Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 17 de 17
Filter
1.
Plast Reconstr Surg ; 149(1): 130e-138e, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1583939

ABSTRACT

BACKGROUND: Since the first documented case of coronavirus disease of 2019 (COVID-19), the greater New York City area quickly became the epicenter of the global pandemic, with over 500,000 cases and 50,000 deaths. This unprecedented crisis affected all aspects of health care, including plastic surgery residency training. The purpose of this study was to understand the specific impact of the COVID-19 pandemic on plastic surgery residencies. METHODS: A survey of all plastic surgery residency training programs in the greater New York City area was conducted. The impact to training during the peak months of infection (March and April of 2020) was evaluated using resident education as measured by case numbers, need for redeployment, and staff wellness as primary outcome variables. RESULTS: A total of 11 programs were identified in the region, and seven programs completed the survey, with a response rate 63.6 percent. When comparing productivity in March and April of 2019 to March and April of 2020, a total decrease in surgical volume of 64.8 percent (range, 19.7 to 84.8 percent) and an average of 940 (range, 50 to 1287) cancelled clinic visits per month were observed. These decreases directly correlated with the local county's COVID-19 incidence rates (p = 0.70). A total of 83 percent of programs required redeployment to areas of need, and correlation between local incidence of COVID-19 and the percentage of residents redeployed to non-plastic surgical clinical environments by a given program (ρ = 0.97) was observed. CONCLUSION: As the first COVID-19 wave passes the greater New York area and spreads to the rest of the country, the authors hope their experience will shed light on the effects of the ongoing COVID-19 pandemic, and inform other programs on what to expect and how they can try and prepare for future public health crises.


Subject(s)
COVID-19/epidemiology , Education, Medical, Graduate/statistics & numerical data , Internship and Residency/standards , Pandemics , Reconstructive Surgical Procedures/education , Surgery, Plastic/education , Humans , New Jersey/epidemiology , New York City/epidemiology , SARS-CoV-2
3.
Innovations (Phila) ; 16(4): 350-357, 2021.
Article in English | MEDLINE | ID: covidwho-1282223

ABSTRACT

OBJECTIVE: We report the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiac surgery trainee education in North America. METHODS: A survey was sent to participating academic adult cardiac surgery centers in North America. Data regarding the effect of COVID-19 on cardiac surgery training were analyzed. RESULTS: Responses were received from 53 academic institutions with diverse geographic distribution. Cardiac surgery trainee re-deployment to alternative clinical duties peaked at the height of the pandemic. We stratified institutions based on high (n = 20) and low burden (n = 33) of patients hospitalized with COVID-19. The majority of institutions have converted didactics (high burden 90% vs low burden 73%) and interviews for jobs/fellowships (high burden 75% vs low burden 73%) from in-person to virtual. Institutions were mixed in preference for administration of the licensing examination, with the most common preference for examinations to be held remotely on normal timeline (high burden 45% vs low burden 30%) or in person with more than 3-month delay (high burden 20% vs low burden 33%). Despite the challenges experienced during the COVID-19 pandemic on trainee clinical experience, re-deployment, and decreased operative volume, institutions expected their trainees to graduate on schedule (high burden 95% vs low burden 91%). CONCLUSIONS: Our study demonstrates that actions taken during the COVID-19 pandemic has led to disruptions in cardiac surgery training with transition of didactics and interviews virtually and re-deployment to alternative duties. Despite this, institutions remain optimistic that their trainees will graduate on schedule.


Subject(s)
COVID-19 , Cardiac Surgical Procedures/education , Education, Medical, Graduate/statistics & numerical data , Pandemics , Adult , COVID-19/epidemiology , Humans , Internship and Residency/statistics & numerical data , North America/epidemiology , Surveys and Questionnaires
4.
J Bone Joint Surg Am ; 103(16): e65, 2021 08 18.
Article in English | MEDLINE | ID: covidwho-1186645

