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Davies LJ, Mathew C, Pourghaderi AR, Leong AXY, Chan DXH, Koh DLK, Tan AYH, Ong CYM, Ong J, Lam SSW, Ong SGK. COVID-19 Pandemic Simulation Modelling in Anaesthesia Residency Training to Predict Delays and Workforce Deficiencies: A Case Study of the Singapore Residency Training Program. Cureus 2024; 16:e51852. [PMID: 38327925 PMCID: PMC10848604 DOI: 10.7759/cureus.51852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Background COVID-19 has been the worst pandemic of this century, resulting in economic, social, and educational disruptions. Residency training is no exception, with training restrictions delaying the progression and graduation of residents. We sought to utilize simulation modelling to predict the impact on future cohorts in the event of repeated and prolonged movement restrictions due to COVID-19 and future pandemics of a similar nature. Method A Delphi study was conducted to determine key Accreditation Council for Graduate Medical Education-International (ACGME-I) training variables affected by COVID-19. Quantitative resident datasets on these variables were collated and analysed from 2018 to 2021. Using the Vensim® software (Ventana Systems, Inc., Harvard, MA), historical resident data and pandemic progression delays were used to create a novel simulation model to predict future progression delay. Various durations of delay were also programmed into the software to simulate restrictions of varying severity that would impact resident progression. Results Using the model with scenarios simulating varying pandemic length, we found that the estimated average delay for residents in each accredited year ranged from an increase of one month for year 2 residents to more than three months for year 4 residents. Movement restrictions lasting a year would require up to six years before the program returned to a pre-pandemic equilibrium. Conclusion Systems dynamic modelling can be used to predict delays in residency training programs during a pandemic. The impact on the workforce can thus be projected, allowing residency programs to institute mitigating measures to avoid progression delay.
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Affiliation(s)
- Lucy J Davies
- Department of Paediatric Anaesthesia, KK Women's and Children's Hospital, Singapore, SGP
| | - Christopher Mathew
- Department of Anaesthesiology, Singapore General Hospital, Singapore, SGP
| | - Ahmad R Pourghaderi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, AUS
| | | | - Diana Xin Hui Chan
- Department of Anaesthesiology, Singapore General Hospital, Singapore, SGP
| | | | - Addy Yong Hui Tan
- Department of Anaesthesia, National University Hospital, Singapore, SGP
| | - Caroline Yu Ming Ong
- Department of Anaesthesiology, Intensive Care, and Pain Medicine, Tan Tock Seng Hospital, Singapore, SGP
| | - John Ong
- Department of Gastroenterology, Hepatology, & General Internal Medicine, University of Cambridge, Cambridge, GBR
| | - Sean Shao Wei Lam
- Singhealth Duke-NUS Academic Medical Centre, Singhealth Duke-NUS Medical School, Singapore, SGP
| | - Sharon Gek Kim Ong
- Department of Anaesthesiology, Sengkang General Hospital, Singapore, SGP
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2
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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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Gordon EB, Wingrove P, Branstetter IV BF, Hughes MA. Evidence for an adverse impact of remote readouts on radiology resident productivity: Implications for training and clinical practice. PLOS DIGITAL HEALTH 2023; 2:e0000332. [PMID: 37738228 PMCID: PMC10516412 DOI: 10.1371/journal.pdig.0000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/18/2023] [Indexed: 09/24/2023]
Abstract
After their rapid adoption at the onset of the coronavirus pandemic, remote case reviews (remote readouts) between diagnostic radiology residents and their attendings have persisted in an increasingly remote workforce, despite relaxing social distancing guidelines. Our objective was to evaluate the impact of the transition to remote readouts on resident case volumes after the recovery of institutional volumes. We tabulated radiology reports co-authored by first-to-third-year radiology residents (R1-R3) between July 1 and December 31 of the first pandemic year, 2020, and compared to the prior two pre-pandemic years. Half-years were analyzed because institutional volumes recovered by July 2020. Resident volumes were normalized to rotations, which were in divisions categorized by the location of the supervising faculty during the pandemic period; in 'remote' divisions, all faculty worked off-site, whereas 'hybrid' divisions had a mix of attendings working on-site and remotely. All residents worked on-site. Data analysis was performed with Student's t test and multivariate linear regression. The largest drops in total case volume occurred in the two remote divisions (38% [6,086 to 3,788], and 26% [11,046 to 8,149]). None of the hybrid divisions with both in-person and remote supervision decreased by more than 5%. With multivariate regression, a resident assigned to a standardized remote rotation in 2020 would complete 32% (253 to 172) fewer studies than in identical pre-pandemic rotations (coefficent of -81.6, p = .005) but would be similar for hybrid rotations. R1 residents would be expected to interpret 40% fewer (180 to 108) cases on remote rotations during the pandemic (coefficient of -72.3, p = .007). No significant effect was seen for R2 or R3 residents (p = .099 and p = .29, respectively). Radiology residents interpreted fewer studies during remote rotations than on hybrid rotations that included in-person readouts. As resident case volume is correlated with clinical performance and board pass rate, monitoring the readout model for downstream educational effects is essential. Until evidence shows that educational outcomes remain unchanged, radiology residencies may wish to preserve in-person resident readouts, particularly for junior residents.
