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Gal-Nădășan EG, Popescu IM, Bădițoiu LM, Gal-Nădășan N, Cioca F, Popovici ED, Dinu AR, Horhat FG, Margan MM, Vulcănescu DD, Anghel A, Marian C, Căpraru ID. Healthcare Workers' Vulnerability to SARS-CoV-2 in Western Romania: A Study on Incidence and Risk Factors for Non-Vaccination and Reinfection. Int J Gen Med 2023; 16:5621-5632. [PMID: 38045906 PMCID: PMC10693272 DOI: 10.2147/ijgm.s442098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/16/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose The COVID-19 pandemic has severely impacted healthcare workers, a professional category at risk of infection in both hospital and community settings. The aim of the study was to compare morbidity among hospital staff and that in general population, as well as the factors predicting non-vaccination and reinfection. Patients and Methods The present study is a retrospective, cross-sectional study. It was conducted by including all the confirmed COVID-19 infection cases in medical staff members during the period 01.01.2021-31.03.2022 that were reported to the Public Health Authority of Timis County, Timisoara, Western Romania. Results Direct, strong, statistically significant correlations were found between the incidence of COVID-19 recorded in all categories of medical personnel and the community pandemic trend, with maximum values for auxiliary and medium medical staff (rho = 0.852/0.821, p < 0.001). The high socio-economic level, as well as the advanced medical education level, were predictor factors for anti-SARS-COV-2 vaccination among the personnel. The non-vaccinated status as well as incomplete vaccination or even the 2-dose vaccination represented independent risk factors for reinfection in 2022. Conversely, receiving a higher number of vaccine doses emerged as the primary protective factor. Notably, reduced adherence to the administration of the following doses was observed particularly among medium and auxiliary staff, leading to additional risks of infection with the Omicron variant. Conclusion Despite over 70% vaccination coverage among all studied medical personnel categories, there was low adherence to repeat doses of vaccination, particularly among medium and auxiliary staff. The study highlighted a distinct necessity for enhanced training on preventive behaviours and targeted prevention/control strategies for all professional groups interacting with patients, including caretakers, ambulance workers, receptionists, physiotherapists, and psychologists.
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Affiliation(s)
| | - Irina-Maria Popescu
- Department of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Luminița Mirela Bădițoiu
- Department of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Multidisciplinary Research Center on Antimicrobial Resistance, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Norbert Gal-Nădășan
- Department of Automation and Applied Informatics, Faculty of Automation and Computers, Politehnica University, Timişoara, Romania
| | - Flavius Cioca
- Department of Medical Informatics and Biostatistics, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Emilian Damian Popovici
- Department of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Anca-Raluca Dinu
- Department of Medical Recovery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Florin George Horhat
- Multidisciplinary Research Center on Antimicrobial Resistance, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Mădălin-Marius Margan
- Department of Functional Sciences, Discipline of Public Health, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Dan Dumitru Vulcănescu
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Andrei Anghel
- Department of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Cătălin Marian
- Department of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Ionuț Dragoș Căpraru
- Department of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Public Health Authority of Timis County, Timisoara, Romania
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Jin W, Fang Y, Zhang Y, Lv Y. The reliability and validity of the training elements scale for clinicians in the new era--based on the perspective of Chinese doctors' job demands. BMC MEDICAL EDUCATION 2023; 23:295. [PMID: 37131155 PMCID: PMC10152000 DOI: 10.1186/s12909-023-04289-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/21/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVE The purpose of this study was to develop a scale of clinician training elements in the new period and test its reliability and validity. METHODS Our approach was based on interdisciplinary theory, systematology, collaborative innovation theory, and whole person education theory combined with the existing post competency model of Chinese doctors and the responsibilities and requirements endowed clinicians in the new historical period. The scale elements were extracted by referring to the relevant literature, and the training elements scale for clinicians in the new period were preliminarily formed. From July to August 2022, 1,086 clinicians from tertiary medical institutions in eastern, central, and western China were sampled and investigated. The questionnaire was revised via the critical ratio method and homogeneity test method, and the reliability and validity of the scale were also tested. RESULTS The training elements scale for clinicians in the new period included the following eight dimensions: basic clinical knowledge, interdisciplinary knowledge, clinical skill operation, public health knowledge, technological innovation capability, lifelong learning needs, medical humanistic literacy, and international exchange vision, as well as 51 other items. The Cronbach's α coefficient of the scale was 0.981, the half-reliability was 0.903, and the average variance extraction of each dimension was greater than 0.5. An exploratory factor analysis extracted eight main factors, and the cumulative variance contribution rate was 78.524%. Confirmatory factor analysis showed that the model fit was ideal and the factor structure was stable. CONCLUSION The clinician training factor scale in the new era can fully meet the current training needs of r clinicians, and has good reliability and validity. It can be widely used in medical colleges and universities as a reference to reform the content of medical training and education, and can also be used in the continuing education of clinicians after graduation to compensate for gaps in knowledge during clinical work.
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Affiliation(s)
- Weiqiong Jin
- Academic Affairs Office, Wenzhou Medical University, Wenzhou, 325000, China
- Key Research Center of Philosophy and Social Sciences of Zhejiang Province (Institute of Medical Humanities), Wenzhou Medical University, Wenzhou, 325000, China
| | - Yinghui Fang
- Academic Affairs Office, Wenzhou Medical University, Wenzhou, 325000, China
| | - Yuchen Zhang
- Alberta Institute, Wenzhou Medical University, Wenzhou, 325000, China
| | - Yijun Lv
- Party Committee, Wenzhou Medical University, Wenzhou, 325000, China.
- Wenzhou Medical University, Ouhai District, Tongxin Building, Chashan Higher Education Park, Zhejiang, Wenzhou, China.
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Roth LT, Mogilner L, Talib H, Silver EJ, Friedman S. Where Do We Go from here? Post-pandemic Planning and the Future of Graduate Medical Education. MEDICAL SCIENCE EDUCATOR 2023; 33:375-384. [PMID: 36778672 PMCID: PMC9900559 DOI: 10.1007/s40670-023-01737-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 05/31/2023]
Abstract
Background As the pandemic wanes, there is an opportunity to reevaluate resultant changes in graduate medical education (GME), particularly from the viewpoints of those affected most. We aimed to assess both trainee and faculty perceptions on the educational changes and innovations resulting from the pandemic to inform future educational planning. Methods We surveyed trainees and core education faculty at three New York City children's hospitals. Surveys assessed perceived changes to educational activities, skills, scholarship, effectiveness of virtual teaching, future desirability, and qualitative themes. Results The survey was completed by 194 participants, including 88 (45.4%) faculty and 106 (54.6%) trainees. Trainees were more likely to report a negative impact of the pandemic compared with faculty (75.5% vs. 50%, p < 0.01). Most respondents reported a decrease in formal educational activities (69.8%), inpatient (77.7%) and outpatient (77.8%) clinical teaching. Despite this, most perceived clinical and teaching skills to have stayed the same. Most (93.4%) participated in virtual education; however, only 36.5% of faculty taught virtually. Only 4.2% of faculty had extensive training in virtual teaching and 28.9% felt very comfortable teaching virtually. In the future, most (87.5%) prefer a hybrid approach, particularly virtual didactic conferences and virtual grand rounds. Faculty themes included challenges to workflows and increased empathy for trainees, while trainee themes included increased work/life balance and support, but increased burnout. Conclusion Many changes and innovations resulted from the pandemic. Hospital systems and GME programs should consider this data and incorporate viewpoints from trainees and faculty when adapting educational strategies in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01737-8.
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Affiliation(s)
- Lauren T. Roth
- Children’s Hospital at Montefiore/Albert Einstein College of Medicine, 3415 Bainbridge Ave, Bronx, NY 10467 USA
| | - Leora Mogilner
- Icahn School of Medicine at Mount Sinai, 1184 5th Ave, New York, NY 10029 USA
| | - Hina Talib
- Children’s Hospital at Montefiore/Albert Einstein College of Medicine, 3415 Bainbridge Ave, Bronx, NY 10467 USA
| | - Ellen J. Silver
- Children’s Hospital at Montefiore/Albert Einstein College of Medicine, 3415 Bainbridge Ave, Bronx, NY 10467 USA
| | - Suzanne Friedman
- Columbia University Vagelos College of Physicians & Surgeons, 622 West 168th Street, NY New York, 10032 USA
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The Impact of COVID-19 on Surgical Training and Education. Cancers (Basel) 2023; 15:cancers15041267. [PMID: 36831609 PMCID: PMC9954522 DOI: 10.3390/cancers15041267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
The COVID-19 pandemic disrupted conventional medical education for surgical trainees with respect to clinical training, didactics, and research. While the effects of the COVID-19 pandemic on surgical trainees were variable, some common themes are identifiable. As hordes of COVID-19 patients entered hospitals, many surgical trainees stepped away from their curricula and were redeployed to other hospital units to care for COVID-19 patients. Moreover, the need for social distancing limited traditional educational activities. Regarding clinical training, some trainees demonstrated reduced case logs and decreased surgical confidence. For residents, fellows, and medical students alike, most didactic education transitioned to virtual platforms, leading to an increase in remote educational resources and an increased emphasis on surgical simulation. Resident research productivity initially declined, although the onset of virtual conferences provided new opportunities for trainees to present their work. Finally, the pandemic was associated with increased anxiety, depression, and substance use for some trainees. Ultimately, we are still growing our understanding of how the COVID-19 pandemic has redefined surgical training and how to best implement the lessons we have learned.
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Lobo BLV, Almeida PCD, Cabral M. COVID-19 e a saúde mental de médicos residentes na atenção primária. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)3163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introdução: A pandemia da COVID-19 tem feito inúmeras vítimas fatais em todo o mundo. Ela não apenas ameaça a esfera física do indivíduo, como também pode gerar importante adoecimento psicológico na população, principalmente por conta do medo de contrair a doença. Objetivo: Avaliar a relação do medo da COVID-19 com sintomas ansiosos e depressivos dos residentes de Medicina de Família e Comunidade da região metropolitana de Fortaleza. Métodos: Realizou-se um estudo quantitativo analítico, correlacional e transversal, no qual os participantes responderam a um formulário eletrônico que continha um questionário elaborado pelos autores e os instrumentos Escala Hospitalar de Ansiedade e Depressão (HADS) e Escala de Medo do COVID-19 (EMC-19). Resultados: A pesquisa contou com 50 participantes. Verificou-se que 52% dos residentes apresentavam sintomas de ansiedade, 36% sintomas depressivos e 22% possuíam medo da doença de moderado a intenso. As maiores médias de medo foram dos residentes que já tratavam ansiedade ou depressão e dos residentes que iniciaram tratamento durante a pandemia. Conclusões: O estudo demonstrou que uma porcentagem relevante dos pesquisados apresentou sintomas de ansiedade e depressão, além de mostrar associação direta entre esses sintomas e o medo da COVID-19. Conclui-se enfatizando que o contexto pandêmico exige maior atenção às circunstâncias da saúde mental dos residentes de Medicina de Família para propor medidas de enfrentamento mais resolutivas à problemática.
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Virtual triaging in an eye emergency department during the COVID-19 pandemic. Ir J Med Sci 2022:10.1007/s11845-022-03160-1. [PMID: 36097319 PMCID: PMC9468233 DOI: 10.1007/s11845-022-03160-1] [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: 03/10/2022] [Accepted: 09/06/2022] [Indexed: 12/01/2022]
Abstract
Aim The aim of this audit was to assess the effect of new guidelines on virtual triage referrals to an Irish eye emergency department (EED) during the COVID-19 pandemic. Methods A retrospective phone triage referral and clinical note audit was performed to assess outcomes of phone triaging in October. Guidelines for phone triage were formulated with particular regard to what conditions should be seen in EED, treated over the phone or sent straight to outpatients clinic or minor procedures. A prospective phone triage referral and case note audit was then done to assess outcomes after introduction of the guidelines in November. Results A total of 1700 patients were referred to the eye emergency department, 861 in October and 839 in November. A total of 577 patients were triaged for in-person EED review in November, compared to 692 prior to implementation of guidelines (p < 0.05). The number of patients referred straight to outpatients (p < 0.05) and treated over the phone (p < 0.05) was also significantly increased. Ultimately, the number of conditions unnecessarily triaged to EED, as per the guidelines implemented, was significantly reduced (p < 0.05). Conclusion This audit addressed the need to reduce footfall during the COVID-19 pandemic, identified suitable avenues of referrals for certain conditions, and demonstrated that these guidelines significantly reduced the number of patients presenting to EED with conditions amenable to phone review or clinic follow-up.
