1
|
Elmohamady B, Omar M, El-Dakhakhny AS, Sayedahmed K, Ghazwani Y, Bin Hamri S, Alkhayal A, Alrabeeah K, Kamal W, Abbasy M, Farahat Y, Noureldin YA. Effects of first year COVID-19 pandemic on urology practice in three major Arab Countries: Sub-Analysis of a survey by Arab association of urology research group. PLoS One 2024; 19:e0293458. [PMID: 38236912 PMCID: PMC10796057 DOI: 10.1371/journal.pone.0293458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 10/13/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The World Health Organization (WHO) declared the coronavirus disease-19 (COVID-19) pandemic on March 11, 2020. The health care system faced tremendous challenges in providing ethical and high-quality care. The impact of COVID-19 on urological practices varied widely worldwide, including in Arab countries. This study aimed to compare the influence of the COVID-19 pandemic on urology practice in Egypt, the KSA, and the UAE during the first year of the pandemic. METHODS This sub-analysis assessed the demographics and COVID-19's effects on urological practice in terms of adjustments to hospital policy, including outpatient consultations, the management of elective and urgent surgical cases, and the continuation of education across the three countries. The availability of personal protective equipment (PPE) and urologists' emotional, physical, and verbal intimidation during COVID-19 were also compared. RESULTS Regarding the impact on hospital policy, consultations replaced by telemedicine were significantly higher in the KSA (36.15%), followed by the UAE (33.3%), then Egypt (10.4%) (P = 0.008). Elective cases requiring ICU admission were 65.1% in Egypt, 45.2% in the KSA, and 58.2% in the UAE and were performed only in high-risk patients. PPE was freely available in 20.8% of the Egyptian hospitals compared to 83.3% in the KSA and 81.8% in the UAE. Online courses were significantly higher in Egypt (70.8%), followed by the UAE (53%) and the KSA (41.7%) (P = 0.02). Emotional intimidation was higher than verbal intimidation, representing 80%, 75.9%, and 76% in the UAE, KSA, and Egypt, respectively. CONCLUSION This sub-analysis outlined significant hospital policy changes across the three Arab countries. Exposure to emotional, verbal, and physical intimidation was observed. The development of teleconsultations and online platforms for educational purposes was observed.
Collapse
Affiliation(s)
- Basheer Elmohamady
- Department of Urology, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Mohamed Omar
- Department of Urology, Menoufiya University Hospital, Menoufiya, Egypt
| | - Amr S. El-Dakhakhny
- Department of Urology, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Khalid Sayedahmed
- Department of Urology, Menoufiya University Hospital, Menoufiya, Egypt
| | - Yahia Ghazwani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, KSA
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, KSA
| | - Saeed Bin Hamri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, KSA
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, KSA
| | - Abdullah Alkhayal
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, KSA
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, KSA
| | - Khalid Alrabeeah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, KSA
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, KSA
| | - Wissam Kamal
- Department of Urology, King Fahd Hospital, Jeddah, KSA
| | - Mohamed Abbasy
- Emergency Medicine Department, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Yasser Farahat
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
- Urology Department, Sheikh Khalifa General Hospital, Umm Al Quwain, UAE
| | - Yasser A. Noureldin
- Department of Urology, Benha Faculty of Medicine, Benha University, Benha, Egypt
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, KSA
- Urology Department, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| |
Collapse
|
2
|
Cheng C, Papadakos J, Umakanthan B, Fazelzad R, Martimianakis MA(T, Ugas M, Giuliani ME. On the advantages and disadvantages of virtual continuing medical education: a scoping review. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:41-74. [PMID: 37465741 PMCID: PMC10351643 DOI: 10.36834/cmej.75681] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Introduction With the COVID-19 pandemic, most continuing medical education activities became virtual (VCME). The authors conducted a scoping review to synthesize the advantages and disadvantages of VCME to establish the impact of this approach on inequities that physicians face along the intersections of gender, race, and location of practice. Methods Guided by the methodological framework of Arksey and O'Malley, the search included six databases and was limited to studies published between January 1991 to April 2021. Eligible studies included those related to accredited/non-accredited post-certification medical education, conferences, or meetings in a virtual setting focused on physicians. Numeric and inductive thematic analyses were performed. Results 282 studies were included in the review. Salient advantages identified were convenience, favourable learning formats, collaboration opportunities, effectiveness at improving knowledge and clinical practices, and cost-effectiveness. Prominent disadvantages included technological barriers, poor design, cost, lack of sufficient technological skill, and time. Analysis of the studies showed that VCME was most common in the general/family practice specialty, in suburban settings, and held by countries in the Global North. A minority of studies reported on gender (35%) and race (4%). Discussion Most studies report advantages of VCME, but disadvantages and barriers exist that are contextual to the location of practice and medical subspecialty. VCME events are largely organized by Global North countries with suboptimized accessibility for Global South attendees. A lack of reported data on gender and race reveals a limited understanding of how VCME affects vulnerable populations, prompting potential future considerations as it evolves.
