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Jolly S, Asokan G. Mental training in general surgery: a qualitative review of Australian trainee perceptions. ANZ J Surg 2024; 94:63-67. [PMID: 37485780 DOI: 10.1111/ans.18620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Mental training is the cognitive process and pedagogical technique of 'viewing' and 'feeling' a task without physically performing it. Its application is well-established within aviation, elite sports and the arts. While surgical trainees often mentally rehearse prior to operating, this technique is yet to be established for educational and skill acquisition purposes. The aim of this study was to investigate trainee awareness of mental training, the use of mental rehearsal, and explore perceived benefits and barriers to its implementation. METHODS An exploratory qualitative study design was employed, with semi-structured interviews of general surgical trainees across Australia. Interviews were transcribed and thematic analysis undertaken to identify common themes. RESULTS A total of 10 General Surgery trainees were interviewed encompassing each Australian state and territory. A consistent finding was that all teaching of operative skills occurs in the clinical environment, without the adjunct of structured practical or cognitive simulation. All trainees reported mentally rehearsing procedures in some capacity as part of personal preparation, and were supportive of implementing formal mental training for surgical skill development. Themes included standardization of training, enhancing training during times of reduced clinical exposure, minimizing anxiety, and improving communication. Implementation was deemed to be most effective through a bank of online mental training resources. CONCLUSION Mental training was supported by General Surgical trainees, with perceived potential benefits in multiple domains. To mitigate the main perceived barrier of time constraints, an online method of delivery was felt to be optimal.
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Affiliation(s)
- Samantha Jolly
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Gayatri Asokan
- The Queen Elizabeth Hospital, Discipline of Surgery, Woodville South, South Australia, Australia
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Briles B, Kahl A, Anaissie J, Brettmann L, Pathak U, Staggers KA, Popat S, Agrawal A, Rose S, Taylor J. Levels and drivers of burnout during the COVID-19 pandemic among a diverse group of resident physicians. Postgrad Med 2024; 136:44-51. [PMID: 38193442 DOI: 10.1080/00325481.2024.2303974] [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: 04/19/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVES Evidence has shown significant impacts of the COVID-19 pandemic on physicians. We hypothesized that these effects would impact surgical and non-surgical resident education differently, with non-surgical specialties being more heavily impacted by frontline work and surgical specialties losing elective cases. METHODS We examined well-being and burnout among resident physicians in surgical and non-surgical specialties during the peak of the COVID-19 pandemic using the Mayo Physician Well-Being Index (WBI). RESULTS Completed surveys were received from 110 residents, 55% of whom were in a surgical training program. 35% of respondents were identified as 'at risk' for burnout. Increased demands from work (adj. OR 3.79, 95% CI 1.50, 9.59, p = 0.005) was associated with an increased likelihood for being 'at risk' compared to those without increased demands. Odds of having increased stress level were higher amongst residents with fear/anxiety of the unknown (adj. OR 4.21, 95% CI 1.63, 10.90, p = 0.003) and more demands outside work (adj. OR 10.54, 95% CI 2.63, 42.16, p = 0.001) but lower amongst residents with more time for studying (OR 0.23, 95% CI 0.09, 0.64, p = 0.005). Risk for burnout was not significantly different between surgical and non-surgical specialties when adjusting for increased demands from work (adj. OR 1.43, 95% CI 0.60, 3.37, p = 0.0.418). CONCLUSION Perceived effects of the COVID-19 pandemic upon residents' educational experience was mixed: reduced clinical volume had a negative impact, while increased time for study was perceived favorably. These findings suggest potential strategies and targets to mitigate the stress and burnout of a future crisis, whether large or small, among surgical and non-surgical trainees.
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Affiliation(s)
- Brenna Briles
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Alyssa Kahl
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - James Anaissie
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Lindsay Brettmann
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Ujval Pathak
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Shreeya Popat
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Anoop Agrawal
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Stacey Rose
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer Taylor
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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Boutros P, Kassem N, Nieder J, Jaramillo C, von Petersdorff J, Walsh FJ, Bärnighausen T, Barteit S. Education and Training Adaptations for Health Workers during the COVID-19 Pandemic: A Scoping Review of Lessons Learned and Innovations. Healthcare (Basel) 2023; 11:2902. [PMID: 37958046 PMCID: PMC10649637 DOI: 10.3390/healthcare11212902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction: The COVID-19 pandemic has considerably impacted the clinical education and training of health workers globally, causing severe disruptions to learning environments in healthcare facilities and limiting the acquisition of new clinical skills. Consequently, urgent adaptation measures, including simulation training and e-learning, have been implemented to mitigate the adverse effects of clinical education. This scoping review aims to assess the impact of COVID-19 on medical education and training, examine the implemented adaptation measures, and evaluate their effectiveness in improving health workers' education and training during the pandemic. Methods: Employing the PRISMA-ScR framework and Arksey and O'Malley's methodological guidance, we conducted a scoping review, systematically searching PubMed, medRxiv, Google, and DuckDuckGo databases to account for the grey literature. The search included studies published between 1 December 2019 and 13 October 2021, yielding 10,323 results. Of these, 88 studies focused on health worker education and training during the pandemic. Results: Our review incorporated 31,268 participants, including physicians, medical trainees, nurses, paramedics, students, and health educators. Most studies (71/88, 81%) were conducted in high-income and lower-middle-income countries. The pandemic's effects on health workers' clinical skills and abilities have necessitated training period extensions in some cases. We identified several positive outcomes from the implementation of simulation training and e-learning as adaptation strategies, such as enhanced technical and clinical performance, increased confidence and comfort, and an expanded global educational outreach. Conclusions: Despite challenges like insufficient practical experience, limited interpersonal interaction opportunities, and internet connectivity issues, simulation training, e-learning, and virtual training have proven effective in improving clinical education and training during the COVID-19 pandemic. Further research is required to bolster preparedness for future pandemics or similar situations.
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Affiliation(s)
- Perla Boutros
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Nour Kassem
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Jessica Nieder
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Catalina Jaramillo
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Jakob von Petersdorff
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Fiona J Walsh
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
- Africa Health Research Institute (AHRI), Somkhele, Mtubatuba 3935, KwaZulu-Natal, South Africa
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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4
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Mahay U, Jenkins P, Watkins L, Mandal I, Lewis O, Harborne KE, Patel S, Reicher J, Liu WY, Zhong J, Hamady M. Interventional radiology training in the UK: a view from within-a national survey. Br J Radiol 2023; 96:20230039. [PMID: 37747294 PMCID: PMC10607392 DOI: 10.1259/bjr.20230039] [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: 01/11/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE Interventional radiology (IR) training in the UK has evolved since recognition as a subspecialty in 2010 and introduction of a new curriculum in 2021. The changing landscape, increasing workload and COVID-19 have affected training. The purpose of this study was to review trainees' perspectives on training and develop strategies to further improve training. METHODS Online survey approved by the British Society of Interventional Radiology Council distributed to British Society of Interventional Radiology Trainee members between 9 March 22 and 25 March 2022. The survey was open to all UK based ST4-6 IR trainees and fellows. Descriptive and thematic analysis was undertaken. RESULTS 43 responses were received from 17/19 UK training regions. Females represented 10% (4/41) and 5% (2/43) less than full time (LTFT) trainees. 82% (31/38) felt their curriculum was suitable for their training and 28/38 (74%) were satisfied with IR training. Vascular IR, Interventional Oncology, paediatrics and stroke thrombectomy were identified as areas of training desiring improvement. 45% (18/40) stated exposure to IR led clinics and 17.5% (7/40) to IR led ward rounds. Only 6/38 (15.7%) received structured IR teaching at least once a month. Approximately, a third of respondents (13/38) stated training opportunities were significantly compromised secondary to COVID-19. CONCLUSION This survey shows overall good satisfaction with IR training. However, improved training opportunities in vascular IR, interventional oncology, paediatric IR and stroke thrombectomy are required. In addition, access to clinics, ward rounds and protected time for research is needed to improve training quality. ADVANCES IN KNOWLEDGE New national UK IR training survey.
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Affiliation(s)
- Usman Mahay
- Department of Interventional Radiology, London North West University Healthcare NHS Trust, London, United Kingdom
| | | | - Linda Watkins
- Department of Interventional Radiology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Indrajeet Mandal
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Omotolani Lewis
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Katrina Elizabeth Harborne
- Department of Interventional Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Shian Patel
- Department of Interventional Radiology, McGill University Health Centre, Montreal, Canada
| | - John Reicher
- Department of Interventional Radiology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
| | - Wing Yan Liu
- Department of Interventional Radiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Jim Zhong
- Department of Diagnostic and Interventional Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
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5
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Hall L, Bisset K, Lynch L, Young Y, Ruggles R. Training during the COVID-19 pandemic: the experience of public health registrars in the London and Kent, Surrey, Sussex training programme. J Public Health (Oxf) 2023; 45:529-534. [PMID: 37326349 DOI: 10.1093/pubmed/fdac130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/29/2022] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Public Health registrars (SpRs) were an important component of the workforce that contributed to the COVID-19 response. This study explores their contribution and the impact the early stages of the pandemic had on their learning and training. METHODS Data were collected from SpRs in the London and Kent, Surrey, Sussex training programme between July and September 2020 through a mixture of questionnaires and semi-structured interviews. A thematic analysis of interview transcripts was undertaken to identify themes. RESULTS 35/128 SpRs responded to the survey and 11 were interviewed. SpRs were placed across a range of organizations and made a significant contribution to the COVID-19 response. Overall, SpRs learned important skills but working on the response may for some have impacted negatively on training. A number of facilitators and barriers to learning were identified. CONCLUSION The study findings highlight the opportunities for learning created by the pandemic. However, changing projects and the desire of SpRs to contribute to the response meant the impacts on training were mixed. Future deployment of SpRs should consider the balance of responsibility and pace when delegating work, as well as the need to supervise effectively and support remote working to maintain good mental wellbeing.
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Affiliation(s)
- L Hall
- Public Health Registrar, UK Health Security Agency, London SE1 8UG, UK
| | - K Bisset
- Public Health Registrar, UK Health Security Agency, London SE1 8UG, UK
| | - L Lynch
- Public Health Registrar, UK Health Security Agency, London SE1 8UG, UK
| | - Y Young
- Consultant in Health Protection, UK Health Security Agency, London SE1 8UG, UK
| | - R Ruggles
- Consultant in Public Health, UK Health Security Agency, London SE1 8UG, UK
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6
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Guraya SS, Menezes P, Lawrence IN, Guraya SY, Rashid-Doubell F. Evaluating the impact of COVID-19 pandemic on the physicians' psychological health: A systematic scoping review. Front Med (Lausanne) 2023; 10:1071537. [PMID: 37056734 PMCID: PMC10086257 DOI: 10.3389/fmed.2023.1071537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/09/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundCOVID-19 has endangered healthcare systems at multiple levels worldwide. Published data suggests that moral dilemmas faced during these unprecedented times have placed physicians at the intersections of ethical and unethical considerations. This phenomenon has questioned the physicians' morality and how that has affected their conduct. The purpose of our review is to tap into the spectrum of the transforming optics of patient care during the pandemic and its impact on psychological wellbeing of physicians.MethodsWe adopted the Arksey and O'Malley's framework, defining research questions, identifying relevant studies, selecting the studies using agreed inclusion and exclusion criteria, charting the data, and summarizing and reporting results. Databases of PubMed/Medline, Web of Science, Scopus, Science Direct, CINAHL, and PsycInfo were searched using a predefined search string. The retrieved titles and abstracts were reviewed. Later, a detailed full-text analysis of the studies which matched our inclusion criteria was performed.ResultsOur first search identified 875 titles and abstracts. After excluding duplicates, irrelevant, and incomplete titles, we selected 28 studies for further analysis. The sample size in 28 studies was 15,509 with an average size of 637 per study. Both quantitative and qualitative approaches were used, with cross-sectional surveys being utilized in all 16 quantitative studies. Using the data from semi-structured interviews, several discrete codes were generated, which led to the identification of five main themes; mental health, individual challenges, decision-making, change in patient care, and support services.ConclusionThis scoping review reports an alarming rise in psychological distress, moral injury, cynicism, uncertainty, burnout, and grief among physicians during the pandemic. Decision-making and patient care were mostly regulated by rationing, triaging, age, gender, and life expectancy. Poor professional controls and institutional services potentially led to physicians' crumbling wellbeing. This research calls for the remediation of the deteriorating mental health and a restoration of medical profession's advocacy and equity.
