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Baker MB, Ortega R, Bilotta F, Wang J, Bernstein W. ICERA: Increasing accessibility to medical education through structured international collaboration. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ELSEVIER) 2024; 74:844522. [PMID: 38821223 DOI: 10.1016/j.bjane.2024.844522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 06/02/2024]
Affiliation(s)
- Maxwell B Baker
- Boston University Chobanian & Avedisian School of Medicine, Department of Anesthesiology, Boston, USA
| | - Rafael Ortega
- Boston University Chobanian & Avedisian School of Medicine, Department of Anesthesiology, Boston, USA
| | - Federico Bilotta
- Sapienza University of Rome, Policlinico Umberto I Teaching Hospital, Department of Anaesthesiology, Critical Care and Pain Medicine, Rome, Italy
| | - Jennifer Wang
- Boston University Chobanian & Avedisian School of Medicine, Department of Anesthesiology, Boston, USA
| | - Wendy Bernstein
- Boston University Chobanian & Avedisian School of Medicine, Department of Anesthesiology, Boston, USA.
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Kumar PR, Large J, Konda N, Hashmi Y, Adebayo O, Sivaraman M, Lee JJ. Student advanced trauma management and skills (SATMAS): a validation study. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02456-4. [PMID: 38305858 DOI: 10.1007/s00068-024-02456-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/14/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Despite trauma accounting 9% of global mortality, it has been demonstrated that undergraduate trauma teaching is inadequate nationally and worldwide. With COVID-19 exacerbating this situation, a scalable, accessible, and cost-effective undergraduate trauma teaching is required. METHODS Our Continual Professional Development United Kingdom (CPUDK)-accredited University Hospitals Birmingham (UHB) Major Trauma Service (MTS) affiliated programme consisted of seven biweekly pre-recorded sessions that were delivered online through the Moodle educational platform to University of Birmingham students. Pre- and post-randomised session-specific multiple-choice questions (MCQs) and anonymous feedback forms were administered. RESULTS There were 489 student responses, with 63 students completing all seven sessions. On an 8-point scale, students' objective knowledge scores increased by a mean of 1.2 (p < 0.001). Using a 5-point Likert scale, students also showed improvement in subjective outcomes including their confidence in assessing trauma patient (absolute difference (AD) 1.38, p < 0.001), advising initial investigations and formulating initial management plans (AD 1.78, p < 0.001) and thereby their confidence to manage a trauma patient overall (AD 1.98, p < 0.001). A total of 410 student responses endorsed the online delivery of SATMAS through Moodle and recommended SATMAS to future medical students. CONCLUSION SATMAS has demonstrated positive student feedback and extensive recruitment from only one centre, demonstrating that our programme can be an indispensable low-cost learning resource that prepares undergraduate medical students for their trauma exams and informs the implementation of clinical skills required by all doctors. We publish our pilot study findings to encourage similar teaching programmes to be adopted at other universities nationally and internationally, to synergistically benefit students, tutors, and ultimately patients, on a larger scale.
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Affiliation(s)
- Prakrit R Kumar
- Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, Hertfordshire, SG1 4AB, UK.
| | - Jamie Large
- Kingston Hospital NHS Foundation Trust, London, UK
| | - Nagarjun Konda
- University Hospital Coventry & Warwickshire, Coventry, UK
- University of Warwick, Coventry, UK
| | - Yousuf Hashmi
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | | | - Justine J Lee
- Major Trauma Service, Queen Elizabeth Hospital, Birmingham, UK
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Ngo TL, Yanek L, Caglar D, Bailey J, Roskind CG, Langhan M. Medical Knowledge Acquisition during a Pandemic: Pediatric Subspecialty in-Training Examination and Board Certification Exam Passing Rate. Acad Pediatr 2024; 24:147-154. [PMID: 37245666 PMCID: PMC10219674 DOI: 10.1016/j.acap.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/09/2023] [Accepted: 05/21/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The COVID-19 pandemic resulted in training programs restructuring their curricula. Fellowship programs are required to monitor each fellow's training progress through a combination of formal evaluations, competency tracking, and measures of knowledge acquisition. The American Board of Pediatrics administers subspecialty in-training examinations (SITE) to pediatric fellowship trainees annually and board certification exams at the completion of the fellowship. The objective of this study was to compare SITE scores and certification exam passing rates before and during the pandemic. METHODS In this retrospective observational study, we collected summative data on SITE scores and certification exam passing rates for all pediatric subspecialties from 2018 to 2022. Trends over time were assessed using analysis of variance (ANOVA) analysis to test for trends across years within one group and t-test analysis to compare groups before and during the pandemic. RESULTS Data were obtained from 14 pediatric subspecialties. Comparing prepandemic to pandemic scores, Infectious Diseases, Cardiology, and Critical Care Medicine saw statistically significant decreases in SITE scores. Conversely, Child Abuse and Emergency Medicine saw increases in SITE scores. Emergency Medicine saw a statistically significant increase in certification exam passing rates, while Gastroenterology and Pulmonology saw decreases in exam passing rates. CONCLUSIONS The COVID-19 pandemic resulted in restructuring didactics and clinical care based on the needs of the hospital. There were also societal changes affecting patients and trainees. Subspecialty programs with declining scores and certification exam passing rates may need to assess their educational and clinical programs and adapt to the needs of trainees' learning edges.
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Affiliation(s)
- Thuy L Ngo
- Department of Pediatrics (TL Ngo), Division of Pediatric Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Lisa Yanek
- Department of Medicine (L Yanek), Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Derya Caglar
- Department of Pediatrics (D Caglar), Division of Pediatric Emergency Medicine, University of Washington School of Medicine/ Seattle Children's Hospital
| | - Jessica Bailey
- Department of Emergency Medicine (J Bailey), Division of Pediatric Emergency Medicine, Oregon Health & Science University
| | - Cindy G Roskind
- Department of Emergency Medicine (CG Roskind), Division of Pediatric Emergency Medicine, Columbia University Irving Medical Center, New York, NY
| | - Melissa Langhan
- Department of Pediatrics (M Langhan), Section of Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, CT
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Ghosh P, Kurian AT, Velmurugan D, Tharumaraj M. Impact of COVID-19 pandemic on surgical residency: Residents' perception. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:398. [PMID: 38333163 PMCID: PMC10852176 DOI: 10.4103/jehp.jehp_252_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/28/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND World Health Organization declared COVID-19 outbreak a pandemic, and till the month of March 2023, globally, there have been 761,402,282 confirmed cases of COVID-19, including 6887,000 deaths. In India, almost 44,707,525 cases been recorded till date. Here, almost 30,000,000 cases been recorded after the second wave. The working force fighting this pandemic is majority formed by resident doctors all over the country and globally. MATERIALS AND METHODS This study was conducted among 110 residents pursuing postgraduation in surgery and allied departments in various training institutions in Tamil Nadu for a duration of 6 months (after the second wave). A pretested and validated questionnaire was formulated to assess the effect of COVID-19 pandemic on surgical trainee's residency program from their perspective. The questionnaire contained basic social-demographic details and general information like the details of surgical specialty they are admitted to, the overall details of changes in their surgical residency experience in the times of COVID pandemic and the changes faced by them in their day-to-day clinical, diagnostic, and surgical learning. The questionnaire also investigated the redeployment status of the surgical trainees to COVID treatment units and their perspective on the changes in their clinical research and surgical skills training. RESULTS The study participants, 66%, were aged between 25 and 30 years, followed by 30 and 35 years (25.5%). Almost 80% of the participants belong to the final year of postgraduation; 67.3% of surgical trainees strongly perceives and all 100% of them accept the fact that their surgical residency has been affected by the ongoing pandemic. Fifty percent of the trainees were redeployed to COVID duties for 8 h a day shift and rest attended a minimum of 4 h of COVID duties. More than 75% of the residents had COVID duties of 5-10 h/day and more than 90% of these redeployed trainees involved in COVID duties have expressed that they had been suffering from extra stress and more than 60% were suffering from stress grade between 5 and 10 suggestive of high-stress level. Fifty-nine percent of the postgraduates in the current study mentioned that they require extra-surgical or skill-based training after their postgraduation period. CONCLUSION The influence of COVID-19 on surgical trainees in various institutions of India has been immense due to overburdening of health systems by the large population of the country. Second wave of COVID, especially, has drastically changed the postgraduate surgical trainees' lives. Detrimental effects are not restricted to operative and clinical experience but also the mental health and well-being of them. The observations of the present study make recommendations for the future provision of training through skill-based surgical simulations so that the lost days of their trainings can be compensated and they become the confident surgeons of the future.
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Affiliation(s)
- Puja Ghosh
- Department of Otorhinolaryngology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
| | - Andrew Thomas Kurian
- Department of Otorhinolaryngology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
| | - Dinesh Velmurugan
- Department of Otorhinolaryngology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
| | - Muthukumar Tharumaraj
- Department of Community Medicine, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
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Thomson WR, Puthucheary ZA, Wan YI. Critical care and pandemic preparedness and response. Br J Anaesth 2023; 131:847-860. [PMID: 37689541 PMCID: PMC10636520 DOI: 10.1016/j.bja.2023.07.026] [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: 03/08/2023] [Revised: 06/21/2023] [Accepted: 07/23/2023] [Indexed: 09/11/2023] Open
Abstract
Critical care was established partially in response to a polio epidemic in the 1950s. In the intervening 70 yr, several epidemics and pandemics have placed critical care and allied services under extreme pressure. Pandemics cause wholesale changes to accepted standards of practice, require reallocation and retargeting of resources and goals of care. In addition to clinical acumen, mounting an effective critical care response to a pandemic requires local, national, and international coordination in a diverse array of fields from research collaboration and governance to organisation of critical care networks and applied biomedical ethics in the eventuality of triage situations. This review provides an introduction to an array of topics that pertain to different states of pandemic acuity: interpandemic preparedness, alert, surge activity, recovery and relapse through the literature and experience of recent pandemics including COVID-19, H1N1, Ebola, and SARS.
