Project description:As students do not qualify as essential health care workers, medical education faced severe disruptions during the COVID-19 pandemic including initial suspension of all in-person lectures and on-site rotations. Our Pathology Department was among the first at Northwestern to offer a completely virtual rotation with the goals of: (1) providing a comprehensive introduction to the practice of anatomic and clinical pathology, (2) emphasizing uninterrupted and continued excellence in education, and (3) minimizing exposure risk during the pandemic. The innovative 2-week curriculum incorporated diverse teaching modalities including live and recorded lectures; live and recorded video demonstrations; interactive small group discussions; interactive virtual sign-outs; and written and multimedia assignments, quizzes, and projects. The virtual elective ran from March to July 2020 with 52 total participating medical students. On post-rotation evaluations, students rated the pathology virtual elective 4.7/5.0 compared to other virtual rotations and 4.0/5.0 compared to all rotations (including in-person and virtual). Furthermore, continual improvements were made to the established framework based on rotation feedback such that curriculum content was more abundant and more favorably rated by the last cohort when compared to the first. Finally, although students identified interest in over 10 different medical specialties, all participants expressed increased interest in choosing pathology as a specialty and better understanding of pathology's role in patient care. We hope our detailed description of creating and evaluating a completely virtual elective rotation serves as a model for other departments to improve pathology education and visibility.
Project description:The World Health Organization has recently declared South America the new epicenter of the COVID-19 pandemic, as Brazil has become one of the most affected countries. Besides public health and economic impacts, social isolation has also caused indirect environmental effects. The aim of this study was to assess environmental impacts caused by shifts on solid waste production and management due to the COVID-19 pandemic in Brazil. We have analyzed data from 30 cities, representing a population of more than 53.8 million people (25.4% of the Brazilian population). Unexpectedly, solid waste production in the main cities in Brazil has decreased during the social isolation period, possibly because of reduced activity in commercial areas. The latest data on solid waste in Brazil have revealed that more than 35% of medical waste has not been treated properly. Furthermore, improper disposal of facemasks has been reported in several cities and may increase the risk for COVID-19 spread. The suspension of recycling programs has hindered natural resources from being saved, with emphasis on 24,076 MWh of electric power and 185,929 m3 of potable water - respectively enough to supply 152,475 households and 40,010 people, over a month. Furthermore, total sale price for recyclable materials during the suspension of recycling programs reaches more than 781 thousand dollars, being these materials disposed in landfills - demanding an extra volume of 19,000 m3 - reducing landfill lifespan, and hence causing a double loss: economic and environmental.
Project description:Study objectivesThe COVID-19 pandemic required sleep centers to consider and implement infection control strategies to mitigate viral transmission to patients and staff. Our aim was to assess measures taken by sleep centers due to the COVID-19 pandemic and plans surrounding reinstatement of sleep services.MethodsWe distributed an anonymous online survey to health care providers in sleep medicine on April 29, 2020. From responders, we identified a subset of unique centers by region and demographic variables.ResultsWe obtained 379 individual responses, which represented 297 unique centers. A total of 93.6% of unique centers reported stopping all or nearly all sleep testing of at least one type, without significant differences between adult and pediatric labs, geographic region, or surrounding population density. By contrast, a greater proportion of respondents continued home sleep apnea testing services. A total of 60.3% reduced home sleep apnea testing volume by at least 90%, compared to 90.4% that reduced in-laboratory testing by at least 90%. Respondents acknowledged that they implemented a wide variety of mitigation strategies. While no respondents reported virtual visits to be ≥ 25% of clinical visits prior to the pandemic, more than half (51.9%) anticipated maintaining ≥ 25% virtual visits after the pandemic.ConclusionsAmong surveyed sleep centers, the vast majority reported near-cessation of in-laboratory sleep studies, while a smaller proportion reported reductions in home sleep apnea tests. A large increase in the use of telemedicine was reported, with the majority of respondents expecting the use of telehealth to endure in the future.
