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Bombaci A, Di Lorenzo F, Pucci E, Solari A, Veronese S. Education needs in palliative care and advance care planning of Italian residents in neurology: an online survey. Eur J Neurol 2024; 31:e16376. [PMID: 38826082 PMCID: PMC11295156 DOI: 10.1111/ene.16376] [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: 02/21/2024] [Revised: 05/05/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND AND PURPOSE Most neurological diseases have a chronic and progressive clinical course, with patients living for extended periods with complex healthcare needs. Evidence from other countries suggests that palliative care (PC) is insufficiently integrated in the care of these patients. This study aims to identify PC and advance care planning (ACP) knowledge and the perceived preparedness of Italian residents in neurology. METHODS This is a cross-sectional online survey of physicians attending the 36 Italian neurology residency programmes. RESULTS Of 854 residents, 188 (22%) participated. Their mean age was 28.4 ± 2.0 years; 49% were women; 45% were from the north, 23% from the centre and 32% from the south of Italy. Few residents (6%) reported that a teaching course in PC was part of the graduate programme, and 3% of the postgraduate programme. During their residency, 9% of participants received PC training, and 18% ACP training. Only 13% reported to have participated in the ACP process, half within their neurology residency programme. Residents considered PC support very/extremely important in all the pre-specified clinical situations, with values ranging between 78% and 96%. Over 70% of residents revealed education needs, particularly concerning ACP. CONCLUSIONS Our data confirm the need for improving PC training in the graduate and postgraduate curriculum. This, together with collaboration and joint training of neurology and PC, is essential to improve the quality and continuity of care and respond to the complex needs of people with neurological disorders causing severe disability.
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Affiliation(s)
- Alessandro Bombaci
- PhD Programme in Neuroscience, ‘Rita Levi Montalcini’ Department of NeuroscienceUniversity of TurinTurinItaly
- Neurology UnitIRCSS Policlinico San DonatoSan Donato MilaneseItaly
- Vita‐Salute San Raffaele UniversityMilanItaly
| | | | | | - Alessandra Solari
- Unit of NeuroepidemiologyFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
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van der Meulen M, Wijnenga MMJ. Education and training in neurology: developments and future challenges. Eur J Neurol 2024:e16332. [PMID: 38773718 DOI: 10.1111/ene.16332] [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: 02/27/2024] [Revised: 04/17/2024] [Accepted: 04/24/2024] [Indexed: 05/24/2024]
Abstract
BACKGROUND AND PURPOSE Training and education is essential for best practice medicine and is especially important in a rapidly evolving field such as neurology. Due to improved imaging techniques and laboratory testing, there is a better understanding of the pathophysiology of diseases. As a result more treatments have become available. The most important developments in neurology over the last two decades and their effect on training and education are described. In addition, how future training should be aware of the challenges ahead of us is described. METHODS This is a narrative review describing developments and challenges based on personal experience and the literature. RESULTS Due to major developments in radiological and immunological testing, major changes have been seen in different subspecialties of neurology, including but not limited to, the treatment of ischaemic stroke, the development of new entities in the field of demyelinating diseases and auto-immune encephalitis, and diffuse glioma. These developments challenge the education and training in neurology with, ahead of us, technological developments, an aging population, and potentially more superspecialization. CONCLUSION Although there are differences in the training curricula between European countries, the developments and future challenges within the field of neurology are very similar. In the development of future curricula it is important to face these developments and challenges and to adapt to them.
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Ercoli T, Loy F, Masala C, Solla P. Neurological and Psychiatric Disorders in the COVID-19 Era. Brain Sci 2024; 14:355. [PMID: 38672007 PMCID: PMC11048350 DOI: 10.3390/brainsci14040355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Over the 4 last years, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has determined the diffusion of the coronavirus disease 2019 (COVID-19) global outbreak [...].