Collapse
Affiliation(s)
| | - Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Ontario, Canada
- The Institute for Education Research, University Health Network, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, University of Toronto, Ontario, Canada
| | - Ben Umakanthan
- Cancer Education Program, Princess Margaret Cancer Centre, Ontario, Canada
| | - Rouhi Fazelzad
- Library and Information Sciences, Princess Margaret Cancer Centre, Ontario, Canada
| | | | - Mohamed Ugas
- Cancer Education Program, Princess Margaret Cancer Centre, Ontario, Canada
| | - Meredith Elana Giuliani
- Cancer Education Program, Princess Margaret Cancer Centre, Ontario, Canada
- The Institute for Education Research, University Health Network, Ontario, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, Ontario, Canada
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
- The Wilson Centre, University Health Network, Ontario, Canada
| |
Collapse
|
3
|
The Impact of COVID-19 on Surgical Training and Education. Cancers (Basel) 2023; 15:cancers15041267. [PMID: 36831609 PMCID: PMC9954522 DOI: 10.3390/cancers15041267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
The COVID-19 pandemic disrupted conventional medical education for surgical trainees with respect to clinical training, didactics, and research. While the effects of the COVID-19 pandemic on surgical trainees were variable, some common themes are identifiable. As hordes of COVID-19 patients entered hospitals, many surgical trainees stepped away from their curricula and were redeployed to other hospital units to care for COVID-19 patients. Moreover, the need for social distancing limited traditional educational activities. Regarding clinical training, some trainees demonstrated reduced case logs and decreased surgical confidence. For residents, fellows, and medical students alike, most didactic education transitioned to virtual platforms, leading to an increase in remote educational resources and an increased emphasis on surgical simulation. Resident research productivity initially declined, although the onset of virtual conferences provided new opportunities for trainees to present their work. Finally, the pandemic was associated with increased anxiety, depression, and substance use for some trainees. Ultimately, we are still growing our understanding of how the COVID-19 pandemic has redefined surgical training and how to best implement the lessons we have learned.
Collapse
|
4
|
Surgical education in the post-COVID era: an EAES DELPHI-study. Surg Endosc 2022; 37:2719-2728. [PMID: 36451042 PMCID: PMC9713174 DOI: 10.1007/s00464-022-09762-1] [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: 07/11/2022] [Accepted: 11/06/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUNDS To date, it is unclear what the educational response to the restrictions on minimally invasive surgery imposed by the COVID-19 pandemic have been, and how MIS-surgeons see the post-pandemic future of surgical education. Using a modified Delphi-methodology, this study aims to assess the effects of COVID on MIS-training and to develop a consensus on the educational response to the pandemic. METHODS A three-part Delphi study was performed among the membership of the European Association of Endoscopic Surgery (EAES). The first survey aimed to survey participants on the educational response in four educational components: training in the operating room (OR), wet lab and dry lab training, assessment and accreditation, and use of digital resources. The second and third survey aimed to formulate and achieve consensus on statements on, and resources in, response to the pandemic and in post-pandemic MIS surgery. RESULTS Over 247 EAES members participated in the three rounds of this Delphi survey. MIS-training decreased by 35.6-55.6%, alternatives were introduced in 14.7-32.2% of respondents, and these alternatives compensated for 32.2-43.2% of missed training. OR-training and assessments were most often affected due to the cancellation of elective cases (80.7%, and 73.8% affected, respectively). Consensus was achieved on 13 statements. Although digital resources were deemed valuable alternatives for OR-training and skills assessments, face-to-face resources were preferred. Videos and hands-on training-wet labs, dry labs, and virtual reality (VR) simulation-were the best appreciated resources. CONCLUSIONS COVID-19 has severely affected surgical training opportunities for minimally invasive surgery. Face-to-face training remains the preferred training method, although digital and remote training resources are believed to be valuable additions to the training palette. Organizations such as the EAES are encouraged to support surgical educators in implementing these resources. Insights from this Delphi can guide (inter)national governing training bodies and hospitals in shaping surgical resident curricula in post pandemic times.
