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Karamitros G, Kontoes P, Wiedner M, Goulas S. The Impact of COVID-19 on Plastic Surgery Residents Across the World: A Country-, Region-, and Income-level Analysis. Aesthetic Plast Surg 2023; 47:2889-2901. [PMID: 37253842 PMCID: PMC10228894 DOI: 10.1007/s00266-023-03389-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/25/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND The COVID-19 pandemic has upended graduate medical education globally. We investigated the COVID-19 impact on learning inputs and expected learning outputs of plastic surgery residents across the world. METHODS We administered an online survey capturing training inputs before and during the pandemic and retrieved residents' expected learning outputs compared with residents who completed their training before COVID. The questionnaire reached residents across the world through the mobilization of national and international societies of plastic surgeons. RESULTS The analysis included 412 plastic surgery residents from 47 countries. The results revealed a 44% decline (ranging from - 79 to 10% across countries) and an 18% decline (ranging from - 76 to across 151% countries) in surgeries and seminars, respectively, per week. Moreover, 74% (ranging from 0 to 100% across countries) and 43% (ranging from 0 to 100% across countries) of residents expected a negative COVID-19 impact on their surgical skill and scientific knowledge, respectively. We found strong correlations only between corresponding input and output: surgeries scrubbed in with surgical skill (ρ = -0.511 with p < 0.001) and seminars attended with scientific knowledge (ρ = - 0.274 with p = 0.006). CONCLUSIONS Our ranking of countries based on their COVID-19 impacts provides benchmarks for national strategies of learning recovery. Remedial measures that target surgical skill may be more needed than those targeting scientific knowledge. Our finding of limited substitutability of inputs in training suggests that it may be challenging to make up for lost operating room time with more seminars. Our results support the need for flexible training models and competency-based advancement. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
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Affiliation(s)
- Georgios Karamitros
- Department of Plastic Surgery, University Hospital of Ioannina, Stavrou Niarchou Avenue, 45500, Ioannina, Greece.
- Medical School, University of Ioannina, Stavrou Niarchou Avenue, 45500, Ioannina, Greece.
| | - Paraskevas Kontoes
- International Society of Aesthetic Plastic Surgery, Mount Royal, NJ, USA
| | - Maria Wiedner
- International Society of Aesthetic Plastic Surgery, Mount Royal, NJ, USA
| | - Sofoklis Goulas
- Brookings Institution, Washington DC, USA
- World Bank, Washington DC, USA
- Aletheia Research Institution, Palo Alto, CA, USA
- Hoover Institution, Stanford University, Stanford, CA, USA
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Sarıdemir Ünal D, Doğru V, Avanaz A, Arıcı C. Impact of COVID-19 on operating assignments in residency training of endocrine surgery: A retrospective cohort study. Asian J Surg 2023; 46:4283-4289. [PMID: 36933961 PMCID: PMC9992058 DOI: 10.1016/j.asjsur.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/30/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE Airborne pandemics illustrate a significant problem in training grounds. From the endocrine surgery point of view, we scrutinized the impact of Covid-19 on general surgery residency training in our university hospital. METHODS The number of endocrine procedure curves was forecasted using the expert modeler in a time series model from March to September 2020 based on data from previous years. We then compared the estimation curves to actual numbers. RESULTS There were 1340 resident participants in thyroid procedures, 405 in parathyroid procedures, 65 in other neck procedures, and 304 in adrenal procedures. In 884 of the endocrine procedures, the operating surgeon was a resident. The median experience of operating residents in endocrine procedures was 3.2 years (interquartile range 2.7-3.6) before the impact and 3.8 years (interquartile range 3.1-4.1) after it (p = 0.023). The monthly number of actual procedures with at least one resident participation in the Covid-19 period was significantly lower (8.7 ± 7.5 vs. 19.9 ± 3.7, p = 0.012) than the forecasted numbers. There were no semi-autonomous operating chief residents, although we expected a moderate level (0 actual vs. 0.5 ± 0.2 predicted, p = 0.002). CONCLUSION This study clearly represents sustainability in surgical training and includes usual trends. Essential endocrine surgical procedures the pandemic disrupted the most were the treatment of thyroid and parathyroid diseases. Covid-19 reduced our surgical volume and resulted in delays in training. A full-scale disaster plan is necessary for possible crises threatening surgical education.
