Rethinking Residency Conferences in the Era of COVID-19

From the lecture hall to the cloud: Theoretical foundations for engaging virtual and hybrid didactics in emergency medicine

Engaging learners in the virtual or hybrid learning environment requires a combination of interactive content, effective communication, and mastery of function in the virtual space. Teaching in the virtual and hybrid environment presents many challenges but it remains a part of emergency medicine resident didactics, making it imperative that theory underpins our approach to virtual and hybrid learning. Connecting didactic techniques to theory can ensure that innovation promotes the intended learning outcome. This paper will demonstrate how to connect education theory to common didactic techniques implemented in the virtual and hybrid environment.

Virtual Learning in Emergency Medicine Residency Programs

During the COVID-19 pandemic, educational systems worldwide faced significant disruptions as in-person learning became unfeasible. In response, many institutions, including graduate medical education programs, swiftly transitioned to virtual learning platforms to adapt to these challenges. The rapid and unplanned pivot in learning format resulted in temporary negative impacts on residency training. Conversely, the experience of the rapid shift may have resulted in some long-term benefits while also preparing programs for future disruptions. This review aimed to discuss the advantages and disadvantages of virtual learning, potential mitigation strategies for the realized disadvantages, and potential areas of future research.

The Effect of COVID-19 on Attendance Rates in Pediatric Residency Training Educational Sessions

INTRODUCTION

Residency education faced significant challenges during the COVID-19 pandemic. Programs had to adopt new methods to maintain high-quality education while adhering to social distancing restrictions. This necessity prompted medical training programs worldwide to change their learning routines dramatically. A notable shift occurred from traditional classroom lectures to online educational tools, with web-based learning becoming a key strategy to address these challenges.

OBJECTIVE

This study aimed to evaluate the impact of the transition to virtual learning during the COVID-19 pandemic on attendance rates at scheduled educational sessions in a pediatric residency program.

HYPOTHESIS

We postulated that the introduction of virtual lectures for residency training will increase the attendance of residents.

METHODOLOGY

All pediatric residents exposed to in-person and virtual learning during the study period (October 2020) were included. Attendance records were reviewed, and data were stratified based on the year of expected graduation (Class of 2021 and Class of 2022). The attendance rate percent (ARP) was calculated as: (Number of educational sessions attended / Total number of sessions held) × 100. ARP during the prepandemic (traditional method; July-September 2019) period was compared with ARP during the pandemic period (virtual learning; July 2020-September 2020). Statistical analysis was done using chi-square analysis.

RESULTS

A total of 23 residents were subjects in the study: 11 from the graduating class of 2021 and 12 from the graduating class of 2022. In July- October 2019, with 54 lectures, the total expected attendance was 1,242 (23 residents × 54 lectures). In July-October 2020, with 62 educational sessions, the total expected attendance was 1,426 (62 sessions × 23 residents). The actual attendance was 451 (36%) in 2019 compared to 722 (51%) in 2020, a 15% increase (p < 0.00001). This increase was associated with the shift to virtual learning for both classes (p < 0.001).

CONCLUSION

Our results show a significant increase in educational session attendance rate among our resident group after the implementation of virtual learning, irrespective of their level of training. However, it is not a given that increased attendance is likely to result in increased knowledge and better clinical performance. Virtual learning should be considered a valuable educational tool for residency training.

How the knowledge shared using social media is taken up into health professions education practice: A qualitative descriptive study

Social media may promote knowledge sharing but what users do with the new knowledge and how it may influence practice remains to be known. This exploratory study used a social constructivist lens to understand how health professions educators and researchers integrate knowledge from social media into their respective practices. We purposively sampled health professions educators and researchers using the hashtags #MedEd, #HPE, and #HealthProfessionsEducation on Twitter/X. We obtained informed consent, conducted interviews via videoconference, and engaged in multiple cycles of deductive and inductive coding and analysis. Participants identified as educators and researchers (n = 12), as researchers (n = 1), or as educators (n = 1) from Canada (n = 8), the United States (n = 3), and Switzerland, Ireland, and China (n = 1, respectively). Eight participants actively used social media (i.e., creating/posting original content); six participants indicated passive use (i.e., reading/retweeting content). They discussed the importance of crafting a consumable message and social media identity to streamline the content shared. Social media's accessible, non-hierarchical nature may facilitate knowledge-sharing, whereas the potential spread of misinformation and technological requirements (e.g., internet access, country-specific restrictions on platforms) present barriers to uptake. Participants described using knowledge gained from social media as teaching tools, new research methodologies, new theoretical frameworks, and low-risk clinical interventions. Previous research has demonstrated how social media has empirically been used for diffusion or dissemination rather than as an active process of evidence uptake. Using knowledge translation frameworks, like the Knowledge to Action or Theoretical Domains frameworks, to inform social media-based knowledge sharing activities in health professions education is recommended.

Social media as a mechanism of dissemination and knowledge translation among health professions educators: a scoping review

Health professions educators often use social media to share knowledge; however, it is unclear what specific dissemination and knowledge translation (KT) processes are occurring and the implications of this sharing for health professions education (HPE). This study explored how educators have used social media as a mechanism of dissemination and KT in the literature. A critical scoping review methodology, informed by Engeström's Activity Theory, was employed. Twelve databases were searched and studies that: (a) addressed health professions educators; (b) described the use of social media for dissemination or KT; (c) focused on a regulated health profession; (d) focused on undergraduate or graduate education; and (e) were published in English or French between 2011 and 2021 were included. Data were analyzed using numerical and qualitative content analyses. Of the 4859 articles screened, 37 were eligible for inclusion. Social media may facilitate knowledge sharing in HPE, but there is a lack of conceptual clarity on what is meant by 'dissemination' and 'KT'. Who is responsible for sharing knowledge, what knowledge is being shared, and the target audiences are not always clear. Multiple factors (e.g., affordances, opportunity costs) influence how social media is used as a mechanism of dissemination, and it remains unclear whether and how it is used as a mechanism of KT. Concepts like KT and dissemination, which are often borrowed from other disciplines, must be critically evaluated for their relevance and suitability if they are to be appropriately applied to HPE and in particular to social media. Educators looking to use social media to teach students about KT should consider whether this use of technology truly aligns with their stated learning outcomes.

