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1.
Surg Clin North Am ; 101(4): 611-624, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34242604

RESUMO

There are myriad types of problem learners in surgical residency and most have difficulty in more than 1 competency. Programs that use a standard curriculum of study and assessment are most successful in identifying struggling learners early. Many problem learners lack appropriate systems for study; a multidisciplinary educational team that is separate from the team that evaluates the success of remediation is critical. Struggling residents who require formal remediation benefit from performance improvement plans that clearly outline the issues of concern, describe the steps required for remediation, define success of remediation, and outline consequences for failure to remediate appropriately.


Assuntos
Competência Clínica/normas , Currículo/normas , Cirurgia Geral/educação , Internato e Residência/métodos , Aprendizagem , Ensino de Recuperação/métodos , Cirurgia Geral/normas , Humanos , Internato e Residência/normas , Ensino de Recuperação/normas , Estados Unidos
4.
J Surg Res ; 264: 534-543, 2021 08.
Artigo em Inglês | MEDLINE | ID: covidwho-1078051

RESUMO

BACKGROUND: Healthcare systems and surgical residency training programs have been significantly affected by the novel coronavirus disease 2019 (COVID-19) pandemic. A shelter-in-place and social distancing mandate went into effect in our county on March 16, 2020, considerably altering clinical and educational operations. Along with the suspension of elective procedures, resident academic curricula transitioned to an entirely virtual platform. We aimed to evaluate the impact of these modifications on surgical training and resident concerns about COVID-19. MATERIALS AND METHODS: We surveyed residents and fellows from all eight surgical specialties at our institution regarding their COVID-19 experiences from March to May 2020. Residents completed the survey via a secure Qualtrics link. A total of 38 questions addressed demographic information and perspectives regarding the impact of the COVID-19 pandemic on surgical training, education, and general coping during the pandemic. RESULTS: Of 256 eligible participants across surgical specialties, 146 completed the survey (57.0%). Junior residents comprised 43.6% (n = 61), compared to seniors 37.1% (n = 52) and fellows 19.3% (n = 27). Most participants, 97.9% (n = 138), anticipated being able to complete their academic year on time, and 75.2% (n = 100) perceived virtual learning to be the same as or better than in-person didactic sessions. Participants were most concerned about their ability to have sufficient knowledge and skills to care for patients with COVID-19, and the possibility of exposure to COVID-19. CONCLUSIONS: Although COVID-19 impacted residents' overall teaching and clinical volume, residency programs may identify novel virtual opportunities to meet their educational and research milestones during these challenging times.


Assuntos
Adaptação Psicológica , COVID-19/prevenção & controle , Internato e Residência/métodos , Especialidades Cirúrgicas/educação , Cirurgiões/psicologia , Adulto , COVID-19/epidemiologia , COVID-19/psicologia , Competência Clínica , Educação à Distância/organização & administração , Educação à Distância/normas , Procedimentos Cirúrgicos Eletivos/educação , Procedimentos Cirúrgicos Eletivos/normas , Feminino , Humanos , Internato e Residência/organização & administração , Internato e Residência/normas , Internato e Residência/estatística & dados numéricos , Masculino , Pandemias/prevenção & controle , Distanciamento Físico , Cirurgiões/educação , Cirurgiões/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos/epidemiologia
5.
Plast Reconstr Surg ; 147(5): 872e-874e, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: covidwho-1198273

RESUMO

SUMMARY: The 2020 global pandemic related to the coronavirus has led to unprecedented interruptions in typical patient care and resident education. Teleconferencing software was deployed by many institutions to comply with quarantine and social-distancing regulations. To supplement the loss of clinical experience for trainees, the authors implemented a novel virtual-educational programming using virtual visiting professors and virtual grand rounds. The authors describe the two different formats and advantages such as access to multiple speakers on diverse, innovative topics and decreased financial burdens to the host program. However, the authors do acknowledge some disadvantages from lack of face-to-face social interaction/networking and the need to consider time-zone differences. Both new programs were embraced by trainees at the authors' own institution and residents/medical students across the United States and Canada and around the world. The authors believe teleconferencing should be permanently incorporated into future educational opportunities for plastic surgeons, as it provides easy access to high-quality information.


