Lessons learned during the COVID-19 pandemic: a single institution radiology chief resident experience

A Review of COVID-19's Impact on Radiology Residents' Academics and Wellness in North America

BACKGROUND

The COVID-19 pandemic caused major disruptions in radiology departments throughout North America. Radiology residency programs were forced to make dramatic changes to their training programs, which had major impacts on resident academics and wellness. The goal of this review is to evaluate the impact of COVID-19 on radiology residents' academics and wellness in North America, while also identifying effective measures taken by programs to mitigate the effects of the pandemic.

METHODS

The search strategy involved database search via PubMed, Embase, and Web of Science with specific key words related to COVID-19, radiology residents, education, wellness, and virtual learning. Studies discussing the education and wellness of radiology residents in North America published after 2020 were included. The data were analyzed using a narrative synthesis approach.

RESULTS

The three main domains affected by the pandemic include the residency curriculum, research, and resident wellness. The decline in case volume and diversity of cases had negative overall impact on education of radiology residents, but simulated cases and virtual learning proved its value during the pandemic and may have lasting implications for the postpandemic world. Research initiatives transitioned to a remote format with greater emphasis on quality improvement and COVID-19-related studies. Reduced face-to-face interaction opportunities made it difficult to establish strong and meaningful interpersonal connections and had a negative impact on resident wellness, mentorship, and professional development. Implementing mentorship programs and virtual "town hall meetings" were effective measures to maintain connections during times of social distancing. Finally, the COVID-19 pandemic introduced unprecedented stressors and challenges for radiology residents that negatively impacted their mental health and wellness. Incorporating wellness initiatives such as wellness hours and team-building activities and using social media were helpful in promoting wellness and mental health for radiology residents.

CONCLUSION

The COVID-19 pandemic has had a significant impact on the academics and wellness of radiology residents across North America but has taught us many lessons that can help us navigate the ongoing challenges of the pandemic, the postpandemic world, and future pandemics.

Perception of pediatric residents from a tertiary hospital in the city of México regarding their training during the COVID-19 pandemic

BACKGROUNDS

On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus (COVID-19) outbreak a global pandemic, which changed the residents' teaching and learning process. The purpose of this study was to determine residents' satisfaction and impressions on their training during the pandemic in a tertiary pediatric hospital.

METHODS

This was a descriptive cross-sectional study. An online survey was designed to determine residents' demographic and personal characteristics, as well as their perception about the theoretical and practical training, as well as about their emotional situation. The analysis separated medical students from surgical students in order to identify any differences existing between these groups, for which χ2 was calculated.

RESULTS

Overall, 148 of 171 residents (86.5%) responded to the questionnaire; 75% belonged to the medical specialty and 25% to the surgical specialty. Statistically significant differences were found in terms of those training aspects they were concerned about during the pandemic (p < 0.001) and about the difficulties associated with online learning (p = 0.001). Differences were also found regarding their satisfaction toward the time needed to complete their thesis (p = 0.059) and activities outside the hospital (p = 0.029). Regarding their degree of satisfaction in general, most medical specialty students felt slightly satisfied (43.2%) and surgical specialty students felt mostly neutral (37.8%). Regarding their feelings about their mental health, statistically significant differences were found between both groups (p = 0.038) although both groups reported the same percentage of overall dissatisfaction (2.7%) in this area.

CONCLUSION

The COVID-19 pandemic has brought significant challenges to medical education systems. Lack of practice in decision-making and maneuver execution are concerns for residents and may affect their future professional performance.

Virtual Mentoring: A Guide to Navigating a New Age in Mentorship

Mentorship is a fundamental part of professional and personal growth. Over time, the fabric of mentorship has been transforming from typical one-on-one mentor-mentee relationship to other types including peer, group, speed, and virtual mentoring. When the COVID-19 pandemic hit, it caused major disruptions in many facets of life and career, including mentoring. In response to the COVID-19 pandemic, live meetings were canceled, and social distancing measures were enacted at many institutions. Thus, the traditional set-up, with a face-to-face mentor and mentee interaction, was impossible. Many virtual platforms were utilized to navigate through these restrictions. In this review, we highlight challenges in mentorship during the COVID-19 pandemic and how we implemented different strategies to promote mentorship.

