Rapid Dissemination of a COVID-19 Airway Management Simulation Using a Train-the-Trainers Curriculum

Hospitals' Collaborations Strengthen Pandemic Preparedness: Lessons Learnt from COVID-19

BACKGROUND

The COVID-19 pandemic strained healthcare systems around the world. This study aims to understand the preparedness of private remote hospitals in Lebanon to respond to the pandemic and evaluate the impact of inter-hospital collaborations on the hospitals' readiness.

METHODS

A multi-centered study was conducted between August 2020 and June 2021 in ten Lebanese private remote hospitals based on a mixed-methods embedded approach where the quantitative supported the qualitative. Through the AUB-USAID (American University of Beirut-United States Agency for International Development) COVID-19 project, these hospitals received personal protective equipment and medical equipment in addition to COVID-19-related training using the Train-the-Trainer model. The quantitative part used knowledge and evaluation questionnaires and a pre-post-intervention hospital preparedness checklist. The qualitative approach adopted semi-structured interviews with a purposive sample from key hospital personnel. Quantitative data were analyzed using SPSS version 27, and a p-value of <0.05 was considered to be statistically significant. For the qualitative data, a thematic analysis was performed by adopting the six-phase process described by Braun and Clarke.

RESULTS

Of the 393 healthcare workers who attended the training and completed the evaluation questionnaire, 326 completed the pre- and post-training knowledge questionnaire. A significant improvement was observed in mean knowledge scores following training for infection control, nursing, and polymerase chain reaction sampling staff (p-value < 0.001, p-value < 0.001, and p-value = 0.006, respectively), but not for housekeeping staff. More than 93% of the participants showed high trainer and content evaluation scores. As for the hospitals' preparedness assessments, there was a clear improvement in the pre- and post-assessment scores for each hospital, and there was a significant difference in the mean of the total scores of partner hospitals pre- and post-USAID-AUB project (p-value = 0.005). These findings were supported by the qualitative analysis, where nine hospitals expressed the positive impact of the USAID-AUB intervention in improving their preparedness to respond to the COVID-19 pandemic at a critical time when it was highly needed. Despite the intervention, persistent challenges remained.

CONCLUSIONS

A timely and proactive collaborative program between academic/tertiary care centers and remote community hospitals that includes sharing supplies and expertise is feasible and highly effective during public health emergencies.

Education and Training Adaptations for Health Workers during the COVID-19 Pandemic: A Scoping Review of Lessons Learned and Innovations

Introduction: The COVID-19 pandemic has considerably impacted the clinical education and training of health workers globally, causing severe disruptions to learning environments in healthcare facilities and limiting the acquisition of new clinical skills. Consequently, urgent adaptation measures, including simulation training and e-learning, have been implemented to mitigate the adverse effects of clinical education. This scoping review aims to assess the impact of COVID-19 on medical education and training, examine the implemented adaptation measures, and evaluate their effectiveness in improving health workers' education and training during the pandemic. Methods: Employing the PRISMA-ScR framework and Arksey and O'Malley's methodological guidance, we conducted a scoping review, systematically searching PubMed, medRxiv, Google, and DuckDuckGo databases to account for the grey literature. The search included studies published between 1 December 2019 and 13 October 2021, yielding 10,323 results. Of these, 88 studies focused on health worker education and training during the pandemic. Results: Our review incorporated 31,268 participants, including physicians, medical trainees, nurses, paramedics, students, and health educators. Most studies (71/88, 81%) were conducted in high-income and lower-middle-income countries. The pandemic's effects on health workers' clinical skills and abilities have necessitated training period extensions in some cases. We identified several positive outcomes from the implementation of simulation training and e-learning as adaptation strategies, such as enhanced technical and clinical performance, increased confidence and comfort, and an expanded global educational outreach. Conclusions: Despite challenges like insufficient practical experience, limited interpersonal interaction opportunities, and internet connectivity issues, simulation training, e-learning, and virtual training have proven effective in improving clinical education and training during the COVID-19 pandemic. Further research is required to bolster preparedness for future pandemics or similar situations.

Analysis of the Protective Effect of Infection Controllers Supervising Third-Party Personnel Entering and Leaving Shanghai Fangcang Shelter Hospital

Objective

To analyze the impact of the new supervision and management methods of infection controllers on the protection of third-party personnel entering and leaving Shanghai Fangcang shelter hospital, to provide a reference for the management of third-party personnel in Fangcang shelter hospitals.

Methods

A total of 200 third-party personnel received with traditional supervision and management methods, and 156 received new supervision and management methods from the Fangcang shelter hospital of the Shanghai International Convention and Exhibition Center. The sociodemographic characteristics of third-party personnel, including gender, age, education level, work experience in fighting the epidemic with safety awareness, was analyzed. The effects of the two different management modes on the protection of third-party personnel were statistically analyzed by the Chi-square test or logistic regression analysis.

Results

There were statistically significant differences in the incidence of infection among third-party personnel in terms of age, education level, work experience in fighting the epidemic in traditional supervision and management group, and whether they accepted the new supervision and management model had statistically significant differences (p <0.05). The main causes of incorrect put on and take off protective clothing, such as wrong way to detach the face screen, wrong way to remove goggles, wrong way to undress protective clothing, wrong way to take off the shoe cover, hand washing steps omitted, are that causes infection of third-party personnel (p <0.05).

Conclusion

The new supervision and management model can reduce the infection rate of third-party personnel in Fangcang shelter hospitals through planned and purposeful training in terms of different age groups, education levels, work experience, and acceptance of protection knowledge.

Challenges and opportunities for educating health professionals after the COVID-19 pandemic

The education of health professionals substantially changed before, during, and after the COVID-19 pandemic. A 2010 Lancet Commission examined the 100-year history of health-professional education, beginning with the 1910 Flexner report. Since the publication of the Lancet Commission, several transformative developments have happened, including in competency-based education, interprofessional education, and the large-scale application of information technology to education. Although the COVID-19 pandemic did not initiate these developments, it increased their implementation, and they are likely to have a long-term effect on health-professional education. They converge with other societal changes, such as globalisation of health care and increasing concerns of health disparities across the world, that were exacerbated by the pandemic. In this Health Policy, we list institutional and instructional reforms to assess what has happened to health-professional education since the publication of the Lancet Commission and how the COVID-19 pandemic altered the education process.