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Barter CA, Humes D, Lund J. The Impact of the Covid-19 Pandemic on Annual Review of Competency Progression Outcomes Issued to General Surgical Trainees. JOURNAL OF SURGICAL EDUCATION 2024; 81:1119-1132. [PMID: 38825562 DOI: 10.1016/j.jsurg.2024.05.003] [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: 02/08/2024] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND The Covid-19 pandemic had a profound impact on surgical training. In this longitudinal cohort study, we quantify the effects of the pandemic on United Kingdom (UK) surgeons in higher specialty training by analyzing the Annual Review of Competency Progression (ARCP) Outcomes issued to them prior to, and during, the pandemic. METHODS Anonymized records were provided from the UK training management system- the Intercollegiate Surgical Curriculum Programme (ISCP)- on the ARCP Outcomes of higher specialty trainees in General Surgery over the period between January 2017 and December 2022. Demographic data including sex and age group on starting higher specialty training were considered, as were working pattern, phase of training during the height of the pandemic (2020 and 2021), and training region. The proportion of nonstandard outcomes, and the use of specific Covid-19 outcomes, were analyzed to assess the impact of these variables on ARCP outcome using univariate and multivariate logistic regression. Prepandemic outcomes in 2017 were used as a comparator. RESULTS A total of 7414 ARCP outcomes issued to 1874 General Surgery higher speciality trainees were analysed. The Adjusted Odds Ratio (AOR) for receiving a nonstandard outcome in 2020 (compared to 2017) was 3.07 (95% CI: 2.47-3.81, p < 0.001) not recovering to prepandemic levels by the end of 2022 (AOR 2.11 (95% CI: 1.69-2.64, p < 0.001)). Female sex (AOR 1.27 (95% CI: 1.13-1.43, p < 0.001) and being older on starting higher surgical training (AOR = 1.51 (95% CI: 1.34-1.70, p < 0.001) were both significantly associated with a higher chance of nonstandard outcome. Working pattern was linked to ARCP outcome on univariate analysis, but this relationship disappeared once corrected for other demographic factors (1.05, 95% CI: 0.88-1.24, p = 0.582). Being at a later stage of training during the pandemic was not linked to an increase in AOR of receiving a nonstandard outcome (1.09, 95% CI: 0.97-1.22, p = 0.134), but trainees receiving a nonstandard outcome in this group were more likely to have extra training time advised (15.49%, vs 4.27% in 2021). The highest AOR of receiving a Covid-19 outcome was in the Wessex Deanery at 2.85 (95% CI: 1.83-4.46, p < 0.001), whilst the lowest AOR were seen in Yorkshire and the Humber (0.32, 95% CI: 0.17-0.62, p < 0.001). Removing Covid-19 specific outcomes from the analysis shows a continued rise in the use of nonstandard outcomes in all years except 2020. CONCLUSIONS The Covid-19 Pandemic had a significant impact on the trajectory of training in General Surgery in the UK. Training extensions were more likely to be recommended later in training. There was considerable variation in the use of Covid-19 ARCP outcomes across the UK. There is ongoing evidence of differential attainment at ARCP in General Surgery, with female trainees and older graduates having greater chances of nonstandard outcomes. The underlying reasons for these associations need to be explored. Efforts to urgently address deficits in training post Covid-19 with an awareness of the intersectional nature of differential attainment are needed.