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Affiliation(s)
- Emile B. Gordon
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
| | - Peter Wingrove
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
| | - Barton F. Branstetter IV
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
| | - Marion A. Hughes
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America
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Pala Z, Atıcı R, Yaldız E. Forecasting Future Monthly Patient Volume using Deep Learning and Statistical Models. WIRELESS PERSONAL COMMUNICATIONS 2023; 130:1479-1502. [PMID: 37168439 PMCID: PMC10004452 DOI: 10.1007/s11277-023-10341-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 05/13/2023]
Abstract
The variety of diseases is increasing day by day, and the demand for hospitals, especially for emergency and radiology units, is also increasing. As in other units, it is necessary to prepare the radiology unit for the future, to take into account the needs and to plan for the future. Due to the radiation emitted by the devices in the radiology unit, minimizing the time spent by the patients for the radiological image is of vital importance both for the unit staff and the patient. In order to solve the aforementioned problem, in this study, it is desired to estimate the monthly number of images in the radiology unit by using deep learning models and statistical-based models, and thus to be prepared for the future in a more planned way. For prediction processes, both deep learning models such as LSTM, MLP, NNAR and ELM, as well as statistical based prediction models such as ARIMA, SES, TBATS, HOLT and THETAF were used. In order to evaluate the performance of the models, the symmetric mean absolute percentage error (sMAPE) and mean absolute scaled error (MASE) metrics, which have been in demand recently, were preferred. The results showed that the LSTM model outperformed the deep learning group in estimating the monthly number of radiological case images, while the AUTO.ARIMA model performed better in the statistical-based group. It is believed that the findings obtained will speed up the procedures of the patients who come to the hospital and are referred to the radiology unit, and will facilitate the hospital managers in managing the patient flow more efficiently, increasing both the service quality and patient satisfaction, and making important contributions to the future planning of the hospital.
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Affiliation(s)
- Zeydin Pala
- Department of Software Engineering, Engineering Faculty, Mus Alparslan University, Mus, Turkey
| | - Ramazan Atıcı
- Department of Electricity and Automation, Technical Sciences Vocational School, Mus Alparslan University, Mus, Turkey
| | - Erkan Yaldız
- Halkbank IT Assistant Specialist, Istanbul, Turkey
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Gharaibeh M, El-Obeid E, Khasawneh R, Karrar M, Salman M, Farah A, Ahmmed S, Al-Omari M, Elheis M, Abualigah L. Impact of the COVID-19 pandemic on imaging case volumes in King Abdullah University Hospitals (KAUH). Front Med (Lausanne) 2023; 10:1103083. [PMID: 36844230 PMCID: PMC9947495 DOI: 10.3389/fmed.2023.1103083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Objective COVID-19 has an increased burden on the delivery of services because the measures taken by the governments forced hospitals to cancel most of their elective procedures and led to the shutting down of outpatient clinics. This study aimed to evaluate the impact COVID-19 pandemic on the volume of radiology exams based on patient service locations and imaging modality in the North of Jordan. Methods The imaging case volumes that were performed at the King Abdullah University Hospital (KAUH), Jordan, from 1 January 2020 to 8 May 2020, were retrospectively collected and compared to those from 1 January 2019 to 28 May 2019, to determine the impact of the pandemic of COVID-19 on the volume of radiological examinations. The 2020 study period was chosen to cover the peak of COVID-19 cases and to record the effects on imaging case volumes. Results A total of 46,194 imaging case volumes were performed at our tertiary center in 2020 compared to 65,441 imaging cases in 2019. Overall, the imaging case volume in 2020 decreased by 29.4% relative to the same period in 2019. The imaging case volumes decreased for all imaging modalities relative to 2019. The number of nuclear images showed the highest decline (41.0%) in 2020, followed by the number of ultrasounds (33.2%). Interventional radiology was the least affected imaging modality by this decline, with about a 22.9% decline. Conclusion The number of imaging case volumes decreased significantly during the COVID-19 pandemic and its associated lockdown. The outpatient service location was the most affected by this decline. Effective strategies must be adopted to avoid the aforementioned effect on the healthcare system in future pandemics.
