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Fredericks-Younger J, Feldman CA, Allareddy V, Funkhouser E, McBurnie M, Meyerowitz C, Ragusa P, Chapman-Greene J, Coker M, Fine D, Gennaro ML, Subramanian G. Pragmatic Return to Effective Dental Infection Control through Triage and Testing (PREDICT): an observational, feasibility study to improve dental office safety. Pilot Feasibility Stud 2024; 10:44. [PMID: 38419131 PMCID: PMC10900666 DOI: 10.1186/s40814-024-01471-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, there was a substantial interruption of care, with patients and workers fearful to return to the dental office. As dental practice creates a highly aerosolized environment, the potential for spread of airborne illness is magnified. As a means to increase safety and mitigate risk, pre-visit testing for SARS-CoV-2 has the potential to minimize disease transmission in dental offices. The Pragmatic Return to Effective Dental Infection Control through Testing (PREDICT) Feasibility Study examined the logistics and impact of two different testing mechanisms (laboratory-based PCR viral testing and point-of-care antigen testing) in dental offices. METHODS Dental healthcare workers (DHCWs) and patients in four dental offices within the National Dental Practice-based Research Network participated in this prospective study. In addition to electronic surveys, participants in two offices completed POC testing, while participants in two offices used lab-based PCR methods to detect SARS-CoV-2 infection. Analysis was limited to descriptive measures, with median and interquartile ranges reported for Likert scale responses and mean and standard deviation for continuous variables. RESULTS Of the total 72 enrolled, 28 DHCWs and 41 patients completed the protocol. Two patients (4.9%) tested positive prior to their visit, while 2 DHCWs (12.5%) tested positive for SARS-CoV-2 infection at the start of the study. DHCWs and patients shared similar degree of concern (69% and 63%, respectively) for contracting COVID-19 from patients, while patients feared contracting COVID-19 from DHCWs less (49%). Descriptive statistics calculations revealed that saliva, tongue epithelial cells, and nasal swabs were the most desirable specimen collection method; both testing (LAB and POC) protocols took similar amounts of total time to complete; and DHCWs and patients reported feeling more comfortable when both groups were tested. CONCLUSIONS While a larger-scale, network study is necessary for generalizability of results, this feasibility study suggests that SARS-CoV-2 testing can be effectively implemented into dental practice workflows and positively impact perception of safety for DHCWs and patients. As new virulent infectious diseases emerge, preparing dental personnel to employ an entire toolbox of risk mitigation strategies, including testing, may have the potential to decrease dental practice closure time, maintaining continuity of dental care services for patients. TRIAL REGISTRATION ClinicalTrials.gov: NCT05123742.
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Affiliation(s)
- Janine Fredericks-Younger
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA.
| | - Cecile A Feldman
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
- School of Public Health, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | | | | | - MaryAnn McBurnie
- Kaiser Permanente, Center for Health Research, Portland, OR, USA
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester, Rochester, USA
| | - Pat Ragusa
- Eastman Institute for Oral Health, University of Rochester, Rochester, USA
| | - Julie Chapman-Greene
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | - Modupe Coker
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | - Daniel Fine
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | - Maria Laura Gennaro
- New Jersey Medical School, PHRI Center, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
| | - Gayathri Subramanian
- School of Dental Medicine, Rutgers University, Office of Academic Affairs, 110 Bergen Street, Rm B813, Newark, NJ, 07103, USA
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Abdul NS, Kumari M, Shenoy M, Shivakumar GC, Herford AS, Cicciù M, Minervini G. Telemedicine in the diagnosis and management of temporomandibular disorders: A systematic review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. J Oral Rehabil 2023; 50:1340-1347. [PMID: 37349872 DOI: 10.1111/joor.13546] [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: 05/17/2023] [Revised: 06/03/2023] [Accepted: 06/11/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Telemedicine (T-Med) has always been an important tool in the arsenal of clinicians worldwide. This technique has become increasingly popular in recent years, especially in light of the COVID-19 pandemic, which has made it difficult for some people to access traditional dental care. The current review aimed to analyse the usage of telemedicine in the diagnosis and management of temporomandibular disorders (TMDs) and its impact on general health. METHODS An extensive search of databases was conducted using keywords such as, "telemedicine," "teledentistry," "TMJ" and "temporomandibular disorders," resulting in a total of 482 papers to be available from which eligible studies were selected. The Risk of Bias in Observational Studies of Exposures (ROBINS-E) tool was used to evaluate methodological quality of included studies. RESULTS Two studies were selected which fulfilled the eligibility criteria. All assessed studies indicated varying degrees of positive outcomes for patients who were intervened for TMDs using T-Med. CONCLUSION T-Med shows promising results for the diagnosis and management of TMDs, especially since the advent of the COVID-19 pandemic and thereafter. Long-term clinical trials with larger samples are needed to further ascertain validity in this regard.