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Affiliation(s)
- Demet Sarıdemir Ünal
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
| | - Volkan Doğru
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ali Avanaz
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
| | - Cumhur Arıcı
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
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Feenstra TM, Tejedor P, Popa DE, Francis N, Schijven MP. Surgical education in the post-COVID era: an EAES DELPHI-study. Surg Endosc 2022;:1-10. [PMID: 36451042 DOI: 10.1007/s00464-022-09762-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/06/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUNDS To date, it is unclear what the educational response to the restrictions on minimally invasive surgery imposed by the COVID-19 pandemic have been, and how MIS-surgeons see the post-pandemic future of surgical education. Using a modified Delphi-methodology, this study aims to assess the effects of COVID on MIS-training and to develop a consensus on the educational response to the pandemic. METHODS A three-part Delphi study was performed among the membership of the European Association of Endoscopic Surgery (EAES). The first survey aimed to survey participants on the educational response in four educational components: training in the operating room (OR), wet lab and dry lab training, assessment and accreditation, and use of digital resources. The second and third survey aimed to formulate and achieve consensus on statements on, and resources in, response to the pandemic and in post-pandemic MIS surgery. RESULTS Over 247 EAES members participated in the three rounds of this Delphi survey. MIS-training decreased by 35.6-55.6%, alternatives were introduced in 14.7-32.2% of respondents, and these alternatives compensated for 32.2-43.2% of missed training. OR-training and assessments were most often affected due to the cancellation of elective cases (80.7%, and 73.8% affected, respectively). Consensus was achieved on 13 statements. Although digital resources were deemed valuable alternatives for OR-training and skills assessments, face-to-face resources were preferred. Videos and hands-on training-wet labs, dry labs, and virtual reality (VR) simulation-were the best appreciated resources. CONCLUSIONS COVID-19 has severely affected surgical training opportunities for minimally invasive surgery. Face-to-face training remains the preferred training method, although digital and remote training resources are believed to be valuable additions to the training palette. Organizations such as the EAES are encouraged to support surgical educators in implementing these resources. Insights from this Delphi can guide (inter)national governing training bodies and hospitals in shaping surgical resident curricula in post pandemic times.
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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. Ann Oper Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Mohammadzadeh N, Tadbir Vajargah K, Nilforoushan N, Ashouri M, Jafarian A, Emami-Razavi SH. The impact of the COVID-19 pandemic on surgical education: A survey and narrative review. Ann Med Surg (Lond) 2022; 82:104598. [PMID: 36101842 PMCID: PMC9458543 DOI: 10.1016/j.amsu.2022.104598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 11/29/2022] Open
Abstract
Background Since the emergence of the COVID-19 pandemic, medical education has been a concerning issue, especially in surgical fields. Due to the postponement of many elective surgeries and even alternations in the pattern of emergent surgeries, concerns have been raised about whether residents of surgical disciplines are experienced enough after graduation or not. We aimed to describe the impact of the COVID-19 pandemic on surgical residency training in different fields. Materials and methods We conducted a cross-sectional study with a 20-item questionnaire on residents of surgical disciplines from three different educational hospitals of Tehran University of Medical Sciences, Iran in 2020. In addition, we reviewed the current literature regarding the impact of COVID-19 pandemic on surgical education worldwide. Results Our survey, with a response rate of 56.8% demonstrated significant reduction in the time spent in elective surgeries, surgical clinics and even in emergent surgeries for residents. Besides, it has reported that significant time has been spent in COVID 19 wards which resulted in decreased satisfaction of educational activities. Conclusions The impacts of COVID 19 pandemic on surgical education are significant and inevitable. Thus, we must integrate novel educational methods in surgical curriculum to optimize training and minimize the adverse effects of the pandemic on surgical education. The impacts of COVID 19 on surgical education are significant and inevitable. We must integrate novel educational methods in surgical curriculum. We need to optimize training and minimize the adverse effects of the pandemic.
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Aparicio Betancourt M, Duarte-Díaz A, Vall-Roqué H, Seils L, Orrego C, Perestelo-Pérez L, Barrio-Cortes J, Beca-Martínez MT, Molina Serrano A, Bermejo-Caja CJ, González-González AI. Global Healthcare Needs Related to COVID-19: An Evidence Map of the First Year of the Pandemic. Int J Environ Res Public Health 2022; 19:10332. [PMID: 36011970 PMCID: PMC9408445 DOI: 10.3390/ijerph191610332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has exposed gaps and areas of need in health systems worldwide. This work aims to map the evidence on COVID-19-related healthcare needs of adult patients, their family members, and the professionals involved in their care during the first year of the pandemic. We searched the databases MEDLINE, Embase, and Web of Science. Two reviewers independently screened titles and abstracts and assessed full texts for eligibility. Disagreements were resolved by consensus. Descriptive data were extracted and inductive qualitative content analysis was used to generate codes and derive overarching themes. Thirty-six studies met inclusion criteria, with the majority reporting needs from the perspective of professionals (35/36). Professionals' needs were grouped into three main clusters (basic, occupational, and psycho-socio-emotional needs); patients' needs into four (basic, healthcare, psycho-socio-emotional, and other support needs); and family members' needs into two (psycho-socio-emotional and communication needs). Transversal needs across subgroups were also identified and grouped into three main clusters (public safety, information and communication, and coordination and support needs). This evidence map provides valuable insight on COVID-19-related healthcare needs. More research is needed to assess first-person perspectives of patients and their families, examine whether needs differ by country or region, and evaluate how needs have evolved over time.