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Affiliation(s)
- Charlotte A Barter
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Royal Derby Hospital, Derby, United Kingdom.
| | - David Humes
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, QMC Campus, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jonathan Lund
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Royal Derby Hospital, Derby, United Kingdom
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Bouhout S, Hébert M, Jakubowska W, Jaworski L, Freeman EE, Aubin MJ. Impact of the COVID-19 Pandemic on Mental Health among Patients with Chronic Ocular Conditions. Vision (Basel) 2023; 7:49. [PMID: 37489328 PMCID: PMC10366822 DOI: 10.3390/vision7030049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023] Open
Abstract
The COVID-19 pandemic had significant impacts on the mental and visual health of patients. This cross-sectional, survey-based, multicentric study evaluates the state of mental and visual health among patients with chronic ocular diseases such as glaucoma, neovascular age-related macular degeneration, diabetic retinopathy, or chronic uveitis during the lockdown period of the COVID-19 pandemic. Mental health was assessed using three questionnaires: the Patient Health Questionnaire-9 (PHQ-9), the Impact of Event Scale-Revised (IES-R), and the National Eye Institute Visual Function Questionnaire-25 (VFQ-25). A total of 145 patients completed the questionnaires. The PHQ-9 showed that most respondents (n = 89, 61%) had none or minimal depressive symptoms, while 31 (21%) had mild depressive symptoms, 19 (13%) had moderate depressive symptoms, 5 (3%) had moderately severe depressive symptoms, and 1 (1%) had severe depressive symptoms. Regarding stress surrounding the pandemic, the median IES-R showed mild distress in 16 (11%), moderate distress in 7 (5%), and severe distress in 4 (3%). The COVID-19 pandemic lockdowns had a negative impact on patients' mental health with close to 20% of the patients reporting at least moderately depressive symptoms and 19% reporting at least mildly distressful symptoms.
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Affiliation(s)
- Soumaya Bouhout
- Department of Ophthalmology, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Mélanie Hébert
- Department of Ophthalmology, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Weronika Jakubowska
- Department of Ophthalmology, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Laurence Jaworski
- Department of Ophthalmology, Université de Montréal, Montréal, QC H3T 1J4, Canada
- University Ophthalmology Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC H2X 3E4, Canada
| | - Ellen E Freeman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
- Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada
| | - Marie-Josée Aubin
- Department of Ophthalmology, Université de Montréal, Montréal, QC H3T 1J4, Canada
- University Ophthalmology Center, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île-de-Montréal-Hôpital Maisonneuve-Rosemont, Montréal, QC H1T 2M4, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, QC H3T 1J4, Canada
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Parmar UPS, Ichhpujani P, Chahal R, Singh RB. Reliability of Ahmed glaucoma valve surgical videos for educational purposes. Int Ophthalmol 2023:10.1007/s10792-023-02734-x. [PMID: 37191927 PMCID: PMC10185961 DOI: 10.1007/s10792-023-02734-x] [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: 11/20/2022] [Accepted: 05/03/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE The use of video-based social media platforms is increasing among trainee residents, fellows, and practicing ophthalmologists. In this study, we objectively evaluate the quality of Ahmed glaucoma valve (AGV) implantation videos on open access, video-based internet platforms. DESIGN Internet-based cross-sectional study. PARTICIPANTS Not applicable. METHODS In this cross-sectional study, 23 websites publishing medical surgery training video content were queried using the keyword "Ahmed glaucoma valve implantation". MAIN OUTCOME MEASURES The descriptive statistics of video parameters were noted, and the videos were assessed using established scoring systems-Sandvik, Health on the Net Foundation Code of Conduct (HON code), mDISCERN, and Global Quality Score (GQS) scores. Video Quality Score (VQS) was determined based on the 14 steps per the AGV implantation rubric. RESULTS One hundred and nineteen videos were evaluated, and 35 were excluded. The total quality of all 84 videos according to their Sandvik, HON Code, GQS, DISCERN, and VQS scores was 11.79 ± 1.70 (excellent quality), 6.86 ± 0.75 (excellent quality), 3.97 ± 0.93 (good quality), 3.26 ± 0.66 (fair quality) and 11.45 ± 2.67 (good quality), respectively. No significant correlation was found between the descriptive parameters and video quality score. However, no significant correlation was found between the descriptive parameters and video quality score. CONCLUSIONS The objective analysis showed that the video quality ranged from good to excellent. AGV implantation videos were sparse on exclusive ophthalmology surgical video portals. Therefore, more peer-reviewed videos following standardized rubric are needed on open-access surgical video platforms.
