Perceptions of Digital Teaching During COVID-19; A National Survey of 359 Internal Medicine Trainees.

Introduction: The Covid-19 pandemic brought significant disruption to post-graduate medical education. Lecture-based training days were rapidly converted to webinars. This study aims to assess the perceptions of digital training in internal medical trainees. Methods: IMTs (internal medicine trainees) nationally were surveyed on their perceptions of digital training, ease of access, engagement, and interactivity via a 10-item questionnaire. A mixed-method approach using qualitative and quantitative questions was used. Likert scales were analysed using a mean result of above 3 to indicate agreement. Results: 359 trainees responded. Trainees agreed that they preferred digital training to face-to-face teaching (mean 3.68); digital training was more engaging (mean 4.25), easier to access (mean 4.49), and as effective for learning as face-to-face teaching (mean 4.69). The most reported advantages were no travel (89%) and the ability to watch later on (88%). 63% of trainees reported loss of social interaction as a disadvantage. Discussion: This survey suggests that digital teaching has a potential role in IMT training beyond the pandemic.

When It Strikes, Are We Ready? Lessons Identified at the 7th Planetary Defense Conference in Preparing for a Near-Earth Object Impact Scenario

Near-Earth object (NEO) impact is one of the examples of high impact and low probability (HILP) event, same as the Covid-19 pandemic the world faces since the beginning of 2020. The 7th Planetary Defense Conference held by the International Academy of Astronautics (IAA) in April 2021 included an exercise on a hypothetical NEO impact event, allowing the planetary defense community to discuss potential responses. Over the span of the 4-day conference this exercise connected disaster response and management professionals to participate in a series of panels, providing feedback and perspective on the unfolding crisis scenario. The hypothetical but realistic asteroid threat scenario illustrated how such a short-warning threat might evolve. The scenario utilized during the conference indicates a need to prepare now for what might come in the future, because even with advance notice, preparation time might be minimal. This scenario chose Europe for the impact, which may likely cope with such a disaster, through the Union Civil Protection Mechanism (UCPM) and other solidarity and support mechanisms within the European Union (EU), as well as with potential support from international partners. This short article raises concern about other areas in the world on how they may access NEO impact information and cope with such disasters. It also provides an idea on vast scale of such disaster vis-à-vis the current capacity of response systems to cope with a larger event in Europe or elsewhere. This scenario showed that planetary defense is a global endeavor. Constant engagement of the planetary defense and disaster response communities is essential in order to keep the world safe from potential disasters caused by NEO impacts.

Safely reducing haemodialysis frequency during the COVID-19 pandemic (preprint)

Background: Patients undergoing haemodialysis (HD) are at higher risk of developing worse outcomes if they contract COVID-19. In our renal service we reduced HD frequency from thrice to twice-weekly in selected patients with the primary aim of reducing COVID 19 exposure and transmission between HD patients. Methods: Dialysis unit nephrologists identified 166 suitable patients (38.4% of our HD population) to temporarily convert to twice-weekly haemodialysis immediately prior to the peak of the COVID-19 pandemic in our area. Changes in pre-dialysis weight, systolic blood pressure (SBP) and biochemistry were recorded weekly throughout the 4-week project. Hyperkalaemic patients (serum potassium > 6.0mmol/L) were treated with a potassium binder, sodium bicarbonate and received responsive dietary advice. Results: There were 12 deaths (5 due to COVID-19) in the HD population, 6 of which were in the twice weekly HD group; no deaths were definitively associated with change of dialysis protocol. A further 19 patients were either hospitalised and/or developed COVID-19 and thus transferred back to thrice weekly dialysis as per protocol. 113 (68.1%) were still receiving twice-weekly HD by the end of the 4-week project. Indications for transfer back to thrice weekly were; fluid overload (19), persistent hyperkalaemia (4), patient request (4) and compliance (1). There were statistically significant increases in SBP and pre-dialysis potassium during the project. Conclusions: Short term conversion of a large but selected HD population to twice-weekly dialysis sessions was possible and safe. This approach could help mitigate COVID-19 transmission amongst dialysis patients in centres with similar organisational pressures.