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Affiliation(s)
- Shaista S. Guraya
- School of Medicine, Royal College of Surgeons Ireland – Medical University Bahrain, Muharraq, Bahrain
| | - Prianna Menezes
- School of Medicine, Royal College of Surgeons Ireland – Medical University Bahrain, Muharraq, Bahrain
| | | | - Salman Yousuf Guraya
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- *Correspondence: Salman Yousuf Guraya
| | - Fiza Rashid-Doubell
- School of Medicine, Royal College of Surgeons Ireland – Medical University Bahrain, Muharraq, Bahrain
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Matsui Y, Yao S, Kumode T, Tanino K, Mizuno R, Ogoshi Y, Honma S, Murakami T, Kan T, Nakajima S, Harada T, Oh K, Nakamura T, Konishi H, Arii S. Surgeons' involvement in COVID-19 treatment: a practice by a regional core hospital in Japan to avoid physician burnout. BMC Health Serv Res 2023; 23:28. [PMID: 36635725 PMCID: PMC9834681 DOI: 10.1186/s12913-023-09042-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND To prevent task accumulation on certain divisions, our institution developed a unique system of allocating inpatient treatment of COVID-19 patients to doctors who were not specialized in respiratory infections. The objective of this study was to investigate whether surgeons can be involved in the COVID-19 inpatient treatment without negatively affecting patient outcome, and how such involvement can affect the wellbeing of surgeons. METHODS There were 300 patients diagnosed with COVID-19 and hospitalized from January to June 2021, and 160 of them were treated by the redeployed doctors. They were divided into 3 groups based on the affiliation of the treating doctor. Patient characteristics and outcomes were compared between the groups. In addition, the impact of COVID-19 duty on participating surgeons was investigated from multiple perspectives, and a postduty survey was conducted. RESULTS There were 43 patients assigned to the Department of Surgery. There were no differences in the backgrounds and outcomes of patients compared with other groups. The surgeon's overtime hours were significantly longer during the duty period, despite no change in the number of operations and the complication rate. The questionnaire revealed that there was a certain amount of mental and physical burden from the COVID-19 duty. CONCLUSION Surgeons can take part in inpatient COVID-19 treatment without affecting patient outcome. However, as such duty could negatively affect the surgeons' physical and mental wellbeing, further effort is needed to maintain the balance of fulfilling individual and institutional needs.
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Affiliation(s)
- Yugo Matsui
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan ,grid.415419.c0000 0004 7870 0146COVID-19 Task Force, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Siyuan Yao
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Takashi Kumode
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Keisuke Tanino
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Ryosuke Mizuno
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Yusuke Ogoshi
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Shusaku Honma
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Teppei Murakami
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Takatsugu Kan
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Sanae Nakajima
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Takehisa Harada
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Koji Oh
- grid.415419.c0000 0004 7870 0146COVID-19 Task Force, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan ,grid.415419.c0000 0004 7870 0146Department of General Internal Medicine, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Takehiro Nakamura
- grid.415419.c0000 0004 7870 0146COVID-19 Task Force, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan ,grid.415419.c0000 0004 7870 0146Department of Diabetes and Endocrinology, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Hiroki Konishi
- grid.415419.c0000 0004 7870 0146COVID-19 Task Force, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan ,grid.415419.c0000 0004 7870 0146Department of General Internal Medicine, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Shigeki Arii
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
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Muacevic A, Adler JR. The Impact of COVID-19 on Postgraduate Training of Doctors in the United Kingdom: A Narrative Review. Cureus 2022; 14:e33156. [PMID: 36726912 PMCID: PMC9885301 DOI: 10.7759/cureus.33156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/01/2023] Open
Abstract
The COVID-19 pandemic caused significant disruption to healthcare systems globally. The delivery of medical education was consequently impacted as a result of this. In order to move past the pandemic, we must identify the gaps in postgraduate education. This literature review examines studies focusing on postgraduate training in the United Kingdom (UK) and attempts to bring together the issues that have been highlighted in these studies and the impact that this has had on trainees. It is important for the providers of healthcare education to have an understanding of the impacts of this disruption in order to maintain the quality of postgraduate medical education. Health Education England, along with the Royal Colleges, has published a report that sets a framework on how these issues can be addressed, with some of these changes starting to be implemented in 2022.
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Adl Amini D, Herbolzheimer M, Lutz PM, Lacheta L, Oezel L, Haffer H, Schömig F, Schreiner A, Limmer J, Muellner M. Effects of the SARS-CoV‑2 pandemic on residency training in orthopedics and traumatology in Germany : A nationwide survey. ORTHOPADIE (HEIDELBERG, GERMANY) 2022; 51:844-852. [PMID: 36006432 PMCID: PMC9406266 DOI: 10.1007/s00132-022-04295-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The spread of the coronavirus disease has impacted healthcare systems worldwide; however, restrictions due to the SARS-CoV‑2 (severe acute respiratory syndrome coronavirus 2) pandemic are particularly drastic for physicians in residency training. Imposed restrictions interrupt the standard educational curricula, and consequently limited residents to meet mandatory requirements. AIM The aim of this study was to evaluate the effects of the SARS-CoV‑2 pandemic on residency training in orthopedics and trauma surgery in Germany. METHODOLOGY An online-based, voluntary, and anonymous survey of physicians in residency training for orthopedics and trauma surgery was conducted. Through email lists of junior physician organizations the survey was sent to 789 physicians. Participation was possible between October and November 2021. RESULTS A total of 95 participants (female 41.1%) with a mean age of 31.3 ± 2.8 years were analyzed. In the everyday clinical practice and care 80% of participants thought that they were set back in time of their general training due to the pandemic. There was an average reduction of 25.0% in time spent in the OR and 88.4% agreed that their surgical training was delayed due to the pandemic. Of the respondents 33.6% were able to attend external continuing education courses. Only 4.2% were able to invest more time in research and 55.8% of participants agreed that their residency training will be extended due to the pandemic. CONCLUSION The COVID pandemic has had a significant impact on the residency training in orthopedics and trauma surgery in Germany. In almost all areas of training, residents had to accept restrictions due to the imposed restrictions, which potentially negatively affected their training.
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Affiliation(s)
- Dominik Adl Amini
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
| | | | - Patricia Maria Lutz
- Department for Trauma Surgery, Feldkirch Academic Hospital, Feldkirch, Austria
| | - Lucca Lacheta
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Lisa Oezel
- Department of Orthopedic Surgery and Traumatology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Henryk Haffer
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Friederike Schömig
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Anna Schreiner
- Department for Trauma and Reconstructive Surgery, BG Unfallklinik Tübingen, University of Tübingen, Tübingen, Germany
| | - Jonas Limmer
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Maximilian Muellner
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
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10
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Luc JGY, Pizano A, Udwadia F, Gupta S, Dairywala M, Joyce C, Robinson E, Rush G, Dunning J, Myers PO, Antonoff MB, Nguyen TC. Early effect of the COVID-19 pandemic on the North American cardiothoracic surgery job market. J Thorac Dis 2022; 14:3304-3313. [PMID: 36245601 PMCID: PMC9562543 DOI: 10.21037/jtd-22-320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/28/2022] [Indexed: 11/12/2022]
Abstract
Background The present study aims to report the early effect of the coronavirus disease 2019 (COVID-19) pandemic on the cardiothoracic surgery job market in North America. Methods The Cardiothoracic Surgery Network (CTSNet) job market database was queried, and patterns from January to May for 2019 versus January to May 2020 were compared for trends in job postings and job seekers. Results Our study is comprised of 395 cardiothoracic surgery job postings, of which 98% were positions located in North America and 63% were academic. The negative impact of the pandemic on the cardiothoracic surgery job market was greatest in the cardiothoracic/cardiovascular combined subspecialty, followed by congenital and adult cardiac surgery, whereas general thoracic surgery experienced an increase in proportion of jobs available. Despite an increase in views per job posted in 2020 vs. 2019 (532 vs. 290), employer views of job seeker curriculum vitae declined over the same time period in 2020 (January, 380 views/month to May, 3 views/month) compared to 2019 (January, 100 views/month to May, 54 views/month). Conclusions An analysis of job postings from CTSNet suggests a decline in job availability in the North American cardiothoracic surgical job market following declaration of the pandemic with acknowledgement that there is month to month variability and a supply-demand mismatch. The COVID-19 pandemic has had an unprecedented impact on our field, and the ultimate consequences remain unknown.
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Affiliation(s)
- Jessica G. Y. Luc
- Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alejandro Pizano
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, TX, USA
| | - Farhad Udwadia
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Saurabh Gupta
- Division of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Mohammed Dairywala
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, TX, USA
| | | | | | - Grahame Rush
- The Cardiothoracic Surgery Network, Chicago, IL, USA
| | - Joel Dunning
- Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK
| | - Patrick O. Myers
- Department of Cardiac Surgery, CHUV-Center Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Mara B. Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tom C. Nguyen
- Division of Cardiothoracic Surgery, Department of Surgery, University of California San Francisco, CA, USA
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11
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Singhal R, Dickerson L, Sakran N, Pouwels S, Chiappetta S, Weiner S, Purkayastha S, Madhok B, Mahawar K. Safe Surgery During the COVID-19 Pandemic. Curr Obes Rep 2022; 11:203-214. [PMID: 34709586 PMCID: PMC8552630 DOI: 10.1007/s13679-021-00458-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE OF REVIEW Coronavirus Disease-2019 (COVID-19) has had an enormous impact on all aspects of healthcare, but its effect on patients needing surgery and surgeons has been disproportionate. In this review, we aim to understand the impact of the pandemic on surgical patients and teams. We compiled the emerging data on pre-operative screening methods, vaccinations, safe-surgery pathways and surgical techniques and make recommendations for evidence-based safe-surgical pathways. We also present surgical outcomes for emergency, oncological and benign surgery in the context of the pandemic. Finally, we attempt to address the impact of the pandemic on patients, staff and surgical training and provide perspectives for the future. RECENT FINDINGS Surgical teams have developed consensus guidelines and established research priorities and safety precautions for surgery during the COVID-19 pandemic. Evidence supports that surgery in patients with a peri-operative SARS-CoV-2 infection carries substantial risks, but risk mitigation strategies are effective at reducing harm to staff and patients. Surgery has increased risk for patients and staff, but this can be mitigated effectively, especially for elective surgery. Elective surgery can be safely performed during the COVID-19 pandemic employing the strategies discussed in this review.