Collapse
|
5
|
Bredella MA, Rubio DM, Attia J, Kelly TH, McIntosh S, Meagher EA, Pusek S, Rubio M, Tsevat J, Umans JG. The Virtual CTSA Visiting Scholar Program to Support Early-Stage Clinical and Translational Researchers: Implementation and Outcomes. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1311-1316. [PMID: 35263302 PMCID: PMC10732303 DOI: 10.1097/acm.0000000000004645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In addition to restrictions on conducting research, COVID-19-related travel bans and scientific meeting cancellations have negatively affected scholars in the Clinical and Translational Science Award (CTSA) Mentored Career Development Award (KL2) program. In response, a national virtual visiting scholar program was developed to provide opportunity for KL2 scholars to be virtual visiting professors at another CTSA hub, meet faculty and scholars, and expand networks and build collaborations. This article describes the design and short-term outcomes of the virtual CTSA Visiting Scholar Program. In 2020, a working group designed core program elements and developed an application and selection process. Anonymized surveys were sent to scholars post visit and to scholars and program directors 6 months post visit to evaluate their experience and solicit suggestions for improvements. Between November 2020 and May 2021, 56 KL2 scholars and 27 hubs participated. Forty-five (80.4%) participating scholars responded to the initial survey. Nearly all scholars (44, 97.7%) agreed their experience was valuable. All respondents indicated they would recommend the program to other KL2 scholars. For the 6-month survey, the response rate was 87.5% (49/56). Within 6 months of their visit, 36 (73.5%) respondents had contacted at least one person at the host hub and for 17 (34.7%) respondents, new collaborations with the host hub ensued. Twenty-five of 27 (92.6%) host hubs responded to the survey. Most (21, 84.0%) agreed that hearing visiting scholar talks was valuable to their own scholars and 23 (92%) indicated likelihood of their hub participating in future round of the program. The virtual Visiting Scholar Program provided KL2 scholars an opportunity to virtually visit another CTSA hub, present their research, and meet with faculty and other scholars to expand their networks. Although geared to KL2 scholars, this model is potentially generalizable to other nationally coordinated career development programs.
Collapse
Affiliation(s)
- Miriam A Bredella
- M.A. Bredella is professor of radiology, vice chair, Department of Radiology, Massachusetts General Hospital, and director, KL2/Catalyst Medical Research Investigator Training Program, Harvard Catalyst, The Harvard Clinical and Translational Science Center, Harvard Medical School, Boston, Massachusetts
| | - Doris M Rubio
- D.M. Rubio is professor of medicine, biostatistics, bioinformatics, and clinical and translational science, assistant vice chancellor for clinical research education and training, Health Sciences, director, Institute for Clinical Research Education, and director, KL2, Team Science, and Workforce Development, Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jacqueline Attia
- J. Attia is health project coordinator, Center for Leading Innovation and Collaboration, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Thomas H Kelly
- T.H. Kelly is Robert Straus Professor and chair, Department of Behavioral Science, College of Medicine, associate dean for research and PhD faculty affairs, College of Nursing, and director, KL2 and Workforce Development, Center for Clinical and Translational Science, University of Kentucky, Lexington, Kentucky
| | - Scott McIntosh
- S. McIntosh is associate professor and survey team faculty lead, Center for Leading Innovation and Collaboration, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Emma A Meagher
- E.A. Meagher is professor of medicine and pharmacology, director, Translational Research Education, Institute for Translational Medicine and Therapeutics, and vice dean, Clinical Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Susan Pusek
- S. Pusek is director, Education Programs, North Carolina TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mercedes Rubio
- M. Rubio is program director, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland
| | - Joel Tsevat
