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Mohammadi E, Smith L, Khan AF, Lee B, Spencer O, Muhammad F, Villeneuve LM, Dunn IF, Smith ZA. Post-pandemic paradigm shift toward telemedicine and tele-education; an updated survey of the impact of Covid-19 pandemic on neurosurgery residents in United States. World Neurosurg X 2024; 23:100326. [PMID: 38497059 PMCID: PMC10937949 DOI: 10.1016/j.wnsx.2024.100326] [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: 07/20/2023] [Accepted: 02/21/2024] [Indexed: 03/19/2024] Open
Abstract
Background Several strategies were implemented during the Covid-19 pandemic to enhance residency training and patient care. Objective This study aims to assess the post-pandemic landscape of neurosurgical training and practice. Method A survey consisting of 28 questions examining the challenges faced in neurosurgery and the adaptive measures was conducted among US neurosurgery residents from May 2022 to May 2023. Results This study encompassed 59 neurosurgical residents, predominantly male (72.9%) and in later years of training (66.1%) and were distributed across 25 states. Telemedicine and tele-education were pivotal during the pandemic, with virtual lecture series, standalone lectures, and virtual discussions highly favored. Remote didactic learning increased for nearly half of the residents, while 54.2% resumed in-person instruction. Telemedicine was deemed effective by 86.4% for evaluating neurosurgical patients. Access to teaching environments was restricted for 61.0% of residents, impacting their training. The pandemic significantly influenced elective surgeries, with complete cancellations reported by 42.4%. Reduced faculty engagement was noted by 35.6% of residents, while 47.5% reported a negative impact on the overall resident experience. The majority (76.3%) considered changes to their training reasonable given the global health situation. Conclusions Strategies implemented during the peak of the pandemic remain crucial in shaping neurosurgery training. Telemedicine has become indispensable, with widespread adoption. Tele-education has also expanded, providing additional learning opportunities. However, traditional didactic courses and hands-on experiences remain essential for comprehensive training. Balancing technology-driven methods with established approaches is crucial for optimizing neurosurgical education and maintaining high-quality patient care.
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Affiliation(s)
- Esmaeil Mohammadi
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Lonnie Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ali F. Khan
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Benjamin Lee
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Oslin Spencer
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Fauziyya Muhammad
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Lance M. Villeneuve
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ian F. Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Zachary A. Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Liu W, Wei H, Wang C, Hua Z. Resilience and adaptation: a mixed-methods exploration of COVID-19's influence on neonatal residency education in China. BMC MEDICAL EDUCATION 2024; 24:654. [PMID: 38862921 PMCID: PMC11167867 DOI: 10.1186/s12909-024-05638-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND This study aimed to assess the impact of the pandemic of the coronavirus disease 2019 (COVID-19) on neonatology residency training in a tertiary children's hospital in Chongqing, located in southwest China. Specifically, the study encompassed the effects on residents' education, lived experiences, well-being, and the quality of neonatal care delivered. As higher educational institutions adapt to the post-COVID-19 era after the pandemic disruption, it is imperative that educational designers/academics learn from their experiences and challenges in curriculum design and delivery, ensuring quality and relevance in education. METHODS This study employed a mixed-methods approach to investigate the influence of the COVID-19 pandemic on neonatology residency training at a tertiary children's hospital in Chongqing. The first phase surveyed residents' perceptions and experiences of their clinical education and well-being during the crisis. The second phase compared the quality of neonatal care between the pre-pandemic and pandemic periods. RESULTS The survey of 123 neonatology residents examines the effects of COVID-19 on their learning, training, and mental health. The survey showed that most residents adapted well to the situation. Still, some faced challenges in their clinical education and experiences, such as reduced clinical exposure and opportunities to see rare diseases and conditions. A retrospective analysis of clinical data revealed that 7,151 neonates were admitted to the neonatology department during the study period. There was a 27.6% decrease in neonatal admissions during COVID-19, with more premature births and transfers. Residents conducted fewer clinical procedures but managed more complex cases. During COVID, hospital stays and costs were higher, but antibiotic use was lower. Although the case-mix index (CMI) score increased during the pandemic (1.25 vs. 1.18, p < 0.05), there was no significant difference in the rates of readmission within 7 days or poor prognosis. CONCLUSIONS Despite reduced clinical exposure, the quality of neonatal care was maintained through innovative training methods that enhanced comprehensive residency programs. The study suggested that neonatology residency education remained effective and resilient during the crisis. Exceptional health professional education is vital to train qualified physicians and enhance healthcare systems for future challenges.
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Affiliation(s)
- Weiqin Liu
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
- Faculty of Internal Medicine, The Pediatric College, Chongqing Medical University, Chongqing, China
- National Demonstration Base for Standardized Residency Training, Chongqing, China
| | - Hong Wei
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China
- Faculty of Internal Medicine, The Pediatric College, Chongqing Medical University, Chongqing, China
| | - Chunyi Wang
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Demonstration Base for Standardized Residency Training, Chongqing, China
| | - Ziyu Hua
- Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China.
- Faculty of Internal Medicine, The Pediatric College, Chongqing Medical University, Chongqing, China.
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Gerk A, Naus A, Carroll M, Ponte L, Salgado LS, Marrazzo E, Secanho M, Botelho F, Mooney D, Ferreira R, Ferreira JL. Perceived Impact of Coronavirus Disease 2019 on Surgical Training: A Brazilian Survey. J Surg Res 2024; 295:619-630. [PMID: 38101108 DOI: 10.1016/j.jss.2023.10.023] [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: 02/06/2023] [Revised: 09/22/2023] [Accepted: 10/27/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Recent studies revealed that coronavirus disease 2019 (COVID-19) negatively impacted residency programs worldwide, particularly procedure-based programs. However, most studies are from high-income countries, with scarce data from low- and middle-income countries. Pandemic effects on surgical training were likely worse in strictly apprenticeship models relying heavily on surgical volume as opposed to competency-based programs. Notably, training programs in Brazil and other low- and middle-income countries follow these strict apprenticeship style frameworks. In this study, we aimed to evaluate the trainees' perceptions of the impact of COVID-19 on their Brazilian surgical programs. METHODS A cross-sectional study was performed using an anonymous survey in Portuguese, distributed via social media platforms to surgical residents enrolled in Brazilian surgery programs. Data collection took place from August 2021 to May 2022. The survey contained 30 questions on the perception of the impact of COVID-19 on surgical training. RESULTS One-hundred sixty-two residents from 17 different surgical specialties and all five regions of Brazil responded to the survey. Of 162 residents, 145 (89%) believed the pandemic negatively impacted their surgical training. Furthermore, of 162 residents, 153 (94%) reported that elective surgical volume decreased during the pandemic and 91 (56%) were redeployed to assist with COVID-19 management. As a result, 102 of 162 (63%) residents believed their surgical skills were negatively impacted by COVID-19. Yet, 95 of 162 (59%) residents reported their residency programs did not offer resources to mitigate the pandemic's impact on training. Of 162 residents, 57 (35%) reported they did not feel on track for graduation, with no statistical difference between responses by year of residency (P = 0.083). Additionally, 124 of 162 (77%) residents reported that the pandemic negatively affected their mental health, most commonly related to stress at work, stress about transmitting COVID-19, and loss in surgical training. CONCLUSIONS Most of the surveyed Brazilian surgical residents felt the COVID-19 pandemic negatively impacted their training. This leads to believe that the detrimental impacts of the pandemic exposed preexisting weaknesses in the Brazilian surgical training model's dependence on a strict apprenticeship model. Our findings suggest a crucial need to redesign surgical education programs to make residency programs more prepared for changes in surgical volume, evolve the apprenticeship model to competency-based approaches, and unify surgical training standards in low- and middle-income countries.
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Affiliation(s)
- Ayla Gerk
- Universidad Católica Argentina, Buenos Aires, Argentina; Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts
| | - Abbie Naus
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts
| | - Madeleine Carroll
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts
| | - Lucas Ponte
- School of Medicine, University of Fortaleza, Fortaleza, Ceará, Brazil
| | | | - Enzzo Marrazzo
- Faculty of Medicine, Institute of Biological Sciences, Pontifícia Universidade Católica de Minas Gerais Poços de Caldas, Poços de Caldas, Minas Gerais, Brazil
| | - Murilo Secanho
- Faculty of Medical Sciences of Botucatu, UNESP Botucatu, Botucatu, São Paulo, Brazil
| | - Fabio Botelho
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Childrens' Hospital, McGill University, Montreal, Quebec, Canada
| | - David Mooney
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts
| | - Roseanne Ferreira
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Júlia Loyola Ferreira
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Childrens' Hospital, McGill University, Montreal, Quebec, Canada.
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Susan Caswell M, Lieffers JR, Wojcik J, Eisenbraun C, Buccino J, Hanning RM. COVID-19 Pandemic Effects on Job Search and Employment of Graduates (2015-2020) of Canadian Dietetic Programmes. CAN J DIET PRACT RES 2023; 84:200-210. [PMID: 37115016 DOI: 10.3148/cjdpr-2023-004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Purpose: Self-reported coronavirus 2019 (COVID-19) pandemic effects on dietetic job search, employment, and practice of recent graduates were explored within a national workforce survey.Methods: Graduates (2015-2020) who were registered/licensed dietitians or eligible to write the Canadian Dietetic Registration Exam were recruited through dietetic programmes, Dietitians of Canada's communication channels, and social media. The online survey, available in English and French from August through October 2020, included questions about pandemic experiences. Descriptive statistics and thematic analysis were applied to closed and open-ended responses, respectively.Results: Thirty-four percent of survey respondents (n = 524) indicated pandemic effects on job search and described delayed entry into dietetics, fewer job opportunities, and challenges including restricted work between sites. The pandemic affected employment for 44% of respondents; of these, 45% indicated working from home, 45% provided virtual counselling, 7% were redeployed within dietetics, 14% provided nondietetic COVID-19 support, and 6% were furloughed or laid off. Changed work hours, predominantly reduced, were identified by 29%. Changes in pay, identified by 12%, included loss (e.g., raises deferred) or gain (e.g., pandemic pay). Fear of infection and stress about careers and finances were expressed.Conclusion: The COVID-19 pandemic profoundly affected both acquiring positions and employment in 2020 for recent dietetic graduates.
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Affiliation(s)
- M Susan Caswell
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
| | - Jessica R Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
| | | | | | | | - Rhona M Hanning
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
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Ghosh P, Kurian AT, Velmurugan D, Tharumaraj M. Impact of COVID-19 pandemic on surgical residency: Residents' perception. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:398. [PMID: 38333163 PMCID: PMC10852176 DOI: 10.4103/jehp.jehp_252_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/28/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND World Health Organization declared COVID-19 outbreak a pandemic, and till the month of March 2023, globally, there have been 761,402,282 confirmed cases of COVID-19, including 6887,000 deaths. In India, almost 44,707,525 cases been recorded till date. Here, almost 30,000,000 cases been recorded after the second wave. The working force fighting this pandemic is majority formed by resident doctors all over the country and globally. MATERIALS AND METHODS This study was conducted among 110 residents pursuing postgraduation in surgery and allied departments in various training institutions in Tamil Nadu for a duration of 6 months (after the second wave). A pretested and validated questionnaire was formulated to assess the effect of COVID-19 pandemic on surgical trainee's residency program from their perspective. The questionnaire contained basic social-demographic details and general information like the details of surgical specialty they are admitted to, the overall details of changes in their surgical residency experience in the times of COVID pandemic and the changes faced by them in their day-to-day clinical, diagnostic, and surgical learning. The questionnaire also investigated the redeployment status of the surgical trainees to COVID treatment units and their perspective on the changes in their clinical research and surgical skills training. RESULTS The study participants, 66%, were aged between 25 and 30 years, followed by 30 and 35 years (25.5%). Almost 80% of the participants belong to the final year of postgraduation; 67.3% of surgical trainees strongly perceives and all 100% of them accept the fact that their surgical residency has been affected by the ongoing pandemic. Fifty percent of the trainees were redeployed to COVID duties for 8 h a day shift and rest attended a minimum of 4 h of COVID duties. More than 75% of the residents had COVID duties of 5-10 h/day and more than 90% of these redeployed trainees involved in COVID duties have expressed that they had been suffering from extra stress and more than 60% were suffering from stress grade between 5 and 10 suggestive of high-stress level. Fifty-nine percent of the postgraduates in the current study mentioned that they require extra-surgical or skill-based training after their postgraduation period. CONCLUSION The influence of COVID-19 on surgical trainees in various institutions of India has been immense due to overburdening of health systems by the large population of the country. Second wave of COVID, especially, has drastically changed the postgraduate surgical trainees' lives. Detrimental effects are not restricted to operative and clinical experience but also the mental health and well-being of them. The observations of the present study make recommendations for the future provision of training through skill-based surgical simulations so that the lost days of their trainings can be compensated and they become the confident surgeons of the future.