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Affiliation(s)
- Maha Gharaibeh
- Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Jordan University of Science and Technology, Irbid, Jordan,*Correspondence: Maha Gharaibeh,
| | - Eyhab El-Obeid
- Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Jordan University of Science and Technology, Irbid, Jordan,Faculty of Medicine, Department of Diagnostic Radiology, Omdurman Islamic University, Omdurman, Sudan
| | - Ruba Khasawneh
- Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Jordan University of Science and Technology, Irbid, Jordan
| | - Musaab Karrar
- Faculty of Medicine, Department of Emergency, Jordan University of Science and Technology, Irbid, Jordan,Faculty of Medicine, Department of Emergency, Omdurman Islamic University, Omdurman, Sudan
| | - Mohamed Salman
- Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmad Farah
- Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Jordan University of Science and Technology, Irbid, Jordan
| | - Sammah Ahmmed
- Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Jordan University of Science and Technology, Irbid, Jordan
| | - Mamoon Al-Omari
- Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Jordan University of Science and Technology, Irbid, Jordan
| | - Mwaffaq Elheis
- Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Jordan University of Science and Technology, Irbid, Jordan
| | - Laith Abualigah
- Prince Hussein Bin Abdullah Faculty for Information Technology, Computer Science Department, Al al-Bayt University, Mafraq, Jordan,Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan,Faculty of Information Technology, Middle East University, Amman, Jordan,Applied Science Research Center, Applied Science Private University, Amman, Jordan,School of Computer Sciences, Universiti Sains Malaysia, Penang, Malaysia,Laith Abualigah,
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Bailey J, Nadeau N, Jordan K, Yerxa H, Lam S. The Effect of COVID-19 on United States Pediatric Emergency Departments and Its Impact on Trainees. West J Emerg Med 2022; 23:893-896. [DOI: 10.5811/westjem.2022.7.57340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/28/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction: The purpose of this study was to quantify the effects of the coronavirus disease 2019 (COVID-19) pandemic on pediatric emergency departments (PED) across the United States (US), specifically its impact on trainee clinical education as well as patient volume, admission rates, and staffing models.
Methods: We conducted a cross-sectional study of US PEDs, targeting PED clinical leaders via a web-based questionnaire. The survey was sent via three national pediatric emergency medicine distribution lists, with several follow-up reminders.
Results: There were 46 questionnaires included, completed by PED directors from 25 states. Forty-two sites provided PED volume and admission data for the early pandemic (March-July 2020) and a pre-pandemic comparison period (March-July 2019). Mean PED volume decreased >32% for each studied month, with a maximum mean reduction of 63.6% (April 2020). Mean percentage of pediatric admissions over baseline also peaked in April 2020 at 38.5% and remained 16.4% above baseline by July 2020. During the study period, 33 (71.1%) sites had decreased clinician staffing at some point. Only three sites (6.7%) reported decreased faculty protected time. All PEDs reported staffing changes, including decreased mid-level use, increased on-call staff, movement of staff between the PED and other units, and added tele-visit shifts. Twenty-six sites (56.5%) raised their patient age cutoff; median was 25 years (interquartile ratio 25-28). Of 44 sites hosting medical trainees, 37 (84.1%) reported a decrease in number of trainees or elimination altogether. Thirty (68.2%) sites had restrictions on patient care provision by trainees: 28 (63.6%) affected medical students, 12 (27.3%) affected residents, and two (4.5%) impacted fellows. Fifteen sites (34.1%) had restrictions on procedures performed by medical students (29.5%), residents (20.5%), or fellows (4.5%).