Trends in point-of-care ultrasound use among emergency medicine residency programs over a 10-year period

Background

Point-of-care ultrasound (POCUS) is increasingly utilized in emergency medicine (EM). While residents are required by the Accreditation Council for General Medical Education to complete a minimum of 150 POCUS examinations before graduation, the distribution of examination types is not well-described. This study sought to assess the number and distribution of POCUS examinations completed during EM residency training and evaluate trends over time.

Methods

This was a 10-year retrospective review of POCUS examinations across five EM residency programs. The study sites were deliberately selected to represent diversity in program type, program length, and geography. Data from EM residents graduating from 2013 to 2022 were eligible for inclusion. Exclusion criteria were residents in combined training programs, residents who did not complete all training at one institution, and residents who did not have data available. Examination types were identified from the American College of Emergency Physicians guidelines for POCUS. Each site obtained POCUS examination totals for every resident upon graduation. We calculated the mean and 95% confidence interval for each procedure across study years.

Results

A total of 535 residents were eligible for inclusion, with 524 (97.9%) meeting all inclusion criteria. The mean number of POCUS examinations per resident increased by 46.9% from 277 in 2013 to 407 in 2022. All examination types had stable or increasing frequency. Focused assessment with sonography in trauma (FAST), cardiac, obstetric/gynecologic, and renal/bladder were performed most frequently. Ocular, deep venous thrombosis, musculoskeletal, skin/soft tissue, thoracic, and cardiac examinations had the largest percentage increase in numbers over the 10-year period, while bowel and testicular POCUS remained rare.

Conclusions

There was an overall increase in the number of POCUS examinations performed by EM residents over the past 10 years, with FAST, cardiac, obstetric/gynecologic, and renal/bladder being the most common examination types. Among less common procedures, increased frequency may be needed to ensure competence and avoid skill decay for those examination types. This information can help inform POCUS training in residency and accreditation requirements.

Is Virtual Learning Here to Stay? A Multispecialty Survey of Residents, Fellows, and Faculty

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.

Guidelines: The Do's, Don'ts and Don't Knows of Creating Open Educational Resources

Background

In medical education, there is a growing global demand for Open Educational Resources (OERs). However, OER creators are challenged by a lack of uniform standards. In this guideline, the authors curated the literature on how to produce OERs for medical education with practical guidance on the Do's, Don'ts and Don't Knows for OER creation in order to improve the impact and quality of OERs in medical education.

Methods

We conducted a rapid literature review by searching OVID MEDLINE, EMBASE, and Cochrane Central database using keywords "open educational resources" and "OER". The search was supplemented by hand searching the identified articles' references. We organized included articles by theme and extracted relevant content. Lastly, we developed recommendations via an iterative process of peer review and discussion: evidence-based best practices were designated Do's and Don'ts while gaps were designated Don't Knows. We used a consensus process to quantify evidentiary strength.

Results

The authors performed full text analysis of 81 eligible studies. A total of 15 Do's, Don't, and Don't Knows guidelines were compiled and presented alongside relevant evidence about OERs.

Discussion

OERs can add value for medical educators and their learners, both as tools for expanding teaching opportunities and for promoting medical education scholarship. This summary should guide OER creators in producing high-quality resources and pursuing future research where best practices are lacking.

The ultrasound use of simulators, current view, and perspectives: Requirements and technical aspects (WFUMB state of the art paper)

Simulation has been shown to improve clinical learning outcomes, speed up the learning process and improve learner confidence, whilst initially taking pressure off busy clinical lists. The World Federation for Ultrasound in Medicine and Biology (WFUMB) state of the art paper on the use of simulators in ultrasound education introduces ultrasound simulation, its advantages and challenges. It describes different simulator types, including low and high-fidelity simulators, the requirements and technical aspects of simulators, followed by the clinical applications of ultrasound simulation. The paper discusses the role of ultrasound simulation in ultrasound clinical training, referencing established literature. Requirements for successful ultrasound simulation acceptance into educational structures are explored. Despite being in its infancy, ultrasound simulation already offers a wide range of training opportunities and likely holds the key to a broader point of care ultrasound education for medical students, practicing doctors, and other health care professionals. Despite the drawbacks of simulation, there are also many advantages, which are expanding rapidly as the technology evolves.

#ENT: Otolaryngology Residency Programs Create Social Media Platforms to Connect With Applicants During COVID-19 Pandemic

OBJECTIVE

To determine which otolaryngology residency programs have social media platforms and to review which programs are utilizing platforms to advertise virtual open houses and virtual subinternships for residency applicants.

STUDY DESIGN

Cross-sectional study.

SETTING

The study was conducted online by reviewing all accredited otolaryngology residency programs in the United States participating in the Electronic Residency Application Service.

METHODS

Otolaryngology residency programs were reviewed for social media presence on Instagram, Twitter, and Facebook. Social media posts were evaluated for virtual open houses and virtual subinternships. Residency websites and the Visiting Student Application Service were evaluated for the presence of virtual subinternships. All data were collected between September 5, 2020, and September 9, 2020. This study did not require approval from the University of Alabama at Birmingham Institutional Review Board for Human Use.

RESULTS

Among 118 otolaryngology residency programs, 74 (62.7%) participate on Instagram, 52 (44.1%) participate on Twitter, and 44 (37.3%) participate on Facebook. Fifty-one Instagram accounts, 20 Twitter accounts, and 4 Facebook accounts have been created during 2020. Forty-two (36%), 30 (25.4%), and 15 (13%) programs are promoting virtual open houses on Instagram, Twitter, and Facebook, respectively. Two programs on the Visiting Student Application Service offered virtual subinternships. Seven residency program websites offered virtual subinternships. Nine, 6, and 1 program offered virtual subinternships on Instagram, Twitter, and Facebook, respectively.

CONCLUSION

This study demonstrates that social media presence on Instagram and Twitter among otolaryngology residency programs has substantially grown in 2020 at a higher rate compared to previous years. These data suggest that otolaryngology residency programs are finding new ways to reach out to applicants amid an unprecedented type of application cycle due to the challenges presented by COVID-19. Many programs are advertising virtual open houses via social media platforms to connect with applicants, and a few programs are offering virtual subinternships to replace traditional subinternships.