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Affiliation(s)
- Puja Ghosh
- Department of Otorhinolaryngology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
| | - Andrew Thomas Kurian
- Department of Otorhinolaryngology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
| | - Dinesh Velmurugan
- Department of Otorhinolaryngology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
| | - Muthukumar Tharumaraj
- Department of Community Medicine, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
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Kuo CC, Aguirre AO, Kassay A, Donnelly BM, Bakr H, Aly M, Ezzat AA, Soliman MA. A look at the global impact of COVID-19 pandemic on neurosurgical services and residency training. SCIENTIFIC AFRICAN 2023; 19:e01504. [PMID: 36531434 PMCID: PMC9747235 DOI: 10.1016/j.sciaf.2022.e01504] [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: 10/28/2022] [Revised: 11/18/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Background The COVID-19 pandemic has left an indelible effect on healthcare delivery and education system, including residency training. Particularly, neurosurgical departments worldwide had to adapt their operating model to the constantly changing pandemic landscape. This review aimed to quantify the reduction in neurosurgical operative volume and describe the impact of these trends on neurosurgical residency training. Methods We performed a comprehensive search of PubMed and EMBASE between December 2019 and October 2022 to identify studies comparing pre-pandemic and pandemic neurosurgical caseloads as well as articles detailing the impact of COVID-19 on neurosurgery residency training. Statistical analysis of quantitative data was presented as pooled odds ratio (OR) and 95% confidence intervals (CI). Results A total of 49 studies met the inclusion criteria, of which 12 (24.5%) were survey-based. The case volume of elective surgeries and non-elective procedures decreased by 70.4% (OR=0.296, 95%CI 0.210-0.418) and 68.2% (OR=0.318, 95%CI 0.193-0.525), respectively. A significant decrease was also observed in functional (OR=0.542, 95%CI 0.394-0.746), spine (OR=0.545, 95%CI 0.409-0.725), and skull base surgery (OR=0.545, 95%CI 0.409-0.725), whereas the caseloads for tumor (OR=1.029, 95%CI 0.838-1.263), trauma (OR=1.021, 95%CI 0.846-1.232), vascular (OR=1.001, 95%CI 0.870-1.152), and pediatric neurosurgery (OR=0.589, 95%CI 0.344-1.010) remained relatively the same between pre-pandemic and pandemic periods. The reduction in caseloads had caused concerns among residents and program directors in regard to the diminished clinical exposure, financial constraints, and mental well-being. Some positives highlighted were rapid adaptation to virtual educational platforms and increasing time for self-learning and research activities. Conclusion While COVID-19 has brought about significant disruptions in neurosurgical practice and training, this unprecedented challenge has opened the door for technological advances and collaboration that broaden the accessibility of resources and reduce the worldwide gap in neurosurgical education.
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Affiliation(s)
- Cathleen C. Kuo
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA
| | - Alexander O. Aguirre
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA
| | - Andrea Kassay
- Department of Neurosurgery, Western University, Windsor, Canada
| | - Brianna M. Donnelly
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | | | - Mohamed Aly
- Department of Radiology, National Heart Institute, Giza, Egypt
| | - Ahmed A.M. Ezzat
- Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed A.R. Soliman
- Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA,Corresponding author at: Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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Evans AZ, Adhaduk M, Jabri AR, Ashwath ML. Is Virtual Learning Here to Stay? A Multispecialty Survey of Residents, Fellows, and Faculty. Curr Probl Cardiol 2023; 48:101641. [PMID: 36773945 PMCID: PMC9911980 DOI: 10.1016/j.cpcardiol.2023.101641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
The transition to virtual learning during the coronavirus disease 2019 pandemic marks a paradigm shift in graduate medical education (GME). From June to September 2021, we conducted a dual-center, multispecialty survey of residents, fellows, and faculty members to determine overall perceptions about virtual learning and assess its benefits, drawbacks, and future role in GME. We discovered a mainly positive view of virtual education among trainees (138/207, 0.67, 95% CI 0.59-0.73) and faculty (180/278, 0.65, 0.59-0.70). Large group sessions, such as didactic lectures, grand rounds, and national conferences, were ranked best-suited for the virtual environment, whereas small groups and procedural training were the lowest ranked. Major benefits and drawbacks to virtual learning was identified. A hybrid approach, combining in-person and virtual sessions, was the preferred format among trainees (167/207, 0.81, 0.75-0.86) and faculty (229/278, 0.82, 0.77-0.87). Virtual learning offers a valuable educational experience that should be retained in postpandemic GME curriculums.
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Affiliation(s)
- Aron Z Evans
- Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Mehul Adhaduk
- Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Ahmad R Jabri
- Heart and Vascular Center, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
| | - Mahi L Ashwath
- Division of Cardiovascular Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA.
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Bresadola V, Brollo PP, Muschitiello D, Quattrin R. General Surgery Training and One Year of COVID-19. What Has Been the Impact on Residents' Operating Room Surgical Activity? A Report From an Italian Academic Hospital. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231169361. [PMID: 37064213 PMCID: PMC10102928 DOI: 10.1177/23821205231169361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND In the last year and a half, the COVID-19 pandemic has put great pressure on the healthcare systems of many countries, Italy included, leading to a reorganization of hospital activities and a dramatic reduction in surgical activity. Our study aimed to evaluate, from a quantitative and qualitative perspective, the impact of this reduction on the formation of surgery residents at the Academic Hospital of Udine. METHODS We compared the resident's surgical activity during the pandemic year (March 2020-2021) with the one during the pre-pandemic year, declining the surgical procedures by timing, type, and complexity and categorizing the residents by postgraduate year (PGY) and surgical role. RESULTS Our analysis highlighted how the main reductions occurred in the elective and medium complexity surgery due to the procrastination of benign pathologies such as hernias, cholelithiasis, and hemorrhoids, which also appeared to be the more frequent cases where the residents are first operators. On the other hand, the residents of the last PGY still maintained a good exposure to neoplasm and high complexity interventions, which are cardinal aspects in the last year of formation. CONCLUSIONS These results mostly confirmed the critical points noted by the resident surgeons themselves, highlighting however the specific impact on different PGY and surgical activities, offering a starting point to better understand how to challenge the negative effect that the COVID-19 pandemic has had on the surgical resident formation.
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Affiliation(s)
- Vittorio Bresadola
- Department of Medicine, General Surgery
Department and Simulation Center, Academic Hospital of Udine, University of Udine,
Udine, Italy
| | - Pier Paolo Brollo
- Department of Medicine, General Surgery
Department and Simulation Center, Academic Hospital of Udine, University of Udine,
Udine, Italy
| | - Davide Muschitiello
- Department of Medicine, General Surgery
Department and Simulation Center, Academic Hospital of Udine, University of Udine,
Udine, Italy
| | - Rosanna Quattrin
- Department of Organization of Hospital
Services, Academic Hospital of Udine, Udine, Italy
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Joshi S, Khan M, Jelen MB, Pandit AS. Current Attitudes Toward Neuroanatomy: A Comparative Cross-Sectional Survey of Neurosurgeons from the United Kingdom and Worldwide. World Neurosurg 2022; 166:e607-e623. [PMID: 35868505 DOI: 10.1016/j.wneu.2022.07.054] [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: 05/09/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE How attitudes toward neuroanatomy and preferences of studying resources vary among neurosurgeons is unknown. The impact of the coronavirus disease 2019 (COVID-19) pandemic on anatomy learning habits is also yet to be elucidated. In this study, we explore these objectives, to guide the development of future neurosurgeon-tailored anatomy education and resources. METHODS This was a 2-stage, cross-sectional study design comprising a local pilot survey followed by a structured 17-item questionnaire, distributed to both neurosurgical trainees and consultants. Grade and nationality differences in sentiment agreement were statistically compared. RESULTS A total of 365 responses were received from 32 countries (overall response rate, 23.2%). Neuroanatomy is highly regarded among most neurosurgeons and takes a central role in their professional identity. Yet, 69% of neurosurgeons wanted to spend more time learning. Common study prompts included perceived operative complexity, lack of familiarity and teaching. Financial barriers and motivation were obstacles limiting neuroanatomy learning, more so among trainee neurosurgeons, with personal commitment barriers significantly varying with geographic location. Surgical relevance, accessibility, and image quality were important factors when selecting anatomy resources, with cost and up-to-datedness being important for juniors. The COVID-19 pandemic saw a shift toward virtual resources, particularly affecting United Kingdom-based trainees. CONCLUSIONS Although neuroanatomy is well regarded, barriers exist that impede further neuroanatomy learning. Neurosurgical training programs should tailor anatomy education according to the seniority and background of their residents. Furthermore, resources that are surgically relevant and accessible and are of high image quality are more likely to be better used.
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Affiliation(s)
- Shivani Joshi
- University College London Medical School, University College London, London, United Kingdom
| | - Mehdi Khan
- University College London Medical School, University College London, London, United Kingdom
| | - Maria B Jelen
- Department of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Anand S Pandit
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
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Bruening DM, Truckenmueller P, Stein C, Fuellhase J, Vajkoczy P, Picht T, Acker G. 360° 3D virtual reality operative video for the training of residents in neurosurgery. Neurosurg Focus 2022; 53:E4. [DOI: 10.3171/2022.5.focus2261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Training of residents is an essential but time-consuming and costly task in the surgical disciplines. During the coronavirus disease 2019 pandemic, surgical education became even more challenging because of the reduced caseload due to the increased shift to corona care. In this context, augmented 360° 3D virtual reality (VR) videos of surgical procedures enable effective off-site training through virtual participation in the surgery. The goal of this study was to establish and evaluate 360° 3D VR operative videos for neurosurgical training.
METHODS
Using a 360° camera, the authors recorded three standard neurosurgical procedures: a lumbar discectomy, brain metastasis resection, and clipping of an aneurysm. Combined with the stereoscopic view of the surgical microscope, 7- to 10-minute 360° 3D VR videos augmented with annotations, overlays, and commentary were created. These videos were then presented to the neurosurgical residents at the authors’ institution using a head-mounted display. Before viewing the videos, the residents were asked to fill out a questionnaire indicating their VR experience and self-assessment of surgical skills regarding the specific procedure. After watching the videos, the residents completed another questionnaire to evaluate their quality and usefulness. The parameters were scaled with a 5-point Likert scale.
