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SETTING AND PARTICIPANTS: Structural racism is defined as the cumulative effects of policies, institutional practices, cultural representations, and other norms that work together to perpetuate racial inequity. This phenomenon extends to academic medicine and is exposed through how we teach, learn, and evaluate patients, students, trainees, and faculty physicians. Thus, the authors created a faculty development series to establish a knowledge of structural competency as a framework for teaching and to change participants' attitudes and confidence. Our participants consisted of clinician-educators (N=122) including internal medicine (generalists and subspecialists), pediatrics, psychiatry, and surgery who participated in sessions rooted in structural competency. The authors developed and facilitated the sessions over Zoom. DESCRIPTION: In the wake of Black Lives Matter protests following the killing of George Floyd, and in light of alarming health disparities uncovered in the COVID-19 pandemic, our institution, like many across the country, realized the importance of actively training providers to address racism and its downstream effects. Despite this, there are few examples of curricula for clinician-educators. Structural competency offers a framework for practicing anti-racism in medical education. We developed a faculty development workshop series consisting of four 90-minute workshops administered in the spring and summer of 2021 and developed or adapted associated tools that could be directly applied to teaching. Session Developed Tools Introduction to Structural Competency & Revising Existing Curricula Structurally competent and anti-racist rubric for revising existing didactics Transforming Resident Report and Case-Based Presentations Using the Structural Differential Step by step guide for building a structural differential with learners Ambulatory Teaching: The Structurally Competent Preceptor Structurally competent adaptations of the One Minute Preceptor and SNAPPS precepting models Inpatient Teaching: Structurally Competent Hospital-Based Medicine Structurally competent inpatient discharge checklist EVALUATION: Preliminary results showed significant improvements in overall faculty attitudes and confidence on pre-and post-intervention surveys (M=1.92, SD=2.29, p= 0.01;M=4.36, SD=3.32, p=.0.00) respectively. Additional results will evaluate whether there are improvements in faculty knowledge and behavior by tracking faculty use of the structural competency rubric and comparing faculty clinical documentation practices before and after the curriculum. DISCUSSION / REFLECTION / LESSONS LEARNED: The potential next step is to integrate into a faculty development program aimed to bolster structurally competent communication with diverse patients, strengthen efficiencies in clinical data gathering, and deepen patient trust in treatment plans. Future investigations will center on the validation of a survey tool to assess anti-racism within an institution's teaching faculty and apply the workshop to various institutional settings.
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SETTING AND PARTICIPANTS: In response to the need for innovative community engagement and pre-medical education, the COVID-19 STEM Community Education and Empowerment Internship program (CCEEI) was developed as a collaboration between six New York City medical schools and Mentoring in Medicine, a non-profit organization. This virtual program was attended by 1045 underrepresented in medicine (UriM), first-generation, and disadvantaged college and gap year students who were interested in medical and health careers, over the first three cohorts. Participants learned about COVID-19 and disparities, vaccine science, the roles of medicine and public health, and strategies for community education and empowerment. 1045 U.S. based students participated over three cohorts as well as additional students from around the world. DESCRIPTION: 4-8 sessions, each 2-4 hours long, each of which consisted of lectures (e.g. virology and pandemics, COVID-19 biology and prevention, how vaccines work, etc.) followed by interactive discussions. Learner assessment included mid-point survey, end of program survey, and post-30 day survey, and capstone projects presented during the final session of the program;capstones were intended to raise awareness of COVID-19 safety measures and vaccines to a lay audience. Examples included Tik Tok videos, infographics, PowerPoint presentations, etc. Each student received a certificate of acknowledgment for their participation in the COVID-19 STEM Education and Empowerment Internship. EVALUATION: Recruiting efforts were successful in providing this premedical program available to students from URiM backgrounds, 55% identified as Black or Latino and 97% were interested in health professional careers. Program evaluation consisted of aggregate learner assessments and administration of a mixed-method survey seeking participant perspectives. Program participants applied knowledge they gained and self-reported outreach to at least 13,499 people in their communities on COVID-19 and COVID-19 vaccination. Most frequent modes of communication included: TikTok, YouTube, and Instagram. DISCUSSION / REFLECTION / LESSONS LEARNED: Program adjustments including curriculum changes were made based on mid-point, end-of-course, and post-surveys. There was an overwhelming response from students wanting to gain knowledge and be a part of outreach efforts to impact their communities. In the first session, many students shared in their e-poster personal impacts of COVID, ranging from loss of family and friends, and isolation experienced. There is much promise in reaching pre-medical students through a virtual education program as students reported gaining communication skills to address myths and vaccine hesitancy and felt empowered to use technology to share knowledge gained from the program with their networks.
