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1.
BJS Open ; 5(2)2021 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-33855364

RESUMO

BACKGROUND: The SARS-CoV-2 pandemic had a profound impact on surgical services, potentially having a detrimental impact on training opportunities. The aim of this global survey was to assess the impact of the COVID-19 crisis on surgical training and to develop a framework for recovery. METHODS: A cross-sectional, web-based survey was conducted. This was designed by a steering committee of medical educationalists and validated by a group of trainees before dissemination. RESULTS: A total of 608 responses were obtained from 34 countries and 15 specialties. The results demonstrated major disruption in all aspects of training. The impact was greatest for conferences (525 of 608) and hands-on courses (517 of 608), but less for inpatient care-related training (268 of 608). European trainees were significantly more likely to experience direct training disruption than trainees in Asia (odds ratio 0.15) or Australia (OR 0.10) (χ2 = 87.162, P < 0.001). Alternative training resources (webinars, 359 of 608; educational videos, 234 of 608) have emerged, although trainees expressed some dissatisfaction with them. The collective responses generated a four-pillar framework for training recovery that involved: guidance from training stakeholders with the involvement of trainees; prioritization of training, especially the roles of senior surgeons/trainers; provision of access to alternative/new teaching methods; and measures to address trainee anxiety. CONCLUSION: Training has been greatly affected by the COVID-19 pandemic. The introduction of new teaching methods and a focus on training after the pandemic are imperative.


Assuntos
Educação de Pós-Graduação em Medicina/tendências , Especialidades Cirúrgicas/educação , /epidemiologia , Estudos Transversais , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/organização & administração , Feminino , Saúde Global , Humanos , Modelos Logísticos , Masculino , Pandemias , Inquéritos e Questionários
2.
GMS J Med Educ ; 38(1): Doc22, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33659627

RESUMO

Introduction: The corona virus pandemic rendered most live education this spring term impossible. Many classes were converted into e-learning formats. But not all learning content and outcomes can readily be transferred into digital space. Project outline: Emergency medicine teaching relies on hands-on simulation training. Therefore, we had to devise a catalogue of measures, that would enable us to offer simulation training for Advanced Life Support. Summary of work: Strict hygienic rules including disinfection of hands, wearing personal protective gear at all times and disinfection of equipment were implemented. Group size and number of staff was reduced, introducing fixed student teams accompanied by the same teacher. Only large rooms with good ventilation were used. Under these conditions, we were allowed to carry out core Advanced Life Support simulations. Other content had to be transferred to online platforms. Discussion: Heeding general hygiene advise and using personal protective gear, a central cluster of simulations was carried out. Students and staff adhered to rules without complaint. No infections within faculty or student body were reported. Conclusion: It seems feasible to conduct core simulations under strict hygienic protocol.


Assuntos
/epidemiologia , Educação de Pós-Graduação em Medicina/organização & administração , Medicina de Emergência/educação , Desinfecção/normas , Desinfecção das Mãos/normas , Humanos , Naftoquinonas , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Piranos
3.
Acad Med ; 96(3): 375-380, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33661849

RESUMO

A critical shortage of physicians is looming in the United States. The situation in Kentucky is especially dire, especially in rural areas. Class size constraints have resulted in the University of Kentucky College of Medicine (UK COM) unable to admit over 100 qualified Kentuckians each year. This article describes how leadership at University of Kentucky committed to addressing the state physician shortage while simultaneously strengthening relationships with critical partners through the establishment of two 4-year UK COM regional medical campuses. Based on criteria (such as a commitment to educating physicians, ample patients, sufficient willing physician preceptors, etc.), partners selected were Med Center Health, the leading health care system in southwestern Kentucky, and St. Elizabeth Healthcare, the predominant health care system in northern Kentucky. These regional campuses allow UK COM to expand its class size to 201 and total enrollment to 804, increasing from historically 70 to currently 120 graduates per year expected to practice in Kentucky. Critical to the success of this expansion is the buy-in of leadership and the Admissions Committee to consider students with a wider range of Medical College Admission Test scores. The regional clinical partners have substantially increased their teaching opportunities, with a greater ability to attract physicians. Both partners have made substantial financial contributions in support of the regional campuses. These relationships have energized UK COM engagement with its area alumni and have resulted in fewer Kentuckians referred out of state for advanced specialty care. Partnerships are also occurring with UK COM to increase graduate medical education offerings at the regional sites, fulfilling the vision of "training Kentuckians in Kentucky to practice in Kentucky."


