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Liu W, Wei H, Wang C, Hua Z. Resilience and adaptation: a mixed-methods exploration of COVID-19's influence on neonatal residency education in China. BMC MEDICAL EDUCATION 2024; 24:654. [PMID: 38862921 PMCID: PMC11167867 DOI: 10.1186/s12909-024-05638-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND This study aimed to assess the impact of the pandemic of the coronavirus disease 2019 (COVID-19) on neonatology residency training in a tertiary children's hospital in Chongqing, located in southwest China. Specifically, the study encompassed the effects on residents' education, lived experiences, well-being, and the quality of neonatal care delivered. As higher educational institutions adapt to the post-COVID-19 era after the pandemic disruption, it is imperative that educational designers/academics learn from their experiences and challenges in curriculum design and delivery, ensuring quality and relevance in education. METHODS This study employed a mixed-methods approach to investigate the influence of the COVID-19 pandemic on neonatology residency training at a tertiary children's hospital in Chongqing. The first phase surveyed residents' perceptions and experiences of their clinical education and well-being during the crisis. The second phase compared the quality of neonatal care between the pre-pandemic and pandemic periods. RESULTS The survey of 123 neonatology residents examines the effects of COVID-19 on their learning, training, and mental health. The survey showed that most residents adapted well to the situation. Still, some faced challenges in their clinical education and experiences, such as reduced clinical exposure and opportunities to see rare diseases and conditions. A retrospective analysis of clinical data revealed that 7,151 neonates were admitted to the neonatology department during the study period. There was a 27.6% decrease in neonatal admissions during COVID-19, with more premature births and transfers. Residents conducted fewer clinical procedures but managed more complex cases. During COVID, hospital stays and costs were higher, but antibiotic use was lower. Although the case-mix index (CMI) score increased during the pandemic (1.25 vs. 1.18, p < 0.05), there was no significant difference in the rates of readmission within 7 days or poor prognosis. CONCLUSIONS Despite reduced clinical exposure, the quality of neonatal care was maintained through innovative training methods that enhanced comprehensive residency programs. The study suggested that neonatology residency education remained effective and resilient during the crisis. Exceptional health professional education is vital to train qualified physicians and enhance healthcare systems for future challenges.
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Affiliation(s)
- Weiqin Liu
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
- Faculty of Internal Medicine, The Pediatric College, Chongqing Medical University, Chongqing, China
- National Demonstration Base for Standardized Residency Training, Chongqing, China
| | - Hong Wei
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
- Faculty of Internal Medicine, The Pediatric College, Chongqing Medical University, Chongqing, China
| | - Chunyi Wang
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Demonstration Base for Standardized Residency Training, Chongqing, China
| | - Ziyu Hua
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China.
- Faculty of Internal Medicine, The Pediatric College, Chongqing Medical University, Chongqing, China.
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Bozkurt I, Holt MW, Robinson EC, Chaurasia B, Zileli M. Do we really apply evidence-based-recommendations to spine surgery? Results of an international survey. Neurosurg Rev 2024; 47:264. [PMID: 38856823 PMCID: PMC11164786 DOI: 10.1007/s10143-024-02502-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/01/2024] [Accepted: 06/04/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVE This international survey investigated Evidence-Based Medicine (EBM) in spine surgery by measuring its acceptance among spine surgeons. It assessed their understanding of EBM and how they apply it in practice by analyzing responses to various clinical scenarios.. MATERIALS AND METHODS Following the CHERRIES guidelines, an e-survey was distributed to multiple social media forums for neurosurgeons and orthopedic surgeons on Facebook, LinkedIn, and Telegram and circulated further through email via the authors' network. Three hundred participants from Africa, Asia, Europe, North America, and Oceania completed the survey. RESULTS Our study revealed that 67.7% (n = 203) of respondents used EBM in their practice, and 97.3% (n = 292) believed training in research methodology and EBM was necessary for the practice of spine surgery. Despite this endorsement of using EBM in spine surgery, we observed varied responses to how EBM is applied in practice based on example scenarios. The responders who had additional training tended to obey EBM guidelines more than those who had no additional training. Most surgeons responded as always or sometimes prescribing methylprednisolone to patients with acute spinal cord injury. Other significant differences were identified between geographical regions, training, practice settings, and other factors. CONCLUSIONS Most respondents used EBM in practice and believed training in research methodology and EBM is necessary for spine surgery; however, there were significant variations on how to use them per case. Thus, the appropriate application of EBM in clinical settings for spinal surgery must be further studied.
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Affiliation(s)
- Ismail Bozkurt
- Department of Neurosurgery, Medical Park Ankara Hospital, Ankara, Turkey
- Department of Neurosurgery, School of Medicine, Yuksek Ihtisas University, Ankara, Turkey
| | - Matthew W Holt
- Department of Natural Sciences, University of South Carolina Beaufort, Bluffton, SC, USA.
| | | | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj, Nepal
| | - Mehmet Zileli
- Department of Neurosurgery, Sanko University, Gaziantep, Turkey
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Pollet N, Trommer M, Shabli S, Marnitz S, Sharma SJ. [The COVID-pandemic and specialist training in Head and Neck oncology: A Survey among Physicians]. Laryngorhinootologie 2024; 103:432-442. [PMID: 38467160 DOI: 10.1055/a-2259-9492] [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: 03/13/2024]
Abstract
OBJECTIVE The COVID-19 pandemic has had a profound impact on the healthcare system and medical education. In this publication, the influence of the pandemic on the education of physicians active in Head and Neck oncology was examined using a survey. METHODS A survey comprising 53 questions was conducted to gather data on work settings, daily activities, team events, and educational aspects during the pandemic. A total of 497 oncologists participated, including 131 individuals working in the field of Head and Neck oncology. This subgroup consisted of 99 (75.6%) radiation oncologists, 10 (7.6%) maxillofacial specialists, and 22 (16.8%) otolaryngologists. RESULTS Nearly half of the participants reported experiencing increased clinical burden, which resulted in reduced engagement in scientific activities. Digital platforms became the predominant mode of continuing education, albeit with reduced accessibility. The pandemic significantly impacted clinical training that involved direct patient interaction. On the other hand, positive effects were observed in terms of cost and availability for external educational events such as conferences. CONCLUSION The findings highlight the detrimental effects of the COVID-19 pandemic on various aspects of medical education. While digitalization has accelerated in response, many physicians expressed a lack of professional interaction. Developing alternative digital learning platforms can provide a means to better cope with similar situations in the future. However, the importance of personal contact with colleagues and supervisors should not be overlooked when considering the quality of teaching.
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Affiliation(s)
- Naomi Pollet
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Uniklinik Köln, Koln, Germany
| | - Maike Trommer
- Radioonkologie, Cyberknife- und Strahlentherapie, Uniklinik Köln, Köln, Germany
| | - Sami Shabli
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Uniklinik Koln, Koln, Germany
| | | | - Shachi Jenny Sharma
- Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Uniklinik Köln, Koln, Germany
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Mohd Noor MN, Fatima S, Grace Cockburn J, Romli MH, Pallath V, Hong WH, Vadivelu J, Foong CC. Systematic review of feedback literacy instruments for health professions students. Heliyon 2024; 10:e31070. [PMID: 38813152 PMCID: PMC11133658 DOI: 10.1016/j.heliyon.2024.e31070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 05/06/2024] [Accepted: 05/09/2024] [Indexed: 05/31/2024] Open
Abstract
Successfully managing and utilizing feedback is a critical skill for self-improvement. Properly identifying feedback literacy level is crucial to facilitate teachers and learners especially in clinical learning to plan for better learning experience. The present review aimed to gather and examine the existing definitions and metrics used to assess feedback literacy (or parts of its concepts) for health professions education. A systematic search was conducted on six databases, together with a manual search in January 2023. Quality of the included studies were appraised using the COSMIN Checklist. Information on the psychometric properties and clinical utility of the accepted instruments were extracted. A total 2226 records of studies were identified, and 11 articles included in the final analysis extracting 13 instruments. These instruments can be administered easily, and most are readily accessible. However, 'appreciating feedback' was overrepresented compared to the other three features of feedback literacy and none of the instruments had sufficient quality across all COSMIN validity rating sections. Further research studies should focus on developing and refining feedback literacy instruments that can be adapted to many contexts within health professions education. Future research should apply a rigorous methodology to produce a valid and reliable student feedback literacy instrument.
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Affiliation(s)
| | - Sahar Fatima
- Medical Education and Research Development Unit, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | | | - Vinod Pallath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Wei-Han Hong
- Medical Education and Research Development Unit, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Jamuna Vadivelu
- Medical Education and Research Development Unit, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chan Chong Foong
- Medical Education and Research Development Unit, Universiti Malaya, Kuala Lumpur, Malaysia
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Can S, Aktoz F. Laparoscopic myomectomy videos on WebSurg and YouTube: does peer review process make a difference? J Turk Ger Gynecol Assoc 2024; 25:24-29. [PMID: 38445464 PMCID: PMC10921074 DOI: 10.4274/jtgga.galenos.2023.2023-5-7] [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: 07/05/2023] [Accepted: 10/02/2023] [Indexed: 03/07/2024] Open
Abstract
Objective This study aimed to evaluate the quality of laparoscopic myomectomy videos on YouTube and WebSurg. Material and Methods We searched using the keyword "laparoscopic myomectomy" on WebSurg and selected surgical interventions in the gynecology section. Eleven videos on WebSurg were enrolled. We selected the 22 most-relevant videos on YouTube to create a comparison group, with a ratio of 1:2. Sound in videos, number of subscribers, views, likes, and comments, number of days since videos were uploaded and durations of videos were recorded. View/day, like/view, like/subscriber, and view/subscriber ratios were calculated. The videos were evaluated with usefulness score (US), global quality scoring (GQS), modified discern score (mDS) and laparoscopic surgery video educational guidelines (LAP-VEGaS). Results The view/day ratio was lower in WebSurg compared to YouTube [1.3 (1.9) vs. 7.5 (30.6), respectively; p=0.039]. No difference was found between WebSurg and YouTube in terms of US, GQS and mDS. On LAP-VEGaS assessment, WebSurg was found to be superior to YouTube in terms of intraoperative findings [2 (1-2) vs. 1 (0-2), p=0.001], additional materials [1 (0-2) vs. 1 (0-1), p=0.041], audio/written commentary [2 (2-2) vs. 2 (0-2), p=0.037], image quality [2 (2-2) vs. 2 (0-2), p=0.023], questions and total score [12 (11-13) vs. 10.5 (4-13), p=0.006]. The proportion of high-quality video was higher in WebSurg compared to YouTube, when the cut-off value of total score of 11 or 12 was used as 10 (100%) vs. 10 (50%), p=0.011 and 9 (90%) vs. 5 (25%), p=0.001, respectively. Conclusion WebSurg was better compared to YouTube in terms of quality of laparoscopic myomectomy videos.
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Affiliation(s)
- Sultan Can
- Clinic of Obstetrics and Gynecology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Fatih Aktoz
- American Hospital, Women’s Health Center, İstanbul, Turkey
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Ben Ammer A, Bryan JL, Asghar-Ali AA. The Impact of COVID-19 in Reshaping Graduate Medical Education: Harnessing Hybrid Learning and Virtual Training. Cureus 2024; 16:e56790. [PMID: 38650783 PMCID: PMC11034976 DOI: 10.7759/cureus.56790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction At the start of the COVID-19 pandemic, many graduate medical education (GME) programs switched from in-person to virtual training to ensure a safe learning environment. However, the preferences of US residents in the wake of the COVID-19 pandemic are largely unknown. Objective The authors surveyed PGY-2 psychiatry residents about their perception of the pandemic's impact on their clinical skills, didactics experience, training preferences, and future career perceptions. Methods The cross-sectional study was conducted from October 31, 2021, to December 31, 2021. The authors emailed a survey to directors of US general psychiatry residency programs to disseminate to PGY-2 residents. The survey had Likert-scale and open-ended questions about the pandemic's perceived impact on PGY-1 training and future training preferences. The authors used descriptive statistics for Likert-scale questions and reflexive thematic analysis for open-ended questions. Results Out of an estimated 1800 residents, only 116 (6.4%) participated; post-pandemic preferences emerged. A strong preference was expressed for hybrid didactics, combining in-person and virtual learning. Virtual patient evaluations, especially in emergency and inpatient settings, were highly valued. Conversely, entirely virtual didactics and clinical rounds were deemed least preferred, emphasizing the importance of interactive, hands-on learning experiences. Conclusions Respondents emphasized the significance of incorporating hybrid models for both in-patient care and didactic sessions in GME. These preferences signify the need for adaptable and flexible approaches to education in psychiatry residency programs as we emerge from the pandemic.
