The Social Emergency Medicine Mini- Curriculum: A Novel, Multifaceted Immersive Approach to Resident Education in Social EM

Learning Objectives: 1) To design, implement and evaluate the feasibility of a replicable multifaceted Social EM curriculum for EM residents 2) To increase EM residents' level of awareness related to Social EM and increase their ability to identify/intervene on social determinants of health in clinical practice Background: Emergency Medicine (EM) physicians are in a unique position to impact both individual and population health needs. Despite this, EM residency training lacks a formalized education on social determinants of health (SDoH) and social EM (SEM). The need for such a curriculum has been previously recognized, however there is a gap in the literature related to the feasibility of such a curriculum addition. This innovation seeks to address this need. Curricular Design: A taskforce of EM clinicianeducators with expertise in SEM developed a 4.5-hour educational curriculum for use during a single Emergency Medicine resident didactic block (1/2-day session). The curriculum (Table 1) included asynchronous learning via a podcast, four SEM subtopic lecture didactics, guest speakers from ED social work and a community outreach partner representative, and a poverty simulation with interdisciplinary debrief. The curriculum was delivered via videoconference due to COVID-19 restrictions. Pre- and post-curricular intervention participant surveys were obtained. Impact: Post-survey results (Table 2) demonstrated improved awareness of SEM concepts and increased confidence in participant's knowledge of community resources and ability to connect patients to these resources following the curricular intervention. In addition, post-survey assessment demonstrated significantly heightened awareness and clinical consideration of SDoH among participants and increased comfort in identifying social risk in the ED. Overall, all components of the curriculum were evaluated as meaningful and specifically beneficial for EM training. The community partner presentation and subtopic lectures were ranked highest, followed closely by the poverty simulation, ED social services presentation, and asynchronous podcast component. This pilot curricular integration study demonstrates the feasibility and perceived participant value of incorporating a SEM curriculum into residency training.

Tackling healthcare inequities through a social media-based platform to connect solid tumor patients with COVID-19 to clinical trials

Background: COVID-19 has contributed to healthcare inequity amongst minorities and lower socioeconomic populations, while complicating present anti-cancer treatment regimens. Due to their immunocompromised status, cancer patients are at an increased risk of severe SARS-CoV-2 infection. While sentiment analysis via SM has seen vast growth among healthcare professional, deeper connection and management has been lacking. Given the higher usage of SM impressions and the increase in healthcare disparities especially at the intersection of oncology and COVID-19, the aim of this study was to develop a platform that can: (1) show that the relationships highlighted within these tweets can be realized in biomolecular interactions-specifically within the interaction between solid tumors and COVID-19;(2) use SM data to connect patients with clinical trials. Methods: To determine this relationship, ontologies, which are groupings of terms and related identifiers, such as genes, were created for general search terms, utilizing the Human Phenotype Ontology. They were then combined with “COVID-19” and used as search terms in Twitter's Standard Search tool. The keywords with the most matches were then queried through clinicaltrials.gov and European Bioinformatics Institute's (EBI) Protein Search Tool to find relevant clinical trials and proteins. Finally, the proteins found by the EBI protein search were run through the SwissModel Tool to find relevant protein structures before being used in binding using Polar+'s Binding Platform from Iff Technologies, which provides K values related to 50% inhibition for each medication or immunotherapy. This produced a set of disease-specific keywords that are related to top tweets, clinical trials, protein structures, and binding concentration values in relevant biomolecular pathways for the keyword set “Tumor COVID-19”. Results: The example shown in Table is produced via our platform, with keywords with tweet numbers greater than 95% of all tweets with connected keywords used. Conclusions: By utilizing SM with highly relevant keywords, this platform can combat healthcare inequity by connecting patients and their tweets to clinical trials and enhance literacy about their medical conditions, while providing a greater understanding of the biomolecular pathways involved.

The rise of social media to connect with emergency medicine residency applicants during covid-19

Learning Objectives: Compare how emergency medicine residency programs are using various online platforms to engage and communicate with applicants during the 2020-2021 application cycle. Background: The COVID-19 pandemic has profoundly impacted this year's residency application and match process. In-person interviews and the majority of visiting rotations have been suspended, impeding traditional avenues that applicants use to evaluate programs. Prior research suggests that emergency medicine residency programs have been using social media as a means of education, outreach, and discussion. Objectives: The objective of this study is to evaluate how emergency medicine residency programs are using online platforms during the 2021 application cycle, specifically to publicize live virtual events showcasing their individual programs. Methods: A standardized google search was used to find every EM program's website, Twitter, Instagram, and Facebook. The pages were further evaluated for virtual open house advertisements posted after March 2020, as well as for date of account creation. Results: Emergency medicine has a large online presence with a total of 258 websites and 452 social media accounts across 260 programs. Nearly all programs (99%) have their own website. Many programs use Twitter (75%), Facebook (38%), or Instagram (61%), and 25% of programs have accounts on all three. Most Twitter and Facebook accounts were created before March 2020 (92% and 93%, respectively), whereas nearly half (44%) of Instagram accounts were created after the start of the COVID-19 pandemic. The majority of programs utilized their Twitter (69%) and Instagram (73%) to advertise virtual open houses;Facebook was used much less often (33%). Only 9% of programs advertised virtual opportunities on their website. Conclusion: In a time of limited travel and social distancing, online platforms can facilitate virtual versions of interactions lost due to the pandemic. There is a clear preference for using social media over traditional websites to promote these networking opportunities. This bias is likely due to the dynamic, brief, and easily accessible nature of social media.

