The Impact of COVID-19 on Pulmonary Fellowship Training in an Irish Setting.
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ABSTRACT:
SUBMITTER: O'Carroll O
PROVIDER: S-EPMC8043323 | biostudies-literature | 2020 Jul
REPOSITORIES: biostudies-literature
Publications
The Impact of COVID-19 on Pulmonary Fellowship Training in an Irish Setting.
O'Carroll Orla O Lynn Evelyn E Keane Michael P MP Gallagher Charles G CG McCarthy Cormac C
ATS scholar 20200714 3
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Project description:BackgroundAlthough it is well known that the coronavirus disease (COVID-19) pandemic has had a profound effect on health care, its impact on fellowship training in Pulmonary and Critical Care Medicine (PCCM) has not been well described.ObjectiveWe conducted an anonymous survey of PCCM program directors (PDs) to assess the impact of the COVID-19 pandemic on PCCM fellowship training across the United States.MethodsWe developed a 30-question web-based survey that was distributed to U.S. PCCM PDs through the Association of Pulmonary and Critical Care Medicine Program Directors.ResultsThe survey was sent to 242 PDs, of whom 28.5% responded. Most of the responses (76.8%) came from university-based programs. Almost universally, PDs reported a decrease in the number of pulmonary function tests (100%), outpatient visits (94.1%), and elective bronchoscopies (96%). Three-quarters (77.6%) of the PDs reported that their PCCM fellows spent more time in the intensive care unit than originally scheduled.ConclusionThe COVID-19 pandemic has had a variable impact on different aspects of fellowship training. PDs reported a significant decrease in the core components of pulmonary training, whereas certain aspects of critical care training increased. It is likely that targeted mitigation strategies will be needed to ensure no gaps in PCCM training while optimizing well-being.
| S-EPMC8787736 | biostudies-literature
Project description:BackgroundCOVID-19 created unprecedented challenges in surgical training especially in specialties with high elective case volume. We hypothesized that case volume during total joint arthroplasty fellowship training would decrease by 25% given widespread economic shutdowns encountered during the fourth quarter of the 2019-2020 academic year.MethodsCase logs from the Accreditation Council for Graduate Medical Education were obtained for accredited total joint arthroplasty fellowships (2017-2018 to 2020-2021). Case volumes were extracted and summarized as means ± SD. Student's t tests were used for inter-year comparisons.ResultsOne hundred and eighty three arthroplasty fellows from 24 accredited fellowships were included. There was a 14% year-over-year decrease in total case volume during the 2019-2020 academic year (390 ± 108 vs 453 ± 128, P < .001). Case volume rebounded during the 2020-2021 academic year to 465 ± 93 (19% increase, P < .001). Case categories with the most significant percentage declines in 2019-2020 were primary total knee arthroplasty (TKA, -23%), revision total hip arthroplasty (THA, -19%), revision TKA (rTKA, -11%), and primary THA (-10%).ConclusionThere was a 14% overall decrease in arthroplasty case volume during the 2019-2020 academic year, which correlated with the widespread economic shutdowns during the COVID-19 pandemic. Certain elective case categories like primary TKA experienced the greatest negative impact. Results from this study may inform prospective trainees and faculty during future national emergencies.