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Affiliation(s)
- Uday Pratap Singh Parmar
- Department of Ophthalmology, Glaucoma and Neuro-Ophthalmology Service, Government Medical College and Hospital, Sector-32, 160030, Chandigarh, India
| | - Parul Ichhpujani
- Department of Ophthalmology, Glaucoma and Neuro-Ophthalmology Service, Government Medical College and Hospital, Sector-32, 160030, Chandigarh, India.
| | - Rutvi Chahal
- Department of Ophthalmology, Glaucoma and Neuro-Ophthalmology Service, Government Medical College and Hospital, Sector-32, 160030, Chandigarh, India
| | - Rohan Bir Singh
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Discipline of Ophthalmology & Vision Sciences, University of Adelaide, Adelaide, South Australia, Australia
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Hébert M, Bouhout S, Freeman EE, Aubin MJ. The Mental Health State of Canadian Ophthalmologists during the COVID-19 Pandemic: A Survey-Based Study and Review. Vision (Basel) 2023; 7:vision7010023. [PMID: 36977303 PMCID: PMC10057889 DOI: 10.3390/vision7010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/02/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic disrupted the practice of medicine, causing stress and uncertainty among ophthalmologists. This cross-sectional, survey-based study of Canadian Ophthalmological Society members (n = 1152) aims to report on Canadian ophthalmologists’ mental health during the COVID-19 pandemic. Four questionnaires were administered between December 2020 and May 2021: the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), the 7-item Insomnia Severity Index (ISI), and the Impact of Event Scale—Revised (IES-R). From all of the responses, 60/85 answers were deemed complete and were included. The median age was 50–59 years and 53% were women. On PHQ-9, most respondents had no or minimal depressive symptoms (n = 38, 63%), while 12% (n = 7) had moderately severe depressive symptoms and 12% (n = 7) reported impaired daily functioning and/or thoughts of suicide or self-harm. On the GAD-7 scale, 65% (n = 39) had no significant anxiety, while 13% (n = 8) had moderate to severe anxiety. Most respondents did not have clinically significant insomnia (n = 41, 68%). Finally, 16 respondents (27%) had an IES-R score ≥24 suggesting possible post-traumatic stress disorder. No significant differences were found based on demographics. During the COVID-19 pandemic, up to 40% of respondents experienced varying degrees of depression, anxiety, insomnia, and distress from the event. In 12%, there were concerns for impaired daily functioning and/or suicidal thoughts.
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Affiliation(s)
- Mélanie Hébert
- Department of Ophthalmology, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Soumaya Bouhout
- Department of Ophthalmology, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Ellen E. Freeman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
- Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada
| | - Marie-Josée Aubin
- Department of Ophthalmology, Université de Montréal, Montreal, QC H3T 1J4, Canada
- University Ophthalmology Center, Centre Intégré Universitaire de Santé et de Services Sociaux de l’Est-de-l’Île-de-Montréal—Hôpital Maisonneuve-Rosemont, Montreal, QC H1T 2M4, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC H3T 1J4, Canada
- Correspondence:
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Alagorie AR, Sorour OA, Eltoukhy H, Nassar E. Evaluation of Urgent Retinal Practice and Safety Measures for Physicians and Patients During COVID-19 Pandemic. Clin Ophthalmol 2022; 16:1197-1205. [PMID: 35480622 PMCID: PMC9037724 DOI: 10.2147/opth.s355628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the impact of the COVID-19 pandemic on urgent retina practice and factors influencing adherence of physicians and patients to safety measures. Methods In this clinical audit, urgent or emergent vitreoretinal surgical disorders that presented to our hospital during the period of 15th March-15th May 2020 were compared with the period just before the pandemic declaration (15th December 2019-15th February 2020). Additionally, two questionnaires assessing the adherence to safety measures were circulated to the medical personnel and a sample of patients. The collected data were analyzed, and accordingly, recommendations were proposed to the hospital administration and specific corrective measures were applied. The outcome of applying these corrective measures was assessed in the re-audit cycle during the period of 15th June-15th August 2020. Results There was a significant decrease in the number of urgent or emergent vitreoretinal surgical disorders that presented to our hospital during the pandemic (161 versus 302 cases in a similar period before the pandemic; p = 0.022). Just with the pandemic recession, there was a significant increase in the number of urgent cases (391 versus 161 cases during the pandemic; p = 0.006), also there was an increased number of complex cases. Residents and fellows were less compliant than attending physicians in adherence to safety measures. Conclusion Delayed presentation of urgent retinal cases during the pandemic highlights the importance of public awareness of urgent conditions that need immediate medical or surgical care. Attention to young physicians during the pandemic is crucial as they are less adherent to safety measures due to work overload.