What to do as a gynecologic oncologist during the COVID-19 pandemic? MEMAGO Statement. (Special Issue: COVID-19 pandemic.)

The SARS-Cov-2 virus pandemic causes an acute public health emergency with millions of infected patients and thousands of deaths. The infection makes adults prone to severe and fatal consequences, especially when they suffer several comorbidities. Our oncologic patients are the most susceptible to its severe repercussions because of their initial diagnosis and the immunosuppressive adjuvant and neoadjuvant treatments they receive. The Chinese CDC reported a 5.6% risk of mortality among cancer patients compared to 0.9% in the general population;likewise, other studies showed a twofold higher risk of death in this patients' subgroup. In order to maintain the best quality of medical services during this crisis, along with the safety of healthcare providers, accurate triage of our oncologic patients must be done before any medical or surgical intervention to decide whether or not postponing treatments may be considered, without risking the disease progression and patients' worsening outcomes, otherwise inpatient and outpatient special precautions must be followed whenever interventions are currently scheduled, according to each gynecologic cancer type. The disease is worldwide but local and regional circumstances vary, thus practice guidelines must be individualized according to each country virus prevalence and available medical resources, in order to limit the burden of the COVID-19 infection on the health system during the crisis and the upcoming months after its resolution.

What to do as a gynecologic oncologist during the COVID-19 pandemic? MEMAGO statement

The SARS-Cov-2 virus pandemic causes an acute public health emergency with millions of infected patients and thousands of deaths. The infection makes adults prone to severe and fatal consequences, especially when they suffer several comorbidities. Our oncologic patients are the most susceptible to its severe repercussions because of their initial diagnosis and the immunosuppressive adjuvant and neoadjuvant treatments they receive. The Chinese CDC reported a 5.6% risk of mortality among cancer patients compared to 0.9% in the general population;likewise, other studies showed a twofold higher risk of death in this patients’ subgroup. In order to maintain the best quality of medical services during this crisis, along with the safety of healthcare providers, accurate triage of our oncologic patients must be done before any medical or surgical intervention to decide whether or not postponing treatments may be considered, without risking the disease progression and patients’ worsening outcomes, otherwise inpatient and outpatient special precautions must be followed whenever interventions are currently scheduled, according to each gynecologic cancer type. The disease is worldwide but local and regional circumstances vary, thus practice guidelines must be individualized according to each country virus prevalence and available medical resources, in order to limit the burden of the COVID-19 infection on the health system during the crisis and the upcoming months after its resolution.

Étude multicentrique de la transmission nosocomiale du SRAS-CoV-2 : le projet NOSO-COR

Introduction Comme pour les autres virus respiratoires, des cas de transmission intra-hospitalière de SRAS-CoV-2 ont été signalés. Dans le contexte d’un taux d’incidence élevé du SRAS-CoV-2 dans la communauté, une augmentation significative du taux de transmission nosocomiale est attendue. Ce risque pourrait même être plus élevé dans les pays à faible revenu qui ont des systèmes de santé plus fragiles, ceci en raison de facteurs tels que le retard de diagnostic, le manque d’infrastructures, de personnel qualifié, d’unités d’isolement et de programmes de contrôle des infections. Une meilleure compréhension des chaînes de transmission du SRAS-CoV-2 et de l’impact des mesures de contrôle dans les unités de soins est essentielle pour maîtriser la pandémie. Cette étude a pour l’objectif principal d’estimer la prévalence et l’incidence des cas suspects ou confirmés d’infection par le SRAS-CoV-2 chez le personnel soignant et les patients dans les hôpitaux participants. Matériels et méthodes Il s’agit d’une étude prospective internationale, observationnelle en milieu hospitalier. Il regroupera des patients et des professionnels de santé en France, au Brésil et dans les hôpitaux affiliés au réseau GABRIEL, un réseau d’institutions de recherche principalement situées dans les pays à faible revenu. Les données démographiques et cliniques sont collectées à l’aide de questionnaires conçus spécialement pour le projet. Un écouvillon nasopharyngé est prélevé et testé pour le SRAS-CoV-2 par RT-PCR. Une modélisation multivariée appropriée sera utilisée pour identifier les déterminants associés à la transmission nosocomiale. Résultats À la date du 12 juin 2020, 1478 patients COVID-19 confirmés et 740 professionnels de santé ont été inclus par les 13 centres Français et 368 patients et professionnels de santé ont été recrutés dans les centres internationaux. Conclusion Les résultats de ce projet fourniront des résultats originaux qui pourraient : – constituer des preuves supplémentaires pour une meilleure compréhension de la durée de l’incubation et de la période contagieuse du SRAS-CoV-2 ;– renforcer les campagnes de prévention de la transmission nosocomiale du virus ;– ouvrir la voie à de nouvelles recommandations en termes de prévention ;– compléter les recommandations existantes grâce aux données supplémentaires concernant la transmission du virus, contribuant ainsi à améliorer les directives de contrôle pour des épidémies virales respiratoires similaires. La communication des résultats aux personnels soignants permettrait de les sensibiliser sur leur rôle dans la prévention de la propagation du virus dans les hôpitaux et dans leur environnement immédiat et pourrait être utilisée pour soutenir la couverture vaccinale si un vaccin devenait disponible.