Tele-Simulated Instruction and Learner Perceptions of Fiberoptic Intubation and Nasopharyngoscopy: A Pilot Study

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The landscape of digital resources in radiation oncology

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.

Medical Education Blog and Podcast Utilization During the COVID-19 Pandemic

Introduction The coronavirus disease 2019 (COVID-19) pandemic disrupted traditional in-person learning models. Free Open Access Medical (FOAM) education resources naturally filled this void, so we evaluated how medical blog and podcast utilization changed during the early months of the pandemic. Methods Academic medical podcast and blog producers were surveyed on blog and podcast utilization immediately before (January-March 2020) and after (April-May 2020) the COVID-19 pandemic declaration and subsequent lockdown. Utilization is quantified in terms of blog post pageviews and podcast downloads. Linear regression was used to estimate the effect of publication during the COVID-19 period on 30-day downloads or pageviews. A linear mixed model was developed to confirm this relationship after adjustment for independent predictors of higher 30-day downloads or pageviews, using the podcast or blog as a random intercept. Results Compared to the pre-pandemic period, downloads and pageviews per unique blog and podcast publication significantly increased for blogs (median 30-day pageviews 802 to 1860, p<0.0001) but not for podcasts (median 30-day downloads 2726 to 1781, p=0.27). Publications that contained COVID-19 content were strongly associated with higher monthly utilization (β=7.21, 95% CI 6.29-8.14 p<0.001), and even non-COVID-19 material had higher utilization in the early pandemic (median 30-day downloads/pageviews 868 to 1380, p<0.0001). Discussion The increased blog pageviews during the early months of the COVID-19 pandemic demonstrated the important role of blogs in rapid knowledge translation. Podcasts did not experience a similar increase in utilization.

Perception of Web-Based Didactic Activities During the COVID-19 Pandemic Among Anesthesia Residents: Pilot Questionnaire Study

BACKGROUND

Physical and social distancing recommendations aimed at limiting exposure during the COVID-19 pandemic have forced residency programs to increasingly rely on videoconferencing and web-based resources.

OBJECTIVE

In this pilot study, we aimed to explore the effects of the COVID-19 pandemic on residency training experience, and to delineate the perceived barriers to the successful implementation of web-based medical education.

METHODS

A 19-item survey was compiled and distributed electronically using Qualtrics. This anonymous survey included information on the training level of each resident, their participation in formal didactics before and during the pandemic, and their perception of the ease and limitations of virtual didactics. The resident's opinions on specific educational resources were assessed, and the effectiveness of new delivery methods on resident engagement and learning was examined.

RESULTS

Thirty anesthesiology residents were surveyed, 19 of whom agreed to participate in the pilot study. One participant with incomplete responses was excluded, yielding a final cohort of 18 respondents. Most residents (56%, 10/18) reported that the COVID-19 pandemic negatively affected their residency training. The time spent on didactic training and independent studies was, nevertheless, not affected by the pandemic for 90% (16/18) of respondents. Nonetheless, 72% (13/18) of residents were less engaged during virtual lectures in comparison to in-person didactics. Important limitations included distraction from the physical environment (67%, 12/18), internet instability (67%, 12/18), less obligation to participate (44%, 8/18), technical difficulty and unmuted microphones (33%, 6/18, each), and people speaking over each other (28%, 5/18). Despite these limitations, most residents stated that they would like to keep a combination of virtual didactics including live Zoom lectures (56%, 10/18), prerecorded web didactics (56%, 10/18), and virtual ground rounds via Zoom (50%, 9/18) as the "new normal."

CONCLUSIONS

Despite important limitations listed in this report, anesthesia residents would like to keep a combination of virtual lectures and presentations as the new normal after the COVID-19 pandemic.

Identifying Social Media Competencies for Health Professionals: An International Modified Delphi Study to Determine Consensus for Curricular Design

STUDY OBJECTIVE

The use of social media by health professionals is widespread. However, there is a lack of training to support the effective use of these novel platforms that account for the nuances of an effective health and research communication. We sought to identify the competencies needed by health care professionals to develop an effective social media presence as a medical professional, with the goal of building a social media curriculum.

METHODS

We conducted a modified Delphi study, utilizing Kraiger's Knowledge, Skills, and Attitudes framework to identify appropriate items for inclusion in a social media curriculum targeted at health care professionals. Experts in this space were defined as health care professionals who had delivered workshops, published papers, or developed prominent social media tools/accounts. They were recruited through a multimodal campaign to complete a series of 3 survey rounds designed to build consensus. In keeping with prior studies, a threshold of 80% endorsement was used for inclusion in the final list of items.

RESULTS

Ninety-eight participants met the expert criteria and were invited to participate in the study. Of the 98 participants, 92 (94%) experts completed the first round; of the 92 experts who completed the first round, 83 (90%) completed the second round; and of the 83 experts who completed the second round, 81 (98%) completed the third round of the Delphi study. Eighteen new items were suggested in the first survey and incorporated into the study. A total of 46 items met the 80% inclusion threshold.

CONCLUSION

We identified 46 items that were believed to be important for health care professionals using social media. This list should inform the development of curricular activities and objectives.

Beyond the CLAIM: A comprehensive needs assessment strategy for creating an Advanced Medical Education Research Training Program (ARMED-MedEd)

BACKGROUND

The health professions education (HPE) landscape has shifted substantively with increasing professionalization of research and scholarship. Clinician educators seeking to become competitive in this domain often pursue fellowships and master's degrees in HPE, but there are few resources for the continuing professional development (CPD) of those who seek to continue developing their scholarly practice within HPE. Acknowledging the multiple players in this landscape, the authors sought to design a new "beyond beginners" HPE research program using a novel needs assessment planning process.

METHODS

The authors developed and conducted a new three-phase, five-step process that sets forth a programmatic approach to conducting a needs assessment for a CPD course in HPE research. The five steps of the CLAIM method are: Competitive analysis, Literature review with thematic analysis, Ask stakeholders, Internal review by experts, and Mapping of a curriculum. These steps are organized into three phases (Discovery, Convergence, and Synthesis).