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Affiliation(s)
- Tommaso Ercoli
- Department of Neurology, University of Sassari, Viale S. Pietro 10, 07100 Sassari, Italy;
| | - Francesco Loy
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042 Cagliari, Italy; (F.L.); (C.M.)
| | - Carla Masala
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042 Cagliari, Italy; (F.L.); (C.M.)
| | - Paolo Solla
- Department of Neurology, University of Sassari, Viale S. Pietro 10, 07100 Sassari, Italy;
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4
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Spagnoli C, Duca M, Pelliccia V, Lanzone J, Masnada S, Chiarello D, Barco TL, Dono F, Nucera B. Educational needs and career development of young epileptologists in Italy. Epilepsia Open 2024; 9:613-625. [PMID: 38386334 PMCID: PMC10984319 DOI: 10.1002/epi4.12888] [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: 08/16/2023] [Revised: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE The Education and Career Task Force of the Young Epilepsy Section-Italy focuses on educational and career development needs of young Italian epileptologists. Two surveys were developed (pre- and post COVID-19 pandemic) in order to identify the needs of members of the Lega Italiana Contro l'Epilessia under 40 years of age. METHODS The first was distributed during the 42nd National Congress (Rome, June 5-7, 2019); the second during the 45th National Congress (Padova, June 8-10, 2022) and subsequently by e-mail until July 9, 2022. Data from the 2019 survey were analyzed descriptively. Data from the 2022 survey were further analyzed with Pearson's chi-square test to establish if gender, field of clinical practice, and professional role were associated with different needs. RESULTS Sixty surveys were completed in 2019 and 69 in 2022. Attendance to courses and congresses as the preferred way to keep medical knowledge updated reduced between 2019 and 2022. The reason was different between trainees (mostly elevated costs) and early-career consultants (mostly organizational issues) (p = 0.005). The main needs for improvement also diverged: trainees indicated differential diagnosis and diagnostic approach to the first seizure while consultants indicated diagnostic approach to genetic epilepsies (p = 0.004); in the genetic field, priority needs were selection of genetic investigations for trainees versus genotype-phenotype correlations for consultants (p = 0.022). The field of practice (pediatric vs. adult) also impacted on the main needs for improvement that is, acquisition of expertise in neuroradiology and drug therapy for pediatric versus genetics for adult neurology trainees or consultants (p = 0.018); in the clinical area, differential diagnosis and approach to the first seizure versus status epilepticus (p = 0.027); in the genetic field, precision medicine versus genotype-phenotype correlations (p = 0.034). No differences were found based on gender. SIGNIFICANCE The surveys identified different needs based on professional role and discipline. PLAIN LANGUAGE SUMMARY The Education and Career Task Force of the Young Epilepsy Section-Italy (YES-I) launched two surveys among young Italian epileptologists. Our research shows that the educational and professional needs of young Italian epileptologists vary based on their job role and field of practice, but not on gender. Their preference for on-site congresses and courses reduced after the pandemic, and the main reason is linked to financial constraints for trainees and to organizational issues for consultants. The main expectation toward YES-I is to receive support for education and career development. Thus, we collected useful suggestions on how to organize our future YES-I activities.
