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1.
N Engl J Med ; 383(11): 1006-1007, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32905672
2.
Med Educ Online ; 25(1): 1818439, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32924869

RESUMO

The COVID-19 crisis has had an unprecedented impact on resident education and well-being: social distancing guidelines have limited patient volumes and forced virtual learning, while personal protective equipment (PPE) shortages, school/daycare closures, and visa restrictions have served as additional stressors. Our study aimed to analyze the effects of COVID-19 crisis-related stressors on residents' professional and personal lives. In April 2020, we administered a survey to residents at a large academic hospital system in order to assess the impact of the pandemic on residency training after >6 weeks of a modified schedule. The primary outcome was to determine which factors or resident characteristics were related to stress during the pandemic. Our secondary goals were to examine which resident characteristics were related to survey responses. Data were analyzed with regression analyses. Ninety-six of 205 residents completed the survey (47% response rate). For our primary outcome, anxiety about PPE (P < 0.001), female gender (P = 0.03), and the interaction between female gender and anxiety about PPE (P = 0.04) were significantly related to increased stress during the COVID-19 pandemic. Secondary analyses suggested that medicine residents were more comfortable than surgical residents using telemedicine (P > 0.001). Additionally, compared to juniors, seniors believed that the pandemic was more disruptive, modified schedules were effective, and virtual meetings were less effective while virtual lectures were more effective (all P ≤ 0.05) Furthermore, the pandemic experience has allowed seniors in particular to feel more confident to lead in future health crises (P ≤ 0.05). Medicine and surgery residency programs should be cognizant of and closely monitor the effects of COVID-19 crisis-related factors on residents' stress and anxiety levels. Transparent communication, telemedicine, online lectures/meetings, procedure simulations, advocacy groups, and wellness resources may help to mitigate some of the challenges posed by the pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Internato e Residência/organização & administração , Pneumonia Viral/epidemiologia , Estudantes de Medicina/psicologia , Adulto , Ansiedade/epidemiologia , Betacoronavirus , Feminino , Humanos , Internato e Residência/normas , Masculino , Pessoa de Meia-Idade , Pandemias , Equipamento de Proteção Individual , Fatores Sexuais , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Adulto Jovem
3.
Plast Reconstr Surg ; 146(2): 447-454, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740604

RESUMO

Plastic surgeons have the unique perspective of working with all types of patients and care teams from almost all specialties in surgery and medicine, which creates unique challenges in times of distress. As the initial epicenter of coronavirus disease 2019 cases in the United States, the University of Washington program was required to rapidly develop strategies to deal with the escalating crisis. All aspects of the program were affected, including the need to triage the urgency of plastic surgery care, safe staffing of plastic surgery teams, and the role of plastic surgery in the greater hospital community. In addition, as a residency training program, limiting the impact of resident education and maintaining a sense of community and connection among members of the program developed into important considerations. The authors hope that the narrative of their experience will provide insight into the decisions made in the University of Washington health care system but also remind others that they are not alone in dealing with the challenges of this pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Internato e Residência/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Cirurgia Plástica/educação , Universidades/organização & administração , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/normas , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Humanos , Internato e Residência/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Procedimentos Cirúrgicos Reconstrutivos/educação , Cirurgiões/educação , Cirurgiões/organização & administração , Universidades/normas , Washington , Recursos Humanos/organização & administração , Recursos Humanos/normas
14.
J Surg Res ; 255: 96-98, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32543384

RESUMO

The COVID-19 pandemic has presented a variety of challenges in the medical education curriculum, one of which is the possible loss of summer and fall away rotations for fourth year students applying into surgical subspecialties. Subsequently, a lack of in-person evaluations may have a major impact on an applicant's perception of the residency and the program's ability to assess the individual applicant. This is especially crucial for applicants without a home program in their specialty of interest, as away rotations are an important opportunity to confirm interest in pursuit of a subspecialty, obtain letters of recommendation, and make positive impressions at programs of interest. The objective of this article is to assess the current COVID-19 pandemic situation in light of away rotations and to provide recommendations for surgical subspecialty programs and applicants to have the best outcome during this upcoming application cycle. In particular, we emphasize the importance of implementing universal processes within each individual subspecialty. This will provide equitable opportunities for all applicants, minimizing potential biases or disadvantages based on geographic location or availability of a program at an applicant's home institution.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Internato e Residência/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Faculdades de Medicina/organização & administração , Estudantes de Medicina , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Controle de Infecções/organização & administração , Internato e Residência/normas , Seleção de Pessoal/organização & administração , Seleção de Pessoal/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Faculdades de Medicina/normas , Inquéritos e Questionários
15.
Can J Surg ; 63(3): E229-E230, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: covidwho-226013