ABSTRACT

ABSTRACT: The COVID-19 crisis has challenged the U.S. health-care system in a variety of ways, including how we teach and train orthopaedic surgery residents and fellows. During the spring of 2020, the cessation of all elective surgical procedures and the diminished number of outpatient visits challenged graduate medical education. While residency programs in less affected areas may not have had to make many dramatic adjustments, some of those located in pandemic hotspots had to redirect trainees from orthopaedic rotations to COVID-19 units. No matter the region, the time that trainees have spent in rotations has been altered, and absences have occurred due to quarantines. This symposium summarizes the impact of restrictions related to the COVID-19 pandemic on residency and fellowship programs from the perspectives of the Accreditation Council for Graduate Medical Education (ACGME), a program director, and a graduating resident. Although new opportunities for virtual curricula, virtual surgical simulation, and virtual interviews have been innovated, residency programs and residents report primarily a negative effect from the pandemic due to decreased surgical volumes and the limitation of patient-care experiences. Ultimately, program directors have an obligation to the program, the trainee, and the general public to graduate only those residents and fellows who are truly prepared to practice independently; they have the responsibility of making the final decision regarding graduation. The COVID-19 pandemic has continued to underscore the need for competency-based medical education. Assessing competency includes evaluation of the knowledge, the operative skills, the nonoperative patient-care skills, and the professional behavior of each and every individual graduating from orthopaedic residency and fellowship training programs. A hybrid model for time and competency-based training, with established national standards not only for accreditation for our training programs but also for board certification of our graduating residents, was enhanced by the COVID-19 pandemic and is highlighted in this symposium.


Subject(s)
COVID-19/epidemiology , Education, Medical, Graduate , Orthopedics/education , Curriculum , Education, Medical, Graduate/statistics & numerical data , Humans , Internship and Residency/statistics & numerical data , Orthopedic Procedures/education , Orthopedic Procedures/statistics & numerical data , United States
5.
J Coll Physicians Surg Pak ; 31(2): 182-187, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1110942

ABSTRACT

OBJECTIVE: To find out various organizational, personal, and systemic factors influencing the performance of the postgraduate trainee doctors in managing COVID-19 pandemic. STUDY DESIGN: Analytical cross-sectional study. PLACE AND DURATION OF STUDY: Conducted in various medical institutions of Pakistan from 15th  April to 30th  June, 2020. METHODOLOGY: An analytical cross-sectional study was conducted on 11,656 postgraduate doctors. They were contacted through the e-log system of College of Physicians and Surgeons Pakistan. Semi-structured questionnaire was used consisting of demographic details, presenting symptoms, systemic involvements, clinical features, diagnostic tests, management of cases, authenticity of the  information used, telemedicine services, practice of preventive measures, training and interactive educational activities, performance-based tasks and details about workplace environment. Mean and standard deviation was reported for continuous variables. Bivariate and multivariate analyses were used to report p values. RESULTS: Among 11,656 postgraduate doctors, 3,193 (27.4%) were directly involved in the management of COVID-19 patients in designated special corona facilities. Multivariate analysis was performed to control confounders. The risk factors, found statistically significant with performance, were presence of comorbidity (OR 1.261; 95% C.I.1.06-1.50), allergic and autoimmune disorders (OR 1.18; 95% C.I.1.03-1.35), confirmed COVID-19 status due to exposure (OR 0.570; 95% C.I.0.41-0.81), and care provision to old parents (OR 1.299; 95% C.I.1.19-1.42). CONCLUSION: The effect of COVID-19 on performance of postgraduate doctors was multi-factorial. Significant risk factors were presence of a comorbidity, allergic and autoimmune disorders, and confirmed COVID-19 due to exposure. Key Words: COVID 19, Postgraduate trainee, Pandemic, Comorbidity, PCR.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Education, Medical, Graduate/statistics & numerical data , Physicians/psychology , Adult , Autoimmune Diseases/epidemiology , COVID-19/epidemiology , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Pakistan/epidemiology , Pandemics , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires
6.
World Neurosurg ; 144: e926-e933, 2020 12.
Article in English | MEDLINE | ID: covidwho-936011