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Affiliation(s)
- Nishath Sayed Abdul
- Department of OMFS and Diagnostic Sciences, Faculty of Oral Pathology, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Minti Kumari
- Public Health Dentistry, Patna Dental College and Hospital, Patna, India
| | - Mahesh Shenoy
- Department of OMFS and Diagnostic Sciences, Faculty of Oral Pathology, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Ganiga Channaiah Shivakumar
- Department of Oral Medicine and Radiology, Peoples College of Dental Sciences and Research Centre, Peoples University, Bhopal, India
| | - Alan Scott Herford
- Maxillofacial Department, Loma Linda University, Loma Linda, California, USA
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, Italy
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Guzmán-Flores EC, Fuentes-Ayala AR, Martínez-Martínez AC, Aguayo-Félix DE, Arellano-Osorio MV, Campuzano-Donoso M, Román-Galeano NM, Llerena-Velásquez M, Vásquez-Tenorio Y. Reduction of aerosol dissemination in a dental area generated by high-speed and scaler ultrasonic devices employing the "Prime Protector". PLoS One 2023; 18:e0278791. [PMID: 37535637 PMCID: PMC10399923 DOI: 10.1371/journal.pone.0278791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/19/2023] [Indexed: 08/05/2023] Open
Abstract
The use of an external dome aerosol containment device (Prime Protector) is proposed to reduce the spread of particles within the dental office. Hence, the aim of our study was to compare the spread of bioaerosols generated by a High-speed Handpiece (HH) and an Ultrasonic Prophylaxis Device (UPD), with and without the Prime Protector dome (PP) by counting Colony Forming Units (CFU) of Lactobacillus casei Shirota, at different distances on the x and y axis. The PP was located considering the parallelism between the base of the dome and the frontal plane of the simulator, aligning the center of the mouth with the center of the dome. The PP dome measurements are 560.0mm x 255.0mm x 5mm. Petri dishes were placed at 0.5 m, 1 m and 1.5 m respectively. Aerosol generation in the laboratory environment was done three times with the following experimental groups 1) HH, 2) HH-PP, 3) UPD, 4) UPD-PP. Each dental device activation (HH and UPD) had a time frame of 2 minutes on the upper anterior teeth of the dental phantom with a liquid suspension containing Lactobacillus casei Shirota (YAKULT 0836A 0123; 1027F 0407). Air pressure and ventilation were parameterized. No separate high-volume evacuation used, nor was there any air removal attached to the dome. Results showed no significant difference between distance and axis in the CFU count. When means for devices and distances were compared between each of them all showed significant differences except for UPD and UPD-PP (p <0,004). In conclusion, external devices like Prime Protector could help decrease aerosol diffusion during high-speed handpiece activation. However, this dome does not replace the use of PPE inside dental clinics.
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Affiliation(s)
| | | | | | | | | | - Martín Campuzano-Donoso
- School of Dentistry, Faculty of Medical Sciences, International University of Ecuador, Quito, Ecuador
| | | | - Melanie Llerena-Velásquez
- School of Dentistry, Faculty of Medical Sciences, International University of Ecuador, Quito, Ecuador
| | - Yajaira Vásquez-Tenorio
- School of Dentistry, Faculty of Medical Sciences, International University of Ecuador, Quito, Ecuador
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Gangwani P, Mooneyham R, Feng C, Kopycka-Kedzierawski D, Kolokythas A. Accuracy of Telemedicine Consultations in Oral and Maxillofacial Surgery During the COVID-19 Pandemic. J Oral Maxillofac Surg 2023; 81:65-71. [PMID: 36252638 PMCID: PMC9494863 DOI: 10.1016/j.joms.2022.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/28/2022] [Accepted: 09/19/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE Telemedicine has been an emerging trend over the past few years and has seen an exponential rise due to the COVID-19 pandemic. The purpose of the present study was to determine the accuracy of planned oral and maxillofacial surgery (OMS) procedures for patients seen initially by telemedicine in the department of OMS during the pandemic. METHODS This was a retrospective cohort study. Record review of all patients who received telemedicine consultations during the pandemic time frame of March 1, 2020, to March 1, 2021, was performed. The primary outcome was the accuracy of the planned OMS procedure. Accuracy was defined as the ability to conduct the planned surgery with chosen anesthesia (local anesthesia, diazepam + local anesthesia, intravenous sedation, general anesthesia) at the immediate follow-up appointment without the need for further preoperative testing, evaluation, and consultation. The secondary outcomes were to determine the change in surgical plan, anesthesia plan, and medical plan. Predictor variables included age at the time of telemedicine consultation, gender, race, ethnicity, and the type of consult. Descriptive statistics and logistic regression analysis were executed. RESULTS The study sample comprised 286 (64.56%) females and 157 (35.44%) males. The age range of the study population was 9 to 92 years, with a mean age of 33.88 years (standard deviation = 16.29 years). In the cohort of 443 patients who obtained telemedicine consultations, 98.19% were successfully treated at the following appointment. Four hundred thirty-one (97.3%) out of the 443 telemedicine consults pertained to dentoalveolar concerns. Logistic regression analysis showed that neither age nor gender had significant effects on the change of surgical and anesthesia plans. CONCLUSIONS Telemedicine can be effectively utilized in performing consultations for routine OMS procedures, especially dentoalveolar surgeries. Telemedicine consultation can also be used to conduct a preoperative assessment to determine anesthesia and setting of care. However, given the lack of control group and the observational nature of this study, the results must be interpreted with caution.