RESULTS
Twenty-two residents participated in this study. The mean years of experience of the participants in neurosurgery was 3.2 years, ranging from the 1st through the 7th year of training. Most participants (86.4%) had no or less than 15 minutes of VR experience. The overall quality of the videos was rated good to very good. Immersion, the feeling of being in the operating room, was high, and almost all participants (91%) stated that 360° VR videos provide a useful addition to the neurosurgical training. VR sickness was negligible in the cohort.
CONCLUSIONS
In this study, the authors demonstrated the feasibility and high acceptance of augmented 360° 3D VR videos in neurosurgical training. Augmentation of 360° videos with complementary and interactive content has the potential to effectively support trainees in acquiring conceptual knowledge. Further studies are necessary to investigate the effectiveness of their use in improving surgical skills.
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Affiliation(s)
| | | | - Christian Stein
- Cluster of Excellence: “Matters of Activity. Image Space Material,” Humboldt University, Berlin
- gamelab.berlin, Cluster of Excellence: “Matters of Activity. Image Space Material,” Humboldt University, Berlin
| | - Josch Fuellhase
- Department of Neurosurgery, Charité–Universitätsmedizin Berlin
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité–Universitätsmedizin Berlin
| | - Thomas Picht
- Department of Neurosurgery, Charité–Universitätsmedizin Berlin
- Cluster of Excellence: “Matters of Activity. Image Space Material,” Humboldt University, Berlin
- Berlin Simulation and Training Center (BeST), Charité–Universitätsmedizin Berlin; and
| | - Gueliz Acker
- Department of Neurosurgery, Charité–Universitätsmedizin Berlin
- Berlin Institute of Health, BIH Academy, Clinician Scientist Program, Charité–Universitätsmedizin Berlin, Germany
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11
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Uche EO, Sundblom J, Iloabachie I, Ozoh II, Alalade A, Revesz D, Sandvik U, Olsson M, Mezue WC, Tisell M, Ryttlefors M. Pilot application of Lecture-Panel-Discussion Model (LPDM) in global collaborative neurosurgical education: a novel training paradigm innovated by the Swedish African Neurosurgery Collaboration. Acta Neurochir (Wien) 2022; 164:967-972. [PMID: 35059854 PMCID: PMC8776360 DOI: 10.1007/s00701-021-05071-z] [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: 09/04/2021] [Accepted: 11/14/2021] [Indexed: 11/29/2022]
Abstract
Background Disruptions in global surgery educational routines by the COVID-19 pandemic have elicited demands for alternative formats for rendering qualitative neurosurgical education. This study presents application of a novel model of online neurosurgical course, the Lecture-Panel-Discussion Model (LPDM). Methods This is a cross-sectional survey of participants who attended the Swedish African Neurosurgery Collaboration (SANC)-100A course. Participants evaluated the course through an online self-administered questionnaire using a 5-point Likert scale ranging from very poor—1, poor—2, average (fair)—3, good—4, to excellent—5. SANC-100A comprises a tripod of Lectures, Panel review, and interactive case Discussion. This model (LPDM) was innovated by SANC and applied at the Enugu International Neurosurgery course in February 2021. Results There were 71 attendees, 19 were course faculty, while 52 were participants. Thirty-five attended from Nigeria, 11 from Sweden, 3 from Malawi, 2 from Senegal, and 1 from the UK. Among 44 participants who completed the questionnaire, there were 9 fellows and 35 residents. The overall median course Likert rating was 4.65 ± 0.1. The median overall rating for course events was similar between day 1 (Likert score = 4.45) and day 2 (Likert score = 4.55), U = 55, Z score = 1.10, P = 0.27. The median rating for lectures was 4.50 ± 0.2 and varied from 4.40 on day 1 to 4.55 on day 2. The median rating for panel review was 4.60 ± 0.1 and varied from 4.55 on day 1 to 4.65 on day 2. Interactive case discussions were rated 4.80 on both course days. There was a significant variability in the rating profiles of the course tripod: U = 24.5, P = 0.03. Fifty-one (98%) participants believe LPDM was COVID-19-compliant, while 90% believe the course was beneficial to training and practice. Conclusion Initial application of LPDM is rewarded with both high acceptance and high rating among participants.
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12
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Zhang JK, Del Valle A, Ivankovic S, Patel N, Alexopoulos G, Khan M, Durrani S, Patel M, Tecle NE, Sujijantarat N, Jenson AV, Zammar SG, Huntoon K, Goulart CR, Wilkinson BM, Bhimireddy S, Britz GW, DiLuna M, Prevedello DM, Dinh DH, Mattei TA. Educational impact of early COVID-19 operating room restrictions on neurosurgery resident training in the United States: A multicenter study. NORTH AMERICAN SPINE SOCIETY JOURNAL 2022; 9:100104. [PMID: 35224520 PMCID: PMC8856749 DOI: 10.1016/j.xnsj.2022.100104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 12/19/2022]
Abstract
Background The coronavirus (COVID-19) pandemic has caused unprecedented suspensions of neurosurgical elective surgeries, a large proportion of which involve spine procedures. The goal of this study is to report granular data on the impact of early COVID-19 pandemic operating room restrictions upon neurosurgical case volume in academic institutions, with attention to its secondary impact upon neurosurgery resident training. This is the first multicenter quantitative study examining these early effects upon neurosurgery residents caseloads. Methods A retrospective review of neurosurgical caseloads among seven residency programs between March 2019 and April 2020 was conducted. Cases were grouped by ACGME Neurosurgery Case Categories, subspecialty, and urgency (elective vs. emergent). Residents caseloads were stratified into junior (PGY1-3) and senior (PGY4-7) levels. Descriptive statistics are reported for individual programs and pooled across institutions. Results When pooling across programs, the 2019 monthly mean (SD) case volume was 214 (123) cases compared to 217 (129) in January 2020, 210 (115) in February 2020, 157 (81), in March 2020 and 82 (39) cases April 2020. There was a 60% reduction in caseload between April 2019 (207 [101]) and April 2020 (82 [39]). Adult spine cases were impacted the most in the pooled analysis, with a 66% decrease in the mean number of cases between March 2020 and April 2020. Both junior and senior residents experienced a similar steady decrease in caseloads, with the largest decreases occurring between March and April 2020 (48% downtrend). Conclusions Results from our multicenter study reveal considerable decreases in caseloads in the neurosurgical specialty with elective adult spine cases experiencing the most severe decline. Both junior and senior neurosurgical residents experienced dramatic decreases in case volumes during this period. With the steep decline in elective spine cases, it is possible that fellowship directors may see a disproportionate increase in spine fellowships in the coming years. In the face of the emerging Delta and Omicron variants, programs should pay attention toward identifying institution-specific deficiencies and developing plans to mitigate the negative educational effects secondary to such caseloads reduction.
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Affiliation(s)
- Justin K Zhang
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Armando Del Valle
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Sven Ivankovic
- Department of Neurological Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, 61605, US
| | - Niel Patel
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Georgios Alexopoulos
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Maheen Khan
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Sulaman Durrani
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Mayur Patel
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Najib El Tecle
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | | | - Amanda V Jenson
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, Texas, 77030, US
| | - Samer G Zammar
- Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania, 17033, US
| | - Kristin Huntoon
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Carlos R Goulart
- Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, 13210, US
| | - Brandon M Wilkinson
- Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, 13210, US
| | - Sujit Bhimireddy
- Department of Neurological Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, 61605, US
| | - Gavin W Britz
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, Texas, 77030, US
| | - Michael DiLuna
- Department of Neurosurgery, Yale University, New Haven, Connecticut, 06510, USA
| | - Daniel M Prevedello
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Dzung H Dinh
- Department of Neurological Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, 61605, US
| | - Tobias A Mattei
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
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13
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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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14
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Zuckerman SL, Chanbour H, Haizel-Cobbina J, Chambless LB, Chitale RV, Dewan MC. Neurosurgery Residency Education in the Post-COVID-19 Era: Planning for the Future. World Neurosurg 2022; 158:312-313. [PMID: 35922971 PMCID: PMC8828363 DOI: 10.1016/j.wneu.2021.11.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Scott L Zuckerman
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Hani Chanbour
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Joseline Haizel-Cobbina
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lola B Chambless
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Rohan V Chitale
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Michael C Dewan
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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15
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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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16
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Abdelsattar JM, Coleman JR, Nagler A, Shabahang M, Ellison EC, Baker Y, Stain SC, Matthews JB, Dent D, Blair P, Britt LD, Sachdeva AK, Spanknebel K. Lived Experiences of Surgical Residents During the COVID-19 Pandemic: A Qualitative Assessment. JOURNAL OF SURGICAL EDUCATION 2021; 78:1851-1862. [PMID: 34045160 PMCID: PMC8101794 DOI: 10.1016/j.jsurg.2021.04.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/29/2021] [Indexed: 05/07/2023]
Abstract
OBJECTIVE As the COVID-19 pandemic dynamically changes our society, it is important to consider how the pandemic has affected the training and wellness of surgical residents. Using a qualitative study of national focus groups with general surgery residents, we aim to identify common themes surrounding their personal, clinical, and educational experiences that could be used to inform practice and policy for future pandemics and disasters. DESIGN Six 90-minute focus groups were conducted by a trained qualitative researcher who elicited responses on six predetermined topics. De-identified transcripts and audio recordings were later analyzed by two independent researchers who organized responses to each topic into themes. SETTING Focus groups were conducted virtually and anonymously. PARTICIPANTS General surgery residents were recruited from across the country. Demographic information of potential participants was coded, and subjects were randomly selected to ensure a diverse group of participants. RESULTS The impact of the COVID-19 pandemic on residents' clinical, educational, and personal experiences varied depending on the institutional response of the program and the burden of COVID-19 cases geographically. Many successes were identified: the use of telehealth and virtual didactics, an increased sense of camaraderie amongst residents, and flexibility in scheduling. Many challenges were also identified: uncertainty at work regarding personal protective equipment and scheduling, decreased case volume and educational opportunities, and emotional trauma and burnout associated with the pandemic. CONCLUSIONS These data gathered from our qualitative study highlight a clear, urgent need for thoughtful institutional planning and policies for the remainder of this and future pandemics. Residency programs must ensure a balanced training program for surgical residents as they attempt to master the skills of their craft while also serving as employed health care providers in a pandemic. Furthermore, a focus on wellness, in addition to clinical competency and education, is vital to resident resilience and success in a pandemic setting.
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Affiliation(s)
- Jad M Abdelsattar
- West Virginia University, Department of Surgery, Morgantown, West Virginia
| | - Julia R Coleman
- University of Colorado, Department of Surgery, Aurora, Colorado
| | - Alisa Nagler
- The American College of Surgeons, Division of Education, Chicago, Illinois
| | - Mohsen Shabahang
- The Geisinger Health System, Department of Surgery, Danville, Pennsylvania
| | | | - Yekaterina Baker
- The American College of Surgeons, Division of Education, Chicago, Illinois
| | - Steven C Stain
- Lahey Hospital and Medical Center, Department of Surgery, Burlington, Massachusetts
| | | | - Daniel Dent
- University of Texas Health San Antonio Long School of Medicine, Department of Surgery, San Antonio, Texas
| | - Patrice Blair
- The American College of Surgeons, Division of Education, Chicago, Illinois
| | - L D Britt
- Eastern Virginia University, Department of Surgery, Norfolk, Virginia
| | - Ajit K Sachdeva
- The American College of Surgeons, Division of Education, Chicago, Illinois
| | - Kathryn Spanknebel
- New York Medical College, School of Medicine, Department of Surgery, Valhalla, New York.