Assuntos
COVID-19/prevenção & controle , Internato e Residência/organização & administração , Visitas com Preceptor/organização & administração , Comunicação por Videoconferência/organização & administração , COVID-19/epidemiologia , COVID-19/transmissão , Canadá , Docentes , Humanos , Internato e Residência/economia , Internato e Residência/normas , Pandemias/prevenção & controle , Estudantes de Medicina , Cirurgiões , Visitas com Preceptor/economia , Visitas com Preceptor/normas , Estados Unidos , Comunicação por Videoconferência/normas
6.
J Surg Res ; 264: 534-543, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33862581

RESUMO

BACKGROUND: Healthcare systems and surgical residency training programs have been significantly affected by the novel coronavirus disease 2019 (COVID-19) pandemic. A shelter-in-place and social distancing mandate went into effect in our county on March 16, 2020, considerably altering clinical and educational operations. Along with the suspension of elective procedures, resident academic curricula transitioned to an entirely virtual platform. We aimed to evaluate the impact of these modifications on surgical training and resident concerns about COVID-19. MATERIALS AND METHODS: We surveyed residents and fellows from all eight surgical specialties at our institution regarding their COVID-19 experiences from March to May 2020. Residents completed the survey via a secure Qualtrics link. A total of 38 questions addressed demographic information and perspectives regarding the impact of the COVID-19 pandemic on surgical training, education, and general coping during the pandemic. RESULTS: Of 256 eligible participants across surgical specialties, 146 completed the survey (57.0%). Junior residents comprised 43.6% (n = 61), compared to seniors 37.1% (n = 52) and fellows 19.3% (n = 27). Most participants, 97.9% (n = 138), anticipated being able to complete their academic year on time, and 75.2% (n = 100) perceived virtual learning to be the same as or better than in-person didactic sessions. Participants were most concerned about their ability to have sufficient knowledge and skills to care for patients with COVID-19, and the possibility of exposure to COVID-19. CONCLUSIONS: Although COVID-19 impacted residents' overall teaching and clinical volume, residency programs may identify novel virtual opportunities to meet their educational and research milestones during these challenging times.


Assuntos
Adaptação Psicológica , COVID-19/prevenção & controle , Internato e Residência/métodos , Especialidades Cirúrgicas/educação , Cirurgiões/psicologia , Adulto , COVID-19/epidemiologia , COVID-19/psicologia , Competência Clínica , Educação à Distância/organização & administração , Educação à Distância/normas , Procedimentos Cirúrgicos Eletivos/educação , Procedimentos Cirúrgicos Eletivos/normas , Feminino , Humanos , Internato e Residência/organização & administração , Internato e Residência/normas , Internato e Residência/estatística & dados numéricos , Masculino , Pandemias/prevenção & controle , Distanciamento Físico , Cirurgiões/educação , Cirurgiões/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos/epidemiologia
7.
Plast Reconstr Surg ; 147(5): 872e-874e, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33890910

RESUMO

SUMMARY: The 2020 global pandemic related to the coronavirus has led to unprecedented interruptions in typical patient care and resident education. Teleconferencing software was deployed by many institutions to comply with quarantine and social-distancing regulations. To supplement the loss of clinical experience for trainees, the authors implemented a novel virtual-educational programming using virtual visiting professors and virtual grand rounds. The authors describe the two different formats and advantages such as access to multiple speakers on diverse, innovative topics and decreased financial burdens to the host program. However, the authors do acknowledge some disadvantages from lack of face-to-face social interaction/networking and the need to consider time-zone differences. Both new programs were embraced by trainees at the authors' own institution and residents/medical students across the United States and Canada and around the world. The authors believe teleconferencing should be permanently incorporated into future educational opportunities for plastic surgeons, as it provides easy access to high-quality information.