| S-EPMC8979627 | biostudies-literature
Project description:Background: The COVID-19 pandemic has had a wide-reaching impact. Graduate medical education of orthopedic surgeons was not spared from the jarring changes. Purpose: We sought to survey fellowship program directors in the field of orthopedic surgery about how the COVID-19 pandemic affected the education of the 2019 to 2020 and 2020 to 2021 fellowship classes and the future of their programs. Methods: In October 2020, an 18-item survey was distributed by an official of the American Academy of Orthopedic Surgeons (AAOS) to the specialty societies that govern fellowship training. Each specialty society then distributed the survey to its respective program directors. A reminder email was sent during the enrollment period. Each respondent was able to complete the survey once. Survey questions were grouped into 3 sections: general information about the fellowship training programs, the impact of COVID-19 on the 2019 to 2020 fellowship class, and the future impact of COVID-19 on the fellowship training programs. Results: Of the 564 accredited orthopedic surgery fellowship programs in the United States, 190 directors responded. Of these, 73.59% reported COVID-19 had a negative impact on the 2019 to 2020 fellowship class. A normal distribution of responses was found regarding didactic and academic learning, research, and mentorship opportunities. A majority of respondents said they believe that there will be no negative impact on patient care the fellows provide in the years to come. Conclusion: Orthopedic surgery fellowship program directors acknowledged that while there were negative effects to training in the pandemic, they did not think these would negatively affect patient care provided by 2019 to 2020 fellows in the short and medium term. They also reported positive outcomes from the experience of the pandemic, including new ways to educate fellows.
| S-EPMC8753546 | biostudies-literature
Project description:A pandemic threatens to disrupt many aspects of a fellowship training program. The University of Washington pulmonary and critical care fellowship program was the first in the United States to encounter coronavirus disease (COVID-19), and it has had the luxury of having adequate staffing and resources to date. In response to questions and concerns from our fellows about the pandemic, our program prioritized patient care, effective communication, and efforts to support fellow well-being. Additional considerations for programs during a health crisis include impacts on clinical care, scheduling, training, and formal education programs. Although we continue to adapt to the needs of our fellows, these early lessons learned may be helpful to those who are just beginning to experience the repercussions of COVID-19.
| S-EPMC8043303 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic catalyzed unprecedented changes to medical education, including CV fellowship programs. CV fellowship PDs offer a unique perspective regarding the impact of the pandemic on CV medical education.ObjectivesThe 4th annual Cardiovascular Diseases (CV) Fellowship Program Directors (PDs) Survey sought to understand the impact of the COVID-19 pandemic on CV fellows and fellowship programs.MethodsThe survey contained 31 items examining the clinical, educational, and academic impact of the COVID-19 pandemic on CV fellowship programs.ResultsSurvey response rate was 54%. Most respondents (58%) represented university-based programs. Most PDs felt that changes to clinical practice during the COVID-19 negatively impacted fellow education in cardiac catheterization (66%), outpatient cardiology (52%), nuclear imaging (51%), and echocardiography (50%). Despite improving attendance, 75% of PDs felt that virtual educational conferences adversely impacted interaction between participants. Only 22% felt they improved fellow education. Most PDs (85%) reported a negative impact of the pandemic on fellow well-being and burnout, and 57% reported a decrease in research productivity among fellows. Even though virtual recruitment allowed programs to interview more competitive candidates, most PDs felt that virtual interviews adversely impacted interactions between their fellows and candidates (71%) and their ability to convey the culture of their program (60%).ConclusionsMost CV fellowship PDs felt the COVID-19 pandemic brought changes that negatively impacted the clinical training, didactic learning, academic productivity, and well-being among cardiology fellows. The implications of these changes on the competency of cardiologists that trained during the COVID-19 pandemic deserve future study.