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Affiliation(s)
- William R Thomson
- Adult Critical Care Unit, Royal London Hospital, Whitechapel, London, UK; William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
| | - Zudin A Puthucheary
- Adult Critical Care Unit, Royal London Hospital, Whitechapel, London, UK; William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Yize I Wan
- Adult Critical Care Unit, Royal London Hospital, Whitechapel, London, UK; William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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Mahay U, Jenkins P, Watkins L, Mandal I, Lewis O, Harborne KE, Patel S, Reicher J, Liu WY, Zhong J, Hamady M. Interventional radiology training in the UK: a view from within-a national survey. Br J Radiol 2023; 96:20230039. [PMID: 37747294 PMCID: PMC10607392 DOI: 10.1259/bjr.20230039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE Interventional radiology (IR) training in the UK has evolved since recognition as a subspecialty in 2010 and introduction of a new curriculum in 2021. The changing landscape, increasing workload and COVID-19 have affected training. The purpose of this study was to review trainees' perspectives on training and develop strategies to further improve training. METHODS Online survey approved by the British Society of Interventional Radiology Council distributed to British Society of Interventional Radiology Trainee members between 9 March 22 and 25 March 2022. The survey was open to all UK based ST4-6 IR trainees and fellows. Descriptive and thematic analysis was undertaken. RESULTS 43 responses were received from 17/19 UK training regions. Females represented 10% (4/41) and 5% (2/43) less than full time (LTFT) trainees. 82% (31/38) felt their curriculum was suitable for their training and 28/38 (74%) were satisfied with IR training. Vascular IR, Interventional Oncology, paediatrics and stroke thrombectomy were identified as areas of training desiring improvement. 45% (18/40) stated exposure to IR led clinics and 17.5% (7/40) to IR led ward rounds. Only 6/38 (15.7%) received structured IR teaching at least once a month. Approximately, a third of respondents (13/38) stated training opportunities were significantly compromised secondary to COVID-19. CONCLUSION This survey shows overall good satisfaction with IR training. However, improved training opportunities in vascular IR, interventional oncology, paediatric IR and stroke thrombectomy are required. In addition, access to clinics, ward rounds and protected time for research is needed to improve training quality. ADVANCES IN KNOWLEDGE New national UK IR training survey.
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Affiliation(s)
- Usman Mahay
- Department of Interventional Radiology, London North West University Healthcare NHS Trust, London, United Kingdom
| | | | - Linda Watkins
- Department of Interventional Radiology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Indrajeet Mandal
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Omotolani Lewis
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Katrina Elizabeth Harborne
- Department of Interventional Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Shian Patel
- Department of Interventional Radiology, McGill University Health Centre, Montreal, Canada
| | - John Reicher
- Department of Interventional Radiology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
| | - Wing Yan Liu
- Department of Interventional Radiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Jim Zhong
- Department of Diagnostic and Interventional Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
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Bud M, Pricope R, Pop R, Korkut B, Lucaciu O, Cimpean S, Delean A. Romanian dental students' learning experience related to lifestyle changes imposed by Covid-19 lockdown. Med Pharm Rep 2023; 96:427-433. [PMID: 37970192 PMCID: PMC10642734 DOI: 10.15386/mpr-2482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/25/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2023] Open
Abstract
Background and aim The SARS-CoV-2 outbreak in Romania was followed by the declaration of an Emergency State and the subsequent lockdown. As all the schools and universities ceased onsite activities, the teaching process continued exclusively online, on different platforms, such as Microsoft Teams or Zoom. Objectives The aim of this cross-sectional study is to evaluate how the lifestyle changes imposed by the Covid-19 lockdown and online lectures influenced the learning experience of Romanian dental students, as their point of view could bring new information which might contribute to improving the teaching process. Methods The questionnaire had 28 items, each with either a Likert Scale or a multiple-choice option and was distributed in April 2020, one month after implementation of circulation restrictions and social distancing. Results Compared to classical teaching, we found that the online teaching process had a lower efficiency, with a higher satisfaction level for online courses, but lower for online practical teaching activities. The absence of human interaction was found to be detrimental to the teaching process. Conclusion Despite the lower efficiency of online learning, it was a good alternative that helped students continue their education in the situation created by the outbreak of Covid-19. For higher learning efficiency, a compromise method consisting of online courses and onsite practical training could be a better alternative.
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Affiliation(s)
- Marius Bud
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Razvan Pricope
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Razvan Pop
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Bora Korkut
- Department of Restorative Dentistry, Marmara Univeristy, Istanbul, Turkey
| | - Ondine Lucaciu
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sanda Cimpean
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ada Delean
- Department of Conservative Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Zhang X, Johannsson H, Tucker JD, Riyat A, Chiu YLT, Greenberg N, Sharpe R. 'Thrown in at the deep end': a qualitative analysis into the transition from trainee to consultant during the COVID-19 pandemic and lessons for the future. BJA OPEN 2023; 7:100217. [PMID: 37638089 PMCID: PMC10291287 DOI: 10.1016/j.bjao.2023.100217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/21/2023] [Indexed: 08/29/2023]
Abstract
Background Sustained crises such as the COVID-19 pandemic would be expected to impact the transition from trainee to consultant for anaesthetists or intensivists, but limited research exists on this important topic. This study aimed to examine the social context of this crucial career transition during the pandemic and post-pandemic periods. Methods We conducted semi-structured interviews with anaesthetists and intensivists who became consultants after the first UK lockdown. Thematic analysis was used and data saturation was reached at 33 interviews. Results The pandemic substantially impacted the transition to consultant role in various ways, including professional identity, clinical and non-clinical responsibilities, and wellbeing. Participants experienced identity confusion, self-doubt, and moral injury, resulting in intense emotional distress, feelings of guilt and helplessness, which persisted beyond the pandemic. They also felt unprepared for their consultant roles because of disruptions in training. The pandemic exaggerated the vulnerability of those transitioning to consultants, because of increased clinical uncertainties, and pressures of the growing backlog. Additionally, the pandemic impacted on the wellbeing of those transitioning to consultants, intensifying feelings of anxiety and stress. We also identified unique opportunities presented by the pandemic, which accelerated learning and encouraged post-traumatic growth. Our study identified practical solutions that may improve transition experience at individual, organisational, and national levels. Conclusions Persistent crises significantly impact the transition from trainee to consultant. Our findings generated insights into the challenges of this critical career transition and staff wellbeing, and serve to inform approaches of ongoing support for those transitioning to consultants.
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Affiliation(s)
- Xiaoxi Zhang
- London North West University Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | | | - Joseph D. Tucker
- London School of Hygiene and Tropical Medicine, London, UK
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, NC, USA
| | - Amardeep Riyat
- London North West University Healthcare NHS Trust, London, UK
| | - Yuan-Li Tiffany Chiu
- Centre for Higher Education Research and Scholarship, Imperial College London, London, UK
| | | | - Roger Sharpe
- London North West University Healthcare NHS Trust, London, UK
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Ahmady S, Khoshgoftar Z, Dabbagh A. Attitudes of Anesthesiology Postgraduate Residents Toward the Influential Factors in Their Success in the Iranian National Board Exam. Anesth Pain Med 2023; 13:e135118. [PMID: 38023999 PMCID: PMC10676654 DOI: 10.5812/aapm-135118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background One of the prominent indicators of academic success in postgraduate medical education is the "Residents' Pass Rate" in the "National Board Exam." Objectives This study was designed and implemented to assess the attitudes of the anesthesiology residents toward factors affecting their success in the National Board Exam. Methods After the Institutional Review Board (IRB) approval, in an attitude assessment study, 20 of the 21 recently graduated anesthesiology residents were asked about the factors affecting their success quantitatively and qualitatively. A self-administered questionnaire with 19 closed questions and a personal virtual WhatsApp Messenger® interview were used for the study. Results The respondents' viewpoints demonstrated that a step-by-step multifaceted integrative program in combination with psychological support (both from the family and the department) and individual motivation positively affected their success and their endurance to overcome the high load of the mandatory texts. In contrast, unplanned stressors leading to program shifts (mainly due to COVID-19) had adverse effects on their success. Conclusions Anesthesiology residents believed that a well-designed and appropriately implemented study plan with psychological support and personal motivating factors could facilitate passing the National Board Exam, and unplanned external stressors could hinder it.
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Affiliation(s)
- Soleiman Ahmady
- Department of Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Khoshgoftar
- Department of Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Dabbagh
- Department of Anesthesiology, Anesthesiology Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hora R, Ray A, Mehra R, Priya T, Koshal SS, Agrawal P, Kaur A, Quadri SF, Deb Roy A. Enablers and Barriers to the Scaling Up of Pneumococcal Conjugate Vaccine in India During the COVID-19 Pandemic: A Qualitative Study. Health Serv Insights 2023; 16:11786329231189407. [PMID: 37533503 PMCID: PMC10392212 DOI: 10.1177/11786329231189407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Background Pneumonia is one of the leading causes of death in under-5 children in India. This led the Ministry of Health & Family Welfare (MoHFW) in India to decide for the nationwide roll-out of the Pneumococcal Conjugate Vaccine (PCV). However, the introduction of PCV became more complex in the face of unprecedented challenges set forth by the COVID-19 pandemic. The study aims to assess enablers and barriers to the introduction of PCV in India during the pandemic. Methodology Qualitative research approach involving key-informant interviews from John Snow India (JSI), the lead technical agency that supported MoHFW in the PCV expansion was employed to delineate the enablers and barriers. Principle of saturation was employed to derive the sample size. Thematic analysis using inductive approach was based on the modified World Health Organization (WHO) framework for new vaccine introduction impact on the Immunization and Health Systems, using NVIVO 12 qualitative data analysis software. Results A total of 11 key informants (4 national-level program managers and 7 state technical officers) were telephonically interviewed. The study found social acceptance, lower cost of the vaccine, and intensive communication activities as potential enablers. Other enablers for PCV introduction included a robust vaccine supply-chain system, ample cold-chain space availability, and strong political commitment, despite the ongoing second wave. Further, the identified barriers included poor physical access, insufficient social mobilization, and limited advocacy along with a stretched workforce. Conclusion The study delineated several enablers and barriers to introducing PCV in the country during the pandemic. The existing barriers in the PCV roll-out prompted the need to address these gaps, making key program-based recommendations to improve future new vaccine introductions during the pandemic.
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Affiliation(s)
| | - Arindam Ray
- Bill and Melinda Gates Foundation, New Delhi, India
| | | | - Tanwi Priya
- Gurugram University, Gurugram, Haryana, India
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Morita T, Muroya S, Takahashi O, Ohde S. Factors Associated with Intention to Resign among Medical Residents during the COVID-19 Pandemic in Japan: A Cross-sectional Study. JMA J 2023; 6:292-299. [PMID: 37560358 PMCID: PMC10407254 DOI: 10.31662/jmaj.2023-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/12/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has significantly affected healthcare workers' mental health worldwide, leading to the intention to resign. Japanese medical residents were no exception to the impact of COVID-19. This study aimed to illustrate how the COVID-19 pandemic affected medical residents' intention to resign. METHODS A cross-sectional study was conducted for Postgraduate Year (PGY)1-5 medical residents in Japan using an internet survey from March 11 to March 18, 2021. During this survey, the Japanese government declared a second-time state of emergency on January 7, 2021, and all restrictions were expanded nationwide until March 21, 2021. Medical residents were categorized into two groups (intention to resign group [IR] or no intention to resign group [NIR]) based on their intention to resign. Multivariate logistic regression analysis was conducted to elucidate the risk factors for the intention to resign. RESULTS 354 medical residents were enrolled in this study (response rate: 40.2%). Ninety-two medical residents (26.0 %) were categorized into IR and 262 (74.0%) into NIR. According to multivariate logistic regression analysis, those who did not have mental support at their hospital had 2.95 times greater chance of intending to resign (Adjusted odds ratio [AOR] = 2.95, 95% confidence interval (CI) [1.42-6.15]). Medical residents who engaged in patients with COVID-19 (AOR = 2.13, 95% Cl [1.08-4.18]) and PGY5 (AOR = 3.38, 95% Cl [1.51-7.56]) had a higher likelihood of intending to resign among residents in all PGY. CONCLUSIONS One in four medical residents intended to resign during the COVID-19 pandemic. Particularly, PGY5 and medical residents who treated patients with COVID-19 were found at risk of having the intention to resign. At times of crisis, such as the COVID-19 epidemic, establishing a mental health support system that targets high-risk residents is critical.
