Post-traumatic growth among general surgery residents during the COVID-19 pandemic: Emerging stronger in the face of adversity.
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ABSTRACT:
SUBMITTER: Rasic G
PROVIDER: S-EPMC8461010 | biostudies-literature | 2021 Sep
REPOSITORIES: biostudies-literature
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Post-traumatic growth among general surgery residents during the COVID-19 pandemic: Emerging stronger in the face of adversity.
Rasic Gordana G Alonso Andrea A He Katherine K Chugh Priyanka P Sacks Olivia O Collado Loreski L Whang Edward E Kristo Gentian G
American journal of surgery 20210924 4
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Project description: Not available
| S-EPMC9077025 | biostudies-literature
Project description:BackgroundThe educational process of young doctors should be a topic of high interest, since it is central to preparing the new generations of healthcare providers. The COVID-19 pandemic has affected the medical system on multiple levels, including medical education.MethodsWe conducted a descriptive survey study, designed to reflect the impact of the pandemic on the training of general surgery residents. Two questionnaires were delivered to general surgery residents at two different periods: one in the pre-COVID-19 era (December 2019) and one in the COVID-19 era (December 2020). Data were gathered on participants' characteristics, current clinical practice and knowledge, extracurricular activities, and involvement in the management of COVID-19 cases.ResultsWe registered 33 responses in the pre-COVID-19 era and 45 responses in the COVID-19 era. Most participants felt that the pandemic significantly affected their training in classic and laparoscopic surgery. The number of days per week that the residents were active in the operating room and the possibility of training in laparoscopic surgery outside the hospital decreased significantly in the COVID-19 era. Most participants consider they have not gained sufficient knowledge to practice laparoscopic surgery or to assure their employment in another hospital after finishing their residency program.ConclusionThe pandemic reduced the hands-on activities of general surgery residents, while training in laparoscopy was deficient both before and during the pandemic. New training methods should be sought and used in order to adapt the educational system to the current context.
| S-EPMC9461445 | biostudies-literature
Project description:Post-traumatic stress disorder (PTSD) can result from a traumatic experience that elicits emotions of fear, helpless or horror. Most individuals remain asymptomatic or symptoms quickly resolve, but in a minority intrusive imagery and nightmares, emotional numbing and avoidance, and hyperarousal persist for decades. PTSD is associated with psychiatric and medical co-morbidities, increased risk for suicide, and with poor social and occupational functioning. Psychotherapy and pharmacotherapy are common treatments. Whereas, research supports the efficacy of the cognitive behavioral psychotherapies, there is insufficient evidence to unequivocally support the efficacy of any specific pharmacotherapy. Proven effective pharmacologic agents are sorely needed to treat core and targeted PTSD symptoms, and for prevention. This review describes current and emerging pharmacotherapies that advance these goals.
| S-EPMC2791537 | biostudies-literature
Project description:IntroductionPoor operative ergonomics can lead to muscle fatigue and injury. However, formal ergonomics education is uncommon in surgical residencies. Our study examines the prevalence of musculoskeletal (MSK) symptoms, baseline ergonomics knowledge, and the impact of an ergonomics workshop in general surgery residents.MethodsAn anonymous voluntary presurvey and postsurvey was distributed to all general surgery residents at a single academic residency, assessing resident characteristics, MSK symptoms, and ergonomic knowledge before and after an ergonomics workshop. The workshop consisted of a lecture and a personalized posture coaching session with a physiatrist.ResultsThe presurvey received 33/35 (94%) responses. Of respondents, 100% reported some degree of MSK pain. Prevalence of muscle stiffness and fatigue decreased with increasing height. Females reported higher frequencies of MSK pain (P = 0.01) and more muscle fatigue than males (100% versus 73%, P = 0.03). All residents reported little to no ergonomics knowledge with 68% reporting that ergonomics was rarely discussed in the operating room. The postsurvey received 26/35 (74%) responses. Of respondents, 100% reported the workshop was an effective method of ergonomics education. MSK symptom severity improved in 82% of residents. Reports that ergonomics was rarely discussed in the operating room significantly decreased to 22.8% of residents (P < 0.01).ConclusionsSurgical resident ergonomics knowledge is poor and MSK symptoms are common. Resident characteristics are associated with different MSK symptoms. Didactic teaching and personalized posture coaching improve ergonomics knowledge and reduce MSK symptom severity. Surgical residencies should consider implementing similar interventions to improve resident wellbeing.
| S-EPMC10084513 | biostudies-literature
Project description:BackgroundTelemedicine provides healthcare to patients at a distance from their treating clinician. There is a lack of high-quality evidence to support the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial-conducted before the COVID-19 pandemic-aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) by telephone compared to face-to-face follow-up after uncomplicated general surgical procedures.MethodsPatients following laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic. Patient demographics, perioperative details and postoperative outcomes were compared. Patient satisfaction was assessed via a standardized Likert-style scale.ResultsOne hundred and twenty-three patients were randomized over 12 months. Mean consultation times were significantly shorter for telemedicine than face-to-face clinics (telemedicine 10.52 ± 7.2 min, face-to-face 15.95 ± 9.96 min, P = 0.0021). There was no difference between groups in the attendance rates, nor the incidence or detection of postoperative complications. Of the 58 patients randomized to the telemedicine arm, 40% reported high, and 60% reported very high satisfaction with the method of clinic follow-up.ConclusionTelemedicine postoperative follow-up is safe and acceptable to patients and could be considered in patients undergoing uncomplicated benign general surgery.