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17
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Lund S, Hinduja P, Stulak J, Elli E, Mishra N, Farres H, Rivera M. Impact of Elective Case Postponement Secondary to COVID-19 on General Surgery Residents' Experience: Operative Cases Logged at Three Academic Teaching Hospitals. JOURNAL OF SURGICAL EDUCATION 2021; 78:1863-1867. [PMID: 34120880 PMCID: PMC8635496 DOI: 10.1016/j.jsurg.2021.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/30/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study aims to characterize changes in the total operative cases logged by general surgery residents across three residency programs. DESIGN Retrospective cohort study. De-identified case logs, divided by institution and post graduate year (PGY) level, were obtained from the general surgery training programs at three academic hospitals. Total cases logged were calculated over the pandemic period (start: beginning of residency, end: May 31st, 2020) and the control period (start: beginning of residency, end: May 31st, 2019). SETTING Three academic tertiary hospitals (Mayo Clinic - Arizona, Mayo Clinic - Florida, and Mayo Clinic - Rochester) PARTICIPANTS: All general surgery residents at these three hospitals, including 25 residents at Mayo Clinic - Arizona in both the pandemic and control period, 16 and 15 residents at Mayo Clinic - Florida in the control and pandemic period, respectively, and 81 and 77 residents at Mayo Clinic - Rochester in the control and pandemic period, respectively. RESULTS Only PGY 4 general surgery residents at Mayo Clinic - Rochester had a decrease in operative cases logged in the pandemic period (759 cases on average compared to 1010 cases, p = 0.005), with no other changes in operative cases logged noted. CONCLUSIONS While elective cases were postponed secondary to the COVID-19 pandemic for around 1 month in the spring of 2020, the decrease in elective cases did not greatly impact overall resident operative cases logged for residents in three general surgery residency programs.
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Affiliation(s)
- Sarah Lund
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Pranav Hinduja
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - John Stulak
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - Enrique Elli
- Department of General Surgery, Mayo Clinic, Jacksonville, Florida
| | - Nitin Mishra
- Department of Colon and Rectal Surgery, Mayo Clinic, Phoenix, Arizona
| | - Houssam Farres
- Department of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Florida
| | - Mariela Rivera
- Division of Trauma, Critical Care, and General Surgery, Mayo Clinic, Rochester, Minnesota.
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18
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Kolikonda MK, Blaginykh E, Brown P, Kovi S, Zhang LQ, Uchino K. Virtual Rounding in Stroke Care and Neurology Education During the COVID-19 Pandemic - A Residency Program Survey. J Stroke Cerebrovasc Dis 2021; 31:106177. [PMID: 34798435 PMCID: PMC8514647 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE During the coronavirus disease 2019 (COVID-19) pandemic, we instituted virtual inpatient stroke rounds and acute stroke evaluations via telemedicine in the emergency department. We sought to explore trainees' and experienced providers' views on stroke care and education. METHODS The implementation and the survey took place at a single academic comprehensive stroke center in northeast Ohio in the United States. "Virtual rounding" consisted of patient presentation and discussion in the morning in on-line virtual team format followed by in-person patient rounds in small groups. Acute stroke evaluations in the emergency department included direct in-person evaluation by neurology residents with supervision over telemedicine.The neurology residents, stroke fellows, stroke nurse practitioners, and stroke staff physicians were surveyed 2 months after implementation. Quantitative data was analyzed using descriptive statistical analysis, written responses in comment sections were analyzed using content analysis. RESULTS Thirty-two of 42 (73%) surveys were completed. Nine (45%) residents and 5 (42%) experienced providers responded that virtual rounds did not compromise learning and education on stroke service. Fifteen (75%) residents and all experienced providers agreed that virtual rounds protected caregivers from exposure to the virus. While more than a third of residents (37%) did not feel comfortable utilizing telemedicine in ED, the majority of experienced providers (89%) were at ease with it. A total of 58% of residents and 67% of experienced providers felt that they were spending less time at the bedside, and 42% of residents and 58% of experienced providers felt less connected to patients during the pandemic. CONCLUSION Majority of neurology residents' experience was not positive utilising telemedicine as compared to other staff providers. This is likely attributed to lack of prior exposure and unpreparedness. Incorporation of telemedicine curricula in medical school and residency training could prepare the next generation physicians to effectively use these technologies and meet the growing need for telehealth services for current and future pandemics.
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Affiliation(s)
- Murali K Kolikonda
- Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Elena Blaginykh
- Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Peter Brown
- Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Shivakrishna Kovi
- Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Lucy Q Zhang
- Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Ken Uchino
- Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States.
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The impact of the COVID-19 pandemic on global neurosurgical education: a systematic review. Neurosurg Rev 2021; 45:1101-1110. [PMID: 34623526 PMCID: PMC8497188 DOI: 10.1007/s10143-021-01664-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/22/2021] [Accepted: 09/30/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has disrupted neurosurgical training worldwide, with the shutdown of academic institutions and the reduction of elective surgical procedures. This impact has disproportionately affected LMICs (lower- and/or middle-income countries), already burdened by a lack of neurosurgical resources. Thus, a systematic review was conducted to examine these challenges and innovations developed to adapt effective teaching and learning for medical students and neurosurgical trainees. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and The Cochrane Handbook of Systematic Reviews of Interventions. MEDLINE, PubMed, Embase and Cochrane databases were accessed, searching and screening literature from December 2019 to 5th December 2020 with set inclusion and exclusion criteria. Screening identified 1254 articles of which 26 were included, providing data from 96 countries. Twenty-three studies reported transition to online learning, with 8 studies also mentioned redeployment into COVID wards with 2 studies mentioning missed surgical exposure as a consequence. Of 7 studies conducted in LMICs, 3 reported residents suffering financial insecurities from reduced surgical caseload and recession. Significant global disruption in neurosurgical teaching and training has arisen from the COVID-19 pandemic. Decreased surgical exposure has negatively impacted educational provision. However, advancements in virtual technology have allowed for more affordable, accessible training especially in LMICs. Using this, initiatives to reduce physical and mental stress experienced by trainees should be paramount.
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Costa F, Servadei F. Webinar During COVID-19 Pandemic: Necessity or Uncontrolled Phenomena? World Neurosurg 2021; 154:186. [PMID: 34583482 PMCID: PMC8529613 DOI: 10.1016/j.wneu.2021.07.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Francesco Costa
- Department of Neurosurgery, Humanitas Clinical and Research Center, IRCCS, Rozzano (MI), Italy; Department of Biomedical Science, Humanitas University, Pieve Emanuele (MI), Italy.
| | - Franco Servadei
- Department of Neurosurgery, Humanitas Clinical and Research Center, IRCCS, Rozzano (MI), Italy; Department of Biomedical Science, Humanitas University, Pieve Emanuele (MI), Italy
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21
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Nugroho SW, Pradhana I, Gunawan K. New adaptation of neurosurgical practice and residency programs during the Covid-19 pandemic and their effects on neurosurgery resident satisfaction and welfare at the National General Hospital, Jakarta, Indonesia. Heliyon 2021; 7:e07757. [PMID: 34458606 PMCID: PMC8379449 DOI: 10.1016/j.heliyon.2021.e07757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/17/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Many institutions in numerous countries have made changes in their health care services during the COVID-19 pandemic. One change has been to reduce elective neurosurgery cases, which has impacted neurosurgery education. Published literature is lacking about the healthcare services, education, and residents’ well-being during adaptation to the pandemic, especially in national referral hospitals in developing countries. Methods We conducted a cross-sectional study on current neurosurgical services during 2020. We evaluated 34 neurosurgery residents in Cipto Mangunkusumo National General Hospital using a self-made questionnaire to determine the effects of the COVID-19 pandemic on their surroundings, education process, and satisfaction with the currently adapted education program. We used the modified Maslach Burnout Inventory to assess burnout in the residents before and during the pandemic. Results Neurosurgical residents spent more time studying neurosurgical theory (Mode 1–1.5h/day, p < 0.05) but spent less time learning neurosurgical skills (Mode 30 min–1 h/day, p < 0.05) compared to before the pandemic. The resident satisfaction mean score (scale 0–10) was 7.58 for live surgery and 8.53 for the microsurgical skills lab training program. On a scale of 1–10, the residents’ stress level increased after the pandemic but the change was not statistically significant (6.61 ± 1.87, p > 0.05). The Modified Maslach Burnout inventory score was 3.02 ± 3.74 during the pandemic, and increased from before the pandemic (2.41 ± 3.18), but the difference was not statistically significant. Conclusion The COVID-19 pandemics have reduced the working hours and the clinical exposure of neurosurgical residents. Fortunately, this pandemic has led to a new opportunity to find many suitable learning methods which may decrease the risk of burnout. The psychological burden of residents is still worrisome, and planned management is necessary to sustain resident performance.
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Affiliation(s)
- Setyo Widi Nugroho
- Department of Neurosurgery, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ivan Pradhana
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Kevin Gunawan
- Department of Neurosurgery, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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22
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Awadallah NS, Czaja AS, Fainstad T, McNulty MC, Jaiswal KR, Jones TS, Rumack CM. The impact of the COVID-19 pandemic on family medicine residency training. Fam Pract 2021; 38:i9-i15. [PMID: 34448487 PMCID: PMC8414919 DOI: 10.1093/fampra/cmab012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Family physicians have played a unique clinical role during the COVID-19 pandemic. We hypothesized that the pandemic would be associated with significant deleterious effects on clinical activity, educational training, personal safety and well-being. OBJECTIVE We conducted a national survey to obtain preliminary data that would assist in future targeted data collection and subsequent evaluation of the impact of the pandemic on family medicine residents and teaching faculty. METHODS An anonymous online survey of residents and faculty was distributed via the Association of Family Medicine Residency Directors list serve between 5/21/2020 and 6/18/2020. Survey questions focused on clinical and educational activities, safety and well-being. RESULTS One hundred and fifty-three residents and 151 teaching faculty participated in the survey. Decreased clinical activity was noted by 81.5% of residents and 80.9% of faculty and the majority began conducting telehealth visits (97.9% of residents, 91.0% of faculty). Distance learning platforms were used by all residents (100%) and 39.6% noted an overall positive impact on their education. Higher levels of burnout did not significantly correlate with reassignment of clinical duties (residents P = 0.164; faculty P = 0.064). Residents who showed significantly higher burnout scores (P = 0.035) and a decline in levels of well-being (P = 0.031) were more likely to participate in institutional well-being support activities. CONCLUSIONS Our preliminary data indicate that family medicine residents and teaching faculty were profoundly affected by the COVID-19 pandemic. Future studies can be directed by current findings with focus on mitigation factors in addressing globally disruptive events such as COVID-19.
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Affiliation(s)
- Nida S Awadallah
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Graduate Medical Education, University of Colorado School of Medicine, Aurora, CO, USA
| | - Angela S Czaja
- Department of Pediatrics, Critical Care Division, University of Colorado School of Medicine, Aurora, CO, USA
| | - Tyra Fainstad
- Department of Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Monica C McNulty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO, USA
| | - Kshama R Jaiswal
- Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA
| | - Teresa S Jones
- Department of Graduate Medical Education, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA
| | - Carol M Rumack
- Department of Graduate Medical Education, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA
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23
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Rivera-Chavarría JP, Gutierrez-Lopez C, Castro-Cordero JA, Jimenez-Ramirez G. Impact of COVID-19 on the surgical volume of general surgery residents as main surgeons in a National Training Program in Costa Rica: A cross-sectional study. Medicine (Baltimore) 2021; 100:e27041. [PMID: 34449488 PMCID: PMC8389926 DOI: 10.1097/md.0000000000027041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT To quantify the impact of coronavirus disease 19 (COVID-19) on the surgical volume of residents' medical practice in Costa Rica's General Surgery Residency Program.The COVID-19 pandemic has caused a significant disruption in people's lives. Health systems worldwide have been forced to adapt to the new normal, which has posed a challenge for medical residency programs, especially in the surgical field.This transversal study includes the surgical records of all residents of the General Surgery program who worked as main surgeons at the Mexico Hospital of the Costa Rican Social Security between December 23, 2019, and June 25, 2020.As main surgeons, a total of 10 residents performed 291 pre-pandemic surgeries and 241 pandemic surgeries.When comparing the distribution of procedures performed by residency levels, it is observed that the postgraduate year -2 increased the number of procedures performed during the pandemic period (pre-pandemic 19% vs pandemic 27%, P = .028). There was no statistically significant difference between the pre-pandemic and pandemic periods in the remaining levels.When comparing the procedures by unit, a statistically significant decrease was observed in the Endocrine-Abdominal Wall Unit (pre-pandemic 18.3% vs pandemic 5.4%, P < .001). Conversely, a statistically significant increase was identified in Surgical Emergencies Unit procedures (40.0% vs post 51.7%, P = .007). No statistically significant differences were observed in the remaining the Units.The COVID-19 pandemic had no statistically significant effect on surgeries performed by residents of the General Surgery Residency Program as main surgeons in a national training center in Costa Rica. The Department's timely measures and pro-resident attitude were the key reasons for the above results.