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Affiliation(s)
- Mariana Aparicio Betancourt
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Helena Vall-Roqué
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Laura Seils
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 El Rosario, Spain
| | - Jaime Barrio-Cortes
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Fundación para la Investigación e Innovación Biosanitaria en Atención Primaria, 28003 Madrid, Spain
| | | | | | - Carlos Jesús Bermejo-Caja
- Unidad de Apoyo Técnico Dirección Técnica de Sistemas de información, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, 28035 Madrid, Spain
- Departamento de Enfermería. Universidad Autónoma de Madrid, 28034 Madrid, Spain
| | - Ana Isabel González-González
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Unidad de Innovación y Proyectos Internacionales, Dirección General de Investigación, Docencia y Documentación, Consejería de Sanidad, 28034 Madrid, Spain
- Institute of General Practice, Goethe University, 60323 Frankfurt, Germany
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Doğru V, Sarıdemir Ünal D, Avanaz A, Yaprak M, Mesci A. Learning-by-teaching coming into play as a reliable trick for lower GI procedures: a learning curve analysis in 13,210 operative logs including the COVID-19 era. Updates Surg 2022; 74:1263-1270. [PMID: 35303256 PMCID: PMC8931573 DOI: 10.1007/s13304-022-01273-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/04/2022] [Indexed: 11/26/2022]
Abstract
After suspecting a plunge in the operative case logs in our clinic, we wanted to explore the COVID-19 impact on surgical training side of the lower gastrointestinal procedures to raise awareness of the possible cracks in the pillars of general surgery residency. Comparing the coronavirus impact to previous years starting from 2014, we examined the procedures of our residents for their roles in the operating room. We performed interrupted time-series analyses to get a sense of the magnitude and then used a new index to identify the trend of change in operator-to-first assistant rate of experience and searched for signs of learning-by-teaching motives. In total, 13,210 operative logs of residents were included; of procedures, 3483 (41%) were emergency. Both overall resident participations and learning-by-teaching dropped during first 3 months, followed by a rebound. The overall operator-to-first assistant rate of experience was 1.06 before and 0.86 after. Emergency procedures, obstruction, perforation, enterostomy closure, appendix, colon, anus and minimally invasive procedures, and COVID-19 were associated with learning-by-teaching (OR and 95% Cl were; 2.20, 1.76–2.75; 0.56, 0.36–0.85; 0.50, 0.38–0.67; 2.29, 1.44–3.63; 11.09, 8.33–14.75; 1.75, 1.32–2.32; 2.56, 2.03–3.22; 0.80, 0.65–0.99 and 1.93, 1.54–2.42, respectively) (p < 0.05). The study provided insights into a vastly underrated surgical education subject: learning-by-teaching. The training index introduced here was a valuable learning curve instrument that has the capacity of comparing different training parameters or different residency programs. The surge in learning-by-teaching after the pandemic was interpreted as a reflex, processing the teaching as a training tool.
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Affiliation(s)
- Volkan Doğru
- Department of Surgery, Colorectal Division, New York University Grossman School of Medicine, New York, NY, USA
- Department of General Surgery, Akdeniz University Hospital, Antalya, Turkey
| | | | - Ali Avanaz
- Department of General Surgery, Akdeniz University Hospital, Antalya, Turkey
| | - Muhittin Yaprak
- Department of General Surgery, Akdeniz University Hospital, Antalya, Turkey
| | - Ayhan Mesci
- Department of General Surgery, Akdeniz University Hospital, Antalya, Turkey
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Harjanto T, Setiyarini S, Prihatiningsih TS. Clinical Learning in Medical and Health Professions Education amid COVID-19 Pandemic: A Literature Review of Various Methods and Innovations. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: COVID-19 has caused disruption to medical education and health care systems around the world. The highly contagious nature of the virus makes it difficult for educational institutions to continue their studies as usual, thus affecting the medical and health professions education which is based on face-to-face lectures, practicum, skills laboratories, and clinical practice in health facilities.
AIM: This paper discovers clinical learning initiatives across the globe and highlights the contribution toward educational processes.
METHODOLOGY: This study utilized an integrated literature review method. A systematic search for articles published was performed in Springer, ScienceDirect, PubMed, and EBSCOHost. Primary search monetary terms were e-learning (all synonyms) and health sciences education (all synonyms), including COVID-19. Articles published within the period of COVID-19 pandemic included in this study. For the synthesis, the 20 included studies selected were coded. In this study, data were synthesized through narrative synthesis using thematic analysis (TA). To identify the recurrent themes author followed six steps when synthesizing data using TA, for example, familiarizing with the data, developing initial (sub) codes, searching for (sub) themes, reviewing (sub) themes, compiling ideas or issues, and producing final data in line with the study aims and objectives.
RESULTS: Out of records identified, a total of citations was screened, of which 20 were found to be of relevance to this study most were quantitative (14.70%) in design. Studies were published in 2020 since the beginning of COVID-19 pandemic. The geographical range of papers covered mostly the moderate-income regions. On conducting TA of the included studies, it was possible to obtain two broad descriptive themes/categories: enablers or drivers of, and barriers or challenges to, under which important themes have emerged.
CONCLUSION: Study suggests that developing e-learning in effective clinical learning is needed, not only limited to moving the learning process but also needing to follow the instructional design, so that learning outcomes can be achieved by students. In addition, a learning process that promotes self-directed-learning is needed so that students have flexibility, use relevant learning styles and are able to integrate knowledge, skills and attitudes as a meaningful learning process.