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Affiliation(s)
- Rishi Singhal
- Upper GI Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, UK.
| | - Luke Dickerson
- Department of General Surgery, Leighton Hospital, Crewe, UK
| | - Nasser Sakran
- Director Bariatric Centre, Department of Surgery, Emek Medical Centre, Afula, Israel
- The Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Sonja Chiappetta
- Head Obesity and Metabolic Surgery, Ospedale Evangelico Betania, Naples, Italy
| | - Sylvia Weiner
- Department of Obesity and Metabolic Surgery, Krankenhaus Nordwest, Frankfurt am Main, Germany
| | | | | | - Kamal Mahawar
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
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12
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Silva B, Ožvačić Adžić Z, Vanden Bussche P, Van Poel E, Seifert B, Heaster C, Collins C, Tuz Yilmaz C, Knights F, de la Cruz Gomez Pellin M, Astier Peña MP, Stylianou N, Gomez Bravo R, Cerovečki V, Klemenc Ketis Z, Willems S. Safety Culture and the Positive Association of Being a Primary Care Training Practice during COVID-19: The Results of the Multi-Country European PRICOV-19 Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10515. [PMID: 36078230 PMCID: PMC9518383 DOI: 10.3390/ijerph191710515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/09/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
The day-to-day work of primary care (PC) was substantially changed by the COVID-19 pandemic. Teaching practices needed to adapt both clinical work and teaching in a way that enabled the teaching process to continue, while maintaining safe and high-quality care. Our study aims to investigate the effect of being a training practice on a number of different outcomes related to the safety culture of PC practices. PRICOV-19 is a multi-country cross-sectional study that researches how PC practices were organized in 38 countries during the pandemic. Data was collected from November 2020 to December 2021. We categorized practices into training and non-training and selected outcomes relating to safety culture: safe practice management, community outreach, professional well-being and adherence to protocols. Mixed-effects regression models were built to analyze the effect of being a training practice for each of the outcomes, while controlling for relevant confounders. Of the participating practices, 2886 (56%) were non-training practices and 2272 (44%) were training practices. Being a training practice was significantly associated with a lower risk for adverse mental health events (OR: 0.83; CI: 0.70-0.99), a higher number of safety measures related to patient flow (Beta: 0.17; CI: 0.07-0.28), a higher number of safety incidents reported (RR: 1.12; CI: 1.06-1.19) and more protected time for meetings (Beta: 0.08; CI: 0.01-0.15). No significant associations were found for outreach initiatives, availability of triage information, use of a phone protocol or infection prevention measures and equipment availability. Training practices were found to have a stronger safety culture than non-training practices. These results have important policy implications, since involving more PC practices in education may be an effective way to improve quality and safety in general practice.
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Affiliation(s)
- Bianca Silva
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Zlata Ožvačić Adžić
- Department of Family Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Health Centre Zagreb-Centar, 10000 Zagreb, Croatia
| | | | - Esther Van Poel
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Bohumil Seifert
- Institute of General Practice, First Medical Faculty, Charles University, CZ-121 08 Prague, Czech Republic
| | - Cindy Heaster
- Department of Family Medicine, Faculty of Medicine, Riga Stradiņš University, LV-1007 Riga, Latvia
| | - Claire Collins
- Research Centre, Irish College of General Practitioners, D02 XR68 Dublin, Ireland
| | - Canan Tuz Yilmaz
- Family Medicine Department, Bursa Uludag University, 16130 Bursa, Turkey
| | - Felicity Knights
- Population Health Research Institute, St George’s University of London, London SW17 0RE, UK
| | | | - Maria Pilar Astier Peña
- Primary Health Centre Universitas, Aragon Health Services, 50009 Zaragoza, Spain
- Medical School, Universidad de Zaragoza, GIBA-ISS-Aragón, 50009 Zaragoza, Spain
| | - Neophytos Stylianou
- RTD Talos, 2404 Nicosia, Cyprus
- International Institute for Compassionate Care, 2415 Nicosia, Cyprus
| | - Raquel Gomez Bravo
- CHNP, Rehaklinik, L-9002 Ettelbruck, Luxembourg
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, L-4366 Esch-sur-Alzette, Luxembourg
| | - Venija Cerovečki
- Department of Family Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Health Centre Zagreb-Centar, 10000 Zagreb, Croatia
| | - Zalika Klemenc Ketis
- Ljubljana Community Health Centre, 1000 Ljubljana, Slovenia
- Department of Family Medicine, Medical Faculty, University of Maribor, 2000 Maribor, Slovenia
- Department of Family Medicine, Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Sara Willems
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
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13
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Joshi MK, Bhattacharjee HK, Suhani, Roy A, Seenu V. Development and use of low-fidelity, low-cost, animal tissue-based simulators for surgical training during the Covid-19 pandemic. THE NATIONAL MEDICAL JOURNAL OF INDIA 2022; 35:239-242. [PMID: 36715035 DOI: 10.25259/nmji_516_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background The Covid-19 pandemic severely affected surgical training as the number of surgeries being done was reduced to a bare minimum. Teaching and training of clinical skills on a simulator are desirable as they may have an even larger role during the Covid-19 pandemic. Commercially available simulators with optimum fidelity are costly and may be difficult to sustain because of their recurring cost. The development of low-cost simulators with optimum fidelity is the need of the hour. Methods We developed animal tissue-based simulators for imparting skills training to surgical residents on some basic and advanced general surgical procedures. Porcine tissue and locally available materials were used to prepare these models. The models were pilot-tested. Standard operating procedures were developed for each skill that was shared with the participants well before the 'hands-on' exercise. An online pre-test was conducted. The training was then imparted on these models under faculty guidance adhering to Covid-19-appropriate behaviour. This was followed by a post-test and participant feedback. The entire exercise was paperless. Results Sixty residents were trained in 10 sessions. Most of the participants were men (44; 73%). The mean pre-test and post-test scores were 40.92 (standard deviation [SD] 6.27) and 42.67, respectively (SD 4.06). Paired sample t-test suggested a significant improvement in the post-test score (p<0.001). The activity and the models were well appreciated by the residents. Conclusion The animal tissue-based indigenous models are easy to prepare, cost-effective and provide optimum fidelity for skill training of surgical residents. In addition to skill acquisition, training on such modules may alleviate the stress and anxiety of the residents associated with the loss of surgical training during a time-bound residency period.
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Affiliation(s)
- Mohit Kumar Joshi
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi 110029, India
| | | | - Suhani
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Vuthaluru Seenu
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi 110029, India
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14
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Bartholomew A, Sanatkar S, Counson I, Harvey SB. Junior doctors' mental health and coronavirus disease safety concerns. Aust N Z J Public Health 2022; 46:307-313. [PMID: 35238447 PMCID: PMC9968570 DOI: 10.1111/1753-6405.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/01/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This article aims to assess whether caring for COVID-19 patients impacted junior doctors' COVID-19-related anxieties, general anxiety and depression, and the relative impact of depression, general anxiety and specific COVID-19 anxiety on work and social functioning during the COVID-19 pandemic in 2020. METHODS Recruitment occurred between June and August 2020 in New South Wales, Australia. Demographic information, symptoms of depression (PHQ-9), generalised anxiety (GAD-7), and COVID-19-related anxieties around infections, help-seeking behaviours, and work and social functioning (WSAS) were collected. RESULTS About one third (n=73, 33%) had cared for a patient with overt or covert COVID-19 in the previous month. However, the extent of COVID-19-related anxiety symptoms was largely unrelated to caring for COVID-19 patients. Instead, the presence of other COVID-19 concerns and gender predicted variations in COVID-19 concerns for one's own safety and the safety of loved ones. CONCLUSION COVID-19 anxiety symptoms were largely unrelated to caring for COVID-19 patients, while COVID-19-related anxiety around the safety of family and friends added to impaired functioning in addition to the established impact of depression and general anxiety. IMPLICATIONS FOR PUBLIC HEALTH Provided the replicability of these findings, this research highlights the importance of addressing pandemic-related anxieties in junior doctor populations.
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Affiliation(s)
- Alexandra Bartholomew
- Black Dog Institute, UNSW Sydney, New South Wales,Correspondence to: Ms Alexandra Bartholomew, Black Dog Institute, Hospital Road, Sydney 2031
| | - Samineh Sanatkar
- Black Dog Institute, UNSW Sydney, New South Wales,School of Psychiatry, UNSW Sydney, New South Wales
| | - Isabelle Counson
- Black Dog Institute, UNSW Sydney, New South Wales,School of Psychiatry, UNSW Sydney, New South Wales
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15
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Hoffman JRH, Higa KC, Lin Y, Reece TB, Cleveland JC, Aftab M, Rove JY. Noteworthy Cardiac Literature From 2021: Coronary Guideline Change Without New Data, Heart Transplant Donation After Cardiac Death, Covid Effects on Global Cardiac Surgery, and Attempt to Improve Dissection Remodeling. Semin Cardiothorac Vasc Anesth 2022; 26:154-161. [PMID: 35591803 DOI: 10.1177/10892532221101298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cardiac surgery continues to evolve. The last year has been notable for many reasons. The guidelines for coronary revascularization introduced significant discord. The pandemic continues to affect the care on a global scale. Advances in organ procurement and dissection care move forward with better understanding and better technology.
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Affiliation(s)
| | - Kelly C Higa
- Division of Cardiothoracic Surgery, Department of, Surgery, 129263University of Colorado School of Medicine, Aurora, CO, USA
| | - Yihan Lin
- Division of Cardiothoracic Surgery, Department of, Surgery, 129263University of Colorado School of Medicine, Aurora, CO, USA
| | - T Brett Reece
- Division of Cardiothoracic Surgery, Department of, Surgery, 129263University of Colorado School of Medicine, Aurora, CO, USA
| | - Joseph C Cleveland
- Division of Cardiothoracic Surgery, Department of, Surgery, 129263University of Colorado School of Medicine, Aurora, CO, USA
| | - Muhammad Aftab
- Division of Cardiothoracic Surgery, Department of, Surgery, 129263University of Colorado School of Medicine, Aurora, CO, USA
| | - Jessica Y Rove
- Division of Cardiothoracic Surgery, Department of, Surgery, 129263University of Colorado School of Medicine, Aurora, CO, USA
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16
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Hamid M, Naumann DN, Digne-Malcolm H, Kanwal A, Puventhiranathan P, Phelan L, Dilworth M. Surgical training during the COVID-19 pandemic at a designated 'cold' site: are we meeting the challenge? Ann R Coll Surg Engl 2022; 104:421-426. [PMID: 34784248 PMCID: PMC9157855 DOI: 10.1308/rcsann.2021.0223] [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] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION There has been a marked reduction in surgical operative training opportunities during the COVID-19 pandemic. This may be improved by the establishment of 'cold' sites for NHS elective surgery. We investigated the training opportunities at a newly designated elective surgery cold site in the West Midlands, UK. METHODS An observational retrospective study was undertaken to include all gastrointestinal and urological elective surgery at a single 'cold' site during the first peak of the COVID-19 pandemic. Patient demographics, details of surgery and data relating to surgical training such as primary surgeon and portfolio index procedure were collected. Factors affecting the likelihood of trainees being the primary surgeon were analysed using logistic regression models. RESULTS There were 880 patients, with a median (interquartile range) age of 62 (48-74). Some 658 (74.8%) procedures were defined as 'index procedures' for specialty training year 4 (ST4) level: 409/509 (80.4%) for urology, 155/235 (66%) for colorectal and 94/136 (69.1%) for upper gastrointestinal (GI). Only 253/880 (28.8%) procedures were performed by a trainee as the primary surgeon: 201/509 (39.4%) for urology, 21/235 (8.9%) for colorectal and 31/136 (22.8%) for upper GI. The likelihood of a trainee being the primary surgeon was reduced for major surgery (p<0.001) and for GI surgery when compared with urology (p<0.001). CONCLUSIONS Surgical training was facilitated at an elective surgery 'cold' site during the COVID-19 pandemic, but at lower levels than anticipated. Type of surgery influenced trainee participation. Surgical training should be incorporated into 'cold' site elective surgical services if trainees are to be prepared for the future.