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Affiliation(s)
| | - Osama A Sorour
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hesham Eltoukhy
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Elsayed Nassar
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
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The Role of Technology in Ophthalmic Surgical Education During COVID-19. CURRENT SURGERY REPORTS 2022; 10:239-245. [PMID: 36404795 PMCID: PMC9662128 DOI: 10.1007/s40137-022-00334-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 11/16/2022]
Abstract
Purpose of Review To describe the effect of COVID-19 on ophthalmic training programs and to review the various roles of technology in ophthalmology surgical education including virtual platforms, novel remote learning curricula, and the use of surgical simulators. Recent Findings COVID-19 caused significant disruption to in-person clinical and surgical patient encounters. Ophthalmology trainees worldwide faced surgical training challenges due to social distancing restrictions, trainee redeployment, and reduction in surgical case volume. Virtual platforms, such as Zoom and Microsoft Teams, were widely used during the pandemic to conduct remote teaching sessions. Novel virtual wet lab and dry lab curricula were developed. Training programs found utility in virtual reality surgical simulators, such as the Eyesi, to substitute experience lost from live patient surgical cases. Summary Although several of these described technologies were incorporated into ophthalmology surgical training programs prior to COVID-19, the pandemic highlighted the importance of developing a formal surgical curriculum that can be delivered virtually. Novel telementoring, collaboration between training institutions, and hybrid formats of didactic and practical training sessions should be continued. Future research should investigate the utility of augmented reality and artificial intelligence for trainee learning.
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The impact of COVID-19 pandemic and national lockdown on the surgical care of ophthalmic patients in a tertiary health care institution. SRP ARK CELOK LEK 2022. [DOI: 10.2298/sarh220211068v] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction/Objective. World Health Organization in January 2020 declared a pandemic of the coronavirus disease named COVID-19. The state of emergency in the Republic of Serbia began on March 15 2020, which greatly influenced the treatment of those patients who were not affected by COVID-19. The aim of this paper is to compare the most common ophthalmic surgeries during quarantine with those performed in 2019 in the same period. Methods. This is a retrospective study. We collected data from the operating protocol of the main ophthalmic operating room. We have followed the changes related to surgical procedures during these two years. Results. During the state of emergency, significantly more operations were performed on male patients than on female patients compared to the same period in 2019 (p = 0.043). In the observed period, in 2019 significantly more patients older than 65 were surgically treated (p < 0.001). During 2019, there were 397 (64.3%) elective and 220 (35.7%) urgent procedures, while for the same period next year there were 9 (9.1%) elective and 90 (90.9%) urgent procedures. Significantly more urgent interventions were performed during 2020 compared to 2019 (p < 0.001). Conclusion. The coronavirus pandemic has led to numerous changes in the treatment of ophthalmic patients. Many patients did not have access to adequate treatment, which certainly led to the impairment of many ophthalmic diseases.
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