Assuntos
COVID-19/prevenção & controle , Internato e Residência/organização & administração , Visitas com Preceptor/organização & administração , Comunicação por Videoconferência/organização & administração , COVID-19/epidemiologia , COVID-19/transmissão , Canadá , Docentes , Humanos , Internato e Residência/economia , Internato e Residência/normas , Pandemias/prevenção & controle , Estudantes de Medicina , Cirurgiões , Visitas com Preceptor/economia , Visitas com Preceptor/normas , Estados Unidos , Comunicação por Videoconferência/normas
8.
Acta Orthop Traumatol Turc ; 55(1): 5-8, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33650503

RESUMO

OBJECTIVE: This study aimed to determine the characteristics of instant messaging application (IMA) usage for clinical consultation among orthopedic residents in Turkey and to explore their experiences and opinions concerning potential legal problems. METHODS: A questionnaire titled "Instant messaging for consultation among orthopedic surgeons" consisting of 21 questions was applied to orthopedic surgery residents, and the results were analyzed. The questions were designed to obtain information on 4 categories: 1) demographics and professional experience, 2) attitudes on the use of cellular phones, 3) IMA usage for clinical consultation purposes, and 4) problems and comments on smartphone application usage for clinical consultation purposes. The participants who had no experience with a smartphone or IMA usage were excluded at the final analysis. RESULTS: A total of 860 orthopedic residents (849 males [98.7%]; mean age=28.6 years; age range=22-44 years) participated in the survey (participation rate: 97.3%). The distribution of residency years was as follows: 1st year, 27%; 2nd year, 21.4%; 3rd year, 18.4%; 4th year, 17.4%; and 5th year, 49.9%. The most frequently used IMAs were WhatsApp (99.3%), Facebook Messenger (14.8%), Viber (8%), and Tango (1.3%). The rate of IMA usage for consultation was 95.3%. The most common reasons to prefer IMAs for consultation were being "fast" and "easy," but only 26.3% of the residents reported that they prefer the use of IMAs because they find them "reliable." Moreover, 41.7% of the respondents reported that they had an experience of misdiagnosis owing to the use of IMAs; 81.2% of the participants used the personal information of the patients during the consultation; 57.6% of the respondents considered that legal problems may arise because of the use of IMAs during the consultation; and 51.4% believed that an electronic platform, solely for consultation purposes, is required. CONCLUSION: This survey has shown that it is necessary to make some legal regulations regarding the use of IMAs for consultation purposes and to develop applications only for medical consultation purposes. Most of the trainees make decisions using IMAs without a proper examination, putting the patients at the risk of misdiagnosis. Moreover, the confidentiality of the patient's personal information appears to be in danger when IMAs are used. LEVEL OF EVIDENCE: Level IV, Diagnostic Study.


Assuntos
Internato e Residência , Ortopedia , Encaminhamento e Consulta , Adulto , Erros de Diagnóstico/prevenção & controle , Feminino , Pesquisas sobre Serviços de Saúde , Troca de Informação em Saúde/normas , Humanos , Internato e Residência/métodos , Internato e Residência/normas , Masculino , Aplicativos Móveis/normas , Determinação de Necessidades de Cuidados de Saúde , Ortopedia/educação , Ortopedia/legislação & jurisprudência , Ortopedia/tendências , Encaminhamento e Consulta/ética , Encaminhamento e Consulta/normas , Smartphone , Turquia
11.
BMC Fam Pract ; 22(1): 39, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: covidwho-1088581