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Affiliation(s)
- Abdualla Ben Ammer
- Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, USA
| | - Jennifer L Bryan
- South Central Mental Illness Research, Education and Clinical Center, Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
- Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, USA
- Veterans Affairs Health Systems Research Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
| | - Ali Abbas Asghar-Ali
- South Central Mental Illness Research, Education and Clinical Center, Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
- Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, USA
- Veterans Affairs Health Systems Research Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
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Wang T, O'Neill TR, Peterson LE, Newton WP. COVID-19 Impact on Family Medicine Residents Exam Performance. Fam Med 2024; 56:163-168. [PMID: 38467034 PMCID: PMC11136621 DOI: 10.22454/fammed.2024.719362] [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] [Indexed: 03/13/2024]
Abstract
BACKGROUND AND OBJECTIVES The COVID-19 pandemic began interrupting family medicine residency training in spring 2020. While a decline in scores on the American Board of Family Medicine In-Training Examination (ITE) has been observed, whether this decline has translated into the high-stakes Family Medicine Certification Examination (FMCE) is unclear. The goal of this study was to systematically assess the magnitude of COVID-19 impact on medical knowledge acquisition during residency, as measured by the ITE and FMCE. METHODS A total of 19,101 initial certification candidates from 2017 to 2022 were included in this study. Annual ITE scores and FMCE scores were reported on the same scale (200-800) and served as the outcome measure. We conducted multilevel regression analysis to determine ITE score growth and FMCE scores compared to cohorts prior to COVID-19. RESULTS During COVID-19, the increase in ITE scores from postgraduate year 2 (PGY-2) to PGY-3 was 25.5 points less, representing a 57.6% relative decrease; and from PGY-3 ITE to FMCE, it was 8.6 points less, a 12.7% relative decrease, compared with cohorts prior to COVID-19. FMCE scores were 6.6 points less during COVID-19, representing a 1.2% relative decline from the average FMCE score prior to COVID-19. CONCLUSIONS This study found nonsubstantive COVID-19 impact on FMCE scores, but a considerable knowledge acquisition decline during residency, especially during the PGY-2 to PGY-3 period. While COVID-19 impacted learning, our findings indicated that residencies were largely able to remediate knowledge deficits before residents took the FMCE.
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Affiliation(s)
- Ting Wang
- American Board of Family MedicineLexington, KY
| | | | - Lars E. Peterson
- American Board of Family MedicineLexington, KY
- Department of Family and Community Medicine, College of Medicine, University of KentuckyLexington, KY
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Clapper TC, Sewell TB, Shen W, Ching K, Solomon AB, Burns KP, Martin PB, Turetz ML, Crawford CV, Joyce CL, Landres IV, Rajwani K. Delivering bad or difficult news. An innovative simulation-based education approach to prepare interdisciplinary fellowships. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024; 17:44-50. [PMID: 36951354 DOI: 10.1080/17538068.2023.2192578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND There is limited data on the effectiveness of training interventions to improve the delivery of bad news. METHODS This preliminary research included pre-post assessments and an open-ended survey to evaluate the effectiveness and perceived value of training on delivering bad news for 26 first- and second-year fellows from five adult and pediatric fellowship programs. RESULTS There was a significant increase in faculty assessment scores (34.5 vs. 41.0, respectively, Z = -3.661, p < 0.001) and Standardized Patient (SP) assessment scores (37.5 vs .44.5, respectively, Z = -2.244, p = 0.025). Fellows valued having a standard framework to aid in the delivery of bad news; receiving targeted feedback and having the opportunity to apply their skills in a subsequent case. CONCLUSIONS A one-hour, four-phase lesson plan that includes an individualized training approach and simulation do-overs can be effective and valuable for preparing fellows to deliver bad news.
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Affiliation(s)
- Timothy C Clapper
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Taylor B Sewell
- Division of Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, New York, NY, USA
| | - Winifred Shen
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Kevin Ching
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Aliza B Solomon
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Kyle P Burns
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Paul B Martin
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Meredith L Turetz
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Carl V Crawford
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Christine L Joyce
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Inna V Landres
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
| | - Kapil Rajwani
- Weill Cornell Medical College, NewYork-Presbyterian, New York, NY, USA
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Kubbara EA, Ahmed NM, Alamri T, Bakarman MA, Malibary H, Eid R, Alzahrani AO. Online case-based learning for medical students as a teaching method for biochemistry at King Abdulaziz University amid COVID-19 pandemic (a study conducted in 2021). BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2024; 52:136-144. [PMID: 37850840 DOI: 10.1002/bmb.21795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023]
Abstract
Online case-based learning (CBL) is a method used by King Abdulaziz University to teach medical students in their preclinical years. The use of CBL in basic sciences is important for enabling medical students to correlate basic sciences with future clinical practice. This study implemented online CBL for biochemistry teaching as part of the medical genetic module for 3rd-year preclinical students. Teaching during the study was completely online because of restricted precautions caused by the COVID-19 pandemic, except for practical sessions that were held on campus. The case was presented to the students involved in prenatal screening and diagnosis. Students were guided to learn and discuss the biochemical tests used for prenatal screening and diagnosis and their clinical importance. They were divided into two groups: the control group was given an online lecture and the intervention group was given an online CBL session before the lecture. The online lecture was given to both groups simultaneously by the same instructor, and then 10 MCQs tests were distributed to both groups after the lecture, and their test scores were compared. A 10-question survey was administered to the intervention group to assess their perception of the online CBL session after the test. A significant difference was found between the intervention and control groups regarding test scores (p < 0.001), and most students found the online CBL session enjoyable and motivating.
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Affiliation(s)
- Eman A Kubbara
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia
- Department of Clinical Biochemistry and Molecular Biology, Faculty of Medicine, Al-Neelain University, Khartoum, Sudan
| | - Nasreldin Marhoum Ahmed
- Department of Medical Education, College of Medicine, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia
| | - Turki Alamri
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Marwan A Bakarman
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Husam Malibary
- Department of Internal Medicine, Faculty of Medicine, King Abdul-Aziz University, Rabigh, Saudi Arabia
| | - Rasha Eid
- Faculty of Medicine, King Abdul-Aziz University, Rabigh, Saudi Arabia
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Ron I, Kyin C, Zari DS, Peskin B, Ghrayeb N, Norman D, Shapira J. COVID-19 Resulted in Reduction Trainee Bedside Experience, But No Reduction in Surgical Experience. Arthrosc Sports Med Rehabil 2024; 6:100856. [PMID: 38260822 PMCID: PMC10801223 DOI: 10.1016/j.asmr.2023.100856] [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: 07/20/2023] [Accepted: 11/28/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose Because of the concerns regarding residency process during the pandemic, this study aimed to investigate the volume of clinical interactions of orthopaedic residents at a tertiary hospital by reporting the number of patients treated in the outpatient clinic, inpatient ward, and operating room. Methods This retrospective chart study evaluated variables such as volume of clinical interactions of orthopaedic residents at a tertiary hospital by reporting the number of patients treated in the outpatient clinic, inpatient ward, and operating room, from an orthopaedic department in a tertiary trauma center throughout the COVID-19 pandemic era. Comparing these measures was an indirect evaluation tool for measuring the amount of work completed and clinical exposure gained by the residents. Results Occupancy percentage, hospitalization days, admissions to the department, and attendance of the outpatient clinic were all decreased during the pandemic. No significant changes were evident in the total number of surgeries nor the number of elective surgeries during the pandemic. Conclusions Overall, a reduction in overall hospitalization days, admissions to the department, total number of visits in the outpatient clinic, and occupancy percentage of the ward was observed during COVID-19. However, there was no difference in the average number of monthly surgeries between the pre-COVID-19 and COVID-19 timeframes. Level of Evidence Level III, retrospective comparative review.
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Affiliation(s)
- Itay Ron
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Cynthia Kyin
- University of Central Florida College of Medicine, Orlando, Florida, U.S.A
| | - David Shaked Zari
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Bezalel Peskin
- Orthopedic Department, Rambam Medical Center, Haifa, Israel
| | - Nabil Ghrayeb
- Orthopedic Department, Rambam Medical Center, Haifa, Israel
| | - Doron Norman
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Orthopedic Department, Rambam Medical Center, Haifa, Israel
| | - Jacob Shapira
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Orthopedic Department, Rambam Medical Center, Haifa, Israel
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Kotwal S, Singh A, Tackett S, Bery AK, Omron R, Gold D, Newman-Toker DE, Wright SM. Assessing clinical reasoning skills following a virtual patient dizziness curriculum. Diagnosis (Berl) 2024; 11:73-81. [PMID: 38079609 DOI: 10.1515/dx-2023-0099] [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: 07/30/2023] [Accepted: 11/09/2023] [Indexed: 02/20/2024]
Abstract
OBJECTIVES Dizziness is a common medical symptom that is frequently misdiagnosed. While virtual patient (VP) education has been shown to improve diagnostic accuracy for dizziness as assessed by VPs, trainee performance has not been assessed on human subjects. The study aimed to assess whether internal medicine (IM) interns after training on a VP-based dizziness curriculum using a deliberate practice framework would demonstrate improved clinical reasoning when assessed in an objective structured clinical examination (OSCE). METHODS All available interns volunteered and were randomized 2:1 to intervention (VP education) vs. control (standard clinical teaching) groups. This quasi-experimental study was conducted at one academic medical center from January to May 2021. Both groups completed pre-posttest VP case assessments (scored as correct diagnosis across six VP cases) and participated in an OSCE done 6 weeks later. The OSCEs were recorded and assessed using a rubric that was systematically developed and validated. RESULTS Out of 21 available interns, 20 participated. Between intervention (n=13) and control (n=7), mean pretest VP diagnostic accuracy scores did not differ; the posttest VP scores improved for the intervention group (3.5 [SD 1.3] vs. 1.6 [SD 0.8], p=0.007). On the OSCE, the means scores were higher in the intervention (n=11) compared to control group (n=4) for physical exam (8.4 [SD 4.6] vs. 3.9 [SD 4.0], p=0.003) and total rubric score (43.4 [SD 12.2] vs. 32.6 [SD 11.3], p=0.04). CONCLUSIONS The VP-based dizziness curriculum resulted in improved diagnostic accuracy among IM interns with enhanced physical exam skills retained at 6 weeks post-intervention.
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Affiliation(s)
- Susrutha Kotwal
- Department of Medicine, Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amteshwar Singh
- Department of Medicine, Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sean Tackett
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anand K Bery
- Department of Medicine, Division of Neurology, The Ottawa Hospital, Ottawa, Canada
| | - Rodney Omron
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel Gold
- Department of Neurology, Division of Neuro-Visual & Vestibular Disorders, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David E Newman-Toker
- Department of Neurology, Division of Neuro-Visual & Vestibular Disorders, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Scott M Wright
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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12
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Zhu GG, Xie AY, Elahi F, Overfield C, Mackner J, Chakraborty A, Wiggins RH. RadDiscord's Big Bang: Perspectives and Impact of Creation of a Successful Radiology Education Community. Acad Radiol 2024; 31:390-398. [PMID: 38160091 DOI: 10.1016/j.acra.2023.12.010] [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: 09/22/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024]
Abstract
The COVID-19 pandemic brought unprecedented challenges in radiology education. RadDiscord, a digital, open-access radiology educational platform now with over 4100 members internationally, emerged as a COVID-era innovation that has transformed radiology education, broken down institutional silos, and equalized access to high-quality education. This special report will discuss the origin of RadDiscord, overcoming early barriers, building an organization and community, innovation and impact, and the future of radiological education. This may offer helpful perspectives to trainees and educators who are interested in innovating in the realm of radiology education.
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Affiliation(s)
- Grace G Zhu
- University of Utah Health Department of Radiology, 30 North 1900 East, Salt Lake City, Utah 84132, USA (G.G.Z., R.H.W.).
| | | | - Fatima Elahi
- Hospital of the University of Pennsylvania, Department of Radiology, 3400 Spruce Street, 1 Silverstein, Philadelphia, Pennsylvania 19104, USA (F.E.)
| | - Cameron Overfield
- Mayo Clinic Jacksonville, 4500 San Pablo Rd, Jacksonville, Florida 32224, USA (C.O.)
| | - Jordan Mackner
- The University of Arizona College of Medicine - Phoenix, 475 N 5th St. Phoenix, Arizona 85004, USA (J.M.)
| | - Amit Chakraborty
- Baptist Health Lexington, 1740 Nicholasville Rd., Lexington, Kentucky 40503, USA (A.C.)
| | - Richard H Wiggins
- University of Utah Health Department of Radiology, 30 North 1900 East, Salt Lake City, Utah 84132, USA (G.G.Z., R.H.W.)