| S-EPMC9826044 | biostudies-literature
Project description:FKBP5 regulates the cortisol-binding affinity and nuclear translocation of the glucocorticoid receptor. Polymorphisms at the FKBP5 locus have been associated with increased recurrence risk of depressive episodes and rapid response to antidepressant treatment. A recent study showed that FKBP5 genotypes moderated the risk of post-traumatic stress disorder (PTSD) symptoms associated with childhood maltreatment. One thousand one hundred forty-three European Americans (EAs) and 1284 African Americans (AAs) recruited for studies of the genetics of substance dependence were also screened for lifetime PTSD. Four single-nucleotide polymorphisms (SNPs) in FKBP5, rs3800373, rs9296158, rs1360780, and rs9470080, were genotyped on the complete sample. Logistic regression analyses were performed to explore the interactive effect of FKBP5 polymorphisms and childhood adversity on the risk for PTSD. After correction for multiple testing, childhood adversity significantly increased the risk for PTSD. FKBP5 genotypes were not associated with the development of the disorder. In AAs, one of the SNPs, rs9470080, moderated the risk of PTSD that was associated with childhood abuse. Without childhood adverse experiences, participants with the TT genotype of this SNP had the lowest risk for PTSD, whereas they had the highest risk for PTSD after childhood adversity exposure. In addition, in EAs, alcohol dependence was observed to interact with childhood adverse experiences, and also FKBP5 polymorphisms, to increase the risk for PTSD. This study provides further evidence of a gene x environment effect of FKBP5 and childhood abuse on the risk for PTSD in AAs. Further study is required in other populations.
| S-EPMC2946626 | biostudies-literature
Project description:ImportancePrevious studies have shown high rates of mistreatment among US general surgery residents, leading to poor well-being. Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) residents represent a high-risk group for mistreatment; however, their experience in general surgery programs is largely unexplored.ObjectiveTo determine the national prevalence of mistreatment and poor well-being for LGBTQ+ surgery residents compared with their non-LGBTQ+ peers.Design, setting, and participantsA voluntary, anonymous survey adapting validated survey instruments was administered to all clinically active general surgery residents training in Accreditation Council for Graduate Medical Education-accredited general surgery programs following the 2019 American Board of Surgery In-Training Examination.Main outcomes and measuresSelf-reported mistreatment, sources of mistreatment, perceptions of learning environment, career satisfaction, burnout, thoughts of attrition, and suicidality. The associations between LGBTQ+ status and (1) mistreatment, (2) burnout, (3) thoughts of attrition, and (4) suicidality were examined using multivariable regression models, accounting for interactions between gender and LGBTQ+ identity.ResultsA total of 6956 clinically active residents completed the survey (85.6% response rate). Of 6381 respondents included in this analysis, 305 respondents (4.8%) identified as LGBTQ+ and 6076 (95.2%) as non-LGBTQ+. Discrimination was reported among 161 LGBTQ+ respondents (59.2%) vs 2187 non-LGBTQ+ respondents (42.3%; P < .001); sexual harassment, 131 (47.5%) vs 1551 (29.3%; P < .001); and bullying, 220 (74.8%) vs 3730 (66.9%; P = .005); attending surgeons were the most common overall source. Compared with non-LGBTQ+ men, LGBTQ+ residents were more likely to report discrimination (men: odds ratio [OR], 2.57; 95% CI, 1.78-3.72; women: OR, 25.30; 95% CI, 16.51-38.79), sexual harassment (men: OR, 2.04; 95% CI, 1.39-2.99; women: OR, 5.72; 95% CI, 4.09-8.01), and bullying (men: OR, 1.51; 95% CI, 1.07-2.12; women: OR, 2.00; 95% CI, 1.37-2.91). LGBTQ+ residents reported similar perceptions of the learning environment, career satisfaction, and burnout (OR, 1.22; 95% CI, 0.97-1.52) but had more frequent considerations of leaving their program (OR, 2.04; 95% CI, 1.52-2.74) and suicide (OR, 1.95; 95% CI, 1.26-3.04). This increased risk of suicidality was eliminated after adjusting for mistreatment (OR, 1.47; 95% CI, 0.90-2.39).Conclusions and relevanceMistreatment is a common experience for LGBTQ+ surgery residents, with attending surgeons being the most common overall source. Increased suicidality among LGBTQ+ surgery residents is associated with this mistreatment. Multifaceted interventions are necessary to develop safer and more inclusive learning environments.