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Affiliation(s)
- Jennifer Rose-Nussbaumer
- Byers Eye Institute, Stanford University, Palo Alto, California.,Francis I. Proctor Foundation, University of California, San Francisco
| | - Thuy Doan
- Francis I. Proctor Foundation, University of California, San Francisco.,Department of Ophthalmology, University of California, San Francisco
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Zavala S, Andolsek KM, Stout JE. To Boost or Not to Boost Residents and Fellows-That Is the Question. J Grad Med Educ 2022; 14:382-385. [PMID: 35991110 PMCID: PMC9380642 DOI: 10.4300/jgme-d-22-00214.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sofia Zavala
- All authors are with Duke University Medical Center
- Sofia Zavala, MD, is a PGY-5, Division of Infectious Diseases
| | - Kathryn M. Andolsek
- All authors are with Duke University Medical Center
- Kathryn M. Andolsek, MD, MPH, is Professor in Family Medicine and Community Health, Department of Family Medicine and Community Health, and Associate Editor, Journal of Graduate Medical Education
| | - Jason E. Stout
- All authors are with Duke University Medical Center
- Jason E. Stout, MD, MHS, is Professor of Medicine, Division of Infectious Diseases
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Anshory M, Wahono CS, Pratama MZ, Rahman PA, Nugraha AS, Sekarani A. Factors Associated with Vaccine Breakthrough Incidence among Health Care Workers Vaccinated with Inactivated SARS-CoV2 Vaccine (CoronaVac). J Res Health Sci 2022; 22:e00551. [PMID: 36511263 PMCID: PMC9818040 DOI: 10.34172/jrhs.2022.86] [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: 04/24/2022] [Revised: 06/12/2022] [Accepted: 06/18/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) run a high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The HCWs are prone to the SARS-CoV-2 infection in the hospital despite being fully vaccinated. The present study aimed to address the factors associated with the coronavirus disease 2019 (COVID-19) vaccine breakthrough among HCWs. STUDY DESIGN A prospective cohort study. METHODS Participants were 184 HCWs receiving two doses of inactivated SARS-CoV-2 vaccine (CoronaVac, Sinovac Life Science). All participants were followed for six months. Confirmed COVID-19 was defined as positive SARS-CoV-2 by reverse transcription-polymerase chain reaction (RT-PCR). Before undergoing RT-PCR, questionnaires were used to obtain information on demographic characteristics, profession, contact with COVID-19 cases, personal protective equipment (PPE), health protocols adherence, exercise, and nutritional habits. RESULTS A number of 57 (31%) participants were COVID-19 positive. Close contact with COVID-19 cases (adjusted RR 6.82, 95% CI: 1.97, 47.98, P = 0.044), being a resident doctor (adjusted RR 4.72, 95% CI: 1.11, 20.11, P = 0.036), improper mask-wearing (adjusted RR 2.36, 95% CI: 1.15, 4.85, P = 0.019), and lower frequency of eating fruit and vegetables (adjusted RR 2.73, 95% CI: 1.34, 5.57, P = 0.006) increased the risk of vaccine breakthrough. Compared to single surgical masks, KN95 and N95 significantly reduced the risk of COVID-19 (adjusted RR 0.27, 95% CI: 0.07, 0.97, P = 0.045 and adjusted RR 0.25, 95% CI: 0.07, 0.87, P = 0.029), respectively. CONCLUSION As evidenced by the obtained results, being a resident doctor, close contact with confirmed COVID-19 cases, health protocol incompliance, as well as the lower frequency of fruit and vegetable consumption were associated with the risk of vaccine breakthrough among HCWs. Appropriate strategies are needed to prevent the risk of SARS-CoV-2 infection among HCWs.
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Affiliation(s)
- Muhammad Anshory
- Allergy and Immunology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya-Saiful Anwar General Hospital, Malang, Indonesia
| | - Cesarius Singgih Wahono
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya-Saiful Anwar General Hospital, Malang, Indonesia
| | - Mirza Zaka Pratama
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya-Saiful Anwar General Hospital, Malang, Indonesia,Corresponding author: Mirza Zaka Pratama Zip code: 65112 Tel:+62 81233549377
| | - Perdana Aditya Rahman
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya-Saiful Anwar General Hospital, Malang, Indonesia
| | - Aditya Satriya Nugraha
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya-Saiful Anwar General Hospital, Malang, Indonesia
| | - Ayu Sekarani
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya-Saiful Anwar General Hospital, Malang, Indonesia
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Cheslack-Postava K, Bresnahan M, Ryan M, Musa GJ, Amsel L, DiMaggio C, Andrews HF, Susser E, Li G, Abramson DM, Lang BH, Hoven CW. Occupational Conditions Associated With Negative Mental Health Outcomes in New York State Health Professionals During the COVID-19 Pandemic. J Occup Environ Med 2022; 64:e417-e423. [PMID: 35732029 PMCID: PMC9322895 DOI: 10.1097/jom.0000000000002566] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to assess occupational circumstances associated with adverse mental health among health care workers during the COVID-19 pandemic. METHODS A cross-sectional study examined responses to an on-line survey conducted among 2076 licensed health care workers during the first pandemic peak. Mental health (depression, anxiety, stress, and anger) was examined as a multivariate outcome for association with COVID-related occupational experiences. RESULTS Odds of negative mental health were increased among those who worked directly with patients while sick themselves (adjusted odds ratio, 2.29; 95% confidence interval, 1.71-3.08) and were independently associated with working more hours than usual in the past 2 weeks, having family/friends who died due to COVID-19, having COVID-19 symptoms, and facing insufficiencies in personal protective equipment/other shortages. CONCLUSIONS Occupational circumstances were associated with adverse mental health outcomes among health care workers during the COVID-19 pandemic, and some are potentially modifiable.
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Hurand V, Ducloyer J, Baudin F, Aho S, Weber M, Kodjikian L, Devin F, Gabrielle P, Creuzot‐Garcher C, Massin P. IMPACT study: Impact of adherence to anti-VEGF intravitreal injections for macular disease during COVID 19-related confinement in France. Acta Ophthalmol 2022; 101:91-99. [PMID: 35765939 PMCID: PMC9350166 DOI: 10.1111/aos.15206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/23/2022] [Accepted: 06/05/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of this study was to evaluate the impact of adherence to French coronavirus disease 2019 (COVID 19)-related guidelines for intravitreal injection (IVI) practice on the visual outcomes of patients treated with anti-vascular endothelial growth factor (VEGF) agents for macular diseases during the first lockdown period. METHODS Observational multicentre study including all patients from 18 centres with an IVI initially planned during the lockdown. Visual acuity (VA, ETDRS) was recorded at 1 and 4 months after lockdown. French COVID 19-related guidelines recommended maintaining IVI practice. We defined three groups of patients: A, adherent to guidelines; NA+, non-adherent with delayed IVIs; and NA-, non-adherent without IVIs performed during the lockdown. Risk factors for non-adherence and visual loss were studied. RESULTS A total of 3020 eyes of 3020 patients, aged 77.8 ± 11.6 years, 59.8% women, were included. 59.3% were non-adherent(46.7% NA+, 12.6% NA-). A smaller decrease in VA at 4 months was observed in the A group than the NA+ and NA- group (-0.2 ± 6.7, -0.3 ± 6.9 and -1.5 ± 6.9, respectively [p < 0.001]). Factors associated with non-adherence were in multivariable analysis, older age, hospital practice, low-density population areas, high viral incidence areas, longer intervals between injection and treat and extent protocol. Factors associated with visual loss at 4 months in multivariable analysis were, being in the NA- group, older age, T&E and fixed regimens. CONCLUSION Strict adherence to guidelines was associated with better visual outcome, although most of our patients did not attend as planned. Identification of patients at risk could help in the future in case of a new pandemic lockdown.
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Affiliation(s)
| | | | - Florian Baudin
- Department of OphthalmologyUniversity HospitalDijonFrance,Pathophysiology and Epidemiology of Cerebro‐Cardiovascular Diseases (PEC2)University HospitalDijonFrance
| | - Serge Aho
- Department of EpidemiologyUniversity HospitalDijonFrance
| | - Michel Weber
- Department of OphthalmologyUniversity HospitalNantesFrance
| | - Laurent Kodjikian
- Department of OphthalmologyCroix Rousse University HospitalLyon 4France
| | - François Devin
- Center of Ophthalmology Monticelli ParadisMarseilleFrance
| | - Pierre‐Henry Gabrielle
- Department of OphthalmologyUniversity HospitalDijonFrance,Eye and Nutrition Research GroupGSGA, INRAeBurgundy, DijonFrance
| | - Catherine Creuzot‐Garcher
- Department of OphthalmologyUniversity HospitalDijonFrance,Eye and Nutrition Research GroupGSGA, INRAeBurgundy, DijonFrance
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Albuquerque MDFPMD, Souza WVD, Montarroyos UR, Pereira CR, Braga C, Araújo TVBD, Ximenes RADA, Miranda-Filho DDB, Szwarcwald CL, Souza-Junior PRBD, Xavier MN, Morais CNLD, Albuquerque GDMD, Bresani-Salvi C, Mariz CA, Siqueira-Filha NTD, Galindo JM, França-Neto CL, Barbosa JMV, Veras MASM, Lima LNGC, Cruz LN, Kendall C, Kerr LRFS, Martelli CMT. Risk of SARS-CoV-2 infection among front-line healthcare workers in Northeast Brazil: a respondent-driven sampling approach. BMJ Open 2022; 12:e058369. [PMID: 35667719 PMCID: PMC9170795 DOI: 10.1136/bmjopen-2021-058369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES We assessed the prevalence of SARS-CoV-2 infection, personal protective equipment (PPE) shortages and occurrence of biological accidents among front-line healthcare workers (HCW). DESIGN, SETTING AND PARTICIPANTS Using respondent-driven sampling, the study recruited distinct categories of HCW attending suspected or confirmed patients with COVID-19 from May 2020 to February 2021, in the Recife metropolitan area, Northeast Brazil. OUTCOME MEASURES The criterion to assess SARS-CoV-2 infection among HCW was a positive self-reported PCR test. RESULTS We analysed 1525 HCW: 527 physicians, 471 registered nurses, 263 nursing assistants and 264 physical therapists. Women predominated in all categories (81.1%; 95% CI: 77.8% to 84.1%). Nurses were older with more comorbidities (hypertension and overweight/obesity) than the other staff. The overall prevalence of SARS-CoV-2 infection was 61.8% (95% CI: 55.7% to 67.5%) after adjustment for the cluster random effect, weighted by network, and the reference population size. Risk factors for a positive RT-PCR test were being a nursing assistant (OR adjusted: 2.56; 95% CI: 1.42 to 4.61), not always using all recommended PPE while assisting patients with COVID-19 (OR adj: 2.15; 95% CI: 1.02 to 4.53) and reporting a splash of biological fluid/respiratory secretion in the eyes (OR adj: 3.37; 95% CI: 1.10 to 10.34). CONCLUSIONS This study shows the high frequency of SARS-CoV2 infection among HCW presumably due to workplace exposures. In our setting, nursing assistant comprised the most vulnerable category. Our findings highlight the need for improving healthcare facility environments, specific training and supervision to cope with public health emergencies.
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Affiliation(s)
| | - Wayner Vieira de Souza
- Department of Collective Health, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
| | | | | | - Cynthia Braga
- Department of Parasitology, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
| | | | | | | | - Celia Landmann Szwarcwald
- Institute of Scientific Communication and Information and Technological (ICIT), FIOCRUZ-RJ, Rio de Janeiro, Brazil
| | | | - Morgana Nascimento Xavier
- Department of Collective Health, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
- Department of Biology, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | | | | | - Carolline Araújo Mariz
- Department of Collective Health, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
- Olinda Medical School, Olinda, Pernambuco, Brazil
| | | | - Jadson Mendonça Galindo
- Department of Collective Health, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
| | | | | | | | | | | | - Carl Kendall
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Community Health, Federal University of Ceara, Fortaleza, Ceara, Brazil
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Martins TGDS, Benchimol GL, Gameiro GR, Schor P. Learning and teaching ophthalmology in the pandemic. EINSTEIN-SAO PAULO 2022; 20:eCE6988. [PMID: 35674631 PMCID: PMC9165563 DOI: 10.31744/einstein_journal/2022ce6988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 09/29/2021] [Indexed: 11/09/2022] Open
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14
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Long-Lasting Olfactory Dysfunction in Hospital Workers Due to COVID-19: Prevalence, Clinical Characteristics, and Most Affected Odorants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095777. [PMID: 35565169 PMCID: PMC9105378 DOI: 10.3390/ijerph19095777] [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: 03/17/2022] [Revised: 04/24/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023]
Abstract
Hospital workers have increased exposure risk of healthcare-associated infections due to the frontline nature of their work. Olfactory dysfunction is highly prevalent. The objectives for this investigation are to study the prevalence of long-lasting olfactory dysfunction associated with COVID-19 infection in hospital workers during the first pandemic wave, to identify clinical characteristics and associated symptomatology, and to analyze how many patients with COVID-19 infection had developed olfactory dysfunction during infection and maintained a reduced olfactory function for approximately 10 weeks after diagnosis. Between June and July of 2020, a cross-sectional study was carried out at the Hospital Central de la Cruz Roja San José and Santa Adela in Madrid, Spain. One hundred sixty-four participants were included, of which 110 were patient-facing healthcare staff and 54 were non-patient-facing healthcare staff. Participants were split into three groups, according to COVID-19 diagnosis and presence of COVID-19 related olfactory symptomatology. Participants were asked to complete a structured online questionnaire along with Sniffin' Stick Olfactory Test measurements. In this study, 88 participants were confirmed for COVID-19 infection, 59 of those participants also reported olfactory symptomatology. The prevalence of COVID-19 infection was 11.35%, and the prevalence for olfactory dysfunction was 67.05%. Olfactory dysfunction associated with COVID-19 infection leads to long-lasting olfactory loss. Objective assessment with Sniffin' Stick Olfactory Test points to odor identification as the most affected process. Lemon, liquorice, solvent, and rose are the odors that are worst recognized. Mint, banana, solvent, garlic, coffee, and pineapple, although they are identified, are perceived with less intensity. The findings of this study confirmed a high prevalence of SARS-CoV-2 infection among the hospital workers.