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13
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Agarwal AK, Gonzales R, Munden C, Albright D, Tsao S. Medical Students' Perceptions on Identifying and Addressing Emotional Responses in Emergency Medicine: Pilot Investigation. JMIR Form Res 2024; 8:e50827. [PMID: 38198202 PMCID: PMC10809065 DOI: 10.2196/50827] [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: 07/13/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Training in acute care, such as emergency medicine (EM), where exposure to critically ill and injured patients is high, impacts the well-being of trainees and contributes to burnout. Investigating how, and if, trainees prepare for these situations is necessary to ensure they are supported. OBJECTIVE This study aimed to evaluate medical students' perspectives and emotional preparedness for handling acute care and trauma. METHODS We conducted a pilot investigation using a remote digital survey of medical students during their EM clerkship at a large, urban academic institution. The primary outcome of interest was student-reported preparedness and comfort in handling trauma and critical care patient encounters. Secondary outcomes included awareness of well-being resources and comfort in accessing digital well-being resources. RESULTS A total of 57 medical students completed the voluntary digital survey, and half of the students (n=28, 49%) reported having witnessed the care of a critically ill or a penetrating trauma patient (eg, a victim of gun violence). A majority (n=40, 70%) had thought about how these events may impact them, and over half felt unprepared to identify the emotional impact these cases may have on them (n=31, 54%) or address the emotional or mental health impact (n=36, 63%). Less than a quarter (n=14, 25%) were aware of digital mental health resources, and 58% (n=33) did not feel fully comfortable connecting with resources if needed. Students who had previously witnessed critical care were significantly more likely to report feeling well prepared in identifying the emotional impact and addressing this impact. CONCLUSIONS In this cross-sectional survey, students did not feel fully prepared to identify or address the emotional impact of working in EM. Additionally, they lacked awareness of or comfort with accessing digital institutional resources meant to support their well-being, such as a large web-based platform. These findings can help inform and guide interventions by educational and academic leaders. The aim would be to create and promote environments that empower students with tools to identify their own emotions and connect to well-being resources.
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Affiliation(s)
- Anish Kumar Agarwal
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Health Care Transformation and Innovation, Penn Medicine, Philadelphia, PA, United States
| | - Rachel Gonzales
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Health Care Transformation and Innovation, Penn Medicine, Philadelphia, PA, United States
| | - Cory Munden
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - DaCarla Albright
- Department of Obstetrics and Gynecology, University of Pennyslvania, Philadelphia, PA, United States
| | - Suzana Tsao
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, United States
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14
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Morrisey Z, Carroll T, Castle P, Botros M, Wilbur D. Trends in orthopaedic surgery resident case volume and the impact of COVID-19 on resident education. J Orthop 2024; 47:50-57. [PMID: 38022839 PMCID: PMC10679526 DOI: 10.1016/j.jor.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction COVID-19 had numerous objective and subjective effects on resident physician education. We intended to examine objective changes in orthopedic education that occurred during the COVID pandemic and other trends from 2018 to 2022 by analyzing surgical case logs from Accreditation Counsel for Graduate Medical Education (ACGME) approved American orthopedics programs. We hypothesized that surgical case load during the COVID pandemic would remain similar to pre-pandemic levels and case logs would show a general upward trend. Methods We analyzed 3146 resident case-logs from the ACGME national case-log report from academic years (AY) 2018-2022. Surgical cases were classified by their Current Procedural Terminology (CPT) codes and grouped by anatomical location (shoulder, hand, etc.). Results From AY 18-19 to "peak pandemic" AY 19-20, resident caseloads either had no change or increased in every orthopedic discipline with few exceptions. Residents performed fewer shoulder (p < 0.0001), wrist (p = 0.0023), knee (p < 0.0001) and leg/ankle (p = .0019) arthroscopies in AY 19-20 than AY 18-19. Hip arthroscopy was notably unchanged. Oncology, Spine, and Foot/Toes did not see any change from AY 18-19 to 21-22 while Microsurgeries decreased (p = .0061). There were substantial differences between high volume (90th percentile) residents, and low volume (10th percentile) residents. All other anatomic areas saw significant increases in caseload over those four academic years. Discussion/conclusion COVID had numerous effects on the orthopedic residency experience, however, any decreases in operative load were small, and largely isolated to the 19-20 AY. Microscopic and arthroscopic surgeries decreased during peak pandemic AY 19-20 when elective surgeries experienced cancellations. This illustrates that these areas of orthopedic education may be supplemented outside of the operating room if similar circumstances arise in the future. Otherwise, resident surgical caseloads continue to rise and show no signs of slowing.
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Affiliation(s)
- Zachary Morrisey
- University of Rochester School of Medicine, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Thomas Carroll
- University of Rochester Department of Orthopaedics and Physical Performance, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Patrick Castle
- University of Rochester Department of Orthopaedics and Physical Performance, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Mina Botros
- University of Rochester Department of Orthopaedics and Physical Performance, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Danielle Wilbur
- University of Rochester Department of Orthopaedics and Physical Performance, 601 Elmwood Ave, Rochester, NY, 14642, USA
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15
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Abstract
Objective: Internal medicine (IM) residents discuss a patient's goals of care (GOC) as part of their initial consultation. Residents have described inexperience, general discomfort, limited formal teaching, and prognostic uncertainty as barriers to effective GOC conversations. The early COVID-19 pandemic resulted in rapid changes to the healthcare system on the individual, patient, and systemic level that might exacerbate and/or introduce new barriers to IM residents' GOC conversations. This qualitative study examines how the early COVID-19 pandemic challenged IM residents' ability to have effective GOC conversations. Methods: Using a constructivist grounded theory approach, participants (n=11) completed a semi-structured interview. Data collection and analysis occurred simultaneously using an open coding, constant comparison process. Interviews were completed until no new themes were identified. Results: Residents self-described their GOC conversations in 5 steps: normalization of the conversation, introduction of expected clinical course, discussion of possible care plans, exploration of the patient's values, and occasionally providing a recommendation. Residents described limited structured teaching around GOC conversations and instead relied on observed role-modelling and self-practice to hone their skillset. Residents described an increased sense of urgency to have GOC conversations due to the uncertainty of clinical course and potential for rapid deterioration of patients with COVID-19. Residents identified restrictive visitor policies as a significant barrier that contributed to feelings of dehumanization. Residents felt that these limitations affected their GOC conversations and potentially resulted in discordant care plans which contributed to moral distress. Conclusion: The early COVID-19 pandemic resulted in several barriers that challenged residents' ability to conduct effective GOC conversations. This is on the background of previously reported discomfort and limited formal training in conducting GOC conversations. Based on our findings, we present a conceptual model involving teaching validated GOC frameworks, positive role-modelling, and experiential learning to support GOC conversation education in post-graduate medical education.
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Affiliation(s)
- Alison T. Lai
- Faculty of Medicine, University of
Toronto, Toronto, Canada
- Department of Medicine, University Health Network, Toronto, Canada
| | - Nadine Abdullah
- Faculty of Medicine, University of
Toronto, Toronto, Canada
- Department of Medicine, University Health Network, Toronto, Canada
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16
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Davies LJ, Mathew C, Pourghaderi AR, Leong AXY, Chan DXH, Koh DLK, Tan AYH, Ong CYM, Ong J, Lam SSW, Ong SGK. COVID-19 Pandemic Simulation Modelling in Anaesthesia Residency Training to Predict Delays and Workforce Deficiencies: A Case Study of the Singapore Residency Training Program. Cureus 2024; 16:e51852. [PMID: 38327925 PMCID: PMC10848604 DOI: 10.7759/cureus.51852] [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: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Background COVID-19 has been the worst pandemic of this century, resulting in economic, social, and educational disruptions. Residency training is no exception, with training restrictions delaying the progression and graduation of residents. We sought to utilize simulation modelling to predict the impact on future cohorts in the event of repeated and prolonged movement restrictions due to COVID-19 and future pandemics of a similar nature. Method A Delphi study was conducted to determine key Accreditation Council for Graduate Medical Education-International (ACGME-I) training variables affected by COVID-19. Quantitative resident datasets on these variables were collated and analysed from 2018 to 2021. Using the Vensim® software (Ventana Systems, Inc., Harvard, MA), historical resident data and pandemic progression delays were used to create a novel simulation model to predict future progression delay. Various durations of delay were also programmed into the software to simulate restrictions of varying severity that would impact resident progression. Results Using the model with scenarios simulating varying pandemic length, we found that the estimated average delay for residents in each accredited year ranged from an increase of one month for year 2 residents to more than three months for year 4 residents. Movement restrictions lasting a year would require up to six years before the program returned to a pre-pandemic equilibrium. Conclusion Systems dynamic modelling can be used to predict delays in residency training programs during a pandemic. The impact on the workforce can thus be projected, allowing residency programs to institute mitigating measures to avoid progression delay.
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Affiliation(s)
- Lucy J Davies
- Department of Paediatric Anaesthesia, KK Women's and Children's Hospital, Singapore, SGP
| | - Christopher Mathew
- Department of Anaesthesiology, Singapore General Hospital, Singapore, SGP
| | - Ahmad R Pourghaderi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, AUS
| | | | - Diana Xin Hui Chan
- Department of Anaesthesiology, Singapore General Hospital, Singapore, SGP
| | | | - Addy Yong Hui Tan
- Department of Anaesthesia, National University Hospital, Singapore, SGP
| | - Caroline Yu Ming Ong
- Department of Anaesthesiology, Intensive Care, and Pain Medicine, Tan Tock Seng Hospital, Singapore, SGP
| | - John Ong
- Department of Gastroenterology, Hepatology, & General Internal Medicine, University of Cambridge, Cambridge, GBR
| | - Sean Shao Wei Lam
- Singhealth Duke-NUS Academic Medical Centre, Singhealth Duke-NUS Medical School, Singapore, SGP
| | - Sharon Gek Kim Ong
- Department of Anaesthesiology, Sengkang General Hospital, Singapore, SGP
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17
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Martínez-Hernández NJ, Fontana Bellorín A, Cerón-Navarro JA, Cabañero Sánchez A, Caballero Silva U, León Atance P. Impact of COVID-19 pandemic in thoracic surgery training in Spain. Cir Esp 2023; 101:853-861. [PMID: 37277065 PMCID: PMC10238275 DOI: 10.1016/j.cireng.2023.05.008] [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] [Accepted: 03/29/2023] [Indexed: 06/07/2023]
Abstract
In the more than 2 years since its emergence, the SARS-CoV-2 pandemic has prompted important changes in healthcare systems and their organization. The aim of this study is to determine the implications in specialized thoracic surgery training as well as the repercussions on thoracic surgery residents. With this objective, the Spanish Society of Thoracic Surgery has conducted a survey among all its trainees and those who had finished their residency during the last 3 years. It consisted of 24 multiple-answer closed questions about the impact of the pandemic on their services, their training, and their personal experience. The response rate was 42% (52 out of a target population of 120). The effect of the pandemic on thoracic surgery services was high or extreme according to 78.8% of the participants. Academic activities were completely cancelled in 42.3% of the cases, and 57.7% of the respondents were required to treat hospitalized COVID patients (25% part-time, and 32.7% full-time). More than 80% of the survey participants believed that changes during the pandemic negatively affected their training, and 36.5% would prefer to extend their training period. In sum, we observe how the pandemic has had deep negative effects on specialized training in thoracic surgery in Spain.
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Affiliation(s)
| | | | - José A Cerón-Navarro
- Coordinador Comité de Docencia de la Sociedad Española de Cirugía Torácica, Spain
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18
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St-Pierre F, Petrosyan R, Gupta A, Hughes S, Trickett J, Read S, Van Doren V, Zeveney A, Shoushtari C. Impact of the COVID-19 pandemic on internal medicine training in the United States: results from a national survey. BMC Health Serv Res 2023; 23:1285. [PMID: 37993947 PMCID: PMC10666403 DOI: 10.1186/s12913-023-10237-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 10/28/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Internal medicine (IM) residency is a notoriously challenging time generally characterized by long work hours and adjustment to new roles and responsibilities. The COVID-19 pandemic has led to multiple emergent adjustments in training schedules to accommodate increasing needs in patient care. The physician training period, in itself, has been consistently shown to be associated with vulnerability with respect to mental well-being. The impact of the COVID-19 pandemic on the experience of IM trainees is not well established. OBJECTIVE Characterize the impact of the COVID-19 pandemic on trainee clinical education, finances, and well-being. METHODS We developed a survey composed of 25 multiple choice questions, 6 of which had an optional short-answer component. The survey was distributed by the American College of Physicians (ACP) to 23,289 IM residents and subspecialty fellows. We received 1,128 complete surveys and an additional 269 partially completed surveys. RESULTS The majority of respondents reported a disruption in their clinical schedule (76%) and a decrease in both didactic conferences (71%) and protected time for education (56%). A majority of respondents (81%) reported an impact on their well-being with an increase in their level of burnout and 41% of respondents reported a decrease in level of direct supervision. Despite these changes, the majority of trainee respondents (78%) felt well prepared for clinical practice after graduation. CONCLUSIONS These results outline the vulnerable position of internal medicine physicians in training. Preserving educational experiences, adequate supervision, and humane work hours are essential in protecting trainees from mental illness and burnout during global emergencies.
