Planning virtual residency interviews as a result of COVID-19: insight from residency applicants and physicians conducting interviews.

BACKGROUND: In response to the COVID-19 pandemic, the 2020-2021 residency interview process will undergo significant changes. Residency programme stakeholders would benefit from knowledge on what students and physicians expect from this process. OBJECTIVE: The purpose of the study was to describe and contrast the perspectives of student applicants and interviewing physicians related to the residency programme virtual interview process. METHODS: A survey consisting of 24 Likert statements was administered across listservs in summer 2020 to physicians (attendings and residents who interview medical students). Medical students also received an anonymous survey and were recruited via email to participate. RESULTS: A total of 155 individuals (104 fourth-year medical students and 51 physicians) completed a survey. Results showed students would prefer in-person interviews over virtual. Residency applicants had high agreement on the limited ability to fully assess the programme and city due to virtual interviews. Individuals with lower step 1 scores had higher agreement on preferring in-person interviews. Individuals in the lowest and highest scoring groups appear more worried about the representation of themselves as a result of virtual interviews. Furthermore, applicants feel that more weight will be placed on steps 1 and 2 scores and class ranks, and they may not be able to fully demonstrate their personality compared with interviewers. CONCLUSION: The result of COVID-19 has created challenges and subsequent reshuffling of medical education requiring careful preparation and planning. This study provides insight for residency programmes to better understand the applicants' expectations for the 2020-2021 residency interview and matching process.

The Effect of Transfer on Outcomes in Burns.

Patients with burn injuries are often initially transported to centers without burn capabilities, requiring subsequent transfer to a higher level of care. This study aimed to evaluate the effect of this treatment delay on outcomes. Adult burn patients meeting American Burn Association criteria for transfer at a single burn center were retrospectively identified. A total of 122 patients were evenly divided into two cohorts-those directly admitted to a burn center from the field vs those transferred to a burn center from an outlying facility. There was no difference between the transfer and direct admit cohorts with respect to age, percentage of total body surface area burned, concomitant injury, or intubation prior to admission. Transfer patients experienced a longer median time from injury to burn center admission (1 vs 8 hours, P < .01). Directly admitted patients were more likely to have inhalation burn (18 vs 4, P < .01), require intubation after admission (10 vs 2, P = .03), require an emergent procedure (18 vs 5, P < .01), and develop infectious complications (14 vs 5, P = .04). There was no difference in ventilator days, number of operations, length of stay, or mortality. The results suggest that significantly injured, high acuity burn patients were more likely to be immediately identified and taken directly to a burn center. Patients who otherwise met American Burn Association criteria for transfer were not affected by short delays in transfer to definitive burn care.

Perceptions diverge on aspects related to substance use disorder: An analysis of individuals in recovery, physicians, nurses, and medical students.

Background: Interactions with healthcare workers can provide effective entrance into treatment, ensuring retention and lifelong recovery for individuals with Substance Use Disorder (SUD). Healthcare providers approach the challenges of patient management with different skills, comfort levels, and viewpoints. Individuals in recovery also provide crucial perspectives relevant to the complex aspects of the drug epidemic. The purpose of this study was to determine if perceptions of SUD diverge among individuals in recovery, physicians, nurses and medical students. Methods: A survey consisting of 29 Likert statements was deployed to physicians, nurses, medical students, and persons with SUD in recovery. Respondents were asked to rate their level of agreement on statements about SUD such as treatment, stigma, medications for opioid use disorder (MOUD), naloxone kits, safe injection sites, and methamphetamine usage. Separate Welch's analysis of variances (ANOVAs) were conducted to determine differences between the respondent groups and each statement. For any statistically significant findings, Games-Howell post-hoc analyses were employed. Results: A total of 523 individuals provided survey responses: individuals in recovery (n = 111), physicians (n = 113), nurses (n = 206), and medical students (n = 93). Survey results revealed the majority of items had statistically significant differences in respondent groups. Perceptions diverged on items related to treatment, stigma, MOUD, take-home naloxone kits, safe injection sites, needle exchange programs, and methamphetamine. Conclusion: As healthcare providers and policymakers develop treatment strategies to engage those with SUD in quality treatment, they will benefit from understanding how different viewpoints on SUD affect treatment for these individuals. These attitudes impact stigma, willingness to prescribe new treatments, and development of clinical relationships. The insight from this study allows for important discussions on the substance use health crisis and further inquiry on why these differences exist and how the diverging viewpoints may impact the lives of persons with SUD.