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Karimov Z, Ozgiray E. The Effect of COVID-19 in a University Hospital Neurosurgery Clinic Comparison to Prepandemic Period: A Retrospective Study with 6 months of Data. World Neurosurg 2023; 173:e616-e621. [PMID: 36870446 PMCID: PMC9981517 DOI: 10.1016/j.wneu.2023.02.114] [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: 11/11/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic affected all countries' health systems and people's lifestyles. In this study, we aimed to investigate its effects in a university hospital neurosurgery clinic. METHODS The 2019 year's 6 months' data as a prepandemic period compared to the 2020 year's same period as a pandemic date. Demographic data were collected. Operations were divided into seven groups: tumor, spinal, vascular, cerebrospinal fluid disorders, hematoma, local, and minor surgery, respectively. We classified the hematoma cluster into subgroups to evaluate the etiology: epidural, acute subdural, subarachnoid hemorrhage, intracerebral hemorrhage, depressed skull fractures, and others. Patients' COVID-19 test results were collected. RESULTS Total operations decreased from 972 to 795 (Δ18.2%) during the pandemic. All groups, except minor surgery cases, decreased compared to the prepandemic period. Also, vascular procedures for females increased during the pandemic period. While focusing on the hematoma subgroups, there was decreasing in epidural and subdural hematomas, depressed skull fractures, and total case numbers; an increase in subarachnoid hemorrhage and intracerebral hemorrhage. Overall mortality significantly increased to 9.6% from 6.8% during the pandemic (P = 0.033). Eight (1.0%) of 795 patients were COVID-19-positive; three of them died. Neurosurgery residents and academicians were unsatisfied with decreased number of operations, training, and research productivity. CONCLUSIONS The pandemic and restrictions affected negatively the health system and people's access to healthcare. Our retrospective observational study aimed to evaluate these effects and take lessons for the next similar situations. People's access to health care should be considered when lockdown restrictions.
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Affiliation(s)
- Ziya Karimov
- Medicine Program, Ege University Faculty of Medicine, Izmir, Turkiye.
| | - Erkin Ozgiray
- Department of Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkiye
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Gurses ME, Hanalioglu S, Mignucci-Jiménez G, Gökalp E, Gonzalez-Romo NI, Gungor A, Cohen-Gadol AA, Türe U, Lawton MT, Preul MC. Three-Dimensional Modeling and Extended Reality Simulations of the Cross-Sectional Anatomy of the Cerebrum, Cerebellum, and Brainstem. Oper Neurosurg (Hagerstown) 2023:01787389-990000000-00693. [PMID: 37083688 DOI: 10.1227/ons.0000000000000703] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/06/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Understanding the anatomy of the human cerebrum, cerebellum, and brainstem and their 3-dimensional (3D) relationships is critical for neurosurgery. Although 3D photogrammetric models of cadaver brains and 2-dimensional images of postmortem brain slices are available, neurosurgeons lack free access to 3D models of cross-sectional anatomy of the cerebrum, cerebellum, and brainstem that can be simulated in both augmented reality (AR) and virtual reality (VR). OBJECTIVE To create 3D models and AR/VR simulations from 2-dimensional images of cross-sectionally dissected cadaveric specimens of the cerebrum, cerebellum, and brainstem. METHODS The Klingler method was used to prepare 3 cadaveric specimens for dissection in the axial, sagittal, and coronal planes. A series of 3D models and AR/VR simulations were then created using 360° photogrammetry. RESULTS High-resolution 3D models of cross-sectional anatomy of the cerebrum, cerebellum, and brainstem were obtained and used in creating AR/VR simulations. Eleven axial, 9 sagittal, and 7 coronal 3D models were created. The sections were planned to show important deep anatomic structures. These models can be freely rotated, projected onto any surface, viewed from all angles, and examined at various magnifications. CONCLUSION To our knowledge, this detailed study is the first to combine up-to-date technologies (photogrammetry, AR, and VR) for high-resolution 3D visualization of the cross-sectional anatomy of the entire human cerebrum, cerebellum, and brainstem. The resulting 3D images are freely available for use by medical professionals and students for better comprehension of the 3D relationship of the deep and superficial brain anatomy.
