Health-related quality of life and patient-centred outcomes with COVID-19 vaccination in patients with breast cancer and gynaecological malignancies.

Introduction: Safety and tolerability of COVID-19 vaccines were demonstrated by several clinical trials which led to the first FDA/EMA approvals in 2021. Because of mass immunizations, most social restrictions were waived with effects on quality of life. Therefore, our a-priori hypothesis was that COVID-19 vaccination impacted the health-related quality of life (HR-QoL) in patients with breast and gynecological cancer. Methods: From March 15th until August 11th, 2022, fully vaccinated patients with breast and gynecological cancer treated in the oncological outpatient clinics of the Department of Obstetrics and Gynecology, LMU University Hospital, Munich, Germany filled out a vaccine related QoL survey. Patients were asked about demographics (age, comorbidities), clinical parameters related to previous COVID-19 infections, and HR-QoL related parameters (living situation, responsibilities in everyday life). Subsequently, a questionnaire with 12 items was designed using a 5-point Likert scale (0 - strongly disagree/4 - strongly agree), covering the aspects health and therapy, social environment, participation in everyday life and overall assessment. Results: By August 11th, 2022, 108 out of 114 (94.7%) patients had received at least three doses of COVID-19 vaccine and six patients at least two doses. More than half of the surveyed patients were >55y (52.6%; mean: 55.1y, range 29-86y). Patients with breast cancer (n= 83) had early (59.0%) or metastatic cancer (41.0%); gynecological cancers (n=31) also included metastatic (54.8%) and non-metastatic cancer (45.2%). 83.3% of the patients stated that COVID-19 vaccination had a positive impact on their HR-QoL. Furthermore, 29 patients (25.4%) had undergone a COVID-19 infection. These patients reported self-limiting symptoms for a median duration of 5.9 days and no hospital admissions were registered. Conclusions: Our study demonstrates that vaccination against COVID-19 was positively associated with HR-QoL in patients with breast and gynecological cancer. Furthermore, vaccinated patients who underwent COVID-19 disease experienced only self-limiting symptoms.

Increased risk for thromboembolic events from combination of a gynecologic malignancy with severe acute respiratory syndrome coronavirus 2 infection: a case report.

PURPOSE: During the severe acute respiratory syndrome coronavirus 2 pandemic, several patient groups are at particular risk. Mortality is higher among cancer patients and may be increased further by thromboembolic events, which are more common in coronavirus 2019 patients according to recent publications. We discuss the association of gynecologic malignancies, Severe acute respiratory syndrome coronavirus 2, and thromboembolism by reporting a case study and summarizing available literature. CASE REPORT: A 71-year-old Caucasian patient with ovarian cancer receiving first-line chemotherapy was diagnosed with deep vein thrombosis and pulmonary embolism. Routine screening revealed infection with severe acute respiratory syndrome coronavirus 2 in absence of specific symptoms. After uneventful recovery, oncologic treatment could be continued a few weeks later. METHODS: We performed a systematic review of the literature on PubMed following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The search included articles ahead of print, published between 1 December 2019 and 1 June 2020. Cross-searches were conducted on all relevant articles. RESULTS: We identified five articles meeting the defined criteria, including two retrospective studies, a review, a position paper, as well as a letter to the editor. CONCLUSION: Cancer patients infected with severe acute respiratory syndrome coronavirus 2 have a relatively poor outcome, which may partially be due to a higher rate of thromboembolic events. Thromboprophylaxis is recommended, and scoring systems are helpful in early detection. In cancer patients with severe acute respiratory syndrome coronavirus 2, individual risk for thromboembolic events should be taken into account when considering interruption versus continuation of antitumoral therapy. However, further data and studies are required.

Translation of a scale measuring cognitive test anxiety (G-CTAS) and its psychometric examination among medical students in Germany.

Aim of the study: Test anxiety expresses itself in a variety of physical and cognitive processes. Due to its influence on test performance, the cognitive component in particular can have a negative impact on those affected. A measuring instrument for this is not yet available in the German-speaking world but does exist in the form of the "Cognitive Test Anxiety Scale" (CTAS), among other languages, in English. The aim of this work was the creation and psychometric review of a German version of the scale (G-CTAS). Methods: A German translation of the scale was created using a forward-backward procedure. Statistical investigations were then carried out on a cohort of medical students, which included an item analysis with calculation of difficulty, variance and item discrimination as well as the determination of the scale's internal consistency. The criterion validity was examined using test performance and gender-specific differences. Results: The final version contains 26 matching items with acceptable item parameters (mean values >1.46, <3.13; variances >0.48; part-whole-discrimination-indices >0.37). Cronbach's alpha was 0.92, the scale was therefore found to be a reliable measuring instrument. The scale validity could be confirmed by significant differences (p<0.01) between total values of female and male participants as well as significant correlations (p<0.001) between total values and test performance in the written and oral part of the first state examination. Conclusion: With G-CTAS a suitable measuring instrument for cognitive test anxiety within the German-speaking world is available, which can be used, among other things, for studies concerning the relationship between stress, exams and test anxiety among medical students.