Conclusion: This study highlights the marked impact of the COVID-19 pandemic on US PEDs, noting decreased patient volumes, increased admission rates, and alterations in staffing models. During the early pandemic, educational restrictions for trainees in the PED setting disproportionately affected medical students over residents, with fellows’ experience largely preserved. Our findings quantify the magnitude of these impacts on trainee pediatric clinical exposure during this period.
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Affiliation(s)
- Jessica Bailey
- Oregon Health & Science University, Department of Emergency Medicine, Portland, Oregon
| | - Nicole Nadeau
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts
| | - Kamyron Jordan
- Oregon Health & Science University, Department of Pediatrics, Portland, Oregon
| | - Hannah Yerxa
- Oregon Health & Science University, Department of Pediatrics, Portland, Oregon
| | - Samuel Lam
- Sutter Medical Center Sacramento, Department of Emergency Medicine, Sacramento, California
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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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Radiology Medical Student Education 2020: Surveys of the Alliance of Medical Student Educators in Radiology and Medical Students. Acad Radiol 2022; 29:298-311. [PMID: 33516589 PMCID: PMC8735856 DOI: 10.1016/j.acra.2021.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/22/2020] [Accepted: 01/01/2021] [Indexed: 02/08/2023]
Abstract
Rationale and Objectives The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant changes to medical student education by disrupting clinical rotations, licensing exams, and residency applications. To evaluate the pandemic's impact and required modifications of radiology medical student courses, the authors developed and administered surveys to Alliance of Medical Student Educators in Radiology (AMSER) faculty and enrolled medical students. The surveys requested feedback and insight about respondents’ experiences and innovations. Materials and Methods Anonymous twenty-question and seventeen-question surveys about the pandemic's impact on medical student education were distributed via email to AMSER members and medical students. The surveys consisted of multiple choice, ranking, Likert scale, and open-ended questions. Differences in the Likert score agreement was performed using one-sided Wilcoxon-Mann-Whitney tests. Survey data were collected using SurveyMonkey (San Mateo, California). This study was IRB exempt. Results The AMSER survey indicated 96% of institutions cancelled medical student courses and 92% resumed with virtual courses, typically general radiology. A total of 64% of faculty enjoyed online teaching, although 82% preferred on-site courses. A total of 62% of students felt an online radiology course was an excellent alternative to an on-site rotation, although 27% disagreed. A total of 69% of students who completed both on-site and online courses preferred the on-site format. Survey-reported innovations and free response comments have been collated as educational resources. Conclusion Faculty were able to adapt radiology courses to the online environment utilizing interactive lectures, self-directed learning, flipped classroom sessions, and virtual readouts, which were effective for student respondents. Hybrid rotations with on-site and online elements may offer the best of both worlds.
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Freeman CW, Dhanaliwala A, Moore S, Kunchala S, Scanlon MH. Homeward Bound: A Comparison of Resident Case Volume on Home-Read Workstations and On-Site during the COVID-19 Pandemic. J Am Coll Radiol 2022; 19:476-479. [PMID: 35123956 PMCID: PMC8786630 DOI: 10.1016/j.jacr.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/04/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022]
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12
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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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Chen SY, Lo HY, Hung SK. What is the impact of the COVID-19 pandemic on residency training: a systematic review and analysis. BMC MEDICAL EDUCATION 2021; 21:618. [PMID: 34911503 PMCID: PMC8671601 DOI: 10.1186/s12909-021-03041-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 11/25/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has greatly affected medical education in addition to clinical systems. Residency training has probably been the most affected aspect of medical education during the pandemic, and research on this topic is crucial for educators and clinical teachers. The aim of this study was to understand the effect of the COVID-19 pandemic comprehensively through a systematic review and analysis of related published articles. METHODS A systematic review was conducted based on a predesigned protocol. We searched MEDLINE and EMBASE databases until November 30, 2020, for eligible articles. Two independent reviewers extracted data by using a customized form to record crucial information, and any conflicts between the two reviewers were resolved through discussion with another independent reviewer. The aggregated data were summarized and analyzed. RESULTS In total, 53 original articles that investigated the effect of the COVID-19 pandemic on residency training were included. Studies from various regions were included in the research, with the largest percentage from the United States (n = 25, 47.2%). Most of these original articles were questionnaire-based studies (n = 44, 83%), and the research target groups included residents (79.55%), program directors (13.64%), or both (6.82%). The majority of the articles (n = 37, 84.0%) were published in countries severely affected by the pandemic. Surgery (n = 36, 67.92%) was the most commonly studied field. CONCLUSIONS The COVID-19 pandemic has greatly affected residency training globally, particularly surgical and interventional medical fields. Decreased clinical experience, reduced case volume, and disrupted education activities are major concerns. Further studies should be conducted with a focus on the learning outcomes of residency training during the pandemic and the effectiveness of assisted teaching methods.