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Affiliation(s)
- Carlotta Spagnoli
- Child Neuropsychiatry Unit, Pediatric DepartmentSanta Maria Nuova Hospital, Azienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Maddalena Duca
- Child Neuropsychiatry UnitOspedale Civile di MacerataMacerataItaly
| | - Veronica Pelliccia
- "Claudio Munari" Epilepsy Surgery CentreAzienda Socio‐Sanitaria Territoriale Grande Ospedale Metropolitano NiguardaMilanItaly
| | - Jacopo Lanzone
- Neurorehabilitation Department of the Milano InstituteIstituti Clinici Scientifici Maugeri IRCCSMilanItaly
| | | | - Daniela Chiarello
- "Claudio Munari" Epilepsy Surgery CentreAzienda Socio‐Sanitaria Territoriale Grande Ospedale Metropolitano NiguardaMilanItaly
| | - Tommaso Lo Barco
- Child Neuropsychiatry Department, Epilepsy CenterC. Poma HospitalMantovaItaly
| | - Fedele Dono
- Department of Neuroscience, Imaging and Clinical Science"G. D'Annunzio" University of Chieti‐PescaraChietiItaly
| | - Bruna Nucera
- Department of NeurologyHospital of Merano (SABES‐ASDAA)MeranoItaly
- Paracelsus Medical UniversitySalzburgAustria
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Shao X, Wu X. How will the public health committees develop after COVID-19 pandemic in China? Exploration from mixed methods study in Pingshan District, Shenzhen. Front Public Health 2024; 12:1307771. [PMID: 38299077 PMCID: PMC10829045 DOI: 10.3389/fpubh.2024.1307771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/03/2024] [Indexed: 02/02/2024] Open
Abstract
Introduction The Public Health Committee has a long-standing presence in the Chinese Constitution. During the pandemic, it served as a grassroots self-governance organization and made significant contributions to China's community epidemic prevention and control system. Currently, 24 provinces in China have promoted the establishment of community public health committees. Methods To gather data, we conducted semi-structured interviews (n = 48) with the heads of superior departments of public health committees, the heads of public health committees, and the heads of community health centers, exploring aspects such as organizational structure, job responsibilities, and job security. In parallel, we administered a capacity-building survey to a sample of 23 community residents (n = 1,986) and performed regression analysis. Finally, we examined the impact of gender, age, and education level on the development of public health committees. Results Our study reveals that the development of public health committees displays features of administration across various dimensions, including personnel appointment, top-level design, medical professionalism, funding path dependence, and data path dependence. However, the decision-making function of the organization does not exhibit a significant impact. Discussion The construction of the Public Health Committee should demonstrate an "autonomization-administration" pendulum effect. Currently, due to the absence of decision-making functions within the Public Health Committee, autonomous organizations are exhibiting characteristics of administration. To prevent excessive autonomization or administrative nature in the development of committees, public health policies are continuously being refined based on the unique characteristics of public health committee construction. During exceptional circumstances or the initial stages of development, the establishment of public health committees should be primarily guided by administrative principles, utilizing political momentum to drive their progress. In contrast, during routine establishment phases or later stages of development, the establishment of public health committees should be primarily led by autonomization, restoring their capacity for self-decision making. It is essential to fully leverage the role of grassroots self-governance organizations, relying on the community to engage in self-management, self-education, and self-service within public health committees.
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Affiliation(s)
- Xu Shao
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
- School of Electronic Information and Artificial Intelligence, Leshan Normal University, Sichuan, China
| | - Xiangling Wu
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
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6
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Ercoli T, Barbato F, Bombaci A, Cuffaro L, Di Lorenzo F, Iodice F, Romoli M, Solla P, Defazio G. Neurological Consequences of COVID-19: A Systematic Review of the Pandemic's Impact on Neurology Training. Brain Sci 2023; 13:1188. [PMID: 37626544 PMCID: PMC10452502 DOI: 10.3390/brainsci13081188] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
The COVID-19 pandemic had a significant impact on neurology training programs, leading to disruptions and changes that may have long-term implications for neurological education. The objective of this study was to investigate the impact of COVID-19 on neurological training programs, collecting available data relating to residents' experience worldwide. We performed a systematic search of the literature published on PubMed from January 2020 to March 2023, including studies referring to quantitative analysis of residents'/trainees' perspectives. Specifically, we included studies that examined how the pandemic has affected clinical and research activities, the use of telemedicine, the delivery of education and the psychological status of residents. Of the 95460 studies identified through database searching, 12 studies met the full criteria and underwent data extraction. In conclusion, the COVID-19 pandemic has had significant impacts on neurology training programs, highlighting the need for resilience and flexibility in medical education. Future research should focus on the long-term outcomes of these adaptations in the quality of neurology education and patient care.