RESUMO

BACKGROUND: Family medicine physicians may encounter a wide variety of conditions, including acute and urgent cases. Considering the limited access to diagnostic investigations in primary care practice, chest X-ray remains the imaging modality of choice. The current study assessed the competency of family medicine residents in the interpretation of chest X-rays for emergency conditions and to compare it with that of diagnostic radiology residents, general practitioners, and medical interns. METHODS: An online survey was distributed to 600 physicians, including family medicine residents, medical interns, general practitioners, and diagnostic radiology residents. The study included some background information such as gender, years in practice, training type, interest in pulmonary medicine and diagnostic radiology, and having adequate training on the interpretation of chest X-rays. The survey had 10 chest X-ray cases with brief clinical information. Participants were asked to choose the most likely diagnosis and to rate their degree of confidence in the interpretation of the chest X-ray for each case. RESULTS: The survey was completed by 205 physicians (response rate = 34.2%). The overall diagnostic accuracy was 63.1% with a significant difference between family medicine and radiology residents (58.0% vs. 90.5%; P < 0.001). The COVID-19 pneumonia (85.4%) and pneumoperitoneum (80.5%) cases had the highest diagnostic accuracy scores. There was a significant correlation between the diagnostic confidence and accuracy (rs = 0.39; P < 0.001). Multivariable regression analysis revealed that being diagnostic radiology residents (odds ratio [OR]: 13.0; 95% confidence interval [CI]: 2.5-67.7) and having higher diagnostic confidence (OR: 2.2; 95% CI: 1.3-3.8) were the only independent predictors of achieving high diagnostic accuracy. CONCLUSION: The competency of family medicine residents in the interpretation of chest X-ray for emergency conditions was far from optimal. The introduction of radiology training courses on emergency conditions seems imperative. Alternatively, the use of tele-radiology in primary healthcare centers should be considered.


Assuntos
Competência Clínica/estatística & dados numéricos , Competência Clínica/normas , Internato e Residência/normas , Médicos de Família/educação , Radiografia Torácica/normas , COVID-19/diagnóstico por imagem , Emergências , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Médicos de Família/normas , Pneumoperitônio/diagnóstico por imagem , Inquéritos e Questionários
12.
J Surg Res ; 262: 240-243, 2021 06.
Artigo em Inglês | MEDLINE | ID: covidwho-1062498

RESUMO

As the SARS-COV-2 pandemic created the need for social distancing and the implementation of nonessential travel bans, residency and fellowship programs have moved toward a web-based virtual process for applicant interviews. As part of the Society of Asian Academic Surgeons 5th Annual Meeting, an expert panel was convened to provide guidance for prospective applicants who are new to the process. This article provides perspectives from applicants who have successfully navigated the surgical subspecialty fellowship process, as well as program leadership who have held virtual interviews.


Assuntos
COVID-19/prevenção & controle , Cirurgia Geral/educação , Internato e Residência/organização & administração , Seleção de Pessoal/métodos , Comunicação por Videoconferência/organização & administração , COVID-19/epidemiologia , COVID-19/transmissão , Certificação/organização & administração , Certificação/normas , Docentes/psicologia , Docentes/normas , Bolsas de Estudo/organização & administração , Bolsas de Estudo/normas , Humanos , Internato e Residência/normas , Liderança , Pandemias/prevenção & controle , Seleção de Pessoal/organização & administração , Seleção de Pessoal/normas , Distanciamento Físico , Interação Social , Conselhos de Especialidade Profissional , Cirurgiões/psicologia , Cirurgiões/normas
13.
Med Educ Online ; 26(1): 1876315, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33606615

RESUMO

The Medical Student Performance Evaluation (MSPE) is an important tool of communication used by program directors to make decisions in the residency application process. To understand the perspective and usage of the MSPE across multiple medical specialties now and in anticipation of the planned changes in USMLE Step 1 score-reporting. A survey instrument including quantitative and qualitative measures was developed and piloted. The final survey was distributed to residency programs across 28 specialties in 2020 via the main contact on the ACGME listserv. Of the 28 specialties surveyed, at least one response was received from 26 (93%). Eight percent of all programs (364/4675) responded to the survey, with most respondents being program directors. Usage of the MSPE varied among specialties. Approximately 1/3 of end-users stated that the MSPE is very or extremely influential in their initial screening process. Slightly less than half agreed or strongly agreed that they trust the information to be an accurate representation of applicants, though slightly more than half agree that the MSPE will become more influential once USMLE Step 1 becomes pass/fail. Professionalism was rated as the most important component and noteworthy characteristics among the least important in the decision-making process. Performance in the internal medicine clerkship was rated as the most influential while neurology and psychiatry performances were rated as less influential. Overwhelmingly, respondents suggested that including comparative performance and/or class rank would make the MSPE more useful once USMLE Step 1 becomes pass/fail. MSPE end-users across a variety of specialties utilize this complex document in different ways and value it differentially in their decision-making processes. Despite this, continued mistrust of the MSPE persists. A better understanding of end-users' perceptions of the MSPE offers the UME community an opportunity to transform the MSPE into a highly valued, trusted document of communication.


