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1.
Glob Health Sci Pract ; 9(3): 690-697, 2021 09 30.
Article in English | MEDLINE | ID: covidwho-1542965

ABSTRACT

Emergency medicine (EM) is rapidly being recognized as a specialty around the globe. This has particular promise for low- and middle-income countries (LMICs) that experience the largest burden of disease for emergency conditions. Specialty education and training in EM remain essentially an apprenticeship model. Finding the required expertise to educate graduate learners can be challenging in regions where there are low densities of specialty providers.We describe an initiative to implement a sustainable, bidirectional partnership between the Emergency Medicine Departments of Weill Cornell Medicine (WCM) in New York, NY, USA, and Bugando Medical Center (BMC) in Mwanza, Tanzania. We used synchronous and asynchronous telecommunication technology to enhance an ongoing emergency medicine education collaboration.The Internet infrastructure for this collaboration was created by bolstering 4G services available in Mwanza, Tanzania. By maximizing the 4G signal, sufficient bandwidth could be created to allow for live 2-way audio/video communication. Using synchronous and asynchronous applications such as Zoom and WhatsApp, providers at WCM and BMC can attend real-time didactic lectures, participate in discussion forums on clinical topics, and collaborate on the development of clinical protocols. Proof of concept exercises demonstrated that this system can be used for real-time mentoring in EKG interpretation and ultrasound technique, for example. This system was also used to share information and develop operations flows during the COVID-19 pandemic. The use of telecommunication technology and e-learning in a format that promotes long-term, sustainable interaction is practical and innovative, provides benefit to all partners, and should be considered as a mechanism by which global partnerships can assist with training in emergency medicine in LMICs.


Subject(s)
Curriculum , Education, Distance/methods , Education, Medical, Graduate/methods , Emergency Medicine/education , Emergency Medicine/methods , Academic Medical Centers , Emergency Service, Hospital , Humans , Mobile Applications , New York City , Social Media , Tanzania
2.
J Otolaryngol Head Neck Surg ; 50(1): 65, 2021 Nov 16.
Article in English | MEDLINE | ID: covidwho-1523331

ABSTRACT

BACKGROUND: The COVID-19 pandemic has deeply impacted healthcare and education systems, including resident education. The impact of the pandemic on the different types of pedagogical activities, and the displacement of pedagogical activities to online modalities have not yet been quantified. We sought to evaluate the impact of the COVID-19 pandemic on formal pedagogic components of otorhinolaryngology-head and neck surgery (ORL-HNS) residency, the switch to distance learning and program director's perceptions of the future of teaching and learning. METHODS: A nationwide online survey was conducted on Canadian ORL-HNS program directors. The use of standard didactic activities in-person and online, before and during the pandemic was rated with Likert scales. Perceptions of the pandemic were described with open-ended questions. RESULTS: A total of 11 of the 13 program directors contacted responded. The analysis were conducted using nonparametric statistics. There was a significant drop in overall didactic activities during the pandemic, regardless of the teaching format (3.5 ± 0.2 to 3.1 ± 0.3, p < 0.05). The most affected activities were simulation and in-house lectures. Online activities increased dramatically (0.5 ± 0.2 to 5.0 ± 0.5, p < 0.001), including attendance to lectures made by other programs (0.5 ± 0.3 to 4.0 ± 0.8, p < 0.05). Respondents stated their intention to maintain the hybrid online and in-person teaching model. CONCLUSIONS: These findings suggest that hybrid online and in-person teaching is likely to persist in the post-pandemic setting. A balanced residency curriculum requires diversity in academic activities. The pandemic can have positive consequences if higher education institutions work to better support distance teaching and learning.


Subject(s)
COVID-19/epidemiology , Curriculum , Disease Transmission, Infectious/prevention & control , Education, Distance/methods , Education, Medical, Graduate/methods , Internship and Residency/methods , Otolaryngology/education , Adolescent , Adult , COVID-19/transmission , Canada , Child , Cross-Sectional Studies , Female , Humans , Male , Pandemics , Quebec/epidemiology , Retrospective Studies , Surveys and Questionnaires , Young Adult
4.
Br J Surg ; 108(10): 1162-1180, 2021 10 23.
Article in English | MEDLINE | ID: covidwho-1462296

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence. METHODS: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. RESULTS: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. CONCLUSION: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.