ABSTRACT

BACKGROUND: The coronavirus disease 2019 pandemic has led to sweeping changes in residency programs across the world, including cancellation of elective cases. The effects of safety measures on neurosurgical training remain unclear. To understand how neurosurgical residents have been affected, we analyzed the operative experience in the months leading up to and during the pandemic. METHODS: The resident and institutional case totals were tallied for a single residency program in Miami-Dade County from January 1, 2019 to June 30, 2020. A matched cohort analysis was performed before and during the pandemic to assess the effects on resident surgical training. RESULTS: The case totals for all levels of training were lower when restrictions were placed on elective surgeries. An average of 11 cases was logged in April 2020, a decrease from 26 cases in April 2019 (95% confidence interval, 8.7-22; P < 0.01). An average of 20 cases was logged in May 2020, a decrease from 25 cases in May 2019 (95% confidence interval, 1.2-8.8; P = 0.01). In April and May 2020, 299 (66%) and 148 (50%) fewer cases had been performed at our institution compared with April and May 2109. CONCLUSIONS: Operative experience was reduced for residents during the months when the performance of elective cases was restricted. Our data suggest experience in some areas of neurosurgery were more affected than were others, and residents at different levels of training were also affected differently. However, the extent of the coronavirus disease 2019 pandemic on neurosurgical training is unlikely to be understood in the short term.


Subject(s)
Academic Medical Centers , COVID-19/epidemiology , Education, Medical, Graduate/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Neurosurgery/education , Neurosurgical Procedures/statistics & numerical data , Education, Medical, Graduate/organization & administration , Florida/epidemiology , Humans , Internship and Residency , Neurosurgery/organization & administration , Neurosurgical Procedures/education , Personnel Staffing and Scheduling/organization & administration , United States/epidemiology
7.
World Neurosurg ; 145: e202-e208, 2021 01.
Article in English | MEDLINE | ID: covidwho-899667

ABSTRACT

OBJECTIVE: To determine the impact of the 2019 novel coronavirus disease (COVID-19) pandemic on operative case volume in 8 U.S. neurosurgical residency training programs in early 2020 and to survey these programs regarding training activities during this period. METHODS: A retrospective review was conducted of monthly operative case volumes and types for 8 residency programs for 2019 and January through April 2020. Cases were grouped as elective cranial, elective spine, and nonelective emergent cases. Programs were surveyed regarding residents' perceptions of the impact of COVID-19 on surgical training, didactics, and research participation. Data were analyzed for individual programs and pooled across programs. RESULTS: Across programs, the 2019 monthly mean ± SD case volume was 211 ± 82; 2020 mean ± SD case volumes for January, February, March, and April were 228 ± 93, 214 ± 84, 180 ± 73, and 107 ± 45. Compared with 2019, March and April 2020 mean cases declined 15% (P = 0.003) and 49% (P = 0.002), respectively. COVID-19 affected surgical case volume for all programs; 75% reported didactics negatively affected, and 90% reported COVID-19 resulted in increased research time. Several neurosurgery residents required COVID-19 testing; however, to our knowledge, only 1 resident from the participating programs tested positive. CONCLUSIONS: This study documents a significant reduction in operative volume in 8 neurosurgery residency training programs in early 2020. During this time, neurosurgery residents engaged in online didactics and research-related activities, reporting increased research productivity. Residency programs should collect data to determine the educational impact of the COVID-19 pandemic on residents' operative case volumes, identify deficiencies, and develop plans to mitigate any effects.


Subject(s)
COVID-19 , Neurosurgery/education , Pandemics , COVID-19 Testing , Education, Medical, Graduate/statistics & numerical data , Elective Surgical Procedures , Humans , Infectious Disease Transmission, Patient-to-Professional , Internship and Residency , Research , Retrospective Studies , Spine/surgery , Surveys and Questionnaires , United States
10.
World Neurosurg ; 144: e164-e177, 2020 12.
Article in English | MEDLINE | ID: covidwho-800041