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Affiliation(s)
- Muhammet Enes Gurses
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Sahin Hanalioglu
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Giancarlo Mignucci-Jiménez
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Elif Gökalp
- Department of Neurosurgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nicolas I Gonzalez-Romo
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Abuzer Gungor
- Department of Neurosurgery, Yeditepe University Faculty of Medicine, Istanbul, Turkey
| | - Aaron A Cohen-Gadol
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
- The Neurosurgical Atlas, Carmel, Indiana, USA
| | - Uğur Türe
- Department of Neurosurgery, Yeditepe University Faculty of Medicine, Istanbul, Turkey
| | - Michael T Lawton
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Mark C Preul
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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Gonzalez-Romo NI, Hanalioglu S, Mignucci-Jiménez G, Abramov I, Xu Y, Preul MC. Anatomic Depth Estimation and 3-Dimensional Reconstruction of Microsurgical Anatomy Using Monoscopic High-Definition Photogrammetry and Machine Learning. Oper Neurosurg (Hagerstown) 2023; 24:432-444. [PMID: 36701667 DOI: 10.1227/ons.0000000000000544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/17/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Immersive anatomic environments offer an alternative when anatomic laboratory access is limited, but current three-dimensional (3D) renderings are not able to simulate the anatomic detail and surgical perspectives needed for microsurgical education. OBJECTIVE To perform a proof-of-concept study of a novel photogrammetry 3D reconstruction technique, converting high-definition (monoscopic) microsurgical images into a navigable, interactive, immersive anatomy simulation. METHODS Images were acquired from cadaveric dissections and from an open-access comprehensive online microsurgical anatomic image database. A pretrained neural network capable of depth estimation from a single image was used to create depth maps (pixelated images containing distance information that could be used for spatial reprojection and 3D rendering). Virtual reality (VR) experience was assessed using a VR headset, and augmented reality was assessed using a quick response code-based application and a tablet camera. RESULTS Significant correlation was found between processed image depth estimations and neuronavigation-defined coordinates at different levels of magnification. Immersive anatomic models were created from dissection images captured in the authors' laboratory and from images retrieved from the Rhoton Collection. Interactive visualization and magnification allowed multiple perspectives for an enhanced experience in VR. The quick response code offered a convenient method for importing anatomic models into the real world for rehearsal and for comparing other anatomic preparations side by side. CONCLUSION This proof-of-concept study validated the use of machine learning to render 3D reconstructions from 2-dimensional microsurgical images through depth estimation. This spatial information can be used to develop convenient, realistic, and immersive anatomy image models.
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Affiliation(s)
- Nicolas I Gonzalez-Romo
- Department of Neurosurgery, The Loyal and Edith Davis Neurosurgical Research Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
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Kuo CC, Aguirre AO, Kassay A, Donnelly BM, Bakr H, Aly M, Ezzat AA, Soliman MA. A look at the global impact of COVID-19 pandemic on neurosurgical services and residency training. SCIENTIFIC AFRICAN 2023; 19:e01504. [PMID: 36531434 PMCID: PMC9747235 DOI: 10.1016/j.sciaf.2022.e01504] [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: 10/28/2022] [Revised: 11/18/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Background The COVID-19 pandemic has left an indelible effect on healthcare delivery and education system, including residency training. Particularly, neurosurgical departments worldwide had to adapt their operating model to the constantly changing pandemic landscape. This review aimed to quantify the reduction in neurosurgical operative volume and describe the impact of these trends on neurosurgical residency training. Methods We performed a comprehensive search of PubMed and EMBASE between December 2019 and October 2022 to identify studies comparing pre-pandemic and pandemic neurosurgical caseloads as well as articles detailing the impact of COVID-19 on neurosurgery residency training. Statistical analysis of quantitative data was presented as pooled odds ratio (OR) and 95% confidence intervals (CI). Results A total of 49 studies met the inclusion criteria, of which 12 (24.5%) were survey-based. The case volume of elective surgeries and non-elective procedures decreased by 70.4% (OR=0.296, 95%CI 0.210-0.418) and 68.2% (OR=0.318, 95%CI 0.193-0.525), respectively. A significant decrease was also observed in functional (OR=0.542, 95%CI 0.394-0.746), spine (OR=0.545, 95%CI 0.409-0.725), and skull base surgery (OR=0.545, 95%CI 0.409-0.725), whereas the caseloads for tumor (OR=1.029, 95%CI 0.838-1.263), trauma (OR=1.021, 95%CI 0.846-1.232), vascular (OR=1.001, 95%CI 0.870-1.152), and pediatric neurosurgery (OR=0.589, 95%CI 0.344-1.010) remained relatively the same between pre-pandemic and pandemic periods. The reduction in caseloads had caused concerns among residents and program directors in regard to the diminished clinical exposure, financial constraints, and mental well-being. Some positives highlighted were rapid adaptation to virtual educational platforms and increasing time for self-learning and research activities. Conclusion While COVID-19 has brought about significant disruptions in neurosurgical practice and training, this unprecedented challenge has opened the door for technological advances and collaboration that broaden the accessibility of resources and reduce the worldwide gap in neurosurgical education.