Assuntos
Avaliação Educacional/métodos , Internato e Residência/organização & administração , Critérios de Admissão Escolar/estatística & dados numéricos , Comunicação , Humanos , Internato e Residência/normas , Especialização
14.
BMC Fam Pract ; 22(1): 39, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33596838

RESUMO

BACKGROUND: Family medicine physicians may encounter a wide variety of conditions, including acute and urgent cases. Considering the limited access to diagnostic investigations in primary care practice, chest X-ray remains the imaging modality of choice. The current study assessed the competency of family medicine residents in the interpretation of chest X-rays for emergency conditions and to compare it with that of diagnostic radiology residents, general practitioners, and medical interns. METHODS: An online survey was distributed to 600 physicians, including family medicine residents, medical interns, general practitioners, and diagnostic radiology residents. The study included some background information such as gender, years in practice, training type, interest in pulmonary medicine and diagnostic radiology, and having adequate training on the interpretation of chest X-rays. The survey had 10 chest X-ray cases with brief clinical information. Participants were asked to choose the most likely diagnosis and to rate their degree of confidence in the interpretation of the chest X-ray for each case. RESULTS: The survey was completed by 205 physicians (response rate = 34.2%). The overall diagnostic accuracy was 63.1% with a significant difference between family medicine and radiology residents (58.0% vs. 90.5%; P < 0.001). The COVID-19 pneumonia (85.4%) and pneumoperitoneum (80.5%) cases had the highest diagnostic accuracy scores. There was a significant correlation between the diagnostic confidence and accuracy (rs = 0.39; P < 0.001). Multivariable regression analysis revealed that being diagnostic radiology residents (odds ratio [OR]: 13.0; 95% confidence interval [CI]: 2.5-67.7) and having higher diagnostic confidence (OR: 2.2; 95% CI: 1.3-3.8) were the only independent predictors of achieving high diagnostic accuracy. CONCLUSION: The competency of family medicine residents in the interpretation of chest X-ray for emergency conditions was far from optimal. The introduction of radiology training courses on emergency conditions seems imperative. Alternatively, the use of tele-radiology in primary healthcare centers should be considered.


Assuntos
Competência Clínica/estatística & dados numéricos , Competência Clínica/normas , Internato e Residência/normas , Médicos de Família/educação , Radiografia Torácica/normas , COVID-19/diagnóstico por imagem , Emergências , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Médicos de Família/normas , Pneumoperitônio/diagnóstico por imagem , Inquéritos e Questionários
15.
Medicine (Baltimore) ; 100(6): e24690, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578603

RESUMO

ABSTRACT: Pediatric procedural sedation (PPS) is often performed outside of the operating room, and by various sub-specialty providers. There is no consistency in how pediatric emergency medicine (PEM) fellows are trained in PPS. The objective of this study was to survey PEM program directors (PDs) and PEM fellows about their current sedation teaching practices via a direct survey. While many fellowship programs train PEM fellows in PPS, we hypothesize that there is no consistent method of developing and measuring this skill.A 12-question survey was sent to PEM PDs directly via email. A separate 17-question survey was sent to current PEM fellows via their program coordinators by email. Each survey had multiple choice, yes-no and select-all program questions. Responses were collected in an online (REDCap) database and summarized as frequencies and percentages.Based on identifiable email, 67 programs were contacted, with a PD response rate of 46 (59%). Sixty-two program coordinators were contacted based on identifiable email with 78 fellow responses. We noted that 11/46 PD respondents offer a formal PPS rotation. Thirty programs report using propofol in the emergency department and 93% of PD respondents (28/30) actively train fellows in the use of propofol. Approximately 62% of PEM fellow respondents (48/78) report sedating without any attending oversight. Twenty-eight percent of PEM fellow respondents report using simulation as a component of their sedation training.PPS is a critical skill. However, there is a lack of consistency in both education and evaluation of competency in this area. An organized PPS rotation would improve PPS case exposure and PPS skills.


