Remote Learning Facilitated by MyScope Explore.

In response to the requirements imposed by the COVID-19 pandemic in 2020, we developed a remote learning undergraduate workshop for 44 students at the University of Newcastle by embedding scanning electron microscope (SEM) images of Maratus (Peacock) spiders into the MyScope Explore environment. The workshop session had two main components: 1) to use the online MyScope Explore tool to virtually image scales with structural color and pigmented color on Maratus spiders; 2) to join a live SEM session via Zoom to image an actual Maratus spider. In previous years, the undergraduate university students attending this annual workshop would enter the Microscopy Facility at the University of Newcastle to image specimens with SEM; however, in 2020 the Microscopy Facility was closed to student visitors, and this virtual activity was developed in order to proceed with the educational event. The program was highly successful and constitutes a platform that can be used in the future by universities for teaching microscopy remotely.

Hospital transmission rates of the SARS-CoV 2 disease amongst orthopaedic in-patients in a secondary care centre: A quantitative review.

INTRODUCTION: Orthopaedic practice changed during COVID-19 with elective work ceasing, trauma reducing and work forces redistributed to medical areas. During the United Kingdom lockdown, hospitals were stretched thinly with admissions of SARS-CoV-2 positive patients. AIM: Evaluate orthopaedic admissions to a district general hospital during lockdown and the volume of those who subsequently were found to be COVID-19 positive. METHOD: Retrospective study of patients admitted under trauma and orthopaedics between March 23, 2020-June 18, 2020. Data includes; diagnosis, COVID-19 swab dates, results and mortality using orthopaedic admission sheets, patient and pathology electronic recording system. RESULTS: 3/4 of admitted patients tested negative for SARS-CoV-2 initially. Of these 240 patients, 12.5% subsequently tested positive during their stay, often within one week of their admission. 17.8% of patients were never tested. 7.8% mortality rate of which 48% were neck of femur fracture (NOF#) patients. 28 NOF# were confirmed COVID-19 positive; mortality rate of 21.4%. 87 NOF# were COVID-19 negative; mortality rate 6.9%. Mortality relative risk (RR) for NOF# and COVID-19 positive was 2.6. COVID-19 positive mortality 27% as compared to 4% in COVID-19 negative patients. Patients who acquired COVID-19 whilst in hospital had a mortality relative risk 6.4. CONCLUSION: 12.5% orthopaedic in-hospital viral transmission rate amongst orthopaedic patients despite the segregation measures taken, possibly due to asymptomatic health care workers or inpatients awaiting swab results. We emphasize the importance of testing all inpatients and regular testing of healthcare workers.

Objective assessment of the efficacy of telephone medicine consultations in dispensing elective orthopaedic care using a novel scoring tool.

BACKGROUND: Telemedicine consultations have increased significantly as a result of the COVID-19 pandemic. As remote consultations have been employed across specialities, there has been limited analysis of their efficacy. The goal of this study is to objectively assess if telephone medicine is valuable for clinical consultations in elective orthopaedics using a novel scoring tool. METHODS: A literature review and survey were performed to determine the objectives of a specialist consultation. Based on the results, a four-component scoring system was developed with a set of guidelines. Eighty telephone consultation letters from a hip and knee clinic were scored by two independent observers. The results were compared and the guidelines were clarified. Clinic letters from previous face to face consultations from the same clinic were scored and compared to telephone medicine letters. The inter-observer reliability was calculated using Cronbach's Alpha. RESULTS: The mean score of the telephone consultations was 7.3 as compared to 7.9 (Maximum possible score-8) with face to face consultations. Second opinion referrals scored the least when consulted over the telephone, while follow-up patients both pre-operative and post-operative scored similar to face to face consultations. The inter observer reliability co-efficient was more than 0.8 for every component of the score suggestive of good reliability. CONCLUSIONS: This study identifies the areas where telephone medicine can make a valuable contribution to making diagnosis and treating orthopedic patients. We plan to use this to stratify future clinic appointments. The score is a simple, concise and reliable tool whose role may not be limited to orthopaedics but can be extended to other medical fields.

Redeployment of the trainee orthopaedic surgeon during COVID-19: a fish out of water?

Background and purpose - COVID-19 has had a significant impact on health services and the entire healthcare sector, including trauma and orthopaedics, has been compelled to adapt. At the heart of this was the redeployment of the orthopaedic trainees to support "frontline specialties". This paper sheds light on the experience of orthopaedic trainees in redeployment. Methods - In this retrospective study, we asked orthopaedic trainees in the KSS (Kent, Surrey, Sussex) and London Deaneries to complete a survey regarding their experience in redeployment during the COVID-19 outbreak. The study took place in the Kent, Surrey, Sussex, and London regions of the United Kingdom over a period of 8 weeks from 15th of March 2020 until 15th of May 2020. The study was based at East Kent Hospitals University NHS Foundation Trust and participants were recruited from a number of secondary and tertiary care centres across the region. 120 orthopaedic trainees were contacted, working in 21 teaching hospitals. Of these, 40 trainees (30%) from 13 hospitals responded and completed the survey. Results - 50% of the surveyed trainees were redeployed to other specialties. Trainees spent varying amounts of time in the redeployed speciality and gave differing views on how comfortable they felt and how useful they felt the experience was. One-third of trainees experienced symptoms and/or tested positive for COVID-19 and the majority of these were redeployed to other specialties. Interpretation - Orthopaedic training appears to have taken a temporary back seat at this time but trainees have made a significant contribution to reinforcing key front-line specialties in the fight against COVID-19.