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Affiliation(s)
- M Hamid
- University Hospitals Birmingham NHS Foundation Trust, UK
| | | | | | - A Kanwal
- University Hospitals Birmingham NHS Foundation Trust, UK
| | | | - L Phelan
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - M Dilworth
- University Hospitals Birmingham NHS Foundation Trust, UK
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17
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The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future. Indian J Surg 2022; 84:131-138. [PMID: 34149230 PMCID: PMC8197597 DOI: 10.1007/s12262-021-02964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 05/19/2021] [Indexed: 01/07/2023] Open
Abstract
The COVID-19 pandemic and infection control measures had an unavoidable impact on surgical services. During the first wave of the pandemic, elective surgery, endoscopy, and 'face-to-face' clinics were discontinued after recommendations from professional bodies. In addition, training courses, examinations, conferences, and training rotations were postponed or cancelled. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a significant negative impact on training. At the same time, they have given space to new technologies, like telemedicine and platforms for webinars, to blossom. While the recovery phase is well underway in some parts of the world, most surgical services are not operating at full capacity. Unfortunately, some countries are still battling a second or third wave of the pandemic with severely negative consequences on surgical services. Several studies have looked into the impact of COVID-19 on surgical training. Here, an objective overview of studies from different parts of the world is presented. Also, evidence-based solutions are suggested for future surgical training interventions.
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18
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Goss CW, Duncan JG, Lou SS, Holzer KJ, Evanoff BA, Kannampallil T. Effects of Persistent Exposure to COVID-19 on Mental Health Outcomes Among Trainees: a Longitudinal Survey Study. J Gen Intern Med 2022; 37:1204-1210. [PMID: 35091924 PMCID: PMC8796740 DOI: 10.1007/s11606-021-07350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The rapid spread of the coronavirus disease 2019 (COVID-19) has created considerable strain on the physical and mental health of healthcare workers around the world. The effects have been acute for physician trainees-a unique group functioning simultaneously as learners and care providers with limited autonomy. OBJECTIVE To investigate the longitudinal effects of physician trainee exposure to patients being tested for COVID-19 on stress, anxiety, depression, and burnout using three surveys conducted during the early phase of the pandemic. DESIGN Longitudinal survey study. PARTICIPANTS All physician trainees (N = 1375) at an academic medical center. MAIN MEASURE Assess the relationship between repeated exposure to patients being tested for COVID-19 and stress, anxiety, depression, and burnout. KEY RESULTS Three hundred eighty-nine trainees completed the baseline survey (28.3%). Of these, 191 and 136 completed the ensuing surveys. Mean stress, anxiety, and burnout decreased by 21% (95% confidence interval (CI): - 28 to - 12%; P < 0.001), 25% (95% CI: - 36 to - 11%; P < 0.001), and 13% (95% CI: - 18 to - 7%; P < 0.001), respectively, per survey. However, for each survey time point, there was mean increase in stress, anxiety, and burnout per additional exposure: stress [24% (95% CI: + 12 to + 38%; P < 0.001)], anxiety [22% (95% CI: + 2 to + 46%; P = 0.026)], and burnout [18% (95% CI: + 10 to + 28%; P < 0.001)]. For depression, the association between exposure was strongest for the third survey, where mean depression scores increased by 33% per additional exposure (95% CI: + 18 to + 50%; P < 0.001). CONCLUSIONS Training programs should adapt to address the detrimental effects of the "pileup" of distress associated with persistent exposure through adaptive programs that allow flexibility for time off and recovery.
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Affiliation(s)
- Charles W Goss
- Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA
| | - Jennifer G Duncan
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Sunny S Lou
- Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA
| | - Katherine J Holzer
- Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA
| | - Bradley A Evanoff
- Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Thomas Kannampallil
- Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA. .,Institute for Informatics, Washington University School of Medicine, St Louis, MO, USA.
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19
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Young K, Yeoh SA, Putman M, Sattui S, Conway R, Graef E, Kilian A, Konig M, Sparks J, Ugarte-Gil M, Upton L, Berenbaum F, Bhana S, Costello W, Hausmann J, Machado P, Robinson P, Sirotich E, Sufka P, Yazdany J, Liew J, Grainger R, Wallace Z, Jayatilleke A. The Impact of Covid-19 on rheumatology training - Results from the COVID-19 Global Rheumatology Alliance trainee survey. Rheumatol Adv Pract 2022; 6:rkac001. [PMID: 35392427 PMCID: PMC8982766 DOI: 10.1093/rap/rkac001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
Objective The aim was to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the clinical experiences, research opportunities and well-being of rheumatology trainees. Methods A voluntary, anonymous, Web-based survey was administered in English, Spanish or French from 19 August 2020 to 5 October 2020. Adult and paediatric rheumatology trainees were invited to participate via social media and email. Using multiple-choice questions and Likert scales, the perceptions of trainees regarding the impact of the COVID-19 pandemic on patient care and redeployment, learning and supervision, research and well-being were assessed. Results There were 302 respondents from 33 countries, with 83% in adult rheumatology training. An increase in non-rheumatology clinical work was reported by 45%, with 68% of these having been redeployed to COVID-19. Overall, trainees reported a negative impact on their learning opportunities during rheumatology training, including outpatient clinics (79%), inpatient consultations (59%), didactic teaching (55%), procedures (53%), teaching opportunities (52%) and ultrasonography (36%). Impacts on research experiences were reported by 46% of respondents, with 39% of these reporting that COVID-19 negatively affected their ability to continue their pre-pandemic research. Burnout and increases in stress were reported by 50% and 68%, respectively. Physical health was negatively impacted by training programme changes in 25% of respondents. Conclusion The COVID-19 pandemic has had a substantial impact on rheumatology training and trainee well-being. Our study highlights the extent of this impact on research opportunities and clinical care, which are highly relevant to future curriculum planning and the clinical learning environment.
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Affiliation(s)
- Kristen Young
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Su-Ann Yeoh
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Michael Putman
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Sebastian Sattui
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Richard Conway
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Elizabeth Graef
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Adam Kilian
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Maximilian Konig
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Jeffrey Sparks
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Manuel Ugarte-Gil
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Laura Upton
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Francis Berenbaum
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Suleman Bhana
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Wendy Costello
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Jonathan Hausmann
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Pedro Machado
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Philip Robinson
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Emily Sirotich
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Paul Sufka
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Jinoos Yazdany
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Jean Liew
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Rebecca Grainger
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Zachary Wallace
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
| | - Arundathi Jayatilleke
- Temple University School of Medicine, 3322 N Broad St, Suite 201, Philadelphia, PA, United States of America
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Bihani P, Jaju R, Saxena M, Paliwal N, Tharu V. “The show must go on”: Aftermath of Covid-19 on anesthesiology residency programs. Saudi J Anaesth 2022; 16:452-456. [DOI: 10.4103/sja.sja_563_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 11/04/2022] Open
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21
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Chen SY, Lo HY, Hung SK. What is the impact of the COVID-19 pandemic on residency training: a systematic review and analysis. BMC MEDICAL EDUCATION 2021; 21:618. [PMID: 34911503 PMCID: PMC8671601 DOI: 10.1186/s12909-021-03041-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 11/25/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has greatly affected medical education in addition to clinical systems. Residency training has probably been the most affected aspect of medical education during the pandemic, and research on this topic is crucial for educators and clinical teachers. The aim of this study was to understand the effect of the COVID-19 pandemic comprehensively through a systematic review and analysis of related published articles. METHODS A systematic review was conducted based on a predesigned protocol. We searched MEDLINE and EMBASE databases until November 30, 2020, for eligible articles. Two independent reviewers extracted data by using a customized form to record crucial information, and any conflicts between the two reviewers were resolved through discussion with another independent reviewer. The aggregated data were summarized and analyzed. RESULTS In total, 53 original articles that investigated the effect of the COVID-19 pandemic on residency training were included. Studies from various regions were included in the research, with the largest percentage from the United States (n = 25, 47.2%). Most of these original articles were questionnaire-based studies (n = 44, 83%), and the research target groups included residents (79.55%), program directors (13.64%), or both (6.82%). The majority of the articles (n = 37, 84.0%) were published in countries severely affected by the pandemic. Surgery (n = 36, 67.92%) was the most commonly studied field. CONCLUSIONS The COVID-19 pandemic has greatly affected residency training globally, particularly surgical and interventional medical fields. Decreased clinical experience, reduced case volume, and disrupted education activities are major concerns. Further studies should be conducted with a focus on the learning outcomes of residency training during the pandemic and the effectiveness of assisted teaching methods.
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Affiliation(s)
- Shou-Yen Chen
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 333, Taoyuan City, Taiwan
- Graduate Institute of Clinical Medical Sciences; Division of Medical Education, College of Medicine, Chang Gung University, 333, Taoyuan City, Taiwan
| | - Hsiang-Yun Lo
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 333, Taoyuan City, Taiwan
| | - Shang-Kai Hung
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 333, Taoyuan City, Taiwan.
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22
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Olive JK, Luc JG, Preventza OA. The status of cardiothoracic surgery trainee education and recruitment: An update one year into the coronavirus disease 2019 (COVID-19) pandemic. JTCVS OPEN 2021; 8:538-539. [PMID: 34901891 PMCID: PMC8643071 DOI: 10.1016/j.xjon.2021.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Çevik H, Ungan M. The impacts of the COVID-19 pandemic on the mental health and residency training of family medicine residents: findings from a nationwide cross-sectional survey in Turkey. BMC FAMILY PRACTICE 2021; 22:226. [PMID: 34781878 PMCID: PMC8591155 DOI: 10.1186/s12875-021-01576-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/29/2021] [Indexed: 12/02/2022]
Abstract
Background The COVID-19 pandemic has had a negative impact on resident training in different branches and affected the physical and mental health of frontline residents adversely. This nationwide cross-sectional survey aimed to investigate the effects of the COVID-19 pandemic on family medicine residents in Turkey, including the levels of depression and burnout. Methods An anonymous online survey was distributed to all family medicine residents via e-mail and a web link between 28.11.2020 and 12.12.2020. Information on sociodemographic data and the residency programme were evaluated, and factors associated with depression and burnout were examined using the Patient Health Questionnaire-9 (PHQ-9) and the Burnout Measure-Short Version (BMS) respectively. Results Although the weekly average working hours of the 477 respondents increased significantly during the pandemic (p < 0.05), the average weekly working time in the Family Medicine (FM) outpatient clinic decreased. The greatest concern of 58.3% of the residents was fear of transmitting COVID-19 to their family members. 90.2% of the residents stated that training programmes were negatively or very negatively affected. According to PHQ-9 scores, 15.7% of residents had moderately severe, and 14.9% severe depression. The BMS scores of the residents demonstrated that 24.1% had a very severe burnout problem, and 23.3% should seek professional help as soon as possible. Being single, having no children, female gender, lack of personal protective equipments and increased contact time with COVID-19 patients were associated with higher scores in the depression and burnout scales (p < 0.05). Conclusions The COVID-19 pandemic has had a negative impact on training programmes for FM residents, who are at the forefront of the pandemic in Turkey, and this situation is closely related to depression and burnout. Due to the unpredictability of the pandemic, long-term plans should be made for the training needs of residents in order to protect their physical and mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01576-9.
