# pos

id: cord-256691-fn4bnnb9
pos: JJ
token:
  names":false,"suffix":""}],"containertitle":"Ecopsychology","id":"ITEM-2″,"issue":"1″,"issued":{"date

lemma:
  names":false,"suffix":""}],"containertitle":"ecopsychology","id":"item-2″,"issue":"1″,"issued":{"date


# ent

id: cord-252661-wa0hdg1u
type: WORK_OF_ART
entity:
  Proclamation on Declaring a National Emergency Concerning the Novel Coronavirus Disease COVID 19 Outbreak


id: cord-276787-6yr3pant
type: ORG
entity:
  the American College of Physicians American Society of Internal Medicine American College of Physicians


id: cord-288679-57ftpsmx
type: ORG
entity:
  Endophthalmitis After Intravitreal Injection of Anti Vascular Endothelial Growth Factor Agents Causative Organisms and Possible Prevention Strategies Priorities


id: cord-272995-yvj2pqh1
type: WORK_OF_ART
entity:
  Presymptomatic Transmission of SARS CoV 2 Amongst Residents and Staff at a Skilled Nursing Facility Results of Real Time PCR


id: cord-272995-yvj2pqh1
type: ORG
entity:
  LTCcovid International Long Term Care Policy Network Care Policy and Evaluation Centre CPEC Finding the Right Balance


id: cord-321088-5gu7rnhj
type: ORG
entity:
  The Institute for Health Metrics and Evaluation COVID 19 Projections A Brief Measure for Assessing Generalized Anxiety


id: cord-321088-5gu7rnhj
type: EVENT
entity:
  Italy COVID 19 Considerations and Implications for Surgical Learners Using Technology to Maintain the Education of Residents During the COVID 19


id: cord-295391-e5it7nxl
type: PERSON
entity:
  Hatlan M Bin Helayel Halah Khandekar Rajiv Al Habash Ahmed Al Shahwan Sami title Residents Perceived Impact of COVID


id: cord-265425-b2ryvctp
type: ORG
entity:
  Coronavirus COVID 19 Society of Critical Care Medicine Critical Care for Non ICU Clinicians Society of Interventional Radiology Critical Care Introductory Course


id: cord-294440-zd0arwmr
type: ORG
entity:
  an Independent and Assisted Living Community for Older Adults Asymptomatic and Presymptomatic SARS CoV


id: cord-294440-zd0arwmr
type: WORK_OF_ART
entity:
  a Skilled Nursing Facility Asymptomatic Transmission the Achilles Heel of Current Strategies to Control Covid 19 Epidemiology of Covid 19 in a Long Term Care Facility


id: cord-337186-5zwt2bfo
type: CELL_LINE
entity:
  U S COVID 19 Pandemic Clinic Akron General Urology Residency Program s COVID 19 Experience College of Obstetricians


id: cord-337186-5zwt2bfo
type: ORG
entity:
  European Association of Urology Guidelines Office Rapid Reaction Group An Organisation wide Collaborative Effort


id: cord-337186-5zwt2bfo
type: ORG
entity:
  COVID 19 Pandemic Accreditation Council for Graduate Medical Education Urology Residency Requirements Using Technology to Maintain the Education of Residents


id: cord-348976-hgty4t7c
type: CELL_LINE
entity:
  U S COVID 19 Pandemic date 2020 05 12 journal Laryngoscope DOI 10 1002 lary 28733 sha b80277c38f948b359d4cebc8b83ec7ed8273a61c doc_id 348976 cord_uid hgty4t7c OBJECTIVE The coronavirus 2019 COVID 19


id: cord-348976-hgty4t7c
type: WORK_OF_ART
entity:
  The Coronavirus Outbreak Web site COVID 19 U S Department of Health Human Services Comprehensive Hospital Preparedness Checklist for Coronavirus Disease 2019 COVID 19


id: cord-348976-hgty4t7c
type: ORG
entity:
  the Difficult Airway Society the Association of Anaesthetists the Intensive Care Society the Faculty of Intensive Care Medicine


# bib

id: cord-011971-h78639ld
author: Wood, D. Brian
date: 2020-07-03
txt: ./txt/cord-011971-h78639ld.txt
cache: ./cache/cord-011971-h78639ld.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7390555/
doi: 10.5811/westjem.2020.5.46762
summary:
  title: Conference Didactic Planning and Structure: An Evidence-based Guide to Best Practices from the Council of Emergency Medicine Residency Directors This paper offers expert guidelines for didactic instruction from members of the Council of Emergency Medicine Residency Directors Best Practices Subcommittee, based on best available evidence. Authors also recommend following the Model of Clinical Practice of Emergency Medicine when developing content, while incorporating sessions dedicated to morbidity and mortality, research methodology, journal article review, administration, wellness, and professionalism. 30, 31 To date, there are no objective data evaluating training level-specific didactics on learning outcomes; however, faculty and residents have been shown to view this targeted instruction positively. 66 This has been demonstrated to be an effective educational model that is positively viewed by trainees and can improve access and attendance at didactic offerings for both residents and faculty.

title:
  Conference Didactic Planning and Structure: An Evidence-based Guide to Best Practices from the Council of Emergency Medicine Residency Directors

abstract:
  Emergency medicine residency programs around the country develop didactic conferences to prepare residents for board exams and independent practice. To our knowledge, there is not currently an evidence-based set of guidelines for programs to follow to ensure maximal benefit of didactics for learners. This paper offers expert guidelines for didactic instruction from members of the Council of Emergency Medicine Residency Directors Best Practices Subcommittee, based on best available evidence. Programs can use these recommendations to further optimize their resident conference structure and content. Recommendations in this manuscript include best practices in formatting didactics, selection of facilitators and instructors, and duration of individual sessions. Authors also recommend following the Model of Clinical Practice of Emergency Medicine when developing content, while incorporating sessions dedicated to morbidity and mortality, research methodology, journal article review, administration, wellness, and professionalism.


id: cord-013443-x74uxdi4
author: Daniel, Dennis A.
date: 2020-06-25
txt: ./txt/cord-013443-x74uxdi4.txt
cache: ./cache/cord-013443-x74uxdi4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597756/
doi: 10.1097/pcc.0000000000002477
summary:
  DESIGN: Prospective cohort study examining curriculum completion data and cross-referencing timestamps for preand posttest attempts with resident schedules to determine the hours that they accessed the curriculum and whether or not they were scheduled for clinical duty. For our ICU residents, we designed curricula that included short videos with pre-and posttests and hypothesized that residents would use these materials most frequently during breaks in patient care while on clinical duty. We collected curriculum completion data for each resident and timestamps for every pre-and the first posttest attempt that occurred during the ICU rotation and in the 14 days preceding. Our data show that residents will engage with online learning materials during and immediately prior to their ICU rotation but do so most often at nighttime and when off-duty, with a portion of use occurring during midnight and 6 am while offduty.

title:
  Pediatric Resident Engagement With an Online Critical Care Curriculum During the Intensive Care Rotation*

abstract:
  Residents are often assigned online learning materials as part of blended learning models, superimposed on other patient care and learning demands. Data that describe the time patterns of when residents interact with online learning materials during the ICU rotation are lacking. We describe resident engagement with assigned online curricula related to time of day and ICU clinical schedules, using website activity data. DESIGN: Prospective cohort study examining curriculum completion data and cross-referencing timestamps for pre- and posttest attempts with resident schedules to determine the hours that they accessed the curriculum and whether or not they were scheduled for clinical duty. Residents at each site were cohorted based on two differing clinical schedules—extended duration (>24 hr) versus shorter (maximum 16 hr) shifts. SETTING: Two large academic children’s hospitals. SUBJECTS: Pediatric residents rotating in the PICU from July 2013 to June 2017. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: One-hundred and fifty-seven pediatric residents participated in the study. The majority of residents (106/157; 68%) completed the curriculum, with no statistically significant association between overall curriculum completion and schedule cohort at either site. Residents made more test attempts at nighttime between 6 pm and 6 am (1,824/2,828; 64%) regardless of whether they were scheduled for clinical duty. Approximately two thirds of test attempts (1,785/2,828; 63%) occurred when residents were not scheduled to work, regardless of time of day. Forty-two percent of all test attempts (1,199/2,828) occurred between 6 pm and 6 am while off-duty, with 12% (342/2,828) occurring between midnight and 6 am. CONCLUSIONS: Residents rotating in the ICU completed online learning materials mainly during nighttime and off-duty hours, including usage between midnight and 6 am while off-duty. Increasing nighttime and off-duty workload may have implications for educational design and trainee wellness, particularly during busy, acute clinical rotations, and warrants further examination.


id: cord-030994-pq9fnc7c
author: Reed, Donovan S
date: 2020-07-13
txt: ./txt/cord-030994-pq9fnc7c.txt
cache: ./cache/cord-030994-pq9fnc7c.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454818/
doi: 10.1093/milmed/usaa193
abstract: nan
summary:
  The Accreditation Council for Graduate Medical Education (ACGME) program requirements for GME in Ophthalmology mandate a minimum of 360 hours of didactic sessions on the basic and clinical sciences during 3 years of residency. Concerning the individual components, 100% of respondents felt the resident-led oral board case simulations and ophthalmic surgery lecture series benefited their education. To determine the generalizability of the methodology presented, program directors of the other ophthalmology residencies affiliated with military training facilities were contacted to define their approach to graduate medical education during the COVID-19 pandemic. Each of the military training programs transitioned to a virtual-based learning initiative, and through coordination amongst the ophthalmology residency program directors, similar approaches to graduate medical education were instituted at all facilities. Open forum group discussion learning initiative with resident-led virtual didactics designed after the model discussed, which effectively maintained resident graduate medical education at the facility.

title:
  Finding Focus in Crisis: Resident-Driven Graduate Medical Education at a Military Training Facility during the COVID-19 Pandemic


id: cord-035176-oryjjoiw
author: Detterline, Stephanie
date: 2020-10-29
txt: ./txt/cord-035176-oryjjoiw.txt
cache: ./cache/cord-035176-oryjjoiw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598991/
doi: 10.1080/20009666.2020.1807218
summary:
  OBJECTIVE: Our large community hospital based internal medicine residency sought to develop and evaluate a crisis response to the demands of the COVID-19 pandemic to meet our residents'' educational and wellness needs. In the context of this system wide response, our IM residency program also initiated a crisis plan to meet the clinical needs of surging patient volumes as well as maintain education for our residents. We describe our residency''s response to the COVID-19 crisis along with our early outcome data as a contribution to what we expect to be a new body of scholarly work: how residencies might best navigate a worldwide pandemic that creates strains on healthcare systems and GME programs. Preliminary feedback from our residents indicates an overall positive evaluation of our crisis response to meet their well-being and educational needs during the first weeks of our system''s surge during the COVID-19 pandemic.