Project description:Background: Corona virus disease (COVID-19) was declared a pandemic by the World Health Organization in March 2020. This has affected service delivery among all medical disciplines in India including neurorehabilitation services. Aims and Objectives: The aims and objectives of the study were to assess the effect of COVID-19 pandemic on neurorehabilitation services across India. Methodology: A prospective nationwide survey study was undertaken by the Indian Federation of Neurorehabilitation during the pandemic. A questionnaire was prepared using Google forms software consisting of four sections: demography, neurorehabilitation practice before COVID-19 pandemic, neurorehabilitation practice during COVID-19 pandemic, and continuing medical education during COVID-19 pandemic. Results: Responses (872) were received from neurorehabilitation professionals across the country out of which 2.2% professionals did not give consent for participating in the survey. Participants (36.6%) were practicing traditional or independent referral basis rehabilitation, while 63.4% participants were practicing multidisciplinary rehabilitation. On an average, respective units were conducting 500-750 therapy sessions per month. Majority of the rehabilitation units in India lacked a physiatrist, rehabilitation nurse, music therapist, cognitive therapist, and urologist. Approximately 80% of the rehabilitation units have the basic rehabilitation modalities and advance technology was present in only 20% of the rehabilitation units. During COVID-19 pandemic, 19.5% centers were providing elective services, 50.3% emergency services, 15.6% new outpatient services, and 22.7% were providing follow-up outpatient services. Centers (51.5%) were providing telerehabilitation services for neurological conditions during the times of COVID-19 pandemic. Professionals (61.1%) providing telerehabilitation were working from home. Among the patients who needed neurorehabilitation, 28% were doing their exercises independently, 31% were supervised by caregivers, 17% were supervised by therapists, and 24% were not receiving any therapy. Participants (95.5%) wanted to receive more training in the field of neurorehabilitation. The participants utilized webinars (71%), online courses (22%), case discussion forums (19%), panel discussions (13%), and literature search (8%) during COVID-19 pandemic to continue education. Conclusion: The study reflects the situation of neurorehabilitation service delivery in India during the pandemic as the respondents were from all parts of the country and included most components of the neurorehabilitation team. Neurorehabilitation services were severely affected across India during the COVID-19 pandemic. Tele-neurorehabilitation has emerged as a new service delivery model during the pandemic. Online means of education has emerged as the primary source of continuing medical education during the pandemic.
Project description:As the COVID-19 pandemic progressed in early 2020, social distancing rules and 'lockdowns' brought face-to-face teaching in universities in the UK, and globally, to a halt, leading to an abrupt move to online teaching and learning. This article details student feedback to a course on applied forensic medicine and pathology - framed as 'safeguarding vulnerable patients' - which was adapted for delivery online in response to restrictions imposed by the pandemic. That feedback indicated that the adapted online course was well-received and, overall, it compared favourably with pervious iterations of the blended learning course, which had included a substantial face-to-face teaching component. Students remained engaged with the teaching, and they continued to see the relevance of forensic medicine to their future clinical practice.
Project description:ObjectivesThe COVID-19 pandemic continues to impact health systems across the United States and worldwide in an unprecedented way; however, its influence on frontline medical trainees' educational experiences is unknown. Our objective was to determine the effects of COVID-19 on emergency medicine (EM) training programs and residents.MethodsWe performed a mixed-methods cross-sectional survey study of faculty and residents at programs registered with Foundations of Emergency Medicine. Participants completed an online survey consisting of closed and open-ended response items. We reported descriptive statistics for discrete and continuous data. Free-response data were analyzed qualitatively using a thematic approach.ResultsNinety-two percent of faculty (119/129) and 47% (1,965/4,154) of residents responded to our survey. We identified three major themes related to effects on learning: 1) impact on clinical training, 2) impact on didactic education, and 3) impact on the trainee. Nearly all residencies (96%, 111/116) allowed residents to work with patients suspected of having COVID-19, although fewer (83%, 96/115) allowed residents to intubate them. We found that 99% (1918/1928) of residents experienced virtual didactics. Faculty and trainees noted multiple educational challenges and strategies for adaptation. Trainees also expressed concerns about stress and safety.ConclusionCOVID-19 has impacted EM education in many ways including clinical training, didactic education, and trainee emotional state and concentration. Challenges and suggested solutions for learning in the virtual environment were also identified. While the pandemic continues to evolve and impact EM residents in various ways, our results may inform strategies to support medical educators and trainees during pandemics or other periods of significant disruption or crisis.
