Educational and personal impacts of the COVID-19 pandemic on emergency medicine resident physicians: a qualitative study.

BACKGROUND: The COVID-19 pandemic had a significant impact on both the clinical practice and the psychological states of frontline physicians in the emergency department. Trainees, at the beginning of their careers and thus still developing their practice styles and identities as physicians, were uniquely affected. OBJECTIVE: In this qualitative study, we sought to explore how the pandemic environment shaped the experiences of emergency medicine resident physicians. METHODS: This was a qualitative study. We conducted in-depth interviews with emergency medicine faculty, resident physicians, and staff at a single emergency department based at an urban academic institution in the northeastern United States. Interviews were audio recorded and transcribed, and transcripts were then analyzed in an iterative process by our coding team for recurring themes related to the resident experience. RESULTS: We reached data saturation with 27 individuals. Of those who were interviewed, 10 were resident physicians [6 senior residents (PGY-3 or PGY-4) and 4 junior residents (PGY-1 or PGY-2)]. Three major recurring themes regarding resident physician experience emerged during our analysis of the interviews: (1) novel educational experiences dampened by negative structural forces from the pandemic, (2) fracturing of social interactions and mitigation through ad-hoc support systems and community of practice, and (3) development of negative emotions and psychological trauma including fear, resentment, and moral injury causing lasting harm. CONCLUSIONS: Our results suggest that emergency medicine resident physicians training during the COVID-19 pandemic faced unique experiences concerning their education, social support systems, and emotional states. While the educational and social experiences were described as having both negative and positive impacts, the emotional experiences were largely negative. Residency program leadership may use these insights to improve resident preparation, wellness, and resilience in the face of future adverse events.

Resource consumption and simulator driving performance using adaptive controls.

This research seeks to understand the usability of portable assistive driving devices as it relates to driver performance and safety. Through the use of a computer-based simulation, two sets of hand controls were tested in an environment containing driving hazards. Ten participants drove an ambulance through two sessions of high-demand, hazardous scenarios in a computer-based driving simulator. Participants drove one session with each of the two available portable hand control devices. From each of these driving sessions, driving performance metrics were measured in the form of time-to-complete, number of damage-inflicting collisions, percentage of vehicle damage accrued by the end of the drive, and percentage of road course completed. Data were also collected from a posttest survey about which hand control device participants preferred using. Results demonstrated no significant differences between hand control devices with regard to course completion, amount of damage sustained to vehicle, or number of collisions. However, a trend was identified for preference of hand control based on experience, regardless of driving performance. Although the objective results of this study were not significant, the study leads to interesting avenues of future research regarding preference as well as the need for larger populations of individuals with disabilities in simulation studies.

Design of instructions for evacuating disabled adults.

We investigated how the design of instructions can affect performance in preparing emergency stair travel devices for the evacuation of disable individuals. We had three hypotheses: 1) Design of instructions would account for a significant portion of explained performance variance, 2) Improvements in design of instructions would reduce time on task across device type and age group, and 3) There would be a performance decrement for older adults compared to younger adults based on the slowing of older adult information processing abilities. Results showed that design of instructions does indeed account for a large portion of explained variance in the operation of emergency stair travel devices, and that improvements in design of instructions can reduce time on task across device type and age group. However, encouragingly for real-world operations, results did not indicate any significant differences between older versus younger adults. We look to explore ways that individuals with disabilities can exploit these insights to enhance the performance of emergency stair travel devices for use.

Examining the impact of age and multitasking on motorcycle conspicuity.

This poster presents a study to assess one's ability to detect motorcycles under different conditions of conspicuity while performing a secondary visual load task. Previous research in which participants were required to detect motorcycles revealed differences in age (young adults/older adult) as well as differences associated with motorcycle conspicuity conditions. Past research has specifically found motorcycles with headlights ON and modulating headlights (flashing) to be more conspicuous than motorcycles with headlights OFF within traffic conditions. The present study seeks to provide more information on the effects of multitasking on motorcycle conspicuity and safety. The current study seeks to determine the degree to which multitasking limits the conspicuity of a motorcycle within traffic. We expect our results will indicate main effects for distraction task, age, gender, motorcycle lighting conditions, and vehicular DRLs on one's ability to effectively detect a motorcycle. The results have implications for motorcycle safety in general and through this research, a better understanding of motorcycle conspicuity can be established so as to minimize the risk involved with motorcycle operation.