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Affiliation(s)
- Takako Morita
- Graduate School of Public Health and Clinical Epidemiology St. Luke's International University, Tokyo, Japan
| | - Saki Muroya
- Graduate School of Public Health and Clinical Epidemiology St. Luke's International University, Tokyo, Japan
| | - Osamu Takahashi
- Graduate School of Public Health and Clinical Epidemiology St. Luke's International University, Tokyo, Japan
| | - Sachiko Ohde
- Graduate School of Public Health and Clinical Epidemiology St. Luke's International University, Tokyo, Japan
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Jang W, Kang H, Shin H, Kim C, Lee H, Choi H. Introduction of Infection Prevention Tracheal Intubation Protocol during the COVID-19 Pandemic Is Not Associated with First-Pass Success Rates of Endotracheal Intubation in the Emergency Department: A Before-and-After Comparative Study. J Pers Med 2023; 13:1017. [PMID: 37374006 DOI: 10.3390/jpm13061017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Aerosols and droplets have put healthcare workers performing airway management at high risk of contracting coronavirus disease 2019 (COVID-19). Experts have developed endotracheal intubation (ETI) guidelines and protocols to protect intubators from infection. We aimed to determine whether changes in the emergency department (ED) intubation protocol to prevent COVID-19 infection were associated with first-pass success (FPS) rates in ETI. We used data from the airway management registries in two academic EDs. The study was divided into pre-pandemic (January 2018 to January 2020) and pandemic (February 2020 to February 2022) periods. We selected 2476 intubation cases, including 1151 and 1325 cases recorded before and during the pandemic, respectively. During the pandemic, the FPS rate was 92.2%, which did not change significantly, and major complications increased slightly but not significantly compared with the pre-pandemic period. The OR for the FPS of applying infection prevention intubation protocols was 0.72 (p = 0.069) in a subgroup analysis, junior emergency physicians (PGY1 residents) had an FPS of less than 80% regardless of pandemic protocol implementation. The FPS rate of senior emergency physicians in physiologically difficult airways decreased significantly during the pandemic (98.0% to 88.5%). In conclusion, the FPS rate and complications for adult ETI performed by emergency physicians using COVID-19 infection prevention intubation protocols were similar to pre-pandemic conditions.
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Affiliation(s)
- Wooseok Jang
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Hyunggoo Kang
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Hyungoo Shin
- Department of Emergency Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
| | - Changsun Kim
- Department of Emergency Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
| | - Heekyung Lee
- Department of Emergency Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
| | - Hyukjoong Choi
- Department of Emergency Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
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Wicks SK, Kumar PR, Kumar RV, Arthur-Quarm S, Gavalas M. Anaesthetic National Teaching Programme for Students (ANTPS). Postgrad Med J 2023; 99:613-623. [PMID: 37319144 DOI: 10.1136/postgradmedj-2021-141353] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/03/2022] [Indexed: 11/04/2022]
Abstract
The COVID-19 pandemic has significantly undermined undergraduate anaesthetic teaching in spite of the vital role of the specialty against the pandemic. Anaesthetic National Teaching Programme for Students (ANTPS) was designed to meet the evolving needs of undergraduates and tomorrow's doctor by standardising anaesthetic training, preparing for final exams and equipping competencies vital for doctors of all grades and specialties. Our Royal College of Surgeons England-accredited University-College-Hospital-affiliated programme consisted of six-biweekly sessions were delivered online by anaesthetic trainees. Prerandomised and postrandomised session-specific multiple-choice questions (MCQs) assessed students' improvement in knowledge. Anonymous feedback forms were provided to students after each session and 2 months following the programme. 3743 student feedback forms (92.2% of attendees) across 35 medical-schools were recorded. There was a mean improvement in test score (0.94±1.27, p<0.001). 313 students completed all six sessions. Based on 5-point Likert scale, students who completed the programme showed an improvement in their confidence in knowledge and skills to face common foundation challenges (1.59±1.12, p<0.001) and thus felt better prepared for life as junior doctors (1.60±1.14, p<0.001). With an increase in confidence in students to pass their MCQs, Observed Structured Clinical Examinations and case-based discussion assessments, 3525 students stated they would recommend ANTPS to other students. Unprecedented COVID-19 factors impacting training, positive student feedback and extensive recruitment, demonstrate that our programme is an indispensable learning resource which standardises anaesthetic undergraduate education nationally, prepares undergraduates for their anaesthetic and perioperative exams and lays strong foundations for implementation of clinical skills required by all doctors, to optimise training and patient care.
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Affiliation(s)
| | - Prakrit Raj Kumar
- Lister Hopsital, East and North Hertfordshire, NHS Foundation Trust, Stevenage, UK
| | | | | | - Manolis Gavalas
- University College London Hospitals NHS Foundation Trust, London, UK
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14
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Hall L, Bisset K, Lynch L, Young Y, Ruggles R. Training during the COVID-19 pandemic: the experience of public health registrars in the London and Kent, Surrey, Sussex training programme. J Public Health (Oxf) 2023; 45:529-534. [PMID: 37326349 DOI: 10.1093/pubmed/fdac130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/29/2022] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Public Health registrars (SpRs) were an important component of the workforce that contributed to the COVID-19 response. This study explores their contribution and the impact the early stages of the pandemic had on their learning and training. METHODS Data were collected from SpRs in the London and Kent, Surrey, Sussex training programme between July and September 2020 through a mixture of questionnaires and semi-structured interviews. A thematic analysis of interview transcripts was undertaken to identify themes. RESULTS 35/128 SpRs responded to the survey and 11 were interviewed. SpRs were placed across a range of organizations and made a significant contribution to the COVID-19 response. Overall, SpRs learned important skills but working on the response may for some have impacted negatively on training. A number of facilitators and barriers to learning were identified. CONCLUSION The study findings highlight the opportunities for learning created by the pandemic. However, changing projects and the desire of SpRs to contribute to the response meant the impacts on training were mixed. Future deployment of SpRs should consider the balance of responsibility and pace when delegating work, as well as the need to supervise effectively and support remote working to maintain good mental wellbeing.
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Affiliation(s)
- L Hall
- Public Health Registrar, UK Health Security Agency, London SE1 8UG, UK
| | - K Bisset
- Public Health Registrar, UK Health Security Agency, London SE1 8UG, UK
| | - L Lynch
- Public Health Registrar, UK Health Security Agency, London SE1 8UG, UK
| | - Y Young
- Consultant in Health Protection, UK Health Security Agency, London SE1 8UG, UK
| | - R Ruggles
- Consultant in Public Health, UK Health Security Agency, London SE1 8UG, UK
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15
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Pereda E, De Hert S, El Tahan M, Romero CS. Retailoring training programmes in anaesthesia and intensive care after the coronavirus disease 2019 outbreak. Curr Opin Anaesthesiol 2023; 36:369-375. [PMID: 36994757 DOI: 10.1097/aco.0000000000001260] [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: 03/31/2023]
Abstract
PURPOSE OF REVIEW In this review, we want to collect all the adaptations that anaesthesiology training has faced because of the health crisis and social distancing measures resulting from coronavirus 2019 disease (COVID-19). We reviewed new teaching tools launched during the COVID-19 outbreak worldwide and particularly those implemented by the European Society of Anaesthesiology and Intensive Care (ESAIC) and the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC). RECENT FINDINGS Globally, COVID-19 has interrupted health services and all aspects of training programmes. These unprecedented changes have led to teaching and trainee support innovation tools, focusing on online learning and simulation programmes. Airway management, critical care and regional anaesthesia, have been enhanced during the pandemic, while there were major obstacles in paediatrics, obstetrics and pain medicine. SUMMARY The COVID-19 pandemic has altered profoundly the functioning of health systems worldwide. Anaesthesiologists and trainees have fought on the front lines of the battle against COVID-19. As a result, training in anaesthesiology during the last 2 years has focused on managing patients in intensive care. New training programmes have been designed to continue teaching residents of this speciality, focusing on e-learning and advanced simulation. It is necessary to present a review describing the impact that this turbulent period has had on the different subsections of anaesthesiology and to review the innovative measures that have been implemented to address these possible deficits in education and training.
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Affiliation(s)
- Elvira Pereda
- Anesthesiology and Critical Care Department at Hospital General Universitario, Valencia, Spain
| | - Stefan De Hert
- Department of Anesthesiology and Perioperative Medicine, Ghent University Hospital, Ghent University, Belgium
| | - Mohamed El Tahan
- Anesthesiology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, Department of Anaesthesia and Surgical Intensive Care, College of Medicine, Mansoura University, Mansoura, Egypt
| | - Carolina S Romero
- Anesthesiology and Critical Care Department, Hospital General Universitario, European University of Valencia, Valencia, Spain
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Jean-Tron MG, Ávila-Montiel D, Hill-de TC, Márquez-González H, Chapa-Koloffon G, Ávila-Hernández AV, Núñez-Benítez MA, Muñoz-Hernández O, Garduño-Espinosa J. How the COVID-19 pandemic affects the moral reasoning of pediatric residents and the general population. BMC MEDICAL EDUCATION 2023; 23:380. [PMID: 37226125 DOI: 10.1186/s12909-023-04265-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 04/15/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Kohlberg's theory of moral development asserts that people progress through different stages of moral reasoning as their cognitive abilities and social interactions mature. Individuals at the lowest stage of moral reasoning (preconventional stage) judge moral issues based on self-interest, those with a medium stage (conventional stage) judge them based on compliance with rules and norms, and those at the highest stage (postconventional stage) judge moral issues based on universal principles and shared ideals. Upon attaining adulthood, it can be considered that there is stability in the stage of individuals' moral development; however, the effect of a global population crisis such as the one experienced in March 2020, when the World Health Organization (WHO) declared the COVID-19 pandemic, is unknown. The purpose of this study was to evaluate the changes in the moral reasoning of pediatric residents before and after one year of the COVID-19 pandemic and compare them with a general population group. METHODS This is a naturalistic quasi-experimental study conducted with two groups, one comprised 47 pediatric residents of a tertiary hospital converted into a COVID hospital during the pandemic and another group comprised 47 beneficiaries of a family clinic who were not health workers. The defining issues test (DIT) was applied to the 94 participants during March 2020, before the pandemic initiated in Mexico, and later during March 2021. To assess intragroup changes, the McNemar-Bowker and Wilcoxon tests were used. RESULTS Pediatric residents showed higher baseline stages of moral reasoning: 53% in the postconventional group compared to the general population group (7%). In the preconventional group, 23% were residents and 64% belonged to the general population. In the second measurement, one year after the start of the pandemic, the group of residents had a significant decrease of 13 points in the P index, unlike the general population group in which a decrease of 3 points was observed. This decrease however, did not equalize baseline stages. Pediatric residents remained 10 points higher than the general population group. Moral reasoning stages were associated with age and educational stage. CONCLUSIONS After a year of the COVID-19 pandemic, we found a decrease in the stage of moral reasoning development in pediatric residents of a hospital converted for the care of patients with COVID-19, while it remained stable in the general population group. Physicians showed higher stages of moral reasoning at baseline than the general population.