title:
  An internal medicine residency’s response to the COVID-19 crisis: caring for our residents while caring for our patients

abstract:
  BACKGROUND: In response to the COVID-19 pandemic, internal medicine residencies have had to develop new teaching strategies and attend to wellness concerns. Providing front-line care for patients in a time of widespread crisis while maintaining attention to training has created unprecedented challenges. OBJECTIVE: Our large community hospital based internal medicine residency sought to develop and evaluate a crisis response to the demands of the COVID-19 pandemic to meet our residents’ educational and wellness needs. METHODS: In March 2020, our residency developed a crisis plan for functioning during the COVID-19 pandemic. A brief survey was sent via email to our 149 residents to obtain their evaluation of how well their needs were being met by this response. RESULTS: 92 (62%) residents completed the survey. 88% indicated their well-being needs were well met. Other components were also rated as successful: effective communication (86%), scheduling/staffing (78%), preparing residents for clinical service (77%), and educational needs (76%). CONCLUSIONS: Our residency crisis response to the COVID-19 pandemic was favorably evaluated by our residents in meeting their training and well-being needs. In future work we plan to seek longer-term and more objective measures to assess how residents fare during these challenging times, and to use lessons learned to prepare for future crisis situations.


id: cord-104462-1eppgxo2
title: Impact of COVID-19 Within a Midwestern General Surgery Residency
author: Brungardt, Joseph G.
date: 2020-07-10
txt: ./txt/cord-104462-1eppgxo2.txt
cache: ./cache/cord-104462-1eppgxo2.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363170/
doi: nan
abstract: nan
summary:
  1 Besides large-scale restructuring from "stay at home" directives and other measures, the Department of Surgery at the University of Kansas Medical Center in Kansas City implemented several measures and procedures to limit staff exposure, continue surgical care throughout the hospital, and create opportunities for learning for its surgical residents. Self-directed learning from question banks, textbooks, and literature review continues to be the crux of surgical resident education, with possibly more time available as surgical case load and clinical schedules lighten. To limit exposure further, the mid-level resident assumed responsibility for all patient contact in traumas, with the intern or senior available as a backup. The clinical education of our residents has continued, though at a distinctly decreased volume and pace, with the silver lining being in the care of the patients. As the stay-at-home orders begin to lift and elective surgeries begin to resume, it is difficult to predict the lasting impact this time will have on surgical resident education.


id: cord-252661-wa0hdg1u
title: Letter: Changes to neurosurgery resident education following onset of the COVID-19 pandemic
author: Pennington, Zach
date: 2020-05-22
txt: ./txt/cord-252661-wa0hdg1u.txt
cache: ./cache/cord-252661-wa0hdg1u.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.wneu.2020.05.139
doi: 10.1016/j.wneu.2020.05.139
summary:
  Here we surveyed program directors 6 (PDs) to ascertain how they have altered the education and clinical care responsibilities of 7 residents in response to the COVID-19 pandemic. Continuing education in spite of decreased case 21 volume and maintaining resident morale are cited as the most common concerns of PDs. 22 23 Conclusion 24 Here we find that there is great homogeneity in the responses of neurosurgical residency 25 programs to the COVID-19 pandemic. Continuing education in spite of decreased case 21 volume and maintaining resident morale are cited as the most common concerns of PDs. 22 23 Conclusion 24 Here we find that there is great homogeneity in the responses of neurosurgical residency 25 programs to the COVID-19 pandemic. Here we present the results of a survey of PDs for ACGME-accredited neurosurgery residency 126 programs regarding their responses to the COVID-19 pandemic.

abstract:
  Abstract Background The COVID-19 pandemic has led to the postponement of a large proportion of neurosurgical cases with an accordant radical change in resident experiences. As residents rely upon operative exposure and in-person didactic lectures for education, the disruptions caused by the pandemic have forced programs to revise how they educate residents. Here we surveyed program directors (PDs) to ascertain how they have altered the education and clinical care responsibilities of residents in response to the COVID-19 pandemic. Methods Surveys were sent to the PDs of all ACGME-accredited neurosurgery programs. Survey questions targeted changes in resident staffing and coverage, changes in didactic material delivery, and changes in resident wellness initiatives. PD concerns were also elicited. Results Of the 116 program PDs invited, 57 responded (49.1%). We found that most programs have reduced resident work weeks (65%) and in-hospital resident shift census (95%). Few have redeployed residents and most are increasingly relying on teleconferencing solutions for meetings and resident education. Most commonly programs are using faculty- (91%) or resident-led (65%) lectures, though nearly 75% are supplementing resident education with materials from the Congress of Neurological Surgeons (CNS). Continuing education in spite of decreased case volume and maintaining resident morale are cited as the most common concerns of PDs. Conclusion Here we find that there is great homogeneity in the responses of neurosurgical residency programs to the COVID-19 pandemic. Programs are increasingly incorporating teleconferencing platforms and third-party education materials, most commonly materials from the CNS. Additionally, most respondents indicated that their program has not redeployed residents in the care of COVID-19 positive patients. The results of the present study may assist program directors in developing a uniform resident curriculum and consider wellness initiatives during this time of crisis.


id: cord-256691-fn4bnnb9
author: Suyin Chalmin-Pui, Lauriane
date: 2020-09-30
txt: ./txt/cord-256691-fn4bnnb9.txt
cache: ./cache/cord-256691-fn4bnnb9.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S016920462030325X
doi: 10.1016/j.landurbplan.2020.103958
summary:
  Pre-and post-wellbeing measures (subjective well-being, perceived stress, diurnal cortisol) were captured over a 2-week data collection period prior to and for at least 3 months after each intervention, with the experiment being repeated over a two-year period, using two sub-populations of residents (i.e. Groups A and B, Fig. 1 ). Data included how residents felt about their lives, well-being, mental and physical health, street, neighbourhood, community, engagement with nature and gardening, attitudes towards the intervention, motivations for participation in the research and expectations regarding the outcomes of the intervention. Thus, the data addresses Q1 and Q2, indicating the intervention reduced perceived stress levels, improved cortisol profiles and thereby had a positive effect on the residents'' health status. The data presented suggests that adding plants and containers to residents'' front gardens was associated with significant reductions in perceived stress (Q1) which was reflected in improved diurnal cortisol patterns (Q2) post-intervention (i.e. steeper diurnal declines, increased daily average concentration and total secretions compared to ''blunted'' levels pre-intervention).

title:
  “It made me feel brighter in myself”- The health and well-being impacts of a residential front garden horticultural intervention

abstract:
  Residential gardens make up 30% of urban space in the UK, yet unlike many other green space typologies, their role in the health and well-being agenda has largely been overlooked. A horticultural intervention introduced ornamental plants to 38 previously bare front gardens (≈ 10 m(2)) within an economically deprived region of North England, UK. Measures of perceived stress and diurnal cortisol profiles (as an indicator of health status) were taken pre- and post-intervention (over 3 months). Residents reported significant decreases in perceived stress post-intervention. This finding was aligned with a higher proportion of ‘healthy’ diurnal cortisol patterns post-intervention, suggesting better health status in those individuals. All residents derived one or more reported socio-cultural benefits as a result of the front garden plantings, although overall scores for subjective well-being did not increase to a significant level. Further qualitative data suggested that the gardens were valued for enhancing relaxation, increasing positive emotions, motivation, and pride of place. The results indicate that adding even small quantities of ornamental plants to front gardens within deprived urban communities had a positive effect on an individual’s stress regulation and some, but not all, aspects of subjective well-being. The research highlights the importance of residential front gardens to human health and well-being, and thus their contribution to the wider debates around city densification, natural capital and urban planning.


id: cord-260279-igra1q3j
title: Coronavirus Disease 2019 (COVID-19) and Radiology Education—Strategies for Survival
author: Slanetz, Priscilla J.
date: 2020-04-23
txt: ./txt/cord-260279-igra1q3j.txt
cache: ./cache/cord-260279-igra1q3j.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1546144020303719
doi: 10.1016/j.jacr.2020.03.034
abstract: nan
summary:
  Although the priority is on providing timely and high-quality imaging to patients, especially those infected with coronavirus disease 2019 (COVID-19), there is still a need to maintain our educational mission. Accrediting and certifying bodies, including the ABR, ACGME, FDA, and NRC Q7 , recognize the impact of this pandemic on trainees'' education, and specific allowances may be granted for those residents impacted by COVID-19. Faculty can also share interesting cases and provide trainees with a list of teaching cases to review at their convenience. Virtual meetings preserve dedicated teaching conferences for both trainees and medical students, facilitate ongoing workstation feedback to residents, and bring the community together in this era of social distancing. For residency programs and trainees, although there remains some uncertainty around how to best meet expected case logs and rotation requirements, we must all remain adaptable, embrace innovation, and continue to add value to patient care.


id: cord-262073-7bhoyg4o
author: Tolu, Lemi Belay
date: 2020-08-10
txt: ./txt/cord-262073-7bhoyg4o.txt
cache: ./cache/cord-262073-7bhoyg4o.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.2147/amep.s262369
doi: 10.2147/amep.s262369
summary:
  We divided the data obtained into six thematic areas: resident staffing, clinical education, surgical education, didactic teaching, research activity, and accreditation process. The clinical education and handson training are affected by the disruption of formal health care delivery like elective surgeries, disruption of skill-based teaching activities, and deployment of residents to COVID-19 related service. 7 Considering the above facts, we did a scoping review to synthesize evidence on adaptive (innovative) ways of maintaining residency education activities during the COVID-19 pandemic. 12 Resident clinical education (Morning, case presentations, bedsides, round, seminars (management session), journal club) Few residency programs suspend resident clinical teachings 9 while many residency training programs designed alternative innovative technologies to maintain resident clinical education during COVID-19 pandemic. Different innovative alternative teaching methods were evolving to substitute the former face to face teaching to maintain residency didactic, clinical, surgical education, and research activity.

title:
  Managing Resident Workforce and Residency Training During COVID-19 Pandemic: Scoping Review of Adaptive Approaches

abstract:
  OBJECTIVE: To review available adaptive residency training approaches and management of the resident workforce in different residency programs amid COVID-19 pandemic. MATERIALS AND METHODS: Websites of different professional associations and international or national specialty accreditation institutions were searched. We looked for English studies (any form), reviews or editorials, perspectives, short or special communications, and position papers on residency education during the COVID-19 pandemic. PubMed, EMBASE, and Google Scholar were also searched using keywords. Two independent reviewers extracted data using a customized tool that was developed to record the key information relevant to the review question. The two authors resolved their difference in data extraction by discussion. RESULTS: We identified 13 documents reporting on residency education during pandemics. Three were articles, 5 short or special communications, and the rest editorials and perspectives. We divided the data obtained into six thematic areas: resident staffing, clinical education, surgical education, didactic teaching, research activity, and accreditation process. CONCLUSION: Residency programs must reorganize the resident’s staffing and provide appropriate training to ensure the safety of residents during the pandemic. There are feasible adaptive approaches to maintaining residency training in the domains of didactic teaching, clinical education, and some research activities. Although some innovative virtual surgical skills training methods are implemented in limited surgical residency disciplines, their effectiveness is not well examined. Guidance and flexibility of the accreditation bodies in ensuring the competency of residents is one component of the adaptive response.