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Affiliation(s)
- Shou-Yen Chen
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 333, Taoyuan City, Taiwan
- Graduate Institute of Clinical Medical Sciences; Division of Medical Education, College of Medicine, Chang Gung University, 333, Taoyuan City, Taiwan
| | - Hsiang-Yun Lo
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 333, Taoyuan City, Taiwan
| | - Shang-Kai Hung
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 333, Taoyuan City, Taiwan.
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Abstract
Physician burnout is increasingly recognized as a public health crisis given the impact of burnout on physicians, their families, patients, communities, and population health. The COVID-19 pandemic has superimposed a new set of challenges for physicians to navigate, including unique challenges presented to radiologists. Radiologists from a diversity of backgrounds, practice settings, and career stages were asked for their perspectives on burnout.
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Woerner A, Chick JFB, Monroe EJ, Ingraham CR, Pereira K, Lee E, Hage AN, Makary MS, Shin DS. Interventional Radiology in the Coronavirus Disease 2019 Pandemic: Impact on Practices and Wellbeing. Acad Radiol 2021; 28:1209-1218. [PMID: 34210612 PMCID: PMC8185184 DOI: 10.1016/j.acra.2021.05.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE To report the impact of the coronavirus disease 2019 (COVID-19) pandemic on interventional radiology (IR). MATERIALS AND METHODS A 78-question survey was distributed to practicing interventional radiologists and IR trainees. The survey consisted of demographic and practice environment queries. Anxiety symptoms were evaluated using the Generalized Anxiety Disorder-7 (GAD-7) screener, and coping strategies were assessed using the Brief-Coping Orientation to Problems Experienced (Brief-COPE) questionnaire. RESULTS There were 422 respondents including 333 (78.9%) attending interventional radiologists and 89 (21.1%) interventional radiologists-in-training from 15 counties. Most respondents were from academic medical centers (n = 218; 51.7%). A large majority (n = 391; 92.7%) performed a procedure on a patient with confirmed COVID-19 infection. An N95 mask was the most common (n = 366; 93.6%) safety measure employed. Cancellation or limitation of elective procedures were reported by 276 (65.4%) respondents. Many respondents (n = 177; 41.9%) had self-reported anxiety (GAD-7 score >5) with an overall mean GAD-7 score of 4.64 ± 4.63 (range: 0-21). Factors associated with reporting anxiety included female gender (p = 0.045), increased call coverage (p = 0.048), lack of adequate departmental adjustments (p <0.0001), and lack of adjustments in a timely manner (p <0.0001). The most utilized coping strategy was acceptance (mean of 5.49 ± 1.88), while the most employed dysfunctional coping strategy was self-distraction (mean of 4.16 ± 1.67). The odds of reporting anxiety increased by >125% with adoption of dysfunctional strategies. CONCLUSION The COVID-19 pandemic induced practice alterations and high rates of self-reported anxiety in IR. Female gender, increased call coverage, and lack of adequate or timely departmental adjustments were associated with increased anxiety levels.
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Affiliation(s)
- Andrew Woerner
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Washington, Seattle, Washington 98195
| | - Jeffrey Forris Beecham Chick
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Washington, Seattle, Washington 98195; Department of Radiology, Section of Interventional Radiology, Seattle Children's Hospital, University of Washington, Seattle, Washington 98105
| | - Eric J Monroe
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Washington, Seattle, Washington 98195; Department of Radiology, Section of Interventional Radiology, Seattle Children's Hospital, University of Washington, Seattle, Washington 98105
| | - Christopher R Ingraham
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Washington, Seattle, Washington 98195
| | - Keith Pereira
- Department of Radiology, Division of Vascular Interventional Radiology, Saint Louis University Hospital, St. Louis, Missouri 63110
| | - Eunjee Lee
- Department of Information and Statistics, Chungnam National University, Yuseong-gu, Daejeon, South Korea
| | - Anthony N Hage
- Department of Radiology, Division of Vascular and Interventional Radiology, Thomas Jefferson Hospital, Philadelphia, Pennsylvania 19107
| | - Mina S Makary
- Department of Radiology, Division of Vascular and Interventional Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210
| | - David S Shin
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Washington, Seattle, Washington 98195.