ABSTRACT
Individuals with malignancies and COVID-19 have a lower survival compared with the general population. However, the information about the impact of COVID-19 on the whole hematological population is scarce. We aimed to describe the 30th day overall survival (OS) after COVID-19 infection in patients with a hematological disease in Argentina. A completely anonymous survey from the Argentine Society of Hematology was delivered to all the hematologists in Argentina;it started in April 2020. A cut-off to analyze the data was performed in December 2020 and, finally, 419 patients were reported and suitable for the analysis (average age: 58 years, 90% with malignant diseases). After the COVID-19 diagnosis, the 30-day OS for the whole population was 80.2%. From the entire group (419), 101 (24.1%) individuals required intensive care unit admission, where the 30-day OS was 46.6%. Among allogeneic stem cell transplant recipients, the 30-day OS was 70.3%. Factors associated with a low OS were two or more comorbidities, an active hematological disease and history of chemotherapy. In individuals with the three factors, the 30-day OS was 49.6% while the 30-day OS in those without those factors was 100%. Patients with hematological diseases have a higher mortality than the general population. This group represents a challenge and requires careful decision-making of the treatment in order not to compromise the chances of cure.
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Introduction. As a measure for controlling COVID-19, lockdown has had a psychological impact on people. Since subjective well-being (SW) has been positively associated with mental health, the identification of its predictors in this context will enable it to be strengthened. Objective. To generate and test explanatory models for SW in men and women under lockdown due to the pandemic. Method. Four thousand seven hundred and seventy-one inhabitants of Mexico, with paid employment, under lockdown, answered a set of instruments via the Internet that evaluated positive and negative psychological factors in addition to SW. Based on correlation and multiple regression analysis, models were proposed for men and women, which were tested by path analysis. Results. Both models successfully fit the data and explained a high proportion of the SW variance. Spiritual strength was the best predictor, mainly for women, while the capacity for enjoyment was central to the models, mediating the effect of empathy and depression. Discussion and conclusion. SW is significantly predicted by the factors studied, especially spiritual strength and capacity for enjoyment, which seem to provide men and women with fortitude and meaning of life in adverse circumstances such as today's.
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In this brief reflective personal essay, I try to describe the possible emotional and psychic problems that Brazilian nurses are presenting in the wake of the current Covid19 pandemic. I would like to send a message, from Canary Islands in Spain, of strength and hope to my partners.
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Mexico is a seismically active country. Earthquakes with magnitudes larger than 7.0 happen, on average, every other year. This fact requires a rapid and consistent response from the national monitoring agency, the Servicio Sismológico Nacional, SSN (Mexican National Seismological Service). For this purpose, in 2014, the SSN created a set of procedures for the daily operations and rapid response called “Protocolo de Respuesta Inmediata ante Sismos Amenazantes” (PRISA, protocol of immediate response to threatening earthquakes). This protocol has been triggered for 292 events with a magnitude larger than or equal to 5.0 that occurred between April 2014 and July 2020. Here we present the response of the SSN, based on this protocol, to three significant earthquakes: the 8 and 19 September 2017 events (Mw 8.2 and 7.1, respectively) and the 23 June 2020 (Mw 7.4). The first two quakes caused severe damage in southern and central Mexico, whereas the third occurred during the coronavirus disease 2019 pandemic and confinement in Mexico. Having PRISA in place contributed to the efficient SSN response in the three events, even though some activities for the 2020 earthquake were performed remotely. © Seismological Society of America