| S-EPMC8529519 | biostudies-literature
Project description:BackgroundCOVID-19 has placed demands on General Surgery residents, who are already at high risk of burnout. This study examined the pandemic's impact on burnout and wellness among General Surgery residents at a large training program.MethodsGeneral Surgery residents at our institution completed a survey focused on self-reported burnout, mental health, perceptions of wellness resources, and changes in activities during the pandemic. Burnout was measured using the Maslach Burnout Inventory (MBI). Unsupervised machine learning (k-means clustering) was used to identify profiles of burnout and comparisons between profiles were made.ResultsOf 82 eligible residents, 51 completed the survey (62% response rate). During COVID-19, 63% of residents had self-described burnout, 43% had depression, 18% acknowledged binge drinking/drug use, and 8% had anxiety. There were no significant differences from pre-pandemic levels (p all >.05). Few residents perceived available wellness resources as effective (6%). Based on MBI scores, the clustering analysis identified three clusters, characterized as "overextended", "engaged", and "ineffective". Engaged residents had the least concerning MBI scores and were significantly more likely to exercise, retain social contact during the pandemic, and had less self-reported anxiety or depression. Research residents were overrepresented in the ineffective cluster (46%), which had high rates of self-reported burnout (77%) and was characterized by the lowest personal accomplishment scores. Rates of self-reported burnout for overextended and engaged residents were 73% and 48%, respectively.ConclusionSurgical residents have high rates of self-reported burnout and depression during the COVID-19 pandemic. Clusters of burnout may offer targets for individualized intervention.
| S-EPMC9382580 | biostudies-literature
Project description:ObjectiveThis scoping review explores the existing literature related to post-pandemic face-to-face learning environments for undergraduate students following their participation in virtual classes during the Covid-19 pandemic. The secondary objectives are focused to identify the cognitive; emotional, or communicative demands that characterize students; changes in pedagogical strategies; and primary recommendations regarding post-pandemic face-to-face education in the context of Covid-19.IntroductionThe global emergency created by the presence of COVID-19 has led to significant change in the daily lives of people worldwide, ranging from lockdowns to the proliferation of virtual channels for social interaction and learning. Interest in its effects remains relevant in various fields including social, economic, health, technological, and educational studies. The transition back to face-to-face studies in university settings requires new adjustment processes for both students and teachers, necessitating pedagogical transformations and addressing cognitive, emotional, communicative, and habituation demands. Studies on the return to face-to-face studies in university settings are relatively scarce and warrant in-depth research.Inclusion criteriaThis review will include studies completed and published in calendar years 2022 and 2024 that involve post-pandemic face-to-face learning environments for undergraduate students from any geographical area.MethodologyThis scoping review will follow the JBI methodology for conducting scoping reviews. The following databases will be used: Academic Search Complete, Inter-American Development Bank, CLACSO, and The UNESCO Institute for Higher Education in Latin America and the Caribbean (IESALC), Dimensions, DOAB, DOAJ, ERIC, LILACS, Psicodoc, Redalyc, Redib, Scielo, Scopus, Dialnet, Web Of Science, Latindex, Google Scholar, SocArXiv. The search will aim to locate publications without language restrictions from any geographic location, including peer-reviewed articles, grey literature, preprints, technical notes, and policy reports. Three independent reviewers will screen, retrieve and review full-text studies and extract data. Consensus will be sought in the event of disagreement. The search results will be presented in the PRISMA-ScR flowchart. A narrative summary will also be included (Tricco AC 2018).Trial registrationRegistration of systematic reviews: Open Science Framework (https://doi.org/10.17605/OSF.IO/6P9QB).
| S-EPMC11559994 | biostudies-literature
Project description:ObjectiveTo determine differences in entrustable professional activity (EPA) assessments between male and female general surgery residents.Summary background dataEvaluations play a critical role in career advancement for physicians. However, female physicians in training receive lower evaluations and underrate their own performance. Competency-based assessment frameworks, such as EPAs, may help address gender bias in surgery by linking evaluations to specific, observable behaviors.MethodsIn this cohort study, EPA assessments were collected from July 2018 to May 2020. The effect of resident sex on EPA entrustment levels was analyzed using multiple linear and ordered logistic regressions. Narrative comments were analyzed using latent dirichlet allocation to identify topics correlated with resident sex.ResultsOf the 2480 EPAs, 1230 EPAs were submitted by faculty and 1250 were submitted by residents. After controlling for confounding factors, faculty evaluations of residents were not impacted by resident sex (estimate = 0.09, P = 0.08). However, female residents rated themselves lower by 0.29 (on a 0-4 scale) compared to their male counterparts (P < 0.001). Within narrative assessments, topics associated with resident sex demonstrated that female residents focus on the "guidance" and "supervision" they received while performing an EPA, while male residents were more likely to report "independent" action.ConclusionsFaculty assessments showed no difference in EPA levels between male and female residents. Female residents rate themselves lower by nearly an entire post graduate year (PGY) level compared to male residents. Latent dirichlet allocation -identified topics suggest this difference in self-assessment is related to differences in perception of autonomy.
| S-EPMC8514571 | biostudies-literature