id: cord-265425-b2ryvctp
title: Radiology Residency Preparedness and Response to the COVID-19 Pandemic
author: Chong, Alice
date: 2020-04-11
txt: ./txt/cord-265425-b2ryvctp.txt
cache: ./cache/cord-265425-b2ryvctp.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.acra.2020.04.001
doi: 10.1016/j.acra.2020.04.001
summary:
  The aim of this article is to provide specific guidance for radiology residency program leadership to prepare and respond to residency-related impact from the pandemic, with focus on safety and education. At the Stage 3 pandemic emergency status, while requirements such as adequate resources and training (including infection protection), adequate supervision, and work hour requirements are in effect, other common program requirements and specialty-specific program requirements are suspended for ACGME-accredited programs to allow for the flexibility of physicians in the clinical care settings. To promote physical/social distancing, ensure the safety of residents, and allow for adequate reserve capacity, a number of residency programs, such as the University of California San Diego (UCSD) in California (resident number= 41 in diagnostic radiology, 10 in interventional Radiology) and Virginia Mason Medical Center (VMMC) in Seattle, Washington (resident number= 12 in diagnostic radiology) have divided the residents into two clinical groups, with one group reporting to clinical service, and the other assigned to home/distance learning; the two groups alternate every other week (one week on, one week off.) The resident group assigned to home/distance learning may be pulled to cover a resident on clinical rotation who becomes ill or needs to be quarantined.

abstract:
  This article provides a guideline for radiology residency programs to prepare and respond to the impact of COVID-19, by offering specific examples from three programs, and provides a list of resources for distance learning and maintaining well-being.


id: cord-266242-d4fo3lsn
title: Impacts on Surgery Resident Education at a first wave COVID-19 epicenter
author: Ostapenko, A.
date: 2020-08-18
txt: ./txt/cord-266242-d4fo3lsn.txt
cache: ./cache/cord-266242-d4fo3lsn.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.08.16.20176073
doi: 10.1101/2020.08.16.20176073
summary:
  Background: This study aims to identify the effects of the COVID-19 pandemic on surgical resident training and education at Danbury Hospital. Methods: We conducted an observational study at a Western Connecticut hospital heavily affected by the first wave of the COVID-19 pandemic to assess its effects on surgical residents, focusing on surgical education, clinical experience, and operative skills development. However, the consequent opportunity cost was to surgery-specific training; there was a significant decrease in operative cases and time spent in surgical didactics, along with elevated concern about overall preparedness for their intended career. 16.20176073 doi: medRxiv preprint For clinical experience, we compared the number of duty hours logged by residents during the period of interest with the same time in 2019, and calculated a gross difference and percent change. . https://doi.org/10.1101/2020.08.16.20176073 doi: medRxiv preprint affect residency programs across the country with changes to clinical work, didactics, and operative experience of surgical residents.

abstract:
  Background: This study aims to identify the effects of the COVID-19 pandemic on surgical resident training and education at Danbury Hospital. Methods: We conducted an observational study at a Western Connecticut hospital heavily affected by the first wave of the COVID-19 pandemic to assess its effects on surgical residents, focusing on surgical education, clinical experience, and operative skills development. Objective data was available through recorded work hours, case logs, and formal didactics. In addition, we created an anonymous survey to assess resident perception of their residency experience during the pandemic. Results: There are 22 surgical residents at our institution; all were included in the study. Resident weekly duty hours decreased by 23.9 hours with the majority of clinical time redirected to caring for COVID-19 patients. Independent studying increased by 1.6 hours (26.2%) while weekly didactics decreased by 2.1 hours (35.6%). The operative volume per resident decreased by 65.7% from 35.0 to 12.0 cases for the period of interest, with a disproportionately high effect on junior residents, who experienced a 76.2% decrease. Unsurprisingly, 70% of residents reported a negative effect of the pandemic on their surgical skills. Conclusions: During the first wave of the COVID-19 pandemic, surgical residents' usual workflows changed dramatically, as much of their time was dedicated to the critical care of patients with COVID-19. However, the consequent opportunity cost was to surgery-specific training; there was a significant decrease in operative cases and time spent in surgical didactics, along with elevated concern about overall preparedness for their intended career.


id: cord-266965-fdxq45rx
author: Rakofsky, Jeffrey J.
date: 2020-07-17
txt: ./txt/cord-266965-fdxq45rx.txt
cache: ./cache/cord-266965-fdxq45rx.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32681418/
doi: 10.1007/s40596-020-01286-x
summary:
  Test scores were based on the proportion of correct responses to questions asked by the virtual patient about possible side effects, dosing, and titration decisions, which depended upon the patient''s tolerability and response to the learner''s selected medications. The validation paradigm included a novice-expert performance comparison across 4th year medical students, psychiatric residents from all four post-graduate year classes, and psychiatry department faculty, and a correlational analysis of simulator performance with the PRITE Somatic Treatments subscale score. Herein, we report on a virtual standardized patient (VSP)-based psychopharmacology simulator developed to provide a summative assessment of the learner''s ability to initiate medication, adjust doses, and manage the emerging side effects in a patient with treatment-resistant major depressive disorder. The participant groups include the trainees (medical students and residents) and faculty members who completed the virtual standardized patient assessment virtual standardized patient is reasonably similar to the outpatient psychiatry experience" was rated in the neutral to agree range, supporting the authenticity of the simulator.

title:
  A Virtual Standardized Patient–Based Assessment Tool to Evaluate Psychiatric Residents’ Psychopharmacology Proficiency

abstract:
  OBJECTIVES: A virtual standardized patient-based assessment simulator was developed to address biases and practical limitations in existing methods for evaluating residents’ proficiency in psychopharmacological knowledge and practice. METHODS: The simulator was designed to replicate an outpatient psychiatric clinic experience. The virtual patient reported symptoms of a treatment-resistant form of major depressive disorder (MDD), requiring the learner to use various antidepressants in order for the patient to fully remit. Test scores were based on the proportion of correct responses to questions asked by the virtual patient about possible side effects, dosing, and titration decisions, which depended upon the patient’s tolerability and response to the learner’s selected medications. The validation paradigm included a novice-expert performance comparison across 4th year medical students, psychiatric residents from all four post-graduate year classes, and psychiatry department faculty, and a correlational analysis of simulator performance with the PRITE Somatic Treatments subscale score. Post-test surveys evaluated the test takers’ subjective impressions of the simulator. RESULTS: Forty-three subjects completed the online exam and survey. Total mean scores on the exam differed significantly across all the learner groups in a step-wise manner from students to faculty (F = 6.10, p = 0.0001). Total mean scores by residency class correlated with PRITE Somatic Therapies subscale scores (p < 0.01). The post-test survey mean Likert results ranged from 3.33 ± 1.20 to 4.4 ± 0.79, indicating neutral to favorable responses for use of the simulator. CONCLUSIONS: This simulator demonstrated strong construct validity and high participant acceptability for assessing proficiency in the psychopharmacologic treatment of MDD.


id: cord-268106-qfpukqwc
author: Wooltorton, Eric
date: 2020-09-23
txt: ./txt/cord-268106-qfpukqwc.txt
cache: ./cache/cord-268106-qfpukqwc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33062090/
doi: 10.36834/cmej.70254
summary:
  In response to these changes, we launched an adapted, rapid consensus process to identify and define specific COVID-19 related competencies to guide teaching, learning, and feedback in the new clinical reality simultaneously affecting all Departments of Family Medicine across Canada. We aimed to engage as many residents, faculty members and leaders in the Department as possible using an adapted approach based on the first three steps of the Kern model 2 : problem identification and general needs assessment (step 1), targeted needs assessment (step 2); writing goals and objectives (step 3) (or more specifically learning ''outcomes'' in this case 3 ); CanMEDS is a one of the most widely used educational frameworks for organizing health professions competencies [4] [5] [6] and was chosen to organize competencies to allow their use in other Canadian family medicine programs, and non-family medicine specialties (Royal College of Physician and Surgeons of Canada).

title:
  Rapid, collaborative generation and review of COVID-19 pandemic-specific competencies for family medicine residency training

abstract:
  BACKGROUND: In March 2020, the COVID-19 pandemic disrupted competency-based medical education in Family Medicine programs across Canada. Faculty and residents identified a need for clear, relevant, and specific competencies to frame teaching, learning, supervision and feedback during the pandemic. METHODS: A rapid, iterative, educational quality improvement process was launched. Phase 1 involved experienced educators defining gaps in our program’s existing competency-database, reviewing emerging public health and regulatory guidelines, and drafting competencies. Phase 2 involved translation, member-checking, and anonymous feedback and editing of draft competencies by residents and other educational leaders. Phase 3 involved wider dissemination, collaborative editing and feedback from residents and faculty throughout the department. RESULTS: A total of 44 physicians including residents and faculty from multiple contexts provided detailed feedback, review, and editing of an ultimate list of 33 competencies organized by CanMEDS-FM roles. Broad agreement was obtained that the competencies form reasonable learning outcomes during the COVID-19 pandemic. CONCLUSIONS: These competencies represent learning objectives reflecting the initial educational mindsets of a wide range of teachers and learners experiencing a global pandemic. The project illustrates a novel collaboration across educational portfolios as a rapid educational response to a public health crisis.


id: cord-272995-yvj2pqh1
author: Bergman, Christian
date: 2020-10-07
txt: ./txt/cord-272995-yvj2pqh1.txt
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mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1525861020308367?v=s5
doi: 10.1016/j.jamda.2020.09.036
summary:
  Regarding visitor guidance, the panel made five strong recommendations: 1) maintain strong infection prevention and control precautions, 2) facilitate indoor and outdoor visits, 3) allow limited physical contact with appropriate precautions, 4) assess individual residents'' care preferences and level of risk tolerance, and 5) dedicate an essential caregiver and extend the definition of compassionate care visits to include care that promotes psychosocial wellbeing of residents. We edited the final guidance statements for clarity, aiming to capture the consensus of the Delphi aspects of the following topics (see Table 1 ): testing of asymptomatic staff and residents, 111 surveillance testing, visitor guidance, immunity from prior COVID-19 infection and associated 112 risk of infecting others. The panel 144 strongly agreed on some preconditions that would be essential prior to welcoming back visitors, 145 such as universal masking for staff, sufficient disinfecting supplies, PPE, and written plans 146 around isolation, cohorting, screening, testing, and outbreak investigations.

title:
  Recommendations for Welcoming Back Nursing Home Visitors during the COVID-19 Pandemic: Results of a Delphi Panel

abstract:
  Objectives Nursing homes became epicenters of COVID-19 in the spring of 2020. Due to the substantial case fatality rates within congregate settings, federal agencies recommended restrictions to family visits. Six months into the COVID-19 pandemic, these largely remain in place. The objective of this study was to generate consensus guidance statements focusing on essential family caregivers and visitors. Design A modified two-step Delphi process was used to generate consensus statements. Setting and Participants The Delphi panel consisted of 21 US and Canadian post-acute and long-term care experts in clinical medicine, administration, and patient care advocacy. Methods State and federal reopening statements were collected in June 2020 and the panel voted on these using a three-point Likert scale with consensus defined as ≥80% of panel members voting “Agree.” The consensus statements then informed development of the visitor guidance statements. Results The Delphi process yielded 77 consensus statements. Regarding visitor guidance, the panel made five strong recommendations: 1) maintain strong infection prevention and control precautions, 2) facilitate indoor and outdoor visits, 3) allow limited physical contact with appropriate precautions, 4) assess individual residents' care preferences and level of risk tolerance, and 5) dedicate an essential caregiver and extend the definition of compassionate care visits to include care that promotes psychosocial wellbeing of residents. Conclusions and Implications The COVID-19 pandemic has seen substantial regulatory changes without strong consideration of the impact on residents. In the absence of timely and rigorous research, the involvement of clinicians and patient care advocates is important to help create the balance between individual resident preferences and the health of the collective. The results of this evidence-based Delphi process will help guide policy decisions as well as inform future research.


