Surgical treatment for fragility hip fractures during the COVID-19 pandemic resulted in lower short-term postoperative functional outcome and a higher complication rate compared to the pre-pandemic period.

The COVID-19 pandemic adversely affected the functional outcomes of fragility hip fracture patients. This study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among patients treated during the pandemic. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods. INTRODUCTION: This study aims to investigate the in-hospital complication rate and short-term postoperative functional outcomes of fragility hip fracture (FHF) patients compared between during the COVID-19 pandemic and the same 14-month time period 1 year prior to the pandemic. METHODS: Using data from the Siriraj Fracture Liaison Service registry, FHF patients treated during the COVID-19 pandemic (1 March 2020 to 30 April 2021) were time-matched with FHF patients treated during the pre-pandemic period (1 March 2018 to 30 April 2019). We collected the rate of in-hospital postoperative complications and the postoperative functional outcomes at discharge and 3 months as measured by the Barthel Index (BI) and EuroQol visual analog scale (EQ-VAS). Functional outcome measures were compared between the pre-pandemic and pandemic periods. RESULTS: There were 197 and 287 patients in the pre-pandemic and pandemic groups, respectively. At the 3-month postoperative follow-up, the mean postoperative BI score and change in BI score were both significantly lower in the pandemic group indicating poorer postoperative function. Moreover, FHF patients treated during the pandemic had significantly more in-hospital complications (36.6% vs. 22.8%, p = 0.002). There was no significant difference in the 3-month EQ-VAS or change in the EQ-VAS between groups. CONCLUSION: The results of this study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among FHF patients treated during the COVID-19 pandemic compared to the pre-pandemic period. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods.

Comparing the effectiveness of blended learning and traditional learning in an orthopedics course.

INTRODUCTION: The ongoing COVID-19 pandemic is forcing medical schools to replace substantial parts of the traditional lecture method with online formats to maintain social distancing guidelines and reduce face-to-face contact in the classroom. To our knowledge, there have to date been few studies comparing the effectiveness of traditional teaching with blended teaching based on the students' final grades which the efficacy of online learning is still controversial, and this study aimed to compare the efficacy of blended teaching with conventional teaching in an orthopedics course. METHODS: This study was a retrospective cohort study based on data collected from fifth-year medical students between April 2019 and March 2021. The students were divided into two groups which based on years of study. The summative assessment was based on summing the MCQs plus KFs, the MEQ plus oral exam, OSCE, simulated patient chart reviews, and OPD work. All students took the same end-of-course quizzes with no differences between the groups regarding the kinds of knowledge tested. The results of these quizzes were used to compare the effectiveness of the conventional teaching in 2019 and the blended teaching in 2020. The paired t-test was used to analyze the data. RESULTS: A total of 252 students were enrolled in the study, of whom 128 and 124 students were in the traditional teaching group or blended teaching groups, respectively. The grade point averages of the students were 3.2 ± 0.4 and 3.3 ± 0.4 in 2019-2020 and 2020-2021, respectively, without significant difference (p-value = 0.06). The scores in the blended learning group were higher than in the traditional learning group in all assessment tools (MCQ, KF, Oral, and OSCE scores) except the MEQ. CONCLUSIONS: Blended learning was not less effective than traditional learning for teaching medical students.

Expectations on online orthopedic course using constructivism theory: A cross-sectional study among medical students.

BACKGROUND: Medical education in this era has been disturbed by coronavirus disease. Our faculty has quickly adapted the curricula to online formats. The online format seems to be more advantageous in terms of content material and virtual activities, but the results of these adjustments will require subsequent evaluation. The aim of this study was to evaluate medical student expectations of online orthopedics learning that was created based on social constructivism theory. MATERIALS AND METHODS: A cross-sectional survey was carried out to assess the fifth-year medical student expectations of our newly developed online orthopedics course during the outbreak. Constructivist Online Learning Environment Survey (COLLES) was applied for evaluating the expectations during orthopedic rotation. The survey contains six aspects based on social constructivist principles: relevance, reflection, interactivity, tutor support, peer support, and interpretation. All students responded to the preferred COLLES before starting the online course, and the actual COLLES was filled out when the online course was completed. Before and after attending the online course, the scores were compared and interpreted to assess student expectations. RESULTS: A total of 126 fifth-year medical students studied the online orthopedic course. The preferred COLLES were completed by 125 students, while 120 students replied to the actual COLLES. The overall scores from the post-course survey in all aspects were significantly higher than scores from the pre-course with P-value < 0.01. The comparison between the preferred and actual scores showed this online course fulfilled student expectations. CONCLUSION: The outbreak of coronavirus disease 19 has disrupted medical student education. The online orthopedic learning course in our department has been developed to deal with the current situation. Using the various activities based on social constructivism theory in the online platform was able to fulfill medical student expectations.