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Affiliation(s)
- Cathleen C. Kuo
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA
| | - Alexander O. Aguirre
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA
| | - Andrea Kassay
- Department of Neurosurgery, Western University, Windsor, Canada
| | - Brianna M. Donnelly
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | | | - Mohamed Aly
- Department of Radiology, National Heart Institute, Giza, Egypt
| | - Ahmed A.M. Ezzat
- Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed A.R. Soliman
- Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA,Corresponding author at: Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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Dedeilia A, Papapanou M, Papadopoulos AN, Karela NR, Androutsou A, Mitsopoulou D, Nikolakea M, Konstantinidis C, Papageorgakopoulou M, Sideris M, Johnson EO, Fitzpatrick S, Cometto G, Campbell J, Sotiropoulos MG. Health worker education during the COVID-19 pandemic: global disruption, responses and lessons for the future-a systematic review and meta-analysis. HUMAN RESOURCES FOR HEALTH 2023; 21:13. [PMID: 36829158 PMCID: PMC9951171 DOI: 10.1186/s12960-023-00799-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This systematic review and meta-analysis identified early evidence quantifying the disruption to the education of health workers by the COVID-19 pandemic, ensuing policy responses and their outcomes. METHODS Following a pre-registered protocol and PRISMA/AMSTAR-2 guidelines, we systematically screened MEDLINE, EMBASE, Web of Science, CENTRAL, clinicaltrials.gov and Google Scholar from January 2020 to July 2022. We pooled proportion estimates via random-effects meta-analyses and explored subgroup differences by gender, occupational group, training stage, WHO regions/continents, and study end-year. We assessed risk of bias (Newcastle-Ottawa scale for observational studies, RοB2 for randomized controlled trials [RCT]) and rated evidence certainty using GRADE. RESULTS Of the 171 489 publications screened, 2 249 were eligible, incorporating 2 212 observational studies and 37 RCTs, representing feedback from 1 109 818 learners and 22 204 faculty. The sample mostly consisted of undergraduates, medical doctors, and studies from institutions in Asia. Perceived training disruption was estimated at 71.1% (95% confidence interval 67.9-74.2) and learner redeployment at 29.2% (25.3-33.2). About one in three learners screened positive for anxiety (32.3%, 28.5-36.2), depression (32.0%, 27.9-36.2), burnout (38.8%, 33.4-44.3) or insomnia (30.9%, 20.8-41.9). Policy responses included shifting to online learning, innovations in assessment, COVID-19-specific courses, volunteerism, and measures for learner safety. For outcomes of policy responses, most of the literature related to perceptions and preferences. More than two-thirds of learners (75.9%, 74.2-77.7) were satisfied with online learning (postgraduates more than undergraduates), while faculty satisfaction rate was slightly lower (71.8%, 66.7-76.7). Learners preferred an in-person component: blended learning 56.0% (51.2-60.7), face-to-face 48.8% (45.4-52.1), and online-only 32.0% (29.3-34.8). They supported continuation of the virtual format as part of a blended system (68.1%, 64.6-71.5). Subgroup differences provided valuable insights despite not resolving the considerable heterogeneity. All outcomes were assessed as very-low-certainty evidence. CONCLUSION The COVID-19 pandemic has severely disrupted health worker education, inflicting a substantial mental health burden on learners. Its impacts on career choices, volunteerism, pedagogical approaches and mental health of learners have implications for educational design, measures to protect and support learners, faculty and health workers, and workforce planning. Online learning may achieve learner satisfaction as part of a short-term solution or integrated into a blended model in the post-pandemic future.