id: cord-274470-82nhmusm
title: Go back to the basics: Cardiac surgery residents at the time of COVID‐19
author: Ricciardi, Gabriella
date: 2020-06-05
txt: ./txt/cord-274470-82nhmusm.txt
cache: ./cache/cord-274470-82nhmusm.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32500923/
doi: 10.1111/jocs.14680
abstract: nan
summary:
  Eventually, due to the inhospital risk of disease transmission, the number of working doctors has been restricted and some providers have been moved to hospital areas in dire need of physicians experienced in caring for critically ill patients. The SOcial MEdia platforms (SoMe), such as LinkedIn or Twitter, provide an excellent example of the unique opportunity of coupling personal professional advancement with up-to-date technological breakthroughs. 5 The role of these networks is undisguised also from the pandemic perspective since they have been used by world-famous iconic surgeons and doctors to popularize educational daily tips in form of "tweets" or short messages about the disease itself, the way it spreads, the measurements to minimize its diffusion and other related virus-issues. To the point, The COVID-19 era is teaching us, as doctors and Residents, that we are scientists before anything else.


id: cord-276787-6yr3pant
title: A Curriculum to Improve Pediatric Residents'' Telephone Triage Skills
author: Roth, Lauren T.
date: 2020-10-22
txt: ./txt/cord-276787-6yr3pant.txt
cache: ./cache/cord-276787-6yr3pant.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33117885/
doi: 10.15766/mep_2374-8265.10993
summary:
  Retrospective pre-post self-assessments evaluated resident perceptions of their skills in taking histories and triaging care over the phone in addition to obtaining qualitative feedback from faculty and residents immediately after the curriculum and 1–2 years postgraduation. Given this significant gap in the literature and a perceived gap in knowledge at our own institution, we developed a curriculum to help residents develop phone triage skills and experience taking after-hours phone calls at one of our pediatric continuity clinics. Faculty members need only to have some experience performing phone triage and general pediatrics knowledge in order to train residents on these necessary skills. Overall, this curriculum showed a significant improvement in resident-reported skills in taking patient histories and triaging over the phone. As a result of this pilot curriculum, residents from all clinic sites in our ambulatory care network are now required to participate in the program and continue to express interest and positive outcomes from their training experience.

abstract:
  INTRODUCTION: Telephone triage systems are frequently used due to their success in decreasing emergency department utilization, reduction of health care costs, and high levels of satisfaction among patients and providers. Despite phone triage's prevalence, few residency programs have designated curricula for residents to learn this vital skill. METHODS: We designed a phone triage curriculum initially piloted with senior residents at one of our continuity clinics. The curriculum consisted of a didactic session, a just-in-time simulation training session, and an experiential component of being on call during the ambulatory rotation. Retrospective pre-post self-assessments evaluated resident perceptions of their skills in taking histories and triaging care over the phone in addition to obtaining qualitative feedback from faculty and residents immediately after the curriculum and 1–2 years postgraduation. RESULTS: Of 11 eligible residents, 10 (91%) chose to participate in the pilot curriculum. Residents reported that their skills in history taking over the phone improved from 20% to 90% and their ability to triage patients over the phone improved from 0% to 80%. This led to a quality improvement initiative to increase patient calls and has continued for 5 years, with continued positive feedback from residents and attendings. DISCUSSION: Phone triage skills are a necessity for pediatric providers, but few residency programs have training curricula in place. Through an experience-based phone triage program, residents significantly improved their self-reported skills at history taking and triaging. Similar curricula could easily be adopted at other institutions.


id: cord-277278-lg38l5gh
author: Tang, Olive
date: 2020-10-14
txt: ./txt/cord-277278-lg38l5gh.txt
cache: ./cache/cord-277278-lg38l5gh.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33153910/
doi: 10.1016/j.jamda.2020.10.011
summary:
  Residents who were positive for COVID-19 and had multiple symptoms at the time of testing had the highest risk of mortality (HR 4.44; 95% CI: 2.97, 6.65) and hospitalization (SHR 2.38; 95% CI: 1.70, 3.33), even after accounting for comorbidity burden. Of 52 SARS-CoV-2 positive residents who were asymptomatic at the time of testing and were closely monitored for 14 days at one facility, only 6 (11.6%) developed symptoms. Conclusions and Implications Asymptomatic infection with SARS-CoV-2 in the nursing home setting was associated with increased risk of death suggesting a need for closer monitoring of these residents, particularly those with underlying cardiovascular and respiratory comorbidities. A 78 cohort of all residents at one facility who were asymptomatic at the time of testing were closely 79 monitored by nursing home staff for development of symptoms over a 14 day period; this was 80 documented in a dedicated line list and included as a sub-analysis.

title:
  Outcomes of nursing home COVID-19 patients by initial symptoms and comorbidity: Results of universal testing of 1,970 residents

abstract:
  Objective Clinical implications of asymptomatic cases of the novel coronavirus disease 2019 (COVID-19) in nursing homes remain poorly understood. We assessed the association of symptom status and medical comorbidities on mortality and hospitalization risk associated with COVID-19 in residents of a large nursing home system. Design Retrospective cohort study. Setting and Participants 1,970 residents from 15 nursing home facilities with universal COVID-19 testing in Maryland. Methods We used descriptive statistics to compare baseline characteristics, logistic regression to assess the association of comorbidities with COVID-19, and Cox regression to assess the association of asymptomatic and symptomatic COVID-19 with mortality and hospitalization. We assessed the association of comorbidities with mortality and hospitalization risk. Symptom status was assessed at the time of the first test. Maximum follow-up was 94 days. Results Among the 1,970 residents (mean age 73.8, 57% female, 68% Black), 752 (38.2%) were positive on their first test. Residents who were positive for COVID-19 and had multiple symptoms at the time of testing had the highest risk of mortality (HR 4.44; 95% CI: 2.97, 6.65) and hospitalization (SHR 2.38; 95% CI: 1.70, 3.33), even after accounting for comorbidity burden. Cases who were asymptomatic at testing had a higher risk of mortality (HR 2.92; 95% CI: 1.95, 4.35), but not hospitalization (HR 1.06; 95% CI: 0.82, 1.38) compared to those who were negative for COVID-19. Of 52 SARS-CoV-2 positive residents who were asymptomatic at the time of testing and were closely monitored for 14 days at one facility, only 6 (11.6%) developed symptoms. Conclusions and Implications Asymptomatic infection with SARS-CoV-2 in the nursing home setting was associated with increased risk of death suggesting a need for closer monitoring of these residents, particularly those with underlying cardiovascular and respiratory comorbidities.


id: cord-287330-glq6t78p
author: Sabharwal, Samir
date: 2020-05-28
txt: ./txt/cord-287330-glq6t78p.txt
cache: ./cache/cord-287330-glq6t78p.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1931720420301616
doi: 10.1016/j.jsurg.2020.05.026
summary:
  Design Description of educational augmentation and programming modifications Setting The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, Baltimore, MD Participants Residents and faculty, Department of Orthopaedic Surgery Methods In response to the COVID-19 pandemic, we developed and implemented a modified operational schedule and remote curriculum in the orthopaedic surgery department of our health system. Our plan was guided by the following principles: protecting the workforce while providing essential clinical care; maintaining continuity of education and research; and promoting social distancing while minimizing the impact on team psychosocial well-being. Our plan was guided by the principles of protecting the workforce while providing essential clinical care; maintaining continuity of education and research; and promoting social distancing while minimizing the impact on team psychosocial well-being. We have developed and implemented a comprehensive set of modifications to our department''s operations to protect our workforce and support patient care, maintain continuity of resident education and research, and ensure social distancing while minimizing the impact on team psychosocial well-being.

title:
  How We Do It: Modified Residency Programming and Adoption of Remote Didactic Curriculum During the COVID-19 Pandemic

abstract:
  ABSTRACT Objective To describe the modified operational plan we implemented for residents and faculty in our orthopaedic surgery department to allow continuation of resident education and other core activities during the novel coronavirus (COVID-19) pandemic. Design Description of educational augmentation and programming modifications Setting The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, Baltimore, MD Participants Residents and faculty, Department of Orthopaedic Surgery Methods In response to the COVID-19 pandemic, we developed and implemented a modified operational schedule and remote curriculum in the orthopaedic surgery department of our health system. Our plan was guided by the following principles: protecting the workforce while providing essential clinical care; maintaining continuity of education and research; and promoting social distancing while minimizing the impact on team psychosocial well-being. Results The operational schedule and remote curriculum have been implemented successfully and allow resident education and other core departmental functions to continue as our health care system responds to the pandemic. Conclusions We have been proactive and deliberate in implementing these operational changes, without compromise of our workforce. This experience provides residents exposure to real-life systems-based practice. We hope that our early experience will provide a framework for other surgical residency programs facing this crisis.


id: cord-288679-57ftpsmx
title: Resident Perspectives on COVID-19: Three Takeaways
author: Ramirez, David A.
date: 2020-09-22
txt: ./txt/cord-288679-57ftpsmx.txt
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mime: text/plain
url: https://doi.org/10.1016/j.ajo.2020.07.028
doi: 10.1016/j.ajo.2020.07.028
abstract: nan
summary:
  As we navigated these changes in our personal lives, our residency program also adapted to meet our new educational challenges. In one study, residents who had previously used a surgical simulator demonstrated shorter J o u r n a l P r e -p r o o f phacoemulsification times and used less phacoemulsification power 1 . Although our surgical experience during the coronavirus pandemic was limited, our quick transition to a simulation curriculum allowed us to maintain progress in surgical training and to continue resident-faculty interaction. We implemented best practices on how to reduce spread in J o u r n a l P r e -p r o o f ophthalmic clinics, published by a group of ophthalmologists in Hong Kong 9 , which involved careful triage of patients with symptoms suggestive of contagious disease, minimizing micro-aerosolizing procedures, and installing protective shields on slit lamps. Influence of surgery simulator training on ophthalmology resident phacoemulsification performance Surgical Simulation Training Reduces Intraoperative Cataract Surgery Complications Among Residents


id: cord-288787-9g2vpdj3
author: Bitonti, Giovanna
date: 2020-08-01
txt: ./txt/cord-288787-9g2vpdj3.txt
cache: ./cache/cord-288787-9g2vpdj3.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S030121152030498X?v=s5
doi: 10.1016/j.ejogrb.2020.07.057
summary:
  OBJECTIVE: to evaluate the impact of the COVID-19 pandemic on the obstetrics and gynecology residency training program in Italy. STUDY DESIGN: This was a cross-sectional survey study aimed to assess the impact of the COVID-19 pandemic on the obstetrics and gynecology residency training program in Italy. The aim of this study was to evaluate the impact of the COVID-19 pandemic on the obstetrics and gynecology residency training program in Italy This was a cross-sectional survey study aimed to assess the impact of the COVID-19 pandemic on the obstetrics and gynecology residency training program in Italy. This cross-sectional survey study aimed to evaluate the impact of the COVID-19 pandemic on the obstetrics and gynecology residency training program in Italy. Findings from the survey showed that among Italian residents in obstetrics and gynecology, COVID-19 pandemic was associated with a significant training impairment. In summary, among Italian residents COVID-19 pandemic had a considerable negative impact on obstetrics and gynecology residency training program.

