Preparing previously COVID-19-positive patients for elective surgery: a framework for preoperative evaluation.

The preoperative evaluation and risk assessment has always been a critical aspect of safe surgical practice, and in the midst of the SARS-CoV-2 pandemic, it has become even more crucial to patient safety. Emerging data show that surgical procedures in patients who test positive for coronavirus disease (COVID) are associated with worse clinical outcomes and increased postoperative complications and mortality. In addition to personal protective equipment (PPE) management, isolation protocols, preoperative SARS-CoV-2 screening, and steps to ensure clinician safety, determining how to deem patients who have recovered from COVID-19 safe to proceed is an added challenge. We present a preoperative protocol for evaluation of previously COVID-positive patients for elective surgery.

Novel Use of Ultrasound to Teach Reproductive System Physical Examination Skills and Pelvic Anatomy.

OBJECTIVES: To determine whether integration of ultrasound (US) into a reproductive system examination clinical skills lab can increase confidence in palpating key reproductive structures during testicular and bimanual pelvic examinations, reduce anxiety about conducting testicular and bimanual pelvic examinations, and improve performance on multiple-choice questions based on structure identification using US images. METHODS: Second-year medical students enrolled in the Life Cycle preclinical course participated in this cross-sectional study. A single learning activity was developed to pair the teaching of the reproductive system physical examination with the use of US in the clinical skills lab. The evaluation of the teaching session consisted of a pre-post analysis of student self-reported knowledge, confidence, and anxiety. RESULTS: The response rate for the pre survey was 82% (n = 96), and the rate for the post survey was 79% (n = 93). Students' confidence in their ability to identify reproductive system structures on US images increased from pre to post survey. Their confidence in their ability to palpate the epididymis, uterus, and ovary during a physical examination improved, and their anxiety about conducting testicular and bimanual pelvic examinations decreased. Student satisfaction with the session was high. Students' performance on multiple-choice questions based on structure identification using US images was at 96% or higher. CONCLUSIONS: Our study findings support the integration of US into a reproductive system examination clinical skills lab. Medical students acquire competency and confidence in reproductive system physical examination skills with US integration.