident) were reassigned outside of the radiology reading room. Conclusion The COVID-19 pandemic caused a marked decrease in radiology resident imaging interpretation volume and has had a tremendous impact on resident education. The decrease in case interpretation, as well as in-person teaching has profound implications for resident education. Knowledge of this differential decrease by training level will help residency programs plan for the future.
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Alpert JB, Young MG, Lala SV, McGuinness G. Medical Student Engagement and Educational Value of a Remote Clinical Radiology Learning Environment: Creation of Virtual Read-Out Sessions in Response to the COVID-19 Pandemic. Acad Radiol 2021; 28:112-118. [PMID: 33268209 DOI: 10.1016/j.acra.2020.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 11/19/2022]
Abstract
RATIONALE AND OBJECTIVES The need for social distancing has resulted in rapid restructuring of medical student education in radiology. While students traditionally spend time learning in the reading room, remote clinical learning requires material shared without direct teaching at the radiology workstation. Can remote clinical learning meet or exceed the educational value of the traditional in-person learning experience? Can student engagement be matched or exceeded in a remote learning environment? MATERIALS AND METHODS To replace the in-person reading room experience, a small-group learning session for medical students named Virtual Read-Out (VRO) was developed using teleconferencing software. After Institutional Review Board approval, two student groups were anonymously surveyed to assess differences in student engagement and perceived value between learning environments: "Conventional" students participating in the reading room (before the pandemic) and "Remote" students participating in VRO sessions. Students reported perceived frequency of a series of five-point Likert statements. Based on number of respondents, an independent t-test was performed to determine the significance of results between two groups. RESULTS Twenty-seven conventional and 41 remote students responded. Remote students reported modest but significantly higher frequency of active participation in reviewing radiology exams (p < 0.05). There was significantly lower frequency of reported boredom among Remote students (p < 0.05). There was no significant difference in perceived educational value between the two groups. CONCLUSION Students report a high degree of teaching quality, clinical relevance, and educational value regardless of remote or in-person learning format. Remote clinical radiology education can be achieved with equal or greater student interaction and perceived value in fewer contact hours than conventional learning in the reading room.
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Affiliation(s)
- Jeffrey B Alpert
- New York University Langone Health, Department of Radiology, 660 First Avenue, 3rd Floor, New York, NY 10016.
| | - Matthew G Young
- New York University Langone Health, Department of Radiology, 660 First Avenue, 3rd Floor, New York, NY 10016
| | - Shailee V Lala
- New York University Langone Health, Department of Radiology, 660 First Avenue, 3rd Floor, New York, NY 10016
| | - Georgeann McGuinness
- New York University Langone Health, Department of Radiology, 660 First Avenue, 3rd Floor, New York, NY 10016
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Nicholas JL, Bass EL, Otero HJ. Can lessons from the COVID-19 pandemic help define a strategy for global pediatric radiology education? Pediatr Radiol 2020; 50:1641-1644. [PMID: 32889584 PMCID: PMC7474308 DOI: 10.1007/s00247-020-04822-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/03/2020] [Accepted: 08/18/2020] [Indexed: 01/02/2023]
Affiliation(s)
- Jennifer Lynn Nicholas
- University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, 11100 Euclid Ave., Cleveland, OH, 44106, USA.
| | - Erika Lynn Bass
- Department of Languages and Literature, University of Northern Iowa, Cedar Falls, IA, USA
| | - Hansel J Otero
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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