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Affiliation(s)
- Aikaterini Dedeilia
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
| | - Michail Papapanou
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Society of Junior Doctors (SJD), Athens, Greece
| | - Andreas N Papadopoulos
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nina-Rafailia Karela
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Androutsou
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitra Mitsopoulou
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Melina Nikolakea
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Konstantinidis
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Manthia Papageorgakopoulou
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece
- School of Medicine, University of Patras, Patras, Greece
| | - Michail Sideris
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | | | | | - Giorgio Cometto
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Jim Campbell
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Marinos G Sotiropoulos
- Harvard Medical School, Boston, MA, USA.
- HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece.
- Department of Neurology, Brigham and Women's Hospital & Massachusetts General Hospital, 55 Fruit Street, WACC721, Boston, MA, 02114, USA.
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Hanalioglu S, Romo NG, Mignucci-Jiménez G, Tunc O, Gurses ME, Abramov I, Xu Y, Sahin B, Isikay I, Tatar I, Berker M, Lawton MT, Preul MC. Development and Validation of a Novel Methodological Pipeline to Integrate Neuroimaging and Photogrammetry for Immersive 3D Cadaveric Neurosurgical Simulation. Front Surg 2022; 9:878378. [PMID: 35651686 PMCID: PMC9149243 DOI: 10.3389/fsurg.2022.878378] [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: 02/17/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Visualizing and comprehending 3-dimensional (3D) neuroanatomy is challenging. Cadaver dissection is limited by low availability, high cost, and the need for specialized facilities. New technologies, including 3D rendering of neuroimaging, 3D pictures, and 3D videos, are filling this gap and facilitating learning, but they also have limitations. This proof-of-concept study explored the feasibility of combining the spatial accuracy of 3D reconstructed neuroimaging data with realistic texture and fine anatomical details from 3D photogrammetry to create high-fidelity cadaveric neurosurgical simulations. Methods Four fixed and injected cadaver heads underwent neuroimaging. To create 3D virtual models, surfaces were rendered using magnetic resonance imaging (MRI) and computed tomography (CT) scans, and segmented anatomical structures were created. A stepwise pterional craniotomy procedure was performed with synchronous neuronavigation and photogrammetry data collection. All points acquired in 3D navigational space were imported and registered in a 3D virtual model space. A novel machine learning-assisted monocular-depth estimation tool was used to create 3D reconstructions of 2-dimensional (2D) photographs. Depth maps were converted into 3D mesh geometry, which was merged with the 3D virtual model’s brain surface anatomy to test its accuracy. Quantitative measurements were used to validate the spatial accuracy of 3D reconstructions of different techniques. Results Successful multilayered 3D virtual models were created using volumetric neuroimaging data. The monocular-depth estimation technique created qualitatively accurate 3D representations of photographs. When 2 models were merged, 63% of surface maps were perfectly matched (mean [SD] deviation 0.7 ± 1.9 mm; range −7 to 7 mm). Maximal distortions were observed at the epicenter and toward the edges of the imaged surfaces. Virtual 3D models provided accurate virtual measurements (margin of error <1.5 mm) as validated by cross-measurements performed in a real-world setting. Conclusion The novel technique of co-registering neuroimaging and photogrammetry-based 3D models can (1) substantially supplement anatomical knowledge by adding detail and texture to 3D virtual models, (2) meaningfully improve the spatial accuracy of 3D photogrammetry, (3) allow for accurate quantitative measurements without the need for actual dissection, (4) digitalize the complete surface anatomy of a cadaver, and (5) be used in realistic surgical simulations to improve neurosurgical education.