title:
  Being an Obstetrics and Gynaecology Resident during the COVID-19: Impact of the Pandemic on the residency training program

abstract:
  OBJECTIVE: to evaluate the impact of the COVID-19 pandemic on the obstetrics and gynecology residency training program in Italy. STUDY DESIGN: This was a cross-sectional survey study aimed to assess the impact of the COVID-19 pandemic on the obstetrics and gynecology residency training program in Italy. An online survey with 45 questions was sent and completed anonymously by residents after accepting an informed consent. The invitation to the online survey was sent to all the Italian residents in obstetrics and gynecology. Those on maternity leave at the time of the study were excluded. Residents were asked about their routinely activity before the COVID-19 pandemic, and to report the reduction in their clinical practice. They were also asked about psychological impact of COVID-19 on their clinical practice. RESULTS: 933 Italian residents in obstetrics and gynecology, were invited for this survey study. Four-hundred and seventy-six (51%) completed the survey and were included in the study. Three-hundred and eighty-seven (81.3%) were female, and 89 (18.7%) were male. Residents age ranged from 25 to 42. In 71,8% (342/476) of the cases residents work in a COVID-19 reference Hospitals. One-hundred and eighty-four out of 76 residents (38.6%) were tested on RT-PCR assay of nasal and pharyngeal swab specimens, and of them 12/184 (6.5%) were positive to SARS-COV-2. Regarding the use of personal protective equipment (PPE), 267 (56.1%) reported to receive adequate device, and 379 (79.6%) felt to be well informed about prevention and management protocols. Three-hundred and thirty-one residents (69.5%) reported to have managed COVID-19 positive patients. For 54,7% of respondent residents, training activity in general decreased significantly during the COVID-19 epidemic. A one-third reduction was reported in 31,4% of the cases, whereas a total suspension of the training in 9,9% of the cases. In 89,3% of cases the reduction was caused by the reorganization of work. Anxiety about the professional future was reported in 84% of the residents, and 59% of them had the perception that their training was irreversibly compromised. CONCLUSIONS: Among Italian residents in obstetrics and gynecology, COVID-19 pandemic was associated with a significant training impairment.


id: cord-292429-28mwv9f7
title: Incorporating telehealth to improve neurosurgical training during the COVID-19 pandemic
author: Miranda, Stephen P.
date: 2020-05-17
txt: ./txt/cord-292429-28mwv9f7.txt
cache: ./cache/cord-292429-28mwv9f7.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020310871
doi: 10.1016/j.wneu.2020.05.116
summary:
  At our institution, we have found that involving residents in telehealth clinic and supplementing this time with virtual, case-based conferences have already enhanced resident education, by taking learning models classically used in surgical skills training and applying them to surgical decision-making and management instead. Nevertheless, outpatient clinical experience provides a critical opportunity for trainees to develop the non-operative skills emphasized by the ACGME Milestones, including information gathering and interpretation, evidence-based practice, critical thinking for diagnosis and therapy, and awareness of healthcare systems (Table 1) . Residents have the autonomy to conduct clinical encounters and deliberately practice their approach (Ericsson''s theory, mastery learning model). Prior to COVID-19, at our weekly case conference with all residents and faculty present, patients from each clinical site are presented and residents have the opportunity to simulate an oral boards examination, practicing surgical decision-making with each case scenario.

abstract:
  • Telehealth clinic provides learning for residents. • Resident education achievable during COVID-19. • Learning model adaptable based on local viral burden.


id: cord-294440-zd0arwmr
title: COVID-19 in seniors: Findings and lessons from mass screening in a nursing home
author: Sacco, Guillaume
date: 2020-06-26
txt: ./txt/cord-294440-zd0arwmr.txt
cache: ./cache/cord-294440-zd0arwmr.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0378512220303194?v=s5
doi: 10.1016/j.maturitas.2020.06.023
summary:
  CONCLUSIONS: The pauci-symptomatic expression of COVID-19 in older residents, together with the high prevalence of asymptomatic forms in caregivers, justifies mass screening in nursing homes, possibly prioritizing residents with suggestive combinations of clinical signs including dyspnea, falls, anorexia and/or altered consciousness. The objective of the present study was to clarify symptoms and chronological aspects of the propagation of the SARS-CoV-2 in a nursing home, both in residents and staff members. The study consisted in a five-week retrospective observational cohort study in a middle-sized nursing home in Maine-et-Loire, West of France, having performed COVID-19 mass screening of residents (n=87) and staff members (n=92). The present report of COVID-19 mass screening in a nursing home showed a high prevalence of asymptomatic infected staff members, and confirmed that older residents exhibit few and mainly nonspecific symptoms.

abstract:
  BACKGROUND/OBJECTIVE: The COVID-19 epidemic is particularly serious in older adults. The symptomatology and epidemic profile remain little known in this population, especially in disabled oldest-old people with chronic diseases living in nursing homes. The objective of the present study was to comprehensively describe symptoms and chronological aspects of the diffusion of the SARS-CoV-2 virus in a nursing home, among both residents and caregivers. DESIGN: Five-week retrospective cohort study. SETTING: A middle-sized nursing home in Maine-et-Loire, west of France. PARTICIPANTS: Eighty-seven frail older residents (87.9 ± 7.2years; 71% female) and 92 staff members (38.3 ± 11.7years; 89% female) were included. MEASUREMENTS: Mass screening for SARS-CoV-2 was performed in both residents and staff. Attack rate, mortality rate, and symptoms among residents and staff infected with SARS-CoV-2 were recorded. RESULTS: The attack rate of COVID-19 was 47% in residents (case fatality rate, 27%), and 24% in staff. Epidemic curves revealed that the epidemic started in residents before spreading to caregivers. Residents exhibited both general and respiratory signs (59% hyperthermia, 49% cough, 42% polypnea) together with geriatric syndromes (15% falls, 10% altered consciousness). The classification tree revealed 100% COVID-19 probability in the following groups: i) residents younger than 90 with dyspnea and falls; ii) residents older than 90 with anorexia; iii) residents older than 90 without anorexia but with altered consciousness. Finally, 41% of staff members diagnosed with COVID-19 were asymptomatic. CONCLUSIONS: The pauci-symptomatic expression of COVID-19 in older residents, together with the high prevalence of asymptomatic forms in caregivers, justifies mass screening in nursing homes, possibly prioritizing residents with suggestive combinations of clinical signs including dyspnea, falls, anorexia and/or altered consciousness.


id: cord-295096-pkcyorav
title: Editorial. Impact of COVID-19 on neurosurgery resident training and education
author: Bambakidis, Nicholas C.
date: 2020-04-17
txt: ./txt/cord-295096-pkcyorav.txt
cache: ./cache/cord-295096-pkcyorav.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32302990/
doi: 10.3171/2020.3.jns20965
abstract: nan
summary:
  When in-person didactics are canceled and surgical volume is significantly reduced, how does a program adapt education rapidly? In addition, with increasing concern for an inadequate supply of PPE, how do we as educators protect our residents from harm while knowing that their knowledge, experience, and grit are exactly what is necessary to help the medical workforce during this crisis? In March 2003, both medical schools in Hong Kong were forced to abruptly transition undergraduate medical education into a recorded lecture format, and students were taken out of clinical rotations until the new cases had ceased. 5 The Accreditation Council for Graduate Medical Education (ACGME) reiterated that residents who are managing suspected or confirmed COVID-19 cases should have adequate supervision by faculty who are trained in such protocols, which may impact the availability of supervision.


id: cord-295391-e5it7nxl
title: Residents'' Perceived Impact of COVID-19 on Saudi Ophthalmology Training Programs-A Survey
author: Alahmadi, Adel Salah
date: 2020-11-03
txt: ./txt/cord-295391-e5it7nxl.txt
cache: ./cache/cord-295391-e5it7nxl.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33173273/
doi: 10.2147/opth.s283073
summary:
  title: Residents'' Perceived Impact of COVID-19 on Saudi Ophthalmology Training Programs-A Survey PURPOSE: To evaluate the impact of the current pandemic on ophthalmology residency training in Saudi Arabia, focusing on its effects on clinical education, training, and the mental well-being of the trainees. CONCLUSION: COVID-19 pandemic has disrupted residents'' clinical and surgical training in the Saudi ophthalmology training programs. 6, 7 In addition to disruption in clinical and surgical teaching, didactic teaching programs such as grand rounds and lectures were administered through virtual platforms such as Zoom, Microsoft Teams, and Cisco WebEx. We believed that ophthalmology residents had experienced remarkable limitations in their clinical training and surgical exposure due to these dramatic changes. The current cross-sectional study aimed to explore COVID-19 related experiences and perceptions of ophthalmology residents in various Saudi programs. We believe that COVID-19 had significantly impacted trainees'' mental health currently enrolled in the Saudi ophthalmology residency programs.

abstract:
  PURPOSE: To evaluate the impact of the current pandemic on ophthalmology residency training in Saudi Arabia, focusing on its effects on clinical education, training, and the mental well-being of the trainees. METHODS: An online self-administered questionnaire was distributed among residents in the Saudi ophthalmology training programs between July 7 and 14, 2020. In this study, we explored residents’ opinions regarding training disruption and virtual education. The patient health questionnaire (PHQ-9) was used to assess the COVID-19 pandemic’s impact on their mental health. We used descriptive statistics for data analysis. RESULTS: Out of 183 registered ophthalmology residents, 142 participated in this study. Ninety-six participants (35.4%) were rotated at a specialized eye hospital during the COVID-19 pandemic, while 52 (19.2%) had rotations in the ophthalmology department at general hospitals. Those who rotated in both types of hospitals were 123 (45.4%). According to the participants, there was a significant decline in exposure to surgical and office-based procedures compared to emergency eye consultations (Friedman P <0.001). The COVID-19 pandemic’s effect on mental health was reported by 100 (70.5%) participants. Eighty-five (55.4%) respondents were satisfied with the virtual method of education. CONCLUSION: COVID-19 pandemic has disrupted residents’ clinical and surgical training in the Saudi ophthalmology training programs. Additionally, we believe that COVID-19 may have a negative impact on trainees’ mental health. Fortunately, the current pandemic provided an innovative education method that will likely be used even after the pandemic.