RESULTS

Over a 12-month period, the authors completed a comprehensive needs assessment. The CLAIM process revealed that longitudinal digital connection, diverse and in depth exposure to HPE research methods, skills around scholarly publishing, and leadership and management of research would be beneficial to our design.

CONCLUSIONS

The CLAIM method provided scaffolding to help the authors create a robust curriculum that adopts a scholarly approach for developing a HPE research course. This needs assessment methodology may be useful in other CPD contexts.

Impact of COVID-19 on Hematology-Oncology Trainees: A Quantitative and Qualitative Assessment

PURPOSE

Graduate medical and research training has drastically changed during the COVID-19 pandemic, with widespread implementation of virtual learning, redeployment from core rotations to the care of patients with COVID-19, and significant emotional and physical stressors. The specific experience of hematology-oncology (HO) fellows during the COVID-19 pandemic is not known.

METHODS

We conducted a mixed-methods study using a survey of Likert-style and open-ended questions to assess the training experience and well-being of HO fellows, including both clinical and postdoctoral trainee members of the American Society of Hematology and ASCO.

RESULTS

A total of 2,306 surveys were distributed by e-mail; 548 (23.8%) fellows completed the survey. Nearly 40% of fellows felt that they had not received adequate mental health support during the pandemic, and 22% reported new symptoms of burnout. Pre-existing burnout before the pandemic, COVID-19-related clinical work, and working in a primary research or nonclinical setting were associated with increased burnout on multivariable logistic regression. Qualitative thematic analysis of open-ended responses revealed significant concerns about employment after training completion, perceived variable quality of virtual education and board preparation, loss of clinical opportunities to prepare for independent clinical practice, inadequate grant funding opportunities in part because of shifting research priorities, variable productivity, and mental health or stress during the pandemic.

CONCLUSION

HO fellows have been profoundly affected by the pandemic, and our data illustrate multiple avenues for fellowship programs and national organizations to support both clinical and postdoctoral trainees.

Forming the Hematology-Oncology Collaborative Videoconferencing (CO-VID) Learning Initiative: Experiential Lessons Learned From a Novel Trainee-Led Multidisciplinary Virtual Learning Platform

PURPOSE

COVID-19 challenged medical practice and graduate medical education. Building on previous initiatives, we describe and reflect on the formative process and goals of the Hematology-Oncology Collaborative Videoconferencing Learning Initiative, a trainee-led multi-institutional virtual COVID-19 learning model.

METHODS

Clinical fellows and faculty from 13 US training institutions developed consensus needs, goals, and objectives, recruited presenters, and generated a multidisciplinary COVID-19 curriculum. Weekly Zoom conferences consisted of two trainee-led instructional segments and a trainee-moderated faculty Q&A panel. Hematology-oncology training program faculty and trainees were the targeted audience. Leadership evaluations consisted of anonymized baseline and concluding mixed methods surveys. Presenter evaluations consisted of session debriefs and two structured focus groups. Conference evaluations consisted of attendance, demographics, and pre- or postmultiple-choice questions on topic learning objectives.

RESULTS

In 6 weeks, the initiative produced five conferences: antivirals, anticoagulation, pulmonology, provider resilience, and resource scarcity ethics. The average attendance was 100 (range 57-185). Among attendees providing both pre- and postconference data, group-level knowledge appeared to increase: antiviral (n = 46) pre-/postcorrect 82.6%/97.8% and incorrect 10.9%/2.2%, anticoagulation (n = 60) pre-/postcorrect 75%/93.3% and incorrect 15%/6.7%, and pulmonary (n = 21) pre-/postcorrect 66.7%/95.2% and incorrect 33.3%/4.8%. Although pulmonary management comfort appeared to increase, comfort managing of antivirals and anticoagulation was unchanged. At the conclusion of the pilot, leadership trainees reported improved self-confidence organizing multi-institutional collaborations, median (interquartile range) 58.5 (50-64) compared with baseline 34 (26-39), but did not report improved confidence in other educational or leadership skills.

CONCLUSION

During crisis, trainees built a multi-institutional virtual education platform for the purposes of sharing pandemic experiences and knowledge. Accomplishment of initiative goals was mixed. Lessons learned from the process and goals may improve future disaster educational initiatives.

An Emergency Medicine Virtual Clerkship: Made for COVID, Here to Stay

Introduction: Safety concerns surrounding the coronavirus 2019 pandemic led to the prohibition of student rotations outside their home institutions. This resulted in emergency medicine (EM)-bound students having less specialty experience and exposure to outside programs and practice environments, and fewer opportunities to gain additional Standardized Letters of Evaluation, a cornerstone of the EM residency application. We filled this void by implementing a virtual clerkship. Methods: We created a two-week virtual, fourth-year visiting clerkship focused on advanced medical knowledge topics, social determinants of health, professional development, and professional identity formation. Students completed asynchronous assignments and participated in small group-facilitated didactic sessions. We evaluated the virtual clerkship with pre- and post-medical knowledge tests and evaluative surveys. Results: We hosted 26 senior medical students over two administrations of the same two-week virtual clerkship. Students had a statistically significant improvement on the medical knowledge post-tests compared to pre-tests (71.7% [21.5/30] to 76.3% [22.9/30]). Students reported being exposed to social determinants of health concepts they had not previously been exposed to. Students appreciated the interactive nature of the sessions; networking with other students, residents, and faculty; introduction to novel content regarding social determinants of health; and exposure to future career opportunities. Screen time, technological issues, and mismatch between volume of content and time allotted were identified as potential challenges and areas for improvement. Conclusion: We demonstrate that a virtual EM visiting clerkship is feasible to implement, supports knowledge acquisition, and is perceived as valuable by participants. The benefits seen and challenges faced in the development and implementation of our clerkship can serve to inform future virtual clerkships, which we feel is a complement to traditional visiting clerkships even though in-person clerkships have been re-established.