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Abdelsattar JM, Coleman JR, Nagler A, Shabahang M, Ellison EC, Baker Y, Stain SC, Matthews JB, Dent D, Blair P, Britt LD, Sachdeva AK, Spanknebel K. Lived Experiences of Surgical Residents During the COVID-19 Pandemic: A Qualitative Assessment. J Surg Educ 2021; 78:1851-1862. [PMID: 34045160 PMCID: PMC8101794 DOI: 10.1016/j.jsurg.2021.04.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/29/2021] [Indexed: 05/07/2023]
Abstract
OBJECTIVE As the COVID-19 pandemic dynamically changes our society, it is important to consider how the pandemic has affected the training and wellness of surgical residents. Using a qualitative study of national focus groups with general surgery residents, we aim to identify common themes surrounding their personal, clinical, and educational experiences that could be used to inform practice and policy for future pandemics and disasters. DESIGN Six 90-minute focus groups were conducted by a trained qualitative researcher who elicited responses on six predetermined topics. De-identified transcripts and audio recordings were later analyzed by two independent researchers who organized responses to each topic into themes. SETTING Focus groups were conducted virtually and anonymously. PARTICIPANTS General surgery residents were recruited from across the country. Demographic information of potential participants was coded, and subjects were randomly selected to ensure a diverse group of participants. RESULTS The impact of the COVID-19 pandemic on residents' clinical, educational, and personal experiences varied depending on the institutional response of the program and the burden of COVID-19 cases geographically. Many successes were identified: the use of telehealth and virtual didactics, an increased sense of camaraderie amongst residents, and flexibility in scheduling. Many challenges were also identified: uncertainty at work regarding personal protective equipment and scheduling, decreased case volume and educational opportunities, and emotional trauma and burnout associated with the pandemic. CONCLUSIONS These data gathered from our qualitative study highlight a clear, urgent need for thoughtful institutional planning and policies for the remainder of this and future pandemics. Residency programs must ensure a balanced training program for surgical residents as they attempt to master the skills of their craft while also serving as employed health care providers in a pandemic. Furthermore, a focus on wellness, in addition to clinical competency and education, is vital to resident resilience and success in a pandemic setting.
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Affiliation(s)
- Jad M Abdelsattar
- West Virginia University, Department of Surgery, Morgantown, West Virginia
| | - Julia R Coleman
- University of Colorado, Department of Surgery, Aurora, Colorado
| | - Alisa Nagler
- The American College of Surgeons, Division of Education, Chicago, Illinois
| | - Mohsen Shabahang
- The Geisinger Health System, Department of Surgery, Danville, Pennsylvania
| | | | - Yekaterina Baker
- The American College of Surgeons, Division of Education, Chicago, Illinois
| | - Steven C Stain
- Lahey Hospital and Medical Center, Department of Surgery, Burlington, Massachusetts
| | | | - Daniel Dent
- University of Texas Health San Antonio Long School of Medicine, Department of Surgery, San Antonio, Texas
| | - Patrice Blair
- The American College of Surgeons, Division of Education, Chicago, Illinois
| | - L D Britt
- Eastern Virginia University, Department of Surgery, Norfolk, Virginia
| | - Ajit K Sachdeva
- The American College of Surgeons, Division of Education, Chicago, Illinois
| | - Kathryn Spanknebel
- New York Medical College, School of Medicine, Department of Surgery, Valhalla, New York.
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Rivera-Chavarría JP, Gutierrez-Lopez C, Castro-Cordero JA, Jimenez-Ramirez G. Impact of COVID-19 on the surgical volume of general surgery residents as main surgeons in a National Training Program in Costa Rica: A cross-sectional study. Medicine (Baltimore) 2021; 100:e27041. [PMID: 34449488 PMCID: PMC8389926 DOI: 10.1097/md.0000000000027041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT To quantify the impact of coronavirus disease 19 (COVID-19) on the surgical volume of residents' medical practice in Costa Rica's General Surgery Residency Program.The COVID-19 pandemic has caused a significant disruption in people's lives. Health systems worldwide have been forced to adapt to the new normal, which has posed a challenge for medical residency programs, especially in the surgical field.This transversal study includes the surgical records of all residents of the General Surgery program who worked as main surgeons at the Mexico Hospital of the Costa Rican Social Security between December 23, 2019, and June 25, 2020.As main surgeons, a total of 10 residents performed 291 pre-pandemic surgeries and 241 pandemic surgeries.When comparing the distribution of procedures performed by residency levels, it is observed that the postgraduate year -2 increased the number of procedures performed during the pandemic period (pre-pandemic 19% vs pandemic 27%, P = .028). There was no statistically significant difference between the pre-pandemic and pandemic periods in the remaining levels.When comparing the procedures by unit, a statistically significant decrease was observed in the Endocrine-Abdominal Wall Unit (pre-pandemic 18.3% vs pandemic 5.4%, P < .001). Conversely, a statistically significant increase was identified in Surgical Emergencies Unit procedures (40.0% vs post 51.7%, P = .007). No statistically significant differences were observed in the remaining the Units.The COVID-19 pandemic had no statistically significant effect on surgeries performed by residents of the General Surgery Residency Program as main surgeons in a national training center in Costa Rica. The Department's timely measures and pro-resident attitude were the key reasons for the above results.