Subject(s)
COVID-19/prevention & control , Perioperative Care/trends , Practice Patterns, Physicians'/trends , Surgical Procedures, Operative/trends , Adult , Biomedical Research/organization & administration , COVID-19/diagnosis , COVID-19/economics , COVID-19/epidemiology , Education, Medical, Graduate/methods , Education, Medical, Graduate/trends , Female , Global Health , Health Resources/supply & distribution , Health Services Accessibility/trends , Humans , Infection Control/economics , Infection Control/methods , Infection Control/standards , International Cooperation , Male , Middle Aged , Pandemics , Perioperative Care/education , Perioperative Care/methods , Perioperative Care/standards , Practice Patterns, Physicians'/standards , Surgeons/education , Surgeons/psychology , Surgeons/trends , Surgical Procedures, Operative/education , Surgical Procedures, Operative/methods , Surgical Procedures, Operative/standards
5.
Ann Surg ; 274(5): e381-e382, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1455427

ABSTRACT

Virtual recruitment of candidates applying into General Surgery residency during the COVID-19 pandemic presented a number of benefits and challenges. Notable benefits for candidates included financial and resource cost savings, the ability to conduct multiple interviews within short time frame, and the ability to meet more faculty members on virtual interview day. Challenges included technological difficulties, difficulty assessing culture and authenticity of in-program relationships, zoom fatigue, and inability to form relationships with co-applicants. After assessing our experiences with these benefits and challenges, the authors recommend that future recruitment cycles maintain virtual interview days with optional, nonevaluative open house days for revisit and second look opportunities.


Subject(s)
COVID-19/epidemiology , Education, Medical, Graduate/methods , Faculty/organization & administration , General Surgery/education , Internship and Residency/organization & administration , Pandemics , Humans
6.
PLoS One ; 16(9): e0257039, 2021.
Article in English | MEDLINE | ID: covidwho-1416882

ABSTRACT

INTRODUCTION: Newly graduated medical doctors in their internships are positioned to strengthen the front line in combating COVID-19. We developed a Massive Open Online Course (MOOC) to equip them with adequate knowledge for COVID-19 management. This paper aims to analyze the MOOC and evaluate participant satisfaction and increase in knowledge after completing the course. METHODS: An observational study was conducted. Quantitative data were obtained from questionnaires and pre- and post-tests. Responses to open-ended questions of the questionnaires were collected. Analysis using the Quality Reference Framework was also completed. RESULTS: The MOOC consisted of fundamental knowledge of COVID-19 (Part A) and further enrichment (Part B), and the content was written in the Indonesian language. A total of 3,424 and 2,462 participants completed the course in August and November 2020, respectively. Most participants agreed that the platform was easy to navigate, the design was interesting, and the content was aligned with their needs. Pre- and post-test scores in Part A's subjects increased significantly. Factors contributing to and inhibiting usability and areas for improvement were further highlighted. DISCUSSION: The use of a specific quality framework facilitated a comprehensive evaluation of the MOOC's strengths, weaknesses, and areas for future improvements. The participants' satisfaction and pre- and post-test results showed that the current MOOC holds great potential benefit for continuing education for medical interns joining the frontliners during the pandemic. Future implementation should consider increasing the quality of learning resources, scaling up the platform and its technical supports, and enhancing organizational supports.


Subject(s)
COVID-19/epidemiology , Education, Distance/methods , Education, Medical, Graduate/methods , Program Evaluation , Educational Measurement , Humans , Indonesia/epidemiology , Surveys and Questionnaires
8.
J Surg Oncol ; 124(2): 193-199, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1378940

ABSTRACT

Telesimulation (TS), the process of using the internet to link educators and trainees at locations remote from one another, harnesses the powers of technology to enable access to high-quality simulation-based education and assessment to learners across the globe. From its first uses in the teaching and assessment of laparoscopic skills to more recent interpretations during the current pandemic, TS has shown promise in helping educators to address pressing dilemmas in medical education.


Subject(s)
Education, Distance/methods , Education, Medical, Graduate/methods , Educational Measurement/methods , Simulation Training/methods , Specialties, Surgical/education , Educational Technology , Global Health , Humans , International Cooperation , Internet
9.
Ann Diagn Pathol ; 54: 151807, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1356125