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Affiliation(s)
- Frederique St-Pierre
- Department of Internal Medicine, Division of Hematology/Oncology, Northwestern University, 676 N St Clair St (Suite 850), Chicago, IL, 60611, USA.
| | - Romela Petrosyan
- Combined Brigham and Women's Hospital and Massachusetts General Hospital Department of Medicine, Division of Nephrology, Harvard University, Boston, MA, USA
| | - Arjun Gupta
- Department of Cardiology, The Mount Sinai Hospital, New York, NY, USA
| | - Stephen Hughes
- Department of Pulmonary, Critical Care, and Sleep Medicine, Naval Medical Center San Diego, San Diego, CA, USA
| | - John Trickett
- Department of Internal Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Susan Read
- Research Center, American College of Physicians, Philadelphia, PA, USA
| | - Vanessa Van Doren
- Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Andrew Zeveney
- Research Center, American College of Physicians, Philadelphia, PA, USA
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19
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Kendall B, Ancell KM, Xu KT, Morris J. Utilizing Post-Clerkship Surveys to Optimize Emergency Medicine Program Outcomes in the Match. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:1249-1256. [PMID: 37954871 PMCID: PMC10638927 DOI: 10.2147/amep.s425877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/17/2023] [Indexed: 11/14/2023]
Abstract
Purpose The Match for Emergency Medicine residency has presented new challenges over the past 2 years (2022-2023). Use of a post-clerkship survey given to clerkship students could improve outcomes in The Match by helping the program identify its different strengths and weaknesses. Methods A post-clerkship survey, sent after The Match, was sent to Emergency Medicine bound students who completed our Emergency Medicine clerkship. This data was then collected and analyzed and, in collaboration with our faculty and residents, changes were made to the clerkship and residency program with the intention that these changes would improve our program and therefore our competitiveness in the upcoming cycle of The Match. These changes were analyzed in the subsequent post-clerkship survey. The survey included questions that asked students to reflect on their experiences with various aspects of the program and how these experiences influenced their personal ranking of our program compared to other emergency medicine residency programs they might have interacted with. Results Results from the initial post-clerkship survey revealed that students found our faculty and residents (55% ranked higher), County hospital (55% ranked higher), and SLOE transparency (64% ranked higher) as the main aspects of our program that led them to rank the program higher. Living in Lubbock, TX was found to be the biggest drawback for students, with 55% ranking our program lower. The 2023 post-clerkship survey revealed that the changes we made to our clerkship and program were effective, with an overall decrease of 10 points in students who ranked our program lower based on "Living in Lubbock, TX". We also were able to keep 4 of our rotators, as opposed to 2 the year before. Lastly, we also did not need to go as far down our rank list in the 2023 cycle of The Match. Conclusion Using a post-clerkship survey to evaluate strengths and weaknesses of a program through a student's perspective can be an effective tool to help programs in their outcomes from The Match. Further study is necessary to validate these findings.
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Affiliation(s)
- Brian Kendall
- Department of Surgery, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Kade M Ancell
- Texas Tech University Health Science Center School of Medicine, Lubbock, TX, USA
| | - Ke Tom Xu
- Department of Surgery, Texas Tech University Health Science Center, Lubbock, TX, USA
- Department of Family & Community Medicine, TTUHSC SOM, Lubbock, TX, USA
| | - James Morris
- Department of Surgery, Texas Tech University Health Science Center, Lubbock, TX, USA
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20
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Shaffrey EC, Grotting AG, Michelotti BF, Siebert JW, Larson JD, Bentz ML. Making Headway in Surgical Education at Home and Abroad: Use of an Inexpensive Three-Dimensional Learning Model to Improve Plastic Surgery Resident Confidence in Mohs Defect Assessment and Closure Planning. Plast Reconstr Surg 2023; 152:540e-546e. [PMID: 36790792 DOI: 10.1097/prs.0000000000010308] [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: 02/16/2023]
Abstract
BACKGROUND The development of simulation, particularly low-cost models, has become a focus of interest within plastic surgery education. Current simulators for Mohs reconstruction are either expensive or not reusable. The authors hypothesize that using a Styrofoam head model during an interactive teaching session will positively affect plastic surgery trainee comfort in designing Mohs reconstructive options. METHODS A cohort of integrated plastic surgery residents at a single institution performed a preactivity questionnaire to obtain baseline comfort in defect assessment and design for five Mohs defects. They subsequently underwent an interactive learning session and were instructed to design flaps on life-size Styrofoam heads with feedback from the senior author (M.L.B.). A postactivity questionnaire was completed to assess improvement in comfort in defect assessment and flap design. Three attending surgeons then compared trainee designs with the senior author's design to assess accuracy. All surveys were based on a five-point Likert scale. RESULTS When analyzing all defects, average postactivity scores increased by 0.63 (SD, ±0.24) ( P = 0.008). Junior residents ( n = 8) had a greater increase in average score responses [mean, 1.07 (0.5 to 1.75)] compared with senior residents ( n = 9) [mean, 0.27 (0 to 1)] ( P < 0.001). When assessed by senior-level surgeons, senior residents had significantly greater accuracy in design for each defect ( P < 0.05) except cheek advancement flap ( P = 0.08). CONCLUSION Participation in an interactive educational activity using a Styrofoam head model demonstrated significant improvements in trainee assessment and design of reconstructive options for Mohs defects.
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Affiliation(s)
- Ellen C Shaffrey
- From the Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics
| | | | - Brett F Michelotti
- From the Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics
| | - John W Siebert
- From the Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics
| | - Jeffrey D Larson
- From the Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics
| | - Michael L Bentz
- From the Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics
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21
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Frank D, Perera T, Weizberg M. COVID-lateral Damage: Impact of the Post-COVID-19 Era on Procedural Training in Emergency Medicine Residency. West J Emerg Med 2023; 24:855-860. [PMID: 37788025 PMCID: PMC10527848 DOI: 10.5811/westjem.59771] [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: 12/29/2022] [Revised: 05/19/2023] [Accepted: 07/03/2023] [Indexed: 10/04/2023] Open
Abstract
Introduction: Hospitalizations during the coronavirus 2019 (COVID-19) pandemic peaked in New York in March-April 2020. In the months following, emergency department (ED) volumes declined. Our objective in this study was to examine the effect of this decline on the procedural experience of emergency medicine (EM) residents compared to the pre-pandemic period. Methods: We conducted this multicenter, retrospective cohort study of patients seen and key procedures performed by EM residents at hospitals spanning three Accreditation Committee for Graduate Medical Education-approved EM residencies in New York City and Nassau County, NY. We obtained numbers of procedures performed during May-July 2020 and compared them to the same time period for 2019 and 2018. We a priori classified critical care procedures-cardioversion, central lines, chest tubes, procedural sedation, and endotracheal intubation. We also studied "fast-track" procedures-fracture/joint reduction, incision and drainage (I&D), laceration repairs, and splints. Results: Total number of critical care procedures in the months following the COVID-19 peak decreased from 694 to 606 (-12.7%, 95% confidence interval [CI] 10.3-15.4%), compared to an increase from 642 to 694 (+8.1%, 95% CI 6.1-10.5%) the previous year (difference -9.3%). Total number of fast-track procedures decreased from 5,253 to 3,369 (-35.9%, 95% CI 34.6-37.2%), compared to a decrease from 5,333 to 5,253 (-1.5%, 95% CI 1.2-1.9%) the year before (difference -36.3%). Specific critical care procedures performed in 2020 compared to the mean of 2019 and 2018 as follows: cardioversion -33.3%; central lines +19.0%; chest tubes -27.9%; procedural sedation -30.8%; endotracheal intubation -13.8%. Specific fast-track procedures: reductions +33.3%; I&D -48.6%; laceration repair -17.3%; and splint application -49.8%. Conclusion: Emergency medicine residents' critical and fast-track procedural experience at five hospitals was reduced during the months following the COVID-19 peak in comparison to a similar period in the two years prior. Training programs may consider increasing simulation-lab and cadaver-lab experiences, as well as ED and critical care rotations for their residents to offset this trend.
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Affiliation(s)
- Daniel Frank
- Zucker Hofstra School of Medicine, Northwell Health, South Shore University Hospital, Bay Shore, New York
| | - Thomas Perera
- Zucker Hofstra School of Medicine, Northwell Health, North Shore/LIJ, Manhasset, New York
| | - Moshe Weizberg
- Zucker Hofstra School of Medicine, Northwell Health, Staten Island University Hospital, Staten Island, New York
- Maimonides Medical Center/Maimonides Midwood Community Hospital, Brooklyn, New York
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22
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Shafique MS, Arham M, Fatima S, Bhatti HW. Impact of the COVID-19 Pandemic on Surgical Education and Training: A Resident Survey in a Developing Country. Cureus 2023; 15:e45283. [PMID: 37846232 PMCID: PMC10576859 DOI: 10.7759/cureus.45283] [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: 09/14/2023] [Indexed: 10/18/2023] Open
Abstract
Background The COVID-19 pandemic has adversely affected medical education and training programs worldwide. Early investigations have shown that surgical residents face a lot of challenges in these unprecedented times. This study aims to assess the impact of the COVID-19 pandemic on surgical education and training in a developing country. Methods This cross-sectional study was conducted in Allied Hospitals of Rawalpindi Medical University, Rawalpindi, Pakistan from June 2021 to July 2021. A structured questionnaire designed by the researchers was distributed to all surgery departments, and surgical residents who consented to participate in this study were included. Results A total of 152 residents participated in this study, of which 53 (34.9%) were in general surgery and 99 (65.1%) in various surgical allied specialties. Of the residents, 14.5% reported full transfer from the parent unit to the COVID-19 unit. An increase in emergency surgical procedures was reported by 52.8% of general surgery residents as compared to surgical allied specialties (P = 0.037). Of the residents, 90.1% reported increased stress and anxiety levels, with the number of allied residents significantly higher than general surgery residents (P = 0.031). A total of 125 (82.2%) respondents claimed that fear of contracting the virus affected proper patient evaluation. Conclusion The COVID-19 pandemic has severely impacted the training and psychological well-being of surgical residents.
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Affiliation(s)
| | - Muhammad Arham
- General Surgery, Rawalpindi Medical University, Rawalpindi, PAK
| | - Sayyam Fatima
- Surgical Unit I, Holy Family Hospital, Rawalpindi, PAK
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Koh SJQ, Woon TH, Fong W, Kwan YH, Lim SH, Lee JLH, Tan HK. Residents' Report of COVID-19 Associated Training Disruptions, Stressors, and Opportunities During the Pandemic-The Singapore Experience. J Grad Med Educ 2023; 15:494-499. [PMID: 37637339 PMCID: PMC10449353 DOI: 10.4300/jgme-d-22-00569.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/26/2023] [Accepted: 05/05/2023] [Indexed: 08/29/2023] Open
Abstract
Background The COVID-19 pandemic has disrupted residency training. Several studies have been performed to investigate the impact of the pandemic on residency training in Accreditation Council for Graduate Medical Education-International (ACGME-I)-accredited institutions. However, these were either limited to certain specialties or failed to consider possible opportunities from the pandemic. Objective To determine the stressors on residents as well as the opportunities that arose from the COVID-19 pandemic across multiple specialities in Singapore. Methods A cross-sectional survey among SingHealth residents was conducted between July and September 2020. The survey assessed the balance between service and training during hospital postings, the pandemic's influence on examination and teaching, the psychological impact of the pandemic, the level of burnout, and the effect on morale of residents during the pandemic. Results The response rate was 27.1% (253 of 934). Out of the 253 residents, 136 (53.8%) felt stressed during the pandemic. Concerns about family's health and safety pertaining to potential COVID-19 infection, progression in training, and completion of examinations were the top 3 stressors. One-hundred and three residents (40.7%) had their training disrupted either by being placed in an interim posting not part of their residency requirements or being deployed to care for patients with COVID-19. Although administrative support and information for virtual teaching were sufficient, only 108 (42.7%) agreed it had the same value as face-to-face sessions. Despite the challenges, 179 (70.8%) thought that experiencing this crisis provided more meaning in their career. Conclusions The COVID-19 pandemic has brought about challenges and learning opportunities for residents.