A Qualitative Exploration of the Teaching- and Learning-Related Content Nursing Students Share to Social Media

Background: Social media have many applications in health professions education. The current literature focuses on how faculty members use social media to supplement their teaching; less is known about how the students themselves use social media to support their educational activities. In this study, this digital artifact collection qualitatively explored what educational content nursing students shared with their social media accounts. Methods: A total of 24 nursing students' Facebook, Twitter, and Instagram accounts were followed over 5 months. A modified directed content analysis was conducted weekly and at the end of the data collection period, using two cycles of inductive and deductive coding. Results: This study demonstrated that nursing students used social media to combat isolation, to consolidate course content, to share resources, and to better anticipate the transition to practice as a new nurse. Conclusions: Faculty members can capitalize on social media platforms to help nursing students explore nursing roles and identities while learning about and enacting professional online behaviours.

Get waivered remote: Nationwide, remote DEA-x waiver course in response to COVID-19

Problem

As of 2020, less than 5% of physicians in the United States have a drug enforcement administration-X waiver to prescribe buprenorphine. The coronavirus-2019 pandemic restricted in-person gatherings, including traditional drug enforcement administration-X waiver courses. As a result, in-person conferences have needed to adopt remote formats. Many programs identified a gap between educational delivery and the faculty skills required to deliver content remotely.

Approach

To address the need for high-quality remote learning, Get Waivered designed and implemented a novel experience for clinicians, called Get Waivered Remote. An educational session was live-streamed via Zoom™. To foster interactivity, like in-person didactic conferences, participants were polled to facilitate discussion among presenters, learners, and facilitators during the broadcast

Outcomes

The RE-AIM framework was used for evaluation. Our program had a Reach encompassing 814 users that participated during the live-streamed event; Effectiveness with 73.79% reporting being somewhat familiar or very familiar with the practice of opioid dependency treatment with approved buprenorphine medications; Adoption with 95.15% reporting a favorable experience and 92.23% reporting it was similar or more enjoyable than their usual teaching; Implementation with 450 messages sent by 281 users to engage with presenters and other learners via Zoom chat in real time.

Next steps

Get Waivered Remote provides a proof-of-concept that a broadcast with a concurrent, interactive remote learning platform is feasible, low cost, and simple to execute. Further study is required to assess the ability of our group to maintain this innovation and also to measure its impact on the treatment of opioid use disorder.

The future of scientific conferences in the era of the COVID-19 pandemic: Critical analysis and future perspectives

The global spread of COVID-19 pandemic forced the scientific community to identify new ways of exchanging and transferring the scientific knowledge, also considering that the measures taken to combat the pandemic, such as travel restrictions, closed borders and gathering bans, led to cancellations of many conferences, meetings and workshops. The enhancement of the existing digital platforms and the development of new systems to share scientific knowledge has allowed the scientific community to "meet" again in new virtual environments (e.g., Zoom, Cisco WebEx, Live Stream, Demio, GoToWebinar Seminar, Google Hangouts, Skype, Microsoft Teams, etc.), providing an unprecedented opportunity to reform methods of organizing academic conferences in all disciplines.Starting from the review of the existing literature, this study aimed at investigating the impact of the spreading of virtual conferences on the field of research. The SWOT analysis was used to identify strengths and weaknesses of the scientific conferences organized in the new format, as well as opportunities and threats created by the socio-economic and political context in the era of the COVID-19 pandemic.

Effect of the COVID-19 Pandemic on the Orthopaedic Surgery Residency Application Process: What Can We Learn?

INTRODUCTION

The goal of this study was to assess the influence of the coronavirus disease 2019 pandemic on the orthopaedic surgery residency application process in the 2020 to 2021 application cycle.

METHODS

A survey was administered to the program directors of 152 Accreditation Council for Graduate Medical Education-accredited orthopaedic surgery residency programs. The following questions were assessed: virtual rotations, open houses/meet and greet events, social media, the selection criteria of applicants, the number of applications received by programs, and the number of interviews offered by programs.

RESULTS

Seventy-eight (51%) orthopaedic residency programs responded to the survey. Of those, 25 (32%) offered a virtual away rotation, and 57 (75%) held virtual open houses or meet and greet events. Thirteen of these programs (52%) reported virtual rotations as either "extremely important" or "very important." A 355% increase was observed in social media utilization by residency programs between the 2019 to 2020 and 2020 to 2021 application cycles, with more programs finding social media to be "extremely helpful" or "very helpful" for recruiting applicants in 2020 to 2021 compared with the previous year (39% versus 10%, P < 0.001).

CONCLUSION

Although many of the changes seen in the 2020 to 2021 application cycle were implemented by necessity, some of these changes were beneficial and may continue to be used in future application cycles.

We're Not Sure We Like It but We Still Want More: Trainee and Faculty Perceptions of Remote Learning During the COVID-19 Pandemic

OBJECTIVE

In this study, the authors aim to compare perceptions of remote learning versus in-person learning among faculty and trainees at a single institution during the COVID-19 pandemic and to evaluate the impact that a brief faculty training on best practices in online teaching would have on faculty attitudes towards remote learning.

METHODS

The authors conducted an attitude survey on remote learning among trainees and faculty members approximately 3 months after the transition from in-person to remote learning. The authors then conducted a faculty training on best practices in online teaching followed by an evaluation survey. Study findings were examined descriptively and by Fisher's exact testing.

RESULTS

The response rates for the attitudes survey were 68% among trainees and 61% among faculty. Trainees and faculty perceived in-person learning more favorably than remote learning across a variety of domains, including overall enjoyment, interpersonal connection, ability to communicate, and concentration. Despite these trends, only 10% of trainees and 14% of faculty felt that all lectures would be most effectively delivered in-person when this becomes possible again. The response rate for the faculty training evaluation survey was 16%. Compared to non-attendees, faculty attendees reported more confidence in their ability to teach remotely (89% vs 56%, p=0.02) but not increased optimism (89% vs 63%, p=0.06).

CONCLUSIONS

The study findings suggest that both trainees and faculty perceive remote learning negatively compared to in-person learning but still feel that some lectures should be delivered remotely even after a return to in-person learning is possible.

ALiEM Connect: Large-Scale, Interactive, Virtual Residency Programming in Response to COVID-19

PROBLEM

The COVID-19 pandemic restricted in-person gatherings, including residency conferences. The pressure to quickly reorganize educational conferences and convert content to a remote format overwhelmed many programs. This article describes the pilot event of a large-scale, interactive, virtual educational conference modeled, designed, and implemented by Academic Life in Emergency Medicine (ALiEM), called ALiEM Connect.