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15
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Eppenberger LS, Golla K, Schmid MK. Emergency Vitrectomies for Retinal Detachment Before and During the Coronavirus Pandemic - A Retrospective Single Centre Analysis. Klin Monbl Augenheilkd 2022; 239:476-483. [PMID: 35472790 PMCID: PMC9042420 DOI: 10.1055/a-1808-6258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background
While the corona pandemic and the resulting containment measures affect the number of elective surgical procedures, the impact on emergency surgical interventions is less
tangible. This analysis quantifies the frequency of emergency vitrectomies for retinal detachment and investigates underlying factors.
Methods
Retrospective identification of patients who underwent primary emergency vitrectomies for retinal detachment at the Cantonal Hospital of Lucerne between
01.01.2018 – 31.12.2020. Parameters were collected, including demographics, date of hospitalisation, reported onset of symptoms, pre-operative best corrected visual acuity (BCVA),
involvement of the macula, and canton of residence.
Results
Overall, a total of 665 patients with 683 eyes underwent emergency surgery for primary retinal detachment in the time span of 01.01.2018 – 31.12.2020. Median monthly number
of surgeries was 20. During the first Swiss national lockdown (16.03.2020 – 19.04.2020), a minimum of 9 vitrectomies was recorded in March 2020. A maximum of 36 vitrectomies was conducted in
August 2020. The mean age of patients was 61.5 years. Of the 665 patients, 133 (20.0%) were residents of the canton of Ticino. Median pre-operative BCVA was 0.25 over all three years, and no
significant reduction in pre-operative BCVA was observed during or after the lockdown. The proportion of eyes with involvement of the macula was 52.2%. In 2018, this proportion (47.6%) was
significantly lower than in 2019 and 2020 (Chi
2
test, p < 0.001). However, cases with macular involvement in post lockdown months were not more frequent. Median time in days
from reported symptom onset to hospitalisation was 5 days. In April 2020, the proportion of patients with > 14 days symptom duration was significantly higher (Chi
2
test,
p < 0.001). During the lockdown, there was a significant reduction in cases from Ticino. Also, patients from Ticino showed proportionally longer symptom duration after the lockdown.
Conclusion
A significant reduction in the number of emergency vitrectomies was observed for the initial period of the coronavirus pandemic. Delayed emergency presentation is not
assumed, since there was no increase in severity (i.e. macular involvement) or prolonged symptoms in the months following the lockdown. More protracted symptoms were only observed in
patients from Ticino. The initial low numbers were generally made good later in the year.
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Affiliation(s)
- Leila Sara Eppenberger
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Kathrin Golla
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland
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16
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Mahjoub H, Zhang SX, Wang J, Memon W, Mostafa H, Breazzano MP. Characterizing the microbiota of instrumentation in ophthalmology clinics during and beyond the COVID-19 pandemic. Graefes Arch Clin Exp Ophthalmol 2022; 260:2585-2590. [PMID: 35355117 PMCID: PMC8967689 DOI: 10.1007/s00417-022-05639-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Increased ophthalmology-specific risk of novel coronavirus 2019 (SARS-CoV-2) transmission is well-established, increasing the fear of infection and causing associated decreased rates of procedures known to save vision. However, the potential transmission from exposure to clinic instrumentation is unknown, including which additional pathogens may be spreading in this context. This study seeks to fill this gap by characterizing the microbiota of instrumentation in ophthalmology clinics during the COVID-19 pandemic and identifying potential sources of pathogenic spread encountered by patients and healthcare workers. Methods Thirty-three samples were captured using standard cultures and media. Ten positive and negative controls were used to confirm proper technique. Descriptive statistics were calculated for all samples. Samples were collected from the retina (N = 17), glaucoma (N = 6), cornea (N = 6), and resident (N = 4) clinics with rigorous disinfection standards at a tertiary academic medical center. Standard media cultures and/or polymerase chain reaction (PCR) was performed for each sample. Results From 33 samples, more than half (17/33, 51.5%) yielded bacterial growth. Using two different molecular methods, three samples (3/33, 9%) tested positive for SARS-CoV-2 (cycle thresholds 36.48, 37.14, and 37.83). There was no significant difference in bacterial growth (95% confidence interval [95% CI]: − 0.644–0.358, p = 0.076) among different clinics (retina, glaucoma, cornea, resident). Staphylococcus (S.) epidermidis grew most frequently (12/35, 34%), followed by S. capitis (7/35, 20%), Micrococcus luteus (2/35, 5.7%), Corynebacterium tuberculostearicum (2/35, 5.7%), and Cutibacterium ([C.], Propionibacterium) acnes (2/35, 5.7%). C. acnes growth was more frequent with imaging device forehead rests (2/7, 28.6%) than other surfaces (0/26, 0%, 95% CI: 0.019–0.619, p = 0.040). No samples isolated fungus or adenovirus. Conclusions Most samples across subspecialty clinic instrumentation grew bacteria, and several tested positive for SARS-CoV-2. Many isolated pathogens have been implicated in causing infections such as endophthalmitis, conjunctivitis, uveitis, and keratitis. The clinical implications of the ophthalmology microbiome for transmitting nosocomial infections warrant optimization of disinfection practices, strategies for mitigating spread, and additional study beyond the pandemic. ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00417-022-05639-0.
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Affiliation(s)
- Heba Mahjoub
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD, 21287, USA
| | - Sean X Zhang
- Division of Medical Microbiology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
- Microbiology Laboratory, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Warda Memon
- Microbiology Laboratory, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Heba Mostafa
- Virology Laboratory, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Mark P Breazzano
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD, 21287, USA.
- Retina-Vitreous Surgeons of Central New York, Liverpool, NY, USA.
- Department of Ophthalmology & Visual Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA.
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17
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Tingley J, Tauber J, Thuma T, Moon JY, Barmettler A. Impact of the COVID-19 Pandemic on Quantity and Characteristics of Ophthalmology Consults. Telemed J E Health 2022; 28:1547-1551. [PMID: 35244471 DOI: 10.1089/tmj.2021.0512] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To assess the COVID-19 exposure risk to consulting ophthalmologists and the pandemic effect on consultations at one of the most impacted hospital systems in New York. Methods: In a retrospective, cross-sectional study, ophthalmology consult notes and COVID-19 test results were collected from the electronic medical record from February to May in 2019 and 2020. Results: Of 2,215 total notes analyzed, consults decreased from 1,374 to 841 between years (p = 0.0002). In 2020, 22.5% of all consults were COVID tested and 2.4% were positive within 2 weeks of in-person evaluation. In 2020, 1.8% of consults were electronic. Ventilated patients increased between years (7.5% to 10.8%; p = 0.04). Conclusions: Although consultations decreased during the Spring 2020 peak, the majority (98.2%) remained as in-person evaluations. While few patients tested COVID positive, this likely reflects the limited availability of testing early in the pandemic. Consulting ophthalmologists remained at high risk of COVID-19 exposure during the pandemic peak.
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Affiliation(s)
- Jennifer Tingley
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York, USA
| | - Jenna Tauber
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York, USA
| | - Tobin Thuma
- Department of Pediatric Ophthalmology and Strabismus, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Jee-Young Moon
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Anne Barmettler
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York, USA
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18
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Abstract
Background: The COVID-19 pandemic has had a negative impact on the training process for resident physicians. The objective of this study was to evaluate the impact of the COVID-19 pandemic on professional training, and also the subjective perception of the levels of stress, anxiety, and depression among resident doctors specializing in gastroenterology in Romania. Methods: We conducted an observational cross-sectional study, for a period of two months, among 180 resident doctors specializing in gastroenterology, working in university hospitals in Romania. A questionnaire consisting of 29 questions distributed through social media platforms was completed in Google Forms. Statistical analyses were performed using IBM SPSS software v.20. Results: A linear relationship was identified between the number of daily hospitalizations in the gastroenterology department and the rate of SARS-CoV-2 infection among resident physicians. In total, 80% of the participants reported an increase in the levels of stress, anxiety, and depression during the COVID-19 pandemic, and 88.3% stated that they were unsatisfied by online courses. Conclusions: The COVID-19 pandemic has had negative effects on both professional training and levesl of stress, anxiety and depression of resident doctors specializing in gastroenterology. In the specialty of gastroenterology there may be certain peculiarities, due to the interventional aspects that this medical specialty involves, for example, endoscopic procedures. Thus, the necessity to acquire practical skills in addition to theoretical knowledge increases the negative impact on gastroenterology internship.
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19
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Hempel A, Cressman A, Daneman N. Resident physicians' perceptions of COVID-19 risk. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2022; 7:36-43. [PMID: 36340846 PMCID: PMC9603020 DOI: 10.3138/jammi-2020-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Resident physicians provide front-line care to coronavirus disease 2019 (COVID-19) patients, but little is known about how they perceive the risk to their own health or how this is affected by the increasing role of social media in disseminating information. This study aims to determine resident physicians' perceptions of personal COVID-19 risk during the first COVID wave and compare risk perceptions between low-average and high social media users. METHODS We conducted a cross-sectional survey at the University of Toronto in May 2020 among resident physicians in internal medicine, emergency medicine, critical care, and anaesthesia. Participants were considered high social media users if above the median for daily social media use and low-average users if at or below the median. The primary outcome was perceived risk of hospitalization with COVID-19 within 6 months. RESULTS A total of 98 resident physicians reported a median of 1-2 hours daily on social media, and 55.7% endorsed social media as a very or the most common source of information on COVID-19. The median overall perceived risk of hospitalization was 10% (inter-quartile range [IQR] 5-25)-7.5% for low-average social media users and 17.5% for high social media users (p = 0.10). CONCLUSIONS Resident physicians have an elevated perception of COVID-19 risk, including a perceived risk of hospitalization 250 times greater than the local population risk. Although social media are an important source of information on COVID-19, risk perception did not significantly differ between high and low-average social media users.
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Affiliation(s)
- Amanda Hempel
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alex Cressman
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nick Daneman
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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20
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Frisch S, Jones S, Willis J, Sinert R. COVID-19 Infection and Symptoms Among Emergency Medicine Residents and Fellows in an Urban Academic Hospital Setting: Cross-sectional Questionnaire Study. JMIRX MED 2022; 3:e29539. [PMID: 35263391 PMCID: PMC8805453 DOI: 10.2196/29539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 09/28/2021] [Accepted: 11/06/2021] [Indexed: 01/29/2023]
Abstract
Background
COVID-19, an illness caused by the novel coronavirus SARS-CoV-2, affected many aspects of health care worldwide in 2020. From March to May 2020, New York City experienced a large surge of cases.
Objective
The aim of this study is to characterize the prevalence of illness and symptoms experienced by residents and fellows in 2 New York City hospitals during the period of March to May 2020.
Methods
An institutional review board–exempt survey was distributed to emergency medicine housestaff in May 2020, and submissions were accepted through August 2020.
Results
Out of 104 residents and fellows, 64 responded to our survey (a 61.5% response rate). Out of 64 responders, 27 (42%) tested positive for SARS-CoV-2 antibodies. Most residents experienced symptoms that are consistent with COVID-19; however, few received polymerase chain reaction testing. Out of 27 housestaff with SARS-CoV-2 antibodies, 18 (67%) experienced fever and chills, compared with 8 out of 34 housestaff (24%) without SARS-CoV-2 antibodies. Of the 27 housestaff with SARS-CoV-2 antibodies, 19 (70%) experienced loss of taste and smell, compared with 2 out of 34 housestaff (6%) without SARS-CoV-2 antibodies. Both fever and chills and loss of taste and smell were significantly more commonly experienced by antibody-positive compared to antibody-negative housestaff (P=.002 and <.001, respectively). All 13 housestaff who reported no symptoms during the study period tested negative for SARS-CoV-2 antibodies.
Conclusions
Our study demonstrated that in our hospitals, the rate of COVID-19 illness among emergency department housestaff was much higher than previously reported. Further studies are needed to characterize illness among medical staff in emergency departments across the nation. The high infection rate among emergency medicine trainees stresses the importance of supplying adequate personal protective equipment for health care professionals.
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Affiliation(s)
- Stacey Frisch
- Department of Emergency Medicine SUNY Downstate Health Sciences University Brooklyn, NY United States
| | - Sarah Jones
- Department of Emergency Medicine Jackson Health System Miami, FL United States
| | - James Willis
- Department of Emergency Medicine SUNY Downstate Health Sciences University Brooklyn, NY United States
| | - Richard Sinert
- Department of Emergency Medicine SUNY Downstate Health Sciences University Brooklyn, NY United States
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21
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Durani U, Major A, Velazquez AI, May J, Nelson M, Zheng Z, Hall AG, Alam ST, Reynolds R, Thompson JC, Kumbamu A, Das DG, Murphy MC, Henry E, Lee AI, Marshall AL, Wun T, Weeks LD. Impact of COVID-19 on Hematology-Oncology Trainees: A Quantitative and Qualitative Assessment. JCO Oncol Pract 2022; 18:e586-e599. [PMID: 34990292 PMCID: PMC9014488 DOI: 10.1200/op.21.00630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Graduate medical and research training has drastically changed during the COVID-19 pandemic, with widespread implementation of virtual learning, redeployment from core rotations to the care of patients with COVID-19, and significant emotional and physical stressors. The specific experience of hematology-oncology (HO) fellows during the COVID-19 pandemic is not known. METHODS We conducted a mixed-methods study using a survey of Likert-style and open-ended questions to assess the training experience and well-being of HO fellows, including both clinical and postdoctoral trainee members of the American Society of Hematology and ASCO. RESULTS A total of 2,306 surveys were distributed by e-mail; 548 (23.8%) fellows completed the survey. Nearly 40% of fellows felt that they had not received adequate mental health support during the pandemic, and 22% reported new symptoms of burnout. Pre-existing burnout before the pandemic, COVID-19-related clinical work, and working in a primary research or nonclinical setting were associated with increased burnout on multivariable logistic regression. Qualitative thematic analysis of open-ended responses revealed significant concerns about employment after training completion, perceived variable quality of virtual education and board preparation, loss of clinical opportunities to prepare for independent clinical practice, inadequate grant funding opportunities in part because of shifting research priorities, variable productivity, and mental health or stress during the pandemic. CONCLUSION HO fellows have been profoundly affected by the pandemic, and our data illustrate multiple avenues for fellowship programs and national organizations to support both clinical and postdoctoral trainees.