The Impact of the COVID-19 Pandemic on Radiology Resident Education: Where Do We Go From Here?

The Coronavirus Disease of 2019 (COVID-19) pandemic caused a dramatic shift in radiology resident education. Primarily, physical distancing prompted a general transition to virtual learning. Common changes made by radiology residency programs included virtual rounds and readouts, the use of simulation technology, and case-based learning which utilized pedagogical approaches such as the flipped classroom for teaching residents. Virtual learning appears to be a suitable alternative to traditional, in-person learning, and may have a place post-pandemic as part of a blended curriculum with in-person and virtual components. The extent of disruption to radiology resident education varied based on the local impact of COVID-19 and the prevalence of redeployment, as did residents’ mental health and wellbeing. Accessibility of mental health resources for residents was highlighted as an issue that programs need to address during these difficult times. Moreover, the pandemic resulted in unavoidable reductions in procedural exposure which programs mitigated through the use of simulation technologies and virtual learning resources. Professional development activities such as mentorship and career planning were also dramatically impacted by the pandemic and remains a challenge that programs need to consider moving forward post-pandemic. The purpose of this review is to outline the changes made to radiology resident education as a result of the COVID-19 pandemic and suggest what changes may be worthwhile to continue.

Clinical Learning in Medical and Health Professions Education amid COVID-19 Pandemic: A Literature Review of Various Methods and Innovations

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.

Initial Experience With Formal Near-Peer Mentoring in Radiology Residency

Mentorship plays an important role in academic medicine and research. This article describes the implementation of a near-peer mentoring program for radiology residents at a single institution and assesses its utility. Of all invited residents, 100% elected to participate. Among the surveyed participants, 63.8% reported that COVID-19 restrictions resulted in feelings of isolation at work, higher in junior residents (74%) as compared to senior residents (50%). Eighty-three percent of residents agreed that the mentorship program allowed them to engage with residents that they would not routinely spend time with, and nearly all (95.7%) of surveyed residents indicated that they would recommend deployment of this mentorship program at other institutions. Together, these findings demonstrate that near-peer mentoring groups in radiology residency are a valuable addition to the training program, serve to increased resident engagement and sense of community, and provide and internal reference for guidance across resident-related issues.

Impact of COVID-19 on radiology training: Royal College of Radiologists Junior Radiologists Forum national survey

AIM

To obtain a national snapshot of radiology trainees' experience during the first wave of the pandemic.

MATERIALS AND METHODS

A 25-item questionnaire was disseminated to representatives from all training regions across the UK in July 2020. Each representative collated the collective experiences of trainees in their training programme in key domains, including redeployment, shielding, training, and teaching.

RESULTS

Ninety-five percent (38 of 40) of representatives completed the questionnaire. Trainees in up to 76% of training programmes were redeployed to wards and some trainees were shielding in 81% of programmes. Only 27% of programmes enabled remote reporting for isolating or shielding trainees. Sixty-two percent of respondents felt their well-being needs were supported. There was an overall increase in the attendance, volume, and quality of teaching and training nationally due to improved accessibility via remote-learning methods. Significant challenges were described with reporting, interventional procedures, and multidisciplinary team meeting attendance, although 62% of programmes noted an increase in service provision. Less in-person feedback was reported with in-person training still deemed necessary for practical skills. The Royal College of Radiologists Junior Radiologists Forum webinars were well received by all trainees with continuation of the series recommended.

CONCLUSION

The COVID-19 pandemic has had a clear impact on many areas of radiology training in the UK. Early strategies have been adopted to mitigate the challenges faced by trainees and opportunities for future improvement are highlighted.