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Affiliation(s)
- Pooja Gangwani
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Rochester/EIOH, Rochester, NY,Address correspondence and reprint requests to Dr Gangwani: Assistant Professor, Associate Program Director, Department of Oral and Maxillofacial Surgery, University of Rochester, Strong Memorial Hospital-EIOH, 601 Elmwood Avenue, AC-4, Box 705, Rochester NY 14642
| | - Ryan Mooneyham
- Resident, Department of Oral and Maxillofacial Surgery, University of Rochester/EIOH, Rochester, NY
| | - Changyong Feng
- Professor, Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY
| | | | - Antonia Kolokythas
- Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Rochester/EIOH, Rochester, NY
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Yang CH, Liu YY, Chiang CH, Su YW. National IoMT platform strategy portfolio decision model under the COVID-19 environment: based on the financial and non-financial value view. ANNALS OF OPERATIONS RESEARCH 2022; 328:1-29. [PMID: 36267801 PMCID: PMC9568921 DOI: 10.1007/s10479-022-05016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
The Internet of Medical Things (IoMT) is an emerging technology in the healthcare revolution which provides real-time healthcare information communication and reasonable medical resource allocation. The COVID-19 pandemic has had a significant effect on people's lives and has affected healthcare capacities. It is important for integrated IoMT platform development to overcome the global pandemic challenges. This study proposed the national IoMT platform strategy portfolio decision-making model from the non-financial (technology, organization, environment) and financial perspectives. As a solution to the decision problem, initially, the decision-making trial and evaluation laboratory (DEMATEL) technology were employed to capture the cause-effect relationship based on the perspectives and criteria obtained from the insight of an expert team. The analytic network process (ANP) and pairwise comparisons were then used to determine the weights for the strategy. Simultaneously, this study incorporated IoMT platform resource limitations into the zero-one goal programming (ZOGP) method to obtain an optimal portfolio selection for IoMT platform strategy planning. The results showed that the integrated MCDM method produced reasonable results for selecting the most appropriate IoMT platform strategy portfolio when considering resource constraints such as system installation costs, consultant fees, infrastructure costs, reduction of medical staff demand, and improvement rates for diagnosis efficiency. The decision-making model of the IoMT platform in this study was conclusive and significantly compelling to aid government decision makers in concentrating their efforts on planning IoMT strategies in response to various pandemic and medical resource allocations.
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Affiliation(s)
- Chih-Hao Yang
- Department of Accounting, Ming Chuan University, Shilin, Taipei, Taiwan
| | - Yen-Yu Liu
- Department of Accounting, Soochow University, Chungcheng, Taipei, Taiwan
| | - Chia-Hsin Chiang
- College of Management, Yuan Ze University, Zhong-Li, Taoyuan, Taiwan
| | - Ya-Wen Su
- Department of Financial Management, National Defense University, Beitou, Taipei, Taiwan
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Sharma BB, Mathur M, Mohan V. Design of a COVID-19 treatment facility in a sustainable health-care environment. MATERIALS TODAY: PROCEEDINGS 2022; 79:6-10. [PMID: 35946044 PMCID: PMC9353620 DOI: 10.1016/j.matpr.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Due to the recent pandemic situation that has erupted all around us, healthcare facility design is a must. Healthcare providers and administrators must concentrate on the changes that must be made in existing healthcare facilities. The isolated healthcare facilities are essential because the corona virus is spread mainly through close contact (within six feet), such as handshaking (if someone's hands are infected) or touching contaminated surfaces. Healthcare facilities are most susceptible to the spread of the corona virus due to the high number of symptomatic patients admitted. Coronavirus is the leading cause of infectious disease morbidity and mortality worldwide. Thus, if the pandemic situation worsens, new plans and designs for existing healthcare facilities will be required, as well as temporary versions. Societal gains from increased research in this area. In the coming years, healthcare workers will be better trained, and healthcare facilities will be upgraded. This paper proposes new plans and designs to address the issues raised.