id: cord-301514-yo2ebphy
title: The Radiology Resident Experience at a Large Tertiary Care Hospital During the COVID-19 Pandemic
author: Holten, John
date: 2020-09-29
txt: ./txt/cord-301514-yo2ebphy.txt
cache: ./cache/cord-301514-yo2ebphy.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33062897/
doi: 10.1177/2382120520963036
summary:
  The COVID-19 pandemic has created unprecedented challenges in healthcare including pressure to provide efficient and timely patient care while maintaining a safe environment for physicians and staff. We found the Review and Commentary Perspective "Chest CT Findings in 2019 Novel Coronavirus (2019-nCoV) Infections from Wuhan, China: Key Points for the Radiologist" by Jeffrey Kanne especially helpful for us to get a sense for how COVID-19 pneumonia presents before cases at our own institution began to rise. Working closely with the hospital administration and the department of pulmonology, the radiology department created a standardized process for imaging patients with clinical suspicion for COVID-19. 10 In accordance with this principle, our department rapidly implemented changes to provide the highest quality care for our patients and assistance to our clinical teams while minimizing the exposure risk to our residents.

abstract:
  The COVID-19 pandemic has created unprecedented challenges in healthcare including pressure to provide efficient and timely patient care while maintaining a safe environment for physicians and staff. Radiology plays a vital role as part of a multidisciplinary team in the care of these patients. We address the experiences of our radiology residency at a large urban US academic institution with an underserved population in our fight against COVID-19. The unprecedented challenges faced during this pandemic has created monumental impacts on our training and allowed for development of skills and resources in order to better handle future situations.


id: cord-303000-tmk2c9eh
author: Alhaj, Ahmad Kh.
date: 2020-05-16
txt: ./txt/cord-303000-tmk2c9eh.txt
cache: ./cache/cord-303000-tmk2c9eh.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1878875020310585
doi: 10.1016/j.wneu.2020.05.087
summary:
  The aim is to identify the level of knowledge, readiness, and the impact of this virus among neurosurgery residents in different programs. To our best knowledge, this is the first study regarding the readiness of neurosurgery residents towards the COVID-19 pandemic and the impact it has on their training. The aim of this study is to identify the level of knowledge, readiness, practices, as well as the impact of this virus among neurosurgery residents in various neurosurgical programs. The final section (6 items) focuses on the impact of this pandemic on the resident in terms of neurosurgical training, studying, mental health, as well as whether their social life was affected or not. Table 3 demonstrates the association of this score about the virus with gender, age, year of residency training, location of the neurosurgery program. Our study is the first regarding the readiness of neurosurgery residents towards the COVID-19 pandemic and the impact it has on their training.

title:
  Neurosurgery Residents Perspective on the COVID-19: Knowledge, Readiness, and Impact of this Pandemic.

abstract:
  Abstract Background The novel Coronavirus disease (COVID-19) is a life-threatening illness, which represents a challenge to all the health-care workers. Neurosurgeons around the world are being affected in different ways. Objectives This is the first study regarding the readiness of neurosurgery residents towards the COVID-19 pandemic and its impact. The aim is to identify the level of knowledge, readiness, and the impact of this virus among neurosurgery residents in different programs. Methods A cross-sectional analysis in which 52 neurosurgery residents from different centers were selected to complete a questionnaire-based survey. The questionnaire comprised of three sections and 27 questions that ranged from knowledge to impact of the current pandemic on various features. Results The median knowledge score was 4 out of 5. The proportion of participants with satisfactory knowledge level was 60%. There was a statistically significant difference between the knowledge score and location of the program. Around 48% of the neurosurgery residents dealt directly with COVID-19 patients. Receiving a session about personal protective equipment (PPE) was reported by 57.7%. The neurosurgery training at the hospital was affected. About 90% believed that this pandemic influenced their mental health. Conclusion Neurosurgery residents have a relatively good knowledge about COVID-19. The location of the program was associated with knowledge level. Most of the participants did not receive a sufficient training about PPE. Almost all responders agree that their training at the hospital was affected. Further studies are needed to study the impact of this pandemic on neurosurgery residents.


id: cord-303731-yrlzxtbw
title: Management of Dysphagia in Nursing Homes During the COVID-19 Pandemic: Strategies and Experiences
author: Fong, Raymond
date: 2020-08-18
txt: ./txt/cord-303731-yrlzxtbw.txt
cache: ./cache/cord-303731-yrlzxtbw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838197/
doi: 10.1007/s42399-020-00464-0
summary:
  The global 2019 novel coronavirus disease (COVID-19) pandemic has had devastating effects not only on healthcare systems worldwide but also on different aspects of the care provided to nursing home residents. This article has summarised the actions taken in this regard and may serve as a reference to clinicians who are responsible for swallowing assessments and dysphagia management in nursing homes. Residents who had been diagnosed with COVID-19 were assessed after discharged to the nursing home as patients with COVID-19 were considered at high risk for oropharyngeal dysphagia [18] , especially those who have been previously intubated [19] . Therefore, standard and at-risk residents should be considered differently with respect to dysphagia assessments and management and personal protective equipment usage. Consequently, a surge in the use of telepractice for dysphagia management in nursing home settings was not observed during the COVID-19 pandemic.

abstract:
  The global 2019 novel coronavirus disease (COVID-19) pandemic has had devastating effects not only on healthcare systems worldwide but also on different aspects of the care provided to nursing home residents. Dysphagia management is a crucial component of the care provided to many nursing home residents. This article presents the dysphagia management strategies applied in Hong Kong during the COVID-19 pandemic and the related experiences. A two-tier protection system was implemented wherein residents were categorised according to their contact and hospitalisation histories. The provided swallowing management and personal protective equipment level differed between the two tiers. The article also discusses the referral and prioritisation of clinical services for residents requiring swallowing management, as well as the adaptations of swallowing assessment and management during the pandemic. The possible effects of COVID-19 on mealtime arrangements in nursing homes, the implications of the pandemic on the use of personal protective equipment and the use of telepractice in nursing homes were also discussed. This article has summarised the actions taken in this regard and may serve as a reference to clinicians who are responsible for swallowing assessments and dysphagia management in nursing homes.


id: cord-306421-r8wzvpn5
author: Sizoo, Eefje M.
date: 2020-10-23
txt: ./txt/cord-306421-r8wzvpn5.txt
cache: ./cache/cord-306421-r8wzvpn5.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1525861020308999?v=s5
doi: 10.1016/j.jamda.2020.10.024
summary:
  title: Dilemmas with restrictive visiting policies in Dutch nursing homes during the COVID-19 pandemic: a qualitative analysis of an open-ended questionnaire with elderly care physicians Objectives To mitigate the spread of COVID-19, a nationwide restriction for all visitors of residents of long-term care facilities including nursing homes (NHs) was established in the Netherlands. Thematic analysis revealed four major themes: (1) The need for balancing safety for all through infection prevention measures versus quality of life of the individual residents and their loved ones; (2) The challenge of assessing the dying phase and how the allowed exception to the strict visitor restriction in the dying phase could be implemented; (3) The profound emotional impact on ECPs; (4) Many alternatives for visits highlight the wish to compensate for the absence of face to face contact opportunities. Conclusions and Implications ECPs reported that the restrictive visitor policy deeply impacts NHs residents, their loved ones and care professionals.

title:
  Dilemmas with restrictive visiting policies in Dutch nursing homes during the COVID-19 pandemic: a qualitative analysis of an open-ended questionnaire with elderly care physicians

abstract:
  Objectives To mitigate the spread of COVID-19, a nationwide restriction for all visitors of residents of long-term care facilities including nursing homes (NHs) was established in the Netherlands. The aim of this study was an exploration of dilemmas experienced by Elderly Care Physicians (ECPs) as a result of the COVID-19 driven restrictive visiting policy. Setting and Participants ECPs working in Dutch NHs. Methods A qualitative exploratory study was performed using an open-ended questionnaire. A thematic analysis was applied. Data was collected between April 17 and May 10, 2020. Results Seventy-six ECPs answered the questionnaire describing a total of 114 cases in which they experienced a dilemma. Thematic analysis revealed four major themes: (1) The need for balancing safety for all through infection prevention measures versus quality of life of the individual residents and their loved ones; (2) The challenge of assessing the dying phase and how the allowed exception to the strict visitor restriction in the dying phase could be implemented; (3) The profound emotional impact on ECPs; (4) Many alternatives for visits highlight the wish to compensate for the absence of face to face contact opportunities. However, given the diversity of NH residents, alternatives were often only suitable for some of them. Conclusions and Implications ECPs reported that the restrictive visitor policy deeply impacts NHs residents, their loved ones and care professionals. The dilemmas encountered as a result of the policy highlight the wish by ECPs to offer solutions tailored to the individual residents. We identified an overview of aspects to consider when drafting future visiting policies for NHs during the COVID-19 pandemic.


id: cord-321088-5gu7rnhj
title: Stress and the Surgical Resident in the COVID-19 Pandemic
author: Collins, Caitlin
date: 2020-07-25
txt: ./txt/cord-321088-5gu7rnhj.txt
cache: ./cache/cord-321088-5gu7rnhj.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S1931720420302658?v=s5
doi: 10.1016/j.jsurg.2020.07.031
summary:
  The aim of this study was to evaluate the impact of COVID-19 on the surgical resident training experience, assess possible sources of stress or anxiety among surgery residents, and examine how patterns of anxiety vary by resident rank. DESIGN: We developed and disseminated a survey, which included the Generalized Anxiety Disorder 7-Item Scale (GAD-7), to all general and integrated plastic surgery residents in their clinical years of training at the University of California, San Francisco. We hypothesized that the COVID-19 pandemic and the resultant surge planning required to prepare for it would have a marked impact on the surgical resident training experience and that the inflexible realities of this time would have a significant emotional toll on surgical residents across different ranks and hospital sites. Because we were interested in the impact of COVID-19 on clinically active surgical residents, general and plastic surgery residents in protected research years were excluded from the survey.