ABSTRACT

OBJECTIVE: Neurosurgery departments worldwide have been forced to restructure their training programs because of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we describe the impact of COVID-19 on neurosurgical training in Southeast Asia. METHODS: We conducted an online survey among neurosurgery residents in Indonesia, Malaysia, Philippines, Singapore, and Thailand from May 22 to 31, 2020 using Google Forms. The 33-item questionnaire collected data on elective and emergency neurosurgical operations, ongoing learning activities, and health worker safety. RESULTS: A total of 298 of 470 neurosurgery residents completed the survey, equivalent to a 63% response rate. The decrease in elective neurosurgical operations in Indonesia and in the Philippines (median, 100% for both) was significantly greater compared with other countries (P < 0.001). For emergency operations, trainees in Indonesia and Malaysia had a significantly greater reduction in their caseload (median, 80% and 70%, respectively) compared with trainees in Singapore and Thailand (median, 20% and 50%, respectively; P < 0.001). Neurosurgery residents were most concerned about the decrease in their hands-on surgical experience, uncertainty in their career advancement, and occupational safety in the workplace. Most of the residents (n = 221, 74%) believed that the COVID-19 crisis will have a negative impact on their neurosurgical training overall. CONCLUSIONS: An effective national strategy to control COVID-19 is crucial to sustain neurosurgical training and to provide essential neurosurgical services. Training programs in Southeast Asia should consider developing online learning modules and setting up simulation laboratories to allow trainees to systematically acquire knowledge and develop practical skills during these challenging times.


Subject(s)
COVID-19/prevention & control , Education, Distance/statistics & numerical data , Education, Medical, Graduate/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Neurosurgery/education , Neurosurgical Procedures/statistics & numerical data , Occupational Health , Asia, Southeastern/epidemiology , Attitude of Health Personnel , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing/statistics & numerical data , Emergencies , Humans , Indonesia/epidemiology , Internship and Residency , Malaysia/epidemiology , Neurosurgical Procedures/education , Personal Protective Equipment/supply & distribution , Philippines/epidemiology , Research/statistics & numerical data , Singapore/epidemiology , Surveys and Questionnaires , Telemedicine/statistics & numerical data , Thailand/epidemiology
11.
Int J Radiat Oncol Biol Phys ; 108(2): 416-420, 2020 Oct 01.
Article in English | MEDLINE | ID: covidwho-739850

ABSTRACT

PURPOSE: Telemedicine was rapidly and ubiquitously adopted during the COVID-19 pandemic. However, there are growing discussions as to its role postpandemic. METHODS AND MATERIALS: We surveyed patients, radiation oncology (RO) attendings, and RO residents to assess their experience with telemedicine. Surveys addressed quality of patient care and utility of telemedicine for teaching and learning core competencies. Satisfaction was rated on a 6-point Likert-type scale. The quality of teaching and learning was graded on a 5-point Likert-type scale, with overall scores calculated by the average rating of each core competency required by the Accreditation Council for Graduate Medical Education (range, 1-5). RESULTS: Responses were collected from 56 patients, 12 RO attendings, and 13 RO residents. Patient feedback was collected at 17 new-patient, 22 on-treatment, and 17 follow-up video visits. Overall, 88% of patients were satisfied with virtual visits. A lower proportion of on-treatment patients rated their virtual visit as "very satisfactory" (68.2% vs 76.5% for new patients and 82.4% for follow-ups). Only 5.9% of the new patients and none of the follow-up patients were dissatisfied, and 27% of on-treatment patients were dissatisfied. The large majority of patients (88%) indicated that they would continue to use virtual visits as long as a physical examination was not needed. Overall scores for medical training were 4.1 out of 5 (range, 2.8-5.0) by RO residents and 3.2 (range, 2.0-4.0) by RO attendings. All residents and 92% of attendings indicated they would use telemedicine again; however, most indicated that telemedicine is best for follow-up visits. CONCLUSIONS: Telemedicine is a convenient means of delivering care to patients, with some limitations demonstrated for on-treatment patients. The majority of both patients and providers are interested in using telemedicine again, and it will likely continue to supplement patient care.