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Affiliation(s)
- Urshila Durani
- Department of Hematology and HCT, City of Hope, Duarte, CA
| | - Ajay Major
- Section of Hematology-Oncology, Department of Medicine, The University of Chicago, Chicago, IL
| | - Ana I Velazquez
- Division of Hematology-Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA.,National Clinician Scholars Program, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA
| | - Jori May
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham Medical Center, Birmingham, AL
| | - Marquita Nelson
- Division of Hematology and Oncology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Ze Zheng
- Division of Endocrinology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.,Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI
| | - Anurekha G Hall
- Division of Hematology and Oncology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA
| | - Sara Taveras Alam
- Division of Hematology and Oncology, Baylor College of Medicine, Houston, TX
| | | | | | - Ashok Kumbamu
- Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Devika G Das
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham Medical Center, Birmingham, AL
| | - Martina C Murphy
- Division of Hematology and Oncology, University of Florida, Gainesville, FL
| | - Elizabeth Henry
- Department of Medical Education, Loyola University Medical Center, Maywood, IL.,Division of Hematology and Oncology, Loyola University Medical Center, Maywood, IL
| | - Alfred Ian Lee
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine and Yale Cancer Center, New Haven, CT
| | - Ariela L Marshall
- Division of Hematology, Mayo Clinic, Rochester, MN.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Ted Wun
- Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA
| | - Lachelle Dawn Weeks
- Division of Hematologic Malignancies, Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA
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22
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Shoji MK, Venincasa MJ, Sridhar J. The Impact of the COVID-19 Pandemic on Ophthalmology Resident Perceptions of Clinical Experience, Surgical Training, and Personal Life. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2021. [DOI: 10.1055/s-0041-1740314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Objective The coronavirus disease 2019 (COVID-19) pandemic has affected multiple areas of health care, including residency training programs. Elucidating the effect of the COVID-19 pandemic on resident clinical experience, surgical training, and wellness is essential to identify areas in which programs can provide additional educational and personal resources to trainees. This study aims to evaluate the experiences of ophthalmology residents during the pandemic.
Design The design is a cross-sectional, nonvalidated survey study. The survey was administered online with data collection from August 22 to August 31, 2020.
Participants Applicants to the Bascom Palmer Eye Institute ophthalmology residency program during the 2016 to 2019 application cycles were invited to complete the survey to encompass trainees currently in ophthalmology residency during the COVID-19 pandemic. Applicants who were not training at an ophthalmology residency program during the pandemic were excluded.
Methods This study involved eliciting feedback from ophthalmology residents on the perceived impact of COVID-19 on their residency experiences through survey questions.
Main Outcome Measures Perceived didactic, clinical, surgical, and overall experiences of residents during the COVID-19 pandemic, effect on cataract and noncataract surgical case volume, and perceived effects on resident personal life.
Results Responses were obtained from 357 (22.8%) individuals, 193 of which met inclusion criteria (59.1% male, 54.9% aged 30–34). Most participants reported overall worsening of their ophthalmology training experience due to COVID-19 (75.1%), with worsening of clinical training reported by 72.5% of participants and worsening of surgical training reported by 89.1% of participants. There were no significant differences in the perception of the impact of COVID-19 on overall training experience, clinical training experience, or surgical training experience among geographic regions (p = 0.43, p = 0.23, p = 0.27, respectively). A higher percentage of post-graduate year 3 (PGY3) and PGY4 trainees reported worsened clinical (p = 0.003) or surgical (p = 0.03) experience compared with PGY2 trainees. Participants also reported impact on personal life including time spent away from family (52.9%), worsened friendships with co-residents (29.5%), forced changes in living situation (15.0%), and increased expenses (13.5%).
Conclusion The COVID-19 pandemic has substantially impacted clinical and surgical experience of ophthalmology residents, who also report personal stressors due to the pandemic. Identifying alterations in the ophthalmology residency experience is essential to provide additional resources to support ophthalmology trainees professionally and personally during this time.
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Affiliation(s)
- Marissa K. Shoji
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Michael J. Venincasa
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
- Department of Vitreoretinal Surgery, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
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23
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Maltser S, Trovato E, Fusco HN, Sison CP, Ambrose AF, Herrera J, Murphy S, Kirshblum S, Bartels MN, Bagay L, Oh-Park M, Stein AB, Cuccurullo S, Nori P, Donovan J, Dams-O’Connor K, Amorapanth P, Barbuto SA, Bloom O, Escalon MX. Challenges and Lessons Learned for Acute Inpatient Rehabilitation of Persons With COVID-19: Clinical Presentation, Assessment, Needs, and Services Utilization. Am J Phys Med Rehabil 2021; 100:1115-1123. [PMID: 34793372 PMCID: PMC8594401 DOI: 10.1097/phm.0000000000001887] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to present: (1) physiatric care delivery amid the SARS-CoV-2 pandemic, (2) challenges, (3) data from the first cohort of post-COVID-19 inpatient rehabilitation facility patients, and (4) lessons learned by a research consortium of New York and New Jersey rehabilitation institutions. DESIGN For this clinical descriptive retrospective study, data were extracted from post-COVID-19 patient records treated at a research consortium of New York and New Jersey rehabilitation inpatient rehabilitation facilities (May 1-June 30, 2020) to characterize admission criteria, physical space, precautions, bed numbers, staffing, employee wellness, leadership, and family communication. For comparison, data from the Uniform Data System and eRehabData databases were analyzed. The research consortium of New York and New Jersey rehabilitation members discussed experiences and lessons learned. RESULTS The COVID-19 patients (N = 320) were treated during the study period. Most patients were male, average age of 61.9 yrs, and 40.9% were White. The average acute care length of stay before inpatient rehabilitation facility admission was 24.5 days; mean length of stay at inpatient rehabilitation facilities was 15.2 days. The rehabilitation research consortium of New York and New Jersey rehabilitation institutions reported a greater proportion of COVID-19 patients discharged to home compared with prepandemic data. Some institutions reported higher changes in functional scores during rehabilitation admission, compared with prepandemic data. CONCLUSIONS The COVID-19 pandemic acutely affected patient care and overall institutional operations. The research consortium of New York and New Jersey rehabilitation institutions responded dynamically to bed expansions/contractions, staff deployment, and innovations that facilitated safe and effective patient care.
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24
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Davila-Siliezar P, Wer A, Barnoya J. SARS-CoV-2 seroprevalence in healthcare workers in a high-volume ophthalmology centre in Guatemala. Ann Med 2021; 53:1956-1959. [PMID: 34727801 PMCID: PMC8567863 DOI: 10.1080/07853890.2021.1993325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
PURPOSE To determine the seroprevalence of SARS-CoV-2 antibodies in eye healthcare workers (EHCW) in the largest ophthalmology centre in Guatemala and factors associated with antibody positivity. METHODS We conducted a cross sectional sero-survey in all the staff at the largest ophthalmology centre in Guatemala. Serum samples were collected and tested for total antibodies against SARS-CoV-2 employing Roche Elecsys Anti-SARS-CoV-2 Immunoassay. Results were reported as reactive or non-reactive. According to patient exposure the staff were divided into low risk (technicians, domestic and administrative staff) and high risk (nurses, ophthalmologists, anaesthesiologists, and optometrists). Among those with positive antibodies, they were given a survey that included demographic characteristics, COVID-19 exposure, and related symptomatology. Logistic regression was used to determine the factors associated with antibody positivity. RESULTS On November 25th a total of 94 healthcare workers were sero-surveyed, mean age was 34.15 years (±8.41), most (57.44%) were females. Seroprevalence was 18%, the majority (77%) were in the low-risk group; while 64% at high-risk, tested negative. Those at low exposure, were five times more likely to have antibodies than those at high exposure (OR:5.69; 95% CI 1.69-19.13). Age and gender were not associated to seropositivity. CONCLUSIONS We found a similar seroprevalence of SARS-CoV-2 antibodies in EHCW to what has been reported in other healthcare groups. Seropositivity was higher among HCW with fewer patient exposure, hence the probability of community transmission.Key messagesEven though eye healthcare workers are believed to be at higher risk of infection, the prevalence of antibodies against SARS-CoV-2 in this group is comparable to what has been reported previously in other healthcare groups.
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Affiliation(s)
| | - Alfonso Wer
- Department of Ophthalmology, Unidad Nacional de Oftalmología, Guatemala City, Guatemala
| | - Joaquin Barnoya
- Department of Ophthalmology, Unidad Nacional de Oftalmología, Guatemala City, Guatemala
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Çevik H, Ungan M. The impacts of the COVID-19 pandemic on the mental health and residency training of family medicine residents: findings from a nationwide cross-sectional survey in Turkey. BMC FAMILY PRACTICE 2021; 22:226. [PMID: 34781878 PMCID: PMC8591155 DOI: 10.1186/s12875-021-01576-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/29/2021] [Indexed: 12/02/2022]
Abstract
Background The COVID-19 pandemic has had a negative impact on resident training in different branches and affected the physical and mental health of frontline residents adversely. This nationwide cross-sectional survey aimed to investigate the effects of the COVID-19 pandemic on family medicine residents in Turkey, including the levels of depression and burnout. Methods An anonymous online survey was distributed to all family medicine residents via e-mail and a web link between 28.11.2020 and 12.12.2020. Information on sociodemographic data and the residency programme were evaluated, and factors associated with depression and burnout were examined using the Patient Health Questionnaire-9 (PHQ-9) and the Burnout Measure-Short Version (BMS) respectively. Results Although the weekly average working hours of the 477 respondents increased significantly during the pandemic (p < 0.05), the average weekly working time in the Family Medicine (FM) outpatient clinic decreased. The greatest concern of 58.3% of the residents was fear of transmitting COVID-19 to their family members. 90.2% of the residents stated that training programmes were negatively or very negatively affected. According to PHQ-9 scores, 15.7% of residents had moderately severe, and 14.9% severe depression. The BMS scores of the residents demonstrated that 24.1% had a very severe burnout problem, and 23.3% should seek professional help as soon as possible. Being single, having no children, female gender, lack of personal protective equipments and increased contact time with COVID-19 patients were associated with higher scores in the depression and burnout scales (p < 0.05). Conclusions The COVID-19 pandemic has had a negative impact on training programmes for FM residents, who are at the forefront of the pandemic in Turkey, and this situation is closely related to depression and burnout. Due to the unpredictability of the pandemic, long-term plans should be made for the training needs of residents in order to protect their physical and mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01576-9.
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Affiliation(s)
- Hüsna Çevik
- Çankaya District Health Directorate, Hacettepe Mah. Talatpaşa Blv. No: 44 Altındağ, Ankara, Turkey.
| | - Mehmet Ungan
- Family Medicine Department, Ankara University Medical School, Ankara, Turkey
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Rich-Edwards JW, Ding M, Rocheleau CM, Boiano JM, Kang JH, Becene I, Nguyen LH, Chan AT, Hart JE, Chavarro JE, Lawson CC. American Frontline Healthcare Personnel's Access to and Use of Personal Protective Equipment Early in the COVID-19 Pandemic. J Occup Environ Med 2021; 63:913-920. [PMID: 34238908 PMCID: PMC8562916 DOI: 10.1097/jom.0000000000002308] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To quantify adequacy of personal protective equipment (PPE) for U.S. healthcare personnel (HCP) at the outset of the COVID-19 pandemic and its association with infection risk. METHODS March-May 2020 survey of the national Nurses' Health Studies and the Growing Up Today study regarding self-reported PPE access, use, and reuse. COVID-19 endpoints included SARS-CoV-2 tests and COVID-19 status predicted from symptoms. RESULTS Nearly 22% of 22,232 frontline HCP interacting with COVID-19 patients reported sometimes or always lacking PPE. Fifty percent of HCP reported not needing respirators, including 13% of those working in COVID-19 units. Lack of PPE was cross-sectionally associated with two-fold or greater odds of COVID-19 among those who interacted with infected patients. CONCLUSION These data show the need to improve the U.S. infection prevention culture of safety when confronting a novel pathogen.
