ABSTRACT
Objective: 1. To identify training gaps in junior clerkship rotations during the COVID-19 pandemic. 2. To develop a Clinical Transition Selective Clerkship (CTSC) during Year 4. 3. To seek student feedback on organization and management of the CTSC. Design and Methods: An online cross-sectional survey of medical students was conducted during June-September 2021 to identify training gaps. In response to identified gaps, the 4-week CTSC was developed to provide further opportunities to develop core competencies. Result(s): Just under half of students reported the opportunity to observe (45.7%) and perform (44.5%) core skills >3 times during the medicine junior clerkship. For the surgical clerkship, 48.3% observed and 44.2% performed core skills 1-3 times. For child health, 39.6% observed and 34.8% performed skills 1-3 times. More than half of respondents (55.3%) expressed concern that they missed the usual clinical clerkship training experiences during online rotations. Three-quarters (74.5%) expressed the need to acquire additional clinical experience. The majority of students rated the following aspects of the CTSC as 'Good' or better: clarity of goals and objectives (58.3%);educational value/amount learned (56.2%);professionalism of faculty (66.7%) and other clinical staff (75%);usefulness of feedback (75%);workload challenge/level of material appropriate (70.8%);overall rating/quality of CTS (60.4%). However, the following aspects were rated as 'Poor' or "Fair": organization and coherency (77.1%);commitment of coordinators (64.6%);CTS achieved stated goals (62.5%). Conclusion(s): Our study identified training gaps in junior clerkship rotations during the COVID-19 pandemic. The CTSC provided opportunities to develop clinical competencies disrupted by the pandemic.
ABSTRACT
Objective: The aim of this study was to determine the prevalence and characteristics of PPE-related adverse skin reactions among HCWs working at Harrison's Point, the main COVID-19 isolation centre in Barbados. Design and Methods: A cross-sectional web-based online survey among HCWs was carried out from 1 April 2021 to 21 June 2021. The questionnaire recorded self-reported demographic information, details of PPE use, and adverse skin reactions including severity and duration of onset of symptoms. Result(s): The majority of the respondents were females (71.2%) and the nurses represented the largest group (45.2%) of HCWs. Most of the respondents used PPE for consecutive days (77.9%), 1-6 hours/day (59.2%), and more than a year (62.5%). More than 45% (n = 47) of participants experienced adverse skin reactions from the use of PPE. The adverse skin reactions were mostly observed in the cheeks (40.4%) and nose bridges (35.6%). Females had more reactions than their male counterparts (p = 0.003). The use of N95 masks and a combination of surgical and N95 masks at no discernable consistency produced adverse effects predominantly in the ears (60%) and cheeks (56.4%) respectively. Only 40.4% of study respondents reported that they attended PPE fit testing. Conclusion(s): The PPE-related skin reactions were common among HCWs which mainly occurred due to prolonged and inappropriate use. Cheeks and nasal bridges were the most affected areas and female HCWs were more susceptible to adverse effects than males. Preventive measures inclusive of appropriate training of HCWs on the use of PPE are recommended to minimize these adverse events.
ABSTRACT
As the SARS-CoV-2 vaccinated population increases, there have been many reports of vaccine-induced cutaneous reactions but scarce information on vaccine-induced autoimmune bullous disease. Vaccinations have been associated with the unmasking or development of autoimmune bullous disease;however, there is little data on SARS-CoV-2, specifically. We report a rare case of new-onset pemphigoid in a 70-year-old male following the second dose of the mRNA-1273 vaccine. The patient’s disease has been refractory to treatment, thus the underlying pathophysiology in vaccine-induced pemphigoid is likely unique, and further investigation into this pathophysiology is warranted. © 2022 THE AUTHORS.
ABSTRACT
This chapter is devoted to the two memoirs of Abraham Verghese. In My Own Country, the author describes the beginning of his career as an infectious disease specialist in rural Tennessee at the onset of the AIDS pandemic. He uses storytelling as a technique to identify the medical and social implications of this disorder on members of his community. Lessons learned from this may be applicable as healthcare is coping with the COVID-19 pandemic and future pandemics. In The Tennis Partner, Verghese takes a similar approach to the topic of substance use disorder in physicians, using narrative writing to identify the factors that put physicians at additional risk. While Verghese can be very detailed and introspective when considering patients, he does not explore his relationships with family with the same level of attention. Nevertheless, the technique of inviting others to share stories, coupled with an opportunity for self-reflection, are skills that can improve care for individual patients and for society. © 2022 selection and editorial matter, Nathan Carlin.