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Affiliation(s)
- M G Jean-Tron
- Hospital Infantil Federico Gómez, Mexico City, Mexico
- National Autonomous University of Mexico, Mexico City, Mexico
| | | | | | | | | | | | | | | | - J Garduño-Espinosa
- Hospital Infantil Federico Gómez, Mexico City, Mexico.
- Dirección de Investigación, Tercer piso Edificio Hemato-Oncología e Investigación, Hospital Infantil Federico Gómez, Calle Dr. Márquez 162, Col. Doctores, Cuauhtémoc, CP 06720, Mexico.
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17
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Aldersley T, Brooks A, Human P, Lawrenson J, Comitis G, De Decker R, Fourie B, Manganyi R, Pribut H, Salie S, Swanson L, Zühlke L. The impact of COVID-19 on a South African pediatric cardiac service: implications and insights into service capacity. Front Public Health 2023; 11:1177365. [PMID: 37234766 PMCID: PMC10206042 DOI: 10.3389/fpubh.2023.1177365] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/05/2023] [Indexed: 05/28/2023] Open
Abstract
Background and Objectives The Western Cape public pediatric cardiac service is under-resourced. COVID-19 regulations are likely to have long-term effects on patient care but may provide insight into service capacity requirements. As such, we aimed to quantify the impact of COVID-19 regulations on this service. Methods An uncontrolled retrospective pre-post study of all presenting patients over two, one-year periods; the pre-COVID-19 period (01/03/2019-29/02/2020) and the peri-COVID-19 period (01/03/2020-28/02/2021). Results Admissions decreased by 39% (624 to 378) and cardiac surgeries decreased by 29% (293 to 208) in the peri-COVID-19 period, with an increase in urgent cases (PR:5.99, 95%CI:3.58-10.02, p < 0.001). Age at surgery was lower in the peri-COVID-19 period, 7.2 (2.4-20.4) vs. 10.8 (4.8-49.2) months (p < 0.05), likewise, age at surgery for transposition of the great arteries (TGA) was lower peri-COVID-19, 15 (IQR:11.2-25.5) vs. 46 (IQR:11-62.5) days (p < 0.05). Length of stay 6 (IQR:2-14) vs. 3 days (IQR:1-9) (p < 0.001), complications (PR:1.21, 95%CI:1.01-1.43, p < 0.05), and age-adjusted delayed-sternal-closure rates (PR:3.20, 95%CI:1.09-9.33, p < 0.05) increased peri-COVID-19. Conclusion Cardiac procedures were significantly reduced in the peri-COVID-19 period which will have implications on an overburdened service and ultimately, patient outcomes. COVID-19 restrictions on elective procedures freed capacity for urgent cases, demonstrated by the absolute increase in urgent cases and significant decrease in age at TGA-surgery. This facilitated intervention at the point of physiological need, albeit at the expense of elective procedures, and also revealed insights into capacity requirements of the Western Cape. These data emphasize the need for an informed strategy to increase capacity and reduce backlog whilst ensuring minimal morbidity and mortality.Graphical Abstract.
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Affiliation(s)
- Thomas Aldersley
- Department of Pediatrics and Child Health, Pediatric Cardiology, University of Cape Town, Cape Town, South Africa
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Andre Brooks
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
- Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
- Groote Schuur Hospital, Cape Town, South Africa
| | - Paul Human
- Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
- Groote Schuur Hospital, Cape Town, South Africa
| | - John Lawrenson
- Department of Pediatrics and Child Health, Pediatric Cardiology, University of Cape Town, Cape Town, South Africa
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
- Division of Pediatric Cardiology, Department of Pediatrics and Child Health, University of Stellenbosch, Cape Town, South Africa
- Tygerberg Hospital, Cape Town, South Africa
| | - George Comitis
- Department of Pediatrics and Child Health, Pediatric Cardiology, University of Cape Town, Cape Town, South Africa
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Rik De Decker
- Department of Pediatrics and Child Health, Pediatric Cardiology, University of Cape Town, Cape Town, South Africa
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Barend Fourie
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
- Division of Pediatric Cardiology, Department of Pediatrics and Child Health, University of Stellenbosch, Cape Town, South Africa
- Tygerberg Hospital, Cape Town, South Africa
| | - Rodgers Manganyi
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
- Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
- Groote Schuur Hospital, Cape Town, South Africa
| | - Harold Pribut
- Department of Pediatrics and Child Health, Pediatric Cardiology, University of Cape Town, Cape Town, South Africa
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Shamiel Salie
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
- Department of Pediatrics and Child Health, Pediatric Intensive and Critical Care Unit, University of Cape Town, Cape Town, South Africa
| | - Lenise Swanson
- Department of Pediatrics and Child Health, Pediatric Cardiology, University of Cape Town, Cape Town, South Africa
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Liesl Zühlke
- Department of Pediatrics and Child Health, Pediatric Cardiology, University of Cape Town, Cape Town, South Africa
- Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
- South African Medical Research Council, Cape Town, South Africa
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Jarvis MS, Samuel K. Impact of the COVID-19 pandemic on anaesthesia training, recruitment and examinations: a survey of UK trainees. Br J Anaesth 2023:S0007-0912(23)00141-1. [PMID: 37080871 PMCID: PMC10067451 DOI: 10.1016/j.bja.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 04/05/2023] Open
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Hussain MM, Zaida SAA, Khalil M, Baqai W, Laghari AA, Bari E. Tailoring of neurosurgical practice during COVID-19 in a developing country: Insights gained and a way forward. Surg Neurol Int 2023; 14:117. [PMID: 37151428 PMCID: PMC10159316 DOI: 10.25259/sni_116_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/15/2023] [Indexed: 04/03/2023] Open
Abstract
Background:
The coronavirus disease-19 pandemic has aggravated the already neglected neurosurgical specialty in developing countries with a mounting shortage of specialists, long queues of operative patients, and a lack of adequate critical care units.
Methods:
We have reviewed the innovative strategies adopted for maintaining an optimal surgical practice while ensuring team safety at the Aga Khan University Hospital, Karachi Pakistan.
Results:
There is already a scarcity of resources in developing countries. The international guidelines had to be tailored to the context of the developing world. A multimodal strategy that focused on infection control, continuum of care, and the well-being of staff was adopted at Aga Khan University. Patients were screened and seen either in person or through telemedicine, depending on the severity of the disease. All educational activities for residents were shifted online, and this helped in preventing overcrowding.
Conclusion:
Optimal surgical practice while ensuring team safety can be achieved through a multimodal strategy focusing on infection control, continuum of care, and the well-being of staff.
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20
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Hughes L, Murphy O, Lenihan M, Mhuircheartaigh RN, Wall TP. Impact of the COVID-19 pandemic on anaesthesia specialty training: a single-centre quantitative analysis. BJA OPEN 2023; 5:100117. [PMID: 36505902 PMCID: PMC9721281 DOI: 10.1016/j.bjao.2022.100117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Background The COVID-19 pandemic disrupted healthcare services worldwide, with a consequent impact on the delivery of medical education and training in all acute care specialties. Anaesthesia training has been challenged by a combination of reduced elective theatre activity, redeployment of trainees to critical care units, and changes in standard anaesthetic practices. Methods The aim of this study was to quantify the impact of COVID-19 on specialist anaesthesia training at a tertiary level teaching hospital in Ireland via a retrospective analysis of data captured by electronic anaesthesia records. The anaesthetic caseloads of trainees in periods before and during the pandemic were analysed along with airway management practices, core procedural skills performed, and critical care rostering. Data relating to 145 anaesthesia trainees were captured during the study periods: pre-pandemic (January 2018 to January 2020) and pandemic (January 2020 to January 2022). Results The mean number of theatre cases logged per trainee in a 6-month period reduced from 156.8 pre-pandemic to 119.2 during the pandemic (23.9% reduction; P<0.0001). Although theatre caseload was reduced, trainees gained additional critical care experience with a significant increase in overall days spent staffing critical care wards. In the theatre setting, the number of arterial lines, central lines, neuraxial blocks, and peripheral nerve blocks performed were significantly reduced during the pandemic. Conclusions Although the COVID-19 pandemic significantly reduced anaesthesia training exposure and increased critical care exposure over an extended period, the overall long-term significance of this alteration in the anaesthesia training experience remains uncertain.
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Affiliation(s)
- Lauren Hughes
- Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Orla Murphy
- Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Martin Lenihan
- Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Thomas P. Wall
- Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland,University College Dublin, Dublin, Ireland,Corresponding author. Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland
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Ku M, Ng I, Barson E, Fisher C, Segal R, Williams DL, Krieser RB, Mezzavia PM, Lee K, Chen Y, Sindoni T, Withiel T. The psychological impact on perioperative healthcare workers during Victoria's second COVID-19 wave: A prospective longitudinal thematic analysis. J Health Psychol 2023; 28:293-306. [PMID: 35837671 PMCID: PMC9982396 DOI: 10.1177/13591053221111021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has had a profound psychological impact on our frontline healthcare workers. Throughout the entire second COVID-19 wave at one major tertiary hospital in Melbourne Australia, longitudinal qualitative data between perioperative staff members, and analyses of intrapersonal changes were reported. Inductive analysis of three open-ended questions generated four major themes: Organisational Response to the Pandemic, Psychological Impact, Changes in Feelings of Support Over Time and Suggestions for Changes. Understanding the challenges, perception and suggestions from this longitudinal study allows us to provide a range of support services and interventions to minimise the long-term negative psychological impact and be better prepared should another similar situation arises again.