Assuntos
Anestesiologia/educação , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Bolsas de Estudo/estatística & dados numéricos , Medicina de Emergência Pediátrica/educação , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/uso terapêutico , Competência Clínica/estatística & dados numéricos , Gerenciamento de Dados , Educação de Pós-Graduação em Medicina/métodos , Escolaridade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Internato e Residência/normas , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Propofol/administração & dosagem , Propofol/uso terapêutico , Treinamento por Simulação/estatística & dados numéricos , Inquéritos e Questionários
16.
J Surg Res ; 262: 240-243, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33549329

RESUMO

As the SARS-COV-2 pandemic created the need for social distancing and the implementation of nonessential travel bans, residency and fellowship programs have moved toward a web-based virtual process for applicant interviews. As part of the Society of Asian Academic Surgeons 5th Annual Meeting, an expert panel was convened to provide guidance for prospective applicants who are new to the process. This article provides perspectives from applicants who have successfully navigated the surgical subspecialty fellowship process, as well as program leadership who have held virtual interviews.


Assuntos
COVID-19/prevenção & controle , Cirurgia Geral/educação , Internato e Residência/organização & administração , Seleção de Pessoal/métodos , Comunicação por Videoconferência/organização & administração , COVID-19/epidemiologia , COVID-19/transmissão , Certificação/organização & administração , Certificação/normas , Docentes/psicologia , Docentes/normas , Bolsas de Estudo/organização & administração , Bolsas de Estudo/normas , Humanos , Internato e Residência/normas , Liderança , Pandemias/prevenção & controle , Seleção de Pessoal/organização & administração , Seleção de Pessoal/normas , Distanciamento Físico , Interação Social , Conselhos de Especialidade Profissional , Cirurgiões/psicologia , Cirurgiões/normas
17.
Actas urol. esp ; 45(1): 0-0, ene.-feb. 2021. tab, mapas, graf
Artigo em Espanhol | IBECS | ID: ibc-194903

RESUMO

OBJETIVO: La pandemia de la COVID-19 ha alterado sustancialmente las actividades de formación de los residentes. Si bien recientemente se han implementado nuevos programas de aprendizaje virtual, aún debe investigarse su utilidad desde la perspectiva de los aprendices de urología. MÉTODOS: Encuesta online transversal de 30 ítems, distribuida a través de Twitter, entre el 4 y el 18 de abril de 2020, con el objetivo de evaluar la perspectiva de los residentes de urología sobre las modalidades (videos pregrabados, seminarios web, podcasts y redes sociales [RRSS]) y contenidos (lecciones frontales, discusiones de casos clínicos, actualizaciones sobre guías y ensayos clínicos, videos quirúrgicos, clubes de revistas y seminarios sobre liderazgo y habilidades no técnicas) del aprendizaje inteligente (Smart learning). RESULTADOS: En total, 501 residentes de urología de 58 países completaron la encuesta. De estos, 78,4, 78,2, 56,9 y 51,9% consideraron los videos pregrabados, seminarios web interactivos, podcasts y RRSS, respectivamente, como modalidades de aprendizaje inteligente muy útiles. Los contenidos considerados como muy útiles por la mayor proporción de residentes fueron las actualizaciones de guías clínicas (84,8%) y videos quirúrgicos (81,0%). Además, más de la mitad de los residentes consideraron los seminarios de liderazgo y los de habilidades no técnicas (58,9 y 56,5%, respectivamente) como contenidos útiles para el aprendizaje inteligente. Las tres combinaciones preferidas de modalidad y contenido de aprendizaje inteligente fueron: videos quirúrgicos pregrabados, seminarios web interactivos sobre casos clínicos y videos pregrabados sobre guías. CONCLUSIÓN: Nuestro estudio proporciona la primera «visión global» de las modalidades y contenidos de aprendizaje inteligente que deben priorizarse con el objetivo de optimizar la educación virtual en urología. Aunque este estudio se llevó a cabo durante la pandemia de la COVID-19, nuestros hallazgos podrían tener un impacto aún mayor en el futuro