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Affiliation(s)
- Hüsna Çevik
- Çankaya District Health Directorate, Hacettepe Mah. Talatpaşa Blv. No: 44 Altındağ, Ankara, Turkey.
| | - Mehmet Ungan
- Family Medicine Department, Ankara University Medical School, Ankara, Turkey
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24
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Hussein N, Zientara A, Gollmann-Tepeköyly C, Loubani M. Is it time to incorporate hands-on simulation into the cardiothoracic surgery curriculum? Interact Cardiovasc Thorac Surg 2021; 34:564-565. [PMID: 34718593 PMCID: PMC8574333 DOI: 10.1093/icvts/ivab290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/25/2021] [Accepted: 09/14/2021] [Indexed: 12/20/2022] Open
Abstract
The COVID pandemic has had huge implications for training in cardiothoracic surgery. The reduction in training opportunities has led to concerns from trainees globally regarding the impact on their learning and their training progression. Surgical simulation is effective in the development of technical skills in cardiothoracic surgery with numerous examples of low and high-fidelity simulators. Despite this the incorporation of such methods into training curricula worldwide is seldom. Core fundamentals are required to successfully implement surgical simulation into training programmes, which includes; commitment from trainers, regular sessions and structured feedback. Few programmes have demonstrated the successful incorporation of surgical simulation and there is a growing acceptance of its place in the speciality. As we recover from this challenging period it may be the right opportunity to evolve how we train our current and future trainees by incorporating hands-on simulation as a fundamental part of the cardiothoracic curriculum.
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Affiliation(s)
- Nabil Hussein
- Department of Congenital Heart Surgery, Yorkshire Heart Centre, Leeds General Infirmary, England, UK
| | | | | | - Mahmoud Loubani
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK
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25
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Luthra S, Duggan S, Ohri S. Impact of COVID-19 on Training and Attainment of Cardiac Surgical Competencies. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2021; 16:414. [PMID: 34585993 DOI: 10.1177/15569845211046948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Suvitesh Luthra
- Wessex Cardiac Surgery Research Group, University Hospital Southampton NHS Foundation Trust, UK
| | - Simon Duggan
- Wessex Cardiac Surgery Research Group, University Hospital Southampton NHS Foundation Trust, UK
| | - Sunil Ohri
- Wessex Cardiac Surgery Research Group, University Hospital Southampton NHS Foundation Trust, UK
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26
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Hennessy O, Fowler AL, Hennessy C, Brinkman D, Hogan A, Nugent E, Joyce M. Riding the waves: the ongoing impact of COVID-19 on a national surgical training cohort. Ir J Med Sci 2021; 191:1823-1829. [PMID: 34453309 PMCID: PMC8397331 DOI: 10.1007/s11845-021-02739-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/03/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND The World Health Organisation declared a global pandemic on the 11 March 2020 resulting in implementation of methods to contain viral spread, including curtailment of all elective and non-emergent interventions. Many institutions have experienced changes in rostering practices and redeployment of trainees to non-surgical services. Examinations, study days, courses, and conferences have been cancelled. These changes have the potential to significantly impact the education and training of surgical trainees. AIM To investigate the impact of the COVID-19 pandemic on training, educational, and operative experiences of Irish surgical trainees. METHODS Surgical trainees were surveyed anonymously regarding changes in working and educational practices since the declaration of the COVID-19 pandemic on 11 March 2020. The survey was circulated in May 2020 to both core and higher RCSI surgical trainees, when restrictions were at level five. Questions included previous and current access to operative sessions as well as operative cases, previous and current educational activities, access to senior-led training, and access to simulation-/practical-based training methods. A repeat survey was carried out in October 2020 when restrictions were at level two. RESULTS Overall, primary and secondary survey response rates were 29% (n = 98/340) and 19.1% (n = 65/340), respectively. At the time of circulation of the second survey, the number of operative sessions attended and cases performed had significantly improved to numbers experienced pre-pandemic (p < 0.0001). Exposure to formal teaching and education sessions returned to pre-COVID levels (p < 0.0001). Initially, 23% of trainees had an examination cancelled; 53% of these trainees have subsequently sat these examinations. Of note 27.7% had courses cancelled, and 97% of these had not been rescheduled. CONCLUSION Surgical training and education have been significantly impacted in light of COVID-19. This is likely to continue to fluctuate in line with subsequent waves. Significant efforts have to be made to enable trainees to meet educational and operative targets.
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Affiliation(s)
- Orla Hennessy
- Department of General Surgery, University Hospital Galway, Galway, Ireland.
| | - Amy Lee Fowler
- Department of General Surgery, University Hospital Galway, Galway, Ireland
| | | | | | - Aisling Hogan
- Department of General Surgery, University Hospital Galway, Galway, Ireland
| | - Emmeline Nugent
- Department of General Surgery, University Hospital Galway, Galway, Ireland
| | - Myles Joyce
- Department of General Surgery, University Hospital Galway, Galway, Ireland
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Rodriguez Santos F, González Salazar E, Dietrich A, Cano Busnelli V, Roni C, Facioni C, Mutchinick A, Palavecino M, Beskow A, Figari M, Pekolj J, de Santibañes M. Teaching strategies and outcomes in 3 different times of the COVID-19 pandemic through a dynamic assessment of medical skills and wellness of surgical trainees. Surgery 2021; 171:908-914. [PMID: 34548160 PMCID: PMC8382581 DOI: 10.1016/j.surg.2021.08.018] [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] [Received: 05/22/2021] [Revised: 07/10/2021] [Accepted: 08/14/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic had a substantial impact on surgical training programs. This study describes the teaching strategies and outcomes in 3 different times of the coronavirus disease 2019 pandemic through a dynamic assessment of medical skills and well-being of trainees. METHODS Three surveys were administered during 2020 to general surgery residents and fellows in a university hospital in Argentina. Perceptions on the impact of coronavirus disease 2019 were described. The stress rate and risk factors were analyzed. RESULTS The study included 124 answers. In total, 59% were men, 82% of trainees reported concerns about the loss of surgical skills in early phase 1. Time spent with academic activities increased in 94.5% of the cases. Owing to the prompt implementation of changes, by the end of 2020, 73% participated in a greater number of procedures (P = .003); personal protective equipment use related problems dropped from 40% to 14% (P = .031), and the lack of adequate spaces where trainees could express reduced from 28% to zero. Half of the trainees felt stressed, and 18% required psychological assistance; reporting problems with personal protective equipment use was identified as a risk factor (P = .012). CONCLUSION Assessing trainees' perceptions at 3 different times of the coronavirus disease 2019 pandemic enabled the implementation of dynamic changes. The negative impact on surgical training was partially offset by the optimal use of virtual learning. Half of them felt stressed, identifying problems in the use of personal protective equipment as a predisposing factor.
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Affiliation(s)
| | | | - Agustin Dietrich
- Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina
| | | | - Carolina Roni
- Department of Education, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina and Hospital Italiano de Buenos Aires, Argentina; University Center for Simulation based Education, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina and Hospital Italiano de Buenos Aires, Argentina
| | - Clara Facioni
- Department of Education, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina and Hospital Italiano de Buenos Aires, Argentina
| | - Agustina Mutchinick
- Department of Education, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina and Hospital Italiano de Buenos Aires, Argentina
| | - Martin Palavecino
- Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina; University Center for Simulation based Education, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina and Hospital Italiano de Buenos Aires, Argentina
| | - Axel Beskow
- Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina
| | - Marcelo Figari
- Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina; Rector, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina and Hospital Italiano de Buenos Aires, Argentina
| | - Juan Pekolj
- Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina
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Johnson J, Al-Ghunaim TA, Biyani CS, Montgomery A, Morley R, O’Connor DB. Burnout in Surgical Trainees: a Narrative Review of Trends, Contributors, Consequences and Possible Interventions. Indian J Surg 2021; 84:35-44. [PMID: 34341627 PMCID: PMC8319710 DOI: 10.1007/s12262-021-03047-y] [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: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 02/03/2023] Open
Abstract
Surgical disciplines are popular and training places are competitive to obtain, but trainees report higher levels of burnout than either their non-surgical peers or attending or consultant surgeons. In this review, we critically summarise evidence on trends and changes in burnout over the past decade, contributors to surgical trainee burnout, the personal and professional consequences of burnout and consider the evidence for interventions. There is no evidence for a linear increase in burnout levels in surgeons over the past decade but the impact of the COVID-19 pandemic has yet to be established and is likely to be significant. Working long hours and experiencing stressful interpersonal interactions at work are associated with higher burnout in trainees but feeling more supported by training programmes and receiving workplace supervision are associated with reduced burnout. Burnout is associated with poorer overall mental and physical well-being in surgical trainees and has also been linked with the delivery of less safe patient care in this group. Useful interventions could include mentorship and improving work conditions, but there is a need for more and higher quality studies.
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Affiliation(s)
- Judith Johnson
- School of Psychology, University of Leeds, Leeds, LS29JT UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, BD96RJ UK
- School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052 Australia
| | | | - Chandra Shekhar Biyani
- Department of Urology, St James’s University Hospital, Beckett Street, Leeds, LS9 7TF UK
- Cadaveric Simulation Programme, Anatomy Department, School of Medicine, University of Leeds, Leeds, LS2 9JT UK
| | - Anthony Montgomery
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
| | - Roland Morley
- Imperial College Healthcare NHS Trust, London, W2 1NY UK
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Jayakumar N, Hellwig S, Allison C, Stummer W, Holling M, Surash S. A Tale of Two Cities: Residents' Operative Experience in the United Kingdom and Germany During the Coronavirus Disease 2019 Pandemic. World Neurosurg 2021; 154:e428-e436. [PMID: 34280539 PMCID: PMC8285217 DOI: 10.1016/j.wneu.2021.07.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 12/23/2022]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has had a detrimental effect on residents’ operative training. Our aim was to identify the proportion of procedures performed by residents across 2 neurosurgical centers (1 in the United Kingdom and 1 in Germany) during the pandemic-affected months of March 2020–May 2020, inclusive, compared with March 2019–May 2019, inclusive. Methods All neurosurgical procedures performed at the United Kingdom and German institutions, between March 1, 2019 and May 31, 2019 (pre-COVID months) and March 1, 2020 and May 31, 2020 (COVID months), were extracted and operative notes evaluated. Statistical analysis was performed on SPSS version 22. Results There was a statistically significant reduction in operative volume in the United Kingdom center from the pre-COVID months to the COVID months (χ2(5) = 84.917; P < 0.001) but no significant difference in the operative volume in the German center (P = 0.61). A Mann-Whitney U test showed a statistically significant difference in the volume of residents operating in the COVID months compared with pre-COVID months in both United Kingdom and German centers (P < 0.001). The average number of procedures performed by residents in the United Kingdom center as the primary surgeon decreased from 82 to 72 per month (pre-COVID vs. COVID months), whereas German residents’ operating volume increased from 68 to 89 per month (pre-COVID vs. COVID months). Conclusions The COVID-19 pandemic has significantly reduced the volume of operating by neurosurgical residents in the United Kingdom center, whereas residents in the German center performed more procedures compared with 2019. This finding may reflect variations in national practice on maintaining surgical activities and provision of critical care beds during the first wave of the pandemic.