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Affiliation(s)
- Janet W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dr Rich-Edwards); Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts (Dr Rich-Edwards and Dr Chavarro); Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts (Dr Ding and Dr Chavarro); National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio (Dr Rocheleau, Dr Boiano, and Dr Lawson); Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts (Dr Kang and Dr Hart); Tufts University, Somerville, Massachusetts (Ms Becene); Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (Dr Nguyen and Dr Chan); Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts (Dr Hart)
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Karslıoğlu MZ, Öztürkmen C, Kesim C, Taş AY, Günel Karadeniz P, Şahin A. Survey of the Impact of the COVID-19 Pandemic on Ophthalmology Clinical Practice in Turkey. Turk J Ophthalmol 2021; 51:269-281. [PMID: 34702020 PMCID: PMC8558689 DOI: 10.4274/tjo.galenos.2020.23169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objectives: To investigate the effect of the novel coronavirus disease 2019 (COVID-19) pandemic on the clinical practice of ophthalmologists in our country. Materials and Methods: A questionnaire consisting of 22 questions was delivered to 250 ophthalmologists via e-mail and a smartphone messaging application. A total of 113 ophthalmologists completed the survey. The questions included the participants’ demographic data (age, years in practice, institution, and city), changes in their working conditions and institutional preventive measures implemented during the pandemic, their personal COVID-19 experiences, the prevalence of telemedicine applications, and their attitudes toward these practices. Results: Nearly half (47.8%) of the 113 ophthalmologists were 36 to 45 years old. In terms of years in practice, the largest proportion of respondents (28.3%) had 6-10 years of experience. Most of the participants worked in private/foundation universities (37.2%), while 22.1% worked in education and research clinics. Participants working at public universities most often reported that they or a close contact had to work in COVID wards (89.5%). Triage was performed in 51.5% of ophthalmology outpatient clinics, with 88.0% of these participants reporting that patients with fever, cough, or dyspnea were directed to the pandemic clinic without ophthalmological examination. All participants working in public hospitals, education and research clinics, and public university hospitals had postponed elective surgeries, whereas 12.5% of those working in private practice and 20.5% of those working in private/foundation universities reported that they continued elective surgeries. While 80.8% of the participants did not conduct online interviews or examinations, 40.4% stated that they considered telemedicine applications beneficial. Seventy-seven percent of participants expressed concern about a decrease in their income during the pandemic, with this being especially common among participants working in private practice (87.5%) and private/foundation university hospitals (85.7%). Conclusion: Ophthalmologists across our country have been affected by this pandemic at a level that will change their clinical approach. We think that ophthalmologists impacted by the difficulty of providing personal protective equipment and economic concerns should be supported more during the pandemic.
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Affiliation(s)
| | | | - Cem Kesim
- Koç University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | - Ayşe Yıldız Taş
- Koç University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | - Pınar Günel Karadeniz
- Sanko University Faculty of Medicine, Department of Biostatistics, Gaziantep, Turkey
| | - Afsun Şahin
- Koç University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
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Rasendran C, Haueisen AJ, Wadhwa R, Singh RP. Geospatial Distribution of Ophthalmologists Older than Age 60 Years Relative to the Prevalence of COVID-19. Ophthalmic Surg Lasers Imaging Retina 2021; 52:556-559. [PMID: 34661463 DOI: 10.3928/23258160-20210930-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate coronavirus disease 2019 (COVID-19) cases as of February 1, 2021 and the proportion of ophthalmologists in the United States older than age 60 years to provide a framework for successful vaccine distribution for the ophthalmology workforce. PATIENTS AND METHODS The Association of American Medical Colleges ophthalmologist workforce dataset (from 2019) for each state was combined with John Hopkins University's COVID-19 tracking data to determine exposure risk for ophthalmologists, especially those older than age 60 years. RESULTS Of the 18,915 practicing ophthalmologists in the US, 37.6% are older than age 60 years. North Dakota (48.4%), Connecticut (46.8%), and Maine (46.7%) have the highest percentages. South Dakota (9,567), Utah (7,559), and Idaho (7,411) currently have the highest COVID-19 exposure burden per ophthalmologist older than age 60 years as of February 1, 2021. CONCLUSION Care must be taken to distribute the COVID-19 vaccine in a safe and proactive manner to ophthalmologists that face high exposure risk, both to ensure physician safety and ensure adequate care for the population they serve. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:556-559.].
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Parravicini S, Provenzi L, Barello S, Nania T, Grumi S, Rinaldi E, Orcesi S, Borgatti R. The Experience of Child Neuropsychiatry Residents who Volunteered in Italian COVID-19-Designated Hospitals. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:587-592. [PMID: 33851341 PMCID: PMC8043436 DOI: 10.1007/s40596-021-01442-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE During the first months of 2020, the coronavirus disease of 2019 (COVID-19) spread rapidly and soon reached a pandemic level. With the increasing number of hospitalizations, medical and nursing personnel resources were soon inadequate. As a consequence, medical volunteers became a key human resource and young medical residents in any specialty were hired on a voluntary basis to contribute to take care of patients with COVID-19. This study reports on the lived experience of residents in child neuropsychiatry who volunteered in Italian hotspot COVID-19-designated hospitals during the epidemic outbreak. METHODS A phenomenological, qualitative approach using semi-structured interviews with open-ended questions was used to obtain in-depth narratives of the experience of residents in child neuropsychiatry volunteering in North Italy COVID-19-designated hospitals. All residents (n = 8) participated in the study. Interviews were conducted by an expert researcher trained in qualitative methods. Data analysis was performed by independent coders. RESULTS Five core themes could be identified from the interviews: acting as mediators on two fronts, facing the shock of COVID-19 reality, capitalizing from specialty education, growing as persons and professionals, and humanizing medical care. CONCLUSIONS This study is unique in providing an in-depth understanding of the experience of young residents in child neuropsychiatry volunteering in general hospitals during the COVID-19 pandemic in Northern Italy. The findings suggest that this experience may be highly beneficial for both the residents and the hospital quality of care. Insights for an accurate planning of residents' engagement in future healthcare emergencies are provided.
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Affiliation(s)
- Stefano Parravicini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, via Mondino 2, 27100, Pavia, PV, Italy.
| | - Serena Barello
- Department of Psychology, Università Cattolica, Milan, MI, Italy
| | - Tiziana Nania
- Department of Psychology, Università Cattolica, Milan, MI, Italy
| | - Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, via Mondino 2, 27100, Pavia, PV, Italy
| | - Elisa Rinaldi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, via Mondino 2, 27100, Pavia, PV, Italy
| | - Simona Orcesi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy
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Fashner J, Espinoza A, Mainous Iii AG. COVID-19 disruption to family medicine residency curriculum: results from a 2020 US programme directors survey. Fam Med Community Health 2021; 9:fmch-2021-001144. [PMID: 34470769 PMCID: PMC8413477 DOI: 10.1136/fmch-2021-001144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective This research project examined the effects of the COVID-19 pandemic on the required curriculum in graduate medical education for family medicine residencies. Design Our questions were part of a larger omnibus survey conducted by the Council of Academic Family Medicine Educational Research Alliance. Data were collected from 23 September to 16 October 2020. Setting This study was set in the USA. Participants Emails were sent to 664 family medicine programme directors in the USA. Of the 312 surveys returned, 35 did not answer our questions and were excluded, a total of 277 responses (44%) were analysed. Results The level of disruption varied by discipline and region. Geriatrics had the highest reported disruption (median=4 on a 5-point scale) and intensive care unit had the lowest (median=1 on a 5-point scale). There were no significant differences for disruption by type of programme or community size. Conclusion Programme directors reported moderate disruption in family medicine resident education in geriatrics, gynaecology, surgery, musculoskeletal medicine, paediatrics and family medicine site during the pandemic. We are limited in generalisations about how region, type of programme, community size or number of residents influenced the level of disruption, as less than 50% of programme directors completed the survey.
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Affiliation(s)
- Julia Fashner
- Family Medicine Residency, Ocala Regional Medical Center, Ocala, Florida, USA
| | - Anthony Espinoza
- Family Medicine Residency, Ocala Regional Medical Center, Ocala, Florida, USA
| | - Arch G Mainous Iii
- Health Services Research, Management and Policy; Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA
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Durmaz Engin C, Senel Kara B, Ozturk T, Dadas OF. The Impact of COVID-19 Pandemic on Practice Patterns and Psychological Status of Ophthalmologists in Turkey. Cureus 2021; 13:e16614. [PMID: 34466311 PMCID: PMC8396407 DOI: 10.7759/cureus.16614] [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] [Accepted: 07/25/2021] [Indexed: 12/05/2022] Open
Abstract
Aim: To investigate the changes in ophthalmologists' working conditions and mental health status in Turkey during the first wave of the COVID-19 outbreak and reveal the relevant individual and workplace-related factors. Methods: This cross-sectional, nationwide, the survey-based study collected data between June and September 2020. Demographic characteristics, working conditions, precautionary measures in the workplace, and participants' Depression Anxiety Stress Scale (DASS-21) and Insomnia Severity Index (ISI) ratings were investigated. Results: This study included 360 actively working ophthalmologists. While 64% of them worked in the pandemic hospitals, 44% were actively involved in COVID-related departments. Among those, 56 (35%) declared that they had all personal protective equipment in sufficient quantity in their COVID department. Despite the restrictions, 32% reported continuing to see 25 to 50 patients per day in ophthalmology clinics, with the most common complaint being the ocular "itching and burning" sensation. 53% stated that they did not perform any surgeries. Symptoms of depression, anxiety, stress and insomnia were present in 65%, 56.9%, and 43% and 46.9% of participants, respectively. All DASS-21 subscales and ISI scores were found to be significantly higher during the pandemic. Female gender, older age, and lower satisfaction levels of hygiene conditions in COVID clinics were independent predictors of higher DASS-21 subscale scores in multivariate analysis. Being a resident was a major predictor of depression. Ophthalmologists working in a pandemic hospital were more likely to experience insomnia. Conclusion: Ophthalmologists have actively worked in COVID departments during the pandemic. Increased psychological distress among ophthalmologists compared to the pre-pandemic period is caused by personal factors and many determinants related to the workplace and practice patterns. Therefore, decreasing the transmission risk by creating a protective workplace and developing psychological support policies should be considered to minimize adverse psychological effects.
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Affiliation(s)
| | | | - Taylan Ozturk
- Ophthalmology, Dokuz Eylül University Faculty of Medicine, Izmir, TUR
| | - Omer Faruk Dadas
- Biostatistics and Medical Informatics, Ege University Faculty of Medicine, Izmir, TUR
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Khusid JA, Kashani M, Fink LE, Weinstein CS, Gupta M. The Impact of the COVID-19 Pandemic on Urology Residents: a Narrative Review. Curr Urol Rep 2021; 22:45. [PMID: 34427779 PMCID: PMC8382932 DOI: 10.1007/s11934-021-01063-9] [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] [Accepted: 07/03/2021] [Indexed: 12/30/2022]
Abstract
Purpose of Review The COVID-19 pandemic brought unprecedented challenges for urology resident education. In this review, we discuss the pandemic’s impact on urology trainees and their education. Recent Findings Urology trainees were often redeployed to frontline services in unfamiliar clinical settings. Residents often experienced increased levels of stress, anxiety, and depression. Many programs instituted virtual “check-ins” and formed liaisons with mental health services to foster cohesiveness. Urology trainees experienced the integration of telehealth into the clinical realm. Virtual surgery lectures and simulations were utilized to augment surgical education. Academic governing bodies upheld resident protections and provided dynamic guidance for training requirement throughout the pandemic. Medical students were unable to participate in traditional in-person away rotations and interviews, complicating the residency application process. Summary The COVID-19 pandemic shook the healthcare system and ushered in seismic changes for urology trainees worldwide. Though the longstanding effects of the pandemic remain to be seen, urology residents have demonstrated tremendous resilience and bravery throughout this challenging period, and those qualities will undeniably withstand the test of time.
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Affiliation(s)
- Johnathan A Khusid
- Department of Urology, Icahn School of Medicine At Mount Sinai, New York, NY, USA.
| | - Mahyar Kashani
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Lauren E Fink
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Corey S Weinstein
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Mantu Gupta
- Department of Urology, Icahn School of Medicine At Mount Sinai, New York, NY, USA
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Abbas M, Ghazanfar A. The impact of coronavirus disease 2019 pandemic on working dynamics of junior and middle grade doctors in the United Kingdom: Learning from their experience requires immediate improvement in health care planning and management-An outcome analysis of a nationwide survey. SAGE Open Med 2021; 9:20503121211039081. [PMID: 34777803 PMCID: PMC8580500 DOI: 10.1177/20503121211039081] [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: 02/02/2021] [Accepted: 07/26/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) pandemic had an unprecedented impact on health services across the world resulting in increased demand of intensive care capacity, opening Nightingale hospitals, and mass movement of doctors across various specialities. This unplanned redeployment raised concerns among various health care workers. The objective of the current study is to explore working dynamics and experience of junior and middle grade doctors during current pandemic. METHODS We organised a nationwide cross-sectional survey of junior and middle grade doctors working in the United Kingdom. The survey was aimed to study their level of participation during coronavirus disease 2019 pandemic and its impact on their clinical practices and well-being. RESULTS In total, 1564 completed questionnaires with representations from all regions of the United Kingdom were included. The mean age of respondents was 30.64 years (95% confidence interval +1.025; standard deviation = 9.9057). There were 51.5% females with significantly more participants from Black, Asian, and minority ethnic group (n = 835, p = 0.0073); 963 (61.6%, p ⩽ 0.0001) doctors were redeployed outside their primary speciality. The major redeployments were from other specialities to Intensive Therapy Units (41.8%, p ⩽ 0.001); 63.3% of respondents spend more than 8 weeks in redeployed speciality (p ⩽ 0.0001). There was a significant impact of coronavirus disease 2019 on personal, mental, and physical well-being of doctors. The major areas requiring immediate attention include proper leadership and clinical support (64.1%), pre-redeployment planning and induction (48.5%), redeployment according to the skills and/or in familiar specialities (44.6%), and regular mental and physical well-being checks (37%). CONCLUSION The outcome of the survey concluded with four major recommendations, including the need to have a named supervisor for these doctors, structured induction program, regular well-being checks, and involving them in crisis planning. These recommendations will help to shape future health care policies and management particularly when it is related to redeployment of doctors during any crisis or pandemic.