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Affiliation(s)
- Jose Pablo Rivera-Chavarría
- Health Services Administration. Colorectal Surgeon, Mexico Hospital, Caja Costarricense Seguro Social. Professor of General Surgery, University of Costa Rica, Department of General Surgery, Hospital México, La Uruca, San José, Costa Rica
| | | | | | - Gustavo Jimenez-Ramirez
- Department of General Surgery, Mexico Hospital, Caja Costarricense Seguro Social, University of Costa Rica, San José, Costa Rica
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24
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Purdy AC, de Virgilio C, Kaji AH, Shields Frey E, Lee-Kong S, Inaba K, Gauvin JM, Neville AL, Donahue TR, Smith BR, Salcedo ES, Calhoun KE, Poola VP, Namm JP, Spain DA, Dickinson KJ, Tanner T, Wolfe M, Amersi F. Factors Associated With General Surgery Residents' Operative Experience During the COVID-19 Pandemic. JAMA Surg 2021; 156:767-774. [PMID: 33929493 DOI: 10.1001/jamasurg.2021.1978] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Importance The suspension of elective operations in March 2020 to prepare for the COVID-19 surge posed significant challenges to resident education. To mitigate the potential negative effects of COVID-19 on surgical education, it is important to quantify how the pandemic influenced resident operative volume. Objective To examine the association of the pandemic with general surgical residents' operative experience by postgraduate year (PGY) and case type and to evaluate if certain institutional characteristics were associated with a greater decline in surgical volume. Design, Setting, and Participants This retrospective review included residents' operative logs from 3 consecutive academic years (2017-2018, 2018-2019, and 2019-2020) from 16 general surgery programs. Data collected included total major cases, case type, and PGY. Faculty completed a survey about program demographics and COVID-19 response. Data on race were not collected. Operative volumes from March to June 2020 were compared with the same period during 2018 and 2019. Data were analyzed using Kruskal-Wallis test adjusted for within-program correlations. Main Outcome and Measures Total major cases performed by each resident during the first 4 months of the pandemic. Results A total of 1368 case logs were analyzed. There was a 33.5% reduction in total major cases performed in March to June 2020 compared with 2018 and 2019 (45.0 [95% CI, 36.1-53.9] vs 67.7 [95% CI, 62.0-72.2]; P < .001), which significantly affected every PGY. All case types were significantly reduced in 2020 except liver, pancreas, small intestine, and trauma cases. There was a 10.2% reduction in operative volume during the 2019-2020 academic year compared with the 2 previous years (192.3 [95% CI, 178.5-206.1] vs 213.8 [95% CI, 203.6-223.9]; P < .001). Level 1 trauma centers (49.5 vs 68.5; 27.7%) had a significantly lower reduction in case volume than non-level 1 trauma centers (33.9 vs 63.0; 46%) (P = .03). Conclusions and Relevance In this study of operative logs of general surgery residents in 16 US programs from 2017 to 2020, the first 4 months of the COVID-19 pandemic was associated with a significant reduction in operative experience, which affected every PGY and most case types. Level 1 trauma centers were less affected than non-level 1 centers. If this trend continues, the effect on surgical training may be even more detrimental.
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Affiliation(s)
- Amanda C Purdy
- Department of Surgery, Harbor-University of California, Los Angeles Medical Center, Torrance
| | - Christian de Virgilio
- Department of Surgery, Harbor-University of California, Los Angeles Medical Center, Torrance
| | - Amy H Kaji
- Department of Emergency Medicine, Harbor-University of California, Los Angeles Medical Center, Torrance.,Statistical Editor, JAMA Surgery
| | - Edgar Shields Frey
- Department of Surgery, Brookwood Baptist Medical Center, Birmingham, Alabama
| | - Steven Lee-Kong
- Department of Surgery, Columbia University Medical Center, New York, New York
| | - Kenji Inaba
- Department of Surgery, University of Southern California/Los Angeles County Medical Center, Los Angeles
| | - Jeffrey M Gauvin
- Department of Surgery, Santa Barbara Cottage Hospital, Santa Barbara, California
| | - Angela L Neville
- Department of Surgery, Harbor-University of California, Los Angeles Medical Center, Torrance
| | - Timothy R Donahue
- Department of Surgery, University of California, Los Angeles Health, Los Angeles
| | - Brian R Smith
- Department of Surgery, University of California, Irvine, Medical Center, Orange
| | - Edgardo S Salcedo
- Department of Surgery, University of California, Davis, School of Medicine, Sacramento
| | | | - V Prasad Poola
- Department of Surgery, Southern Illinois School of Medicine, Springfield
| | - Jukes P Namm
- Department of Surgery, Loma Linda University Health, Loma Linda, California
| | - David A Spain
- Department of Surgery, Stanford University, Stanford, California
| | | | - Tiffany Tanner
- Department of Surgery, University of Nebraska Medical Center, Omaha
| | - Mary Wolfe
- Department of Surgery, University of California, San Francisco, at Fresno, Fresno
| | - Farin Amersi
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
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25
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Almufarriji R, Elarjani T, Abdullah J, Alobaid A, Alturki AY, Aldakkan A, Ajlan A, Lary A, Al Jehani H, Algahtany M, Alqahatani S, Alsubaie F. Impact of COVID-19 on Saudi Neurosurgery Residency: Trainers' and Trainees' Perspectives. World Neurosurg 2021; 154:e547-e554. [PMID: 34325024 PMCID: PMC8461645 DOI: 10.1016/j.wneu.2021.07.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 12/23/2022]
Abstract
Introduction After the official announcement of the coronavirus disease-19 pandemic on March 11, 2020, the disease impacted most aspects of health care delivery, especially postgraduate education and training. Method A cross-sectional, online questionnaire-based assessment was performed. The study participants involved neurosurgery residents and program directors (PDs) across the country between May 16 and May 27, 2020. Results Approximately 74 of 95 (77.9%) of the residents experienced an impact on their training calendar. Before the pandemic, 51 residents (53.3%) were involved in 2–3 surgeries per week, but during the pandemic, 66 (69.5%) were attending 0–1 case per week. Fifty-three residents (55.8%) agreed that academic sessions were affected despite the helpful effort of online teaching sessions. Thirty-four (35.8%) residents graded their anxiety during coronavirus disease-19 times as high. Ten PDs (58.8%) confirmed spending 3–5 hours per week on educational activities normally, whereas during the pandemic, 15 PDs (88.2%) reduced their educational hours to 0–2 hours per week. Conclusion Our study showed that educational activities significantly decreased and shifted toward virtual teaching methods. Operative volume showed a substantial reduction for both junior and senior residents. Academic and clinical teaching was the main concern for PDs, and they faced challenges interviewing newly matched residents.
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Affiliation(s)
- Razan Almufarriji
- Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Turki Elarjani
- Neurosurgery Division, Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Jamal Abdullah
- Neurosurgery Department, Prince Sultan Military Hospital, Riyadh, Saudi Arabia
| | - Abdullah Alobaid
- Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.
| | - Abdulrahman Y Alturki
- Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman Aldakkan
- Neurosurgery Department, King Khaled University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrazag Ajlan
- Neurosurgery Department, King Khaled University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Lary
- Neurosurgery Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Hosam Al Jehani
- Neurosurgery Department, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Alkhobar, Saudi Arabia
| | - Mubarak Algahtany
- Neurosurgery Division, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Saad Alqahatani
- Neurosurgery Department, King Abdulaziz Medical City, National Guard, Riyadh, Saudi Arabia
| | - Fahd Alsubaie
- Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
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26
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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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27
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The Impact of the Coronavirus Pandemic on European Neurosurgery Trainees. World Neurosurg 2021; 154:e283-e291. [PMID: 34252632 PMCID: PMC8461641 DOI: 10.1016/j.wneu.2021.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/05/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has placed tremendous strain on the national health care systems throughout Europe. As a result, there has been a significant influence on residents' education. We surveyed European neurosurgery residents to estimate the magnitude of the pandemic's impact on neurosurgical training. METHODS An anonymous, voluntary, 44-question, web-based survey was administered to European neurosurgical residents from November 2, 2020, to January 15, 2021, by e-mail invitation. Close-ended, multiple-choice questions were used to examine the perspectives of neurosurgical trainees of different training programs in Europe regarding the pandemic's impact on education, as well as to evaluate the online webinars as a sufficient alternative educational tool, and their future role. RESULTS The total number of participants was 134 from 22 European countries. Nearly 88.8 % of respondents reported that the pandemic had a negative influence on their education. A statically significant decrease in surgical exposure, outpatient clinic involvement, and working hours was observed (P < 0.05). Webinars, although widely disseminated, were not considered as a sufficient training alternative. CONCLUSIONS The SARS-CoV-2 pandemic had a significant impact on neurosurgical training. During the last year, with the outbreak of the pandemic, formal training education was heavily compromised. Online webinars do not seem to be a sufficient alternative, and some trainees estimate that a whole year of training has been compromised. Our current data have to be cautiously considered for possibly reorganizing the whole training experience. The pandemic may well function as a stimulus for optimizing neurosurgical training.
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28
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Clements JM, Burke JR, Hope C, Nally DM, Doleman B, Giwa L, Griffiths G, Lund JN. The quantitative impact of COVID-19 on surgical training in the United Kingdom. BJS Open 2021; 5:6309263. [PMID: 34169311 PMCID: PMC8226285 DOI: 10.1093/bjsopen/zrab051] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/05/2021] [Indexed: 12/20/2022] Open
Abstract
Background COVID-19 has had a global impact on all aspects of healthcare including surgical training. This study aimed to quantify the impact of COVID-19 on operative case numbers recorded by surgeons in training, and annual review of competency progression (ARCP) outcomes in the UK. Methods Anonymized operative logbook numbers were collated from electronic logbook and ARCP outcome data from the Intercollegiate Surgical Curriculum Programme database for trainees in the 10 surgical specialty training specialties. Operative logbook numbers and awarded ARCP outcomes were compared between predefined dates. Effect sizes are reported as incident rate ratios (IRR) with 95 per cent confidence intervals. Results Some 5599 surgical trainees in 2019, and 5310 in surgical specialty training in 2020 were included. The IRR was reduced across all specialties as a result of the COVID-19 pandemic (0.62; 95 per cent c.i. 0.60 to 0.64). Elective surgery (0.53; 95 per cent c.i. 0.50 to 0.56) was affected more than emergency surgery (0.85; 95 per cent c.i. 0.84 to 0.87). Regional variation indicating reduced operative activity was demonstrated across all specialties. More than 1 in 8 trainees in the final year of training have had their training extended and more than a quarter of trainees entering their final year of training are behind their expected training trajectory. Conclusion The COVID-19 pandemic has had a major effect on surgical training in the UK. Urgent, coordinated action is required to minimize the impacts from the reduction in training in 2020.