Project description:The COVID-19 pandemic has forced educational programs, including pathology residency, to move to a physically distanced learning environment. Tandem microscopic review (also known as "double-scoping") of pathology slides is a traditional cornerstone of pathology education. However, this requires the use of a double- or multi-headed optical light microscope which is unfortunately not amenable to physical distancing. The loss of double-scoping has forced educational innovation in order to continue teaching microscopy. Digital pathology options such as whole slide imaging could be considered; however, financial constraints felt by many departments often render this option cost-prohibitive. Alternatively, a shift toward teaching via dynamic virtual microscopy offers a readily available, physically distanced, and cost-conscious alternative for pathology education. Required elements include a standard light microscope, a mounted digital camera, computers, and videoconferencing software to share a slide image with the learner(s). Through survey data, we show immediate benefits include maintaining the essence of the traditional light microscope teaching experience, and additional gains were discovered such as the ability for educators and learners to annotate images in real time, among others. Existing technology may not be initially optimized for a dynamic virtual experience, resulting in lag time with image movement, problems focusing, image quality issues, and a narrower field of view; however, these technological barriers can be overcome through hardware and software optimization. Herein, we share the experience of establishing a dynamic virtual microscopy educational system in response to the COVID-19 pandemic, utilizing readily available technology in the pathology department of a major academic medical center.
Project description:To date, the practice of global emergency medicine (GEM) has involved being "on the ground" supporting in-country training of local learners, conducting research, and providing clinical care. This face-to-face interaction has been understood as critically important for developing partnerships and building trust. The COVID-19 pandemic has brought significant uncertainty worldwide, including international travel restrictions of indeterminate permanence. Following the 2020 Society for Academic Emergency Medicine meeting, the Global Emergency Medicine Academy (GEMA) sought to enhance collective understanding of best practices in GEM training with a focus on multidirectional education and remote collaboration in the setting of COVID-19. GEMA members led an initiative to outline thematic areas deemed most pertinent to the continued implementation of impactful GEM programming within the physical and technologic confines of a pandemic. Eighteen GEM practitioners were divided into four workgroups to focus on the following themes: advances in technology, valuation, climate impacts, skill translation, research/scholastic projects, and future challenges. Several opportunities were identified: broadened availability of technology such as video conferencing, Internet, and smartphones; online learning; reduced costs of cloud storage and printing; reduced carbon footprint; and strengthened local leadership. Skills and knowledge bases of GEM practitioners, including practicing in resource-poor settings and allocation of scarce resources, are translatable domestically. The COVID-19 pandemic has accelerated a paradigm shift in the practice of GEM, identifying a previously underrecognized potential to both strengthen partnerships and increase accessibility. This time of change has provided an opportunity to enhance multidirectional education and remote collaboration to improve global health equity.
Project description:BackgroundEmergency medicine (EM) physicians have been on the front line of the COVID-19 pandemic. This study aims to determine the impact of COVID-19 pandemic and other related factors such as resource availability and institutional support on well-being, burnout and job-satisfaction of EM physicians in the United States.MethodsA cross-sectional survey study of EM physicians was conducted through the Emergency Medicine Practice Research Network of the ACEP. The survey focused on resource adequacy, institutional support, well-being, and burnout. A total of 890 EM physicians were invited to participate. Both descriptive and risk adjusted, and multivariate regressions were performed with a statistical significance defined as p < 0.05.ResultsEM physicians' response rate was 18.7% (166) from 39 states. Burnout was reported by 74.7% (124) since the start of the pandemic. Factors contributing included work-related emotional strain and anxiety, isolation from family and friends, and increased workload. Those reporting inadequate resources felt ignored by their institutions (p < 0.0001). Physicians who felt there was inadequate institutional support, were also dissatisfied with patient care resources (p = 0.001). Physicians expressing job dissatisfaction were more likely to report feelings of burnout (p = 0.001).ConclusionEM physicians face greater burnout in the COVID-19 pandemic. This may be compounded by resource scarcity, psychological stress, isolation, and job dissatisfaction. Many of the survey respondents reported inadequate mental health services and resources. The findings of this study may help identify solutions to mitigate these issues.