APPROACH

The pilot ALiEM Connect event was conceptualized and implemented within a 2-week period in March 2020. The pilot was livestreamed via a combination of Zoom and YouTube and was archived by YouTube. Slack was used as a backchannel to allow interaction with other participants and engagement with the speakers (via moderators who posed questions from the backchannel to the speakers live during the videoconference).

OUTCOMES

The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework was used for program evaluation, showing that 64 U.S. Accreditation Council for Graduate Medical Education-accredited emergency medicine residency programs participated in the pilot event, with 1,178 unique users during the event (reach). For effectiveness, 93% (139/149) of trainees reported the pilot as enjoyable and 85% (126/149) reported it was equivalent to or better than their usual academic proceedings. Adoption for ALiEM Connect was fairly good with 64/237 (27%) of invited residency programs registering and participating in the pilot event. Implementation was demonstrated by nearly half of the livestream viewers (47%, 553/1,178) interacting in the backchannel discussion, sending a total of 4,128 messages in the first 4 hours.

NEXT STEPS

The final component of the RE-AIM framework, maintenance, will take more time to evaluate. Further study is required to measure the educational impact of events like the ALiEM Connect pilot. The ALiEM Connect model could potentially be used to replace educational conferences that have been canceled or to implement and/or augment a large-scale, shared curriculum among residency programs in the future.

Online-synchronized clinical simulation: an efficient teaching-learning option for the COVID-19 pandemic time and: beyond

Face-to-face clinical simulation has been a powerful methodology for teaching, learning, and research, and has positioned itself in health science education. However, due to the COVID-19 pandemic, social distancing has forced universities to abandon simulation centers and make use of alternatives that allow the continuation of educational programs safely for students and teachers through virtual environments such as distance simulation. In Latin America, before the pandemic, the use of non-presential simulation was very limited and anecdotal. This article has three main objectives: to establish the efficacy of online-synchronized clinical simulation in the learning and performance of medical students on the management of patients with COVID-19 in simulation centers of three Latin American countries, to determine the quality of the online debriefing from the students' perspective, and to deepen the understanding of how learning is generated with this methodology.

Maximizing the Morning Commute: A Randomized Trial Assessing the Effect of Driving on Podcast Knowledge Acquisition and Retention

STUDY OBJECTIVE

Emergency medicine residents use podcasts as part of their learning process, often listening while driving. It is unclear how driving while listening to a podcast affects knowledge acquisition and retention. This study evaluated the knowledge gained from listening to podcasts while driving compared to that gained from undistracted listening.

METHODS

This was a multicenter, randomized, crossover trial among postgraduate year (PGY) 1 to 4 emergency medicine residents at 4 institutions. Residents were randomized with stratification by site and PGY level to listen to podcasts while driving first or sitting undistracted in a room first. Within 30 minutes of listening, they completed a 20-question test. They subsequently crossed over to the alternate intervention, serving as their own controls, and listened to a different podcast before completing a second 20-question test. Each of the podcasts was professionally recorded and based on 5 emergency medicine-relevant journal articles that had not been covered in a journal club or curriculum at any of the institutions. One month later, participants completed a delayed recall test composed of 40 new questions based on both podcasts. Questions were derived and validity evidence was collected prior to use. Data were compared using a paired-sample t test and ANOVA.

RESULTS

A total of 100 residents completed the initial recall tests, and 96 residents completed the delayed recall test. There was no statistically significant difference between the driving and undistracted cohorts on the initial recall (74.2% versus 73.3%) or delayed recall (52.2% versus 52.0%).

CONCLUSION

Driving while listening to a podcast does not meaningfully affect knowledge acquisition or retention when compared with undistracted podcast listening among emergency medicine residents.

Socially distanced, virtually connected: Faculty and resident perceptions of virtual didactics

BACKGROUND

During the COVID-19 pandemic, emergency medicine (EM) residency programs have transitioned from traditional in-person to virtual synchronous didactics to comply with social distancing guidelines. This study explores the perceptions of EM residents and faculty regarding this new virtual format.

METHODS

This was a multicenter, cross-sectional study at five EM residencies using a mixed-methods approach to investigate resident and faculty perceptions of virtual didactics. Institutions selected reflect different program lengths and geographic locations. Quantitative data measured on a Likert scale were summarized as percentages. Differences were calculated using Welch's t-test and chi-square, where p < 0.05 was significant. Open-ended responses were analyzed qualitatively.

RESULTS

Our response rate was 64% (n = 141) for residents and 48% (n = 108) for faculty. Fifty-one percent of faculty and 54% of residents felt that they were more likely to attend virtually than in person. Among residents, 77% felt that they were more likely to attend virtual conferences during vacation or elective rotations. Perceived retention of information from virtual sessions was perceived to be the same or better for 69% of residents and 58% of faculty. Residents felt that they paid more attention in the virtual format (29% vs. 26%, p = 0.037). Both groups missed the social interactions of in-person conference (86% of faculty, 75% of residents). Respondents from both groups felt that < 20% of total didactic time should remain virtual once social distancing recommendations are lifted. Qualitative analysis revealed recommendations from residents and faculty to optimize lecture style and interactivity. Decreased commute time and ability to multitask at home increased wellness for both groups.

CONCLUSIONS

While benefits of virtual didactics were acknowledged, residents and faculty missed the social interaction of in-person conference and preferred < 20% of future didactics to be virtual. Further research should assess the difference in knowledge acquisition and retention between conference models.

Evaluating a Web-based Point-of-care Ultrasound Curriculum for the Diagnosis of Intussusception

OBJECTIVES

Intussusception is a pediatric medical emergency that can be difficult to diagnose. Radiology-performed ultrasound is the diagnostic study of choice but may lead to delays due to lack of availability. Point-of-care ultrasound for intussusception (POCUS-I) studies have shown excellent accuracy and reduced lengths of stay, but there are limited POCUS-I training materials for pediatric emergency medicine (PEM) providers.

METHODS

We performed a prospective cohort study assessing PEM physicians undergoing a primarily Web-based POCUS-I curriculum. We developed the POCUS-I curriculum using Kern's six-step model. The curriculum included a Web-based module and a brief, hands-on practice that was developed with a board-certified pediatric radiologist. POCUS-I technical skill, knowledge, and confidence were determined by a direct observation checklist, multiple-choice test, and a self-reported Likert-scale survey, respectively. We assessed participants immediately pre- and postcourse as well as 3 months later to assess for retention of skill, knowledge, and confidence.