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Affiliation(s)
| | - Irene Ng
- The University of Melbourne,
Australia
- Royal Melbourne Hospital,
Australia
| | | | | | - Reny Segal
- The University of Melbourne,
Australia
- Royal Melbourne Hospital,
Australia
| | | | | | | | - Keat Lee
- The University of Melbourne,
Australia
- Royal Melbourne Hospital,
Australia
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Virtual Practical Examination for Student Nurse Educators in Health Sciences Education during the COVID-19 Pandemic: A Narrative Review. NURSING REPORTS 2023; 13:214-229. [PMID: 36810272 PMCID: PMC9944566 DOI: 10.3390/nursrep13010021] [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: 12/10/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
(1) Background: There is a gap in the literature that explores challenges and opportunities relating to virtual or e-assessment health science education with particular relevance to the Health Sciences Education practical examination for student nurse educators. Therefore, this review aimed to address this gap and provide recommendations for enhancing identified opportunities and for overcoming identified challenges.; (2) Methods: The review was conducted across Google Scholar, PubMed/MEDLINE, Science Direct, Directory of Open Access Journals, Complementary Index, SCOPUS, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) with the intention of identifying opportunities and challenges presented by e-assessment in the HSE practical examination for student nurse educators during the COVID-19 pandemic.; (3) Results: The following aspects are discussed: (1) opportunities, including benefits, for both student nurse educators and facilitators and opportunities for Nursing Education; and (2) challenges, including issues with accessibility and connectivity as well as the attitudes of both students and facilitators.; (4) Conclusions: Despite challenges which included connectivity issues that led to frustration and stress, the unpreparedness and attitudes of students and facilitators, there are some opportunities that have emerged from e-assessment that can be beneficial to both the students and the facilitators, as well as the institutions. These include a reduced administrative burden, improved teaching and learning, and immediate feedback from facilitators to students and from students to facilitators.
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23
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Chen F, Isaak R, Afroze F, Mulaikal TA, Licatino LK, Ladlie B, Jain A, Willie C, Bairde E, Hayes BH, Carter T, Zisblatt L, Diachun C, Martin TW, Marshall JM, Huffmyer J, Hindle AK, Stahl DL, Liu Y, Martinelli SM. A Multi-Site Survey Study on the Association Between the COVID-19 Pandemic and United States Anesthesiology Residents' Mental Health. Cureus 2023; 15:e34782. [PMID: 36915835 PMCID: PMC10005895 DOI: 10.7759/cureus.34782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND At the onset of the coronavirus disease 2019 (COVID-19) pandemic, anesthesiology residency programs were impacted differently due to various factors such as the local severity of COVID-19, exposure to patient suffering, and inability to complete rotations. We sought to investigate the impact of local-level pandemic severity on the well-being of anesthesiology residents. METHODS This multi-site study surveyed postgraduate year two residents from 15 United States (US) anesthesiology programs using the Perceived Stress Scale, Mini-Z, Patient Health Questionnaire-9,WHO-5 Well-Being Index,and the Multidimensional Scale of Perceived Social Support before the pandemic (baseline survey) and during the first COVID-19 surge (post survey). RESULTS A total of 144 (65%) residents responded to the initial baseline survey; 73 (33%) responded to the post survey, and 49 (22%) completed both surveys. There was not a statistically significant difference in any well-being outcomes of participants between the surveys, nor was there a significant difference based on the severity of COVID-19 impact at the program's hospital. Male participants had higher perceived stress scores (β = 4.05, 95%CI: 0.42, 7.67, P = 0.03) and lower social support from family (β = -6.57, 95%CI: -11.64, -1.51, P = 0.01) at the post survey compared to female participants after controlling for baseline scores. Additionally, married participants or those with domestic partners reported higher perceived social support in the post survey (β = 5.79, 95%CI: -0.65, 12.23, P = 0.03). CONCLUSION The local COVID-19 severity at a residency program did not disproportionately impact well-being scores among anesthesiology residents. Those most vulnerable to diminished well-being appeared to be male and single participants. As a result, targeted well-being interventions, including those aiming to increase social support, to higher-risk resident groups may be indicated. Future work is needed to assess the longstanding COVID-19 pandemic impacts on resident well-being.
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Affiliation(s)
- Fei Chen
- Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, USA
| | - Robert Isaak
- Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, USA
| | - Farzana Afroze
- Department of Anesthesiology, Albany Medical Center, Albany, USA
| | - Teresa A Mulaikal
- Department of Anesthesiology, Columbia University, New York City, USA
| | - Lauren K Licatino
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA
| | - Beth Ladlie
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, USA
| | - Ankit Jain
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, Augusta, USA
| | - Chelsea Willie
- Department of Anesthesiology and Pediatrics, Medical College of Wisconsin, Milwaukee, USA
| | - Emily Bairde
- Department of Anesthesiology, Oregon Health & Science University, Portland, USA
| | - Blair H Hayes
- Department of Anesthesiology, The Ohio State University, Columbus, USA
| | - Tekuila Carter
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Lara Zisblatt
- Department of Anesthesiology, University of Michigan, Ann Arbor, USA
| | - Carol Diachun
- Department of Anesthesiology, University of Florida College of Medicine, Jacksonville, USA
| | - Timothy W Martin
- Department of Anesthesiology, University of Florida, Gainesville, USA
| | - Julie M Marshall
- Department of Anesthesiology, University of Missouri, Columbia, USA
| | - Julie Huffmyer
- Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, USA
| | - Anna K Hindle
- Department of Anesthesiology, The George Washington University, Washington, D.C., USA
| | - David L Stahl
- Department of Anesthesiology, The Ohio State University, Columbus, USA
| | - Yutong Liu
- Department of Biostatistics, University of North Carolina, Chapel Hill, USA
| | - Susan M Martinelli
- Department of Anesthesiology, University of North Carolina School of Medicine, Chapel HIll, USA
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Baryeh K, Bradley A, Cotzias C. The recovery of training and education post-COVID-19: the importance of supporting the consultant workforce. Br J Hosp Med (Lond) 2023; 84:1-9. [PMID: 36708341 DOI: 10.12968/hmed.2022.0471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND/AIMS Since the COVID-19 pandemic began, training and education have been significantly disrupted, causing an incalculable effect on trainees. However, the consultant workforce is crucial to the success of training recovery. The motivation of the consultant workforce to assist in training recovery, in a context of significant workload and increasing pressures on resources, is currently unknown. METHODS This survey gathered the consultant workforce's views on assisting training recovery at one site of a large NHS foundation trust. RESULTS There was reduced motivation to engage in training and education when compared to pre-pandemic levels, widespread indicators of burnout, and changes in attitude towards reducing their working hours and early retirement. CONCLUSIONS These findings demonstrate a worrying trend that is likely to be replicated nationwide, which highlights the need to support consultants to avoid further disruption to training recovery.
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Affiliation(s)
- Kwaku Baryeh
- Department of Medical Education, West Middlesex University Hospital, Isleworth, UK
| | - Anna Bradley
- Department of Medical Education, West Middlesex University Hospital, Isleworth, UK
| | - Christina Cotzias
- Department of Medical Education, West Middlesex University Hospital, Isleworth, UK
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Chan KKW, Yang TX, Chan AKM. The Impact of COVID-19 on the Training of Anesthesiologists in Hong Kong: Overcoming the Challenge. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231216264. [PMID: 38025021 PMCID: PMC10664445 DOI: 10.1177/23821205231216264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023]
Abstract
Objectives This study aimed to investigate the impact of COVID-19 on the training of anesthesiologists in Hong Kong. Introduction COVID-19 has caused a substantial impact on anesthesiology training in multiple domains. The challenges faced by both trainees and educators remain a significant concern and adaptations in clinical teaching are warranted. We conducted this study to quantify the impact and identify learning areas in recurring pandemics. Methods Electronic surveys were distributed to anesthesiology trainees and fellows in Hospital Authority in Hong Kong. Data from respondents were collated and analyzed. Reliability analysis and exploratory factor analysis (EFA) were performed. Results A total of 97 responses were collected and analyzed. Majority (59% of trainees and 79% of fellows) agreed that the COVID-19 pandemic negatively impacted anesthesia training overall. Bag-mask ventilation and direct laryngoscopy were the 2 most affected areas in airway training; 47% of fellows observed a technical skill decline among trainees. Most respondents (64% of trainees and 71% of fellows) agreed that simulation sessions could help with residents' training. Exploratory factor analysis indicated the following subscales: loss of educational opportunities, loss of caseload and formal training, loss of technical skills (regional and procedural), loss of technical skills (airway management), the hampering of ICU rotations, and difficulty teaching residents. Conclusion The COVID-19 pandemic has caused disruptions in caseload, technical skills training, work-based assessment, and continued medical education, hampering both trainees' and fellows' education. Measures to counter the effect of the pandemic were discussed. Our findings will help educators better understand the challenges, marshal resources, and plan to enhance trainees' educational experience.
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Affiliation(s)
- Kevin Kai Wai Chan
- Department of Anaesthesiology & Operating Theatre Services, Queen Elizabeth Hospital, Hong Kong
| | - Timothy Xianyi Yang
- Department of Anaesthesiology & Operating Theatre Services, Queen Elizabeth Hospital, Hong Kong
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Muacevic A, Adler JR, Hodge CB, Anders MG, Conti BM, Brookman JC, Martz DG, Hong CM, Gibbons M, Rock P. Impact of Pandemic Response on Training Experience of Anesthesiology Residents in an Academic Medical Center: A Retrospective Cohort Study. Cureus 2023; 15:e33500. [PMID: 36756025 PMCID: PMC9903179 DOI: 10.7759/cureus.33500] [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: 01/08/2023] [Indexed: 01/09/2023] Open
Abstract
Background The impact of the coronavirus disease 2019 (COVID-19) pandemic substantially altered operations at hospitals that support graduate medical education. We examined the impact of the pandemic on an anesthesiology training program with respect to overall case volume, subspecialty exposure, procedural skill experience, and approaches to airway management. Methods Data for this single center, retrospective cohort study came from an Institutional Review Board approved repository for clinical data. Date ranges were divided into the following phases in 2020: Pre-Pandemic (PP), Early Pandemic (EP), Recovery 1 (R1), and Recovery 2 (R2). All periods were compared to the same period from 2019 for case volume, anesthesia provider type, trainee exposure to Accreditation Council for Graduate Medical Education (ACGME) index case categories, airway technique, and patient variables. Results 15,087 cases were identified, with 5,598 (37.6%) in the PP phase, 1,570 (10.5%) in the EP phase, 1,451 (9.7%) in the R1 phase, and 6,269 (42.1%) in the R2 phase. There was a significant reduction in case volume during the EP phase compared to the corresponding period in 2019 (-55.3%; P < .001) that improved but did not return to baseline by the R2 phase (-17.6%; P < .001). ACGME required minimum cases were reduced during the EP phase compared to 2019 data for pediatric cases (age < 12 y, -72.1%; P < .001 and age < 3 y, -53.5%; P < .006) and cardiopulmonary bypass cases (52.3%, P < .003). Surgical subspecialty case volumes were significantly reduced in the EP phase except for transplant surgery. By the R2 phase, all subspecialty volumes had recovered except for plastic surgery (14.9 vs. 10.5 cases/week; P < .006) and surgical endoscopy (59.2 vs. 40 cases/week; P < .001). Use of video laryngoscopy (VL) and rapid sequence induction and intubation (RSII) also increased from the PP to the EP phase (24.6 vs. 79.6%; P < .001 and 10.3 vs. 52.3%; P < .001, respectively) and remained elevated into the R2 phase (35.2%; P < 0.001 and 23.1%; P < .001, respectively). Conclusions The COVID-19 pandemic produced significant changes in surgical case exposure for a relatively short period. The impact was short-lived, with sufficient remaining time to meet the annual ACGME program minimum case requirements and procedural experiences. The longer-term impact may be a shift towards the increased use of VL and RSII, which became more prevalent during the early phase of the pandemic.