Subject(s)
Education, Medical, Graduate/statistics & numerical data , Internship and Residency/statistics & numerical data , Patient Care/statistics & numerical data , Radiation Oncology , Telemedicine , COVID-19 , Coronavirus Infections/epidemiology , Humans , Pandemics , Pneumonia, Viral/epidemiology
12.
Can Assoc Radiol J ; 72(3): 564-570, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-736313

ABSTRACT

PURPOSE: The aim of this national survey was to assess the overall impact of the coronavirus disease 2019 (COVID-19) pandemic on the provision of interventional radiology (IR) services in Canada. METHODS: An anonymous electronic survey was distributed via national and regional radiology societies, exploring (1) center information and staffing, (2) acute and on-call IR services, (3) elective IR services, (4) IR clinics, (5) multidisciplinary rounds, (6) IR training, (7) personal protection equipment (PPE), and departmental logistics. RESULTS: Individual responses were received from 142 interventional radiologists across Canada (estimated 70% response rate). Nearly half of the participants (49.3%) reported an overall decrease in demand for acute IR services; on-call services were maintained at centers that routinely provide these services (99%). The majority of respondents (73.2%) were performing inpatient IR procedures at the bedside where possible. Most participants (88%) reported an overall decrease in elective IR services. Interventional radiology clinics and multidisciplinary rounds were predominately transitioned to virtual platforms. The vast majority of participants (93.7%) reported their center had disseminated an IR specific PPE policy; 73% reported a decrease in case volume for trainees by at least 25% and a proportion of trainees will either have a delay in starting their careers as IR attendings (24%) or fellowship training (35%). CONCLUSION: The COVID-19 pandemic has had a profound impact on IR services in Canada, particularly for elective cases. Many centers have utilized virtual platforms to provide multidisciplinary meetings, IR clinics, and training. Guidelines should be followed to ensure patient and staff safety while resuming IR services.


Subject(s)
Academic Medical Centers/statistics & numerical data , COVID-19/prevention & control , Delivery of Health Care/statistics & numerical data , Hospitals, Community/statistics & numerical data , Radiography, Interventional/statistics & numerical data , Radiology, Interventional/statistics & numerical data , Academic Medical Centers/organization & administration , After-Hours Care/statistics & numerical data , Canada , Education, Medical, Graduate/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Fellowships and Scholarships/statistics & numerical data , Health Services Needs and Demand/statistics & numerical data , Hospitals, Community/organization & administration , Humans , Organizational Policy , Patient Care Team , Personal Protective Equipment , Radiology, Interventional/education , Radiology, Interventional/organization & administration , SARS-CoV-2 , Surveys and Questionnaires , Teaching Rounds/statistics & numerical data
13.
World Neurosurg ; 144: e204-e209, 2020 12.
Article in English | MEDLINE | ID: covidwho-720739

ABSTRACT

BACKGROUND: The 2019 novel coronavirus disease (COVID-19) pandemic has directly and indirectly impacted health care systems, including residency programs. Social distancing, cancellation of elective cases, and staff re-deployment have compromised clinical and academic teaching. We describe the neurosurgical experience at Emory University during the COVID-19 pandemic and the impact of COVID-19-related policies on resident experience. METHODS: We retrospectively reviewed all neurosurgical cases performed at Emory University Hospital between March 16, the day cancellation of elective cases was effective, and April 15, 2020, and the same period in the preceding 3 years. For the study period, we collected the number of cases and their distribution by subspecialty along with total hospital charges. RESULTS: Compared with an average of 606 cases performed during the study period over the past 3 years, only 145 neurosurgical cases were performed between March 16 and April 15, 2020, which corresponds to an 80% reduction in case volume and 66% decrease in hospital revenue in 2020. When divided by subspecialty, the most significant reduction was observed in functional (84%; P < 0.01) followed by spine (78%; P < 0.01) surgery, although all subspecialties were significantly impacted. Assessing junior resident experience, we observed a significant reduction in number of neurosurgical admissions (47%; P < 0.01) and bedside procedures (59%; P < 0.01) in the study period in 2020 compared with the past 3 years, with no significant reduction in number of consultations (17%; P > 0.1). CONCLUSIONS: Even at academic centers that were not hugely impacted by the COVID-19 pandemic, prophylactic and preparedness measures still exhibited an unprecedented toll on neurosurgical resident and fellow experience.