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Affiliation(s)
- J M Clements
- The Association of Surgeons in Training, London, UK
| | - J R Burke
- The Association of Surgeons in Training, London, UK
| | - C Hope
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, Royal Derby Hospital, Derby, UK
| | - D M Nally
- The Association of Surgeons in Training, London, UK
| | - B Doleman
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, Royal Derby Hospital, Derby, UK
| | - L Giwa
- The Association of Surgeons in Training, London, UK
| | - G Griffiths
- Joint Committee on Surgical Training, London, UK
| | - J N Lund
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, Royal Derby Hospital, Derby, UK.,Joint Committee on Surgical Training, London, UK
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29
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Sahin B, Hanalioglu S. The Continuing Impact of Coronavirus Disease 2019 on Neurosurgical Training at the 1-Year Mark: Results of a Nationwide Survey of Neurosurgery Residents in Turkey. World Neurosurg 2021; 151:e857-e870. [PMID: 33974985 DOI: 10.1016/j.wneu.2021.04.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The impact of the coronavirus disease 2019 (COVID-19) pandemic has led to a significant transformation in medical practice and training. This nationwide survey study aims to evaluate the 1-year impact of the pandemic on training of neurosurgical residents. METHODS A 38-question Web-based survey was sent to 356 neurosurgery residents. Two hundred and thirty-five participated in the study (66% response rate), representing more than half of all neurosurgical residents in the country. RESULTS Assignment to direct COVID-19 medical care was common (85.5%). Many of the neurosurgery residents (37.9%) were tested positive for COVID-19. Almost half of the respondents reported a decrease in work hours. Most participants (84.3%) reported a decline in total operative case volume (mean change, -29.1% ± 1.6%), largely as a result of a decrease in elective (-33.2% ± 1.6%) as opposed to emergency cases (-5.1% ± 1.8%). For theoretic education, most respondents (54.9%) indicated a negative impact, whereas 25.1% reported a positive impact. For practical training, most respondents (78.7%) reported an adverse effect. A decrease in elective surgical case volume predicted a positive impact on theoretic training but a negative impact on practical training. Research productivity was reported by 33.2% to have decreased and by 23% to have increased. Forty-two percent indicated an increase in concerns about their training and career, with a negative impact on practical training being the most important predictor. Most (57.4%) had considered extending residency training to overcome negative effects of the pandemic. CONCLUSIONS COVID-19 has had a significant impact on neurosurgical practice and training. Effective measures should be used to mitigate these effects and better prepare for the future challenges.
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Affiliation(s)
- Balkan Sahin
- Department of Neurosurgery, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Sisli, Istanbul, Turkey
| | - Sahin Hanalioglu
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey.
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30
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Kilcoyne MF, Coyan GN, Aranda-Michel E, Kilic A, Morell VO, Sultan I. The impact of coronavirus 2019 on general surgery residency: A national survey of program directors. Ann Med Surg (Lond) 2021; 65:102285. [PMID: 33948166 PMCID: PMC8080449 DOI: 10.1016/j.amsu.2021.102285] [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: 03/08/2021] [Revised: 04/03/2021] [Accepted: 04/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has had a widespread impact on graduate medical education. This survey aims to assess how general surgery residency programs adapted to the initial wave of the COVID-19 pandemic in the United States (US). Materials and methods General surgery program directors (PDs) in the US were invited to partake in a 16-question survey between April 17 and May 1, 2020. The survey included questions about basic program information, clinical practice changes, changes to education structure, surgery resident clinical duties, and perceived impact on resident operative experience and future career choices. Results Forty-eight PDs completed the survey in the designated two-week period. Almost all (44/48, 91.7%) programs changed their didactic education to an online video conference-based format. Thirteen programs (27.1%) decreased the amount/frequency of formal education, and 13 (27.1%) reported canceling didactic education for some period of time. The majority of PDs (26/48, 54.2%) felt these changes had no impact on resident didactic participation, 14 (29.2%) reported an increase in participation, and 8 (16.7%) reported decreased participation. Ten programs (20.8%) redeployed residents to non-surgical services at the time of this survey, 30 (62.5%) have not redeployed residents but plan to if needed, and 8 (16.7%) did not have any plans to redeploy residents. Conclusions The outbreak of COVID-19 has required general surgery residency PDs to change numerous aspects of resident education and clinical roles. Future inquiry is needed to assess if these changes lead to appreciable differences in resident preparedness and career selection. At the time of this survey, all institutions had cancelled elect cases. Over 90% of program directors implemented video-based didactic education. Alternating blocks of on- and off-service was the most common schedule change. Residents participated in “line” or “procedural” teams in 14.6% of programs.
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Affiliation(s)
- Maxwell F Kilcoyne
- Department of Surgery, Mercy Catholic Medical Center, 1500, Lansdowne Avenue Darby, PA, USA
| | - Garrett N Coyan
- Department of Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop St C, Pittsburgh, PA, 15213, USA
| | - Edgar Aranda-Michel
- Department of Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop St C, Pittsburgh, PA, 15213, USA
| | - Arman Kilic
- Department of Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop St C, Pittsburgh, PA, 15213, USA.,Heart and Vascular Institute, University of Pittsburgh Medical Center, 1350 Locust Street Mercy Professional Building, Pittsburgh, PA, 15219, USA
| | - Victor O Morell
- Department of Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop St C, Pittsburgh, PA, 15213, USA.,Heart and Vascular Institute, University of Pittsburgh Medical Center, 1350 Locust Street Mercy Professional Building, Pittsburgh, PA, 15219, USA
| | - Ibrahim Sultan
- Department of Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop St C, Pittsburgh, PA, 15213, USA.,Heart and Vascular Institute, University of Pittsburgh Medical Center, 1350 Locust Street Mercy Professional Building, Pittsburgh, PA, 15219, USA
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Tosi U, Chidambaram S, Schwarz J, Diaz SM, Singh S, Norman S, Radwanski R, Murthy S, Apuzzo M, Schwartz TH, Pannullo SC. The World of Neurosurgery Reimagined Post COVID-19: Crisis ↔ Opportunities. World Neurosurg 2021; 148:251-255. [PMID: 33770847 DOI: 10.1016/j.wneu.2020.11.167] [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] [Received: 09/01/2020] [Accepted: 11/10/2020] [Indexed: 10/21/2022]
Abstract
The COVID-19 pandemic has impacted neurosurgery in unforeseeable ways. Neurosurgical patient care, research, and education have undergone extraordinary modifications as medicine and mankind have adapted to overcome the challenges posed by this pandemic. Some changes will disappear as the situation slowly recovers to a prepandemic status quo. Others will remain: This pandemic has sparked some long-overdue systemic transformations across all levels of medicine, including in neurosurgery, that will be beneficial in the future. In this paper, we present some of the challenges faced across different levels of neurosurgical clinical care, research, and education, the changes that followed, and how some of these modifications have transformed into opportunities for improvement and growth in the future.
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Affiliation(s)
- Umberto Tosi
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Swathi Chidambaram
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Justin Schwarz
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Sunidhi Singh
- Weill Cornell Medical College, New York, New York, USA
| | - Sofya Norman
- Weill Cornell Medical College, New York, New York, USA
| | - Ryan Radwanski
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Weill Cornell Medical College, New York, New York, USA
| | - Santosh Murthy
- Department of Neurology, Weill Cornell Medicine, New York, New York, USA
| | - Michael Apuzzo
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Theodore H Schwartz
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Susan C Pannullo
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
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Kilgore MD, Scullen T, Mathkour M, Dindial R, Carr C, Zeoli T, Werner C, Kahn L, Bui CJ, Keen JR, Maulucci CM, Dumont AS. Effects of the COVID-19 Pandemic on Operative Volume and Residency Training at Two Academic Neurosurgery Centers in New Orleans. World Neurosurg 2021; 151:e68-e77. [PMID: 33812067 DOI: 10.1016/j.wneu.2021.03.122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Medical subspecialties including neurosurgery have seen a dramatic shift in operative volume in the wake of the coronavirus disease 2019 (COVID-19) pandemic. The goal of this study was to quantify the effects of the COVID-19 pandemic on operative volume at 2 academic neurosurgery centers in New Orleans, Louisiana, USA from equivalent periods before and during the COVID-19 pandemic. METHODS A retrospective review was conducted analyzing neurosurgical case records for 2 tertiary academic centers from March to June 2020 and March to June 2019. The records were reviewed for variables including institution and physician coverage, operative volume by month and year, cases per subspecialty, patient demographics, mortality, and morbidity. RESULTS Comparison of groups showed a 34% reduction in monthly neurosurgical volume per institution during the pandemic compared with earlier time points, including a 77% decrease during April 2020. There was no change in mortality and morbidity across institutions during the pandemic. CONCLUSIONS The COVID-19 pandemic has had a significant impact on neurosurgical practice and will likely continue to have long-term effects on patients at a time when global gross domestic products decrease and relative health expenditures increase. Clinicians must anticipate and actively prepare for these impacts in the future.
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Affiliation(s)
- Mitchell D Kilgore
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Tyler Scullen
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Mansour Mathkour
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA; Neurosurgery Division, Department of Surgery, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Rishawn Dindial
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Christopher Carr
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Tyler Zeoli
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Cassidy Werner
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Lora Kahn
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Cuong J Bui
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Joseph R Keen
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Christopher M Maulucci
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
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Seifman MA, Fuzzard SK, To H, Nestel D. COVID-19 impact on junior doctor education and training: a scoping review. Postgrad Med J 2021; 98:466-476. [PMID: 33688067 DOI: 10.1136/postgradmedj-2020-139575] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/06/2021] [Indexed: 11/03/2022]
Abstract
COVID-19 has had a significant impact on healthcare resources and the medical workforce. Clinically-based medical education is the principal source of learning, and this has been profoundly impacted by restrictions due to COVID-19. It follows that junior medical staff and their education would be significantly impacted due to the altered volume and breadth of their clinical exposure. Some literature has been published regarding the impact to medical training during COVID-19. This study sought to review junior medical staff perceptions and their reported impact of the COVID-19 pandemic on their education and training.Nine databases (three Ovid MEDLINE databases, Embase, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Centre and PsychINFO) were searched for studies published in 1 January 2020 through 24 August 2020. Via a scoping review protocol, an iterative process was used to perform the identification, review and charting analysis of the reported outcomes and themes. Descriptive analysis was performed using quantitative and qualitative methods.Of the 25 343 sources identified, 32 were included in the review. There were studies published from nearly all continents, predominantly in surgical journals, with a wide spread of specialties. Themes identified included the current impact of the pandemic in relation to continuation of and modifications to training programmes, as well as the future impact due to training requirements and career progression.Junior medical staff report that the COVID-19 pandemic has had a significant impact on their education and training. Whether the changes imposed by the pandemic on education are temporary measures or permanent fixtures, and whether standards of competence may be impacted, is not yet known. This scoping review forms a basis for further investigation in the field.