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Affiliation(s)
- Sahin Hanalioglu
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nicolas Gonzalez Romo
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Giancarlo Mignucci-Jiménez
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Osman Tunc
- BTech Innovation, METU Technopark, Ankara, Turkey
| | - Muhammet Enes Gurses
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Irakliy Abramov
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Yuan Xu
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Balkan Sahin
- Department of Neurosurgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ilkay Isikay
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ilkan Tatar
- Department of Anatomy, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Berker
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Michael T. Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Mark C. Preul
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
- Correspondence: Mark C. Preul
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Çevik H, Ungan M. The impacts of the COVID-19 pandemic on the mental health and residency training of family medicine residents: findings from a nationwide cross-sectional survey in Turkey. BMC FAMILY PRACTICE 2021; 22:226. [PMID: 34781878 PMCID: PMC8591155 DOI: 10.1186/s12875-021-01576-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/29/2021] [Indexed: 12/02/2022]
Abstract
Background The COVID-19 pandemic has had a negative impact on resident training in different branches and affected the physical and mental health of frontline residents adversely. This nationwide cross-sectional survey aimed to investigate the effects of the COVID-19 pandemic on family medicine residents in Turkey, including the levels of depression and burnout. Methods An anonymous online survey was distributed to all family medicine residents via e-mail and a web link between 28.11.2020 and 12.12.2020. Information on sociodemographic data and the residency programme were evaluated, and factors associated with depression and burnout were examined using the Patient Health Questionnaire-9 (PHQ-9) and the Burnout Measure-Short Version (BMS) respectively. Results Although the weekly average working hours of the 477 respondents increased significantly during the pandemic (p < 0.05), the average weekly working time in the Family Medicine (FM) outpatient clinic decreased. The greatest concern of 58.3% of the residents was fear of transmitting COVID-19 to their family members. 90.2% of the residents stated that training programmes were negatively or very negatively affected. According to PHQ-9 scores, 15.7% of residents had moderately severe, and 14.9% severe depression. The BMS scores of the residents demonstrated that 24.1% had a very severe burnout problem, and 23.3% should seek professional help as soon as possible. Being single, having no children, female gender, lack of personal protective equipments and increased contact time with COVID-19 patients were associated with higher scores in the depression and burnout scales (p < 0.05). Conclusions The COVID-19 pandemic has had a negative impact on training programmes for FM residents, who are at the forefront of the pandemic in Turkey, and this situation is closely related to depression and burnout. Due to the unpredictability of the pandemic, long-term plans should be made for the training needs of residents in order to protect their physical and mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01576-9.
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Affiliation(s)
- Hüsna Çevik
- Çankaya District Health Directorate, Hacettepe Mah. Talatpaşa Blv. No: 44 Altındağ, Ankara, Turkey.
| | - Mehmet Ungan
- Family Medicine Department, Ankara University Medical School, Ankara, Turkey
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The Impact of the Coronavirus Pandemic on European Neurosurgery Trainees. World Neurosurg 2021; 154:e283-e291. [PMID: 34252632 PMCID: PMC8461641 DOI: 10.1016/j.wneu.2021.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/05/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has placed tremendous strain on the national health care systems throughout Europe. As a result, there has been a significant influence on residents' education. We surveyed European neurosurgery residents to estimate the magnitude of the pandemic's impact on neurosurgical training. METHODS An anonymous, voluntary, 44-question, web-based survey was administered to European neurosurgical residents from November 2, 2020, to January 15, 2021, by e-mail invitation. Close-ended, multiple-choice questions were used to examine the perspectives of neurosurgical trainees of different training programs in Europe regarding the pandemic's impact on education, as well as to evaluate the online webinars as a sufficient alternative educational tool, and their future role. RESULTS The total number of participants was 134 from 22 European countries. Nearly 88.8 % of respondents reported that the pandemic had a negative influence on their education. A statically significant decrease in surgical exposure, outpatient clinic involvement, and working hours was observed (P < 0.05). Webinars, although widely disseminated, were not considered as a sufficient training alternative. CONCLUSIONS The SARS-CoV-2 pandemic had a significant impact on neurosurgical training. During the last year, with the outbreak of the pandemic, formal training education was heavily compromised. Online webinars do not seem to be a sufficient alternative, and some trainees estimate that a whole year of training has been compromised. Our current data have to be cautiously considered for possibly reorganizing the whole training experience. The pandemic may well function as a stimulus for optimizing neurosurgical training.
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