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Allan-Blitz LT, Valtis Y, Sundberg M, Sharma N, Petersen E, Cuneo CN. Implementation and first experiences with a multimodal mentorship curriculum for medicine-paediatrics residents. Ann Med 2022; 54:1313-1319. [PMID: 35543194 PMCID: PMC9103397 DOI: 10.1080/07853890.2022.2070661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Mentorship increases trainee productivity, promotes career satisfaction and reduces burnout. Beginning in 2016, our Medicine-Paediatrics residency program developed and implemented a longitudinal mentorship curriculum among trainees. We report initial experiences with that program and discuss potential future directions. CURRICULUM STRUCTURE AND METHOD OF IMPLEMENTATION We implemented and adapted a peer mentorship model and expanded it to include guest lectures and workshops centred around 13 core topics. Our expanded model included five longitudinal components: (1) peer mentorship; (2) virtual check-ins with residency leadership; (3) focussed didactics and workshops; (4) small-group dinners highlighting different career paths; and (5) dedicated faculty who pair residents with mentors based on common interests. We compared annual survey results on resident satisfaction with program mentorship, using chi-square and fisher's exact tests to assess statistically significant differences pre- (2012-2016) and post-intervention (2016-2020). RESULTS We analysed 112 responses with annual response rate varying between 41.2% and 100%. Overall satisfaction with mentorship improved from 57.6% to 73.4% (p = .53), satisfaction with emotional support improved from 63.1% to 71.6% (p = .21), and satisfaction with career-specific mentorship improved from 48.5% to 59.5% (p = .70). Residents reported consistently high satisfaction with peer mentorship (77.8%-100%). The percent of residents reporting they had identified a career mentor increased from 60.0% in 2017 to 88.9% in 2019, which was sustained at 90.0% in 2020. CONCLUSION We report our experience in implementing and adapting a mentorship curriculum for resident physicians in a single training program, including transitioning to a primarily online-based platform at the outset of the SARS-CoV-2 pandemic. Our results showed a trend towards improvement in resident satisfaction with overall and career-specific mentorship, as well as improved emotional support. Future work is needed using more objective outcome markers among a larger and more diverse group of residents. KEY MESSAGESAmong resident physicians in a single training program, a mix of mentor-mentee dyads, group-based peer mentoring and a structured curriculum has shown promise in improving resident-reported satisfaction with programmatic mentorshipWhile we attempted to adapt the mentorship curriculum to an online platform with the development of the SARS-CoV-2 pandemic, reported satisfaction in overall mentorship and emotional support decreased in comparison to the prior year, an important focus for future work.
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Affiliation(s)
- Lao-Tzu Allan-Blitz
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Yannis Valtis
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Michael Sundberg
- Departments of Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Niraj Sharma
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Elizabeth Petersen
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - C Nicholas Cuneo
- Departments of Pediatrics and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Guran E, Yan M, Ho D, Vandse R. Evaluation of psychological impact of COVID-19 on anesthesiology residents in the United States. Heliyon 2022; 8:e11815. [PMID: 36451756 PMCID: PMC9683519 DOI: 10.1016/j.heliyon.2022.e11815] [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: 04/28/2022] [Revised: 09/19/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022] Open
Abstract
The aim of our study was to evaluate the impact of COVID-19 on the mental health of in-training anesthesiology residents in the United States. A link containing validated survey tools including the Depression-Anxiety-Stress-Scale (DASS-21), the Abbreviated Maslach Burnout Inventory (aMBI), and the Brief Resilient Coping Scale (BRCS) along with questions related to work environment, and additional personal factors were emailed to 159 Anesthesiology residency programs across the US. 143 responses were received of which 111 were complete. The prevalence of depression, anxiety, stress and burnout was 42%, 24%, 31% and 71% respectively. Emotional exhaustion, depersonalization, and reduced feelings of personal accomplishment were experienced by 80%, 53%, and 65% of respondents, respectively. The BRCS scale showed 33% of respondents with low, 44% with moderate and 22% with high coping scales. Logistic regression analyses indicated those with a prior mental health diagnosis were 3 times more likely to have a non-normal DASS depression score, 4 times more likely to have a non-normal DASS anxiety score, and 11.74 times more prone to emotional exhaustion. Increased work hours and higher training levels were associated with increased levels of stress. In our survey, prior mental health illness, gender and increased work hours were the main drivers of increased risk .
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Baryeh K. The rise of the clinical teaching fellow: a personal view of the postgraduate experience. Br J Hosp Med (Lond) 2022; 83:1-6. [DOI: 10.12968/hmed.2022.0339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Clinical teaching fellowships are becoming increasingly popular, with the numbers of posts ever-expanding. This increase has accelerated as education and training start to recover from the effects of the COVID-19 pandemic. However, the nature of these roles, the entry requirements and the potential benefits are often poorly defined. This article outlines the author's experience of working as a clinical teaching fellow for a year and provides tips on what to look out for when considering these roles, as well as how to get the most out of them.
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Affiliation(s)
- Kwaku Baryeh
- Department of Postgraduate Medical Education, West Middlesex University Hospital, London, UK
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30
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What is the Best Method to Teach Screen-Based Simulation in Anesthesia Distance Education? Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Fu D, Li W, Li W, Han Y. Improved skill for tracheal intubation using optical stylets through remote training model: a before and after interventional study. BMC MEDICAL EDUCATION 2022; 22:668. [PMID: 36085051 PMCID: PMC9462891 DOI: 10.1186/s12909-022-03715-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Conducting on-site, hands-on training during the Coronavirus disease 2019 (COVID-19) pandemic has been challenging. We conducted a before and after interventional study to estimate the efficacy of a new remote hands-on training model for improving the trainees' tracheal intubation competency using optical stylets. METHODS Residents or physicians in anesthesiology apartment who have not received the nominated training in tracheal intubation using optical stylets were enrolled. The 4-week training course contains theoretical knowledge along with preclinical and clinical training of optical stylets techniques. Competency of intubation using optical stylets on patients with normal airways was evaluated according to an assessment tool with a maximum score of 29 points based on video recording pre-post training performance. Pre-post questionnaires measured theoretical knowledge and self-efficacy. RESULTS Twenty-two participants were included (8 females, 14 men, mean age of 33.5 years). The total score of intubation competency was significantly improved after training from 14.6±3.7 to 25.3±2.6 (P < 0.0001). The scores of three subitems (anatomical identification, hand-eye coordination, and optimized intubation condition) were all significantly increased after training (P < 0.0001). The total percentage of correct answers in the multiple-choice questionnaire increased from 58.2%±8.2% before training to 85.2%±7.2% shortly after training (P < 0.0001). In addition, the self-efficacy score was significantly increased from 2.5±1.2 to 4.4±0.6 (P < 0.0001). CONCLUSIONS The new remote and progressively advanced hands-on training model improved the competency of intubation using optical stylets under the COVID-19 pandemic.
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Affiliation(s)
- Danyun Fu
- Department of Anesthesiology, Eye & ENT Hospital of Fudan University, No.83 Fenyang Road, Xuhui District, Shanghai, 200031 China
| | - Weixing Li
- Department of Anesthesiology, Eye & ENT Hospital of Fudan University, No.83 Fenyang Road, Xuhui District, Shanghai, 200031 China
| | - Wenxian Li
- Department of Anesthesiology, Eye & ENT Hospital of Fudan University, No.83 Fenyang Road, Xuhui District, Shanghai, 200031 China
| | - Yuan Han
- Department of Anesthesiology, Eye & ENT Hospital of Fudan University, No.83 Fenyang Road, Xuhui District, Shanghai, 200031 China
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Liu H, Liu X, Xu W. Prevalence and influencing factors of anxiety in medical students during the COVID-19 pandemic. Heliyon 2022; 8:e10487. [PMID: 36091964 PMCID: PMC9444338 DOI: 10.1016/j.heliyon.2022.e10487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/06/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objective The novel coronavirus disease (COVID-19) pandemic has caused a traumatic impact on the whole world in all aspects including physical health, economic condition, and mental health. Psychological problems are commonly neglected for their inconspicuous symptoms. Little is known about the medical students' psychological status during the COVID-19 pandemic. Our study aimed to investigate the prevalence and influencing factors of anxiety among medical students during the COVID-19 pandemic. Methods Two thousand and two medical students were investigated in this cross-sectional study. Zung's self-rating anxiety scale was used to evaluate their anxiety symptoms. A total of 1917 questionnaires were collected, and the response rate was 95.8%. Results There were 1735 (90.5%) complete and valid questionnaires. The average SAS standard score was 42.8 ± 11.0. The results indicated that the prevalence of anxiety in medical students was 25.9%. Less social support (OR = 1.4, 95%CI 1.2-1.7) is an independent risk factor of anxiety syndrome, while the female (OR = 0.6, 95%CI 0.5-0.8) is less likely to have anxiety syndrome. Conclusion The prevalence of anxiety in medical students is higher during the COVID-19 pandemic. Male students and students with less social support are more likely to have anxiety syndrome. Medical educators and students themselves should take serious steps to prevent, recognize and deal with the anxiety prevalence.
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Kartsoni E, Bakalis N, Patelarou E, Markakis G, Lahana E, Patelarou A. Translation, cultural adaptation and validation of the Attitude Scale towards e-learning (ATel) into the Greek language. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/151522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Loiseau M, Ecarnot F, Meunier-Beillard N, Laurent A, Fournier A, François-Purssell I, Binquet C, Quenot JP. Mental Health Support for Hospital Staff during the COVID-19 Pandemic: Characteristics of the Services and Feedback from the Providers. Healthcare (Basel) 2022; 10:healthcare10071337. [PMID: 35885862 PMCID: PMC9324679 DOI: 10.3390/healthcare10071337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 01/01/2023] Open
Abstract
French authorities created mental health support services to accompany HCWs during the pandemic. We aimed to obtain feedback from staff providing these mental health support services within French hospitals to identify positive and negative features and avenues for improvement. A mixed-methods study was performed between 1 April and 30 June 2020. We contacted 77 centres to identify those providing mental health support services. We developed a questionnaire containing questions about the staff providing the service (quantitative part), with open questions to enable feedback from service providers (qualitative part). Of the 77 centres, 36 had mental health support services; 77.8% were created specifically for the epidemic. Services were staffed principally by psychologists, mainly used a telephone platform, and had a median opening time of 8 h/day. Thirty-seven professionals provided feedback, most aged 35–49 years. For 86.5%, it was their first time providing such support. Median self-reported comfort level was 8 (interquartiles 3–10), and 95% would do it again. Respondents reported (i) difficulties with work organisation, clinical situations, and lack of recognition and (ii) a desire for training. This study suggests that mental health support needs to be adapted to the needs of HCWs, both in terms of the content of the service and the timing of delivery.