ABSTRACT

Digital pathology has become an integral part of pathology education in recent years, particularly during the COVID-19 pandemic, for its potential utility as a teaching tool that augments the traditional 1-to-1 sign-out experience. Herein, we evaluate the utility of whole slide imaging (WSI) in reducing diagnostic errors in pigmented cutaneous lesions by pathology fellows without subspecialty training in dermatopathology. Ten cases of 4 pigmented cutaneous lesions commonly encountered by general pathologists were selected. Corresponding whole slide images were distributed to our fellows, along with two sets of online surveys, each composed of 10 multiple-choice questions with 4 answers. Identical cases were used for both surveys to minimize variability in trainees' scores depending on the perceived level of difficulty, with the second set being distributed after random shuffling. Brief image-based teaching slides as self-assessment tool were provided to trainees between each survey. Pre- and post-self-assessment scores were analyzed. 61% (17/28) and 39% (11/28) of fellows completed the first and second surveys, respectively. The mean score in the first survey was 5.2/10. The mean score in the second survey following self-assessment increased to 7.2/10. 64% (7/11) of trainees showed an improvement in their scores, with 1 trainee improving his/her score by 8 points. No fellow scored less post-self-assessment than on the initial assessment. The difference in individual scores between two surveys was statistically significant (p = 0.003). Our study demonstrates the utility of WSI-based self-assessment learning as a source of improving diagnostic skills of pathology trainees in a short period of time.


Subject(s)
COVID-19/prevention & control , Clinical Competence , Education, Distance/methods , Education, Medical, Graduate/methods , Image Interpretation, Computer-Assisted/methods , Pathology, Clinical/education , Skin Diseases/pathology , Diagnostic Errors/prevention & control , Fellowships and Scholarships , Humans , Pathology, Clinical/methods , Skin Diseases/diagnosis , United States
11.
J Surg Oncol ; 124(7): 989-994, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1333014

ABSTRACT

INTRODUCTION: The early COVID-19 pandemic rapidly transformed healthcare and medical education. We sought to evaluate the professional and personal impact of the pandemic on 2019-2020 Breast Surgical Oncology (BSO) fellows in Society of Surgical Oncology approved programs to capture the experience and direct future changes. METHODS: From July 15, 2020 to August 4, 2020 a survey was administered to the American Society of Breast Surgeons' fellow members. The survey assessed the impact of the pandemic on clinical experience, education/research opportunities, personal health/well-being, and future career. Responses were collected and aggregated to quantify the collective experience of respondents. RESULTS: Twenty-eight of fifty-seven (54%) eligible fellows responded. Twenty-one (75%) indicated the clinical experience changed. Twenty-seven (96%) reported less time spent caring for ambulatory breast patients and sixteen (57%) reported the same/more time spent in the operating room. Fourteen (50%) stated their future job was impacted and eight (29%) delayed general surgery board examinations. Stress was increased in 26 (93%). Personal health was unaffected in 20 (71%), and 3 (10%) quarantined for COVID-19 exposure/infection. CONCLUSION: The COVID-19 pandemic altered the clinical experience of BSO fellows; however, the operative experience was generally unaffected. The creation of frameworks and support mechanisms to mitigate potential challenges for fellows and fellowship programs in the ongoing pandemic and other times of national crisis should be considered.


Subject(s)
Breast Neoplasms/surgery , COVID-19/epidemiology , Education, Medical, Graduate/methods , Fellowships and Scholarships/statistics & numerical data , SARS-CoV-2/physiology , Surgeons/education , Surgical Oncology/education , Adult , COVID-19/virology , Female , Humans , United States/epidemiology
12.
Cardiol Young ; 31(3): 377-380, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1331353

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on medical educational curricula. We aimed to examine the impact of these unprecedented changes on the formal education of paediatric cardiology fellows through a nationwide survey. A REDCap™-based voluntary anonymous survey was sent to all current paediatric cardiology fellows in the United States of America in May, 2020. Of 143 respondents, 121 were categorical fellows, representing over one-fourth of all categorical paediatric cardiology fellows in the United States of America. Nearly all (140/143, 97.9%) respondents utilised online learning during the pandemic, with 134 (93.7%) reporting an increase in use compared to pre-pandemic. The percentage of respondents reporting curriculum supplementation with outside lectures increased from 11.9 to 88.8% during the pandemic. Respondents considered online learning to be "equally or more effective" than in-person lectures in convenience (133/142, 93.7%), improving fellow attendance (132/142, 93.0%), improving non-fellow attendance (126/143, 88.1%), and meeting individual learning needs (101/143, 70.6%). The pandemic positively affected the lecture curriculum of 83 respondents (58.0%), with 35 (24.5%) reporting no change and 25 (17.5%) reporting a negative effect. A positive effect was most noted by those whose programmes utilised supplemental outside lectures (62.2 versus 25.0%, p = 0.004) and those whose lecture frequency did not decrease (65.1 versus 5.9%, p < 0.001). Restrictions imposed by the COVID-19 pandemic have greatly increased utilisation of online learning platforms by medical training programmes. This survey reveals that an online lecture curriculum, despite inherent obstacles, offers advantages that may mitigate some negative consequences of the pandemic on fellowship education.