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Affiliation(s)
- Jose Pablo Rivera-Chavarría
- Health Services Administration. Colorectal Surgeon, Mexico Hospital, Caja Costarricense Seguro Social. Professor of General Surgery, University of Costa Rica, Department of General Surgery, Hospital México, La Uruca, San José, Costa Rica
| | | | | | - Gustavo Jimenez-Ramirez
- Department of General Surgery, Mexico Hospital, Caja Costarricense Seguro Social, University of Costa Rica, San José, Costa Rica
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Purdy AC, de Virgilio C, Kaji AH, Shields Frey E, Lee-Kong S, Inaba K, Gauvin JM, Neville AL, Donahue TR, Smith BR, Salcedo ES, Calhoun KE, Poola VP, Namm JP, Spain DA, Dickinson KJ, Tanner T, Wolfe M, Amersi F. Factors Associated With General Surgery Residents' Operative Experience During the COVID-19 Pandemic. JAMA Surg 2021; 156:767-774. [PMID: 33929493 DOI: 10.1001/jamasurg.2021.1978] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Importance The suspension of elective operations in March 2020 to prepare for the COVID-19 surge posed significant challenges to resident education. To mitigate the potential negative effects of COVID-19 on surgical education, it is important to quantify how the pandemic influenced resident operative volume. Objective To examine the association of the pandemic with general surgical residents' operative experience by postgraduate year (PGY) and case type and to evaluate if certain institutional characteristics were associated with a greater decline in surgical volume. Design, Setting, and Participants This retrospective review included residents' operative logs from 3 consecutive academic years (2017-2018, 2018-2019, and 2019-2020) from 16 general surgery programs. Data collected included total major cases, case type, and PGY. Faculty completed a survey about program demographics and COVID-19 response. Data on race were not collected. Operative volumes from March to June 2020 were compared with the same period during 2018 and 2019. Data were analyzed using Kruskal-Wallis test adjusted for within-program correlations. Main Outcome and Measures Total major cases performed by each resident during the first 4 months of the pandemic. Results A total of 1368 case logs were analyzed. There was a 33.5% reduction in total major cases performed in March to June 2020 compared with 2018 and 2019 (45.0 [95% CI, 36.1-53.9] vs 67.7 [95% CI, 62.0-72.2]; P < .001), which significantly affected every PGY. All case types were significantly reduced in 2020 except liver, pancreas, small intestine, and trauma cases. There was a 10.2% reduction in operative volume during the 2019-2020 academic year compared with the 2 previous years (192.3 [95% CI, 178.5-206.1] vs 213.8 [95% CI, 203.6-223.9]; P < .001). Level 1 trauma centers (49.5 vs 68.5; 27.7%) had a significantly lower reduction in case volume than non-level 1 trauma centers (33.9 vs 63.0; 46%) (P = .03). Conclusions and Relevance In this study of operative logs of general surgery residents in 16 US programs from 2017 to 2020, the first 4 months of the COVID-19 pandemic was associated with a significant reduction in operative experience, which affected every PGY and most case types. Level 1 trauma centers were less affected than non-level 1 centers. If this trend continues, the effect on surgical training may be even more detrimental.
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Affiliation(s)
- Amanda C Purdy
- Department of Surgery, Harbor-University of California, Los Angeles Medical Center, Torrance
| | - Christian de Virgilio
- Department of Surgery, Harbor-University of California, Los Angeles Medical Center, Torrance
| | - Amy H Kaji
- Department of Emergency Medicine, Harbor-University of California, Los Angeles Medical Center, Torrance.,Statistical Editor, JAMA Surgery
| | - Edgar Shields Frey
- Department of Surgery, Brookwood Baptist Medical Center, Birmingham, Alabama
| | - Steven Lee-Kong
- Department of Surgery, Columbia University Medical Center, New York, New York
| | - Kenji Inaba
- Department of Surgery, University of Southern California/Los Angeles County Medical Center, Los Angeles
| | - Jeffrey M Gauvin
- Department of Surgery, Santa Barbara Cottage Hospital, Santa Barbara, California
| | - Angela L Neville
- Department of Surgery, Harbor-University of California, Los Angeles Medical Center, Torrance
| | - Timothy R Donahue
- Department of Surgery, University of California, Los Angeles Health, Los Angeles
| | - Brian R Smith
- Department of Surgery, University of California, Irvine, Medical Center, Orange
| | - Edgardo S Salcedo
- Department of Surgery, University of California, Davis, School of Medicine, Sacramento
| | | | - V Prasad Poola
- Department of Surgery, Southern Illinois School of Medicine, Springfield
| | - Jukes P Namm
- Department of Surgery, Loma Linda University Health, Loma Linda, California
| | - David A Spain
- Department of Surgery, Stanford University, Stanford, California
| | | | - Tiffany Tanner
- Department of Surgery, University of Nebraska Medical Center, Omaha
| | - Mary Wolfe
- Department of Surgery, University of California, San Francisco, at Fresno, Fresno
| | - Farin Amersi
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
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Wise CE, Bereknyei Merrell S, Sasnal M, Forrester JD, Hawn MT, Lau JN, Lin DT, Schmiederer IS, Spain DA, Nassar AK, Knowlton LM. COVID-19 Impact on Surgical Resident Education and Coping. J Surg Res 2021; 264:534-543. [PMID: 33862581 PMCID: PMC7877215 DOI: 10.1016/j.jss.2021.01.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Healthcare systems and surgical residency training programs have been significantly affected by the novel coronavirus disease 2019 (COVID-19) pandemic. A shelter-in-place and social distancing mandate went into effect in our county on March 16, 2020, considerably altering clinical and educational operations. Along with the suspension of elective procedures, resident academic curricula transitioned to an entirely virtual platform. We aimed to evaluate the impact of these modifications on surgical training and resident concerns about COVID-19. MATERIALS AND METHODS We surveyed residents and fellows from all eight surgical specialties at our institution regarding their COVID-19 experiences from March to May 2020. Residents completed the survey via a secure Qualtrics link. A total of 38 questions addressed demographic information and perspectives regarding the impact of the COVID-19 pandemic on surgical training, education, and general coping during the pandemic. RESULTS Of 256 eligible participants across surgical specialties, 146 completed the survey (57.0%). Junior residents comprised 43.6% (n = 61), compared to seniors 37.1% (n = 52) and fellows 19.3% (n = 27). Most participants, 97.9% (n = 138), anticipated being able to complete their academic year on time, and 75.2% (n = 100) perceived virtual learning to be the same as or better than in-person didactic sessions. Participants were most concerned about their ability to have sufficient knowledge and skills to care for patients with COVID-19, and the possibility of exposure to COVID-19. CONCLUSIONS Although COVID-19 impacted residents' overall teaching and clinical volume, residency programs may identify novel virtual opportunities to meet their educational and research milestones during these challenging times.