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Affiliation(s)
- Mélanie Loiseau
- Service de Médecine Légale, CHU Dijon, Cellule d’Urgence Médico-Psychologique CUMP-21, 21000 Dijon, France; (M.L.); (I.F.-P.)
| | - Fiona Ecarnot
- EA3920, University of Burgundy Franche-Comté, 25000 Besancon, France
- Department of Cardiology, University Hospital Besancon, 25000 Besancon, France
- Correspondence:
| | - Nicolas Meunier-Beillard
- Clinical Epidemiology/Clinical Trials Unit, Clinical Investigation Center, INSERM, CIC 1432, Dijon University Hospital, 21000 Dijon, France; (N.M.-B.); (C.B.); (J.-P.Q.)
| | - Alexandra Laurent
- Laboratoire de Psychologie, Dynamiques Relationnelles Et Processus Identitaires (PsyDREPI), Université Bourgogne Franche-Comté, 21000 Dijon, France; (A.L.); (A.F.)
- Service d’Anesthésie et de Réanimation, CHU Dijon-Bourgogne, 21000 Dijon, France
| | - Alicia Fournier
- Laboratoire de Psychologie, Dynamiques Relationnelles Et Processus Identitaires (PsyDREPI), Université Bourgogne Franche-Comté, 21000 Dijon, France; (A.L.); (A.F.)
| | - Irene François-Purssell
- Service de Médecine Légale, CHU Dijon, Cellule d’Urgence Médico-Psychologique CUMP-21, 21000 Dijon, France; (M.L.); (I.F.-P.)
| | - Christine Binquet
- Clinical Epidemiology/Clinical Trials Unit, Clinical Investigation Center, INSERM, CIC 1432, Dijon University Hospital, 21000 Dijon, France; (N.M.-B.); (C.B.); (J.-P.Q.)
| | - Jean-Pierre Quenot
- Clinical Epidemiology/Clinical Trials Unit, Clinical Investigation Center, INSERM, CIC 1432, Dijon University Hospital, 21000 Dijon, France; (N.M.-B.); (C.B.); (J.-P.Q.)
- Service de Médecine Intensive-Réanimation, CHU Dijon-Bourgogne, 21000 Dijon, France
- Équipe Lipness, Centre de Recherche INSERM UMR1231, 21000 Dijon, France
- Espace de Réflexion Éthique Bourgogne Franche-Comté (EREBFC), 21000 Dijon, France
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Wisbach GG, Johnson KA, Sormalis C, Johnson A, Ham J, Blair PG, Houg S, Burden AR, Sinz EH, Fortner SA, Steadman RH, Sachdeva AK, Rooney DM. Impact of the COVID-19 Pandemic on American College of Surgeons – Accredited Education Institutes & American Society of Anesthesiologists – Simulation Education Network: Opportunities for Interdisciplinary Collaboration. Surgery 2022; 172:1330-1336. [PMID: 36041927 PMCID: PMC9257111 DOI: 10.1016/j.surg.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/27/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022]
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Radoslaw C. Webinar satisfaction factors in the stories of participants. INTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT 2022. [DOI: 10.1111/ijtd.12275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Czahajda Radoslaw
- Department of Management in Networked and Digital Societies Kozminski University Warsaw Poland
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Exploring the Unexpected Transition to Online Learning Due to the COVID-19 Pandemic in an Ethiopian-Public-University Context. EDUCATION SCIENCES 2022. [DOI: 10.3390/educsci12060399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In this paper, we present the initial changes and continuing challenges that are faced by teachers and students due to the unexpected transition to online learning from the COVID-19 pandemic at Bahir Dar University, Ethiopia. For this, the authors applied a phenomenological-case-study design, collecting qualitative data from purposively selected Ph.D. students (n = 10) and teachers (n = 4), examiners (n = 2), as well as the postgraduate coordinator. The results indicate that the teachers experienced some difficulties in effectively using learning technologies. Moreover, the students were overburdened with increased accountability and excessive challenges. However, the institutional capacity to support was relatively minimal. Despite these odds, the study participants showed higher levels of willingness and completed the program successfully. The study participants reported moderate satisfaction with their personal and professional experiences. The COVID-19 pandemic is an opportunity to remind universities and colleges about the essential skills that students need in this unpredictable world, for example, informed decision making, creative problem solving, and adaptability.
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Bartholomew A, Sanatkar S, Counson I, Harvey SB. Junior doctors' mental health and coronavirus disease safety concerns. Aust N Z J Public Health 2022; 46:307-313. [PMID: 35238447 PMCID: PMC9968570 DOI: 10.1111/1753-6405.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/01/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This article aims to assess whether caring for COVID-19 patients impacted junior doctors' COVID-19-related anxieties, general anxiety and depression, and the relative impact of depression, general anxiety and specific COVID-19 anxiety on work and social functioning during the COVID-19 pandemic in 2020. METHODS Recruitment occurred between June and August 2020 in New South Wales, Australia. Demographic information, symptoms of depression (PHQ-9), generalised anxiety (GAD-7), and COVID-19-related anxieties around infections, help-seeking behaviours, and work and social functioning (WSAS) were collected. RESULTS About one third (n=73, 33%) had cared for a patient with overt or covert COVID-19 in the previous month. However, the extent of COVID-19-related anxiety symptoms was largely unrelated to caring for COVID-19 patients. Instead, the presence of other COVID-19 concerns and gender predicted variations in COVID-19 concerns for one's own safety and the safety of loved ones. CONCLUSION COVID-19 anxiety symptoms were largely unrelated to caring for COVID-19 patients, while COVID-19-related anxiety around the safety of family and friends added to impaired functioning in addition to the established impact of depression and general anxiety. IMPLICATIONS FOR PUBLIC HEALTH Provided the replicability of these findings, this research highlights the importance of addressing pandemic-related anxieties in junior doctor populations.
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Affiliation(s)
- Alexandra Bartholomew
- Black Dog Institute, UNSW Sydney, New South Wales,Correspondence to: Ms Alexandra Bartholomew, Black Dog Institute, Hospital Road, Sydney 2031
| | - Samineh Sanatkar
- Black Dog Institute, UNSW Sydney, New South Wales,School of Psychiatry, UNSW Sydney, New South Wales
| | - Isabelle Counson
- Black Dog Institute, UNSW Sydney, New South Wales,School of Psychiatry, UNSW Sydney, New South Wales
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Stark N, Hayirli T, Bhanja A, Kerrissey M, Hardy J, Peabody CR. Unprecedented Training: Experience of Residents During the COVID-19 Pandemic. Ann Emerg Med 2022; 79:488-494. [PMID: 35277294 PMCID: PMC8784436 DOI: 10.1016/j.annemergmed.2022.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Indexed: 01/25/2023]
Affiliation(s)
- Nicholas Stark
- Department of Emergency Medicine, University of California, San Francisco, CA.
| | | | | | | | - James Hardy
- Department of Emergency Medicine, University of California, San Francisco, CA
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Goss CW, Duncan JG, Lou SS, Holzer KJ, Evanoff BA, Kannampallil T. Effects of Persistent Exposure to COVID-19 on Mental Health Outcomes Among Trainees: a Longitudinal Survey Study. J Gen Intern Med 2022; 37:1204-1210. [PMID: 35091924 PMCID: PMC8796740 DOI: 10.1007/s11606-021-07350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The rapid spread of the coronavirus disease 2019 (COVID-19) has created considerable strain on the physical and mental health of healthcare workers around the world. The effects have been acute for physician trainees-a unique group functioning simultaneously as learners and care providers with limited autonomy. OBJECTIVE To investigate the longitudinal effects of physician trainee exposure to patients being tested for COVID-19 on stress, anxiety, depression, and burnout using three surveys conducted during the early phase of the pandemic. DESIGN Longitudinal survey study. PARTICIPANTS All physician trainees (N = 1375) at an academic medical center. MAIN MEASURE Assess the relationship between repeated exposure to patients being tested for COVID-19 and stress, anxiety, depression, and burnout. KEY RESULTS Three hundred eighty-nine trainees completed the baseline survey (28.3%). Of these, 191 and 136 completed the ensuing surveys. Mean stress, anxiety, and burnout decreased by 21% (95% confidence interval (CI): - 28 to - 12%; P < 0.001), 25% (95% CI: - 36 to - 11%; P < 0.001), and 13% (95% CI: - 18 to - 7%; P < 0.001), respectively, per survey. However, for each survey time point, there was mean increase in stress, anxiety, and burnout per additional exposure: stress [24% (95% CI: + 12 to + 38%; P < 0.001)], anxiety [22% (95% CI: + 2 to + 46%; P = 0.026)], and burnout [18% (95% CI: + 10 to + 28%; P < 0.001)]. For depression, the association between exposure was strongest for the third survey, where mean depression scores increased by 33% per additional exposure (95% CI: + 18 to + 50%; P < 0.001). CONCLUSIONS Training programs should adapt to address the detrimental effects of the "pileup" of distress associated with persistent exposure through adaptive programs that allow flexibility for time off and recovery.
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Affiliation(s)
- Charles W Goss
- Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA
| | - Jennifer G Duncan
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Sunny S Lou
- Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA
| | - Katherine J Holzer
- Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA
| | - Bradley A Evanoff
- Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Thomas Kannampallil
- Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA. .,Institute for Informatics, Washington University School of Medicine, St Louis, MO, USA.
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Bouiller K, Peiffer-Smadja N, Cevik M, Last K, Antunović IA, Šterbenc A, Lopes MJ, Barac A, Schweitzer V, Dellière S. Role and perception of clinical microbiology and infectious diseases trainees during the COVID-19 crisis. Future Microbiol 2022; 17:411-416. [PMID: 35285247 PMCID: PMC8958984 DOI: 10.2217/fmb-2021-0129] [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] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate the role and perceptions of trainees during the COVID-19 pandemic. Method: An online survey was designed to provide an insight into the significance of the COVID-19 pandemic on working conditions of infectious diseases and clinical microbiology trainees. Results: The main roles of trainees included management of patients hospitalized for COVID-19 (55%), research (53%) and diagnostic procedures (43%). The majority (82%) of trainees felt useful in managing the crisis. However, more than two-thirds felt more stressed and more tired compared with other rotations. Only 39% of the participants had access to psychological support. Conclusion: Due to the significant impact of the pandemic on infectious diseases and clinical microbiology trainees, further research should focus on their health and welfare in the post-pandemic period.