Subject(s)
COVID-19 , Education, Medical, Graduate/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Hospitalization/statistics & numerical data , Neurosurgery/education , Neurosurgical Procedures/statistics & numerical data , Vascular Surgical Procedures/statistics & numerical data , Georgia , Hospital Charges/statistics & numerical data , Hospitals, University/statistics & numerical data , Humans , Neuroendoscopy/education , Neuroendoscopy/statistics & numerical data , Neurosurgical Procedures/education , Personnel Staffing and Scheduling , Referral and Consultation/statistics & numerical data , Retrospective Studies , Vascular Surgical Procedures/education
14.
Int Orthop ; 44(9): 1611-1619, 2020 09.
Article in English | MEDLINE | ID: covidwho-660016

ABSTRACT

PURPOSE: This study aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on orthopaedic and trauma surgery training in Europe by conducting an online survey among orthopaedic trainees. METHODS: The survey was conducted among members of the Federation of Orthopaedic and Trauma Trainees in Europe (FORTE). It consisted of 24 questions (single-answer, multiple-answer, Likert scales). Orthopaedic trainees' demographic data (six questions), clinical role changes (four questions), institutional changes due to the COVID-19 pandemic (nine questions), and personal considerations (five questions) were examined. RESULTS: Three hundred and twenty-seven trainees from 23 European countries completed the survey. Most trainees retained their customary clinical role (59.8%), but a significant number was redeployed to COVID-19 units (20.9%). A drastic workload decrease during the pandemic was reported at most institutions. Only essential activities were performed at 57.1% of institutions and drastic disruptions were reported at 36.0%. Of the respondents, 52.1% stated that faculty-led education was restricted and 46.3% pursued self-guided learning, while 58.6% stated that surgical training was significantly impaired. Concerns about the achievement of annual training goals were expressed by 58.2% of the participants, while 25.0% anticipated the need for an additional year of training. CONCLUSIONS: The SARS-CoV-2 pandemic significantly affected orthopaedic and trauma training in Europe. Most trainees felt the decrease in clinical, surgical, and educational activities would have a detrimental effect on their training. Many of them consulted remote learning options to compensate training impairment, stating that after the COVID-19 pandemic electronic educational approaches may become more relevant in future.


Subject(s)
COVID-19 , Clinical Competence/standards , Internship and Residency/standards , Orthopedics/education , Pandemics , Traumatology/education , Adult , Education, Distance/statistics & numerical data , Education, Medical, Graduate/standards , Education, Medical, Graduate/statistics & numerical data , Europe/epidemiology , Female , Humans , Internet , Internship and Residency/statistics & numerical data , Male , Orthopedics/standards , Orthopedics/statistics & numerical data , SARS-CoV-2 , Surveys and Questionnaires/statistics & numerical data , Traumatology/standards , Traumatology/statistics & numerical data , Workload/standards , Workload/statistics & numerical data
16.
Clin Exp Dermatol ; 45(7): 876-879, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-628698

ABSTRACT

Teledermatology has had an explosive impact on the provision of dermatology services in recent times, and even more so with the unprecedented situation created by the COVID-19 pandemic. Although teledermatology is not presently a feature of the Joint Royal Colleges of Physicians Training Board (JRCPTB) curriculum for dermatology training, this is due to change imminently. Specialty trainees need training in this area to be able to confidently and competently meet the demands of the changing face of dermatology services. We surveyed dermatology registrars in training across the UK, prior to the outbreak of COVID-19, to ascertain the teledermatology teaching available and trainee confidence in this area. Our survey found that only 15% of respondents felt slightly confident in their ability to deal with teledermatology referrals and almost all (96%) felt more teaching was needed.


Subject(s)
COVID-19 , Dermatology/education , Education, Medical, Graduate/statistics & numerical data , Self Efficacy , Telemedicine , Humans , Referral and Consultation , SARS-CoV-2 , Skin Diseases/diagnostic imaging , Surveys and Questionnaires , United Kingdom
SELECTION OF CITATIONS
SEARCH DETAIL