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Rim D, Shin H, Jeon H, Kim J, Chun H, Oh H, Shon S, Shim K, Kim KM. [Collaborative Disaster Governance Recognized by Nurses during a Pandemic]. J Korean Acad Nurs 2022; 51:703-719. [PMID: 35023859 DOI: 10.4040/jkan.21163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE We aimed to identify collaborative disaster governance through the demand and supply analysis of resources recognized by nurses during the COVID-19 pandemic. METHODS We used a descriptive study design with an online survey technique for data collection. The survey questions were developed based on focus group interviews with nurses responding to COVID-19 and expert validity testing. A 42-question online survey focusing on disaster governance was sent to nurses working in COVID-19 designated hospitals, public health offices, and schools. A total of 630 nurses participated in the survey. Demand and supply analysis was used to identify the specific components of disaster governance during a pandemic situation and analyze priority areas in disaster governance, as reported by nurses. RESULTS Demand and supply analysis showed that supplies procurement, cooperation, education, and environment factors clustered in the high demand and supply quadrant while labor condition, advocacy, emotional support, and workload adjustment factors clustered in the high demand but low supply quadrant, indicating a strong need in those areas of disaster governance among nurses. The nurses practicing at the public health offices and schools showed major components of disaster governance plotted in the second quadrant, indicating weak collaborative disaster governance. CONCLUSION These findings show that there is an unbalanced distribution among nurses, resulting in major challenges in collaborative disaster governance during COVID-19. In the future and current pandemic, collaborative disaster governance, through improved distribution, will be useful for helping nurses to access more required resources and achieve effective pandemic response.
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Affiliation(s)
- Dahae Rim
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | - Hyunsook Shin
- College of Nursing Science, Kyung Hee University, Seoul, Korea.
| | - Hyejin Jeon
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | - Jieun Kim
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | - Hyojin Chun
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | - Hee Oh
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | | | - Kaka Shim
- Department of Nursing, College of Convergence Technology, Sang Myung University, Cheonan, Korea
| | - Kyung Mi Kim
- Department of Nursing Science, College of Medicine, Chungbuk National University, Cheongju, Korea
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Adel-Khattab D, Samy AM, Horowitz RA. Dentists' perception toward COVID-19: A cross-sectional study among a sample of Egyptian dentists. Oral Dis 2021; 28 Suppl 2:2601-2602. [PMID: 34674360 PMCID: PMC8662133 DOI: 10.1111/odi.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Doaa Adel-Khattab
- Department of Oral Medicine, Periodontology and Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Amira Mohammad Samy
- Department of Conservative Dentistry, Faculty of Dentistry, Badr University, Cairo, Egypt
| | - Robert A Horowitz
- Oral Surgery, Periodontology and Implant Dentistry, The NYU College of Dentistry, New York, New York, USA
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Nadella S, Wang TT, Bear A, Panchal N. Do Medical Insurance Companies Reimburse Telemedicine Office Visits the Same as In-Person Office Visits in an Academic Oral and Maxillofacial Surgeon Setting? J Oral Maxillofac Surg 2021; 79:2398-2403. [PMID: 34547264 DOI: 10.1016/j.joms.2021.08.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE The use of telemedicine has grown exponentially over the last decade, but its widespread adoption has been hindered, at least in part, by uncertainty over reimbursement rate for services. The aim of this study is to compare reimbursement rates of telemedicine and in-person visits in an academic oral and maxillofacial surgery practice. METHODS The investigators implemented a retrospective cohort study. The sample was composed of patients who were treated by the oral-maxillofacial surgery service at the University of Pennsylvania Health System from March 17, 2020 to February 27, 2021. The primary predictor variable was the type of patient visit, either telemedicine or in-person. Patient status, either established or new, was a covariate. The outcome variable was the mean reimbursement-to-charge (RC) ratio. Descriptive and bivariate statistics were computed, and the P value was set at .05. RESULTS This study included 6,082 submitted claims for 4,045 patients for in-person and telemedicine oral-maxillofacial surgery office visits. The mean reimbursement per insurance payor was $98.07 for a telemedicine visit (mean RC ratio = 0.48 with a standard deviation of ± 0.20) and $109.5 for an in-person visit (mean RC ratio = 0.50 with a standard deviation of ± 0.19). While there was a significant difference between the RC ratio for total telemedicine versus in-person visits (P = .001), the magnitude of the difference was only 2%. When stratifying the comparison by new (P = .73) and established patients (P = .20) for both telemedicine and in-person office visits, there was no significant difference in RC ratios. CONCLUSIONS The results suggest that there are no major discrepancies in financial reimbursement rate between telemedicine and in-person office visits. Both methods of treatment may be financially effective for oral-maxillofacial surgery providers. Future studies can compare reimbursement rates among different insurance providers and among different institutions in the United States.