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Affiliation(s)
- Tommaso Ercoli
- Neurological Unit, AOU Sassari, University of Sassari, 07100 Sassari, SS, Italy;
| | | | - Alessandro Bombaci
- “Rita Montalcini” Department of Neurology, University of Turin, 10124 Turin, TO, Italy;
| | - Luca Cuffaro
- Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, MI, Italy;
| | - Francesco Di Lorenzo
- Noninvasive Brain Stimulation Unit, Scientific Institute for Research, Hospitalisation and Health Care Santa Lucia Foundation, 00179 Rome, RM, Italy;
| | - Francesco Iodice
- Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Pisana, 00163 Rome, RM, Italy;
| | - Michele Romoli
- Neurology and Stroke Unit, “Maurizio Bufalini” Hospital, 47521 Cesena, FC, Italy;
| | - Paolo Solla
- Neurological Unit, AOU Sassari, University of Sassari, 07100 Sassari, SS, Italy;
- Department of Clinical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, SS, Italy
| | - Giovanni Defazio
- Department of Translational Biomedicine and Neuroscience, University of Bari, 70121 Bari, BA, Italy;
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Hmoud M, Salamatullah HK, Faidah DE, Makkawi S. Experience and perception of utilizing virtual clinic in neurological assessment in Saudi Arabia. Front Neurol 2023; 14:1111254. [PMID: 36873439 PMCID: PMC9983690 DOI: 10.3389/fneur.2023.1111254] [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: 12/01/2022] [Accepted: 01/25/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction The World Health Organization defined electronic health as "the unified usage of information technology and electronic communications in the health sector." In the Kingdom of Saudi Arabia, outpatient encounters were largely shifted to virtual clinics due to the crisis caused by COVID-19. This study aimed to evaluate the neurology consultants', specialists', and residents' experience and perception of utilizing virtual services for neurological assessment in Saudi Arabia. Methods This cross-sectional study was conducted by sending an anonymous online survey to neurologists and neurology residents in Saudi Arabia. The survey was developed by the authors and contained three main sections: demographics, subspecialty and years of experience after residency, and virtual clinics during the coronavirus disease 2019 (COVID-19) pandemic. Result A total of 108 neurology-practicing physicians in Saudi Arabia responded to the survey. Overall, 75% experienced virtual clinics, and 61% of them used phones for consultation. In neurology clinical practice, there was a significant difference (P < 0.001) regarding the teleconsultations for follow-up patients compared to the newly referred patients, being more suitable for the follow-up cases. Additionally, most neurology practicing physicians showed more confidence in performing history-taking tasks virtually (82.4%) than in physical examination. However, it was found that consultants were significantly (P < 0.03) more confident to virtually perform the cranial nerve, motor, coordination, and extrapyramidal assessments than the neurology residents. Physicians deemed it more suitable to conduct teleconsultations for patients with headaches and epilepsy than for those with neuromuscular and demyelinating diseases/multiple sclerosis. Furthermore, they agreed that patients' experiences (55.6%) and physicians' acceptance (55.6%) were the two main limitations to implementing virtual clinics. Discussion This study revealed that neurologists were more confident in performing history-taking in virtual clinics than in physical exams. On the contrary, consultants were more confident in handling the physical examination virtually than the neurology residents. Moreover, the most accepted clinics to be handled electronically were the headache and epilepsy clinics in comparison to the other subspecialties, being mainly diagnosed using history. Further studies with larger sample sizes are warranted to observe the level of confidence in performing different duties in neurology virtual clinics.