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Affiliation(s)
- Nithish Jayakumar
- Department of Neurosurgery, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom.
| | - Sönke Hellwig
- Department of Neurosurgery, University Hospital Münster, Münster, North Rhine-Westphalia, Germany
| | - Callum Allison
- Medical School, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Münster, Münster, North Rhine-Westphalia, Germany
| | - Markus Holling
- Department of Neurosurgery, University Hospital Münster, Münster, North Rhine-Westphalia, Germany
| | - Surash Surash
- Department of Neurosurgery, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom
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30
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Shafi AMA, Sheikh AM, Awad WI. Comparison of Cardiothoracic Surgical Training Before and During the COVID Pandemic in the United Kingdom. ACTA ACUST UNITED AC 2021; 7:394-410. [PMID: 34308383 PMCID: PMC8282444 DOI: 10.1016/j.xjon.2021.07.004] [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: 10/04/2020] [Accepted: 07/09/2021] [Indexed: 11/25/2022]
Abstract
Background Cardiothoracic training during the Coronavirus disease 2019 (COVID-19) pandemic witnessed a dramatic change in the United Kingdom, resulting in changes in surgical provisions, centralization of services, and reduced surgical case volume. The aim of this study was to assess the impact COVID-19 on surgical training and seek opinions regarding the future role of surgical simulation in cardiothoracic training. Methods A cross-sectional survey was designed and distributed to 200 cardiothoracic national and non-national trainees in the United Kingdom. The survey consisted of 31 questions in 4 sections: Demographics, Service Provision, Training, and Simulation Training. Results Eighty-three of the 200 trainees (41.5%) completed the survey, including 44 of 129 national trainees (34.1%) and 39 of 71 non-national trainees (54.9%). Sixty-seven respondents (80.7%) agreed that cardiothoracic training had been negatively impacted as a result of COVID-19 (P < .001). In addition, 12% agreed that adequate resources were available for learning/practicing technical skills, 87% agreed that simulation had a role in cardiothoracic training, 81% recognized simulations is an important tool in improving their surgical skills, and 79.5% agreed that simulation should be used to meet the increasing need in training/education moving forward. Conclusions COVID-19 has had a significant impact on surgical training, with concerns that these effects could have further implications downstream. Simulation training has been underused thus far, and trainees face an uphill challenge to enhance their skills and technical abilities in the operating room. Simulation is recommended by trainees and may represent a solution to the challenges of safe and effective cardiothoracic surgical training.
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Affiliation(s)
| | - Amir Majid Sheikh
- Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK
| | - Wael Ibrahim Awad
- Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK
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31
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Gardas S, Nair S, Pitchai P, Panhale V. Postgraduate Physiotherapy Training in a Quandary - Ramifications of Corona virus pandemic Lockdown: A Survey-based Study. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2021; 9:144-153. [PMID: 34277845 PMCID: PMC8273526 DOI: 10.30476/jamp.2021.89189.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Coronavirus disease-2019 (COVID-19) has disrupted clinical services and postgraduate training across the world. Hence, this survey was conducted to understand the impact of pandemic on Physiotherapy post-graduate (PG) education. METHODS It was a cross-sectional, observational study. A total of 254 Physiotherapy PG trainees were recruited through snowball sampling from Physiotherapy colleges across the state of Maharashtra. A 34-item structured questionnaire was developed, based on available literature, to evaluate the impact of COVID-19 pandemic on four domains: academic training, clinical training, research activities, and concerns faced by a PG trainee. The face validity of this questionnaire was assessed by six academicians and their suggestions were examined. Subsequently, it was piloted on five PG trainees before administering it to the participants. The validated questionnaire was then circulated via various social media platforms and personal contacts using Google form. Descriptive statistics were summarized as frequencies/ percentages. McNemar's test was used to determine the differences on a dichotomous dependent variable between the two related groups using SPSS software. RESULTS Overall 131 trainees provided complete responses. Although 85% (n=111) of them claimed they attended PG teaching activities through online mode, almost 67% (n=101) disagreed to have achieved their learning objectives. A vast majority (91%, n=119) of them felt that their specialty related practical training was severely affected, and 98% (n=129) reported that reduced caseload had impacted their clinical learning. Also, 70% (n=54) of final year PGs had difficulty in recruiting new participants for their dissertation. Spread of infections to family (98%), commuting in public transport (98%), uncertainty about exam dates (91%), and competency development in specialty areas (96%) were some of their concerns. CONCLUSION COVID-19 pandemic had impacted various domains of Physiotherapy PG program such as academic, clinical and research areas. Regulatory authorities should take serious consideration and devise strategies to overcome it.
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Affiliation(s)
- Shailesh Gardas
- Department of Neurophysiotherapy, Mahatma Gandhi Missions College of Physiotherapy, Navi Mumbai, India
| | - Shruti Nair
- Department of Cardiovascular & Respiratory Physiotherapy, MGM College of Physiotherapy, Navi Mumbai, India
| | - Pothiraj Pitchai
- Department of Community Physiotherapy, MGM College of Physiotherapy, Navi Mumbai, India
| | - Vrushali Panhale
- Department of Musculoskeletal Physiotherapy, MGM College of Physiotherapy, Navi Mumbai, India
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Smood B, Spratt JR, Mehaffey JH, Luc JGY, Vinck EE, Lehtinen ML, Wallen TJ, Jenkinson CG, Kim W, Kesieme EB, Han JJ, Helmers MR, Iyengar A, Patrick WL, Kelly JJ, Watkins AA, Cevasco M, Williams ML. COVID-19 and cardiothoracic surgery: Effects on training and workforce utilization in a global pandemic. J Card Surg 2021; 36:3296-3305. [PMID: 34173279 PMCID: PMC8447436 DOI: 10.1111/jocs.15773] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/12/2022]
Abstract
Background The COVID‐19 pandemic has disrupted all aspects of healthcare, including cardiothoracic surgery (CTS). We sought to determine the pandemic's impact on CTS trainees' educational experiences. Methods A survey was developed and distributed to members of the Thoracic Surgery Residents Association and other international CTS trainees. Trainees were asked to evaluate their cumulative experiences and share their overall perceptions of how CTS training had been impacted during the earliest months of the COVID‐19 pandemic (i.e., since March 01, 2020). Surveys were distributed and responses were recorded June 25–August 05, 2020. In total, 748 surveys were distributed and 166 responses were received (overall response rate 22.2%). Of these, 126 of 166 responses (75.9%) met inclusion criteria for final analysis. Results Final responses analyzed included 45 of 126 (35.7%) United States (US) and 81 of 126 (64.3%) international trainees, including 101 of 126 (80.2%) senior and 25 of 126 (19.8%) junior trainees. Most respondents (76/126, 43.2%) lost over 1 week in the hospital due to the pandemic. Juniors (12/25, 48.0%) were more likely than seniors (20/101, 19.8%) to be reassigned to COVID‐19‐specific units (p < .01). Half of trainees (63/126) reported their case volumes were reduced by over 50%. US trainees (42/45, 93.3%) were more likely than international trainees (58/81, 71.6%) to report reduced operative case volumes (p < .01). Most trainees (104/126, 83%) believed their overall clinical acumen was not adversely impacted by the pandemic. Conclusions CTS trainees in the United States and abroad have been significantly impacted by the COVID‐19 pandemic, with time lost in the hospital, decreased operative experiences, less time on CTS services, and frequent reassignment to COVID‐19‐specific care settings.
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Affiliation(s)
- Benjamin Smood
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John R Spratt
- Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Florida College of Medicine, Gainesville, Florida, USA
| | - J Hunter Mehaffey
- Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Virginia Medical Center, Charlottesville, Virginia, USA
| | - Jessica G Y Luc
- Department of Surgery, Division of Cardiovascular Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eric E Vinck
- Department of Surgery, Division of Cardiovascular Surgery, Clínica Cardio VID, Pontifical Bolivarian University, Medellín, Colombia
| | - Miia L Lehtinen
- Department of Cardiac Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Tyler J Wallen
- Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Charles G Jenkinson
- St. Vincent's Hospital, Sydney, Australia.,The University of Western Australia, Western Australia, Australia.,Murdoch University, Perth, Australia.,Heart and Lung Research Institute of Western Australia, Western Australia, Australia.,The University of New South Wales, New South Wales, Australia
| | - Woojung Kim
- Department of Thoracic and Cardiovascular Surgery, National University Hospital, Seoul, Republic of Korea
| | - Emeka B Kesieme
- Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Jason J Han
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark R Helmers
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amit Iyengar
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - William L Patrick
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John J Kelly
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ammara A Watkins
- Department of Surgery, Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Marisa Cevasco
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Matthew L Williams
- Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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33
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Luc JGY, Nguyen TC, Ad N. Impact of the Coronavirus Disease 2019 Pandemic on Cardiac Surgical Education in North America. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2021; 16:350-357. [PMID: 34167378 DOI: 10.1177/15569845211011459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE We report the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiac surgery trainee education in North America. METHODS A survey was sent to participating academic adult cardiac surgery centers in North America. Data regarding the effect of COVID-19 on cardiac surgery training were analyzed. RESULTS Responses were received from 53 academic institutions with diverse geographic distribution. Cardiac surgery trainee re-deployment to alternative clinical duties peaked at the height of the pandemic. We stratified institutions based on high (n = 20) and low burden (n = 33) of patients hospitalized with COVID-19. The majority of institutions have converted didactics (high burden 90% vs low burden 73%) and interviews for jobs/fellowships (high burden 75% vs low burden 73%) from in-person to virtual. Institutions were mixed in preference for administration of the licensing examination, with the most common preference for examinations to be held remotely on normal timeline (high burden 45% vs low burden 30%) or in person with more than 3-month delay (high burden 20% vs low burden 33%). Despite the challenges experienced during the COVID-19 pandemic on trainee clinical experience, re-deployment, and decreased operative volume, institutions expected their trainees to graduate on schedule (high burden 95% vs low burden 91%). CONCLUSIONS Our study demonstrates that actions taken during the COVID-19 pandemic has led to disruptions in cardiac surgery training with transition of didactics and interviews virtually and re-deployment to alternative duties. Despite this, institutions remain optimistic that their trainees will graduate on schedule.
