Resident education in the time of the COVID-19pandemic

Objectives: The COVID-19 pandemic began in the United States and California in March 2020. At that timenumerous academic Radiology programs began efforts to increase the safety of their trainees and minimizeexposure of trainees, faculty, staff, and patients. In this presentation, we will address the methods undertaken at ourinstitution, University of California in San Diego, CA in the Radiology Department and the Nuclear Medicine Division.Decreasing exposure while maintaining daily workflow and quality teaching will be explored.Methods and Results:At the beginning of the pandemic, PACS support was engaged quickly with radiology leadership, agreeing to anorganized approach moving workstations within the department such that the 6 foot distancing requirement was metin the reading rooms and offices. The clinical coverage system initially created by the Radiology department was a2-tiered trainee team approach with on campus and off campus radiology residents. In case 1 team becameexposed or ill, requiring time away, then a back-up team was in place. A similar approach to portions of the facultywas utilized, however, Nuclear Medicine faculty remained onsite given the daily workflow that includes physician performed procedures, including all myocardial stress perfusion studies. Readouts were conducted in a variety ofsettings: in person with appropriate distancing and PPE, telephone readouts, and increasing utilization of Zoom forreadouts as the UCSD health system made available Zoom accounts for faculty and trainees. While logged into theirindividual PACS, the trainee could also login to an invited Zoom meeting where the attending could project the studyon the resident's side monitor. Zoom allowed for audiovisual interaction including allowing the trainee or attending to“take over” the mouse as needed. Zoom was utilized for attending teaching simulating side-by-side seating at thePACS for case review and also powerpoint presentations.In our Nuclear Medicine division and with departmentchair approval, the decision was made early to continue to have the residents participate in therapies withappropriate PPE and distancing such that the residents could fulfill low-dose and high-dose I-131 therapyrequirements and fulfill requirements for authorized user status. While on the Nuclear Medicine service at eachhospital site, residents obtain familiarity with laboratory, clinic, and camera equipment. The residents don gloves andPPE, handle equipment, measure doses, and have other hands-on experiences, as was done prior to the pandemic.They are encouraged to participate in procedures such as lymphoscintigraphy and diagnostic studies as can bedone safely to continue to enhance their education. Conclusions: The feedback from the residents has been positive especially with the utilization of Zoom, continuingin person readouts at our main hospital site and onsite teaching. Currently, the Radiology department is in processto obtain cameras for the PACS such that residents, especially the more junior who may not be as familiar with thefaculty, will have an enhanced interactive experience more akin to traditional in person readouts. Nuclear medicinepresents a weekly lecture series that is given via Zoom and depending on the location of the presenting attending,the presentations are sometimes given in the traditional conference rooms with appropriate distancing and PPE.Overall, a combination of methods including in person, on site, and teleradiology methods have been employed inthe education of our residents. The key lessons that we have learned include quickly adapting to each phase of thepandemic, while optimizing safety and educational experiences.

COVID-19: Initial experience of an international group of hand surgeons.

The emergence of the COVID-19 pandemic has severely affected medical treatment protocols throughout the world. While the pandemic does not affect hand surgeons at first glance, they have a role to play. The purpose of this study was to describe the different measures that have been put in place in response to the COVID-19 pandemic by hand surgeons throughout the world. The survey comprised 47 surgeons working in 34 countries who responded to an online questionnaire. We found that the protocols varied in terms of visitors, health professionals in the operating room, patient waiting areas, wards and emergency rooms. Based on these preliminary findings, an international consensus on hand surgery practices for the current viral pandemic, and future ones, needs to be built rapidly.