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16
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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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Chalfant JS, Pittman SM, Kothari PD, Chong A, Grimm LJ, Sohlich RE, Leung JWT, Downey JR, Cohen EO, Ojeda-Fournier H, Hoyt AC, Joe BN, Feig SA, Trinh L, Rosen EL, Aminololama-Shakeri S, Ikeda DM. Impact of the COVID-19 Pandemic on Breast Imaging Education. JOURNAL OF BREAST IMAGING 2021; 3:354-362. [PMID: 34056594 DOI: 10.1093/jbi/wbab021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Indexed: 12/13/2022]
Abstract
Objective To determine the impact of the COVID-19 pandemic on breast imaging education. Methods A 22-item survey addressing four themes during the early pandemic (time on service, structured education, clinical training, future plans) was emailed to Society of Breast Imaging members and members-in-training in July 2020. Responses were compared using McNemar's and Mann-Whitney U tests; a general linear model was used for multivariate analysis. Results Of 136 responses (136/2824, 4.8%), 96 U.S. responses from radiologists with trainees, residents, and fellows were included. Clinical exposure declined during the early pandemic, with almost no medical students on service (66/67, 99%) and fewer clinical days for residents (78/89, 88%) and fellows (48/68, 71%). Conferences shifted to remote live format (57/78, 73%), with some canceled (15/78, 19%). Compared to pre-pandemic, resident diagnostic (75/78, 96% vs 26/78, 33%) (P < 0.001) and procedural (73/78, 94% vs 21/78, 27%) (P < 0.001) participation fell, as did fellow diagnostic (60/61, 98% vs 47/61, 77%) (P = 0.001) and procedural (60/61, 98% vs 43/61, 70%) (P < 0.001) participation. Most thought that the pandemic negatively influenced resident and fellow screening (64/77, 83% and 43/60, 72%, respectively), diagnostic (66/77, 86% and 37/60, 62%), and procedural (71/77, 92% and 37/61, 61%) education. However, a majority thought that decreased time on service (36/67, 54%) and patient contact (46/79, 58%) would not change residents' pursuit of a breast imaging fellowship. Conclusion The pandemic has had a largely negative impact on breast imaging education, with reduction in exposure to all aspects of breast imaging. However, this may not affect career decisions.
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Affiliation(s)
- James S Chalfant
- David Geffen School of Medicine at University of California, Los Angeles, Department of Radiological Sciences, Santa Monica, CA, USA
| | - Sarah M Pittman
- Stanford University School of Medicine, Department of Radiology, Stanford, CA,USA
| | - Pranay D Kothari
- Stanford University School of Medicine, Department of Radiology, Stanford, CA,USA
| | - Alice Chong
- University of California, San Diego, Department of Radiology, La Jolla, CA,USA
| | - Lars J Grimm
- Duke University Medical Center, Department of Radiology, Durham, NC,USA
| | - Rita E Sohlich
- Sutter Health, Palo Alto Medical Foundation, Department of Radiology, Palo Alto, CA,USA
| | - Jessica W T Leung
- The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX,USA
| | - John R Downey
- Kaiser Permanente, Department of Radiology, Walnut Creek, CA,USA
| | - Ethan O Cohen
- The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX,USA
| | | | - Anne C Hoyt
- David Geffen School of Medicine at University of California, Los Angeles, Department of Radiological Sciences, Santa Monica, CA, USA
| | - Bonnie N Joe
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA,USA
| | - Stephen A Feig
- University of California, Irvine Medical Center, Department of Radiological Sciences, Orange, CA,USA
| | - Long Trinh
- Santa Clara Valley Medical Center, Department of Radiology, San Jose, CA,USA
| | - Eric L Rosen
- Stanford University School of Medicine, Department of Radiology, Stanford, CA,USA
| | | | - Debra M Ikeda
- Stanford University School of Medicine, Department of Radiology, Stanford, CA,USA
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