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Affiliation(s)
- Mohammed Hmoud
- Department of Medicine, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.,College of Medicine, University of Bisha, Bisha, Saudi Arabia
| | - Hassan K Salamatullah
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Dania E Faidah
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Seraj Makkawi
- Department of Medicine, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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8
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Ercoli T, Barbato F, Cuffaro L, Iodice F, Romoli M, Tedeschi G, Berardelli A, Di Lorenzo F, Bombaci A. The future of neurology after the COVID-19 pandemic according to neurology residents. Neurol Sci 2023; 44:9-12. [PMID: 36227386 PMCID: PMC9559160 DOI: 10.1007/s10072-022-06450-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/10/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The ongoing COVID-19 pandemic has resulted in significant changes in the delivery of neurological disease care and in neurology training in academic departments. OBJECTIVE We aimed to investigate how neurology residents viewed the future of neurology after the COVID-19 pandemic with regard to three main aspects: (i) organization of neurological activity, (ii) patient care, and (iii) funding availability for neurological diseases. METHODS We surveyed Italian neurology residents in order to investigate how they viewed the future of neurology after the COVID-19 pandemic. RESULTS Responses were collected from 254 residents who reported: a high risk of reduction of hospital neurological beds, of worsening of the quality of neurological patient management, and of lack of funding for neurological care and research. CONCLUSION The survey results demonstrate the views of future neurologists regarding the direction of neurology after the COVID-19 emergency. It is important to focus on these aspects in order to adapt neurology training to the societal changes introduced by the pandemic, and to safeguard the essential role of neurology in the management and prevention of chronic degenerative illnesses and emergencies.
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Affiliation(s)
- Tommaso Ercoli
- Department of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, Cagliari, Italy
| | | | - Luca Cuffaro
- Department of Health Sciences, Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy
| | - Francesco Iodice
- Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy
| | - Michele Romoli
- Neurology and Stroke Unit, "Maurizio Bufalini" Hospital, Cesena, Italy
| | - Gioacchino Tedeschi
- Department of Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, Sapienza, University of Rome, Rome, Italy
| | - Francesco Di Lorenzo
- Noninvasive Brain Stimulation Unit, Scientific Institute for Research, Hospitalisation and Health Care Santa Lucia Foundation, Rome, Italy.
| | - Alessandro Bombaci
- Rita Montalcini" Department of Neurology, University of Turin, Turin, Italy
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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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10
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Rayhill ML, Rosen N, Robbins MS. Headache Education Adaptation During the COVID-19 Pandemic: Impact on Undergraduate and Graduate Medical Education. Curr Pain Headache Rep 2022; 26:827-833. [PMID: 36190679 PMCID: PMC9528878 DOI: 10.1007/s11916-022-01084-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 11/26/2022]
Abstract
Purpose of Review Our goal was to describe the changes to headache and neurological education that occurred as a result of the COVID-19 pandemic, and the impact this had on medical learners. We also discuss subsequent implications for the future of education in the field of headache medicine. Recent Findings Both educators and learners faced many challenges during the pandemic. These include the following: cancellation of in-person educational meetings, limited in-person networking and wellness events, disengagement from virtual didactic curricula, limitations in procedure-based learning, redeployment to inpatient settings with a decrease in outpatient exposures, and blurred boundaries between home and work life due to more virtual collaboration and home computer use. The development of telehealth programs and trainee wellness initiatives, improved collaboration opportunities among geographically distant institutions, and greater access to conferences for learners are among the many improvements forged by these challenging times in medical education. Summary Given the high prevalence of headache disorders and the paucity of headache specialists, training new clinicians with competency in headache medicine is essential. There were many educational challenges and opportunities identified in the literature that resulted from the pressures of the pandemic. Educators need to develop assessments that capture any gaps in learning that may have occurred during this tumultuous time and be vigilant of remediation needs in our learners over the coming years. It is imperative to intentionally design curricula for the future by harnessing new pedagogical tools, innovations, and perspectives gleaned from our experience with the COVID-19 pandemic.