RESUMO

Summary: The coronavirus disease 2019 (COVID-19) pandemic has accentuated the importance of leadership training for health care professionals, particularly surgeons. Surgeons are expected to lead and thrive in multidisciplinary teams. There is, however, a critical gap in teaching residents about fundamental leadership principles, such as developing productive and vision-driven teams, conflict resolution and emotional intelligence. We discuss the merits of leadership training for surgical residents and future directions for implementing a leadership curriculum for Canadian residency programs in the competency by design era.


Assuntos
Infecções por Coronavirus , Cirurgia Geral/educação , Internato e Residência/organização & administração , Liderança , Pandemias , Equipe de Assistência ao Paciente/organização & administração , Pneumonia Viral , Canadá , Competência Clínica , Currículo , Cirurgia Geral/normas , Internato e Residência/métodos , Internato e Residência/normas , Equipe de Assistência ao Paciente/normas , Ensino
16.
World Neurosurg ; 139: e848-e858, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32426064

RESUMO

BACKGROUND: The novel coronavirus disease (COVID-19) is a life-threatening illness, which represents a challenge to all health care workers. Neurosurgeons worldwide are affected in different ways. OBJECTIVE: This is the first study regarding the readiness of neurosurgery residents for the COVID-19 pandemic and its impact. The aim is to identify the level of knowledge and readiness and the impact of this virus among neurosurgery residents in different programs. METHODS: A cross-sectional analysis was performed in which 52 neurosurgery residents from different centers were selected to complete a questionnaire-based survey. The questionnaire comprised 3 sections and 27 questions that ranged from knowledge to impact of the pandemic on various features. RESULTS: The median knowledge score was 4 out of 5. The proportion of participants with a satisfactory level of knowledge was 60%. There was a statistically significant difference between the knowledge score and location of the program. Around 48% of the neurosurgery residents dealt directly with patients with COVID-19. Receiving a session about personal protective equipment was reported by 57.7%. Neurosurgery training at the hospital was affected. About 90% believed that this pandemic had influenced their mental health. CONCLUSIONS: Neurosurgery residents have a relatively good knowledge about COVID-19. The location of the program was associated with knowledge level. Most participants did not receive sufficient training about personal protective equipment. Almost all responders agreed that their training at the hospital had been affected. Further studies are needed to study the impact of this pandemic on neurosurgery residents.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Internato e Residência/normas , Neurocirurgia/normas , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Infecções por Coronavirus/terapia , Estudos Transversais , Feminino , Humanos , Masculino , Neurocirurgiões/psicologia , Neurocirurgiões/normas , Neurocirurgia/educação , Pneumonia Viral/terapia , Inquéritos e Questionários , Adulto Jovem
17.
Pediatrics ; 145(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32434760

RESUMO

BACKGROUND: Pediatric emergency department (PED) overcrowding and prolonged boarding times (admission order to PED departure) decrease quality of care. Timely transfer of patients from the PED to inpatient units is a key driver that relieves overcrowding. In 2015, PED boarding time at our hospital was 10% longer than the national benchmark. We described a resident-led quality-improvement initiative to decrease PED mean boarding times by 10% (from 173 to 156 minutes) within 6 months among general pediatric admissions. METHODS: We applied Plan-Do-Study-Act (PDSA) methodology. PDSA 1 (October 2016) interventions were bundled to include streamlined mobile communications, biweekly educational presentations, and reminder signs. PDSA 2 (August 2017) provided alternative workflows for senior residents. Outcomes were mean PED boarding times for general pediatrics admissions. The proportion of PICU transfers within 12 hours of admission served as a balancing measure. Statistical process control charts were used to analyze boarding times and PICU transfer rates. RESULTS: Leading up to PDSA 1, monthly mean boarding times decreased from 173 to 145 minutes and were sustained throughout the study period and up to 1 year after study completion. The X-bar chart demonstrated a shift with 57 consecutive months of mean boarding times below the preintervention mean. There were no changes in PICU transfer rates within 12 hours of admission. CONCULSIONS: Resident-led quality improvement efforts, including education and streamlined workflow, significantly improved PED boarding time without causing harm to patients.