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Affiliation(s)
- Srighana Nadella
- DMD Candidate, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA; BA Candidate, School of Arts & Sciences, University of Pennsylvania, Philadelphia, PA
| | - Tim T Wang
- Associate Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Adam Bear
- Supervisor of Billing, University of Pennsylvania Health System, Philadelphia, PA
| | - Neeraj Panchal
- Assistant Professor and Section Chief of Oral and Maxillofacial Surgery, Philadelphia Veterans Affairs Medical Center, Penn Presbyterian Medical Center, University of Pennsylvania School of Dental Medicine, Philadelphia, PA.
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Subjective Smell Assessment as An Office-based Rapid Procedure In COVID-19 Era. J Craniofac Surg 2021; 32:e439-e441. [PMID: 33208702 PMCID: PMC8237839 DOI: 10.1097/scs.0000000000007245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A recent history of smell disorder may be a potential predictor for COVID-19. The authors used a subjective olfaction score that was demonstrated on a hard paper-bar. The authors examined 480 patients who were attending the outpatient clinic. Ninety-seven patients (20.2%) demonstrated variable degrees of recent smell disorder. For those patients, lab testing including nasopharyngeal swab for real-time polymerase chain reaction (RT-PCR) was performed. Eighty-eight of them (90.7%) have been confirmed to be COVID-19 positive. Although psychophysical testing is more reliable, subjective assessment of smell is a rapid procedure and can be used as an office-based method for patients’ screening in COVID-19 era. Smell disorder could be an alarming sign for COVID-19 even with absent characteristic symptoms.
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Pu JJ, McGrath CP, Leung YY, Choi WS, Yang WF, Li KY, Su YX. The Impact of Coronavirus Disease 2019 on the Disease Pattern of Oral and Maxillofacial Surgery Inpatients: A Comparative Study. Front Med (Lausanne) 2021; 8:613663. [PMID: 33996845 PMCID: PMC8116897 DOI: 10.3389/fmed.2021.613663] [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: 10/03/2020] [Accepted: 03/19/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: Oral and maxillofacial surgery (OMFS) is a high-risk specialty involving airway and aerosol-generating procedures, which is potentially of more risk in the era of coronavirus disease 2019 (COVID-19). We aimed to identify the impact of COVID-19 on the disease pattern of OMFS inpatients and surgeries under general anesthesia in a comparative study. Materials and Methods: We reviewed the admission and operating theater records of OMFS patients from Jan 1 to Aug 31 in 2020 and 2019. The total number of cases, presenting disease patterns, and proportion of essential and non-essential medical services were compared between 2020 and 2019. Results: There were 664 admissions and 356 general anesthesia surgical procedures included in this study. Both admission and surgery numbers were significantly reduced in 2020, compared with 2019 (p = 0.012 and 0.007, respectively). The proportion of malignancy cases increased significantly, whereas that of cleft lip and palate and temporomandibular disorder (TMD) decreased. There was a significant increase in the proportion of essential services compared with non-essential services in 2020 compared with 2019. Conclusion: Our results first reported the epidemiological data of the impact of COVID-19 on OMFS disease pattern in a comparative study. The change of disease pattern and caseload will have a long-term impact on OMFS patient care, education, and training during the pandemic. Our paper provides evidence for health policy makers to consider the relocation of medical resources and optimization of medical education and services.
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Affiliation(s)
- Jingya Jane Pu
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Colman Patrick McGrath
- Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Yiu Yan Leung
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Wing Shan Choi
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Wei-Fa Yang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kar Yan Li
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Yu-Xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
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Goto M, Nagao T, Hasegawa S, Watanabe S, Miyabe S, Miyachi H. Impact of COVID-19 pandemic on oral and maxillofacial surgery in Japan: A report from a questionnaire survey during the different phases of the pandemic. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [PMCID: PMC7983448 DOI: 10.1016/j.adoms.2021.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
COVID-19 pandemic has provided a new challenge to healthcare systems and medical care providers. In the current study, we describe the challenges faced and actions taken to provide optimum healthcare in Japan during the COVID-19 pandemic based on the results of a questionnaire survey that was conducted by oral and maxillofacial surgeons. A total of 24 Japanese institutions participated in the study. The first survey was conducted between June 22, 2020 and June 26, 2020, and the second survey was conducted between October 23, 2020 and November 8, 2020. The questionnaire focused on the practical situation in the respondent's hospital, personal protective equipment (PPE) availability, and what alterations had occurred compared to the situation before the COVID-19 pandemic. The commonest reported duration of restrictions to the outpatient clinic was 1–2 months. All of the institutions had lifted their restrictions on outpatient services by September 2020. Surgical procedures in the operating room were restricted in 74% of hospitals in the first wave of the pandemic; however, 88% lifted their restrictions and restarted their regular surgical services by November 2020. Although, non-urgent or elective procedures were delayed, surgeries for malignant tumors, maxillofacial infections, and trauma were performed at almost all hospitals during the pandemic. Health care institutions will require a new approach to maintain patient volume and recover from the pandemic. Going forward, it is also necessary to minimize the risk of exposure and transmission to health care personnel as well as patients.