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Affiliation(s)
| | - Sylvia Bereknyei Merrell
- Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) Center, Stanford, California
| | - Marzena Sasnal
- Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) Center, Stanford, California
| | - Joseph D Forrester
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Mary T Hawn
- Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) Center, Stanford, California; Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - James N Lau
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Dana T Lin
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Ingrid S Schmiederer
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - David A Spain
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Aussama K Nassar
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Lisa Marie Knowlton
- Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) Center, Stanford, California; Department of Surgery, Stanford University School of Medicine, Stanford, California.
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Kilgore LJ, Murphy BL, Postlewait LM, Liang DH, Bedrosian I, Lucci A, Kuerer HM, Hunt KK, Teshome M. Impact of the early COVID-19 pandemic on Breast Surgical Oncology fellow education. J Surg Oncol 2021; 124:989-994. [PMID: 34328640 PMCID: PMC8426719 DOI: 10.1002/jso.26627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The early COVID-19 pandemic rapidly transformed healthcare and medical education. We sought to evaluate the professional and personal impact of the pandemic on 2019-2020 Breast Surgical Oncology (BSO) fellows in Society of Surgical Oncology approved programs to capture the experience and direct future changes. METHODS From July 15, 2020 to August 4, 2020 a survey was administered to the American Society of Breast Surgeons' fellow members. The survey assessed the impact of the pandemic on clinical experience, education/research opportunities, personal health/well-being, and future career. Responses were collected and aggregated to quantify the collective experience of respondents. RESULTS Twenty-eight of fifty-seven (54%) eligible fellows responded. Twenty-one (75%) indicated the clinical experience changed. Twenty-seven (96%) reported less time spent caring for ambulatory breast patients and sixteen (57%) reported the same/more time spent in the operating room. Fourteen (50%) stated their future job was impacted and eight (29%) delayed general surgery board examinations. Stress was increased in 26 (93%). Personal health was unaffected in 20 (71%), and 3 (10%) quarantined for COVID-19 exposure/infection. CONCLUSION The COVID-19 pandemic altered the clinical experience of BSO fellows; however, the operative experience was generally unaffected. The creation of frameworks and support mechanisms to mitigate potential challenges for fellows and fellowship programs in the ongoing pandemic and other times of national crisis should be considered.
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Affiliation(s)
- Lyndsey J Kilgore
- Division of Breast Surgical Oncology, Department of Surgery, University of Kansas Cancer Center, Kansas City, Kansas, USA
| | - Brittany L Murphy
- Division of Breast Surgical Oncology, Department of Surgical Oncology, Banner MD Anderson Cancer Center, Phoenix, Arizona, USA
| | - Lauren M Postlewait
- Division of Surgical Oncology, Department of Surgery, Emory University, Atlanta, Georgia, USA
| | - Diana H Liang
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Isabelle Bedrosian
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anthony Lucci
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Henry M Kuerer
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kelly K Hunt
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mediget Teshome
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Shah SMI, Bin Zafar MD, Yasmin F, Ghazi EM, Jatoi HN, Jawed A, Nadeem A, Khan Z, Anas Z, Siddiqui SA. Exploring the impact of the COVID-19 pandemic on cardiac surgical services: A scoping review. J Card Surg 2021; 36:3354-3363. [PMID: 34137067 PMCID: PMC8447444 DOI: 10.1111/jocs.15746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022]
Abstract
Cardiac surgery was severely affected by the COVID‐19 pandemic. Reallocation of resources, conversion of surgical intensive care units and wards to COVID‐19 facilities, increased risk of nosocomial transmission to cardiac surgery patients, lead to reduced accessibility, quality, and affordability of health care facilities to cardiac surgery patients. Increasing the mortality and morbidity rate among such patients. Cardiac patients are at an increased risk to develop a severe illness if infected by COVID‐19 and are associated with a high mortality rate. Therefore, measures had to be taken to reduce the spread of the virus. Various approaches such as the hubs and the spokes centers, or parallel system were enforced. Elective surgeries were postponed while urgent surgeries were prioritized. Use of personal protective equipments and surgeries performed by only senior surgeons became necessary. Surgical trainees were also affected as limited training opportunities deprived them of the experience required to complete their fellowship. Some of the trainees were reallocated to COVID‐19 wards, while others invested their time in research opportunities. Online platforms were used for teaching, meetings, and workshops across the globe. Although some efforts have been made to reduce the impact of the pandemic, more research and innovation is required.