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Affiliation(s)
- Jessica G Y Luc
- 8166 Division of Cardiovascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Tom C Nguyen
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, TX, USA
| | - Niv Ad
- 12264 Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.,Adventist White Oak Medical Center, Silver Spring, MD, 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] [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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Alexander A, Radke H. Reshaping surgical specialist training in small animal surgery during and after the COVID-19 pandemic. Vet Surg 2021; 50:924-932. [PMID: 34036591 PMCID: PMC8242755 DOI: 10.1111/vsu.13660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/05/2021] [Accepted: 05/08/2021] [Indexed: 01/28/2023]
Abstract
Objective To assess the perceived effects of the COVID‐19 pandemic on small animal surgical specialist training, among trainees and supervisors and to propose changes, based upon the results, that could be incorporated into training programs. Study Design Anonymous online questionnaire survey. Sample Population Eighty‐one eligible responses were collected in September 2020, including 52 European College of Veterinary Surgeons (ECVS) residents and 29 ECVS Diplomates acting as supervisors. Methods Descriptive statistics were used to analyze the data. Fisher's exact test was used to test for significance. Results A reduction in surgical case load was reported by 82% (n = 66/81) of respondents, with 82% (n = 54/66) of those believing that COVID‐19 had a mild‐to‐moderate impact on training. Compared to supervisors, residents were less likely to feel that appropriate guidance, a safe working environment, and measures to preserve training had been provided (p < .01). Only 45% (n = 22/49) of residents reported confidence with performing teleconsultations. Ninety percent (n = 73/81) of respondents considered online “case presentations” and “edited surgical video footage” as a positive ancillary tool. Conclusion COVID‐19 has resulted in a reduction in case load and training for the majority of residents. A discrepancy between the opinions of residents and supervisors was noted on various aspects of COVID‐19 related effects. Impact Open communication, as well as the use of additional training tools through digital platforms may help to preserve safe and effective training during times of decreased clinical activity. While this study has focused on surgical specialist training, the results could be applied to other disciplines.
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Affiliation(s)
- Akash Alexander
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Heidi Radke
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Rai A, Huda F, Basu S. How the COVID-19 pandemic has enforced a new way of surgical training. Eur Surg 2021; 53:327-328. [PMID: 33948108 PMCID: PMC8085472 DOI: 10.1007/s10353-021-00712-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/08/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Ankit Rai
- All India Institute of Medical Sciences, 249203 Rishikesh, India
| | - Farhanul Huda
- All India Institute of Medical Sciences, 249203 Rishikesh, India
| | - Somprakas Basu
- All India Institute of Medical Sciences, 249203 Rishikesh, India
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Mallick R, Odejinmi F, Sideris M, Egbase E, Kaler M. The impact of COVID-19 on obstetrics and gynaecology trainees; how do we move on? Facts Views Vis Obgyn 2021; 13:9-14. [PMID: 33889856 PMCID: PMC8051193 DOI: 10.52054/fvvo.13.1.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Obstetrics and Gynaecology (O&G) is an evolving specialty that encompasses women’s health at its core. The COVID-19 pandemic has caused significant patient care challenges, however simultaneously it has resulted in the interruption of clinical training and cessation of all elective work. Our primary aim was to assess the impact of the pandemic on the experiences of O&G trainees. Methods: An email invite was sent to all 127 O&G trainees in Kent, Surrey and Sussex (KSS), inviting them to participate in an anonymous 33-question survey. The survey data was collected and analysed over a 4-week period. Results: Of the 127 trainees sent the survey, 87 responded (69%). 39% and 75% of trainees agreed that the pandemic had a negative impact on their overall physical and mental wellbeing respectively. 43% agreed that the COVID-19 pandemic had adversely affected their obstetric training experience whilst almost all trainees stated a significant negative impact on benign gynaecology surgical training. Reassuringly, over 80% were positive they would recover from the negative impacts of COVID-19. Conclusions: It is evident that COVID-19 has impacted O&G trainees in several ways. Whilst we face uncertain times, we must firstly ensure the physical and mental well-being of all trainees. It is encouraging that non-emergency consultations and benign surgery are being restarted nationwide and whilst this will inevitably help with re-booting surgical training, we must also think “outside” the box and utilise other modes of teaching and training to safeguard learning whilst mitigating against the negative impacts of subsequent waves.
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Affiliation(s)
- R Mallick
- Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Lewes Road, Haywards Heath, RH16 4EX, UK
| | - F Odejinmi
- Whipps Cross Hospital, Barts Health NHS Trust, Whipps Cross Road, Leytonstone, London, E11 1NR, UK
| | - M Sideris
- Whipps Cross Hospital, Barts Health NHS Trust, Whipps Cross Road, Leytonstone, London, E11 1NR, UK
| | - E Egbase
- Whipps Cross Hospital, Barts Health NHS Trust, Whipps Cross Road, Leytonstone, London, E11 1NR, UK
| | - M Kaler
- Whipps Cross Hospital, Barts Health NHS Trust, Whipps Cross Road, Leytonstone, London, E11 1NR, UK
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ENT trainees' experience of redeployment during the coronavirus disease 2019 pandemic: a qualitative study. The Journal of Laryngology & Otology 2021; 135:391-395. [PMID: 33734060 PMCID: PMC8047395 DOI: 10.1017/s0022215121000840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background As a response to the acute strain placed on the National Health Service during the first wave of coronavirus disease 2019 in the UK, a number of junior doctors including ENT trainees were redeployed to other clinical specialties. This presented these trainees with novel challenges and opportunities. Methods A qualitative study was performed to explore these experiences, undertaking semi-structured interviews with ENT trainees between 17th and 30th July. Participants were recruited through purposeful sampling. Interview transcripts underwent thematic analysis using Dedoose software. Results Seven ENT trainees were interviewed, ranging from specialty trainee years four to eight (‘ST4’ to ‘ST8’) in grade. Six core themes were identified: organisation of redeployment, utilisation of skill set, emotional impact of redeployment, redeployed team dynamics, concerns about safety and impact on training. Conclusion The ENT trainees’ experiences of redeployment described highlight some important lessons and considerations for future redeployments.
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Griffiths CD, Mertz D, Serrano PE. Pre-operative testing and personal protective equipment in the operating room during a pandemic: A survey of Ontario general surgeons. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2021; 6:23-31. [PMID: 36340209 PMCID: PMC9612436 DOI: 10.3138/jammi-2020-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/06/2020] [Indexed: 06/16/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had major implications for general surgery practice. We sought to characterize general surgeons' perceptions of their surgical practice in Ontario, Canada, regarding operating room precautions to maximize safety during the pandemic. METHODS A web-administered cross-sectional survey was sent to general surgeons registered with the College of Physicians and Surgeons of Ontario on May 19, 2020. Surgeons were surveyed regarding their practices in pre-operative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, use of intra-operative personal protective equipment (PPE) given a patient's COVID-19 status, and management of common general surgical emergencies with COVID-19 patients. Responses were compared between surgeons from high- and low-prevalence public health units (PHUs) in Ontario using chi-square tests. RESULTS There were 81 respondents (rate: 81/271, 30%), 48 (59%) of whom were from a PHU in the top quartile of COVID-19 prevalence. Surgeons from low-prevalence PHUs reported pre-procedural COVID-19 testing rates similar to those reported in high-prevalence PHUs for elective (36% versus 55%), urgent (36% versus 54%), and emergent (20% versus 33%) surgeries. Seventy-eight percent of surgeons with COVID-19-negative patients limited trainees in the operating room compared with 96% of surgeons with COVID-19-positive patients. Use of N95 respirators was 17% for surgeons with COVID-19-negative patients, which dramatically increased to 62% for surgeons with patients whose COVID-19 status was unknown. CONCLUSIONS These findings support a need for improved understanding of local disease prevalence and risk of COVID-19 transmission to conserve PPE and return surgical trainees to pre-pandemic standards.
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Affiliation(s)
| | - Dominik Mertz
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Pablo E Serrano
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Ontario Clinical Oncology Group, Hamilton, Ontario, Canada
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Toman E, Soon WC, Thanabalasundaram G, Burns D, Petrik V, Watts C, Wykes V, White A. Comparison of outcomes of neurosurgical operations performed before and during the COVID-19 pandemic: a matched cohort study. BMJ Open 2021; 11:e047063. [PMID: 33622958 PMCID: PMC7907613 DOI: 10.1136/bmjopen-2020-047063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To determine how the first wave of the COVID-19 pandemic affected outcomes for all operatively managed neurosurgical patients, not only those positive for SARS-CoV-2. DESIGN Matched cohort (pairwise method). SETTING A single tertiary neurosurgical referral centre at a large UK Major Trauma Centre. PARTICIPANTS During the first COVID-19 wave, 231 neurosurgical cases were performed. These cases were matched to cases from 2019. Cases were matched for age (±10 years), primary pathology and surgical procedure. Cases were excluded from analysis if either the age could not be matched to within 10 years, or the primary pathology or procedure was too unique. After exclusions, 191 cases were included in final analysis. OUTCOME MEASURES Primary outcomes were 30-day mortality and postoperative pulmonary complications. Secondary outcomes included Glasgow Outcome Score (GOS) on discharge, length of stay (LoS), operative and anaesthetic times and grade of primary surgeon. An exploratory outcome was the SARS-CoV-2 status of patients. RESULTS There was no significant difference between the pandemic and matched cohorts in 30-day mortality, pulmonary complications, discharge GOS, LoS, operative or anaesthetic times. There was a significant difference in the variation of grade of primary surgeon. Only 2.2% (n=5) of patients had a SARS-CoV-2 positive swab. CONCLUSION During the first UK wave of the COVID-19 pandemic, the mortality, morbidity and functional outcomes of operatively managed neurosurgical patients at University Hospitals Birmingham were not significantly affected compared with normal practice. The grade of primary surgeon was significantly more senior and adds to the growing body of evidence that demonstrates how the pandemic has negatively impacted UK surgical training. Mixing COVID-19 positive, unknown and negative cases did not significantly impact on outcomes and indicates that further research is required to support the implementation of evidence-based surgical pathways, such as COVID-light sites, throughout the next stage of the pandemic.
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Affiliation(s)
- Emma Toman
- Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Wai Cheong Soon
- Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, UK
| | - Gopiga Thanabalasundaram
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Daniel Burns
- Department of Infectious Diseases and Tropical Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Department of Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - Vladimir Petrik
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Colin Watts
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Cancer and Genomic Studies, University of Birmingham, Birmingham, UK
| | - Victoria Wykes
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Cancer and Genomics, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Anwen White
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Coleman JR, Abdelsattar JM, Glocker RJ. COVID-19 Pandemic and the Lived Experience of Surgical Residents, Fellows, and Early-Career Surgeons in the American College of Surgeons. J Am Coll Surg 2021; 232:119-135.e20. [PMID: 33069850 PMCID: PMC7561602 DOI: 10.1016/j.jamcollsurg.2020.09.026] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND To better understand how the COVID-19 pandemic has affected surgical trainees' and early-career surgeons' professional and personal experiences, a survey of the membership of the American College of Surgeons (ACS) Resident and Associate Society (RAS) and Young Fellows Association (YFA) was performed. STUDY DESIGN An anonymous online survey was disseminated to members of RAS and YFA. Descriptive analyses were performed and factors associated with depression and burnout were examined with univariate and multivariable stepwise logistic regression. RESULTS Of the RAS/YFA membership of 21,385, there were 1,160 respondents. The majority of respondents (96%) reported the COVID-19 pandemic having a negative impact on their clinical experience, with 84% of residents reporting a > 50% reduction in operative volume and inability to meet minimum case requirements. Respondents also reported negative impacts on personal wellness. Nearly one-third reported inadequate access to personal protective equipment, and depression and burnout were pervasive (≥21% of respondents reported yes to every screening symptom). On multivariable analysis, female sex (odds ratio [OR] 1.54 for depression, OR 1.47 for burnout) and lack of wellness resources (OR 1.55 for depression, OR 1.44 for burnout) predicted depression and burnout. Access to adequate personal protective equipment was protective against burnout (OR 0.52). CONCLUSIONS These data demonstrate a significant impact of the COVID-19 pandemic on the lives of residents and early-career surgeons. Actionable items from these data include mitigation of burnout and depression through increasing personal protective equipment access and provision of wellness programs, with a particular focus on high-risk groups.