RESULTS

A total of 17 of 17 eligible PEM physicians at a single institution participated in the study. For the direct observation skills test, participants scored well after the course with a median (interquartile range [IQR]) score of 20 of 22 (20-21) and maintained high scores even after 3 months (20 [20-21]). On the written knowledge test, there was significant improvement from 57.4% (95% CI = 49.8 to 65.2) to 75.3% (95% CI = 68.1 to 81.6; p < 0.001) and this improvement was maintained at 3 months at 81.2% (95% CI = 74.5 to 86.8). Physicians also demonstrated improved confidence with POCUS-I after exposure to the curriculum, with 5.9% reporting somewhat or very confident prior to the course to 76.5% both after the course and after 3 months (p < 0.001).

CONCLUSION

After a primarily Web-based curriculum for POCUS-I, PEM physicians performed well in technical skill in POCUS-I and showed improvement in knowledge and confidence, all of which were maintained over 3 months.

Holes in the FOAM: An Analysis of Curricular Comprehensiveness in Online Educational Resources

OBJECTIVES

We sought to evaluate Free Open Access Medical Education (FOAM), defined as online educational content available free to anyone, anywhere, at any time, by classifying the most impactful FOAM content per the Social Media Index into the topics and subtopics of the American Board of Emergency Medicine's Model of the Clinical Practice of Emergency Medicine. We then analyzed FOAM's comprehensiveness by describing over- and underrepresentation among these topics and subtopics.

METHODS

First, we searched for FOAM resources based on the most recent 12 months of relevant content for each organ system from the top 50 Social Media Index sites. Next, we classified all 898 posts into its related topics or subtopics per the American Board of Emergency Medicine's Model of the Clinical Practice of Emergency Medicine. Finally, we analyzed how comprehensively FOAM covered each organ system and the frequency of posts that covered each organ system subtopic as well as identified the subtopics with the most frequent coverage.

RESULTS

The search yielded 898 FOAM posts, of which cardiology and neurology were significantly overrepresented and psychobehavioral; obstetrics and gynecology; and head, ears, eyes, nose, and throat were significantly underrepresented. Among subtopics, acute coronary syndrome had the highest subtopic coverage consisting of 55.5% of all cardiology content. Other highly represented subtopics include renal colic; diabetic ketoacidosis; sepsis; and stroke with 39, 40, 40, and 71% of each of their topic's content, respectively.

CONCLUSIONS

Although residents and programs are frequently incorporating FOAM into the educational curriculum, these materials seem to lack comprehensiveness. Educators and learners must be aware of these deficits in creating comprehensive emergency medicine curricula.

Beyond the emergency department: Effects of COVID-19 on emergency medicine resident education

BACKGROUND

In December 2019, a novel coronavirus (COVID-19) caused widespread clinical disease, triggering limited in-person gatherings and social-distancing guidelines to minimize transmission. These regulations led most emergency medicine (EM) residency training programs to rapidly transition to virtual didactics. We sought to evaluate EM resident perceptions of the effects of COVID-19 on their didactic and clinical education.

METHODS

We performed a cross-sectional survey study at seven EM residency programs using a mixed-methods approach designed to understand resident perceptions regarding the impact of COVID-19 on their educational experience. Quantitative data were presented as percentages with comparison of subgroups, while open-ended responses were analyzed using qualitative methodology.

RESULTS

We achieved a 59% response rate (187/313). The majority of respondents (119/182, 65.4%) reported that the COVID-19 pandemic had a negative impact on their residency education with junior residents disproportionately affected. A total of 81 of 182 (44.5%) participants reported that one or more of their clinical rotations were partially or completely canceled due to the pandemic. Additionally, we identified four themes and 34 subthemes highlighting the contextual effects of the pandemic, which were then divided into positive and negative influences on the residency experience. The four themes include systems experience, clinical experience, didactic experience, and wellness.

CONCLUSION

Our study examined the impact of COVID-19 on residents' educational experiences. We found overall mixed responses with a slightly negative impact on residency education, wellness, and clinical rotations, while satisfaction with EM as a career choice was increased. Factors influencing this included systems, clinical, and didactic experiences as well as overall wellness.

A Model Oncologic Emergency Medicine Curriculum for Residency Training

Background Emergency medicine (EM) resident training in oncologic emergencies is limited, and significant gaps have been identified. Although 90% of emergency medicine residency program directors recognize the importance of residency training in oncologic emergencies, there is no standardized oncologic emergency curriculum. Objective We propose a focused oncologic EM curriculum that serves as a complement to existing EM didactics curriculums to prepare EM residents to recognize and manage the most common oncologic emergencies. It will also allow for familiarization with constantly evolving therapies, such as chimeric antigen receptor cellular therapy and immune checkpoint inhibitors.Discussion This curriculum consists of 10 hours of didactic instruction, which can be incorporated into an already existing didactic curriculum. The curriculum encompasses education on the recognition, rapid diagnosis, and management of oncologic emergencies, with the goal of improving the EM resident's understanding of cancer complications. The suggested topics can be delivered in a variety of methods, allowing for flexible integration in an already existing emergency education curriculum. The proposed curriculum should be introduced during the first postgraduate year and then in the second or third year of the residency to reinforce the learning points.Conclusions Our proposal of a focused, standardized 10 hour program curriculum aims to help to fill the gaps in knowledge of oncologic emergencies. To assist in wide dissemination and standardization of these curriculum topics, outlines for each module are given in the article and we also propose creation of open access online lectures and content to be shared for education purposes.

The Challenging Case Conference: A Gamified Approach to Clinical Reasoning in the Video Conference Era

The development of clinical reasoning abilities is a core competency of emergency medicine (EM) resident education and has historically been accomplished through case conferences and clinical learning. The advent of the SARS-CoV-2 pandemic has fundamentally changed these traditional learning opportunities by causing a nationwide reliance on virtual education environments and reducing the clinical diversity of cases encountered by EM trainees.