Assuntos
Centros Médicos Acadêmicos/organização & administração , Mão de Obra em Saúde/estatística & dados numéricos , Médicos/estatística & dados numéricos , Política Pública/legislação & jurisprudência , Centros Médicos Acadêmicos/provisão & distribução , Redes Comunitárias , Educação de Pós-Graduação em Medicina/organização & administração , Humanos , Kentucky/epidemiologia , Médicos/provisão & distribução , Encaminhamento e Consulta/estatística & dados numéricos , Encaminhamento e Consulta/tendências , População Rural/estatística & dados numéricos , Especialização/estatística & dados numéricos , Planejamento Estratégico/normas , Estados Unidos/epidemiologia
6.
Medicine (Baltimore) ; 100(5): e23680, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592827

RESUMO

BACKGROUND: Healthcare professionals have negative implicit biases toward minority and poor patients. Few communication skills interventions target implicit bias as a factor contributing to disparities in health outcomes. We report the protocol from the COmmuNity-engaged SimULation Training for Blood Pressure Control (CONSULT-BP), a trial evaluating a novel educational and training intervention targeting graduate medical and nursing trainees that is designed to mitigate the effects of implicit bias in clinical encounters. The CONSULT-BP intervention combines knowledge acquisition, bias awareness, and practice of bias mitigating skills in simulation-based communication encounters with racially/ethnically diverse standardized patients. The trial evaluates the effect of this 3-part program on patient BP outcomes, self-reported patient medication adherence, patient-reported quality of provider communication, and trainee bias awareness. METHODS: We are conducting a cluster randomized trial of the intervention among cohorts of internal medicine (IM), family medicine (FM), and nurse practitioner (NP) trainees at a single academic medical center. We are enrolling entire specialty cohorts of IM, FM, and NP trainees over a 3-year period, with each academic year constituting an intervention cycle. There are 3 cycles of implementation corresponding to 3 sequential academic years. Within each academic year, we randomize training times to 1 of 5 start dates using a stepped wedge design. The stepped wedge design compares outcomes within training clusters before and after the intervention, as well as across exposed and unexposed clusters. Primary outcome of blood pressure control is measured at the patient-level for patients clustered within trainees. Eligible patients for outcomes analysis are: English-speaking; non-White racial/ethnic minority; Medicaid recipient (regardless of race/ethnicity); hypertension; not have pregnancy, dementia, schizophrenia, bipolar illness, or other serious comorbidities that would interfere with hypertension self-control; not enrolled in hospice. Secondary outcomes include trainee bias awareness. A unique feature of this trial is the engagement of academic and community stakeholders to design, pilot test and implement a training program addressing healthcare. DISCUSSION: Equipping clinicians with skills to mitigate implicit bias in clinical encounters is crucial to addressing persistent disparities in healthcare outcomes. Our novel, integrated approach may improve patient outcomes. TRIAL REGISTRATION: NCT03375918. PROTOCOL VERSION: 1.0 (November 10, 2020).


Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Educação em Enfermagem/organização & administração , Hipertensão/etnologia , Grupos Minoritários , Profissionais de Enfermagem , Simulação de Paciente , Pressão Sanguínea , Competência Cultural , Medicina Geral/educação , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Medicina Interna/educação , Medicaid , Profissionais de Enfermagem/educação , Estados Unidos
7.
Can J Cardiol ; 37(3): 519-522, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33476752

RESUMO

The COVID-19 pandemic has had an unprecedented impact on cardiology training. Novel opportunities have been identified in several domains: patient exposure, procedural experience, didactic education, research and development, advocacy and well-being, and career advancement. Lessons learned from COVID-19 should be used to further improve fellowship training such as, for example, through the development of a competency-based training and evaluation system. Multimodality teaching that incorporates telelearning provides creative solutions for trainee and continuing medical education. Fellow-initiated research should be supported and nurtured. Enhanced attention to trainee well-being and burnout is particularly important. The emerging cardiologists of the future and the way they are trained will be shaped by the COVID-19 challenge of our generation.


Assuntos
Cardiologia/educação , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/normas , Qualidade da Assistência à Saúde , Educação de Pós-Graduação em Medicina/organização & administração , Previsões
9.
Neurol Sci ; 42(3): 817-823, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33443668

RESUMO

The ongoing COVID-19 pandemic is having a huge impact on clinical activity of all hospitals, including the ones involved in training of residents. In addition, neurology residents underwent substantial modifications of their training program. Aim of our investigation was to evaluate the impact of COVID-19 pandemic on the educational activities of Italian neurology residents through an online questionnaire delivered to neurology residents. The results obtained showed that almost 30% of the respondents were redistributed to COVID-19 units. Neurology departments underwent substantial modifications of their organization influencing clinical educational activities; lessons and seminars were rescheduled online and research protocols were stopped and transferred to remote working, when feasible. There was a relevant use of telemedicine approach even if most of the respondents had never been trained before. Some of the changes had a North-South gradient, following the epidemiology of the pandemic. The data obtained from our survey highlight those points to address to be prepared for possible future emergencies.


Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Internato e Residência/organização & administração , Neurologia/educação , Adulto , Feminino , Humanos , Itália , Masculino , Inquéritos e Questionários
11.
Adv Physiol Educ ; 45(1): 37-43, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33464190

RESUMO

In the wake of COVID-19, the postgraduate activities in physiology were shifted from live (face-to-face teaching) to virtual mode. This transition posed a challenge to postgraduate students and faculty moderators, especially for participant-centric group discussion, wherein face-to-face interaction contributes significantly to active learner engagement. To bridge the gap between live group discussion (GD) and virtual GD in the conventional format (VGD), we implemented an innovative yet feasible multistep approach of conducting structured virtual group discussion (sVGD). It involved priming of students during the preparatory phase and incorporation of the Tuckman model of group dynamics, which consists of sequential substages of forming, storming, norming, and performing into the virtual format. Unsupervised synchronous and asynchronous, as well as supervised synchronous interactions within and in between the minigroups in a structured way, led to active engagement of students with one another and the moderator, despite the constraints imposed by the virtual format. After establishing the feasibility of the approach during the first GD (sVGD-1), sVGD-2 was conducted, further refining the approach, and feedback was obtained from the postgraduate students. Pre-GD feedback revealed that the live session was preferred over virtual for the conduct of GD, whereas both live GD and sVGD were perceived to be more effective than VGD in the post-GD feedback. Such pedagogical innovations may also help to address the challenges posed in traditional teaching across the undergraduate and postgraduate courses in medical education and beyond during such unforeseeable circumstances.


Assuntos
Educação a Distância/organização & administração , Educação de Pós-Graduação/organização & administração , Pandemias , Fisiologia/educação , Estudantes/psicologia , Realidade Virtual , Educação a Distância/métodos , Educação de Pós-Graduação/métodos , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/organização & administração , Estudos de Viabilidade , Retroalimentação Psicológica , Processos Grupais , Humanos , Índia , Internet , Estudantes de Medicina/psicologia
12.
Acad Med ; 96(3): 384-389, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33332906

RESUMO

PROBLEM: The World Health Organization and the World Bank have identified improvement in access to surgical care as an urgent global health challenge and a cost-effective investment in public health. However, trainees in standard U.S. general surgery programs do not have adequate exposure to the procedures, technical skills, and foundational knowledge essential for providing surgical care in resource-limited settings. APPROACH: The Michael E. DeBakey Department of Surgery at Baylor College of Medicine (BCM) created a 7-year global surgery track within its general surgery residency in 2014. Individualized rotations equip residents with the necessary skills, knowledge, and experience to operate in regions with low surgeon density and develop sustainable surgical infrastructures. BCM provides a formal, integrated global surgery curriculum-including 2 years dedicated to global surgery-with surgical specialty rotations in domestic and international settings. Residents tailor their individual experience to the needs of their future clinical practice, region of interest, and surgical specialty. OUTCOMES: There have been 4 major outcomes of the BCM global surgery track: (1) increased exposure for trainees to a broad range of surgeries critical in resource-limited settings, (2) meaningful international partnerships, (3) contributions to global surgery scholarship, and (4) establishment of sustainable global surgery activities. NEXT STEPS: To better facilitate access to safe, timely, and affordable surgical care worldwide, global surgeons should pursue expertise in topics not currently included in U.S. general surgical curricula, such as setting-specific technical skills, capacity building, and organizational collaboration. Future evaluations of the BCM global surgery track will assess the effect of individualized education on trainees' professional identities, clinical practices, academic pursuits, global surgery leadership preparedness, and comfort with technical skills not encompassed in general surgery programs. Increasing availability of quality global surgery training programs would provide a critical next step toward contributing to the delivery of safe surgical care worldwide.


Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Saúde Global/economia , Especialidades Cirúrgicas/organização & administração , Cirurgiões/provisão & distribução , Competência Clínica , Análise Custo-Benefício/estatística & dados numéricos , Currículo/normas , Bolsas de Estudo/métodos , Cirurgia Geral/educação , Acesso aos Serviços de Saúde/normas , Humanos , Cooperação Internacional , Internato e Residência , Conhecimento , Desenvolvimento de Programas/métodos , Especialidades Cirúrgicas/estatística & dados numéricos , Estados Unidos/epidemiologia
14.
GMS J Med Educ ; 37(7): Doc97, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33364376