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Affiliation(s)
| | | | - Roan J Glocker
- Department of Surgery, University of Rochester, Rochester, NY.
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Maduke T, Dorroh J, Bhat A, Krvavac A, Regunath H. Are We Coping Well with COVID-19?: A Study on Its Psycho-Social Impact on Front-line Healthcare Workers. MISSOURI MEDICINE 2021; 118:55-62. [PMID: 33551487 PMCID: PMC7861609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Global pandemics have a profound psycho-social impact on health systems and their impact on healthcare workers is under-reported. METHODS We performed a cross-sectional survey with 13 Likert-scale responses and some additional polar questions pertaining to dressing habits and learning in a university hospital in the midwest United States. Descriptive and analytical statistics were performed. RESULTS The 370 respondents (66.1% response rate, age 38.5±11.6 years; 64.9% female), included 102 supervising providers [96 (25.9%) physicians, 6 (1.6%) mid-level], 64 (17.3%) residents/fellows, 73 (19.7% nurses, 45 (12.2%) respiratory therapists, 31 (8.4%) therapy services and others: 12 (3.2%) case-managers, 4 (1.1%) dietitians, 39 (10.5%) unclassified]. Overall, 200 (54.1%) had increased anxiety, 115 (31.1%) felt overwhelmed, 159 (42.9%) had fear of death, and 281 (75.9%) changed dressing habits. Females were more anxious (70.7% vs. 56%, X2 (1, N=292)=5.953, p=0.015), overwhelmed (45.6% vs. 27.3%, X2 (1, N=273)=8.67, p=0.003) and suffered sleep disturbances (52% vs. 39%, X2 (1, N=312)=4.91, p=0.027). Administration was supportive; 243 (84.1%, N=289), 276 (74.5%) knew another co-worker with COVID-19, and only 93 (25.1%) felt healthcare employment was less favorable. Residents and fellows reported a negative impact on their training despite feeling supported by their program. CONCLUSION Despite belief of a supportive administration, over half of healthcare workers and learners reported increased anxiety, and nearly a third felt overwhelmed during this current pandemic.
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Affiliation(s)
- Tinashe Maduke
- Clinical Fellow, Department of Medicine, Division of Pulmonary, Critical Care and Environmental Medicine, University of Missouri-Columbia, (UMC), Columbia, Missouri
| | - James Dorroh
- Second-year Medical Student, Department of Medicine, UMC
| | | | - Armin Krvavac
- Assistant Professor, Department of Internal Medicine - Division of Pulmonary, Critical Care and Sleep Medicine, Saint Louis University, St. Louis, Missouri
| | - Hariharan Regunath
- Clinical Assistant Professor, Department of Medicine - Divisions of Pulmonary, Critical Care and Infectious Diseases-UMC
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Woodfin M, Bojikian KD, Taravati P, Ding L, Lee MD, Feng S. The Early Impact of COVID-19 on Ophthalmology Resident Training and Wellness. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2020. [DOI: 10.1055/s-0040-1721071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Abstract
Objective The aim of this article is to assess the initial impact of the coronavirus disease 2019 (COVID-19) pandemic on ophthalmology resident training and wellness.
Design Online national survey of ophthalmology residents distributed by residency program directors and education coordinators of participating programs.
Setting US ophthalmology residency programs during the COVID-19 pandemic (May 20th, 2020 to June 10th, 2020).
Participants Ophthalmology residents enrolled in the US residency programs currently in postgraduate years two through four of training.
Results Two-hundred thirty-six of 785 (30.1%) residents responded to the survey. One-hundred eighteen of 234 (50.4%) residents reported exposure to known COVID-19 positive patients, and of those exposed, 44 of 118 (37.2%) felt that they did not have adequate personal protective equipment. One-hundred ninety-five of 233 (83.7%) residents reported a decrease in primary surgical cases during the pandemic, with 68 (29.2%) reporting a loss of more than 50 primary cases. One-hundred sixty-four of 234 (70.1%) residents were concerned that the pandemic would negatively impact their surgical skills beyond residency, and 15% reported that they were more likely to pursue fellowship due to the pandemic. 31.0% of residents met criteria of burnout, 9.1% were depressed, and 13.4% had generalized anxiety. Concerns about COVID-19 infection were correlated with increased anxiety and burnout during the pandemic.
Conclusions The COVID-19 pandemic has decreased resident surgical and clinical volumes and has negatively impacted ophthalmology residency training. Residents with increased concern for contracting COVID-19 and those actively engaged in a job search had significantly higher odds of increased anxiety.
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Affiliation(s)
- Michael Woodfin
- Department of Ophthalmology, University of Washington, Seattle, Washington
| | - Karine D. Bojikian
- Department of Ophthalmology, University of Washington, Seattle, Washington
| | - Parisa Taravati
- Department of Ophthalmology, University of Washington, Seattle, Washington
| | - Leona Ding
- Department of Ophthalmology, University of Washington, Seattle, Washington
| | - Michele D. Lee
- Department of Ophthalmology, University of Washington, Seattle, Washington
| | - Shu Feng
- Department of Ophthalmology, University of Washington, Seattle, Washington
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Gonzi G, Gwyn R, Rooney K, Boktor J, Roy K, Sciberras NC, Pullen H, Mohanty K. The role of orthopaedic trainees during the COVID-19 pandemic and impact on post-graduate orthopaedic education: a four-nation survey of over 100 orthopaedic trainees. Bone Jt Open 2020; 1:676-682. [PMID: 33263107 PMCID: PMC7690758 DOI: 10.1302/2633-1462.111.bjo-2020-0095.r1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
AIMS The COVID-19 pandemic has had a significant impact on the provision of orthopaedic care across the UK. During the pandemic orthopaedic specialist registrars were redeployed to "frontline" specialties occupying non-surgical roles. The impact of the COVID-19 pandemic on orthopaedic training in the UK is unknown. This paper sought to examine the role of orthopaedic trainees during the COVID-19 and the impact of COVID-19 pandemic on postgraduate orthopaedic education. METHODS A 42-point questionnaire was designed, validated, and disseminated via e-mail and an instant-messaging platform. RESULTS A total of 101 orthopaedic trainees, representing the four nations (Wales, England, Scotland, and Northern Ireland), completed the questionnaire. Overall, 23.1% (23/101) of trainees were redeployed to non-surgical roles. Of these, 73% (17/23) were redeployed to intensive treatment units (ITUs), 13% (3/23) to A/E, and 13%(3/23%) to general medicine. Of the trainees redeployed to ITU 100%, (17/17) received formal induction. Non-deployed or returning trainees had a significant reduction in sessions. In total, 42.9% (42/101) % of trainees were not timetabled into fracture clinic, 53% (53/101) of trainees had one allocated theatre list per week, and 63.8%(64/101) of trainees did not feel they obtained enough experience in the attached subspecialty and preferred repeating this. Overall, 93% (93/101) of respondents attended at least one weekly online webinar, with 79% (79/101) of trainees rating these as useful or very useful, while 95% (95/101) trainees attended online deanery teaching which was rated as more useful than online webinars (p = 0.005). CONCLUSION Orthopaedic specialist trainees occupied an important role during the COVID-19 pandemic. COVID-19 has had a significant impact on orthopaedic training. It is imperative this is properly understood to ensure orthopaedic specialist trainees achieve competencies set out in the training curriculum.Cite this article: Bone Joint Open 2020;1-11:676-682.
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Affiliation(s)
- Gianluca Gonzi
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, UK
| | - Rhodri Gwyn
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, UK
| | - Kathryn Rooney
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, UK
| | - Joseph Boktor
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, UK
| | - Kunal Roy
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, UK
| | - Nadia C. Sciberras
- Department of Trauma and Orthopaedics, Queen Elizabeth University Hospital, Glasgow, UK
| | - Huw Pullen
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, UK
| | - Khitish Mohanty
- Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, UK
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Do-Nguyen CC, Hong JC, Luc JGY. The importance of mentorship and sponsorship for thoracic surgery residency applicants during the coronavirus disease 2019 (COVID-19) pandemic. J Thorac Cardiovasc Surg 2020; 161:S0022-5223(20)32451-X. [PMID: 32981704 PMCID: PMC7515560 DOI: 10.1016/j.jtcvs.2020.08.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/03/2020] [Accepted: 08/18/2020] [Indexed: 01/04/2023]
Affiliation(s)
| | - Jonathan C Hong
- Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital, Chicago, Ill
| | - Jessica G Y Luc
- Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
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Dearani JA, Stephens EH, Guleserian KJ, Overman DM, Backer CL, Romano JC, Louis JDS, Sarris GE, Bacha E, Tweddell JS. COVID-19: FAQs-Congenital Heart Surgery Recovery and Defining a "New Normal". World J Pediatr Congenit Heart Surg 2020; 11:548-556. [PMID: 32662334 PMCID: PMC7361125 DOI: 10.1177/2150135120934741] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 12/13/2022]
Abstract
As recovery of congenital heart surgery programs begins during this COVID-19 pandemic, we review key considerations such as screening, protection of patients and health care workers (HCWs), case prioritization, barriers to reactivation, redesign of patient care teams, contribution of telemedicine, modification of trainees' experiences, preparation for potential resurgence, and strategies to maintain HCW wellness. COVID-19 has tested the resolve and grit of our specialty and we have an opportunity to emerge more refined.
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Affiliation(s)
- Joseph A. Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Kristine J. Guleserian
- Department of Congenital Heart Surgery, Medical City Children’s
Hospital, Dallas, TX, USA
| | - David M. Overman
- Division of Cardiac Surgery, Children’s Minnesota, Minneapolis, MN,
USA
| | - Carl L. Backer
- Section of Pediatric Cardiothoracic Surgery, Kentucky Children’s
Hospital, Lexington, KY, USA
| | - Jennifer C. Romano
- Department of Cardiac Surgery, C. S. Mott Children’s Hospital, University of Michigan, Ann
Arbor, MI, USA
| | - James D. St Louis
- Department of Pediatric Cardiac Surgery, University of
Missouri–Kansas City School of Medicine, Kansas City, MO, USA
| | - George E. Sarris
- Department of Pediatric Heart Surgery, Athens Heart Surgery
Institute, Athens, Greece
| | - Emile Bacha
- Department of Surgery, Division of Cardiothoracic Surgery, Columbia University Irving Medical
Center/New York–Presbyterian, NY, USA
| | - James S. Tweddell
- Department of Surgery, Division of Cardiothoracic Surgery,
Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, OH,
USA
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47
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Bhamidipati CM, Song HK. Commentary: Adaptations to COVID-19 or permanent reforms in the "new normal"? J Thorac Cardiovasc Surg 2020; 160:988-989. [PMID: 32811677 PMCID: PMC7314668 DOI: 10.1016/j.jtcvs.2020.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Castigliano M Bhamidipati
- Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health & Science University, Portland, Ore
| | - Howard K Song
- Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health & Science University, Portland, Ore.
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48
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Stephens EH. Commentary: COVID-19: "There is no education like adversity". J Thorac Cardiovasc Surg 2020; 160:989-990. [PMID: 32624304 PMCID: PMC7834009 DOI: 10.1016/j.jtcvs.2020.05.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 10/28/2022]
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