abstract:
  OBJECTIVES: The COVID-19 pandemic has drastically transformed the healthcare community and medical education across the United States. The aim of this study was to evaluate the impact of COVID-19 on the surgical resident training experience, assess possible sources of stress or anxiety among surgery residents, and examine how patterns of anxiety vary by resident rank. DESIGN: We developed and disseminated a survey, which included the Generalized Anxiety Disorder 7-Item Scale (GAD-7), to all general and integrated plastic surgery residents in their clinical years of training at the University of California, San Francisco. Statistical analysis of the survey responses was performed using the Kruskal-Wallis or Wilcoxon rank sum test. Post-hoc analysis was performed using the Bonferroni-corrected Dunn test. Survey data were combined with aggregated duty hour information and operative case numbers from select hospitals for March and April of 2019 (historical baseline) and 2020. RESULTS: The overall survey response rate was 73.7% (n=73). With an estimated operative volume reduction of 63.3% for general surgery cases, over 90% of residents expressed concern about the decline in operative exposure. While the senior residents tended to work more shifts, they were not more likely to have higher risk perception scores for contracting COVID-19 nor higher anxiety levels about the possibility of contracting COVID-19. They were, however, significantly more likely to have high GAD-7 scores (≥ 10) when compared to interns (z=-2.82, p-adj=0.014). Overall, residents were more concerned about the general health of loved ones than about their own risk of contracting COVID-19 (U=3,897.5, p<0.01). CONCLUSIONS: While the work-related experiences of residents varied across a number of factors during the pandemic, residents tended to report similar sources of anxiety. Moving forward, surgical residency training programs will need to develop ways to optimize available surgical experiences and address the unique resident anxieties that an infectious pandemic presents. CORE COMPETENCIES: Practice-Based Learning and Improvement, Medical Knowledge, Patient Care


id: cord-327809-9uhhqasl
title: Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic
author: Dimitriu, Mihai C.T.
date: 2020-06-07
txt: ./txt/cord-327809-9uhhqasl.txt
cache: ./cache/cord-327809-9uhhqasl.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.mehy.2020.109972
doi: 10.1016/j.mehy.2020.109972
summary:
  A study in China, comparing burnout of front line workers with that of normal ward staff, in COVID context, used Maslach questionnaire for medical workers and the results were interesting and quite unexpected [3] . The aim of our study was to compare the frequency of burnout syndrome between medical residents considered to work on the front line (emergency unit, radiology and intensive care unit) and those working in normal hospital wards (surgery, obstetrics and gynecology, obstetrics). The burnout was significantly more frequent in normal wards workers (lot B) (prevalence 86%) compared to medical residents working in places that we considered front-line departments: emergency unit, radiology, including CT/MRI department and intensive care unit -lot A in our study, that showed a prevalence of burnout of only 66% (p<0.05, from chi-square statistic test) (table 2).

abstract:
  Burnout is a state of physical or mental collapse caused by overwork or stress. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. The new COVID-19 pandemic has raised public health problems around the world and required a reorganization of health services. In this context, burnout syndrome and physical exhaustion have become even more pronounced. Resident doctors, and especially those in certain specialties, seem even more exposed due to the higher workload, prolonged exposure and first contact with patients. This article is a short review of the literature and a presentation of some considerations regarding the activity of the medical residents in a non-Covid emergency hospital in Romania, based on the responses obtained via a questionnaire. Burnout prevalence is not equal in different specialties. We studied its impact and imagine the potential steps that can be taken in order to reduce the increasing rate of burnout syndrome in the pandemics.


id: cord-331911-arif1ejj
author: Barik, Sitanshu
date: 2020-09-14
txt: ./txt/cord-331911-arif1ejj.txt
cache: ./cache/cord-331911-arif1ejj.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32926255/
doi: 10.1007/s00167-020-06274-0
summary:
  There were a total of 44 single answer questions with answers according to the increasing difficulty at present situation compared to a previous time before the COVID-19 pandemic. Routine clinical work in the operating room, out-patient department, and inpatient department was found to be difficult according to the majority of the residents along with the anxiety of contracting the infection. All participants were also required to answer general questions about their age, current affiliation, the experience of treating COVID-19 positive patients, awareness about precautions while working in COVID-19 designated area including steps of donning and doffing personal protective equipment (PPE), history of quarantine, or taking COVID-19 tests and if anyone tested positive for the infection. The most important findings of the present study were that the orthopedic residents had been facing difficulties in performing routine OR, OPD, and IPD works during COVID-19 pandemic.

title:
  Insight into the changing patterns in clinical and academic activities of the orthopedic residents during COVID-19 pandemic: a cross-sectional survey

abstract:
  PURPOSE: The COVID-19 pandemic has presented an unprecedented challenge to the orthopedic residency training programs to adapt to a form of a web-based learning process and simulation-based training. This study focusses on the viewpoint of the orthopedic residents to the paradigm shift in clinical care as well as the academic activities. METHODS: An anonymous questionnaire was created in an online survey generator and was sent through e-mail to 227 orthopedic residents of seven tertiary care centres in North India. The questionnaire was divided into three sections, academic activity section, mental health section, and clinical activity section. There were a total of 44 single answer questions with answers according to the increasing difficulty at present situation compared to a previous time before the COVID-19 pandemic. RESULTS: A total of 158 questionnaires were filled by 107 junior residents (67.7%) and 51 senior residents (32.3%). 49 residents (31%) were quarantined and three became positive for COVID-19. Although all of them knew about necessary precautions, personal protective equipment was difficult to avail at times. Increased difficulty in recruiting new patients for research (48.9%) and conducting prospective research (48.7%) was observed. The online-based learning process was reported to be easier (44.2%) by most of the residents. Routine clinical work in the operating room, out-patient department, and inpatient department was found to be difficult according to the majority of the residents along with the anxiety of contracting the infection. CONCLUSION: There are unique opportunities for improvement of residency programs during these times of uncertainty and the findings of this study can help the universities as well as program chairs to develop a robust program that can outlive this pandemic. The web-based learning process might prove to be useful and can be incorporated into the resident training program in the long term. LEVEL OF EVIDENCE: Level V.


id: cord-337186-5zwt2bfo
author: Fero, Katherine E.
date: 2020-06-06
txt: ./txt/cord-337186-5zwt2bfo.txt
cache: ./cache/cord-337186-5zwt2bfo.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0090429520306464
doi: 10.1016/j.urology.2020.05.051
summary:
  Respondents reported decreased surgical volume (83%-100% varying by subspecialty), increased use of telehealth (99%), a transition to virtual educational platforms (95%) and decreased size of inpatient resident teams (90%). Significantly more respondents from high COVID-19 regions reported decreased emergency urologic surgical volume (76% vs 22%, p = 0.01) and cancelled educational activities (11% vs 1%, p < 0.01). A significantly larger proportion of respondents in high COVID-19 regions reported urology trainees caring for COVID-19 patients (91% vs 7%, p= 0.03), being re-deployed (37% vs 11%, p<0.01), and being required to stay at home due to sickness or exposure (78% vs 20%, p <0.01). In the months after the emergence of COVID-19, US urology residency programs underwent significant modifications including decreased surgical and ambulatory volume, increased use of telehealth, increased educational activities via virtual platforms and significant workforce restructuring.

title:
  Perceived Impact of Urologic Surgery Training Program Modifications due to COVID-19 in the United States

abstract:
  OBJECTIVE: Significant healthcare disruption due to pandemic coronavirus disease 2019 (COVID-19) has implications across all aspects of clinical care in the United States (US). In this study, we aim to assess urology residency program modifications in the context of COVID-19, and perceptions of the impact on urology trainees. METHODS: A cross-sectional survey of program leadership and residents at accredited US urology residencies was administered between April 28, 2020 – March 11, 2020. Total cohort responses are reported, and sub-analyses were preformed comparing responses between those in in high vs low COVID-19 geographic regions, and between program leaders vs residents. RESULTS: Program leaders from 43% of programs and residents from 18% of programs responded. Respondents reported decreased surgical volume (83%-100% varying by subspecialty), increased use of telehealth (99%), a transition to virtual educational platforms (95%) and decreased size of inpatient resident teams (90%). Most residents are participating in care of COVID-19 patients (83%) and 20% endorsed that urology residents have been re-deployed. 79% of respondents perceive a negative impact of recent events on urology surgery training and anxiety regarding competency upon completion of residency training was more pronounced among respondents in high COVID-19 regions. CONCLUSION: Major modifications to urology training programs were implemented in response to COVID-19. Attention must be paid to the downstream effects of the training disruption on urology residents.


id: cord-337958-472xu87g
title: SHOULD I BE CONCERNED? SURGICAL TRAINING IN THE TIME OF COVID19
author: Zuberi, Maaz K.
date: 2020-10-15
txt: ./txt/cord-337958-472xu87g.txt
cache: ./cache/cord-337958-472xu87g.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1931720420303834
doi: 10.1016/j.jsurg.2020.10.006
summary:
  1, 2 In light of the expected decline in case volumes for the residents, the American Board of Surgery (ABS) has responded by changing its graduation requirements for the current academic year; it has reduced required annual work weeks to 44 from 48 and slashed required surgical cases by 10%. Even though there is a looming fear of contracting the disease, junior residents share a feeling of achievement in being able to support our medical colleagues during these tough times, and we believe that this crucial experience will not only help improve our ventilator management skills but also enable us to better understand the critically ill patient. Understandably, most ER and medical residencies have reduced their resident exposure by only having attendings manage COVID positive patients, however this structure is not always possible for general surgery programs.

abstract:
  As the US healthcare system restructured to deal with the COVID-19 pandemic, medical training was significantly disrupted. During the peak of the crisis, three surgical trainees in different stages of their residency shared their experiences and concerns on how this pandemic affected their training. The article is intended to generate discussion on the concerns of derailment and stagnation of surgical training and difficulties faced at all levels of surgical training to perform clinical duties and fulfill academic responsibilities during the early months of the COVID pandemic.


id: cord-340701-eeqgtk34
title: COVID-19 and Nursing Home Residents’ Rights
author: Kusmaul, Nancy
date: 2020-07-29
txt: ./txt/cord-340701-eeqgtk34.txt
cache: ./cache/cord-340701-eeqgtk34.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32883598/
doi: 10.1016/j.jamda.2020.07.035
abstract: nan
summary:
  title: COVID-19 and Nursing Home Residents'' Rights Born from a time when nursing homes residents were subject to physical 30 restraints and sedation, these rights sought to give residents greater control over daily routines 31 and social interactions 2 . While the Covid-19 pandemic seemed urgent and the risks to nursing home residents 39 were real, these directives superseded and countered residents'' rights. To have visitors at any time, as long as you wish to see them, as long 42 as the visit does not interfere with the provision of care and privacy rights of other residents." 4 43 As defined in the 45 federal register, §483.24 "Quality of life is a fundamental principle that applies to all care and 46 services provided to facility residents. Empowering the elderly nursing home resident: The resident rights 86 campaign Protect Nursing Home Residents from COVID 19 Your Rights and Protections as a 92 Nursing Home Resident


id: cord-340887-k88hchau
author: Khusid, Johnathan A.
date: 2020-05-27
txt: ./txt/cord-340887-k88hchau.txt
cache: ./cache/cord-340887-k88hchau.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32460433/
doi: 10.1111/ijcp.13559
summary:
  To address this gap, in the current study we aim to assess the well-being, clinical practice, and education of urology residents throughout the USA during the COVID-19 pandemic through the use of an anonymous survey. Potential risk factors included: resident age, gender identity, level of training, practice setting (urban/suburban/rural), AUA geographical section, perception of local COVID-19 severity (Likert), marital status, children, perceived household susceptibility to disease (Likert), history of COVID-19 symptoms, months of intensive care unit training, redeployment status, perceptions of availability of PPE (Likert) and COVID-19 testing, cancellation of elective cases, number of weekly operations before the pandemic, perceived program and hospital support (Likert), perception of shared responsibility with attendings (Likert), and perceived difficulty meeting case minimums (Likert). Perception of support from hospital administration (β=-0.23, 95% CI=-0.40, -0.05) and shared responsibility between residents and attendings (β=-0.22, 95% CI=-0.39, -0.07) were associated with lower declination of redeployment whereas concern regarding ability to reach graduation case requirements was associated with higher declination of redeployment (β=0.16, 95% CI=0.00, 0.32).