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Affiliation(s)
- Marc Adam Seifman
- Plastic, Reconstructive and Hand Surgery Unit, Peninsula Health, Frankston, Victoria, Australia .,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sibon K Fuzzard
- Plastic, Reconstructive and Hand Surgery Unit, Peninsula Health, Frankston, Victoria, Australia
| | - Henry To
- Northern Health Research and Education, Epping, Victoria, Australia
| | - Debra Nestel
- Surgery-Austin Health Precinct, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
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Impact of the Coronavirus Disease 2019 Pandemic on Working and Training Conditions of Neurosurgery Residents in Latin America and Spain. World Neurosurg 2021; 150:e182-e202. [PMID: 33689850 PMCID: PMC7936760 DOI: 10.1016/j.wneu.2021.02.137] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 12/11/2022]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has exerted a significant impact on health care workers. Recent studies have reported the detrimental effects of the pandemic on neurosurgery residents in North America, Asia, and Italy. However, the impact of the pandemic on neurosurgical training in Latin America and Spain has not yet been reported. In the present report, we describe effects of COVID-19 on training and working conditions of neurosurgery residents in these countries. Methods An electronic survey with 33 questions was sent to neurosurgery residents between September 7, 2020 and October 7, 2020. Statistical analysis was made in SPSS version 25. Results A total of 293 neurosurgery residents responded. The median age was 29.47 ± 2.6 years, and 79% (n = 231) were male. Of respondents, 36.5% (n = 107) were residents training from Mexico; 42% surveyed reported COVID symptoms and 2 (0.7%) received intensive care unit care; 61.4% of residents had been tested for COVID and 21.5% had a positive result; 84% of the respondents mentioned persisted with the same workload (≥70 hours per week) during the pandemic. Most residents from Mexico were assigned to management of patients with COVID compared with the rest of the countries (88% vs. 68.3%; P < 0.001), mainly in medical care (65.4% vs. 40.9%; P < 0.001), mechanical ventilators (16.8% vs. 5.9%; P = 0.003), and neurologic surgeries (94% vs. 83%; P = 0.006). Conclusions Our results offer a first glimpse of the changes imposed by the COVID-19 pandemic on neurosurgical work and training in Latin America and Spain, where health systems rely strongly on a resident workforce.
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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: 83] [Impact Index Per Article: 27.7] [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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Palacios Huatuco RM, Liaño JE, Moreno LB, Ponce Beti MS. Analysis of the impact of the pandemic on surgical residency programs during the first wave in Argentina: A cross - sectional study. Ann Med Surg (Lond) 2021; 62:455-459. [PMID: 33532065 PMCID: PMC7843101 DOI: 10.1016/j.amsu.2021.01.065] [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] [Received: 01/13/2021] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction COVID – 19 emerged as a global pandemic in 2020 and affected the teaching methods at all levels. Surgical education has also been significantly affected by this pandemic, but the effect remains unknown. We developed a survey in order to obtain more information on how this pandemic affected the training and education of surgical residency programs. Material and methods Cross-sectional study. We surveyed 195 residents of various surgical programs, from August 20th to September 30th, 2020, in Córdoba, Argentina. The effect of the COVID – 19 pandemic was analyzed on surgical training, on the academic program, and professional burnout. Results The volume of surgical cases performed during the pandemic decreased dramatically, affecting mainly residents of lower years. Comparing the number of cases (>7) that residents carried out per week (Pre pandemic vs pandemic), we found that PGY – 1: 47% vs 9%; p = 0.01 and PGY – 2: 46% vs 8%; p = 0.03. 83.2% reported that the impact of the pandemic affected their surgical training negatively and 45% were not adequately trained to carry out their surgical activity in the residency program. On the other hand, 71.3% affirmed that this health emergency allowed them to dedicate more time to the development of their academic training. Conclusion This is the first cross – sectional survey study that shows the impact of the pandemic on surgical residences during the first wave in Argentina. Surgical training performed by residents had a negative impact. First cross-sectional survey study showing the impact of the pandemic on surgical residences in Argentina. The effect on surgical training, academic program, and professional exhaustion was evaluated. The majority of residents considered a negative impact on their surgical training. The impact of COVID-19 was positive in the educational program.
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Affiliation(s)
- René M Palacios Huatuco
- General Surgery Service, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina
| | - Julián E Liaño
- General Surgery Service, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina
| | - Laura B Moreno
- General Surgery Service, Nuevo Hospital San Roque, Bajada Pucará 1900, Córdoba Capital, Argentina
| | - María S Ponce Beti
- General Surgery Service, Hospital Militar Regional Córdoba, Cruz Roja Argentina 1174, Córdoba Capital, Argentina
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Abstract
Background Coronavirus disease (COVID-19) has caused global disruption to health care. Non-urgent elective surgical cases have been cancelled, outpatient clinics have reduced and there has been a reduction in the number of patients presenting as an emergency. These factors will drastically affect the training opportunities of surgical trainees. The aim of this systematic review is to describe the impact of COVID-19 on surgical training globally. Methods The review was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered with the Open Science Framework (OSF). Medline, EMBASE, PubMed and the Cochrane Central Register of Controlled Trials were searched. Results The searches identified 499 articles, 29 of which were included in the review. This contained data from more than 20 countries with 5260 trainees and 339 programme directors. Redeployment to non-surgical roles varied across studies from 6% to 35.1%. According to all of the studies, operative experience has been reduced. Knowledge learning had been switched to online platforms across 17 of the studies and 7 reported trainees had increased time to devote to educational/academic activities. All of the studies reporting on mental health report negative associations with increased stress, ranging from 54.9% to 91.6% of trainees. Conclusions The impact of COVID-19 on surgical trainees has been experienced globally and across all specialities. Negative effects are not limited to operative and clinical experience, but also the mental health and wellbeing of trainees. Delivery of surgical training will need to move away from traditional models of learning to ensure trainees are competent and well supported. Supplementary Information The online version contains supplementary material available at 10.1007/s10151-020-02404-5.
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Wittayanakorn N, Nga VDW, Sobana M, Bahuri NFA, Baticulon RE. Impact of COVID-19 on Neurosurgical Training in Southeast Asia. World Neurosurg 2020; 144:e164-e177. [PMID: 32805466 PMCID: PMC7428452 DOI: 10.1016/j.wneu.2020.08.073] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Neurosurgery departments worldwide have been forced to restructure their training programs because of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we describe the impact of COVID-19 on neurosurgical training in Southeast Asia. METHODS We conducted an online survey among neurosurgery residents in Indonesia, Malaysia, Philippines, Singapore, and Thailand from May 22 to 31, 2020 using Google Forms. The 33-item questionnaire collected data on elective and emergency neurosurgical operations, ongoing learning activities, and health worker safety. RESULTS A total of 298 of 470 neurosurgery residents completed the survey, equivalent to a 63% response rate. The decrease in elective neurosurgical operations in Indonesia and in the Philippines (median, 100% for both) was significantly greater compared with other countries (P < 0.001). For emergency operations, trainees in Indonesia and Malaysia had a significantly greater reduction in their caseload (median, 80% and 70%, respectively) compared with trainees in Singapore and Thailand (median, 20% and 50%, respectively; P < 0.001). Neurosurgery residents were most concerned about the decrease in their hands-on surgical experience, uncertainty in their career advancement, and occupational safety in the workplace. Most of the residents (n = 221, 74%) believed that the COVID-19 crisis will have a negative impact on their neurosurgical training overall. CONCLUSIONS An effective national strategy to control COVID-19 is crucial to sustain neurosurgical training and to provide essential neurosurgical services. Training programs in Southeast Asia should consider developing online learning modules and setting up simulation laboratories to allow trainees to systematically acquire knowledge and develop practical skills during these challenging times.
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Affiliation(s)
- Nunthasiri Wittayanakorn
- Division of Neurosurgery, Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | | | - Mirna Sobana
- Division of Pediatric Neurosurgery, Hasan Sadikin Hospital/Padjadjaran University, Bandung, West Java, Indonesia
| | | | - Ronnie E Baticulon
- Division of Neurosurgery, Philippine General Hospital, and Department of Anatomy, College of Medicine, University of the Philippines Manila, Manila, Philippines.
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Ashry AH, Soffar HM, Alsawy MF. Neurosurgical education during COVID-19: challenges and lessons learned in Egypt. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020; 56:110. [PMID: 33262563 PMCID: PMC7689385 DOI: 10.1186/s41983-020-00242-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/03/2020] [Indexed: 12/12/2022] Open
Abstract
Background The coronavirus pandemic (COVID-19) has disrupted the routine neurosurgical education and practice worldwide and so more in developing countries. Continuing the neurosurgical training while maintaining the well-being of our residents should be the primary concern of leaders of training programs. Objectives The aim of this cross-sectional study was the evaluation of the impact of COVID-19 on neurosurgical residency programs and neurosurgical practice in five tertiary medical centers in our country. We also aimed at detecting the shortcomings in training programs and provide solutions. Methods An online questionnaire-based survey was prepared and sent to 73 neurosurgery residents in 5 tertiary centers in 4 governorates by social networks. The questions focused on the evaluation of clinical and surgical activities before and after the pandemic. Safety precautions, education, and residents’ mental health were also evaluated. Results Fifty residents responded to our survey. We identified a significant reduction in surgical cases, inpatient services, and working hours per week during the pandemic comparing to the pre-pandemic era. We also identified a significant increase in research hours and changes in educational methods from in-person methods to virtual ones. Seventy-four percent reported that personal protective equipment was not adequate for their duties. Sixty-eight percent experienced burnout symptoms. Unavailability of personal protective equipment, negative concerns regarding the surgical career, and financial strains significantly affected the mental health of residents. Conclusions The survey highlighted the negative impact of COVID-19 on neurosurgical practice and education. Being in a developing country, this negative effect was amplified due to financial reasons and weak infrastructure. Inadequate personal protective equipment increased the risk of infection and work-related stress among neurosurgery residents. We lacked telemedicine services in our country. Online education gained more visibility and awareness.
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Affiliation(s)
- Ahmed Hamdy Ashry
- Neurosurgery Department, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
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Baticulon RE, Nga VDW, Sobana M, Bahuri NFA, Wittayanakorn N. In Reply to the Letter to the Editor Regarding "Impact of COVID-19 on Neurosurgical Training in Southeast Asia". World Neurosurg 2020; 144:332. [PMID: 33227873 DOI: 10.1016/j.wneu.2020.09.086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 09/15/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Ronnie E Baticulon
- Division of Neurosurgery, Philippine General Hospital, and Department of Anatomy, College of Medicine, University of the Philippines, Manila, Philippines.
| | | | - Mirna Sobana
- Division of Pediatric Neurosurgery, Hasan Sadikin Hospital/Padjadjaran University, Bandung, West Java, Indonesia
| | | | - Nunthasiri Wittayanakorn
- Division of Neurosurgery, Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
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Al-Ahmari AN, Ajlan AM, Bajunaid K, Alotaibi NM, Al-Habib H, Sabbagh AJ, Al-Habib AF, Baeesa SS. Perception of Neurosurgery Residents and Attendings on Online Webinars During COVID-19 Pandemic and Implications on Future Education. World Neurosurg 2020; 146:e811-e816. [PMID: 33181378 DOI: 10.1016/j.wneu.2020.11.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/04/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Online education has provided an important tool to continue medical education during the COVID-19 pandemic. Our study aimed to evaluate trainee and attending perceptions of online webinars as an educational tool in neurosurgery. METHODS We conducted a cross-sectional survey study. A web-based 19-question survey was distributed to the people who attended the webinar series that was carried out by the Saudi Association of Neurological Surgery from March 29, 2020 to May 31, 2020. Candidates were identified through their registration e-mails. The survey was distributed June 5-8, 2020. RESULTS A total of 156 responses were received (survey response rate: 60%). The overall satisfaction rate among residents and attendings (board-certified neurosurgeons) was similar (>80%). However, only 56.4% of attendings reported they were comfortable with online webinars compared with 81.2% of residents (P value <0.0001). Seventy-five percent of residents found online lectures more useful than traditional in-person lectures compared with 52% of attendings (P value = 0.01). CONCLUSIONS Online educational webinars provide an educational value that can be considered as an adjunct to traditional (in-person) education methods. Among trainees, the satisfaction of neurosurgery webinars was encouraging to consider as an education method. More objective research and progress are required to adopt and refine existing online didactic and neurosurgical teaching tools while creating more engaging future distant learning models.