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Affiliation(s)
- Samuel Ji Quan Koh
- Samuel Ji Quan Koh, MBBS, MRCP,* is a Resident, SingHealth Internal Medicine Residency Programme, Singapore Health Services, Singapore
| | - Ting Hui Woon
- Ting Hui Woon, MS, BSc,* is a Research Coordinator, Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Warren Fong
- Warren Fong, MBBS, MRCP, FAMS, is Clinical Associate Professor, Department of Rheumatology and Immunology, Singapore General Hospital, Senior Consultant, Duke-NUS Medical School, and Program Director, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yu Heng Kwan
- Yu Heng Kwan, BSc, MD, PhD, is a Resident, SingHealth Internal Medicine Residency Program, Singapore Health Services, Singapore, Adjunct Senior Research Fellow, Program in Health Services & Systems Research, Duke NUS Medical School, and Adjunct Lecturer, Department of Pharmacy, National University of Singapore, Singapore
| | - Swee Han Lim
- Swee Han Lim, MBBS, FRCSEd, FRCP, FAMS, is Clinical Professor, Department of Emergency Medicine, Singapore General Hospital, and Senior Consultant and Associate Designated Institutional Official, SingHealth Residency, Singapore Health Services, Singapore, and Duke-NUS Medical School
| | - Jodie Ling Horng Lee
- Jodie Ling Horng Lee, MS, BEng, PGDip, EMBA, is Senior Manager, Centre for Residents and Faculty Development, Graduate Medical Education Office, SingHealth Residency, Singapore Health Services, Singapore; and
| | - Hak Koon Tan
- Hak Koon Tan, MBBS, FRCOG, MMed, MRACOG, FAMS, is Designated Institutional Official, Department of Obstetrics and Gynecology, Singapore General Hospital, SingHealth Residency, Singapore Health Services, Singapore, and Duke-NUS Medical School
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Kwabla W, Dinc F, Oumimoun K, Kockara S, Halic T, Demirel D, Arikatla S, Ahmadi S. Evaluation of WebRTC in the Cloud for Surgical Simulations: A case study on Virtual Rotator Cuff Arthroscopic Skill Trainer (ViRCAST). LEARNING AND COLLABORATION TECHNOLOGIES : 10TH INTERNATIONAL CONFERENCE, LCT 2023, HELD AS PART OF THE 25TH HCI INTERNATIONAL CONFERENCE, HCII 2023, COPENHAGEN, DENMARK, JULY 23-28, 2023, PROCEEDINGS. PART II. LCT (CONFERENCE) (10TH : 2... 2023; 14041:127-143. [PMID: 37961077 PMCID: PMC10642557 DOI: 10.1007/978-3-031-34550-0_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Web Real-Time Communication (WebRTC) is an open-source technology which enables remote peer-to-peer video and audio connection. It has quickly become the new standard for real-time communications over the web and is commonly used as a video conferencing platform. In this study, we present a different application domain which may greatly benefit from WebRTC technology, that is virtual reality (VR) based surgical simulations. Virtual Rotator Cuff Arthroscopic Skill Trainer (ViRCAST) is our testing platform that we completed preliminary feasibility studies for WebRTC. Since the elasticity of cloud computing provides the ability to meet possible future hardware/software requirements and demand growth, ViRCAST is deployed in a cloud environment. Additionally, in order to have plausible simulations and interactions, any VR-based surgery simulator must have haptic feedback. Therefore, we implemented an interface to WebRTC for integrating haptic devices. We tested ViRCAST on Google cloud through haptic-integrated WebRTC at various client configurations. Our experiments showed that WebRTC with cloud and haptic integrations is a feasible solution for VR-based surgery simulators. From our experiments, the WebRTC integrated simulation produced an average frame rate of 33 fps, and the hardware integration produced an average lag of 0.7 milliseconds in real-time.
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Affiliation(s)
| | - Furkan Dinc
- University of Central Arkansas, Conway, Arkansas, USA
| | | | | | - Tansel Halic
- Intuitive Surgical, Peachtree Corners, Georgia, USA
| | - Doga Demirel
- Florida Polytechnic University, Lakeland Florida, USA
| | | | - Shahryar Ahmadi
- Memorial Orthopaedic Surgical Group, Long Beach, California, USA
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Thomas AA, Yoshida H, Keilman AE, Burns B, McDade J, Anderson T, Reid J. Gamification of a Low-Fidelity Paper Doll to Teach Primary Survey to Pediatric Residents. Cureus 2023; 15:e41996. [PMID: 37593309 PMCID: PMC10427884 DOI: 10.7759/cureus.41996] [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: 03/07/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
When critically ill pediatric patients arrive in the emergency department (ED), a rapid physical evaluation is performed in order to systematically evaluate and address life-threatening conditions. This is commonly referred to as the primary survey. At our institution, pediatric residents are frequently tasked with this role, but they have limited training for or experience with this task. Quality improvement review of real resuscitation recordings at our institution revealed delays in initiation and incomplete primary surveys. We sought to utilize gamification to standardize and optimize reproducible training for the primary survey task for pediatric residents using a low-fidelity paper doll model simulation to improve primary survey performance in actual resuscitations.
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Affiliation(s)
- Anita A Thomas
- Pediatric Emergency Medicine, University of Washington, Seattle, USA
- Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, USA
| | - Hiromi Yoshida
- Pediatric Emergency Medicine, University of Washington, Seattle, USA
| | - Ashley E Keilman
- Pediatric Emergency Medicine, Seattle Childrens Hospital, Seattle, USA
| | - Brian Burns
- Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, USA
| | - Jessica McDade
- Pediatric Critical Care Medicine, University of Washington, Seattle, USA
| | - Tamar Anderson
- Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, USA
| | - Jennifer Reid
- Pediatric Emergency Medicine, University of Washington Medical Center, Seattle, USA
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Martínez-Hernández NJ, Fontana-Bellorín A, Cerón-Navarro JA, Cabañero-Sánchez A, Caballero-Silva U, León-Atance P. [Impact of the COVID-19 pandemic on thoracic surgery training in Spain]. Cir Esp 2023; 101:S0009-739X(23)00141-0. [PMID: 38620103 PMCID: PMC10289123 DOI: 10.1016/j.ciresp.2023.03.009] [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: 03/08/2023] [Accepted: 03/29/2023] [Indexed: 04/17/2024]
Abstract
In the more than 2 years since its emergence, the SARS-CoV-2 pandemic has prompted important changes in healthcare systems and their organization. The aim of this study is to determine the implications in specialized thoracic surgery training as well as the repercussions on thoracic surgery residents. With this objective, the Spanish Society of Thoracic Surgery has conducted a survey among all its trainees and those who had finished their residency during the last 3 years. It consisted of 24 multiple-answer closed questions about the impact of the pandemic on their services, their training, and their personal experience. The response rate was 42% (52 out of a target population of 120). The effect of the pandemic on thoracic surgery services was high or extreme according to 78.8% of the participants. Academic activities were completely cancelled in 42.3% of the cases, and 57.7% of the respondents were required to treat hospitalized COVID patients (25% part-time, and 32.7% full-time). More than 80% of the survey participants believed that changes during the pandemic negatively affected their training, and 36.5% would prefer to extend their training period. In sum, we observe how the pandemic has had deep negative effects on specialized training in thoracic surgery in Spain.
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Affiliation(s)
| | | | - José A Cerón-Navarro
- Coordinador Comité de Docencia de la Sociedad Española de Cirugía Torácica, España
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Cayley WE. Expecting Uncertainty. Fam Med 2023; 55:286-288. [PMID: 37307596 PMCID: PMC10622107 DOI: 10.22454/fammed.2023.300519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- William E Cayley
- School of Medicine and Public Health, University of Wisconsin, Eau Claire, WI
- Prevea Family Medicine Residency, Eau Claire, WI
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Beaulieu-Jones BR, de Geus SWL, Rasic G, Woods AP, Papageorge MV, Sachs TE. COVID-19 Did Not Stop the Rising Tide: Trends in Case Volume Logged by Surgical Residents. JOURNAL OF SURGICAL EDUCATION 2023; 80:499-510. [PMID: 36528544 PMCID: PMC9682049 DOI: 10.1016/j.jsurg.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The coronavirus pandemic has profoundly impacted all facets of surgical care, including surgical residency training. The objective of this study was to assess the operative experience and overall case volume of surgery residents before and during the pandemic. METHODS Using data from the Accreditation Council for Graduate Medical Education annual operative log reports, operative volume for 2015 to 2021 graduates of Accreditation Council for Graduate Medical Education -accredited general, orthopedic, neuro- and plastic surgery residency programs was analyzed using nonparametric Kendall-tau correlation analysis. The period before the pandemic was defined as AY14-15 to AY18-19, and the pandemic period was defined as AY19-20 to AY20-21. RESULTS Operative data for 8556 general, 5113 orthopedic, 736 plastic, and 1278 neurosurgery residency graduates were included. Between 2015 and 2021, total case volume increased significantly for general surgery graduates (Kendall's tau-b: 0.905, p = 0.007), orthopedic surgery graduates (Kendall's tau-b: 1.000, p = 0.003), neurosurgery graduates (Kendall's tau-b: 0.905, p = 0.007), and plastic surgery graduates (Kendall's tau-b: 0.810, p = 0.016). Across all specialties, the mean total number of cases performed by residents graduating during the pandemic was higher than among residents graduating before the pandemic, though no formal significance testing was performed. Among general surgery residents, the number of cases performed as surgeon chief among residents graduating in AY19-20 decreased for the first time in 5 years, though the overall volume remained higher than the prior year, and returned to prepandemic trends in AY20-21. CONCLUSIONS Over the past 7 years, the case volume of surgical residents steadily increased. Surgical trainees who graduated during the coronavirus pandemic have equal or greater total operative experience compared to trainees who graduated prior to the pandemic.
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Affiliation(s)
- Brendin R Beaulieu-Jones
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Susanna W L de Geus
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Gordana Rasic
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Alison P Woods
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marianna V Papageorge
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Teviah E Sachs
- Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
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Roth LT, Mogilner L, Talib H, Silver EJ, Friedman S. Where Do We Go from here? Post-pandemic Planning and the Future of Graduate Medical Education. MEDICAL SCIENCE EDUCATOR 2023; 33:375-384. [PMID: 36778672 PMCID: PMC9900559 DOI: 10.1007/s40670-023-01737-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 05/31/2023]
Abstract
Background As the pandemic wanes, there is an opportunity to reevaluate resultant changes in graduate medical education (GME), particularly from the viewpoints of those affected most. We aimed to assess both trainee and faculty perceptions on the educational changes and innovations resulting from the pandemic to inform future educational planning. Methods We surveyed trainees and core education faculty at three New York City children's hospitals. Surveys assessed perceived changes to educational activities, skills, scholarship, effectiveness of virtual teaching, future desirability, and qualitative themes. Results The survey was completed by 194 participants, including 88 (45.4%) faculty and 106 (54.6%) trainees. Trainees were more likely to report a negative impact of the pandemic compared with faculty (75.5% vs. 50%, p < 0.01). Most respondents reported a decrease in formal educational activities (69.8%), inpatient (77.7%) and outpatient (77.8%) clinical teaching. Despite this, most perceived clinical and teaching skills to have stayed the same. Most (93.4%) participated in virtual education; however, only 36.5% of faculty taught virtually. Only 4.2% of faculty had extensive training in virtual teaching and 28.9% felt very comfortable teaching virtually. In the future, most (87.5%) prefer a hybrid approach, particularly virtual didactic conferences and virtual grand rounds. Faculty themes included challenges to workflows and increased empathy for trainees, while trainee themes included increased work/life balance and support, but increased burnout. Conclusion Many changes and innovations resulted from the pandemic. Hospital systems and GME programs should consider this data and incorporate viewpoints from trainees and faculty when adapting educational strategies in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01737-8.
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Affiliation(s)
- Lauren T. Roth
- Children’s Hospital at Montefiore/Albert Einstein College of Medicine, 3415 Bainbridge Ave, Bronx, NY 10467 USA
| | - Leora Mogilner
- Icahn School of Medicine at Mount Sinai, 1184 5th Ave, New York, NY 10029 USA
| | - Hina Talib
- Children’s Hospital at Montefiore/Albert Einstein College of Medicine, 3415 Bainbridge Ave, Bronx, NY 10467 USA
| | - Ellen J. Silver
- Children’s Hospital at Montefiore/Albert Einstein College of Medicine, 3415 Bainbridge Ave, Bronx, NY 10467 USA
| | - Suzanne Friedman
- Columbia University Vagelos College of Physicians & Surgeons, 622 West 168th Street, NY New York, 10032 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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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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de Mélo Silva Júnior ML, Sapia AV, Cavalcanti Neto JM, Barbosa NMG, Neiva VBC, Sauaia Filho EN. The first wave of COVID-19 and mental distress of physician residents in Brazil: a comparison between two cohorts. HUMAN RESOURCES FOR HEALTH 2023; 21:10. [PMID: 36788532 PMCID: PMC9926430 DOI: 10.1186/s12960-022-00790-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/21/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The reorganization of healthcare systems to face the COVID-19 pandemic has led to concerns regarding psychological distress of healthcare workers, and training requirements of physician residents. OBJECTIVE To assess the influence of COVID-19 pandemic on depression, anxiety, burnout and training schedules of residents. METHODS Two independent cross-sectional studies (the first in November 2019 [control], the second in June 2020, during the first wave of COVID-19 pandemic) enrolling physician residents from Brazil, using online surveys. In each of them, we collected demographic and training program data, and assessed depression, anxiety and burnout through PHQ-2, GAD-2 and MBI (2-item version) scales, respectively. We controlled confounding variables with logistic regression analysis. RESULTS The COVID-19 cohort (n = 524) presented a briefer workload and had at least 1 day off per week more frequently, in relation to the control cohort (n = 1 419). The majority of residents (464/524, 89.5%) had a reduction in their duty hours, and believed they would need an extra training period after the end of the pandemic (399/524, 76.2%). The frequency of depression increased (46.0% vs. 58.8%, aOR = 1.64, 95% CI = 1.32-2.05), anxiety did not change (56.5% vs. 56.5%, aOR = 1.24, 95% CI = 0.99-1.55) and burnout decreased (37.0% vs. 26.1%, aOR = 0.77, 95% CI = 0.60-0.99). Sensitivity analysis did not change these results. CONCLUSION Mental distress is frequent among residents and associated with both training program and social environments. The consequences of the COVID-19 pandemic on training requirements should be specifically addressed by supervisors and policymakers, in a case-by-case basis. Psychological support must be provided to healthcare workers.