RESUMO

Background: The task of the Competence Centers for vocational training (KW) is to increase the attractiveness and quality of vocational (=post-graduate) training in general practice. For this purpose, they offer, among other things, a structured seminar program for post-graduate trainees in general practice (GP-trainees). During the Covid-19 pandemic the seminar program of the KWBW-Verbundweiterbildungplus® in Baden-Württemberg was converted to digital formats. The goal of the paper is to evaluate the acceptance by the GP-trainees and lecturers, to describe experiences with the conversion to e-learning and to derive recommendations with regard to the future orientation of seminar programs in post-graduate as well as continuing medical education. The implementation was based on a modified Kern-cycle and aimed at offering eight teaching units of 45 minutes each to a large number of GP-trainees. It tried to maintain the high quality of content and education as well as the interactive character of the previous seminars. For this purpose, the events were designed as synchronous webinars (six units) with asynchronous preparation and post-processing (two units) according to the flipped classroom method. The evaluation by the participating GP-trainees and lecturers was performed online using a multi-center developed and pre-piloted questionnaire. Results and discussion: N=101 GP-trainees participated in the evaluation of five individual seminar days in the second quarter of 2020 (response rate 97%). 58% (N=59) of the trainees were satisfied or very satisfied with the implementation. 82% (n=83) rated pre-tasks as helpful. 99% (n=100) would participate in an online seminar again. For 52% (n=53) of the trainees, the attitude towards e-learning had changed positively. The main advantages mentioned were no travel, save in time and costs as well as increased flexibility. The main disadvantages mentioned were less personal interaction and technical obstacles. The high acceptance of the new digital format showed the fundamental potential of e-learning in continuing medical education. The experiences can be a source of inspiration for other departments and KW. However, it also shows that important goals of KW, such as the personal interaction of the peer group, could not be achieved. In the future, it is important to develop a suitable mix of presence and digital formats with the aim to improve the attractiveness as well as sustainability of continuing medical education.


Assuntos
/epidemiologia , Instrução por Computador/métodos , Educação a Distância/organização & administração , Educação de Pós-Graduação em Medicina/organização & administração , Medicina Geral/educação , Adulto , Competência Clínica , Docentes de Medicina/psicologia , Feminino , Humanos , Masculino , Motivação , Pandemias , Estudantes de Medicina/psicologia
17.
BMC Med Educ ; 20(1): 341, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008392

RESUMO

BACKGROUND: As COVID-19 has been declared as a pandemic disease by the WHO on March 11th, 2020, the global incidence of COVID-19 disease increased dramatically. In response to the COVID-19 situation, Jordan announced the emergency state on the 19th of March, followed by the curfew on 21 March. All educational institutions have been closed as well as educational activities including clinical medical education have been suspended on the 15th of March. As a result, Distance E-learning emerged as a new method of teaching to maintain the continuity of medical education during the COVID-19 pandemic related closure of educational institutions. Distance E-Learning is defined as using computer technology to deliver training, including technology-supported learning either online, offline, or both. Before this period, distance learning was not considered in Jordanian universities as a modality for education. This study aims to explore the situation of distance E-learning among medical students during their clinical years and to identify possible challenges, limitations, satisfaction as well as perspectives for this approach to learning. METHODS: This cross-sectional study is based on a questionnaire that was designed and delivered to medical students in their clinical years. For this study, the estimated sample size (n = 588) is derived from the online Raosoft sample size calculator. RESULTS: A total of 652 students have completed the questionnaire, among them, 538 students (82.5%) have participated in distance learning in their medical schools amid COVID-19 pandemic. The overall satisfaction rate in medical distance learning was 26.8%, and it was significantly higher in students with previous experience in distance learning in their medical schools as well as when instructors were actively participating in learning sessions, using multimedia and devoting adequate time for their sessions. The delivery of educational material using synchronous live streaming sessions represented the major modality of teaching and Internet streaming quality and coverage was the main challenge that was reported by 69.1% of students. CONCLUSION: With advances in technologies and social media, distance learning is a new and rapidly growing approach for undergraduate, postgraduate, and health care providers. It may represent an optimal solution to maintain learning processes in exceptional and emergency situations such as COVID-19 pandemic. Technical and infrastructural resources reported as a major challenge for implementing distance learning, so understanding technological, financial, institutional, educators, and student barriers are essential for the successful implementation of distance learning in medical education.


Assuntos
Betacoronavirus , Medicina Clínica/educação , Infecções por Coronavirus/epidemiologia , Educação a Distância/organização & administração , Educação de Pós-Graduação em Medicina/organização & administração , Pneumonia Viral/epidemiologia , Adulto , Instrução por Computador , Estudos Transversais , Currículo , Feminino , Humanos , Jordânia , Masculino , Pandemias , Inquéritos e Questionários , Adulto Jovem
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