- J. Tsevat is professor of medicine, Joaquin G. Cigarroa, Jr., MD, Distinguished Chair, director, ReACH Center, director, KL2 Program, University of Texas Health Science Center at San Antonio, and professor of population health, Dell Medical School, University of Texas at Austin, and Institute for the Integration of Medicine and Science, Center for Research to Advance Community Health, Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Jason G Umans
- J.G. Umans is KL2 program director, Georgetown-Howard Universities Center for Clinical and Translational Science, associate professor of medicine and of obstetrics and gynecology, Georgetown University, Washington, DC, scientific director, Biomarker, Biochemistry and Biorepository Core, and scientific director, Field Studies Division, MedStar Health Research Institute, Hyattsville, Maryland
| |
Collapse
|
6
|
Telehealth in Trans and Gender Diverse Communities: the Impact of COVID-19. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2022; 11:75-80. [PMID: 35463051 PMCID: PMC9016376 DOI: 10.1007/s13669-022-00334-7] [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] [Accepted: 03/18/2022] [Indexed: 11/18/2022]
Abstract
Purpose of Review This paper synthesizes current knowledge regarding telehealth and the impact of the SARS-COV2 pandemic on transgender and gender diverse (TGD) patients. We discuss the benefits and challenges of telehealth for patients, providers, and trainees. Recent Findings Mental health of TGD populations has been disproportionately challenged in the context of SARS-COV2, and telehealth interventions focused on gender affirmation and mental health are desired and acceptable by TGD populations. Summary Telehealth in the era of SARS-COV-2 has a mixed impact on TGD patients and families, increasing access, decreasing travel time, and allowing for comfort and safety during care while also leaving gaps in care for patients without web/phone access and/or without a confidential place to participate in appointments, or to manage health concerns that require in-person evaluation. Providers have benefitted from the ability to reach TGD patients that are far from practice sites and to provide remote consultation for procedures and other interventions. Trainees have challenges as a result of telehealth practice which can impair the ability to learn in-person care, but have benefitted from remote training opportunities, including surgical training. Alterations in compensation structures have allowed sustainable telehealth practice to be an option for providers and health systems. As telehealth evolves, quality improvement and research efforts aimed at resolving known challenges and expanding beneficial uses of telehealth should consistently include and consider not only the beneficiaries of telehealth but also those who may struggle with access.
Collapse
|
7
|
Ng M, Chamileke N, Mapulanga V, Campain N, Payne S. The benefits of virtual learning webinars to both low and high-income countries. BJU Int 2022; 129:434-441. [PMID: 35128806 DOI: 10.1111/bju.15705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
Abstract
The 2019 Covid pandemic has brought about many changes in the relationships between high income countries (HICs) and partner organisations in low or low-middle income countries (LMICs), such as predominate in sub-Saharan Africa. Medicine, surgery and in particular urology is no exception to the changes that Covid-19 has demanded. Urolink represents the British Association of Urological Surgeons (BAUS) on the global urology stage and has been deleteriously impacted by the pandemic. Education, one of the pillars of Urolink's founding philosophies, has conventionally been delivered by face-to face (F2F) teaching, training or mentoring by UK urologists at their host's site outside of the United Kingdom (UK). As a consequence of the inability to travel due to the pandemic, BAUS Urolink has evolved a virtual online webinar package evolved by, and delivered between, urologists in Lusaka, Zambia, and various centres in the United Kingdom. The aim was to deliver curricular-based educational topics to trainees in both countries. This programme has generated a number of live webinars, and archived recordings, during the pandemic that has proven accessible, and educationally acceptable, to trainees in the UK and Zambia. This webinar series has also generated relationships between young urologists on different continents, given each a different view of healthcare delivery outside of their country of origin at no appreciable cost, and would appear to be an educational mechanism that is durable for, and applicable to, a wider participation in the post-pandemic world.
Collapse
|