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Affiliation(s)
- Mário Luciano de Mélo Silva Júnior
- Division of Neuropsychiatry, Medical Science Center, Universidade Federal de Pernambuco, 1235 Moraes Rego Av, Cidade Universitária, Recife, 50670-901 Brazil
- Medical School, Uninassau, Recife, Brazil
- Neurology Unit, Hospital da Restauração, Recife, Brazil
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Evans AZ, Adhaduk M, Jabri AR, Ashwath ML. Is Virtual Learning Here to Stay? A Multispecialty Survey of Residents, Fellows, and Faculty. Curr Probl Cardiol 2023; 48:101641. [PMID: 36773945 PMCID: PMC9911980 DOI: 10.1016/j.cpcardiol.2023.101641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
The transition to virtual learning during the coronavirus disease 2019 pandemic marks a paradigm shift in graduate medical education (GME). From June to September 2021, we conducted a dual-center, multispecialty survey of residents, fellows, and faculty members to determine overall perceptions about virtual learning and assess its benefits, drawbacks, and future role in GME. We discovered a mainly positive view of virtual education among trainees (138/207, 0.67, 95% CI 0.59-0.73) and faculty (180/278, 0.65, 0.59-0.70). Large group sessions, such as didactic lectures, grand rounds, and national conferences, were ranked best-suited for the virtual environment, whereas small groups and procedural training were the lowest ranked. Major benefits and drawbacks to virtual learning was identified. A hybrid approach, combining in-person and virtual sessions, was the preferred format among trainees (167/207, 0.81, 0.75-0.86) and faculty (229/278, 0.82, 0.77-0.87). Virtual learning offers a valuable educational experience that should be retained in postpandemic GME curriculums.
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Affiliation(s)
- Aron Z Evans
- Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Mehul Adhaduk
- Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Ahmad R Jabri
- Heart and Vascular Center, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
| | - Mahi L Ashwath
- Division of Cardiovascular Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA.
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Agarwal A, Sangha H, Deutsch A, Spadaro A, Gonzales R, Goldenring J, Mamtani M, Conlon LW, Scott K. Emergency medicine resident perspectives on well-being during COVID-19: a qualitative study. J Accid Emerg Med 2023; 40:92-95. [PMID: 36171075 DOI: 10.1136/emermed-2022-212368] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/07/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Emergency medicine (EM) clinician well-being has been negatively impacted throughout the COVID-19 pandemic. Resident physicians are particularly vulnerable yet less is known about their perspectives. METHODS The objective of this study was to use qualitative methods to understand EM residents' perspectives on well-being during COVID-19. EM residents at an urban, academic institution in the USA were recruited via email and participated in virtual, semi-structured interviews between November 2020 and February 2021. Interviews were conducted by a trained qualitative researcher, recorded, transcribed and de-identified by a third party vendor. All transcripts were double coded by two trained study team members using thematic analysis to identify the themes and interviews were stopped when no new themes emerged. RESULTS Seventeen semi-structured interviews were conducted until thematic saturation was reached with residents in their first 4 years of training: 6 postgraduate year (PGY)-1 (35%), 6 PGY-2 (35%), 2 PGY-3 (12%) and 3 PGY-4 (18%). Five themes were identified: (1) isolation from peers in training contrasting with a collective call to action, (2) desire for increased acknowledgement and structured leadership support, (3) concerns about personal needs and safety within the clinical environment, (4) fear of missed educational opportunities and lack of professional development and (5) need for enhanced mental and physical health resources. CONCLUSIONS This qualitative study elucidated factors inside and outside of the clinical environment which impacted EM resident well-being. The findings suggest that programme and health system leadership can focus on supporting peer-to-peer and faculty connections, structured guidance and mentorship on resident career development and develop programmes which bolster resident on-shift support and acknowledgement. These lessons can be used by training programmes to better support residents, but the generalisability is limited due to the single-centre design and participation.
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Affiliation(s)
- Anish Agarwal
- Center for Digital Health, Penn Medicine, Philadelphia, Pennsylvania, USA .,Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Hareena Sangha
- Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Amanda Deutsch
- Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Anthony Spadaro
- Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Rachel Gonzales
- Center for Digital Health, Penn Medicine, Philadelphia, Pennsylvania, USA.,Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jacob Goldenring
- Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Mira Mamtani
- Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lauren W Conlon
- Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kevin Scott
- Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Jin JW, Smith K, Helminiak A, John V, Wu HE. Current Curricular Trends After the COVID-19 Pandemic: A National Survey of Psychiatry Residency Programs. Int J Psychiatry Med 2023:912174231152575. [PMID: 36653916 PMCID: PMC9871443 DOI: 10.1177/00912174231152575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES With the COVID-19 pandemic, psychiatry residencies (academic, community, and hybrid) have adopted different learning modalities to preserve a high quality of educational training. There is minimal data on specific program adaptations, related change perspectives, and program type stratification. This study aims to analyze trends in curriculum changes in accredited psychiatry residency programs in the United States. METHODS Program directors of accredited general psychiatry programs in the United States were surveyed to assess both general program details and changes in educational content, delivery, and perspectives of their respective program curricula. Data was analyzed with SPSS with 0.05 significance level. RESULTS A total of 63 program directors of 264 eligible programs were included (23.9%). We observed a dramatic shift to integrate virtual learning post-pandemic (98.5%) compared to pre-pandemic (3%). However, there was no association between these modality changes and program type [P = 0.1343]. Furthermore, changes were noted in respect to didactic content (60%), decreased rotation sites (38%), and increased telemedicine exposure (84%) with no change of wellness days (67%) or protected time (97%) and above changes had no association with program type. Interestingly, we found the use of virtual educational platforms was described as positive (59.7%) with 9 programs noting a future transition to a hybrid learning model for didactics and grand rounds. CONCLUSIONS The findings suggest that pandemic-related curriculum adaptations infiltrated all different types of psychiatry residencies and suggest a national trend to continue virtual platform integration into psychiatry didactics. However, future investigation of virtual learning outcomes are warranted.
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Affiliation(s)
- Jeff Wang Jin
- 12339The University of Texas Health Science Center Houston - McGovern Medical School, Houston, TX, USA
| | - Kacy Smith
- 12339The University of Texas Health Science Center Houston - McGovern Medical School, Houston, TX, USA
| | - Amanda Helminiak
- Department of Psychiatry and Behavioral Sciences, 12339The University of Texas Health Science Center Houston - McGovern Medical School, Houston, TX, USA.,144383The University of Texas Health Science Center Houston - Harris County Psychiatric Center, Houston, TX, USA
| | - Vineeth John
- Department of Psychiatry and Behavioral Sciences, 12339The University of Texas Health Science Center Houston - McGovern Medical School, Houston, TX, USA
| | - Hanjing Emily Wu
- Department of Psychiatry and Behavioral Sciences, 12339The University of Texas Health Science Center Houston - McGovern Medical School, Houston, TX, USA.,144383The University of Texas Health Science Center Houston - Harris County Psychiatric Center, Houston, TX, USA
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Nishizaki Y, Nagasaki K, Shikino K, Kurihara M, Shinozaki T, Kataoka K, Shimizu T, Yamamoto Y, Fukui S, Nishiguchi S, Katayama K, Kobayashi H, Tokuda Y. Relationship between COVID-19 care and burnout among postgraduate clinical residents in Japan: a nationwide cross-sectional study. BMJ Open 2023; 13:e066348. [PMID: 36639218 PMCID: PMC9842597 DOI: 10.1136/bmjopen-2022-066348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The relationship between the care of patients with COVID-19 and mental health among resident physicians in Japan is imperative for ensuring appropriate care of patients with COVID-19 and should be clarified. We herein assessed the relationship between the care of patients with COVID-19 and mental health among postgraduate year 1 (PGY-1) and PGY-2 resident physicians and factors associated with mental health. DESIGN This nationwide cross-sectional study analysed data obtained using the clinical training environment self-reported questionnaire. SETTING An observational study across Japan among resident physicians (PGY-1 and PGY-2) from 583 teaching hospitals. PARTICIPANTS Examinees who took the general medicine in-training examination of academic year 2020. PRIMARY AND SECONDARY OUTCOME MEASURES The Patient Health Questionnaire and Mini-Z 2.0 were used to assess mental health, and experience of caring for patients with COVID-19 was divided into three groups (none, 1-10 and ≥11). The prevalence of mental conditions in the three groups was compared using the 'modified' Poisson generalised estimating equations by adjusting for prefecture-level, hospital-level and resident-level variables. RESULTS Of the 5976 participants analysed, 50.9% were PGY-1. The prevalence of burnout was 21.4%. Moreover, 47.0% of all resident physicians had no experience in the care of patients with COVID-19. The well-experienced group accounted for only 7.9% of the total participants. A positive association was found between the number of caring patients with COVID-19 and burnout (prevalence ratio 1.25; 95% CI 1.02 to 1.53). Moreover, the shortage of personal protective equipment was identified as a major contributor to burnout (prevalence ratio 1.60; 95% CI 1.36 to 1.88). CONCLUSIONS Resident physicians who experienced more care of patients with COVID-19 had slightly greater burnout prevalence than those who did not. Approximately half of resident physicians did not participate in the care of patients with COVID-19, which posed a challenge from an educational perspective.
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Affiliation(s)
- Yuji Nishizaki
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuya Nagasaki
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Kiyoshi Shikino
- Department of General Medicine, Chiba University Hospital, Chiba, Japan
| | - Masaru Kurihara
- Department of Patient Safety, Nagoya University Hospital, Aichi, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Koshi Kataoka
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Yu Yamamoto
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Sho Fukui
- Department of Emergency and General Medicine, Kyorin University, Tokyo, Japan
| | - Sho Nishiguchi
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Kohta Katayama
- Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hiroyuki Kobayashi
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Yasuharu Tokuda
- Muribushi Okinawa Center for Teaching Hospitals, Okinawa, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
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Gallo G, Guaitoli E, Barra F, Picciariello A, Pasculli A, Coppola A, Pertile D, Meniconi RL. Restructuring surgical training after COVID-19 pandemic: A nationwide survey on the Italian scenario on behalf of the Italian polyspecialistic young surgeons society (SPIGC). Front Surg 2023; 9:1115653. [PMID: 36713665 PMCID: PMC9875563 DOI: 10.3389/fsurg.2022.1115653] [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: 12/04/2022] [Accepted: 12/20/2022] [Indexed: 01/14/2023] Open
Abstract
Introduction The COVID-19 pandemic has led to the disruption of surgical training. Lack of communication, guidelines for managing clinical activity as well as concerns for safety in the workplace appeared to be relevant issues. This study aims to investigate how surgical training has been reorganized in Italy, almost 2 years after the outbreak of COVID-19 pandemic. Materials and methods A 16-item-electronic anonymous questionnaire was designed through SurveyMonkey© web application. This survey was composed of different sections concerning demographic characteristics and impacts of the second COVID-19 pandemic wave on surgical and research/didactic activities. Changes applied in the training programme and activities carried out were also investigated. The survey was carried out in the period between June and October 2021. Results Four hundred and thirty responses were collected, and 399 were considered eligible to be included in the study analysis. Three hundred and thirty-five respondents continued working in Surgical Units, with a significant reduction (less than one surgical session per week) of surgical sessions in 49.6% of them. With concern to didactic and research activities, 140 residents maintained their usual activity, while 116 reported a reduction. A sub-group analysis on resident moved to COVID-19 departments showed a reduction of research activities in 35% of them. During the period considered in this survey, the surgical training program was not substantially modified for most of participants (74.6%). Conclusion Our survey demonstrated that surgical residency programs haven't improved 2 years after the beginning of the pandemic. Further improvements are needed to guarantee completeness of surgical training, even in emergency conditions.