Subject(s)
COVID-19 , Cardiology/education , Education, Distance , Education, Medical, Graduate/methods , Fellowships and Scholarships , Pediatrics/education , Curriculum , Female , Humans , Male , Needs Assessment , SARS-CoV-2 , Surveys and Questionnaires
13.
Ann Glob Health ; 87(1): 61, 2021.
Article in English | MEDLINE | ID: covidwho-1325924

ABSTRACT

Objectives: The changing global landscape of disease and public health crises, such as the current COVID-19 pandemic, call for a new generation of global health leaders. As global health leadership programs evolve, many have incorporated experiential learning and mentoring (ELM) components into their structure. However, there has been incomplete consideration on how ELM activities are deployed, what challenges they face and how programs adapt to meet those challenges. This paper builds on the co-authors' experiences as trainees, trainers, organizers and evaluators of six global health leadership programs to reflect on lessons learned regarding ELM. We also consider ethics, technology, gender, age and framing that influence how ELM activities are developed and implemented. Findings: Despite the diverse origins and funding of these programs, all six are focused on training participants from low- and middle-income countries drawing on a diversity of professions. Each program uses mixed didactic approaches, practice-based placements, competency and skills-driven curricula, and mentorship via various modalities. Main metrics for success include development of trainee networks, acquisition of skills and formation of relationships; programs that included research training had specific research metrics as well. Common challenges the programs face include ensuring clarity of expectations of all participants and mentors; maintaining connection among trainees; meeting the needs of trainee cohorts with different skill sets and starting points; and ensuring trainee cohorts capture age, gender and other forms of diversity. Conclusions: ELM activities for global health leadership are proving even more critical now as the importance of effective individual leaders in responding to crises becomes evident. Future efforts for ELM in global health leadership should emphasize local adaptation and sustainability. Practice-based learning and established mentoring relationships provide the building blocks for competent leaders to navigate complex dynamics with the flexibility and conscientiousness needed to improve the health of global populations. Key Takeaways: Experiential learning and mentorship activities within global health leadership programs provide the hands-on practice and support that the next generation of global health leaders need to address the health challenges of our times.Six global health leadership programs with experiential learning and mentorship components are showcased to highlight differences and similarities in their approaches and capture a broad picture of achievements that can help inform future programs.Emphasis on inter-professional training, mixed-learning approaches and mentorship modalities were common across programs. Both individual capacity building and development of trainees' professional networks were seen as critical, reflecting the value of inter-personal connections for long-term leadership success.During program design, future programs should recognize the "frame" within which the program will be incorporated and intentionally address diversity-in all its forms-during recruitment as well as consider North-South ethics, leadership roles, hierarchies and transition plans.


Subject(s)
Education, Medical, Graduate/methods , Global Health/education , Leadership , Mentoring/methods , Problem-Based Learning/methods , Clinical Competence , Developing Countries , Education, Medical, Graduate/organization & administration , Humans , International Cooperation , Mentoring/organization & administration , Problem-Based Learning/organization & administration , Program Development/methods
14.
J Child Adolesc Psychopharmacol ; 31(7): 457-463, 2021 09.
Article in English | MEDLINE | ID: covidwho-1317895

ABSTRACT

Objectives: Our goal was to develop an open access nationally disseminated online curriculum for use in graduate and continuing medical education on the topic of pediatric telepsychiatry to enhance the uptake of telepsychiatry among child psychiatry training programs and improve access to mental health care for youth and families. Methods: Following Kern's 6-stage model of curriculum development, we identified a core problem, conducted a needs assessment, developed broad goals and measurable objectives in a competency-based model, and developed educational content and methods. The curriculum was reviewed by experts and feedback incorporated. Given the urgent need for such a curriculum due to the COVID-19 pandemic, the curriculum was immediately posted on the American Academy of Child and Adolescent Psychiatry and American Association of Directors of Psychiatric Residency Training websites. Further evaluation will be conducted over the next year. Results: The curriculum covers the six areas of core competence adapted for pediatric telepsychiatry and includes teaching content and resources, evaluation tools, and information about other resources. Conclusion: This online curriculum is available online and provides an important resource and set of standards for pediatric telepsychiatry training. Its online format allows for ongoing revision as the telepsychiatry landscape changes.