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Affiliation(s)
| | - Muhammad Daim Bin Zafar
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Farah Yasmin
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Erum Mir Ghazi
- Department of Internal Medicine, Ziauddin Medical University, Karachi, Pakistan
| | - Hafsa Nazir Jatoi
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Areesha Jawed
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Areeba Nadeem
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Zarlish Khan
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Zahra Anas
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Sarush Ahmed Siddiqui
- Department of General Surgery, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
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Kattan AE, Mortada H, Alzaidi S, Gelidan AG. Perceptions of Saudi Plastic Surgery Residents and Attendings of Online Education during the COVID-19 Pandemic. Plast Reconstr Surg Glob Open 2021; 9:e3658. [PMID: 34168946 PMCID: PMC8219255 DOI: 10.1097/gox.0000000000003658] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The world has faced an unprecedented challenge in controlling the spread of COVID-19-a rapid reshaping of the healthcare system and education was inevitable. Consequently, residency programs adopted e-learning as a social distancing tool for the continuity of the learning process. In this study, we explore the opinions and perspectives of plastic surgery attending doctors and residents on the implications of e-learning. METHODS After obtaining ethical approval, this cross-sectional study was conducted electronically between October and December 2020 among plastic surgery residents and board-certified plastic surgeons in Saudi Arabia. Participants completed a validated, anonymous, self-administered questionnaire. The questionnaire gathered participants' demographic data, perceptions of online webinars, and audiovisual evaluations. Finally, we compared traditional (in-person) teaching with online webinars. The analysis was performed at a 95% confidence interval using the Statistical Package for Social Sciences (SPSS), version 23.0 (IBM, Armonk, N.Y.). RESULTS A total of 61 responses were included in this study. The majority of respondents (78.7%) were comfortable during webinars, with 38 (62.3%) believing they should supplement traditional teaching methods. Overall, 50.8% were satisfied with the webinars. However, 37.7% were neutral. Most believed that the webinars increased their clinical (67.2%) and surgical skills (67.2%) to reasonable levels. CONCLUSIONS Online education provided an excellent educational tool as a viable option to supplement traditional face-to-face training, with most residents being satisfied, supporting the use of this educational tool. More objective research is required to refine existing online plastic surgery teaching methods while creating novel distance e-learning approaches for the future.
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Affiliation(s)
- Abdullah E. Kattan
- From the Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University and Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia
| | - Salman Alzaidi
- Plastic and Reconstructive Surgery, King Faisal Medical Complex, Taif, Saudi Arabia
| | - Adnan G. Gelidan
- From the Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Nolte MT, Tornetta P 3rd, Mehta S, Ponce BA, Grabowski G, Turner NS, Spitnale MJ, Kogan M. Resident Wellness During the COVID-19 Pandemic: A Nationwide Survey of Orthopaedic Residents. J Am Acad Orthop Surg 2021; 29:407-13. [PMID: 33651749 DOI: 10.5435/JAAOS-D-20-01372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has influenced the resident workforce to a particularly powerful and unexpected extent. Given the drastic changes to resident roles, expectations, and responsibilities, many valuable lessons regarding resident concerns and wellness can be garnered from this unique experience. METHODS A voluntary survey was sent to 179 Accreditation Council for Graduate Medical Education-accredited orthopaedic surgery residency program directors to distribute to their residents. Questions focused on issues that may have occurred, program's responses, and expectations of programs during the pandemic. RESULTS In total, 507 residents completed the survey, and 10% reported being deployed to do nonorthopaedic-related care, with junior classes being more likely to receive this assignment (P < 0.001). The greatest concern for respondents was the possibility of getting family members sick (mean = 3.89, on scale of 1-5), followed by personally contracting the illness (mean = 3.38). DISCUSSION The COVID-19 pandemic has resulted in numerous changes and novel sources of adversity for the orthopaedic surgery resident. Contrary to popular opinion, most residents are comfortable with the proposition of providing nonorthopaedic care. The possibility of bringing a pathogen to the home environment and infecting family members seems to be an overarching concern, and efforts to ensure resident and family safety are key.
