Navigating the virtual medical school experience during COVID - What comes next?

Examining How Postpartum Videoconferencing Support Sessions Can Facilitate Connections between Parents: A Poststructural and Sociomaterial Analysis

Postpartum support for new parents can normalize experiences, increase confidence, and lead to positive health outcomes. While in-person gatherings may be the preferred choice, not all parents can or want to join parenting groups in person. Online asynchronous chat spaces for parents have increased over the past 10 years, especially during the COVID pandemic, when "online" became the norm. However, synchronous postpartum support groups have not been as accessible. The purpose of our study was to examine how parents experienced postpartum videoconferencing support sessions. Seven one-hour videoconferencing sessions were conducted with 4-8 parents in each group (n = 37). Nineteen parents from these groups then participated in semi-structured interviews. Feminist poststructuralism and sociomaterialism were used to guide the research process and analysis. Parents used their agency to actively think about and interact using visual (camera) and audio (microphone) technologies to navigate socially constructed online discourses. Although videoconferencing fostered supportive connections and parents felt less alone and more confident, the participants also expressed a lack of opportunities for individual conversations. Nurses should be aware of the emerging opportunities that connecting online may present. This study was not registered.

Applying TEC-VARIETY to Motivate and Engage Learners for Online Learning Success

ABSTRACT

Learner motivation plays an essential role in overcoming barriers to achieve online learning success. Many health professions educators, however, are not familiar with evidence-based motivational principles and techniques that tap into learners' inner resources to promote online learning success. The TEC-VARIETY (T-Tone; E-Encouragement; C-Curiosity; V-Variety; A-Autonomy; R-Relevance; I-Interactivity; E-Engagement; T-Tension; and Y-Yielding products) framework provides evidence-based principles and techniques that motivate and engage learners. Health professions educators can identify and assemble appropriate activities to motivate and engage online learners. Educators are encouraged to use Design-Based Research to guide their adoption of TEC-VARIETY and evaluation of outcomes.

Becoming a Sustainable Academic Surgeon

INTRODUCTION

Health care facilities represent a significant source of pollution, contributing to the growing problems associated with global warming. The resulting climate change impacts our health through worsening air and water quality, diminished access to nutritious food, and safe shelter.

METHODS

We outline here the not only the role of the surgeon in contributing to climate change, but also ways in which to minimize one's carbon footprint.

RESULTS

Surgeons are leaders within healthcare systems. Adopting environmentally conscious practices can reduce solid waste, energy usage, and carbon emissions. Practices outside of the clinical setting can also incorporate sustainability, including the use of virtual recruitment and educational programs, as well as thoughtful and conscientious travel practices.

CONCLUSIONS

Academic surgery combines clinical practice with an element of leadership, at all levels. Our recognition and action to reduce wasteful practices can help leave a better earth for generations to come.

Virtual Interactions and the 2020-2021 Residency Application Cycle in General Surgery: A Look Ahead

INTRODUCTION

General surgery residency training programs adapted to the COVID-19 pandemic by going online instead of in-person, through virtual interviews, social media engagement, and virtual open houses. The impact of these virtual interactions is unknown. We sought to understand their effectiveness as per residency program directors and assistant program directors.

MATERIALS AND METHODS

An institutional review board approval was obtained to conduct this anonymous survey. A Qualtrics XM survey containing multiple-choice and short-answer questions was distributed to 590 residency program and assistant program directors through the Association of Program Directors in Surgery (APDS) listserv on July 6, July 13, and July 20.

RESULTS

We observed a response rate of approximately 11% across the 590 surgeons contacted. Nearly all (90%) respondents offered virtual preinterview interactions, primarily virtual open houses, virtual facility tours, and virtual question and answer (Q&A) sessions with residents and faculty; 48% of respondents were unsure of the utility of virtual interactions and the majority (54%) felt that virtual interaction limits a program's ability to evaluate applicants. Virtual Q&As were ranked to be the most effective interaction (7.6/10); 80% of respondents felt that visiting rotations were "somewhat important" to "very important," the two highest options available. In addition, 74% felt that applicants missed out on fully experiencing the program by forgoing these rotations. Most respondents (78%) noted that evaluation of applicants' preinterview did not change as a result of virtual interactions. Nearly half (48%) of the respondents offered more interview days due to the virtual format. A fifth (21%) of respondents stated that virtual interactions resulted in a change in the rank position of an applicant. Respondents ranked Twitter and Instagram higher in applicant engagement than Facebook. Factors that impacted interview or rank order list the most were late/absent step two CK scores (33%) and a lack of away rotations (31%), both being limitations largely due to the pandemic. With respect to future application cycles, most (71%) raised concerns regarding disparities between applicants applying in-person and virtually if both or either are offered.

CONCLUSIONS

Our study suggests that program directors and associate program directors have reservations about the use of virtual interactions with applicants. Interestingly, these data suggest that visiting subinternships are useful for programs in evaluating applicants. This may encourage students to pursue rotations at other institutions at the expense of already-limited resources. It remains unclear whether virtual interactions will be used in the future, but respondents largely agreed that the virtual means of interacting with and disseminating information to the applicants of the 2020-2021 general surgery Match were a success.

Comparison of outcomes of ventral hernia repair using different meshes: a systematic review and network meta-analysis

PURPOSE

We conducted a network meta-analysis to evaluate potential differences in patient outcomes when different meshes, especially biological meshes, were used for ventral hernia repair.

METHODS

PubMed, Embase, Cochrane Library, and Clinical Trials.gov databases were searched for studies comparing biological meshes with biological or synthetic meshes for ventral hernia repair. The outcomes were hernia recurrence rate, surgical site infection, and seroma. We performed a two-step network meta-analysis to investigate the outcomes of several biological meshes: non-cross-linked human acellular dermal matrix (NCHADM), non-cross-linked porcine ADM (NCPADM), non-cross-linked bovine ADM (NCBADM), cross-linked porcine ADM (CPADM), and porcine small intestinal submucosa (PSIS).

RESULTS

From 6304 publications, 23 studies involving 2603 patients were finally included. We found no differences between meshes in recurrence at 1-year follow-up and in surgical site infection rate. NCBADM was associated with the lowest recurrence rate and the lowest surgical site infection rate. NCHADM implantation was associated with the lowest rate of seroma. PSIS was associated with a higher risk of seroma than NCHADM (pooled risk ratio 3.89, 95% confidence interval 1.13-13.39) and NCPADM (RR 3.42, 95% CI 1.29-9.06).

CONCLUSIONS

Our network meta-analysis found no differences in recurrence rate or surgical site infection among different biological meshes. The incidence of postoperative seroma was higher with PSIS than with acellular dermal matrices. We observed large heterogeneity in the studies of ventral hernia repair using biological meshes, and, therefore, well-designed randomized clinical trials are needed.