title:
  Well‐Being and Education of Urology Residents During the COVID‐19 Pandemic: Results of an American National Survey

abstract:
  BACKGROUND: The rapid spread of COVID‐19 has placed tremendous strain on the American healthcare system. Few prior studies have evaluated the well‐being of or changes to training for American resident physicians during the COVID‐19 pandemic. We aim to study predictors of trainee well‐being and changes to clinical practice using an anonymous survey of American urology residents. METHODS: An anonymous, voluntary, 47‐question survey was sent to all ACGME‐accredited urology programs in the United States. We executed a cross‐sectional analysis evaluating risk factors of perception of anxiety and depression both at work and home and educational outcomes. Multiple linear regressions models were used to estimate beta coefficients and 95% confidence intervals. RESULTS: Among approximately 1,800 urology residents in the USA, 356 (20%) responded. Among these respondents, 24 had missing data leaving a sample size of 332. Important risk factors of mental health outcomes included perception of access to PPE, local COVID‐19 severity, and perception of susceptible household members. Risk factors for declination of redeployment included current redeployment, having children, and concerns regarding ability to reach case minimums. Risk factors for concern of achieving operative autonomy included cancellation of elective cases and higher level of training. CONCLUSIONS: Several potential actions, which could be taken by urology residency program directors and hospital administration, may optimize urology resident well‐being, morale, and education. These include advocating for adequate access to PPE, providing support at both the residency program and institutional levels, instituting telehealth education programs, and fostering a sense of shared responsibility of COVID‐19 patients.


id: cord-343483-puly7tyv
title: A Urology Department''s Experience at the Epicenter of the COVID-19 Pandemic
author: Pak, Jamie S.
date: 2020-06-30
txt: ./txt/cord-343483-puly7tyv.txt
cache: ./cache/cord-343483-puly7tyv.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0090429520307792?v=s5
doi: 10.1016/j.urology.2020.06.024
abstract: nan
summary:
  As the ED-ICU gained prominence in the care pathway of COVID-19 patients at CUIMC, we also played an instrumental role in onboarding providers from other specialties to the attending/resident pair role. Given the residents'' increasing comfort with caring for critically ill COVID-19 patients, urology residents were redeployed to this ICU without an accompanying attending. Eventually, as the overall volume of critically ill patients with COVID-19 began to subside, our department was informed that we were no longer needed in the OR-ICUs on May 4 and in the satellite hospital "pop-up" ICU on May 6. Though COVID-19 put a heavy strain on our health care system in general, the changes required to respond to the pandemic led to an overall increased amount of available time for urology residents and faculty. This slow process of rescheduling elective surgeries may prolong the detrimental effects of the COVID-19 pandemic on both resident surgical training and patient care.


id: cord-345979-f0e6a0s4
title: Slowdown of urology residents’ learning curve during the COVID‐19 emergency
author: Porpiglia, Francesco
date: 2020-04-28
txt: ./txt/cord-345979-f0e6a0s4.txt
cache: ./cache/cord-345979-f0e6a0s4.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1111/bju.15076
doi: 10.1111/bju.15076
summary:
  In order to limit the impact of the COVID-19 emergency on the residents'' learning curves, which can further affect surgical and scientific learning, new alternative teaching methods should be introduced (Table 1) . The first one is represented by an online dedicated platform, where pre-recorded videos of lessons or surgical procedures are uploaded; these files could be available on-demand for the residents. Finally, notwithstanding the well-established usefulness of surgical simulation training programmes [6] , in this particular historic moment, where the Authorities have limited unnecessary transfers, the access to simulation platforms usually located in hospitals or universities is difficult. Now, during this extraordinary emergency in which it is very difficult to predict the duration of disruption, the current necessity should hopefully be translated into a future opportunity, in which smart-learning can become a useful tool integrated routinely into residency training programmes and urology daily life.

abstract:
  The coronavirus disease 2019 (COVID-19), has rapidly been spreading worldwide and Italy has been hit hard, forced the Italian Healthcare System to change and adapt to these extreme conditions. The Urology Department daily activities were drastically reduced and limited only to non-deferrable procedures and the entire organogram were reorganized following a rigorous flow-chart. It's evident that this unprecedent scenario is having an impact on residents training program, considering that it is very difficult to predict the duration of emergency. The urology residents do not have the opportunity to carry out clinical activities nor to be tutored, as the senior physicians are engaged in the emergency's management.


id: cord-346109-fcytebfz
author: Lie, Jessica J.
date: 2020-07-19
txt: ./txt/cord-346109-fcytebfz.txt
cache: ./cache/cord-346109-fcytebfz.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.jsurg.2020.07.017
doi: 10.1016/j.jsurg.2020.07.017
summary:
  title: Optimizing Resident Wellness During a Pandemic: University of British Columbia''s General Surgery Program''s COVID-19 Experience Objective: The University of British Columbia''s General Surgery Program delineates a unique and systematic approach to wellness for surgical residents during a pandemic. Objective: The University of British Columbia''s General Surgery Program delineates a unique and systematic approach to wellness for surgical residents during a pandemic. Measures must be put in place to protect resident from the increased physical and mental health stress in order to best serve patients during this difficult time. Measures must be put in place to protect resident from the increased physical and mental health stress in order to best serve patients during this difficult time. The General Surgery Program at UBC optimized the wellness of residents by targeting three domains: efficiency of practice, culture of wellness and personal resilience.

title:
  Optimizing Resident Wellness During a Pandemic: University of British Columbia''s General Surgery Program''s COVID-19 Experience

abstract:
  OBJECTIVE: The University of British Columbia's General Surgery Program delineates a unique and systematic approach to wellness for surgical residents during a pandemic. SUMMARY BACKGROUND DATA: During the COVID-19 pandemic, health care workers are suffering from increased rates of mental health disturbances. Residents’ duty obligations put them at increased physical and mental health risk. It is only by prioritizing their well-being that we can better serve the patients and prepare for a surge. Therefore, it is imperative that measures are put in place to protect them. METHODS: Resident wellness was optimized by targeting three domains: efficiency of practice, culture of wellness and personal resilience. RESULTS: Efficiency in delivering information and patient care minimizes additional stress to residents that is caused by the pandemic. By having a reserve team, prioritizing the safety of residents and taking burnout seriously, the culture of wellness and sense of community in our program are emphasized. All of the residents’ personal resilience was further optimized by the regular and mandatory measures put in place by the program. CONCLUSIONS: The new challenges brought on by a pandemic puts increased pressure on residents. Measures must be put in place to protect resident from the increased physical and mental health stress in order to best serve patients during this difficult time.


id: cord-348414-y6vh63xk
title: Dutch cardiology residents and the COVID-19 pandemic: Every little thing counts in a crisis
author: Berger, W. R.
date: 2020-11-03
txt: ./txt/cord-348414-y6vh63xk.txt
cache: ./cache/cord-348414-y6vh63xk.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s12471-020-01519-6
doi: 10.1007/s12471-020-01519-6
summary:
  title: Dutch cardiology residents and the COVID-19 pandemic: Every little thing counts in a crisis The COVID-19 pandemic has overwhelmed healthcare systems worldwide, and a large part of regular cardiology care came to a quick halt. A Dutch nationwide survey showed that 41% of cardiology residents suspended their training and worked at COVID-19 cohort units for up to 3 months. Due to the very rapid and unprecedented increase of COVID-19 patients, the regular cardiology care came to a quick halt. Residents have shown flexibility in both the continuation of regular healthcare for the (acute) cardiac patient and dedicated care for COVID-19 patients. These future cardiologists, who conquered COVID-19 in the front-lines of healthcare with tremendous effort and flexibility, are well prepared for a great future in clinical care. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic

abstract:
  The COVID-19 pandemic has overwhelmed healthcare systems worldwide, and a large part of regular cardiology care came to a quick halt. A Dutch nationwide survey showed that 41% of cardiology residents suspended their training and worked at COVID-19 cohort units for up to 3 months. With tremendous flexibility, on-call schedules were altered and additional training was provided in order for residents to be directly available where needed most. These unprecedented times have taught them important lessons on crisis management. The momentum is used to incorporate novel tools for patient care. Moreover, their experience of pandemic and crisis management has provided future cardiologists with unique skills. This crisis will not be wasted; however, several challenges have to be overcome in the near future including, but not limited to, a second pandemic wave, a difficult labour market due to an economic recession, and limitations in educational opportunities.


id: cord-348976-hgty4t7c
author: Cai, Yi
date: 2020-05-12
txt: ./txt/cord-348976-hgty4t7c.txt
cache: ./cache/cord-348976-hgty4t7c.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/lary.28733
doi: 10.1002/lary.28733
summary:
  The high viral loads in the nasal 11 and oropharyngeal mucosa, along with our current understanding of the route of severe acute respiratory syndrome (SARS) transmission 12 and anecdotal reports of disease transmission during aerosolizing procedures, place otolaryngologists at a higher risk for contracting COVID-19. 14, 15 Recent recommendations from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and Society of University Otolaryngologists (SUO) necessitated changes to resident clinical responsibilities, rotation schedules, and PPE guidelines during this pandemic. Lastly, participants were asked about their concerns, satisfaction with their department response, and perceived level of risk for residents and attendings for contracting COVID-19. Satisfaction level was strongly correlated with comfort in communicating their concerns (r = 0.72, P < .00001) and inversely correlated with resident perception of increased risk of contracting COVID-19 relative to attendings (r = −0.52, P < .00001).

title:
  Otolaryngology Resident Practices and Perceptions in the Initial Phase of the U.S. COVID‐19 Pandemic

abstract:
  OBJECTIVE: The coronavirus 2019 (COVID‐19) pandemic has had widespread implications on clinical practice at U.S. hospitals. These changes are particularly relevant to otolaryngology–head and neck surgery (OHNS) residents because reports suggest an increased risk of contracting COVID‐19 for otolaryngologists. The objectives of this study were to evaluate OHNS residency program practice changes and characterize resident perceptions during the initial phase of the pandemic. STUDY DESIGN: A cross‐sectional survey of U.S. OHNS residents at 81 programs was conducted between March 23, 2020, and March 29, 2020. RESULTS: Eighty‐two residents from 51 institutions (63% of invited programs) responded. At the time of survey, 98% of programs had enacted policy changes to minimize COVID‐19 spread. These included filtered respirator use for aerosol‐generating procedures even in COVID‐19‐negative patients (85%), decreased resident staffing of surgeries (70%), and reduced frequency of tracheotomy care (61%). The majority of residents (66%) perceived that residents were at higher risk of contracting COVID‐19 compared to attendings. Residents were most concerned about protective equipment shortage (93%) and transmitting COVID‐19 to patients (90%). The majority of residents (73%) were satisfied with their department's COVID‐19 response. Resident satisfaction correlated with comfort level in discussing concerns with attendings (r = 0.72, P < .00001) and inversely correlated with perceptions of increased risk compared to attendings (r = −0.52, P < .00001). CONCLUSION: U.S. OHNS residency programs implemented policy changes quickly in response to the COVID‐19 pandemic. Sources of resident anxieties demonstrate the importance of open communication and an integrated team approach to facilitate optimal patient and provider care during this unprecedented crisis. LEVEL OF EVIDENCE: 4. Laryngoscope, 2020