Subject(s)
Adolescent Psychiatry/education , COVID-19 , Child Psychiatry/education , Curriculum/trends , Education, Medical, Continuing , Education, Medical, Graduate , Access to Information , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , Child , Education/methods , Education/organization & administration , Education, Medical, Continuing/methods , Education, Medical, Continuing/organization & administration , Education, Medical, Graduate/methods , Education, Medical, Graduate/organization & administration , Health Services Accessibility , Humans , Mental Health Services/standards , Mental Health Services/trends , Organizational Innovation , Organizational Objectives , SARS-CoV-2 , Telemedicine/methods
15.
J Surg Oncol ; 124(2): 181-192, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1303281

ABSTRACT

Innovations in surgical education follow advancing clinical technology. New surgical methods have prompted demand for systematic methods to leverage computing power and internet tools to achieve proficiency-based training goals. Virtual reality, high-fidelity patient simulation, web-based resources to facilitate performance assessment, and telementoring have become mainstream practices, although patient outcomes benefits are not well studied. Remote virtual meeting and mentoring have had transformative effects on resident experiences, the full effects of which remain to be seen.


Subject(s)
Education, Distance/methods , Education, Medical, Graduate/methods , Educational Technology , General Surgery/education , Inventions , Simulation Training/methods , Educational Measurement , Humans , Mentoring/methods , United States , Virtual Reality
16.
J Surg Oncol ; 124(2): 174-180, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1303279

ABSTRACT

Electronic resources have changed surgical education in the 21st century. Resources spanning from digital textbooks to multiple choice question banks, online society meetings, and social media can facilitate surgical education. The COVID pandemic drastically changed the paradigm for education. The ramifications of Zoom lectures and online surgical society meetings will last into the future. Educators and learners can be empowered by the many available electronic resources to enhance surgical training and education.


Subject(s)
Education, Distance/trends , Education, Medical, Graduate/trends , General Surgery/education , Internet/trends , Audiovisual Aids , COVID-19/epidemiology , COVID-19/prevention & control , Congresses as Topic/trends , Education, Distance/methods , Education, Medical, Graduate/methods , General Surgery/trends , Humans , Models, Educational , Social Media/trends , Societies, Medical/trends , United States/epidemiology , Videoconferencing/trends
19.
Clin Radiol ; 76(11): 854-860, 2021 11.
Article in English | MEDLINE | ID: covidwho-1275247

ABSTRACT

AIM: To assess trainee perceptions of the Radiology-Integrated Training Initiative (R-ITI)) e-learning modules. MATERIALS AND METHODS: A mixed methodology approach was used, with triangulation between a thematic analysis of eight semi-structured interviews from radiology trainees and trainers, and a contextual analysis of 60 free-text feedback comments and module ratings from trainees after completion of R-ITI modules. RESULTS: Three broad themes emerged: "learning the subject matter", "learning the role," and "e-learning preferences". Superficial learning techniques were prevalent when "learning the subject matter" during early training, with e-learning resources providing a good pedagogical fit for this learning. Much of what was considered "learning the role" of the radiologist was learned at the workplace. This included topics with inherent subjectivity, which were difficult to convey with e-learning. Trainees' "e-learning preferences" favoured modules that incorporated many imaging cases with layer annotation, clinical relevance, and self-assessment. CONCLUSIONS: The ease of reproducing imaging studies using the R-ITI platform represents a huge potential for e-learning. Content tailored to the learning needs of the trainee, the appropriateness of the subject matter for an online platform, and the design of the e-learning modules are important considerations. Radiology training also involves important tacit learning and discussions around subjective topics, which are difficult to capture on this platform.


Subject(s)
COVID-19/prevention & control , Clinical Competence/statistics & numerical data , Education, Distance/methods , Education, Medical, Graduate/methods , Radiology/education , Students, Medical/psychology , Computer-Assisted Instruction/methods , Humans , Interviews as Topic , Pandemics , SARS-CoV-2 , Students, Medical/statistics & numerical data , United Kingdom
20.
Ann Surg ; 274(5): e383-e384, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1266243

ABSTRACT

The COVID-19 pandemic has led many of us to re-evaluate our approaches to disaster management, reflect on our experiences, and be reminded of the strong resolve for our work. This article details a resident's perspective on redeployment of surgical residents to the COVID-19 frontline setting, using the example of the COVID-19 intensive care unit. Redeployment during a pandemic brings the unique opportunity to collaborate with colleagues on the frontlines and learn alongside one another about the evolving management of this disease. During this ongoing pandemic, it is incumbent upon us as clinicians to work together in a multidisciplinary manner and reflect on ways this pandemic impacts the delivery of patient care.


Subject(s)
COVID-19/epidemiology , Education, Medical, Graduate/methods , General Surgery/education , Intensive Care Units/supply & distribution , Internship and Residency/organization & administration , Pandemics , Surgeons/supply & distribution , Humans
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