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Robiony M, Bocin E, Sembronio S, Costa F, Arboit L, Tel A. Working in the era of COVID-19: An organization model for maxillofacial surgery based on telemedicine and video consultation. J Craniomaxillofac Surg 2021; 49:323-328. [PMID: 33581957 PMCID: PMC7862884 DOI: 10.1016/j.jcms.2021.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/28/2020] [Accepted: 01/31/2021] [Indexed: 11/01/2022] Open
Abstract
The worldwide pandemic caused by the COVID-19 outbreak has led to an unprecedented burden on hospital structures, posing new challenges in terms of reshaping healthcare services. At the same time, the so-called 'lockdown' restrictions have decreased overall mobility, thereby challenging the traditional concept of clinical examination. Moreover, the need for security for both patients and healthcare personnel has posed a further limitation to face-to-face meeting. Telemedicine has provided a valuable solution for such issues, allowing the evaluation of oral and maxillofacial surgery patients through technological interfaces, restricting physical consultations to cases with high clinical priority, intercepting suspects, and maintaining contact with discharged patients. Thanks to the experience gained during the previous wave of infections, the purpose of this study was to present a reorganization of clinical services for oral and maxillofacial surgery in order to help cope with the latest COVID-19 resurgence. Using commonly available software for telecommunications and online meetings, the Oral and Maxillofacial Surgery Department of the University Hospital of Udine has reshaped the organization of healthcare services, with telemedicine central to the continuity of assistance, while at the same time minimizing the risk of exposure for both patients and operators. Additionally, the high number of patients evaluated through telemedicine improved our ability to define signs and symptoms of diseases using informatic tools, thus allowing the introduction of the concept of 'telesemiology'. During our previous lockdown experience, between March and April 2020, 78 patients were evaluated using teleconsultation. All outpatient examinations were rescheduled and translated into a virtual platform, allowing each patient to undergo evaluation in the most appropriate setting. Special attention was paid to the follow-up of oncological patients. The rehabilitation team represented a crucial element in maintaining contact with more complex patients in this crucial time. This study was based on our previous lockdown experience - a situation that many will be facing again over the coming months. Our hope is that the organizational structure that our department applied during the previous wave of infections may offer other colleagues a solution to facing the current COVID-19 recrudescence.
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Affiliation(s)
- Massimo Robiony
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Italy.
| | - Elena Bocin
- Rehabilitation Unit, Academic Hospital of Udine, Department of Medicine, University of Udine, Italy
| | - Salvatore Sembronio
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Italy
| | - Fabio Costa
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Italy
| | - Lorenzo Arboit
- Faculty of Medicine and Surgery, University of Pisa, Italy
| | - Alessandro Tel
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Italy
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Nasrabadi AN, Shali M, Ghorbani A, Matourypour P, Harati Khalilabad T. Challenges with healthcare workers' protection during the COVID-19 pandemic in Iran. Br J Oral Maxillofac Surg 2020; 59:e114-e117. [PMID: 33579542 PMCID: PMC7584918 DOI: 10.1016/j.bjoms.2020.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/15/2020] [Indexed: 11/29/2022]
Abstract
During the COVID-19 pandemic, healthcare workers stand in the frontline of the fight against the disease. This study aimed to assess the challenges with personal protection during the pandemic in Tehran, Iran. Seven-hundred healthcare workers were surveyed between April and May 2020, and the study was performed in surgical care wards. Questionnaires, which were sent to 1000 workers via online platforms, social networks, and emails to different associations, were used to assess the use of personal protective equipment (PPE) and the reasons for not using it. A total of 700 replied. Face masks and face shields had the highest and lowest use, respectively. Equipment shortage, time constraint, low supervision, and lack of information were the reasons for personnel not using PPE. To reduce the burden of COVID-19 and accelerate the process of patient care, it is important to protect and maintain the well-being of staff. Organised national and international arrangements to protect them are critical.
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Affiliation(s)
- A N Nasrabadi
- School of Nursing and Midwifery, Medical Surgical Nursing Department, Tehran University of Medical Sciences, Tehran, Iran.