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Affiliation(s)
- Madiha Abbas
- Department of Anaesthesia and Intensive Care Unit, Epsom and St Helier Hospitals NHS Trust, London, UK
| | - Abbas Ghazanfar
- Department of Renal and Transplant, St George’s University Hospitals NHS Foundation Trust, London, UK
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Dar S, De Moraes CG, Karani R, Khan S, Chen R, Blumberg D, Harizman N, Krawitz B, Valenzuela IA, Aliancy J, Tezel T, Horowitz J, Bearelly S, Coleman DJ, Chang S, Cioffi GA, Liebmann JM. Patient Concerns Regarding Suspended Ophthalmic Care Due to COVID-19. J Glaucoma 2021; 30:750-757. [PMID: 33979109 PMCID: PMC8366515 DOI: 10.1097/ijg.0000000000001877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/14/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE The temporary cessation and profound changes in ophthalmic care delivery that occurred as a result of the coronavirus disease 2019 (COVID-19) pandemic have yet to be fully understood. Our objective is to assess patients' self-reported impact of health care lockdown measures on their fears and anxieties during the crisis period of the COVID-19 pandemic in New York City. METHODS We conducted a digital, self-reported, patient care survey distributed by an e-mail at Columbia University's Department of Ophthalmology outpatient faculty practice. Inclusion criteria were age greater than or equal to 18 years, a diagnosis of either retinal disease or glaucoma, and a canceled or rescheduled ophthalmology established patient appointment during the acute phase of the COVID-19 pandemic in New York City. Patients without an e-mail address listed in their electronic medical records were excluded. The survey occurred between March 2, 2020, to May 30, 2020. Primary measures were survey responses to assess key areas of patient anxiety or concern during the pandemic including the safety of care delivery in a COVID pandemic, difficulties contacting or being seen by their ophthalmologist, concern of vision loss or disease progression, and concern over missed or access to treatments. Secondary measures were correlating survey response to factors such as visual acuity, intraocular pressure, diagnosis, disease severity, follow-up urgency, recent treatments, and diagnostic testing data. RESULTS Of the 2594 surveys sent out, 510 (19.66%) were completed. Over 95% of patients were at least as concerned as in normal circumstances about their ocular health during the peak of the pandemic. Overall, 76% of respondents were more concerned than normal that they could not be seen by their ophthalmologist soon enough. Increased concern over ocular health, disease progression, and access to care all showed positive correlations (P<0.05) with worse disease severity as measured with testing such as visual fields and optical coherence tomography. In addition, 55% of patients were afraid of contracting COVID-19 during an office visit. CONCLUSION AND RELEVANCE We found a majority of our patients were concerned about limitations in access to ophthalmic care and were fearful of disease progression. In addition, we found a number of demographic and clinical factors that correlated with increased anxiety in our patients.
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Costa C, Teodoro M, Briguglio G, Vitale E, Giambò F, Indelicato G, Micali E, Italia S, Fenga C. Sleep Quality and Mood State in Resident Physicians during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158023. [PMID: 34360316 PMCID: PMC8345574 DOI: 10.3390/ijerph18158023] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023]
Abstract
Since the novel coronavirus (SARS-CoV-2) has spread worldwide, healthcare workers—resident physicians in particular—have been hugely involved in facing the COVID-19 pandemic, experiencing unprecedented challenges in fighting the disease. We aimed to evaluate the prevalence of poor sleep quality, daytime sleepiness, and alterations in mood state profiles in this category. This cross-sectional study, conducted in 2020, enrolled 119 subjects from a university hospital in southern Italy. Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Profile of Mood States (POMS) questionnaires were administered to physicians divided into four areas: anesthesiology, medicine, service, and surgery. In the overall sample, approximately 45% reported poor sleep quality, although only nine subjects (8%) reported an ESS score that suggested excessive daytime sleepiness. Alterations in mood profiles were also observed; the Vigor and Fatigue factors were the most altered. In particular, anesthesiologists seem to be the most affected category, showing a profound decrease in Vigor with a concomitant increase in Fatigue. Considering the possible consequences of the COVID-19 pandemic, preventive measures should be adopted, especially those aimed at facilitating a better turnover of physicians, optimizing the working schedule, and improving the organization of work.
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Affiliation(s)
- Chiara Costa
- Clinical and Experimental Medicine Department, University of Messina, 98125 Messina, Italy;
| | - Michele Teodoro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy; (M.T.); (G.B.); (E.V.); (F.G.); (G.I.); (E.M.); (C.F.)
| | - Giusi Briguglio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy; (M.T.); (G.B.); (E.V.); (F.G.); (G.I.); (E.M.); (C.F.)
| | - Ermanno Vitale
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy; (M.T.); (G.B.); (E.V.); (F.G.); (G.I.); (E.M.); (C.F.)
| | - Federica Giambò
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy; (M.T.); (G.B.); (E.V.); (F.G.); (G.I.); (E.M.); (C.F.)
| | - Giuliano Indelicato
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy; (M.T.); (G.B.); (E.V.); (F.G.); (G.I.); (E.M.); (C.F.)
| | - Elvira Micali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy; (M.T.); (G.B.); (E.V.); (F.G.); (G.I.); (E.M.); (C.F.)
| | - Sebastiano Italia
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy; (M.T.); (G.B.); (E.V.); (F.G.); (G.I.); (E.M.); (C.F.)
- Correspondence:
| | - Concettina Fenga
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, 98125 Messina, Italy; (M.T.); (G.B.); (E.V.); (F.G.); (G.I.); (E.M.); (C.F.)
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Bergner AL, Ecker LA, Ernst ME, Goelz MZ, Habermann K, Karger L, Zinberg RE. The evolution of genetic counseling graduate education in New York City during the COVID-19 pandemic: In the eye of the storm. J Genet Couns 2021; 30:1057-1068. [PMID: 34218495 PMCID: PMC8427056 DOI: 10.1002/jgc4.1461] [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: 02/12/2021] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 11/23/2022]
Abstract
The COVID‐19 pandemic has ravaged the globe in the past year, demanding shifts in all aspects of life including health profession education. The New York City area was the first major United States epicenter and is home to four genetic counseling graduate programs. We set out to explore the multifaceted programmatic changes required from the four institutions in an early pandemic epicenter, providing the longest time horizon available for assessing the implications of this restructuring on graduate education in the profession. Using practitioner‐based enquiry, our iterative reflections identified three phases of COVID‐19 response within our programs from March through December 2020. The spring months were marked by significant upheaval and reactivity, with a focus on stabilizing our programs in an unstable environment that included a significant medical response required in our area. By summer, we were reinvesting time and energy into our programs and prioritizing best practices in online learning. Relative predictability returned in the fall with noticeable improvements in flexibility and proactive problem‐solving within our new environment. We have begun to identify changes in both curricula and operations that are likely to become more permanent. Telehealth fieldwork, remote supervision, simulated cases with standardized clients, and virtual recruitment and admission events are some key examples. We explored early outcome measures, such as enrollment, retention, course evaluations, and student academic and fieldwork progress, all indicating little change from prior to the pandemic to date. Overall, we found our programs, and genetic counseling graduate education more broadly, to be much more resilient and flexible than we would ever have realized. The COVID‐19 pandemic has awakened in us a desire to move ahead with reduced barriers to educational innovation.
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Affiliation(s)
- Amanda L Bergner
- Department of Genetics and Development, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Lindsey Alico Ecker
- Joan H. Marks Graduate Program in Human Genetics, Sarah Lawrence College, Bronxville, NY, USA
| | - Michelle E Ernst
- Department of Genetics and Development, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Monika Zak Goelz
- Genetic Counseling Graduate Program, Long Island University Post, Brookville, NY, USA
| | - Kristina Habermann
- Genetic Counseling Graduate Program, Long Island University Post, Brookville, NY, USA
| | - Lisa Karger
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Randi E Zinberg
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Weygandt PL, Jordan J, Caretta‐Weyer H, Osborne A, Grabow Moore K. Impact of the COVID-19 pandemic on emergency medicine education: Insights from faculty and residents. AEM EDUCATION AND TRAINING 2021; 5:e10603. [PMID: 34141998 PMCID: PMC8190515 DOI: 10.1002/aet2.10603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/25/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The COVID-19 pandemic continues to impact health systems across the United States and worldwide in an unprecedented way; however, its influence on frontline medical trainees' educational experiences is unknown. Our objective was to determine the effects of COVID-19 on emergency medicine (EM) training programs and residents. METHODS We performed a mixed-methods cross-sectional survey study of faculty and residents at programs registered with Foundations of Emergency Medicine. Participants completed an online survey consisting of closed and open-ended response items. We reported descriptive statistics for discrete and continuous data. Free-response data were analyzed qualitatively using a thematic approach. RESULTS Ninety-two percent of faculty (119/129) and 47% (1,965/4,154) of residents responded to our survey. We identified three major themes related to effects on learning: 1) impact on clinical training, 2) impact on didactic education, and 3) impact on the trainee. Nearly all residencies (96%, 111/116) allowed residents to work with patients suspected of having COVID-19, although fewer (83%, 96/115) allowed residents to intubate them. We found that 99% (1918/1928) of residents experienced virtual didactics. Faculty and trainees noted multiple educational challenges and strategies for adaptation. Trainees also expressed concerns about stress and safety. CONCLUSION COVID-19 has impacted EM education in many ways including clinical training, didactic education, and trainee emotional state and concentration. Challenges and suggested solutions for learning in the virtual environment were also identified. While the pandemic continues to evolve and impact EM residents in various ways, our results may inform strategies to support medical educators and trainees during pandemics or other periods of significant disruption or crisis.
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Affiliation(s)
- Paul L. Weygandt
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Jaime Jordan
- Department of Emergency MedicineDavid Geffen School of Medicine at UCLAAcute Care CollegeLos AngelesCaliforniaUSA
- Department of Emergency MedicineRonald Reagan UCLA Medical CenterLos AngelesCaliforniaUSA
| | - Holly Caretta‐Weyer
- Evaluation and AssessmentDepartment of Emergency MedicineStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Anwar Osborne
- Internal MedicineDepartment of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Kristen Grabow Moore
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
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Boggs K, Goodwin T, Simpson J. Disaster Training Following COVID-19 for Pediatric Medical Residents: Demand and Format. Disaster Med Public Health Prep 2021; 16:1-4. [PMID: 34140056 PMCID: PMC8376853 DOI: 10.1017/dmp.2021.209] [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: 04/07/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Assess the knowledge, confidence, and attitudes of residents toward disaster medicine education in the coronavirus disease 2019 (COVID-19) era. METHODS Survey distributed to pediatric residents at a tertiary care center, assessing confidence in disaster medicine knowledge and skills, and preferred educational methods. Based on residents' responses, virtual and in-person educational session implemented with a postsurvey to analyze effectiveness of education. RESULTS Distributed to 120 residents with a 51.6% response rate. Almost half (46.8%) of residents had less than 1 h of disaster training, with only 9.7% having experience with a prior disaster event. However, most residents were motivated to increase their knowledge of disaster medicine due to COVID-19 and other recent disasters, with 96.8% interested in this education as a curriculum standard. Simulation and peer learning were the most preferred method of teaching. Subsequent virtual and in-person educational session demonstrated improvement in confidence scores. However, 66.7% of the virtual subset conveyed they would have preferred in-person learning. CONCLUSIONS COVID-19 has highlighted to trainees that disasters can affect all specialties, and pediatric residents are enthusiastic to close the educational gap of disaster medicine. However, residents stressed that, although virtual education can provide a foundation, in-person simulation is preferred for effective training.
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Affiliation(s)
- Kaitlyn Boggs
- Children’s National Hospital, Washington, District of Columbia, USA
| | - Tress Goodwin
- Children’s National Hospital, Washington, District of Columbia, USA
| | - Joelle Simpson
- Children’s National Hospital, Washington, District of Columbia, USA
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Abstract
Background Survey by the commission for cross-sectoral ophthalmology, as a joint commission of the German Ophthalmological Society (DOG) and the Professional Association of German Ophthalmologists (BVA) on the effects of the SARS-CoV‑2 pandemic on ophthalmological patient care in Germany. Methods Online-based survey. Results A total of 1190 questionnaires were (partly) answered. With respect to outpatient care and consultations from 15 March to 15 April 2020, a total of 69 (5.8%) participants indicated unlimited, 756 (63.5%) reduced and 330 (27.7%) emergency care only, independent of the type of institution. Outpatient surgery was restricted to emergency surgery in 68% of clinics, 42.0% of inpatient wards, 45.0% of surgical medical care centers and group practices and 33.0% of private practices. Inpatient procedures were limited to emergency care in 75.0% of inpatient wards and in 71.0% of clinics. With the exception of endophthalmitis (+8.2%), the number of urgent indications and emergencies declined: retinal detachment (−34.8%), perforating eyeball injuries (−7.3%), acute glaucoma (−17.8%), central retinal artery occlusion and anterior ischemic optic neuropathy (−31.0%), others (−30.9%), penetrating keratoplasty and amniotic membrane transplantation (−59.1%). Institutional or professional policy requirements (76.0%) and appointment cancellation by patients (84.0%) were the most common reasons for limitations in ophthalmic patient care. Conclusion The initial phase of the pandemic was characterized by a massive reduction in non-urgent conservative and surgical treatment that affected all areas of ophthalmology. Due to intensive care capacities required for COVID-19 patients, inpatient treatment was largely restricted to emergencies. Treatment of ophthalmological patients, including ocular emergencies and urgent treatment, was maintained across all sectors with a (considerable) decrease in the number of cases even in these groups.
