ABSTRACT
Background: First-year resident physicians began training in July 2020 in an environment of decreased clinical case exposure and increased feelings of discomfort because of the COVID-19 pandemic. To improve specialty learning, the University of Toronto Department of Otolaryngology - Head and Neck Surgery piloted a novel virtual case-based teaching intervention for first-year residents. Methods: A weekly virtual resident-led casebased discussion series was designed. Six residents and 4 staff otolaryngologists participated. A Likert-type survey administered retrospectively evaluated the effect on resident confidence. The survey rated participant comfort level on a scale of 1 to 5, from "not well prepared or comfortable" to "very well prepared or comfortable," in 7 different areas at the beginning of postgraduate year (PGY) 1 in July 2020, and in April 2021. Qualitative data collected assessed strengths and weaknesses of the intervention. Results: Residents reported increased comfort level in all areas assessed, including overall emergency department consults, inpatient consults, and specific epistaxis consults by 28%;triaging consults and addressing peritonsillar abscess consults by 24%;addressing pediatric otolaryngologic and airway concerns by 20% each;and addressing otologic concerns by 32%. All respondents agreed the intervention would benefit residents of other programs. Conclusion: The studied intervention can potentially improve both resident education and patient care. It facilitated real-time discussion of topics relevant to self-perceived knowledge deficits and timely advice on management of a new and changing population of patients with COVID-19. The intervention described could be applied to benefit residents in otolaryngology and other surgical specialty programs nationwide during and after the pandemic.
ABSTRACT
SARS-CoV-2 is a respiratory pathogen that can cause severe disease in at-risk populations but results in asymptomatic infections or a mild course of disease in the majority of cases. We report the identification of SARS-CoV-2-reactive B cells in human tonsillar tissue obtained from children who were negative for coronavirus disease 2019 prior to the pandemic and the generation of mAbs recognizing the SARS-CoV-2 Spike protein from these B cells. These Abs showed reduced binding to Spike proteins of SARS-CoV-2 variants and did not recognize Spike proteins of endemic coronaviruses, but subsets reacted with commensal microbiota and exhibited SARS-CoV-2-neutralizing potential. Our study demonstrates pre-existing SARS-CoV-2-reactive Abs in various B cell populations in the upper respiratory tract lymphoid tissue that may lead to the rapid engagement of the pathogen and contribute to prevent manifestations of symptomatic or severe disease.
Subject(s)
Adenoids/immunology , B-Lymphocyte Subsets/immunology , B-Lymphocytes/immunology , COVID-19/immunology , Mucous Membrane/immunology , Receptors, Antigen, B-Cell/genetics , Respiratory System/immunology , SARS-CoV-2/physiology , Antibodies, Viral/metabolism , Child , HEK293 Cells , Humans , Immunologic Memory , Lymphocyte Activation , Single-Cell Analysis , Spike Glycoprotein, Coronavirus/immunology , TranscriptomeABSTRACT
The COVID-19 pandemic has disrupted healthcare systems around the world, impacting how we deliver medical education. The normal day-to-day routines have been altered for a number of reasons, including changes to scheduled training rotations, physical distancing requirements, trainee redeployment, and heightened level of concern. Medical educators will likely need to adapt their programs to maximize learning, maintain effective care delivery, and ensure competent graduates. Along with a continued focus on learner/faculty wellness, medical educators will have to optimize existing training experiences, adapt those that are no longer viable, employ new technologies, and be flexible when assessing competencies. These practical tips offer guidance on how to adapt medical education programs within the constraints of the pandemic landscape, stressing the need for communication, innovation, collaboration, flexibility, and planning within the era of competency-based medical education.