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Affiliation(s)
- Gaetano Gallo
- Department of Surgical Sciences, La Sapienza” University of Rome, Rome, Italy
| | | | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Arcangelo Picciariello
- Department of Emergency and Organ Transplantation, University Aldo Moro, Bari, Italy,Correspondence: Arcangelo Picciariello
| | - Alessandro Pasculli
- Department of Biomedical Sciences and Human Oncology - Unit of Endocrine, Digestive and Emergency Surgery, University “A. Moro” of Bari, Policlinic of Bari, Bari, Italy
| | | | - Davide Pertile
- Department of Surgery, Policlinico San Martino, Genova, Italy
| | - Roberto Luca Meniconi
- Department of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy
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Brulin E, Henriksson K, Landstad BJ. An impaired learning environment: Resident physicians' experience of the transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden. Front Psychol 2023; 13:1090515. [PMID: 36687854 PMCID: PMC9853888 DOI: 10.3389/fpsyg.2022.1090515] [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: 11/05/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Extensive studies regarding the COVID-19 pandemic have shown negative effects on physicians-in-training. Besides a high workload, their learning environment has been affected. A quality learning environment is vital for residents' physician's clinical development and also their health. Nevertheless, few studies have explored this. The aim of this study was to explore resident physicians' experiences of transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden. Method In this qualitative study, 12 Swedish resident physicians were interviewed using a semi-structured interview guide. They were interviewed between June and October of 2020 and asked to reflect on the pandemic and, more specifically, the first wave. The empirical material was analysed using qualitative content analysis. The analysis resulted in one theme and four categories. Results The theme identified was An impaired learning environment which signifies the disruptions the resident physicians experienced during the first wave of the pandemic. The four categories, Professional role insecurity, High expectations but little influence, Stagnant clinical development, and Professional growth through experience, describe in what way the learning environment was impacted.
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Affiliation(s)
- Emma Brulin
- The Department of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Bodil J. Landstad
- The Department of Health Sciences, Mid Sweden University, Östersund, Sweden,The Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden,*Correspondence: Bodil J. Landstad, ✉
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Karpe A, Nguyen CDT, Raza Z, Yan J, Murphy N, O’Brien B. Times Constraints, Lack of Confidence in Treatment, Stigma, and Confidentiality Concerns: Barriers to Care Among First-year Internal Medicine Residents During the COVID-19 Pandemic. J Psychiatr Pract 2023; 29:11-14. [PMID: 36649547 PMCID: PMC9851508 DOI: 10.1097/pra.0000000000000676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has presented unprecedented challenges for frontline health care workers. First-year medical residents have been at high risk of psychological distress given these challenges as well as those related to transitioning to a provider role. Virtual peer discussion groups were organized for first-year residents (N=47) at a large, American academic medical center to process the emotional impacts from the pandemic and provide support. Residents completed an anonymous survey before the initiation of the discussion groups to assess their level of psychological distress, perceived sources of stress, impact of the pandemic on their mental health, and attitudes toward seeking mental health services. Results from the survey identified time constraints as the greatest barrier to accessing mental health care, followed by lack of confidence in treatment, stigma, and concerns about confidentiality. We discuss potential ways to address some of these barriers to improve access and acceptability of mental health support for this specific population during a pandemic.
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Chandwar K, Mukherjee S, Ekbote D, Kishor K, Dogga P, Dixit J, Kumar P, Dhakad U. Impact of COVID-19 pandemic on rheumatology trainees: an online survey. Rheumatol Int 2023; 43:59-68. [PMID: 36255483 PMCID: PMC9579629 DOI: 10.1007/s00296-022-05225-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/02/2022] [Indexed: 02/02/2023]
Abstract
To assess the impact of the COVID-19 pandemic on the training of rheumatology trainees. We conducted an observational cross-sectional study using an online survey-based questionnaire sent to rheumatology trainees in India. Rheumatology trainees from India, including DM/DNB residents and fellows, were included. A total of 78 trainees from 24 institutes in 12 states participated in the study. An overwhelming majority of residents (84%) felt COVID-19 Pandemic Negatively impacted their residency and their Physical (65%), Mental (74%) and Social well-being (80%); 79% of trainees felt burnt out. Majority of trainees felt the pandemic negatively impacted their training with clinical teaching (91%), Clinical examination skills (74%), current (80%) and future (70%) research opportunities suffering during the pandemic. Most had significant reduction in the overall footfall (72%) of patients in rheumatology including OPD (77%) and indoor (67%) admissions along with academics (35%), procedures (66%) and exposure to musculoskeletal ultrasound (71%). Almost 60% and 40% of trainees had OPDs, and indoor admissions stopped during COVID-19 pandemic of these 20% had OPDs, and Admissions closed for more than 6 months. 85% of participants had one or the other psychological symptoms with almost half experiencing anxiety (44%), low mood (47%) or lack of sleep (41%). We found The COVID-19 Pandemic has significantly affected the physical, social and mental well-being of Rheumatology trainees. Academic and clinical training reduced, current and future Research became difficult, disruptions in OPDs and Admissions, recurrent COVID postings and reduction in patient footfall, procedures and MSK-US have been detrimental to trainees.
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Affiliation(s)
- Kunal Chandwar
- grid.411275.40000 0004 0645 6578Department of Clinical Immunology and Rheumatology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Sayan Mukherjee
- grid.411275.40000 0004 0645 6578Department of Clinical Immunology and Rheumatology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Digvijay Ekbote
- grid.411275.40000 0004 0645 6578Department of Clinical Immunology and Rheumatology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Kriti Kishor
- grid.411275.40000 0004 0645 6578Department of Clinical Immunology and Rheumatology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Prasanna Dogga
- grid.411275.40000 0004 0645 6578Department of Clinical Immunology and Rheumatology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Juhi Dixit
- grid.411275.40000 0004 0645 6578Department of Clinical Immunology and Rheumatology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Puneet Kumar
- grid.411275.40000 0004 0645 6578Department of Clinical Immunology and Rheumatology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Urmila Dhakad
- grid.411275.40000 0004 0645 6578Department of Clinical Immunology and Rheumatology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
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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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Chang M, Cuyegkeng A, Breuer JA, Alexeeva A, Archibald AR, Lepe JJ, Greenberg ML. Medical student exam performance and perceptions of a COVID-19 pandemic-appropriate pre-clerkship medical physiology and pathophysiology curriculum. BMC MEDICAL EDUCATION 2022; 22:833. [PMID: 36460995 PMCID: PMC9716147 DOI: 10.1186/s12909-022-03907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Medical schools were compelled to abruptly transition pre-clerkship curricula to remote learning formats due to the emergence of the Coronavirus Disease 2019 (COVID-19) pandemic. We evaluated student perceptions of remote learning, exam performance, and utilization of third-party learning resources to assess the implementation of a newly developed pandemic-appropriate physiology curriculum. METHODS This was an observational study based on a survey conducted in the Spring of 2021 at the University of California, Irvine, School of Medicine (UCISOM). This study aimed to assess first (MS1) and second year (MS2) medical students' perceptions of satisfaction, support, academic performance, and connectedness before and during the COVID-19 pandemic. The MS1 class began medical school during the first year of the COVID-19 pandemic, whereas the MS2 class did so prior to the start of the pandemic. A survey instrument was developed and validated to identify the impact remote learning had on student self-perceptions of the Medical Physiology and Pathophysiology course. Surveys were distributed to all students and responses were collected on a voluntary basis. Exam scores on a customized National Board of Medical Examiners (NBME) physiology shelf exam were also compared to objectively identify how the remote curriculum during the pandemic impacted academic performance. RESULTS Of 204 students enrolled, 74 responses were analyzed, with 42 MS1 (40% of MS1s) and 32 MS2 (31% of MS2s) responses. Overall, MS1s and MS2s were satisfied with the curriculum they received (95 and 97% respectively) and the school's support of their concerns (86 and 100% respectively). Notably, only 50% of MS1s felt connected to their peers, compared to 94% of MS2s. Lecture attendance and self-perception of their academic performance were similar between both classes. Interestingly, the intra-pandemic class's NBME exam average in 2020 (60.2% ± 8.9, n = 104) was significantly higher than the pre-pandemic class average in 2019 (56.8% ± 11.3, n = 100). Both classes primarily used course materials over third-party learning resources. An additional set of survey questions distributed only to the MS1 class found that the majority of MS1s reported minimal barriers with regards to accessibility, including internet connectivity, study-conducive environments, and balancing family commitments. Overall, pre-clerkship medical students had positive perceptions of the newly developed pandemic-appropriate physiology curriculum. CONCLUSIONS Changes to the pre-clerkship physiology curriculum during the COVID-19 pandemic were met with overall satisfaction from the students and an increase in NBME scores. More attention to student connectedness is needed to improve how remote learning can be best optimized into future curricula development.
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Affiliation(s)
- Melissa Chang
- School of Medicine, University of California, Irvine, USA
- Institute for Clinical and Translational Science, University of California, Irvine, USA
| | - Andrew Cuyegkeng
- School of Medicine, University of California, Irvine, USA
- Institute for Clinical and Translational Science, University of California, Irvine, USA
| | - Joseph A Breuer
- School of Medicine, University of California, Irvine, USA
- Institute for Clinical and Translational Science, University of California, Irvine, USA
| | - Arina Alexeeva
- School of Medicine, University of California, Irvine, USA
- Institute for Clinical and Translational Science, University of California, Irvine, USA
| | | | - Javier J Lepe
- School of Medicine, University of California, Irvine, USA
- Department of Neurology, University of California, Irvine, USA
| | - Milton L Greenberg
- School of Medicine, University of California, Irvine, USA.
- Institute for Clinical and Translational Science, University of California, Irvine, USA.
- Department of Physiology and Biophysics, University of California, Irvine, Medical Sciences D350, CA, 92697, Irvine, USA.
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Culbert MM, Brisson RJ, Oladeru OT. The landscape of digital resources in radiation oncology. Tech Innov Patient Support Radiat Oncol 2022; 24:19-24. [PMID: 36133932 PMCID: PMC9483774 DOI: 10.1016/j.tipsro.2022.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
In recent years, the number of educational medical resources accessible to residents and practicing radiation oncologists online has grown exponentially to include discussion boards, wikis, videos, podcasts, journal clubs, online communities, and interactive experiences to augment medical education. In this review, we identify, catalog, and critically evaluate educational websites, smartphone applications, web-based multimedia, and podcasts for radiation oncologists. Literature searches were conducted over a 2-month period (April to May 2022) using OVID-MEDLINE and PubMed with a combination of relevant search terms. Websites of relevant radiation oncology societies were reviewed for e-learning resources. Internet searches including the Google search engine, application stores, and podcast-publisher websites were conducted to identify digital resources for radiation oncology education. To ensure credibility, resources were assessed by two independent reviewers utilizing the criteria of authority, accuracy, objectivity, currency, depth, and appearance per suggested formats for evaluating digital resources in medical literature. Literature searches using OVID-MEDLINE and PubMed yielded 425 citations. Those pertinent to radiation oncology provide examples of resource development, integrations into curriculum, interactive modules, case studies, and learner experiences. The multilevel search identified 47 free digital education resources including online radiation oncology tutorials, podcasts, videos, slide sets, applications, and other interactive resources, some requiring membership or a fee for full access. The myriad online educational tools available to radiation oncology residents represent excellent resources for continuing education. This review represents the first comprehensive summary of available online education resources for radiation oncologists to guide clinicians who are increasingly reliant on digital resources, especially during the COVID-19 pandemic.
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Affiliation(s)
- Matthew M. Culbert
- Corresponding author at: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL 32610, United States.