Assuntos
Serviço Hospitalar de Emergência/normas , Internato e Residência/normas , Admissão do Paciente/normas , Transferência de Pacientes/normas , Medicina de Emergência Pediátrica/normas , Melhoria de Qualidade/normas , Baltimore/epidemiologia , Criança , Pré-Escolar , Serviço Hospitalar de Emergência/tendências , Feminino , Hospitais Urbanos/normas , Hospitais Urbanos/tendências , Humanos , Internato e Residência/tendências , Masculino , Admissão do Paciente/tendências , Transferência de Pacientes/tendências , Medicina de Emergência Pediátrica/tendências , Melhoria de Qualidade/tendências , Fluxo de Trabalho
18.
Tunis Med ; 98(3): 219-224, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32395815

RESUMO

INTRODUCTION: The initial medical certificate (IMC) is the first document delivered to an injured person, or his or her legal representative. The objective of this study was to determine the knowledge and writing habits of Tunisian dental post-graduate students regarding the IMC. METHOD: This was a descriptive study conducted at the Faculty of Dentistry of Monastir (Tunisia) during the period from October 1, 2018 to March 31, 2019. All the post graduate students were included in the survey. For data collection, a questionnaire written in French was used. The platform "Google Forms" was used to perform the questionnaire and the link was sent by mail to all participants. RESULTS: For 19.9% of respondents , the IMC was considered as an expertise and 22% of them declared that even non-graduates can deliver it. In addition, 22% of participants have already given a IMC to a third party and 12.2% have reported photos and X-rays to the IMC. On the other hand, 82.4% of respondents do not indicate total incapacity for work (TIW) when writing the IMC. In fact, 13.7% of them do not know what a TIW is and 52.1% think that it will be determined during the expertise. Finally, 85.6% of respondents estimated that they did not have the necessary information about the IMC and 96.9% of them thought that an information support would be useful to help them in writing it. CONCLUSION: The writing of IMC incurs the criminal, civil and ethical responsibility of the practitioner.


Assuntos
Educação de Pós-Graduação em Odontologia , Conhecimentos, Atitudes e Prática em Saúde , Registros Médicos/normas , Padrões de Prática Médica , Estudantes de Odontologia/estatística & dados numéricos , Odontologia/normas , Odontologia/estatística & dados numéricos , Educação de Pós-Graduação em Odontologia/estatística & dados numéricos , Humanos , Internato e Residência/normas , Internato e Residência/estatística & dados numéricos , Traumatismos Maxilofaciais/terapia , Registros Médicos/estatística & dados numéricos , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Inquéritos e Questionários , Tunísia/epidemiologia , Redação/normas
20.
Can J Surg ; 63(3): E229-E230, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32386472

RESUMO

Summary: The coronavirus disease 2019 (COVID-19) pandemic has accentuated the importance of leadership training for health care professionals, particularly surgeons. Surgeons are expected to lead and thrive in multidisciplinary teams. There is, however, a critical gap in teaching residents about fundamental leadership principles, such as developing productive and vision-driven teams, conflict resolution and emotional intelligence. We discuss the merits of leadership training for surgical residents and future directions for implementing a leadership curriculum for Canadian residency programs in the competency by design era.


Assuntos
Infecções por Coronavirus , Cirurgia Geral/educação , Internato e Residência/organização & administração , Liderança , Pandemias , Equipe de Assistência ao Paciente/organização & administração , Pneumonia Viral , Canadá , Competência Clínica , Currículo , Cirurgia Geral/normas , Internato e Residência/métodos , Internato e Residência/normas , Equipe de Assistência ao Paciente/normas , Ensino
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