| S-EPMC11312764 | biostudies-literature
Project description:BackgroundCoronavirus disease 2019 (COVID-19) has profoundly impacted residency and fellowship training and education. However, how and to what extent the daily involvement of trainees in clinical and surgical activities was compromised by the COVID-19 pandemic is currently unknown.Materials and methodsWe conducted an electronic survey. An invitation was sent through the executive training administration of the Saudi Commission for Health Specialties (SCFHS) randomly to 400 residents and fellows over two weeks period from April 23, 2020 until May 6, 2020. Descriptive statistics were presented using counts and proportions (%). The comparison between the trainees among the socio-demographic and the characteristics of trainees toward the impact of COVID-19 pandemic on their training had been conducted using the Chi-square test. A p-value cut off point of 0.05 at 95% Confidence Interval (CI) used to determine statistical significance.ResultsOut of the 400 questionnaires distributed, 240 trainees responded, resulting in a response rate of 60%. The most frequently cited specialty was surgical (41.3%) and medical (38.3%). Approximately 43% of them had direct contact with patients with COVID-19, and 43.8% had enough training regarding the proper use of Personal Protective Equipment (PPE). There were seven responders (2.9%) who had been infected by the disease. Among them, 6 (2.5%) members of their family had also been infected. Approximately 84.6% reported a reduction in training activities due to the current pandemic. Of those with surgical specialties, almost all (97%) reported that their surgical exposure reduced due to the COVID-19 pandemic.ConclusionThe adoption of smart learning is critical. For those who have been affected by examination delays, we recommend continuing to revise steadily using webinars, podcasts, prerecorded sessions, and social media. Routine activities such as journal clubs and departmental teaching should continue through webinars, if possible.
| S-EPMC7377677 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has affected every facet of American health care, including graduate medical education (GME). Prior studies show that COVID-19 resulted in reduced opportunities for elective surgeries, lower patient volumes, altered clinical rotations, increased reliance on telemedicine, and dependence on virtual didactic conferences. These studies, however, focused on individual specialties. Because the Accreditation Council for Graduate Medical Education (ACGME) routinely collects information from all programs it has an obligation to use these data to inform the profession about important trends affecting GME.ObjectiveTo describe how the pandemic influenced resident training across all specialty programs in areas of clinical experiences, telemedicine, and extended trainings.MethodsThe ACGME validated a questionnaire to supplement the Annual Update reporting requirements of all accredited programs. The questionnaire was tested to ensure easy interpretation of instructions, question wording, response options, and to assess respondent burden. The questionnaire was administered through the Accreditation Data System, which is a password-protected online environment for communication between the ACGME and ACGME-accredited programs.ResultsWe received a response rate of 99.6% (11 290 of 12 420). Emergency medicine, family medicine, internal medicine, and obstetrics and gynecology programs experienced the most significant impact. Most programs reported reduced opportunities for in-person didactics and ambulatory continuity rotations. Hospital-based programs on the "frontline" of COVID-19 care relied least on telemedicine. Family medicine and internal medicine programs accounted for the greatest number of extended trainings.ConclusionsCOVID-19 has affected GME training, but its consequences are unevenly distributed across program types and regions of the country.
| S-EPMC9200244 | biostudies-literature
Project description:ObjectivesThe objectives of this study include characterizing the practice patterns and testing strategies of facial plastic and reconstructive surgery (FPRS) fellowship directors (FDs) secondary to COVID-19 and to quantify the impact of COVID-19 on FPRS fellowship training.Study designCross-sectional survey.SettingOnline.MethodsA survey was sent to all American Academy of Facial Plastic and Reconstructive Surgery FDs and co-FDs in September 2020. Descriptive analyses were performed.ResultsOf 77 eligible FDs, 45 responded (58.4%) representing a diverse group across the United States. All but 1 FD routinely screened patients for COVID-19 in the preoperative setting. FDs largely believed that universal preoperative testing was cost-effective (66.7%), improved patient safety (80.0%) and health care worker safety (95.6%), and was not burdensome for patients (53.3%). With regard to volume of cosmetic/aesthetic, reconstructive, facial nerve, and trauma surgery, FDs indicated largely no change in volume (34.9%, 71.0%, 68.4%, and 80.0%, respectively) or fellow experience (67.4%, 80.6%, 84.2%, and 80.0%). Half (50.0%) of the FDs reported decreased volume of congenital/craniofacial surgery, but 75.0% did not believe that there was a change in fellow experience. Overall, of the 15 responses indicating "worsened training" across all domains of FPRS, 14 were located in the Northeast (93.33%).ConclusionsThe COVID-19 pandemic has had the least impact on the volume of reconstructive procedures, facial nerve operations, and trauma surgery and a negative impact on congenital/craniofacial surgery volume, and it has accelerated the demand for cosmetic/aesthetic operations. Overall, the majority of FDs did not feel as though their fellows' trainings would be adversely affected by the ongoing pandemic.