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Affiliation(s)
- Ahmed N Al-Ahmari
- Division of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Abdulrazag M Ajlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Khalid Bajunaid
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia
| | - Naif M Alotaibi
- Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Husam Al-Habib
- Department of Spine Surgery, Dr. Sulaiman Al-Habib Medical Group, Al-Khobar, Kingdom of Saudi Arabia
| | - Abdulrahman J Sabbagh
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Research and Development Unit, Clinical Skills and Simulation Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Amro F Al-Habib
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Saleh S Baeesa
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
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Affiliation(s)
- Kurt A Yaeger
- Department of Neurological Surgery, Mount Sinai Health System, New York, New York, USA
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Lee JE, Mohanty A, Albuquerque FC, Couldwell WT, Levy EI, Benzel EC, Wakhloo AK, Hirsch JA, Fiorella D, Fargen KM, Burkhardt JK, Srinivasan VM, Johnson J, Mokin M, Kan P. Trends in academic productivity in the COVID-19 era: analysis of neurosurgical, stroke neurology, and neurointerventional literature. J Neurointerv Surg 2020; 12:1049-1052. [PMID: 32998982 PMCID: PMC7528313 DOI: 10.1136/neurintsurg-2020-016710] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/05/2020] [Accepted: 09/15/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Academic physicians aim to provide clinical and surgical care to their patients while actively contributing to a growing body of scientific literature. The coronavirus disease 2019 (COVID-19) pandemic has resulted in procedural-based specialties across the United States witnessing a sharp decline in their clinical volume and surgical cases. OBJECTIVE To assess the impact of COVID-19 on neurosurgical, stroke neurology, and neurointerventional academic productivity. METHODS The study compared the neurosurgical, stroke neurology, and neurointerventional academic output during the pandemic lockdown with the same time period in previous years. Editors from a sample of neurosurgical, stroke neurology, and neurointerventional journals provided the total number of original manuscript submissions, broken down by months, from the year 2016 to 2020. Manuscript submission was used as a surrogate metric for academic productivity. RESULTS 8 journals were represented. The aggregated data from all eight journals as a whole showed that a combined average increase of 42.3% was observed on original submissions for 2020. As the average yearly percent increase using the 2016-2019 data for each journal exhibited a combined average increase of 11.2%, the rise in the yearly increase for 2020 in comparison was nearly fourfold. For the same journals in the same time period, the average percent of COVID-19 related publications from January to June of 2020 was 6.87%. CONCLUSION There was a momentous increase in the number of original submissions for the year 2020, and its effects were uniformly experienced across all of our represented journals.
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Affiliation(s)
- Jae Eun Lee
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Alina Mohanty
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Felipe C Albuquerque
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | | | - Elad I Levy
- Neurosurgery, Jacobs School of Medicine University at Buffalo, Buffalo, New York, USA
- Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Edward C Benzel
- Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ajay K Wakhloo
- Neurointerventional Radiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Joshua A Hirsch
- NeuroEndovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - David Fiorella
- Department of Neurosurgery, Stony Brook University, Stony Brook, New York, USA
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Kyle M Fargen
- Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
- Department of Neurosurgery, Texas Children's Hospital, Houston, Texas, USA
| | | | - Jeremiah Johnson
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Maxim Mokin
- Department of Neurosurgery, University of South Florida, Tampa, Florida, USA
| | - Peter Kan
- Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas, USA
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Huamanchumo-Suyon ME, Urrunaga-Pastor D, Ruiz-Perez PJ, Rodrigo-Gallardo PK, Toro-Huamanchumo CJ. Impact of the COVID-19 pandemic on general surgery residency program in Peru: A cross-sectional study. Ann Med Surg (Lond) 2020; 60:130-134. [PMID: 33133592 PMCID: PMC7585630 DOI: 10.1016/j.amsu.2020.10.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/17/2020] [Indexed: 12/20/2022] Open
Abstract
Background General surgey is a specialty of high demand and relevance. We aimed to collect the opinions of the residents and their tutors and heads of department, regarding the impact that this COVID-19 pandemic is having - and will probably have - on the training of future general surgeons in Peru. Methods We conducted a cross-sectional study in Lima, Peru. We surveyed residents of general surgery, as well as their tutors and heads of surgery departments from 14 Peruvian hospitals. Results The impact of COVID-19 was considered severe in approximately 60% of first-year residents, 100% of second-year residents, 40% of third-year residents and about 80% of attending physicians. The 68.8% of the residents considered that the loss of surgical training opportunities during the pandemic would negatively affect their job performance. In addition, as of 03/16/2020, no residents had performed more than 25 elective surgeries, trauma surgeries or laparoscopic procedures. All the participants (including tutors and heads of departments) highlighted the need to extend the residency period. Conclusion The COVID-19 pandemic has affected the training of the general surgery residents. Deficiencies need to be identified in order to evaluate extending the period of the medical residency program in Peru.
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Affiliation(s)
| | | | | | | | - Carlos J Toro-Huamanchumo
- Clínica Avendaño, Lima, Peru.,Universidad Católica Los Ángeles de Chimbote, Instituto de Investigación, Chimbote, Peru
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Pelargos PE, Chakraborty AR, Adogwa O, Swartz K, Zhao YD, Smith ZA, Dunn IF, Bauer AM. An Evaluation of Neurosurgical Practices During the Coronavirus Disease 2019 Pandemic. World Neurosurg 2020; 146:e91-e99. [PMID: 33065352 PMCID: PMC7550862 DOI: 10.1016/j.wneu.2020.10.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022]
Abstract
Objective We sought to understand how the coronavirus disease 2019 pandemic has affected the neurosurgical workforce. Methods We created a survey consisting of 22 questions to assess the respondent's operative experience, location, type of practice, subspecialty, changes in clinic and operative volumes, changes to staff, and changes to income since the pandemic began. The survey was distributed electronically to neurosurgeons throughout the United States and Puerto Rico. Results Of the 724 who opened the survey link, 457 completed the survey. The respondents were from throughout the United States and Puerto Rico and represented all practices types and subspecialties. Nearly all respondents reported hospital restrictions on elective surgeries. Most reported a decline in clinic and operative volume. Nearly 70% of respondents saw a decrease in the work hours of their ancillary providers, and almost one half (49.1%) of the respondents had had to downsize their practice staff, office assistants, nurses, schedulers, and other personnel. Overall, 43.6% of survey respondents had experienced a decline in income, and 27.4% expected a decline in income in the upcoming billing cycle. More senior neurosurgeons and those with a private practice, whether solo or as part of a group, were more likely to experience a decline in income as a result of the pandemic compared with their colleagues. Conclusion The coronavirus disease 2019 pandemic will likely have a lasting effect on the practice of medicine. Our survey results have described the early effects on the neurosurgical workforce. Nearly all neurosurgeons experienced a significant decline in clinical volume, which led to many downstream effects. Ultimately, analysis of the effects of such a pervasive pandemic will allow the neurosurgical workforce to be better prepared for similar events in the future.
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Affiliation(s)
- Panayiotis E Pelargos
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Arpan R Chakraborty
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Owoicho Adogwa
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Karin Swartz
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Yan D Zhao
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Zachary A Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Ian F Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Andrew M Bauer
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
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Early Changes to Neurosurgery Resident Training During the COVID-19 Pandemic at a Large U.S. Academic Medical Center. World Neurosurg 2020; 144:e926-e933. [PMID: 32992058 PMCID: PMC7521299 DOI: 10.1016/j.wneu.2020.09.125] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic has led to sweeping changes in residency programs across the world, including cancellation of elective cases. The effects of safety measures on neurosurgical training remain unclear. To understand how neurosurgical residents have been affected, we analyzed the operative experience in the months leading up to and during the pandemic. METHODS The resident and institutional case totals were tallied for a single residency program in Miami-Dade County from January 1, 2019 to June 30, 2020. A matched cohort analysis was performed before and during the pandemic to assess the effects on resident surgical training. RESULTS The case totals for all levels of training were lower when restrictions were placed on elective surgeries. An average of 11 cases was logged in April 2020, a decrease from 26 cases in April 2019 (95% confidence interval, 8.7-22; P < 0.01). An average of 20 cases was logged in May 2020, a decrease from 25 cases in May 2019 (95% confidence interval, 1.2-8.8; P = 0.01). In April and May 2020, 299 (66%) and 148 (50%) fewer cases had been performed at our institution compared with April and May 2109. CONCLUSIONS Operative experience was reduced for residents during the months when the performance of elective cases was restricted. Our data suggest experience in some areas of neurosurgery were more affected than were others, and residents at different levels of training were also affected differently. However, the extent of the coronavirus disease 2019 pandemic on neurosurgical training is unlikely to be understood in the short term.
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Khalafallah AM, Lam S, Gami A, Dornbos DL, Sivakumar W, Johnson JN, Mukherjee D. A national survey on the impact of the COVID-19 pandemic upon burnout and career satisfaction among neurosurgery residents. J Clin Neurosci 2020; 80:137-142. [PMID: 33099336 PMCID: PMC7438065 DOI: 10.1016/j.jocn.2020.08.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/09/2020] [Indexed: 12/13/2022]
Abstract
U.S. neurosurgery residents report moderate burnout during the COVID-19 pandemic. Neurosurgery residents report uncertainty about future healthcare reform & earnings. The COVID-19 pandemic may impair residents’ achievement of surgical milestones. Burnout is associated with altered rotation or vacation schedules and lower PGY. Career satisfaction is associated with delivery of neurosurgical patient care.
The coronavirus disease 2019 (COVID-19) pandemic has posed significant changes to resident education and workflow. However, the impact of the pandemic on U.S. neurosurgery residents has not been well characterized. We investigated the impact of the COVID-19 pandemic on U.S. neurosurgery resident workflow, burnout, and career satisfaction. In 2020, a survey evaluating factors related to career satisfaction and burnout was emailed to 1,374 American Association of Neurological Surgeons (AANS) residents. Bivariate and multivariate (logistic) analyses were performed to characterize predictors of burnout and career satisfaction. 167 survey responses were received, with a response rate (12.2%) comparable to that of similar studies. Exclusion of incomplete responses yielded 111 complete responses. Most respondents were male (65.8%) and White (75.7%). Residents reported fewer work hours (67.6%) and concern that COVID-19 would impair their achievement of surgical milestones (65.8%). Burnout was identified in 29 (26.1%) respondents and career satisfaction in 82 (73.9%) respondents. In multivariate analysis, burnout was significantly associated with alterations in elective rotation/vacation schedules (p = .013) and the decision to not pursue neurosurgery again if given the choice (p < .001). Higher post-graduate year was associated with less burnout (p = .011). Residents displayed greater career satisfaction when focusing their clinical work upon neurosurgical care (p = .065). Factors related to COVID-19 have contributed to workflow changes among U.S. neurosurgery residents. We report a moderate burnout rate and a paradoxically high career satisfaction rate among neurosurgery residents. Understanding modifiable stressors during the COVID-19 pandemic may help to formulate interventions to mitigate burnout and improve career satisfaction among residents.
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Affiliation(s)
- Adham M Khalafallah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shravika Lam
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Abhishek Gami
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David L Dornbos
- Department of Neurological Surgery, Semmes Murphey Clinic, Memphis, TN, USA
| | - Walavan Sivakumar
- Department of Neurosurgery, Pacific Neuroscience Institute, Santa Monica, CA, USA
| | - Jeremiah N Johnson
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Debraj Mukherjee
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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