| | - M Shali
- Critical Care Nursing and Management Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - A Ghorbani
- Medical Surgical Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - P Matourypour
- Medical Surgical Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - T Harati Khalilabad
- Department of Health Economics, School of Health Management and Health Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Fujii Y, Hirota K. Critical Care Demand and Intensive Care Supply for Patients in Japan with COVID-19 at the Time of the State of Emergency Declaration in April 2020: A Descriptive Analysis. ACTA ACUST UNITED AC 2020; 56:medicina56100530. [PMID: 33053765 PMCID: PMC7600748 DOI: 10.3390/medicina56100530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/03/2020] [Accepted: 10/08/2020] [Indexed: 01/08/2023]
Abstract
Background and objectives: The coronavirus disease 2019 (COVID-19) pandemic is overwhelming Japan's intensive care capacity. This study aimed to determine the number of patients with COVID-19 who required intensive care and to compare the numbers with Japan's intensive care capacity. Materials and Methods: Publicly available datasets were used to obtain the number of confirmed patients with COVID-19 undergoing mechanical ventilation and extracorporeal membrane oxygenation (ECMO) between 15 February and 19 July 2020 to determine and compare intensive care unit (ICU) and attending bed needs for patients with COVID-19, and to estimate peak ICU demands in Japan. Results: During the epidemic peak in late April, 11,443 patients (1.03/10,000 adults) had been infected, 373 patients (0.034/10,000 adults) were in ICU, 312 patients (0.028/10,000 adults) were receiving mechanical ventilation, and 62 patients (0.0056/10,000 adults) were under ECMO per day. At the peak of the epidemic, the number of infected patients was 651% of designated beds, and the number of patients requiring intensive care was 6.0% of ICU beds, 19.1% of board-certified intensivists, and 106% of designated medical institutions in Japan. Conclusions: The number of critically ill patients with COVID-19 continued to rise during the pandemic, exceeding the number of designated beds but not exceeding ICU capacity.
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Serafim Vilela AC, Costa NL. The COVID-19 and Saliva Paradox. J Oral Maxillofac Surg 2020; 78:2105. [PMID: 32961125 PMCID: PMC7501522 DOI: 10.1016/j.joms.2020.07.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 11/29/2022]
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17
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Anghel L, Popovici CG, Stătescu C, Sascău R, Verdeș M, Ciocan V, Șerban IL, Mărănducă MA, Hudișteanu SV, Țurcanu FE. Impact of HVAC-Systems on the Dispersion of Infectious Aerosols in a Cardiac Intensive Care Unit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186582. [PMID: 32927583 PMCID: PMC7560168 DOI: 10.3390/ijerph17186582] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 01/08/2023]
Abstract
At the end of 2019, a variation of a coronavirus, named SARS-CoV-2, has been identified as being responsible for a respiratory illness disease (COVID-19). Since ventilation is an important factor that influences airborne transmission, we proposed to study the impact of heating, ventilation and air-conditioning (HVAC) with a variable air volume (VAV) primary air system, on the dispersion of infectious aerosols, in a cardiac intensive care unit, using a transient simulation with computational fluid dynamics (CFD), based on the finite element method (FEM). We analyzed three scenarios that followed the dispersion of pathogen carrying expiratory droplets particles from coughing, from patients possibly infected with COVID-19, depending on the location of the patients in the intensive care unit. Our study provides the mechanism for spread of infectious aerosols, and possibly of COVID-19 infection, by air conditioning systems and also highlights important recommendations for disease control and optimization of ventilation in intensive care units, by increasing the use of outdoor air and the rate of air change, decreasing the recirculation of air and using high-efficiency particulate air (HEPA) filters. The CFD-FEM simulation approach that was applied in our study could also be extended to other targets, such as public transport, theaters, philharmonics and amphitheaters from educational units.
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Affiliation(s)
- Larisa Anghel
- Internal Medicine Department, Grigore T. Popa University of Medicine and Pharmacy, 700503 Iași, Romania;
- Cardiology Department, Cardiovascular Diseases Institute, Prof. Dr. George I.M. Georgescu, 700503 Iași, Romania
| | - Cătălin-George Popovici
- Building Services Department, Faculty of Civil Engineering and Building Services, Gheorghe Asachi Technical University, 700050 Iaşi, Romania; (C.-G.P.); (M.V.); (V.C.); (S.-V.H.); (F.-E.Ț.)
| | - Cristian Stătescu
- Internal Medicine Department, Grigore T. Popa University of Medicine and Pharmacy, 700503 Iași, Romania;
- Cardiology Department, Cardiovascular Diseases Institute, Prof. Dr. George I.M. Georgescu, 700503 Iași, Romania
- Correspondence: (C.S.); (R.S.); Tel.: +40-0232-211834 (C.S. & R.S.)
| | - Radu Sascău
- Internal Medicine Department, Grigore T. Popa University of Medicine and Pharmacy, 700503 Iași, Romania;
- Cardiology Department, Cardiovascular Diseases Institute, Prof. Dr. George I.M. Georgescu, 700503 Iași, Romania
- Correspondence: (C.S.); (R.S.); Tel.: +40-0232-211834 (C.S. & R.S.)
| | - Marina Verdeș
- Building Services Department, Faculty of Civil Engineering and Building Services, Gheorghe Asachi Technical University, 700050 Iaşi, Romania; (C.-G.P.); (M.V.); (V.C.); (S.-V.H.); (F.-E.Ț.)