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Herzog M, Beule AG, Lüers JC, Guntinas-Lichius O, Sowerby LJ, Bogdanov V, Grafmans D. Follow-up of a national web-based survey on the SARS-CoV-2 infectious state of otorhinolaryngologists in Germany. HNO 2021; 69:658-665. [PMID: 34086058 PMCID: PMC8176277 DOI: 10.1007/s00106-021-01075-4] [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] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 11/26/2022]
Abstract
Purpose The SARS-CoV‑2 pandemic has affected the health and practice of otorhinolaryngologists (ORLs) for over 1 year. Follow-up data of a national survey with German ORLs were evaluated regarding differences between the two waves of the pandemic. Methods As in the initial survey, German ORLs were addressed via e‑mail through the German Society of ORL, Head and Neck Surgery and the German ENT Association. All ORLs afflicted with SARS-CoV‑2 were invited to participate in a web-based survey. General data on infections and concomitant parameters were evaluated. Results Since the start of the pandemic, 129 ORLs reported testing positive for SARS-CoV‑2 in Germany. The ORLs infected during the first wave had a relative risk (RR) of 4.07 (95% CI: 3.20; 5.19) of contracting SARS-CoV‑2. During the second wave, the RR decreased to 0.35 (95% CI: 0.28; 0.45). The availability of personal protective equipment (PPE) increased from the first to the second wave along with an increased perception of protection in the professional environment. The source of infection shifted from infections via medical staff during the first wave to patients and household exposure during the second wave. Regular medical practice was resumed by clinicians and general practitioners in the second wave. Nevertheless, a proportionally lower infection rate was observed compared with the German population as a whole. Conclusion The data reflect a unique long-term survey of ORLs during the pandemic. Differences in the source of infection were seen between the first and second wave, confirming the need for appropriate PPE for medical professionals working in high-risk environments. Further strategies to reduce the risk of infection include consistent testing for SARS-CoV‑2 in healthcare professionals, patients, and the general public as well as vaccination of high-risk medical groups. Supplementary Information The online version of this paper (10.1007/s00106-021-01075-4) contains the German version of the COVID-19 questionnaire. The article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field. The additional material can be found at the article under “Ergänzende Inhalte”. ![]()
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Affiliation(s)
- Michael Herzog
- Dept. of Otorhinolaryngology, Head and Neck Surgery, Carl-Thiem-Klinikum, Thiemstr. 111, 03048, Cottbus, Germany.
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University, Halle-Wittenberg, Halle (Saale), Germany.
| | - Achim G Beule
- Dept. of Otorhinolaryngology, University Hospital Münster, Münster, Germany
- Dept. of Otorhinolaryngology, Head and Neck Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Jan-Christoffer Lüers
- Dept. of Otorhinolaryngology, Medical Faculty, University of Cologne, Cologne, Germany
| | | | - Leigh J Sowerby
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | - Vasyl Bogdanov
- Dept. of Otorhinolaryngology, Head and Neck Surgery, Carl-Thiem-Klinikum, Thiemstr. 111, 03048, Cottbus, Germany
| | - Daniel Grafmans
- Dept. of Otorhinolaryngology, Head and Neck Surgery, Carl-Thiem-Klinikum, Thiemstr. 111, 03048, Cottbus, Germany
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Soffin EM, Reisener MJ, Padgett DE, Kelly BT, Sama AA, Zhu J, Salzmann SN, Chiapparelli E, Okano I, Oezel L, Miller AO, Cammisa FP, Girardi FP, Hughes AP. Coronavirus Disease 2019 Exposure in Surgeons and Anesthesiologists at a New York City Specialty Hospital: A Cross-Sectional Study of Symptoms and SARS-CoV-2 Antibody Status. J Occup Environ Med 2021; 63:521-527. [PMID: 34048384 PMCID: PMC8168673 DOI: 10.1097/jom.0000000000002182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE We measured the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) immunoglobulin G (IgG) antibodies among surgeons and anesthesiologists and associated antibody status with coronavirus disease 2019 (COVID-19) clinical illness. METHODS A cross-sectional study of SARS-CoV-2 IgG seroprevalence with a survey assessing demographics, SARS-CoV-2 exposure risk, and COVID-19 illness. The primary outcome was the period prevalence of SARS-CoV-2 IgG antibodies associated with COVID-19 illness. RESULTS One hundred forty three surgeons and anesthesiologists completed both serology and survey testing. We found no significant relationships between antibody status and clinical role (anesthesiologist, surgeon), mode of commuting to work, other practice settings, or place of residence. SARS-CoV-2 IgG seroprevalence was 9.8%. Positive IgG status was highly correlated with presence of symptoms of COVID-19 illness. CONCLUSIONS These results suggest the relative safety of surgeons and anesthesiologists where personal protective equipment (PPE) is available and infection control protocols are implemented.
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Affiliation(s)
- Ellen M Soffin
- Department of Anesthesiology, Critical Care and Pain Management (Dr Soffin); Department of Orthopaedic Surgery, The Spine Care Institute (Dr Reisener, Dr Sama, Dr Salzmann, Dr Chiapparelli, Dr Okano, Dr Oezel, Dr Cammisa, Dr Girardi, Dr Hughes); Department of Orthopaedic Surgery, Hip and Knee Arthroplasty (Dr Padgett); Department of Orthopaedic Surgery, Sports Medicine (Dr Kelly); Department of Epidemiology, Biostatistics Core (Ms Zhu); Department of Medicine, Infectious Diseases (Dr Miller), Hospital for Special Surgery, New York, New York; Orthopaedic and Trauma Surgery, University Hospital Duesseldorf, Duesseldorf, Germany (Dr Oezel)
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Salomon B, Howk A, Heidel R, McKnight CL. Impact of coronavirus disease 2019 (COVID-19) on trauma surgical education at a level I trauma center. Surgery 2021; 170:1359-1363. [PMID: 34116858 PMCID: PMC8141696 DOI: 10.1016/j.surg.2021.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 10/29/2022]
Abstract
BACKGROUND During the coronavirus disease 2019 pandemic, trauma presentations to the emergency room decreased across the country. The goal of this study is to analyze the educational impact of coronavirus disease 2019 on trauma education and training at a level I trauma center. METHODS Trauma patient presentations were analyzed 6 months before a Tennessee executive stay-at-home order and 6 months after the state executive order. To control for the seasonal trauma volumes, an additional 6 months before the executive order was then analyzed comparing month to month. Total number of presentations, demographics, procedures, airway management, and coronavirus disease 2019 status of patients and residents were analyzed. RESULTS The number of trauma presentations were sustained after executive orders at our level I trauma center. There was no significant difference in intubations, central line placements, and chest tube placements before and during the pandemic. Blunt trauma decreased after stay-at-home orders. Of the 36 residents, no residents tested positive during the study period. CONCLUSION Trauma-focused surgical education was not affected at an academic level I trauma center. Understanding that it is region, city, and hospital specific, this study shows that quality trauma education can continue throughout the coronavirus disease 2019 pandemic while keeping trainees safe. Proper airway management, personal protective equipment, social distancing, and coronavirus disease 2019-preventative protocols seem to protect residents from potential harm while allowing them to participate and continue in quality trauma education and training.
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Affiliation(s)
- Brett Salomon
- Department of Surgery, University of Tennessee at Knoxville Graduate Medical Education, TN.
| | - Amy Howk
- Department of Surgery, University of Tennessee at Knoxville Graduate Medical Education, TN
| | - Robert Heidel
- Division of Biostatistics, Department of Surgery, University of Tennessee Medical Center at Knoxville, TN
| | - C Lindsay McKnight
- Division of Trauma and Critical Care Surgery, Department of Surgery, University of Tennessee Medical Center at Knoxville, TN
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Pawloski KR, Kolod B, Khan RF, Midya V, Chen T, Oduwole A, Camins B, Colicino E, Leitman IM, Nabeel I, Oliver K, Valvi D. Factors Associated with SARS-CoV-2 Infection in Physician Trainees in New York City during the First COVID-19 Wave. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5274. [PMID: 34063533 PMCID: PMC8156350 DOI: 10.3390/ijerph18105274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 01/25/2023]
Abstract
Occupational and non-occupational risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported in healthcare workers (HCWs), but studies evaluating risk factors for infection among physician trainees are lacking. We aimed to identify sociodemographic, occupational, and community risk factors among physician trainees during the first wave of coronavirus disease 2019 (COVID-19) in New York City. In this retrospective study of 328 trainees at the Mount Sinai Health System in New York City, we administered a survey to assess risk factors for SARS-CoV-2 infection between 1 February and 30 June 2020. SARS-CoV-2 infection was determined by self-reported and laboratory-confirmed IgG antibody and reverse transcriptase-polymerase chain reaction test results. We used Bayesian generalized linear mixed effect regression to examine associations between hypothesized risk factors and infection odds. The cumulative incidence of infection was 20.1%. Assignment to medical-surgical units (OR, 2.51; 95% CI, 1.18-5.34), and training in emergency medicine, critical care, and anesthesiology (OR, 2.93; 95% CI, 1.24-6.92) were independently associated with infection. Caring for unfamiliar patient populations was protective (OR, 0.16; 95% CI, 0.03-0.73). Community factors were not statistically significantly associated with infection after adjustment for occupational factors. Our findings may inform tailored infection prevention strategies for physician trainees responding to the COVID-19 pandemic.
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Affiliation(s)
- Kate R. Pawloski
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Betty Kolod
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
| | - Rabeea F. Khan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
| | - Vishal Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
| | - Tania Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
| | - Adeyemi Oduwole
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
| | - Bernard Camins
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
| | - I. Michael Leitman
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Department of Graduate Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ismail Nabeel
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
| | - Kristin Oliver
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (K.R.P.); (B.K.); (R.F.K.); (V.M.); (T.C.); (A.O.); (E.C.); (I.N.); (K.O.)
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Lai THT, Tang EWH, Li KKW. The Implications of COVID-19 to Ophthalmology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:637-655. [PMID: 33973203 DOI: 10.1007/978-3-030-63761-3_35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to ophthalmology. At least 16 ophthalmologists worldwide have succumbed to COVID-19. It reflects the susceptibility of ophthalmologists to COVID-19 infection as they are in close proximity to patients. This chapter provides an overview of the ocular manifestations of COVID-19, risks of COVID-19 to ophthalmologists and patients, clinical service adjustments due to COVID-19, and infection control measures to minimize the transmission of COVID-19 in ophthalmic practice.
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Affiliation(s)
- Tracy H T Lai
- Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong
- Department of Ophthalmology, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong
| | - Emily W H Tang
- Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong
- Department of Ophthalmology, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong
| | - Kenneth K W Li
- Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong.
- Department of Ophthalmology, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong.
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Breazzano MP, Nair AA, Arevalo JF, Barakat MR, Berrocal AM, Chang JS, Chen A, Eliott D, Garg SJ, Ghadiali Q, Gong D, Grewal DS, Handa JT, Henderson M, Leiderman YI, Leng T, Mannina A, Mendel TA, Mustafi D, de Koo LCO, Patel SN, Patel TP, Prenner J, Richards P, Singh RP, Wykoff CC, Yannuzzi NA, Yu H, Modi YS, Chang S. Frequency of Urgent or Emergent Vitreoretinal Surgical Procedures in the United States During the COVID-19 Pandemic. JAMA Ophthalmol 2021; 139:456-463. [PMID: 33662093 DOI: 10.1001/jamaophthalmol.2021.0036] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance The American Academy of Ophthalmology (AAO) indicated that urgent or emergent vitreoretinal surgical procedures should continue during the coronavirus disease 2019 (COVID-19) pandemic. Although decreases in the frequency of critical procedures have been reported outside the field of ophthalmology, analyses are limited by volume, geography, and time. Objective To evaluate whether the frequency of ophthalmic surgical procedures deemed urgent or emergent by the AAO changed across the United States during the COVID-19 pandemic. Design, Setting, and Participants Vitreoretinal practices from 17 institutions throughout the US participated in this multicenter cross-sectional study. The frequency of 11 billed vitreoretinal Current Procedural Terminology (CPT) codes across respective weeks was obtained from each practice between January 1, 2019, and May 31, 2020. Data were clustered into intravitreal injections (code 67028), lasers and cryotherapy (codes 67141, 67145, and 67228), retinal detachment (RD) repairs (codes 67107, 67108, 67110, and 67113), and other vitrectomies (codes 67036, 67039, and 67040). Institutions were categorized by region (Northeast, Midwest, South, and West Coast), practice setting (academic [tax-exempt] or private [non-tax-exempt]), and date of respective statewide stay-at-home orders. Main Outcomes and Measures Nationwide changes in the frequency of billing for urgent or emergent vitreoretinal surgical procedures during the COVID-19 pandemic. Results A total of 526 536 CPT codes were ascertained: 483 313 injections, 19 257 lasers or cryotherapy, 14 949 RD repairs, and 9017 other vitrectomies. Relative to 2019, a weekly institutional decrease in injections was observed from March 30 to May 2, 2020, with a maximal 38.6% decrease (from a mean [SD] of 437.8 [436.3] to 273.8 [269.0] injections) from April 6 to 12, 2020 (95% CI, -259 to -69 injections; P = .002). A weekly decrease was also identified that spanned a longer interval, at least until study conclusion (March 16 to May 31, 2020), for lasers and cryotherapy, with a maximal 79.6% decrease (from a mean [SD] of 6.6 [7.7] to 1.5 [2.0] procedures) from April 6 to 12, 2020 (95% CI, -6.8 to -3.3 procedures; P < .001), for RD repairs, with a maximal 59.4% decrease (from a mean [SD] of 3.5 [4.0] to 1.6 [2.2] repairs) from April 13 to 19, 2020 (95% CI, -2.7 to -1.4 repairs; P < .001), and for other vitrectomies, with a maximal 84.3% decrease (from a mean [SD] of 3.0 [3.1] to 0.4 [0.8] other vitrectomies) from April 6 to 12, 2020 (95% CI, -3.3 to -1.8 other vitrectomies; P < .001). No differences were identified by region, setting, or state-level stay-at-home order adjustment. Conclusions and Relevance Although the AAO endorsed the continued performance of urgent or emergent vitreoretinal surgical procedures, the frequency of such procedures throughout the country experienced a substantial decrease that may persist after the COVID-19 pandemic's initial exponential growth phase. This decrease appears independent of region, setting, and state-level stay-at-home orders. It is unknown to what extent vitreoretinal intervention would have decreased without AAO recommendations, and how the decrease is associated with outcomes. Although safety is paramount during the COVID-19 pandemic, practices should consider prioritizing availability for managing high-acuity conditions until underlying reasons for the reduction are fully appreciated.
