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Perceived Impact of Urologic Surgery Training Program Modifications due to COVID-19 in the United States.

ABSTRACT: OBJECTIVE:To assess urology residency program modifications in the context of COVID-19, and perceptions of the impact on urology trainees. METHODS:A cross-sectional survey of program leadership and residents at accredited US urology residencies was administered between April 28, 2020 to March 11, 2020. Total cohort responses are reported, and subanalyses were preformed comparing responses between those in in high vs low COVID-19 geographic regions, and between program leaders vs residents. RESULTS:Program leaders from 43% of programs and residents from 18% of programs responded. Respondents reported decreased surgical volume (83%-100% varying by subspecialty), increased use of telehealth (99%), a transition to virtual educational platforms (95%) and decreased size of inpatient resident teams (90%). Most residents are participating in care of COVID-19 patients (83%) and 20% endorsed that urology residents have been re-deployed. Seventy nine percent of respondents perceive a negative impact of recent events on urology surgery training and anxiety regarding competency upon completion of residency training was more pronounced among respondents in high COVID-19 regions. CONCLUSION:Major modifications to urology training programs were implemented in response to COVID-19. Attention must be paid to the downstream effects of the training disruption on urology residents.

SUBMITTER: Fero KE

PROVIDER: S-EPMC7274971 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Perceived Impact of Urologic Surgery Training Program Modifications due to COVID-19 in the United States.

Fero Katherine E KE Weinberger James M JM Lerman Steven S Bergman Jonathan J

Urology 20200606

<h4>Objective</h4>To assess urology residency program modifications in the context of COVID-19, and perceptions of the impact on urology trainees.<h4>Methods</h4>A cross-sectional survey of program leadership and residents at accredited US urology residencies was administered between April 28, 2020 to March 11, 2020. Total cohort responses are reported, and subanalyses were preformed comparing responses between those in in high vs low COVID-19 geographic regions, and between program leaders vs r ...[more]

PMID: 32512110

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Project description:INTRODUCTION:Academic Emergency Medicine (EM) departments are not immune to natural disasters, economic or political forces that disrupt a training program's operations and educational mission. Due process concerns are closely intertwined with the challenges that program disruption brings. Due process is a protection whereby an individual will not lose rights without access to a fair procedural process. Effects of natural disasters similarly create disruptions in the physical structure of training programs that at times have led to the displacement of faculty and trainees. Variation exists in the implementation of transitions amongst training sites across the country, and its impact on residency programs, faculty, residents and medical students. METHODS:We reviewed the available literature regarding due process in emergency medicine. We also reviewed recent examples of training programs that underwent disruptions. We used this data to create a set of best practices regarding the handling of disruptions and due process in academic EM. RESULTS:Despite recommendations from organized medicine, there is currently no standard to protect due process rights for faculty in emergency medicine training programs. Especially at times of disruption, the due process rights of the faculty become relevant, as the multiple parties involved in a transition work together to protect the best interests of the faculty, program, residents and students. Amongst training sites across the country, there exist variations in the scope and impact of due process on residency programs, faculty, residents and medical students. CONCLUSION:We report on the current climate of due process for training programs, individual faculty, residents and medical students that may be affected by disruptions in management. We outline recommendations that hospitals, training programs, institutions and academic societies can implement to enhance due process and ensure the educational mission of a residency program is given due consideration during times of transition.

Project description:BackgroundThe impact of the coronavirus disease 19 (COVID-19) pandemic on health care workers has been substantial. However, the impact on vascular surgery (VS) trainees has not yet been determined. The goals of our study were to gauge the impact of COVID-19 on VS trainees' personal and professional life and to assess stressors, coping, and support structures involved in these trainees' response to the COVID-19 pandemic.MethodsThis was an anonymous online survey administered in April 12-24, 2020 during the surge phase of the global COVID-19 pandemic. It is a subset analysis of the cross-sectional Society for Vascular Surgery Wellness Committee Pandemic Practice, Anxiety, Coping, and Support Survey. The cohort surveyed was VS trainees, integrated residents and fellows, in the United States of America. Assessment of the personal impact of the pandemic on VS trainees and the coping strategies used by them was based on the validated Generalized Anxiety Disorder 7-item (GAD-7) scale and the validated 28-time Brief Coping Orientation to Problems Experienced inventory.ResultsA total of 145 VS trainees responded to the survey, with a 23% response rate (145/638). Significant changes were made to the clinical responsibilities of VS trainees, with 111 (91%) reporting cancellation of elective procedures, 101 (82%) with call schedule changes, 34 (24%) with duties other than related to VS, and 29 (24%) participation in outpatient care delivery. Over one-third (52/144) reported they had performed a procedure on a patient with confirmed COVID-19; 37 (25.7%) reported they were unaware of the COVID-19 status at the time. The majority continued to work after exposure (29/34, 78%). Major stressors included concerns about professional development, infection risk to family/friends, and impact of care delay on patients. The median score for GAD-7 was 4 (interquartile range 1-8), which corresponds to no or low self-reported anxiety levels. VS trainees employed mostly active coping and rarely avoidant coping mechanisms, and the majority were aware and used social media and online support systems. No significant difference was observed between integrated residents and fellows, or by gender.ConclusionsThe pandemic has had significant impact on VS trainees. Trainees reported significant changes to clinical responsibilities, exposure to COVID-19, and pandemic-related stressors but demonstrated healthy coping mechanisms with low self-reported anxiety levels. The VS community should maintain awareness of the impact of the pandemic on the professional and personal development of surgeons in training. We recommend adaptive evolution in training to accommodate the changing learning environment for trainees.

Dataset Information

Perceived Impact of Urologic Surgery Training Program Modifications due to COVID-19 in the United States.

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Perceived Impact of Urologic Surgery Training Program Modifications due to COVID-19 in the United States.

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