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AlHilali S, Al-Swailem SA, Albdaya N, Mousa A, Khandekar R. Impact and Determinants of COVID-19 Pandemic on the Cataract Surgery Rate at a Tertiary Referral Center. Risk Manag Healthc Policy 2022; 15:2335-2342. [DOI: 10.2147/rmhp.s384456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
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Abati E, Nelva Stellio L, Manini A, Moroni F, Azzalini L, Vilca LM. A cross-sectional survey study of the impact of COVID-19 pandemic on the training and quality of life of Italian medical residents in the Lombardy region. Ann Med 2022; 54:2326-2339. [PMID: 36001504 PMCID: PMC9415486 DOI: 10.1080/07853890.2022.2105392] [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: 11/01/2022] Open
Abstract
INTRODUCTION The reorganization of the healthcare system prompted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has posed unique challenges for Residency Training Programs worldwide. To mitigate its potential negative effects, it is crucial to assess how the pandemic influenced the activity and quality of life of residents. The purpose of this study was to assess the impact of the pandemic on residents' competencies, satisfaction, working load, training patterns and occupational exposure in the clinical, surgical, research and didactic fields and to quantify its effects on quality of life and risk perception. METHODS An online cross-sectional survey was distributed between 1 June 2020 and 31 July 2020 to 1645 residents enrolled in all Residency Programs of four Universities in northern Italy. The survey included questions about clinical, surgical, and research competencies, educational activity, and quality of life pre- and post-pandemic, and on policies and workplace interventions to reduce exposure to SARS-CoV-2. The main outcome measure was the variation in self-perceived clinical, surgical and research competencies and in specialistic training. Data were analysed using the statistical package R Core Team 4.0.0, estimating mean and standard deviation or median and interquartile range for continuous variables. Variables were compared using chi-square test, Fisher exact tests or McNemar test, as appropriate.A multivariate binary logistic regression analysis was performed to test the effect of different factors on the impact of coronavirus disease-2019 (COVID-19) on self-perceived clinical and research competencies and on didactic training. RESULTS A total of 498 residents completed the survey (response rate 30.3%). The mean age of respondents was 28.9 years, 62.9% were women, and 52.4% were enrolled in the first two years of Training Programs. On the first pandemic wave, over 60% of residents reported a negative impact of the pandemic on their specialistic training. In contrast, 40% of residents involved in clinical duties perceived an improvement in their clinical competences, especially those involved in COVID-19 care, and 34.5% perceived an improvement in their research competences, particularly junior residents, while only 3.5% reported an improvement in surgical skills. Most surgical residents (88.5%) reported a decrease in surgical activities, mainly due to reduced hospital bed capacity and reduction of elective surgery. Almost 90% of all residents experienced a reduction in their didactic activities, but 80% stated their Residency Program adopted virtual training methods. A statistically significant reduction in all examined quality of life items post-pandemic vs. pre-pandemic was found. Even though most survey participants reported the availability of personal protective equipment for residents, 44% considered themselves to be at higher risk of exposure compared to senior staff. CONCLUSION COVID-19 pandemic caused a significant disruption in surgical training, but it had a positive impact on clinical competencies among residents involved in COVID-19 and urgent care. The pandemic had a detrimental effect on all quality of life aspects, and most residents considered themselves at higher risk of SARS-CoV-2 infection compared to other healthcare professionals.Key MessagesCoronavirus disease-2019 (COVID-19) pandemic caused a significant disruption in surgical training, but it had a positive impact on clinical competencies among residents involved in COVID-19 and urgent care.Most residents experienced a reduction of didactic activities. Although the majority of training programs implemented virtual training methods to counteract the restrictions imposed by the pandemic, only half of the residents were satisfied of them.A vast proportion of residents had a high occupational exposure to SARS-CoV-2 and considered themselves at higher risk of COVID-19 infection compared to senior staff.The survey highlighted a statistically significant reduction in five key quality of life measures (i.e. sleep, mood, familiar relationships and social relationships quality and employment satisfaction) during the first wave, with mood and social relationships being the most affected. Notably, employment satisfaction was significantly higher in medical compared to surgical residents.
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Affiliation(s)
- Elena Abati
- Department of Pathophysiology and Transplant (DEPT), Dino Ferrari Centre, Neuroscience Section, University of Milan, Milan, Italy
| | - Leonardo Nelva Stellio
- Department of Women, Mothers and Neonates, Buzzi Children's Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Arianna Manini
- Department of Pathophysiology and Transplant (DEPT), Dino Ferrari Centre, Neuroscience Section, University of Milan, Milan, Italy
| | - Francesco Moroni
- Università Vita-Salute San Raffaele, Milan, Italy.,Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Lorenzo Azzalini
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Luz Maria Vilca
- Unit of Obstetrics and Gynecology, Buzzi Children's Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
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Aktoz F, Tercan C, Dagdeviren E, Kaya C. Comparison of laparoscopic hysterectomy videos on YouTube and WebSurg platforms in terms of educational reliability and quality. J Gynecol Obstet Hum Reprod 2022; 51:102435. [DOI: 10.1016/j.jogoh.2022.102435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/24/2022] [Indexed: 10/17/2022]
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Mohammadzadeh N, Tadbir Vajargah K, Nilforoushan N, Ashouri M, Jafarian A, Emami-Razavi SH. The impact of the COVID-19 pandemic on surgical education: A survey and narrative review. Ann Med Surg (Lond) 2022; 82:104598. [PMID: 36101842 PMCID: PMC9458543 DOI: 10.1016/j.amsu.2022.104598] [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: 07/23/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 11/29/2022] Open
Abstract
Background Since the emergence of the COVID-19 pandemic, medical education has been a concerning issue, especially in surgical fields. Due to the postponement of many elective surgeries and even alternations in the pattern of emergent surgeries, concerns have been raised about whether residents of surgical disciplines are experienced enough after graduation or not. We aimed to describe the impact of the COVID-19 pandemic on surgical residency training in different fields. Materials and methods We conducted a cross-sectional study with a 20-item questionnaire on residents of surgical disciplines from three different educational hospitals of Tehran University of Medical Sciences, Iran in 2020. In addition, we reviewed the current literature regarding the impact of COVID-19 pandemic on surgical education worldwide. Results Our survey, with a response rate of 56.8% demonstrated significant reduction in the time spent in elective surgeries, surgical clinics and even in emergent surgeries for residents. Besides, it has reported that significant time has been spent in COVID 19 wards which resulted in decreased satisfaction of educational activities. Conclusions The impacts of COVID 19 pandemic on surgical education are significant and inevitable. Thus, we must integrate novel educational methods in surgical curriculum to optimize training and minimize the adverse effects of the pandemic on surgical education. The impacts of COVID 19 on surgical education are significant and inevitable. We must integrate novel educational methods in surgical curriculum. We need to optimize training and minimize the adverse effects of the pandemic.
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Wådell M, Örtqvist AK, Linden K, Akerstrom M, Andersson O, Carlsson Y, Graner S, Jonsson M, Naurin E, Sengpiel V, Veje M, Wessberg A, Zaigham M. Challenges imposed by the COVID-19 pandemic on the Obstetrics and Gynecology residency program: a mixed-methods Swedish survey in the COPE Staff cohort study. BMC MEDICAL EDUCATION 2022; 22:602. [PMID: 35927725 PMCID: PMC9354310 DOI: 10.1186/s12909-022-03631-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND To outline how the training program and work situation of residents in Obstetrics and Gynecology (OB-GYN) was affected by the pandemic and to illuminate how residents experienced these changes. METHODS As part of the COVID-19 in Pregnancy and Early Childhood Staff (COPE Staff) cohort study, between January and May 2021, all participating residents were invited to answer a 28-question online Resident Survey focusing on their specialist education, work situation and experiences during the COVID-19 pandemic. Descriptive statistics were given in percentages for categorical variables and means and standard deviations (SD) for continuous variables. Univariate comparative analyses were performed with the use of the Pearson's Chi-2-test for dichotomous data. The association between residents' worry about the quality and length of their specialist training, with extra clinical hours and transfer to other healthcare institutions were assessed by multivariate logistic regression. Free text responses were analyzed by content analysis. RESULTS Of the 162 participating OB-GYN residents, 69% expressed concern that the pandemic would have a negative impact on their training. Ninety-five (95%) reported cancellation/postponement of educational activities, 70% performed fewer surgeries and 27% had been transferred to other healthcare institutions where about half reported having gained more general knowledge as a physician. Working extra clinical hours was reported by 69% (7.4 ± 5.3 hours per week) and 14% had considered changing their profession due to the pandemic. Senior residents, compared to junior residents, more often experienced cancelled/postponed clinical rotations (30% vs 15%, P=0.02) and reported performing fewer surgeries (P=0.02). The qualitative analysis highlighted the lack of surgical procedural training as a major concern for residents. CONCLUSION The COVID-19 pandemic has strongly impacted the training program and work situation of OB-GYN residents in Sweden. Residents were concerned over the negative impact of the pandemic on their training program and senior residents reported more missed educational opportunities as compared to junior residents. Program directors, head of institutions and clinical supervisors can use the problem areas pinpointed by this study to support residents and compensate for missed educational opportunities. While hands-on-training and operating time cannot be compensated for, the authors hope that the findings of the study can help develop new strategies to minimize the negative impact of the current and future pandemics on resident education and work situation.
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Affiliation(s)
- Matilda Wådell
- Department of Obstetrics and Gynecology, Hudiksvall Hospital, Hudiksvall, Sweden
| | - Anne K Örtqvist
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynecology, Visby County Hospital, Visby, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Akerstrom
- Region Västra Götaland, The Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ola Andersson
- Pediatrics, Institution of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Neonatology, Skåne University Hospital, Malmö, Sweden
| | - Ylva Carlsson
- Region Västra Götaland, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sofie Graner
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- BB Stockholm, Danderyds Hospital, 182 88, Danderyd, Sweden
| | - Maria Jonsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Obstetrics and Gynecology, Uppsala University Hospital, Uppsala, Sweden
| | - Elin Naurin
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Verena Sengpiel
- Region Västra Götaland, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Veje
- Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Wessberg
- Region Västra Götaland, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mehreen Zaigham
- Obstetrics and Gynecology, Institution of Clinical Sciences Lund, Lund University, Lund, Sweden.
- Department of Obstetrics & Gynecology, Lund University and Skåne University Hospital, 205 01, Malmö, Sweden.
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Olortegui Yzu A, Fernández Coronado R. [Perceptions of resident physicians on the development of the cardiology resident program during the COVID-19 pandemic in Lima, Peru]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2022; 3:145-152. [PMID: 37284574 PMCID: PMC10241333 DOI: 10.47487/apcyccv.v3i2.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/28/2022] [Indexed: 06/08/2023]
Abstract
Objective To describe the perceptions of resident doctors about the development of their training program during the pandemic in the city of Lima - Peru. Materials and methods Through a cross-sectional study, a questionnaire was applied to seventy-eight cardiology residents in the last two years of training in the specialty. The perceptions about the accompaniment and support of the universities in the educational venues, for the development of the training program in cardiology during the pandemic, were evaluated. Results Regarding the support provided for their training, the items evaluated showed shortcomings above 60%, where permanent supervision was lacking in 90.0% of the residents. Regarding compliance with the rotations, the residents only received supervision in 24.4%, observing that they did not manage to carry out adequate rotations in 80.8% of the cases. The courses of the curricular plan were adequately developed in 92.5% of the cases, and the actions for the health of the resident were very low, highlighting that only in 9.0% of the cases did the university inquire about the state of health of the resident. Conclusions The development of the cardiology residency training program during the pandemic presented important shortcomings, showing that the deficiencies were accentuated compared to previous studies.
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Affiliation(s)
- Adriel Olortegui Yzu
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, PerúUniversidad Nacional Mayor de San MarcosDepartamento de Medicina Preventiva y Salud PúblicaFacultad de MedicinaUniversidad Nacional Mayor de San MarcosLimaPeru
| | - Rosalía Fernández Coronado
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, PerúUniversidad Nacional Mayor de San MarcosFacultad de MedicinaUniversidad Nacional Mayor de San MarcosLimaPeru
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Hogan SO, Holmboe ES. Effects of COVID-19 on Residency and Fellowship Training: Results of a National Survey. J Grad Med Educ 2022; 14:359-364. [PMID: 35754650 PMCID: PMC9200244 DOI: 10.4300/jgme-d-22-00351.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected every facet of American health care, including graduate medical education (GME). Prior studies show that COVID-19 resulted in reduced opportunities for elective surgeries, lower patient volumes, altered clinical rotations, increased reliance on telemedicine, and dependence on virtual didactic conferences. These studies, however, focused on individual specialties. Because the Accreditation Council for Graduate Medical Education (ACGME) routinely collects information from all programs it has an obligation to use these data to inform the profession about important trends affecting GME. OBJECTIVE To describe how the pandemic influenced resident training across all specialty programs in areas of clinical experiences, telemedicine, and extended trainings. METHODS The ACGME validated a questionnaire to supplement the Annual Update reporting requirements of all accredited programs. The questionnaire was tested to ensure easy interpretation of instructions, question wording, response options, and to assess respondent burden. The questionnaire was administered through the Accreditation Data System, which is a password-protected online environment for communication between the ACGME and ACGME-accredited programs. RESULTS We received a response rate of 99.6% (11 290 of 12 420). Emergency medicine, family medicine, internal medicine, and obstetrics and gynecology programs experienced the most significant impact. Most programs reported reduced opportunities for in-person didactics and ambulatory continuity rotations. Hospital-based programs on the "frontline" of COVID-19 care relied least on telemedicine. Family medicine and internal medicine programs accounted for the greatest number of extended trainings. CONCLUSIONS COVID-19 has affected GME training, but its consequences are unevenly distributed across program types and regions of the country.
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Affiliation(s)
- Sean O. Hogan
- Sean O. Hogan, PhD, is Director, Outcomes Research and Evaluation, Accreditation Council for Graduate Medical Education (ACGME)
| | - Eric S. Holmboe
- Eric S. Holmboe, MD, is Chief Research, Milestone Development, and Evaluation Officer, ACGME
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