The Effects of Face Masks on the Doctor-Patient Relationship in Orthopaedics.

Background: Since the onset of the COVID-19 pandemic, the widespread use of face masks has grown exponentially. There is limited data highlighting the patient perception of face mask use during this pandemic, specifically in orthopaedic clinics. The purpose of this study was to determine the patient's perception of the implementation of face masks in the orthopaedic clinic during a period of mask mandates and if this change impacted the success of their interactions with physicians. The secondary aim includes measures of patient satisfaction such as the ability to understand conversation and communicate effectively with the physician. Methods: Participants were recruited on the day of their appointment at our institution's orthopaedic clinic and provided with instructions via email. The online, anonymous survey included the CARE questionnaire - a tool to examine patient satisfaction by assessing perception of empathy and was conducted using Qualtrics. Results: Does patient preference to have their physician wear a face mask impact the success of their interactions with physicians? Overall, the use of face masks by physicians did not negatively impact patient encounters. CARE scores for patients who preferred masks (37.2) were similar to those who preferred their physician did not wear a mask (37.5). Is patient satisfaction affected by the use of face masks in the orthopaedic clinic? Patients who preferred that their doctor wear a face mask stated that it had no negative impact on the effect of communication or conversation with the physician. Other factors such as how well the patients knew the physician and patient gender had a greater impact on the CARE score than masks did. Conclusion: Our study determined that the preference of face masks by patients does not impact the success of their interactions with physicians using the CARE score. The findings of this study are valuable in informing orthopaedic physicians about patient attitudes towards mask use and could influence decision making for not only the COVID-19 pandemic, but also future infectious outbreaks that may arise. Level of Evidence: III.

Virtual Versus In-person Grand Rounds in Orthopaedics: A Framework for Implementation and Participant-reported Outcomes.

INTRODUCTION: Grand rounds have been weekly gatherings at academic orthopaedic surgery programs across the country for decades. During the 50th year of grand rounds at our institution, the COVID-19 pandemic prompted the transformation of this in-person forum into a virtual setting. The purpose of this study was to detail this initiative and to report survey data providing participant-reported perceptions and satisfaction of virtual versus in-person grand rounds. MATERIALS AND METHODS: Once in-person meetings were discontinued, virtual grand rounds commenced using the Zoom video application. At the conclusion of the 2020 to 2021 academic year, a 30-item online survey was sent to all residents, faculty, and visiting faculty to assess their perspective and satisfaction. A five-point Likert scale ranging from 1 to 5, with 5 being extremely effective, was used. A 21-item follow-up survey was sent to all speakers as well. RESULTS: Thirty-six virtual grand rounds were successfully hosted. The response rate for the survey was excellent-80 of 86 (93.0%) surveys returned completed. Respondents found that virtual grand rounds were more convenient to attend, were more convenient to obtain Continuing Medical Education, and were more satisfied with virtual grand rounds. Respondents reported that in-person grand rounds were more effective for stimulating social collegiality and networking. Speakers found that virtual grand rounds were more effective for uploading the presentation and overall convenience, whereas they were less effective at retaining audience attention and receiving audience feedback. Improved faculty attendance after the switch to virtual grand rounds was also noted. CONCLUSION: This study found that respondents across all groups appreciated the convenience of attending and obtaining Continuing Medical Educations at virtual grand rounds while also noting the merits of in-person grand rounds for promoting peer interaction, camaraderie, and departmental identity. All respondents strongly recommended continuation of this program in a hybrid format. Virtual orthopaedic grand rounds are viable, readily implemented and demonstrate improved participant satisfaction.

Telemedicine in orthopaedic surgery during the COVID-19 pandemic : patient attitudes and barriers.

AIMS: This study assesses patient barriers to successful telemedicine care in orthopaedic practices in a large academic practice in the COVID-19 era. METHODS: In all, 381 patients scheduled for telemedicine visits with three orthopaedic surgeons in a large academic practice from 1 April 2020 to 12 June 2020 were asked to participate in a telephone survey using a standardized Institutional Review Board-approved script. An unsuccessful telemedicine visit was defined as patient-reported difficulty of use or reported dissatisfaction with teleconferencing. Patient barriers were defined as explicitly reported barriers of unsatisfactory visit using a process-based satisfaction metric. Statistical analyses were conducted using analysis of variances (ANOVAs), ranked ANOVAs, post-hoc pairwise testing, and chi-squared independent analysis with 95% confidence interval. RESULTS: The survey response rate was 39.9% (n = 152). The mean age of patients was 51.1 years (17 to 85), and 55 patients (38%) were male. Of 146 respondents with completion of survey, 27 (18.5%) reported a barrier to completing their telemedicine visit. The majority of patients were satisfied with using telemedicine for their orthopaedic appointment (88.8%), and found the experience to be easy (86.6%). Patient-reported barriers included lack of proper equipment/internet connection (n = 13; 8.6%), scheduling difficulty (n = 2; 1.3%), difficulty following directions (n = 10; 6.6%), and patient-reported discomfort (n = 2; 1.3%). Barriers based on patient characteristics were age > 61 years, non-English primary language, inexperience with video conferencing, and unwillingness to try telemedicine prior to COVID-19. CONCLUSION: The barriers identified in this study could be used to screen patients who would potentially have an unsuccessful telemedicine visit, allowing practices to provide assistance to patients to reduce the risk of an unsuccessful visit. Cite this article: Bone Jt Open 2021;2(9):745-751.

The Impact of COVID-19 on the Orthopaedic Surgery Residency Application Process.

Over recent months, coronavirus disease 2019 (COVID-19) has swept the world as a global pandemic, largely changing the practice of medicine as it was previously known. Physician trainees have not been immune to these changes-uncertainty during this time is undeniable for medical students at all levels of training. Of particular importance is the potential impact of COVID-19 on the upcoming residency application process for rising fourth-year students; a further source of added complexity in light of the newly integrated allopathic and osteopathic match in the 2020 to 2021 cycle. Owing to the impact COVID-19 could have on the residency match, insight regarding inevitable alterations to the application process and how medical students can adapt is in high demand. Furthermore, it is very possible that programs will inquire about how applicants spent their time while not in the hospital because of COVID-19, and applicants should be prepared to provide a meaningful answer. Although competitive at a basal level, the complexity of COVID-19 now presents an unforeseen, superimposed development in the quest to match. In this article, we aim to discuss and provide potential strategies for navigating the impact of COVID-19 on the residency application process for orthopaedic surgery.