Faculty development in the age of competency-based medical education: A needs assessment of Canadian emergency medicine faculty and senior trainees.

OBJECTIVES: The Royal College of Physicians and Surgeons of Canada (RCPSC) emergency medicine (EM) programs transitioned to the Competence by Design training framework in July 2018. Prior to this transition, a nation-wide survey was conducted to gain a better understanding of EM faculty and senior resident attitudes towards the implementation of this new program of assessment. METHODS: A multi-site, cross-sectional needs assessment survey was conducted. We aimed to document perceptions about competency-based medical education, attitudes towards implementation, perceived/prompted/unperceived faculty development needs. EM faculty and senior residents were nominated by program directors across RCPSC EM programs. Simple descriptive statistics were used to analyse the data. RESULTS: Between February and April 2018, 47 participants completed the survey (58.8% response rate). Most respondents (89.4%) thought learners should receive feedback during every shift; 55.3% felt that they provided adequate feedback. Many respondents (78.7%) felt that the ED would allow for direct observation, and most (91.5%) participants were confident that they could incorporate workplace-based assessments (WBAs). Although a fair number of respondents (44.7%) felt that Competence by Design would not impact patient care, some (17.0%) were worried that it may negatively impact it. Perceived faculty development priorities included feedback delivery, completing WBAs, and resident promotion decisions. CONCLUSIONS: RCPSC EM faculty have positive attitudes towards competency-based medical education-relevant concepts such as feedback and opportunities for direct observation via WBAs. Perceived threats to Competence by Design implementation included concerns that patient care and trainee education might be negatively impacted. Faculty development should concentrate on further developing supervisors' teaching skills, focusing on feedback using WBAs.

INTRODUCTION: Les programmes de médecine d'urgence (MU) du Collège royal des médecins et chirurgiens du Canada sont passés, en juillet 2018, à un nouveau modèle de formation appelé Compétence par conception. Avant ce passage, une enquête avait été menée à l'échelle nationale pour dégager une meilleure compréhension des attitudes du personnel enseignant et des résidents séniors en MU à l'égard de la mise en œuvre du nouveau programme d'évaluation. MÉTHODE: Il s'agit d'une enquête transversale et multicentrique sur l'évaluation des besoins. Elle visait à recueillir des renseignements sur les perceptions des personnes concernées sur la formation médicale axée sur les compétences, sur leurs attitudes à l'égard de la mise en application du programme ainsi que sur les besoins perçus, suscités ou inaperçus du personnel en matière de perfectionnement. Les membres du personnel enseignant en MU et les résidents séniors ont été désignés par les directeurs de tous les programmes de MU du Collège royal. Les données ont été analysées à l'aide de simples statistiques descriptives. RÉSULTATS: Au total, 47 participants ont rempli le questionnaire d'enquête (taux de réponse : 58,8%) entre février et avril 2018. La plupart des répondants (89,4%) ont indiqué que les apprenants devraient recevoir de la rétroaction à tous les postes de travail, et 55,3% avaient l'impression de donner une rétroaction adéquate. Bon nombre de répondants (78,7%) étaient également d'avis que les services des urgences se prêtaient bien à l'observation directe, et la plupart des participants (91,5%) avaient bon espoir d'intégrer les évaluations en milieu de travail (EMT). Par ailleurs, si un assez bon nombre de répondants (44,7%) croyaient que la formation axée sur la Compétence par conception n'aurait aucune incidence sur les soins aux patients, d'autres (17,0%) s'en inquiétaient. Enfin, les priorités perçues en matière de perfectionnement du personnel comprenaient la communication des rétroactions, la réalisation des EMT et les décisions relatives à la promotion des résidents. CONCLUSION: Le personnel enseignant en MU du Collège royal a des attitudes favorables à l'égard de certains concepts liés à la formation médicale axée sur les compétences, tels que les rétroactions et les possibilités d'observation directe au moyen des EMT. Par contre, la mise en œuvre du programme de Compétence par conception suscite également des craintes, comme une incidence défavorable sur les soins aux patients et la formation des stagiaires. Le perfectionnement du personnel enseignant devrait donc porter davantage sur les aptitudes à enseigner des superviseurs, notamment sur la communication des rétroactions à l'aide des EMT.