The Perceived Impact of COVID-19 on Graduate Medical Education and Recommendations for Bridging the Educational Gap.

INTRODUCTION: COVID-19 generated a system-wide shock causing an unbalanced equilibrium between producing adequately trained physicians and meeting extraordinary operational needs. Previous studies report the experience of surgical residents during COVID-19 at a regional level. This study measures the learning losses related with the redeployment of highly specialized medical professionals to the care of COVID-19 patients, while we systematically investigate proposed remedial strategies. METHODS: We administered an online cross-sectional survey in 67 countries capturing training inputs (i.e., surgeries and seminars residents participated in) before and during the pandemic and retrieved residents' expected learning outputs, career prospects and recommended remedial measures for learning losses. We compared responses of residents working in (treatment group) and out (control group) of hospitals with COVID-19 patients. RESULTS: The analysis included 432 plastic surgery residents who were in training during the pandemic. Most of the learning losses were found in COVID-19 hospitals with 37% and 16% loss of surgeries and seminars, respectively, per week. Moreover, 74%, 44%, and 55% of residents expected their surgical skill, scientific knowledge, and overall competence, respectively, to be lower than those of residents who graduated before COVID. Residents in COVID-19 hospitals reported participating in significantly (P < 0.001) fewer surgeries and having significantly (P < 0.001) lower surgical skill relative to those not in COVID-19 hospitals. CONCLUSIONS: The perceived lower competence and the fall-off in surgical skill and scientific knowledge among future surgeons suggest that health-care systems globally may have limited capacity to perform specialized and costly procedures in the future.

How to harness the power of web scraping for medical and surgical research: An application in estimating international collaboration.

The transformative potential of web scraping in surgical research through a comprehensive analysis of its revolutionary applications and profound impact is now within reach. This manuscript unveils the pivotal role of web scraping in driving innovation, enabling more effective management of human capital dynamics, and enhancing patient outcomes in the surgical field. As an example, we demonstrate how web scraping can uncover insights into international collaboration in surgery research revealing limited collaboration between surgeons in developed and developing countries.

Evaluating the Internet as a Source of Information for Patients With Hidradenitis Suppurativa: A Review of Websites' Content, Insights Into Engagement, and Access.

BACKGROUND: The Internet has become the primary information source for patients, with most turning to online resources before seeking medical advice. OBJECTIVE: The aim of this study is to evaluate the quality of online information on hidradenitis suppurativa available to patients. METHODS: The authors performed an Internet search using the search terms "hidradenitis suppurativa," "hidradenitis suppurativa treatment," "hidradenitis suppurativa surgery," and "acne inversa." They identified the initial 100 websites from Google, Yahoo, and Bing. Websites were evaluated based on the modified Ensuring Quality Information for Patients instrument. RESULTS: Of the 300 websites, 95 (31.7%) were incorporated after accounting for the exclusion criteria: duplicate entries, websites not pertinent to the subject matter, websites inaccessible due to location restrictions or necessitating user accounts for access, websites in languages other than English, and websites originating from scientific publications directed at a scientific audience rather than the general population. Ensuring Quality Information for Patients scores ranged from 5 to 30/36, with a median of 17. CONCLUSION: This analysis unveils a diverse array of websites that could confound patients navigating toward high-caliber resources. These barriers may hinder the access to top-tier online patient information and magnify disparities in referral rates, patient engagement, treatment satisfaction, and quality of life.

Evaluating the web as a source of information for patients with chest wall deformities: insights into engagement and disparities.

BACKGROUND: Recent data highlight the internet's pivotal role as the primary information source for patients. In this study, we emulate a patient's/caregiver's quest for online information concerning chest deformities and assess the quality of available information. METHODS: We conducted an internet search using combination of the terms "pectus excavatum," "pectus excavatum surgery," "funnel chest," "pectus excavatum repair" and identified the first 100 relevant websites from the three most popular search engines: Google, Yahoo, and Bing. These websites were evaluated using the modified Ensuring Quality Information for Patients (EQIP) instrument. RESULTS: Of the 300 websites generated, 140 (46.7%) were included in our evaluation after elimination of duplicates, non-English websites, and those targeting medical professionals. The EQIP scores in the final sample ranged from 8 to 32/36, with a median score of 22. Most of the evaluated websites (32.8%) originated from hospitals, yet none met all 36 EQIP criteria. DISCUSSION: None of the evaluated websites pertaining to pectus excavatum achieved a flawless "content quality" score. The diverse array of websites potentially complicates patients' efforts to navigate toward high-quality resources. Barriers in accessing high-quality online patient information may contribute to disparities in referral, patient engagement, treatment satisfaction, and overall quality of life. LEVEL OF EVIDENCE: IV.

Human Capital and Productivity in Plastic Surgery Research Across Nations.

BACKGROUND: Understanding country differences in production and human capital in plastic surgery research is crucial in identifying current and future leaders in the field. In this study, we document each country's human capital and productivity in plastic surgery research. METHODS: A web scraping algorithm was deployed on PubMed to retrieve information on every publication and every first author in 10 major research outlets in plastic surgery between 2015 and 2021. Each country's human capital in the field is proxied by the number of first authors affiliated with that country. We compare aggregate patterns and volume trajectories of publications affiliated with 110 countries in the context of their human capital. RESULTS: We find that over the studied period, two countries, the USA and China, are represented in roughly 50% and 45% of global research output and first authors, respectively, in plastic surgery. Specifically in the USA, California has the highest number of affiliated first authors and publications compared with other States. CONCLUSIONS: Our findings reveal the clear dominance of the USA in plastic surgery research production. No specific US State stands out in the nation as much as the USA does in the global ranking of plastic surgery publications. This suggests that US plastic surgeons across the nation aim to publish. Our global analysis also suggests that countries with a higher share of first authors relative to their research output may have greater capacity to expand their research output in the future. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Impact of COVID-19 on Plastic Surgery Residents Across the World: A Country-, Region-, and Income-level Analysis.

BACKGROUND: The COVID-19 pandemic has upended graduate medical education globally. We investigated the COVID-19 impact on learning inputs and expected learning outputs of plastic surgery residents across the world. METHODS: We administered an online survey capturing training inputs before and during the pandemic and retrieved residents' expected learning outputs compared with residents who completed their training before COVID. The questionnaire reached residents across the world through the mobilization of national and international societies of plastic surgeons. RESULTS: The analysis included 412 plastic surgery residents from 47 countries. The results revealed a 44% decline (ranging from - 79 to 10% across countries) and an 18% decline (ranging from - 76 to across 151% countries) in surgeries and seminars, respectively, per week. Moreover, 74% (ranging from 0 to 100% across countries) and 43% (ranging from 0 to 100% across countries) of residents expected a negative COVID-19 impact on their surgical skill and scientific knowledge, respectively. We found strong correlations only between corresponding input and output: surgeries scrubbed in with surgical skill (ρ = -0.511 with p < 0.001) and seminars attended with scientific knowledge (ρ = - 0.274 with p = 0.006). CONCLUSIONS: Our ranking of countries based on their COVID-19 impacts provides benchmarks for national strategies of learning recovery. Remedial measures that target surgical skill may be more needed than those targeting scientific knowledge. Our finding of limited substitutability of inputs in training suggests that it may be challenging to make up for lost operating room time with more seminars. Our results support the need for flexible training models and competency-based advancement. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

School attendance during a pandemic.

When officials relax school attendance requirements as a prophylactic measure against a pandemic, students of higher prior performance take more absences, while students of lower prior performance keep going to school. Prior performance is positively associated with neighborhood income.