| | - Vasilică Ciocan
- Building Services Department, Faculty of Civil Engineering and Building Services, Gheorghe Asachi Technical University, 700050 Iaşi, Romania; (C.-G.P.); (M.V.); (V.C.); (S.-V.H.); (F.-E.Ț.)
| | - Ionela-Lăcrămioara Șerban
- Physiology Department, Grigore T. Popa University of Medicine and Pharmacy, 700503 Iași, Romania; (I.-L.Ș.); (M.A.M.)
| | - Minela Aida Mărănducă
- Physiology Department, Grigore T. Popa University of Medicine and Pharmacy, 700503 Iași, Romania; (I.-L.Ș.); (M.A.M.)
| | - Sebastian-Valeriu Hudișteanu
- Building Services Department, Faculty of Civil Engineering and Building Services, Gheorghe Asachi Technical University, 700050 Iaşi, Romania; (C.-G.P.); (M.V.); (V.C.); (S.-V.H.); (F.-E.Ț.)
| | - Florin-Emilian Țurcanu
- Building Services Department, Faculty of Civil Engineering and Building Services, Gheorghe Asachi Technical University, 700050 Iaşi, Romania; (C.-G.P.); (M.V.); (V.C.); (S.-V.H.); (F.-E.Ț.)
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Al-Izzi T, Breeze J, Elledge R. Following COVID-19 clinicians now overwhelmingly accept virtual clinics in Oral and Maxillofacial Surgery. Br J Oral Maxillofac Surg 2020; 58:e290-e295. [PMID: 32798104 PMCID: PMC7833799 DOI: 10.1016/j.bjoms.2020.07.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/28/2020] [Indexed: 01/12/2023]
Abstract
Virtual consultations and telemedicine have been an emerging trend in modern medicine, which has seen acceleration in uptake across a wide range of specialties as a result of the COVID-19 pandemic. Following on from previous work by the authors in 2019 examining clinician and patient appetite for virtual consultations in maxillofacial surgery, we sought to evaluate whether there had been a change in attitudes as a result of the pandemic. A clinician survey of the consultants at a large teaching hospital and prospective data collection of virtual consultation outcomes was carried out from the inception of UK government lockdown measures to tackle the pandemic. From 151 consultations, 149 (98.7%) successfully established a working diagnosis and treatment plan and/or concluded an episode of patient care, without the need to convert to a face-to-face encounter between clinician and patient. The total number of consultations (virtual or otherwise) was significantly lower than the same time period the preceding year however (1,223 compared with 465 consultations). All consultants surveyed felt the pandemic had altered their opinion of virtual clinics and their place in maxillofacial surgery but cited a number of issues. Further work is required to understand the driving forces behind staff attitudes and the long-term adoption of telemedicine within the specialty as services return to some sense of normalcy.
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Affiliation(s)
- T Al-Izzi
- Queen Elizabeth Hospital Birmingham, B15 2TH, UK.
| | - J Breeze
- Queen Elizabeth Hospital Birmingham, B15 2TH, UK
| | - R Elledge
- Queen Elizabeth Hospital Birmingham, B15 2TH, UK
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Elledge R, Williams R, Fowell C, Green J. Maxillofacial education in the time of COVID-19: the West Midlands experience. Br J Oral Maxillofac Surg 2020; 60:52-57. [PMID: 32807595 PMCID: PMC7392048 DOI: 10.1016/j.bjoms.2020.07.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
Abstract
COVID-19 has accelerated a reliance on virtual technology for the delivery of postgraduate surgical education. We sought to develop a regional teaching programme with robust quality assurance. Webinars were delivered on a weekly basis by subspecialty experts using Zoom™ augmented with interactive polling software. Trainee feedback comprised Likert item rating on content and delivery, free text comments and self-assessed confidence levels using visual analogue scale (VAS) scores. A focus group was also convened and transcripts assessed with grounded theory analysis. Likert items revealed 442 (93.2%) positive responses regarding content and 642 (96.7%) positive responses regarding trainer delivery. There were statistically significant improvements in VAS scores across all programme content. Key themes from the focus group analysis were the pragmatics of delivering online education, issues surrounding trainer interactivity in the virtual world, the identification of the FRCS as a driving factor and a desire for case-based content and pre-learning of information (the ‘flipped classroom’). We are continuing to be reactive to trainee feedback in developing our online learning programme which will also include a regional Moodle-based virtual learning environment (VLE), the subject of future educational research in our region.
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Affiliation(s)
- R Elledge
- University Hospitals Birmingham NHS Foundation Trust, University of Birmingham; College of Medical and Dental Sciences, University of Birmingham.
| | - R Williams
- University Hospitals Birmingham NHS Foundation Trust, University of Birmingham.
| | - C Fowell
- Cambridge University Hospitals NHS Foundation Trust.
| | - J Green
- University Hospitals Birmingham NHS Foundation Trust, University of Birmingham.
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