PURPOSE: The COVID-19 outbreak has substantially altered residents' training activities. While several new virtual learning programs have been recently implemented, the perspective of urology trainees regarding their usefulness still needs to be investigated. METHODS: A cross-sectional, 30-item, web-based Survey was conducted through Twitter from April 4th, 2020 to April 18th, 2020, aiming to evaluate the urology residents' perspective on smart learning (SL) modalities (pre-recorded videos, webinars, podcasts, and social media [SoMe]), and contents (frontal lessons, clinical case discussions, updates on Guidelines and on clinical trials, surgical videos, Journal Clubs, and seminars on leadership and non-technical skills). RESULTS: Overall, 501 urology residents from 58 countries completed the survey. Of these, 78.4, 78.2, 56.9 and 51.9% of them considered pre-recorded videos, interactive webinars, podcasts and SoMe highly useful modalities of smart learning, respectively. The contents considered as highly useful by the greatest proportion of residents were updates on guidelines (84.8%) and surgical videos (81.0%). In addition, 58.9 and 56.5% of responders deemed seminars on leadership and on non-technical skills highly useful smart learning contents. The three preferred combinations of smart learning modality and content were: pre-recorded surgical videos, interactive webinars on clinical cases, and pre-recorded videos on guidelines. CONCLUSION: Our study provides the first global «big picture» of the smart learning modalities and contents that should be prioritized to optimize virtual Urology education. While this survey was conducted during the COVID-19 outbreak, our findings might have even more impact in the future


Assuntos
Humanos , Masculino , Feminino , Educação em Saúde/métodos , Infecções por Coronavirus , Urologia/educação , Internato e Residência/estatística & dados numéricos , Educação à Distância , Pandemias , Pneumonia Viral , Internato e Residência/normas , Inquéritos e Questionários , Telemedicina , Procedimentos Cirúrgicos Urológicos/educação
18.
J Med Internet Res ; 23(2): e24266, 2021 02 22.
Artigo em Inglês | MEDLINE | ID: covidwho-1097249

RESUMO

BACKGROUND: Transition to digital pathology usually takes months or years to be completed. We were familiarizing ourselves with digital pathology solutions at the time when the COVID-19 outbreak forced us to embark on an abrupt transition to digital pathology. OBJECTIVE: The aim of this study was to quantitatively describe how the abrupt transition to digital pathology might affect the quality of diagnoses, model possible causes by probabilistic modeling, and qualitatively gauge the perception of this abrupt transition. METHODS: A total of 17 pathologists and residents participated in this study; these participants reviewed 25 additional test cases from the archives and completed a final psychologic survey. For each case, participants performed several different diagnostic tasks, and their results were recorded and compared with the original diagnoses performed using the gold standard method (ie, conventional microscopy). We performed Bayesian data analysis with probabilistic modeling. RESULTS: The overall analysis, comprising 1345 different items, resulted in a 9% (117/1345) error rate in using digital slides. The task of differentiating a neoplastic process from a nonneoplastic one accounted for an error rate of 10.7% (42/392), whereas the distinction of a malignant process from a benign one accounted for an error rate of 4.2% (11/258). Apart from residents, senior pathologists generated most discrepancies (7.9%, 13/164). Our model showed that these differences among career levels persisted even after adjusting for other factors. CONCLUSIONS: Our findings are in line with previous findings, emphasizing that the duration of transition (ie, lengthy or abrupt) might not influence the diagnostic performance. Moreover, our findings highlight that senior pathologists may be limited by a digital gap, which may negatively affect their performance with digital pathology. These results can guide the process of digital transition in the field of pathology.