| S-EPMC8127772 | biostudies-literature
Project description:Background: Dedicated ambulatory training during pulmonary and critical care medicine (PCCM) fellowships is often limited. A novel 2-year longitudinal outpatient pulmonary fellowship curriculum was previously developed, piloted, and studied. The exportability and potential impact of this ambulatory curriculum on PCCM fellowship training nationally is not known. Objective: We aim to understand the current state of ambulatory training in PCCM fellowships and the impact of a standardized outpatient curriculum on fellows' ambulatory knowledge and competency. Methods: Nineteen programs participated in the study from 2017 to 2019. Six programs received the first year of content, seven programs received the entire 2-year curriculum, and seven programs served as a control. Fellows, faculty, and program directors (PDs) completed a series of surveys assessing satisfaction with ambulatory education and the curriculum. Fellows completed a series of medical knowledge inventories, and programs submitted in-training exam scores. Results: A total of 221 fellows (39%) and 17 PDs (89%) completed the precurriculum surveys, and 38 (12%) fellows and 10 (53%) PDs completed postcurriculum surveys. Before curriculum implementation, only 34.4% of fellows rated the quality of their ambulatory education as good or outstanding compared with 57.9% at the end of the study. Eighty-five percent of faculty and 89% of PDs rated the curriculum as good or excellent. Faculty believed that the teaching scripts were easy to use (78.4%), were factually accurate (86.3%), and provided high-yield information (82.1%). The majority of PDs indicated that the curriculum positively impacted patient care (78%) and fulfilled an unmet educational need (100%), and most planned to continue the curriculum after the study (78%). Feedback surrounded the need for updated content based on recently published guidelines and studies. Conclusion: The curriculum is a standardized and feasible way to address a previously unmet need in PCCM fellowship education. PDs rated the curriculum highly and most plan to continue it in the future. Our limited data set suggests that the curriculum was well received by fellows and faculty and positively impacted perceptions of ambulatory education and preparedness for independent practice. Future study with a larger sample of fellows is needed to better understand the generalizability of these findings.
| S-EPMC8362762 | biostudies-literature
Project description:Over the last year, coronavirus disease 2019 (COVID-19) has spread across the world as a global pandemic, bringing unprecedented changes to the healthcare landscape for patients and physicians. Medical trainees have been similarly affected, as medical schools throughout the United States have implemented remote learning-based curriculums and withdrawn third- and fourth-year students from in-hospital clerkships. Of particular importance is the impact of COVID-19 on current orthopaedic surgery residents applying to subspecialty fellowship programs. Because of the highly transmissible nature of the virus and current social distancing restrictions, orthopaedic sports medicine fellowship interviews are being held virtually during the 2020-2021 application cycle. This transition to videoconference interviewing may de-emphasize an applicant's unique personality or interpersonal interactions that are traditionally captured in a variety of settings during the interview day. In turn, this may lead to increased prioritization of various aspects of the application, such as the applicant's residency program, letters of recommendation, and research productivity. Matching to a sports medicine fellowship program is an inherently competitive process and the COVID-19 pandemic presents novel challenges to orthopaedic residents in their efforts to successfully match. The purpose of this review is to describe the changes made to the orthopaedic sports medicine fellowship interview process resulting from COVID-19 during the 2020-2021 application cycle and discuss how these changes may impact the future fellowship application process. This review discusses the changes made to the orthopaedic sports medicine fellowship interview process caused by COVID-19 during the 2020-2021 application cycle. This review also assesses how such changes may impact the future application process and proposes potential adaptations to the current virtual interview format if it should become the new standard moving forward.
| S-EPMC8365211 | biostudies-literature