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Affiliation(s)
- Kevin Bouiller
- Infectious disease department, University hospital of Jean-Minjoz, Besancon, France.,UMR-CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France.,Network of young French infectious diseases specialists (RéJIF)
| | - Nathan Peiffer-Smadja
- Network of young French infectious diseases specialists (RéJIF).,Université de Paris, Service de maladies infectieuses et tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - Muge Cevik
- Division of Infection & Global Health Research, School of Medecine, University of St Andrews, St Andrews, UK.,Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID)
| | - Katharina Last
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Center for Infectious Diseases, Institute of Medical Microbiology & Hygiene, Saarland University Hospital, Homburg, Germany
| | - Ivana A Antunović
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Hospital for Infections Diseases, Clinical Microbiology, Mirogojska 8, Zagreb, Croatia
| | - Anja Šterbenc
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Institute of Microbiology & Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maria J Lopes
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Infectious Diseases Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Aleksandra Barac
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Clinic for Infectious & Tropical Diseases, University Clinical Center of Serbia, Belgrade, Serbia
| | - Valentijn Schweitzer
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sarah Dellière
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP, Paris, France
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Carey C, Gale TCE, Evans CR. Recruitment to anaesthesia training posts during the
COVID
pandemic and beyond. Anaesthesia 2022; 77:514-518. [PMID: 35279823 PMCID: PMC9111468 DOI: 10.1111/anae.15710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Affiliation(s)
- C. Carey
- Department of Anaesthesia University Hospitals Sussex NHS Trust Sussex UK
| | - T. C. E. Gale
- Department of Anaesthesia University Hospitals Plymouth NHS Trust Plymouth UK
- Peninsula Medical School University of Plymouth UK
| | - C. R. Evans
- Department of Anaesthesia Cardiff and Vale University Health Board Cardiff UK
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Clyburn PA, Davies SJ, Clyburn RD. Are we creating another ‘lost tribe’ of anaesthetic trainees? Anaesthesia 2022; 77:510-513. [DOI: 10.1111/anae.15642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 11/29/2022]
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Bihani P, Jaju R, Saxena M, Paliwal N, Tharu V. “The show must go on”: Aftermath of Covid-19 on anesthesiology residency programs. Saudi J Anaesth 2022; 16:452-456. [DOI: 10.4103/sja.sja_563_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 11/04/2022] Open
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Ahuja V, Nair L, Das S, Sandhu S. Psychological stress among anesthesia residents during COVID-19 pandemic and how to mitigate them. J Anaesthesiol Clin Pharmacol 2022; 38:S3-S7. [PMID: 36060160 PMCID: PMC9438815 DOI: 10.4103/joacp.joacp_104_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/05/2021] [Accepted: 04/22/2021] [Indexed: 11/25/2022] Open
Abstract
The impact of the novel coronavirus disease 19 (COVID-19) has overburdened the anesthesia fraternity both physically and mentally. The academic and training schedule of the medical residents in the last year was also disrupted. Since we are in the early phase of the second peak of the COVID-19 pandemic, it is time to reconsider the causes of stress in anesthesia residents and methods to mitigate them. In this non-systematic review, authors have included articles from PubMed, Medline, and Google scholar with keywords “identify strategies” “preventing and treating psychological disorders,” and “medical students” from year 2010 onwards were included. Apart from these keywords, we have included the coping strategies and early psychiatric consultation methods. This review article aims at early identification, workplace environment changes, and implementation of early coping strategies in anesthesia residents during this second peak of COVID-19.
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Sasidharan S, Chhabra S, Malhotra N, Singh Bajwa S, Choubey S, Sahni N. Breaking barriers to remain healthy and fit during a residency in anaesthesiology. Indian J Anaesth 2022; 66:77-81. [PMID: 35309027 PMCID: PMC8929323 DOI: 10.4103/ija.ija_1110_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 11/04/2022] Open
Abstract
Anaesthesiology is a high-demand speciality of medicine in terms of long and unpredictable work hours, stressful work requirements, pressure for a cent per cent productivity in academics, clinical work and research. Higher stress levels can cause non-communicable diseases like hypertension, obesity and depressed immunity, among many others. In the journey as a trainee anaesthetist, vigorous and diligent efforts are needed to gain perfection in knowledge and skills ultimately. While this path is being transversed, it is essential to address physical and mental fitness by exercising it to the recommended benefits, to ward away stress and burnout. In this special article, the authors will discuss the barriers young anaesthesia trainees face to staying healthy and fit during their training and practical and appropriate measures to mitigate the same through intervention at various levels of hierarchy.
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Pinyavat T, Lynch LR, Jaconia GD, Miller LK, Hines RL. The Impact of COVID-19 on Trainees: Lessons Learned and Unanticipated Opportunities. J Neurosurg Anesthesiol 2022; 34:158-162. [PMID: 34870641 DOI: 10.1097/ana.0000000000000810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 10/19/2022]
Abstract
Dr. Emanuel Martin Papper was a Professor and Department Chair at Columbia University whose top passion was training the next generation of anesthesiologists. As such, a fitting topic for discussion at Columbia University Department of Anesthesiology's Papper Symposium was the "The Impact of the COVID-19 Pandemic on Trainees: Lessons Learned and Unanticipated Opportunities," presented by Dr. Roberta L. Hines, Nicholas M. Greene Professor of Anesthesiology and Department Chair and Chief of Anesthesiology at Yale-New Haven Hospital. The pandemic led to abrupt changes at the national, hospital, and training program levels, all of which impacted trainees in anesthesiology and other disciplines. Nationally, there were sweeping regulatory changes that helped to shape the coronavirus disease-2019 response by medical front line workers. At each individual hospital, coronavirus disease-2019 units were created and teams were restructured to keep up with patient care demands. Educational programs adapted their curricula and trainees lost valuable clinical and academic opportunities. The innovative educational responses, including a pivot to virtual learning and virtual recruitment, provided a silver lining to the health care crisis. Another bright spot was that anesthesiology as a specialty rose to the forefront of patient care. Anesthesiologists displayed impactful leadership during the pandemic, paving the way for future growth and broadened reach of our specialty.
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Frost E, Starnes S. 118 Simulation for Novice Anaesthetists: Addressing Training Gaps Created by a Global Pandemic. Simul Healthc 2021. [DOI: 10.54531/mvnw1487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
It is well documented that the COVID-19 pandemic is having a huge impact on doctors in training. Much of novice anaesthetists’ training is delivered during high turnover, elective theatre lists of low-risk patients The aim of the study was to create a trust-wide high-fidelity simulation course for novice anaesthetists, focussing on confidence building and preparation for on-calls, together with clinical and non-technical management of specific anaesthetic complications.A pre-course questionnaire aided a learning needs analysis and informed the learning objectives. Poor confidence due to lack of training was a common theme. Issues identified included limited case numbers, exposure to common emergencies and difficulty progressing to more distant supervision. Using a standardized scenario authoring platform (IRIS) we collaborated with a multi-professional faculty group to design a 1-day simulation course. To ensure an authentic learner experience, scenarios were designed for delivery in a high-fidelity simulation suite using Laerdal SimMan3G with LEAP software. Familiar clinical equipment, such as a Datex Ohmeda anaesthetic machine, was used and access to typical cognitive aids provided to mirror a real theatre environment.Initially, participants prepared for an anaesthetic induction following standard operating procedures, including performing the World Health Organisation Surgical Safety Checklist. They then carried out this uncomplicated induction with the assistance of a trained Operating Department Practitioner. This aided in embedding good clinical practice and promoted patient safety. A second scenario followed, during which an emergency unfolded. The group observed each scenario through a video link and contributed to a consultant-led debrief. To assess course impact participants completed post-course questionnaires. Confidence universally improved after the course. Every attendee found the course useful and was highly likely to recommend it to a colleague. For several participants, this provided their first experience carrying out an emergency anaesthetic induction without direct supervision. In this setting, simulation has been used as a valuable tool to supplement clinical exposure where there were significant barriers to traditional training methods. We intend to further develop this course to become an integral part of novice anaesthetic training within our trust.
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Harjanto T, Setiyarini S, Prihatiningsih TS. Clinical Learning in Medical and Health Professions Education amid COVID-19 Pandemic: A Literature Review of Various Methods and Innovations. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: COVID-19 has caused disruption to medical education and health care systems around the world. The highly contagious nature of the virus makes it difficult for educational institutions to continue their studies as usual, thus affecting the medical and health professions education which is based on face-to-face lectures, practicum, skills laboratories, and clinical practice in health facilities.
AIM: This paper discovers clinical learning initiatives across the globe and highlights the contribution toward educational processes.
METHODOLOGY: This study utilized an integrated literature review method. A systematic search for articles published was performed in Springer, ScienceDirect, PubMed, and EBSCOHost. Primary search monetary terms were e-learning (all synonyms) and health sciences education (all synonyms), including COVID-19. Articles published within the period of COVID-19 pandemic included in this study. For the synthesis, the 20 included studies selected were coded. In this study, data were synthesized through narrative synthesis using thematic analysis (TA). To identify the recurrent themes author followed six steps when synthesizing data using TA, for example, familiarizing with the data, developing initial (sub) codes, searching for (sub) themes, reviewing (sub) themes, compiling ideas or issues, and producing final data in line with the study aims and objectives.
RESULTS: Out of records identified, a total of citations was screened, of which 20 were found to be of relevance to this study most were quantitative (14.70%) in design. Studies were published in 2020 since the beginning of COVID-19 pandemic. The geographical range of papers covered mostly the moderate-income regions. On conducting TA of the included studies, it was possible to obtain two broad descriptive themes/categories: enablers or drivers of, and barriers or challenges to, under which important themes have emerged.
CONCLUSION: Study suggests that developing e-learning in effective clinical learning is needed, not only limited to moving the learning process but also needing to follow the instructional design, so that learning outcomes can be achieved by students. In addition, a learning process that promotes self-directed-learning is needed so that students have flexibility, use relevant learning styles and are able to integrate knowledge, skills and attitudes as a meaningful learning process.
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Chu LF, Kurup V. Graduate medical education in anaesthesiology and COVID-19: lessons learned from a global pandemic. Curr Opin Anaesthesiol 2021; 34:726-734. [PMID: 34608056 PMCID: PMC8577310 DOI: 10.1097/aco.0000000000001065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The recent global pandemic has dramatically altered the anaesthesiology educational landscape in unexpected ways. It is important that we pause to learn from this crisis. RECENT FINDINGS Most resident trainees actively caring for COVID-19 patients present with probable or subclinical finding of post-traumatic stress disorder. Anaesthesia resident training programmes evolved to continue the mission of anaesthesia education in the face of institutional restrictions and evolving clinical crises. SUMMARY The recent global COVID-19 pandemic has illustrated how external stressors can cause significant disruption to traditional medical education pathways. Resilience to external disruptive forces in anaesthesia education include a willingness of leadership to understand the problem, flexibility in adapting to the needs of learners and instructors in the face of key challenges, deployment of technology and innovation-minded solution-finding where appropriate, and attention to Maslow's hierarchy of needs. VIDEO ABSTRACT http://links.lww.com/COAN/A77.
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Affiliation(s)
- Larry F. Chu
- Department of Anesthesiology, Stanford Anesthesia Informatics and Media (AIM) Lab, Stanford University School of Medicine, Palo Alto California
| | - Viji Kurup
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA
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