Postgraduate-Year-1 Residents' Perceptions of Social Media and Virtual Applicant Recruitment: Cross-sectional Survey Study.

BACKGROUND: The dissemination of information about residency programs is a vital step in residency recruitment. Traditional methods of distributing information have been printed brochures, websites, in-person interviews, and increasingly, social media. Away rotations and in-person interviews were cancelled, and interviews were virtual for the first time during the COVID-19 pandemic. OBJECTIVE: The purpose of our study was to describe postgraduate-year-1 (PGY1) residents' social media habits in regard to residency recruitment and their perceptions of the residency programs' social media accounts in light of the transition to virtual interviews. METHODS: A web-based 33-question survey was developed to evaluate personal social media use, perceptions of social media use by residency programs, and perceptions of the residency program content. Surveys were sent in 2021 to PGY1 residents at Mayo Clinic in Arizona, Florida, and Minnesota who participated in the 2020-2021 interview cycle. RESULTS: Of the 31 program directors contacted, 22 (71%) provided permission for their residents to complete the survey. Of 219 residents who received the survey, 67 (30%) completed the survey. Most respondents applied to a single specialty, and greater than 61% (41/67) of respondents applied to more than 30 programs. The social media platforms used most regularly by the respondents were Instagram (42/67, 63%), Facebook (36/67, 54%), and Twitter (22/67, 33%). Respondents used the program website (66/67, 99%), residents (47/67, 70%), and social media (43/67, 64%) as the most frequent resources to research programs. The most commonly used social media platforms to research programs were Instagram (38/66, 58%), Twitter (22/66, 33%), and Doximity (20/66, 30%). The type of social media post ranked as most interesting by the respondents was "resident life outside of the hospital." In addition, 68% (39/57) of the respondents agreed or strongly agreed that their perception of a program was positively influenced by the residency program's social media account. CONCLUSIONS: In this multispecialty survey of PGY1 residents participating in the 2020-2021 virtual interview season, respondents preferred Instagram to Twitter or Facebook for gathering information on prospective residency programs. In addition, the program website, current residents, and social media platforms were the top-ranked resources used by prospective applicants. Having an up-to-date website and robust social media presence, particularly on Instagram, may become increasingly important in the virtual interview environment.

Sepsis-Induced Cardiomyopathy Reviewed: The Case for Early Consideration of Mechanical Support.

Sepsis-induced cardiomyopathy (SCM) is an increasingly recognized problem encountered in critical care medicine. It generally is characterized as a decrease in left, right, or biventricular ejection fraction followed by a recovery of function over a period of days to weeks. Venoarterial extracorporeal membrane oxygenation (ECMO) has been used for the treatment of adults with various etiologies of shock, including cardiogenic and septic shock. This review summarizes current pathophysiologic mechanisms leading to SCM and provides a detection and treatment algorithm for SCM, as well as a discussion about the rationale and recent clinical data surrounding the use of ECMO and other forms of mechanical circulatory support for SCM.

Urine output and acute kidney injury following laparoscopic pancreas operations.

BACKGROUND: This study aims to assess if intraoperative urine output is associated with acute kidney injury (AKI) during laparoscopic pancreas surgery. METHODS: Medical records of adult patients who underwent laparoscopic pancreas surgery from 2010 to 2020 were reviewed to identify patients who experienced AKI (creatinine increase of 0.3 mg/dL within 72 h). Surgeries were classified as with 'vascular reconstruction' (e.g. Whipple, total pancreatectomy) versus 'without reconstruction' (e.g., distal pancreatectomy). RESULTS: Included were 365 patients (221 with and 114 without reconstruction), and 42 (11.4%) developed AKI (32 [14.5%] reconstruction and 10 [6.9%] without reconstruction (P = 0.164)). The median urine output for AKI group was 0.79 [0.43, 1.15] mL/kg/h and 0.88 [0.55, 1.53] mL/kg/h for non-AKI group, P = 0.121. Urine output between AKI and non-AKI did not vary among reconstruction cases (P = 0.383), but was lower in AKI patients without reconstruction (P = 0.047). Older age, preexisting kidney disease, higher disease burden, and intraoperative hypotension were associated with AKI. Postoperative course was more complicated for AKI patients including rates of pancreatic fistulas and mortality. CONCLUSION: Incidence of AKI increases with more extensive surgery, but is not associated with low urine output. However, low urine output was associated with AKI in patients undergoing operation without reconstruction.

Thrombocytopenia: Perioperative Considerations for Patients Undergoing Cardiac Surgery.

The etiologies of thrombocytopenia in patients presenting for cardiac surgery are extensive, but clinically relevant conditions generally can be categorized by those related to decreased platelet production or increased platelet destruction. Many causes require mere acknowledgment and availability of allogeneic platelet transfusion; others have unique considerations for which providers should be familiar. The purpose of this review is to provide an overview of the common causes of thrombocytopenia, summarize the literature, and discuss perioperative considerations for patients undergoing cardiac surgery.

Getting the First Thousand-Optimizing Instagram Residency Content to Increase Followers During the COVID-19 Pandemic.

BACKGROUND: Social media remains a growing platform for physicians to facilitate learning, network, and disseminate information. The Coronavirus Disease 2019 (COVID-19) pandemic has challenged traditional medical student recruitment and outreach. Instagram is a platform that can be used by residency programs to increase engagement and as a potential recruitment tool. The authors present social media failed and successful strategies used to increase engagement and gain new followers. METHODS: In June 2020, an initiative began to use Instagram on a more frequent and intentional basis. Three different strategies were implemented during the pandemic: mirroring Twitter posts, increasing multimedia, and leveraging Instagram Stories. The outcomes of interest included number of followers and engagement on posts. Data were collected October 2020. RESULTS: After June 1, 2020, the @mayoanesthesia account gained 1000 followers through 127 days, an average of 4.26 new followers each day. Before June 1, there were 24 total posts over 3.3 years with a total of 458 followers. Three different strategies were implemented at different times during the pandemic. During the mirroring Twitter posts period, the mean number of interactions per post was 14.5. During the second phase after separating the Twitter and Instagram strategy, the mean number of interactions per post increased to 57.8. CONCLUSION: Residency programs can creatively, yet methodically, use Instagram posts to increase social media engagement during resident recruitment season during the COVID-19 pandemic and likely beyond.

Pulmonary artery sheath hematoma.

Dissection of the ascending aorta (AA) represents a life-threatening condition typically treated by emergent surgical repair. A rare, potential complication of AA dissection is pulmonary artery (PA) sheath hematoma. Due to the presence of a common adventitial layer between the proximal AA and the PA, dissection can propagate between both vessels, potentially compromising the PA lumen. The resultant acute narrowing of the PA lumen may abruptly increase right ventricular (RV) afterload. Recognition of PA sheath hematoma is important; when seen on echocardiography it is suggestive of AA dissection and has the potential to result in RV hypertension and dysfunction if significant PA compression occurs.