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Irastorza LE, Hopson P, Ta A, Kemme S, Mallon D, Lee CK. The Impact of COVID-19 on Job Prospects and Educational Training for Pediatric Gastroenterology Fellows. J Pediatr Gastroenterol Nutr 2021; 72:514-519. [PMID: 33399332 PMCID: PMC7984674 DOI: 10.1097/mpg.0000000000003037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/05/2020] [Indexed: 12/10/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has significantly affected graduate medical education with redistribution of trainees, altered clinical care, and decreased research. For graduating trainees, there remains concern that financial stability of health systems will affect the availability of new positions and hiring practices. This survey aims to evaluate the pandemic's impact from pediatric gastroenterology fellows' perspectives. METHODS An anonymous survey was distributed by e-mail from June 11 to July 1, 2020 to all North American pediatric gastroenterology and advanced training fellows. The survey was tailored for the fellows' year of training including questions on education, clinical experience, research, and job outlook. RESULTS Of the 434 pediatric gastroenterology fellows, 145 completed the survey. Of all respondents, negative impact was reported in 52% on clinical training, 46% research projects, and 41% procedural confidence. A majority (93%) of third-year respondents had a job contract signed at the time of the survey; however, 18% of those contracts were subsequently altered with 5 respondents having job contracts rescinded due to hiring freezes. Fifty-four percent of first- and second-year fellow respondents reported concern regarding finding a job with the majority being second-year fellows (78%). CONCLUSIONS The COVID-19 pandemic continues to affect the medical system and healthcare professionals. This survey identified significant impact on job acquisition for graduating pediatric gastroenterology fellows and other critical components of training, which are likely applicable to other pediatric trainees. The survey results raise questions about potential strategies to improve medical education and job search success for graduating trainees.
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Affiliation(s)
| | - Puanani Hopson
- Orlando Health Arnold Palmer Hospital for Children, Orlando, FL
- Mayo Clinic Children's Center, Rochester, MN
| | - Allison Ta
- Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, OH
| | - Sarah Kemme
- Children's Hospital Colorado/University of Colorado Denver School of Medicine, Aurora, CO
| | - Daniel Mallon
- Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, OH
| | - Christine K. Lee
- Boston Children's Hospital, Division of Gastroenterology, Hepatology and Nutrition, Boston, MA
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19
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Ellison EC, Spanknebel K, Stain SC, Shabahang MM, Matthews JB, Debas HT, Nagler A, Blair PG, Eberlein TJ, Farmer DL, Sloane R, Britt LD, Sachdeva AK. Impact of the COVID-19 Pandemic on Surgical Training and Learner Well-Being: Report of a Survey of General Surgery and Other Surgical Specialty Educators. J Am Coll Surg 2020; 231:613-626. [PMID: 32931914 PMCID: PMC7486868 DOI: 10.1016/j.jamcollsurg.2020.08.766] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 10/27/2022]
Abstract
BACKGROUND The COVID-19 pandemic disrupted the delivery of surgical services. The purpose of this communication was to report the impact of the pandemic on surgical training and learner well-being and to document adaptations made by surgery departments. STUDY DESIGN A 37-item survey was distributed to educational leaders in general surgery and other surgical specialty training programs. It included both closed- and open-ended questions and the self-reported stages of GME during the COVID-19 pandemic, as defined by the ACGME. Statistical associations for items with stage were assessed using categorical analysis. RESULTS The response rate was 21% (472 of 2,196). US stage distribution (n = 447) was as follows: stage 1, 22%; stage 2, 48%; and stage 3, 30%. Impact on clinical education significantly increased by stage, with severe reductions in nonemergency operations (73% and 86% vs 98%) and emergency operations (8% and 16% vs 34%). Variable effects were reported on minimal expected case numbers across all stages. Reductions were reported in outpatient experience (83%), in-hospital experience (70%), and outside rotations (57%). Increases in ICU rotations were reported with advancing stage (7% and 13% vs 37%). Severity of impact on didactic education increased with stage (14% and 30% vs 46%). Virtual conferences were adopted by 97% across all stages. Severity of impact on learner well-being increased by stage-physical safety (6% and 9% vs 31%), physical health (0% and 7% vs 17%), and emotional health (11% and 24% vs 42%). Regardless of stage, most but not all made adaptations to support trainees' well-being. CONCLUSIONS The pandemic adversely impacted surgical training and the well-being of learners across all surgical specialties proportional to increasing ACGME stage. There is a need to develop education disaster plans to support technical competency and learner well-being. Careful assessment for program advancement will also be necessary. The experience during this pandemic shows that virtual learning and telemedicine will have a considerable impact on the future of surgical education.
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Affiliation(s)
| | | | - Steven C Stain
- Department of Surgery, Albany Medical College, Albany, NY
| | | | | | - Haile T Debas
- Department of Surgery, University of California-San Francisco, San Francisco, CA
| | - Alisa Nagler
- Division of Education, American College of Surgeons, Chicago, IL
| | | | - Timothy J Eberlein
- Department of Surgery, Washington University School of Medicine, St Louis, MO
| | - Diana L Farmer
- Department of Surgery, University of California-Davis, Sacramento, CA
| | - Richard Sloane
- Duke Center for the Study of Aging and Human Development, Duke University, Durham, NC
| | - L D Britt
- Department of Surgery, Eastern Virginia University, Norfolk, VA
| | - Ajit K Sachdeva
- Division of Education, American College of Surgeons, Chicago, IL
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