We propose an innovative case conference that combines low-fidelity simulation with elements of gamification to foster the development of clinical reasoning skills and increase engagement among trainees during a virtual conference. After a team of residents submits a real clinical case that challenged their clinical reasoning abilities, a different team of residents “plays” through a gamified, simulated version of the case live on a video conference call. The case concludes with a facilitated debriefing led by a simulation-trained faculty, where both the resident teams and live virtual audience discuss the challenges of the case. Participants described how the Challenging Case Conference improved their perceptions of their clinical reasoning skills. Audience members reported increased engagement compared to traditional conferences. Participants also reported an unexpected, destigmatizing effect on the discussion of medical errors produced by this exercise. Residency programs could consider implementing a similar case conference as a component of their conference curriculum.

Homeschooling for Quarantined Residents: A Virtual Back to the Basics Curriculum

Introduction The COVID 19 pandemic resulted in local and institutional restrictions with significant effects on the clinical environment for graduate medical education, displacing residents from non-emergency medicine (EM) based rotations. Additionally, resident physicians considered patients under investigation (PUI) were furloughed from clinical practice. The necessity for supplemental learning in a virtual setting prompted the development of an online homeschooling curriculum that incorporated back to the basics textbook learning, application, and retention via virtual sessions for the quarantined and furloughed learners.  Methods An online homeschooling curriculum was developed to replace the cancelled clinical experiences for EM residents and for those who were quarantined utilizing Google Classroom and Zoom teleconference software. After completion of their quarantine or return to normal rotation schedule, residents were asked to evaluate the homeschooling curriculum using an anonymous survey.  Results A total of 12 residents participated in the homeschooling program over eight weeks during the spring of 2020. Of the nine residents surveyed, 88.8% percent felt the homeschooling added to their knowledge of EM, 100% found the online format easy to use, and 88.8% stated it helped maintain a sense of social connection to peers and faculty.  Conclusion An online homeschooling program was considered an effective means of providing an opportunity for synchronous and continuous education for EM resident physicians. This program could be sustainable long term to fill in knowledge gaps or supplement remediation in emergency resident education, post pandemic.

The new norm: Computer Science conferences respond to COVID-19

The disruption from COVID-19 has been felt deeply across all walks of life. Similarly, academic conferences as one key pillar of dissemination and interaction around research and development have taken a hit. We analyse an interesting focal point as to how conferences in the area of Computer Science have reacted to this disruption with respect to their mode of offering and registration prices, and whether their response is contingent upon specific factors such as where the conference was to be hosted, its ranking, its publisher or its original scheduled date. To achieve this, we collected metadata associated with 170 conferences in the area of Computer Science and as a means of comparison; 25 Psychology conferences. We show that conferences in the area of Computer Science have demonstrated agility and resilience by progressing to an online mode due to COVID-19 (approximately 76% of Computer Science conferences moved to an online mode), many with no changes in their schedule, particularly those in North America and those with a higher ranking. Whilst registration fees have lowered by an average of 42% due to the onset of COVID-19, conferences still have to facilitate attendance on a large scale due to the logistics and costs involved. In conclusion, we discuss the implications of our findings and speculate what they mean for conferences, including those in Computer Science, in the post-COVID-19 world.

Conference Didactic Planning and Structure: An Evidence-based Guide to Best Practices from the Council of Emergency Medicine Residency Directors

Emergency medicine residency programs around the country develop didactic conferences to prepare residents for board exams and independent practice. To our knowledge, there is not currently an evidence-based set of guidelines for programs to follow to ensure maximal benefit of didactics for learners. This paper offers expert guidelines for didactic instruction from members of the Council of Emergency Medicine Residency Directors Best Practices Subcommittee, based on best available evidence. Programs can use these recommendations to further optimize their resident conference structure and content. Recommendations in this manuscript include best practices in formatting didactics, selection of facilitators and instructors, and duration of individual sessions. Authors also recommend following the Model of Clinical Practice of Emergency Medicine when developing content, while incorporating sessions dedicated to morbidity and mortality, research methodology, journal article review, administration, wellness, and professionalism.

Emergency Medicine Residency Curricular Innovations: Creating a Virtual Emergency Medicine Didactic Conference

Currently, there is a pandemic forcing social distancing and, consequently, traditional in-person education must shift to a virtual curriculum to protect all parties and continue professional development. Recognizing that not all emergency medicine (EM) content can be taught through a virtual platform, we propose a model for nearly all EM resident didactic conference adaptation to a virtual format to meet the needs of the adult learner while protecting all participants from the current coronavirus pandemic.

Surgery in the COVID-19 Era: A Narrative Review

The coronavirus disease 2019 (COVID-19) pandemic affected the delivery of surgical care and services. This review article aims to appraise the impact of COVID-19 on surgical care. The authors discuss the literature on surgery and COVID-19 under the following themes: emergency case triaging, elective surgery triaging, operating on a COVID-19-positive patient, surgical smoke, management of scarce resources, and restarting elective surgery. Most of the large surgical societies recommended and most surgical departments all over the world implemented the cancellation of elective surgeries, while emergency surgeries proceeded as usual. Elective surgeries were triaged taking into consideration the COVID-19 infection rate in the locality, availability of resources, and the need for intensive care unit beds and ventilators. A COVID-19-positive patient should not be denied surgery if indicated, and the recommended precautions and use of personal protective equipment should be adhered to. The generation of surgical smoke occurs in both laparoscopic and open surgeries, and it has not been shown to contain this novel virus. Smoke generation should be minimized and laid down guidelines followed. Laparoscopic surgery seems to have an advantage over open surgery in this regard. In resuming elective surgeries, the local infection rates, bed occupancy rate, and availability of resources should be taken into cognizance. We should learn from this pandemic so as to be prepared for future occurrences, which is a significant possibility.

Rethinking the Approach to Continuing Professional Development Conferences in the Era of COVID-19

The COVID-19 pandemic has required a substantial change to the approach used for traditional, in-person continuing professional development (CPD) conferences. Running a virtual CPD conference will necessitate consideration of digital platforms and conversion of large group and small group sessions, abstract presentations, and networking events to a digital medium. This paper will discuss these challenges and present strategies to address them for CPD conference planning in the era of COVID-19.