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Affiliation(s)
- Mark P Breazzano
- Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York.,NYU Langone Eye Center, New York University, New York.,Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Audina M Berrocal
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida
| | - Jonathan S Chang
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison School of Medicine, Madison
| | - Andrew Chen
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Dean Eliott
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - Sunir J Garg
- Wills Eye Hospital, Mid-Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Quraish Ghadiali
- Department of Surgery, Cook County Health, Chicago, Illinois.,Retina Consultants Ltd, Chicago, Illinois
| | - Dan Gong
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - Dilraj S Grewal
- Department of Ophthalmology, Duke Eye Center, Duke University School of Medicine, Durham, North Carolina
| | - James T Handa
- Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew Henderson
- NJRetina, Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | | | - Theodore Leng
- Byers Eye Institute of Stanford, Stanford University School of Medicine, Palo Alto, California
| | - Amar Mannina
- Department of Surgery, Cook County Health, Chicago, Illinois
| | | | - Debarshi Mustafi
- Department of Ophthalmology, University of Washington School of Medicine, Seattle
| | - Lisa C Olmos de Koo
- Department of Ophthalmology, University of Washington School of Medicine, Seattle
| | - Shriji N Patel
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Tapan P Patel
- Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan Prenner
- NJRetina, Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Paige Richards
- Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison School of Medicine, Madison
| | - Rishi P Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Nicolas A Yannuzzi
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida
| | - Hannah Yu
- Retina Consultants of Houston, Houston, Texas
| | - Yasha S Modi
- NYU Langone Eye Center, New York University, New York
| | - Stanley Chang
- Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York
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46
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Gholami M, Fawad I, Shadan S, Rowaiee R, Ghanem H, Hassan Khamis A, Ho SB. COVID-19 and healthcare workers: A systematic review and meta-analysis. Int J Infect Dis 2021; 104:335-346. [PMID: 33444754 PMCID: PMC7798435 DOI: 10.1016/j.ijid.2021.01.013] [Citation(s) in RCA: 180] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has focused attention on the challenges and risks faced by frontline healthcare workers (HCW). This study aimed to describe the clinical outcomes and risk factors for SARS-CoV-2 infection in HCW. METHODS Three databases were surveyed and 328 articles were identified. Of these, 225 articles did not meet inclusion criteria; therefore, 97 full-text article were reviewed. Finally, after further revision, 30 articles were included in the systematic review and 28 were used for meta-analysis. RESULTS Twenty-eight studies were identified involving 119,883 patients. The mean age of the patients was 38.37 years (95% CI 36.72-40.03) and males comprised 21.4% (95% CI 12.4-34.2) of the population of HCW. The percentage of HCW who tested positive for COVID-19 was 51.7% (95% CI 34.7-68.2). The total prevalence of comorbidities in seven studies was 18.4% (95% CI 15.5-21.7). The most prevalent symptoms were fever 27.5% (95% CI 17.6-40.3) and cough 26.1% (95% CI 18.1-36). The prevalence of hospitalisation was 15.1% (95% CI 5.6-35) in 13 studies and of death was 1.5% (95% CI 0.5-3.9) in 12 studies. Comparisons of HCW with and without infection showed an increased relative risk for COVID-19 related to personal protective equipment, workplace setting, profession, exposure, contacts, and testing. CONCLUSION A significant number of HCW were reported to be infected with COVID-19 during the first 6 months of the COVID-19 pandemic, with a prevalence of hospitalisation of 15.1% and mortality of 1.5%. Further data are needed to track the continued risks in HCW as the pandemic evolves and health systems adapt.
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Affiliation(s)
- Mandana Gholami
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Iman Fawad
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Sidra Shadan
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Rashed Rowaiee
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - HedaietAllah Ghanem
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Amar Hassan Khamis
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Samuel B Ho
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates; Department of Medicine, Mediclinic City Hospital, Dubai Healthcare City, Dubai, United Arab Emirates.
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47
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Mavroudis CL, Landau S, Brooks E, Bergmark R, Berlin NL, Blumenthal B, Cooper Z, Hwang EK, Lancaster E, Waljee J, Wick E, Yeo H, Wirtalla C, Kelz RR. Exploring the Experience of the Surgical Workforce During the Covid-19 Pandemic. Ann Surg 2021; 273:e91-e96. [PMID: 33351461 PMCID: PMC7869967 DOI: 10.1097/sla.0000000000004690] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To explore the impact of the Covid-19 pandemic on the stress levels and experience of academic surgeons by training status (eg, housestaff or faculty). BACKGROUND Covid-19 has uniquely challenged and changed the United States healthcare system. A better understanding of the surgeon experience is necessary to inform proactive workforce management and support. METHODS A multi-institutional, cross-sectional telephone survey of surgeons was conducted across 5 academic medical centers from May 15 to June 5, 2020. The exposure of interest was training status. The primary outcome was maximum stress level, measured using the validated Stress Numerical Rating Scale-11 (range 0-10). RESULTS A total of 335 surveys were completed (49.3% housestaff, 50.7% faculty; response rate 63.7%). The mean maximum stress level of faculty was 7.21 (SD 1.81) and of housestaff was 6.86 (SD 2.06) (P = 0.102). Mean stress levels at the time of the survey trended lower amongst housestaff (4.17, SD 1.89) than faculty (4.56, SD 2.15) (P = 0.076). More housestaff (63.6%) than faculty (40.0%) reported exposure to individuals with Covid-19 (P < 0.001). Subjects reported inadequate personal protective equipment in approximately a third of professional exposures, with no difference by training status (P = 0.557). CONCLUSIONS During the early months of the Covid-19 pandemic, the personal and professional experiences of housestaff and faculty differed, in part due to a difference in exposure as well as non-work-related stressors. Workforce safety, including adequate personal protective equipment, expanded benefits (eg, emergency childcare), and deliberate staffing models may help to alleviate the stress associated with disease resurgence or future disasters.
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Affiliation(s)
- Catherine L Mavroudis
- Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sarah Landau
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ezra Brooks
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Regan Bergmark
- Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Zara Cooper
- Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | | | | | - Heather Yeo
- Weill Cornell Medical College, New York City, New York
| | - Christopher Wirtalla
- Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rachel R Kelz
- Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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48
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Beiser M, Lu V, Paul S, Ni J, Nazar N, Epstein E, Mammen A, Short J, Tomer Y, Jariwala SP. Electronic Health Record Usage Patterns: Assessing Telemedicine's Impact on the Provider Experience During the COVID-19 Pandemic. Telemed J E Health 2021; 27:934-938. [PMID: 33600728 DOI: 10.1089/tmj.2020.0490] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Telemedicine has been widely implemented during the coronavirus disease 2019 (COVID-19) pandemic; however, its impact on those providing care remains largely understudied. Provider documentation data collected by the electronic health record (EHR) represents an underutilized tool for assessing the provider experience. Through Epic Signal, we collected data regarding the actions logged in the EHR by health care providers of the Montefiore Health System (Bronx, NY) before and after the implementation of telemedicine during the pandemic. Focusing on five metrics (appointments per day, visits closed same day, time spent outside 7 AM-7 PM, time spent on unscheduled days, and pajama time), we performed a preliminary analysis of providers across the institution, by specialty, and according to demographic characteristics such as gender and years since graduation. We observed that after telemedicine implementation, a greater proportion of providers had fewer appointments per day, closed more notes same day, and spent less time in the EHR outside of normal working hours for each of the time-related metrics. We additionally found that providers who graduated longer ago as well as female providers spent more time documenting in the EHR after hours. This brief analysis highlights the potential of using EHR data to inform decisions based on provider well-being, specifically in the setting of telemedicine implementation.
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Affiliation(s)
- Moshe Beiser
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Vivian Lu
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Soaptarshi Paul
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Jason Ni
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Nijas Nazar
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Eric Epstein
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Adrin Mammen
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Jeffrey Short
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Yaron Tomer
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Sunit P Jariwala
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA.,Division of Allergy/Immunology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA
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49
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Socio-ecological predictors of mental health outcomes among healthcare workers during the COVID-19 pandemic in the United States. PLoS One 2021; 16:e0246602. [PMID: 33544761 PMCID: PMC7864435 DOI: 10.1371/journal.pone.0246602] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/22/2021] [Indexed: 12/11/2022] Open
Abstract
Background Healthcare workers are at increased risk of adverse mental health outcomes during the COVID-19 pandemic. Studies are warranted that examine socio-ecological factors associated with these outcomes to inform interventions that support healthcare workers during future disease outbreaks. Methods We conducted an online cross-sectional study of healthcare workers during May 2020 to assess the socio-ecological predictors of mental health outcomes during the COVID-19 pandemic. We assessed factors at four socio-ecological levels: individual (e.g., gender), interpersonal (e.g., social support), institutional (e.g., personal protective equipment availability), and community (e.g., healthcare worker stigma). The Personal Health Questionnaire-9, Generalized Anxiety Disorder-7, Primary Care Post-Traumatic Stress Disorder, and Alcohol Use Disorders Identification Test-Concise scales assessed probable major depression (MD), generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and alcohol use disorder (AUD), respectively. Multivariable logistic regression models were used to assess unadjusted and adjusted associations between socio-ecological factors and mental health outcomes. Results Of the 1,092 participants, 72.0% were female, 51.9% were frontline workers, and the mean age was 40.4 years (standard deviation = 11.5). Based on cut-off scores, 13.9%, 15.6%, 22.8%, and 42.8% had probable MD, GAD, PTSD, and AUD, respectively. In the multivariable adjusted models, needing more social support was associated with significantly higher odds of probable MD, GAD, PTSD, and AUD. The significance of other factors varied across the outcomes. For example, at the individual level, female gender was associated with probable PTSD. At the institutional level, lower team cohesion was associated with probable PTSD, and difficulty following hospital policies with probable MD. At the community level, higher healthcare worker stigma was associated with probable PTSD and AUD, decreased satisfaction with the national government response with probable GAD, and higher media exposure with probable GAD and PTSD. Conclusions These findings can inform targeted interventions that promote healthcare workers’ psychological resilience during disease outbreaks.
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50
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Tang OY, Ruddell JH, Hilliard RW, Schiffman FJ, Daniels AH. Improving the online presence of residency programs to ameliorate COVID-19's impact on residency applications. Postgrad Med 2021; 133:404-408. [PMID: 33412975 DOI: 10.1080/00325481.2021.1874195] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: The coronavirus disease 2019 (COVID-19) pandemic has created several challenges for residency programs and prospective interns alike during the upcoming application cycle, including the cancellation of away sub-internships and in-person interviews. Given prior research documenting that applicants' application and ranking decisions are significantly influenced by residency webpages, a potential solution to the loss of in-person experiences during the pandemic is the expansion of residency programs' online presence through their program websites, provision of virtual grand rounds and pseudo-away rotations, and enhancement of virtual interviews. This study seeks to summarize the existing literature on these areas and provide concrete suggestions for improving programs' virtual presence.Methods: The authors summarize earlier literature querying the content of program websites across 14 medical specialties, which documented significant gaps in the content of interest to applicants.Results: Among 14 analyzed specialties, the majority of programs had a functional website (>90%), with the exception of interventional radiology (73.9%). However, significant gaps in content were documented, with the percentage of content variables contained on websites ranging from 33.3% to 70.5% (median = 47.0%, interquartile range = 37.8-52.6%). Program websites were also limited by underrepresentation of content most valued by applicants as well as potential areas of inaccurate or outdated information.Conclusions: There are several interventions programs can undertake to address existing gaps in online presence. During an application cycle facing unprecedented resource strain, bolstering the online presence of programs may facilitate an improved fit between programs and future residents.
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Affiliation(s)
- Oliver Y Tang
- Department of Internal Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jack H Ruddell
- Department of Internal Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ross W Hilliard
- Department of Internal Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Fred J Schiffman
- Department of Internal Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Alan H Daniels
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
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