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Affiliation(s)
- Melissa L Rayhill
- Department of Neurology, University at Buffalo Jacobs School of Medicine, The State University of New York, 1010 Main Street, 2nd floor, Buffalo, Buffalo, NY, 14202, USA.
| | - Noah Rosen
- Department of Neurology, Northwell Health, Long Island, NY, USA
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11
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Benedek I, Hapca E, Vacaras V, Mureșanu D. Clinical neurology during the COVID-19 pandemic - physicians in training perspective series. J Med Life 2022; 15:1-3. [PMID: 35186128 PMCID: PMC8852638 DOI: 10.25122/jml-2022-1001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/06/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Irina Benedek
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Elian Hapca
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Vitalie Vacaras
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Dafin Mureșanu
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
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12
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Impact of Covid-19 on research and training in Parkinson's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 165:283-305. [PMID: 36208905 PMCID: PMC9066297 DOI: 10.1016/bs.irn.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The Coronavirus Disease 2019 (Covid-19) pandemic and the consequent restrictions imposed worldwide have posed an unprecedented challenge to research and training in Parkinson's disease (PD). The pandemic has caused loss of productivity, reduced access to funding, an oft-acute switch to digital platforms, and changes in daily work protocols, or even redeployment. Frequently, clinical and research appointments were suspended or changed as a solution to limit the risk of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) spread and infection, but since the care and research in the field of movement disorders had traditionally been performed at in-person settings, the repercussions of the pandemic have even been more keenly felt in these areas. In this chapter, we review the implications of this impact on neurological research and training, with an emphasis on PD, as well as highlight lessons that can be learnt from how the Covid-19 pandemic has been managed in terms of restrictions in these crucial aspects of the neurosciences. One of the solutions brought to the fore has been to replace the traditional way of performing research and training with remote, and therefore socially distanced, alternatives. However, this has introduced fresh challenges in international collaboration, contingency planning, study prioritization, safety precautions, artificial intelligence, and various forms of digital technology. Nonetheless, in the long-term, these strategies will allow us to mitigate the adverse impact on PD research and training in future crises.
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Tarantino D, Gnasso R, Migliore F, Iommazzo I, Sirico F, Corrado B. The effects of COVID-19 pandemic countermeasures on patients receiving botulinum toxin therapy and on their caregivers: a study from an Italian cohort. Neurol Sci 2021; 42:3071-3077. [PMID: 33956258 PMCID: PMC8100930 DOI: 10.1007/s10072-021-05282-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/21/2021] [Indexed: 11/11/2022]
Abstract
COVID-19 outbreak had a huge worldwide impact, and several countermeasures to contain its spread have been adopted, such as the interruption of nonurgent outpatient clinics. We wanted to describe the effects of the national lockdown on the well-being of a cohort of Italian patients with cerebral palsy (CP) receiving botulinum toxin (BT) therapy and of their caregivers. Twenty-five patients receiving BT therapy were surveyed using the structuralized questionnaire by Dressler and Adib Saberi, while the caregivers were assessed using the Caregiver Burden Scale. The lockdown delayed BT therapy by 9 ± 2.8 months. Around 44% of the selected patients noticed increased muscle cramps, 24% increased muscle pain, and 32% both of them. Due to the lockdown, the patient’s quality of life was reduced by 68.4 ± 21.1%. After the lockdown, 100% of patients perceived BT therapy as more important than before. Around 76% of the patients perceived the lockdown as inadequate and felt that their rights were not respected. The overall score of the Caregiver Burden Scale, as regarded before the lockdown, was 29.12 ± 11.63, while the overall score as regarded after the lockdown was 37.44 ± 14.85. The overall score increased, from before the lockdown to after the lockdown, for 92% of caregivers. The BT outpatient clinic’s interruption was seen to significantly worsen the psychophysical condition of subjects with CP and the care burden of their caregivers, exposing them to greater stress than before. Therefore, any kind of BT treatment suspension or delay should be avoided.
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Affiliation(s)
- Domiziano Tarantino
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Rossana Gnasso
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Federico Migliore
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Irene Iommazzo
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Felice Sirico
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Bruno Corrado
- Department of Public Health, University Federico II of Naples, Naples, Italy.
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