Special Report of the RSNA COVID-19 Task Force: Crisis Leadership of Major Health System Radiology Departments during COVID-19

Severe acute respiratory syndrome coronavirus 2 has spread across the world since December 2019, infecting 100 million and killing millions. The impact on health care institutions during the coronavirus disease 2019 pandemic has been considerable, with exhaustion of institutional and personal protective equipment resources during local outbreaks and crushing financial consequences for many institutions. Establishing adaptive principles of leadership is necessary during crises, fostering quick decision-making and workflow modifications, while a rapid review of data must determine necessary course corrections. This report describes concepts of crisis leadership teams that can help maximize their effectiveness during the current and future pandemics.

Impact of the COVID-19 outbreak on the profession and psychological wellbeing of radiologists: a nationwide online survey

Background

The COVID-19 outbreak has played havoc within healthcare systems, with radiology sharing a substantial burden. Our purpose is to report findings from a survey on the crisis impact among members of the Italian Society of Medical and Interventional Radiology (SIRM).

Methods

All members were invited to a 42-question online survey about the impact of the COVID-19 outbreak on personal and family life, professional activity, socioeconomic and psychological condition. Participants were classified based on working in the most severely affected Italian regions (“hot regions”) or elsewhere.

Results

A total of 2150 radiologists joined the survey. More than 60% of respondents estimated a workload reduction greater than 50%, with a higher prevalence among private workers in hot regions (72.7% vs 66.5% elsewhere, p = 0.1010). Most respondents were concerned that the COVID-19 outbreak could impact the management of non-COVID-19 patients and expected a work overload after the crisis. More than 40% were moderately or severely worried that their professional activity could be damaged, and most residents believed that their training had been affected. More than 50% of respondents had increased emotional stress at work, including moderate or severe symptoms due to sleep disturbances, feeling like living in slow motion and having negative thoughts, those latter being more likely in single-living respondents from hot regions [log OR 0.7108 (CI95% 0.3445 ÷ 1.0770), p = 0.0001].

Conclusions

The COVID-19 outbreak has had a sensible impact on the working and personal life of SIRM members, with more specific criticalities in hot regions. Our findings could aid preserving the radiologists’ wellbeing after the crisis.

Lessons Learned From the Effects of COVID-19 on the Training and Education Workflow of Radiology Residents-A Time for Reflection: Perspectives of Residency Program Directors and Residents in Canada

PURPOSE

The coronavirus disease 2019 (COVID-19) pandemic has led to widespread changes in all health care settings including academic radiology departments. The purpose of this survey-based study was to investigate the impact of COVID-19 on radiology resident training and education workflow in Canada in terms of the nature, scale, and heterogeneity of the changes, preparedness and adaptation, and perceptions of the present and future of radiology training.

METHODS

A 30-question web-based survey was sent to 17 radiology residency program directors across Canada. A separate 32-question survey was sent to 460 residents currently enrolled in a radiology residency in Canada. These surveys were open for 3 weeks.

RESULTS

We received responses from 16 program directors and 80 residents (response rates 94.1% and 17.4%, respectively). Most respondents agreed that objectives were being met for knowledge and interpretation but less so for case volumes and technical skills. Less time was allotted for on-site activities (eg, readouts) with more time for off-site activities (eg, videoconferencing). Daytime rotations were at least partly cancelled. Most respondents felt these changes were met with enthusiasm by both faculty and residents. However, there were perceived challenges including lack of training on virtual platforms for delivery of teaching and decreased staff-resident interaction, with short- and long-term anxiety reported.

CONCLUSIONS

The coronavirus disease 2019 has dramatically changed radiology resident training in Canada, with increased virtual learning at the expense of cancelled rotations and the resultant reduction in case volumes and staff-resident interaction. Although adopted with enthusiasm, these changes present substantial challenges and anxiety regarding the future of radiology resident education.