Assuntos
COVID-19/epidemiologia , Competência Clínica , Diagnóstico por Imagem/métodos , Diagnóstico por Imagem/normas , Processamento de Imagem Assistida por Computador/métodos , Processamento de Imagem Assistida por Computador/normas , Patologia Clínica/métodos , Patologia Clínica/normas , Teorema de Bayes , Surtos de Doenças , Humanos , Internato e Residência/métodos , Internato e Residência/normas , Itália/epidemiologia , Microscopia , Inquéritos e Questionários
19.
J Med Internet Res ; 23(2): e24266, 2021 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-33503002

RESUMO

BACKGROUND: Transition to digital pathology usually takes months or years to be completed. We were familiarizing ourselves with digital pathology solutions at the time when the COVID-19 outbreak forced us to embark on an abrupt transition to digital pathology. OBJECTIVE: The aim of this study was to quantitatively describe how the abrupt transition to digital pathology might affect the quality of diagnoses, model possible causes by probabilistic modeling, and qualitatively gauge the perception of this abrupt transition. METHODS: A total of 17 pathologists and residents participated in this study; these participants reviewed 25 additional test cases from the archives and completed a final psychologic survey. For each case, participants performed several different diagnostic tasks, and their results were recorded and compared with the original diagnoses performed using the gold standard method (ie, conventional microscopy). We performed Bayesian data analysis with probabilistic modeling. RESULTS: The overall analysis, comprising 1345 different items, resulted in a 9% (117/1345) error rate in using digital slides. The task of differentiating a neoplastic process from a nonneoplastic one accounted for an error rate of 10.7% (42/392), whereas the distinction of a malignant process from a benign one accounted for an error rate of 4.2% (11/258). Apart from residents, senior pathologists generated most discrepancies (7.9%, 13/164). Our model showed that these differences among career levels persisted even after adjusting for other factors. CONCLUSIONS: Our findings are in line with previous findings, emphasizing that the duration of transition (ie, lengthy or abrupt) might not influence the diagnostic performance. Moreover, our findings highlight that senior pathologists may be limited by a digital gap, which may negatively affect their performance with digital pathology. These results can guide the process of digital transition in the field of pathology.


Assuntos
COVID-19/epidemiologia , Competência Clínica , Diagnóstico por Imagem/métodos , Diagnóstico por Imagem/normas , Processamento de Imagem Assistida por Computador/métodos , Processamento de Imagem Assistida por Computador/normas , Patologia Clínica/métodos , Patologia Clínica/normas , Teorema de Bayes , Surtos de Doenças , Humanos , Internato e Residência/métodos , Internato e Residência/normas , Itália/epidemiologia , Microscopia , Inquéritos e Questionários
20.
Neurosurgery ; 88(4): E345-E350, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33471893

RESUMO

Over the last decade, strict duty hour policies, pressure for increased work related value units from faculty, and the apprenticeship model of education have coalesced to make opportunities for intraoperative teaching more challenging. Evidence is emerging that graduating residents are not exhibiting competence by failing to recognize major complications, and perform routine operations independently. In this pilot study, we combine Vygotsky's social learning theory with a modified version of the competency-based scale called TAGS to study 1 single operation, anterior cervical discectomy and fusion, with 3 individual residents taught by a single faculty member. In order for the 3 residents to achieve "Solo and Observe" in all 4 zones of proximal development, the number of cases required was 10 cases for postgraduate year (PGY)-3a, 19 cases for PGY 3b, and 22 cases for the PGY 2. In this pilot study, the time required to complete an independent 2-level anterior cervical discectomy and fusion by the residents correlated with the number of cases to reach competence. We demonstrate the Surgical Autonomy Program's ability to track neurosurgical resident's educational progress and the feasibility of using the Surgical Autonomy Program (SAP) to teach residents in the operating room and provide immediate formative feedback. Ultimately, the SAP represents a paradigm shift towards a modern, scalable competency-focused subspecialty teaching, evaluation and assessment tool that provides increases in resident's autonomy and metacognitive skills, as well as immediate formative feedback.


Assuntos
Competência Clínica/normas , Educação Baseada em Competências/normas , Condicionamento Psicológico , Internato e Residência/normas , Neurocirurgia/educação , Neurocirurgia/normas , Educação Baseada em Competências/métodos , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/normas , Humanos , Internato e Residência/métodos , Salas Cirúrgicas/métodos , Salas Cirúrgicas/normas , Projetos Piloto
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