ObjectivesDuring the COVID-19 pandemic wearing a mask in public has been recommended in some settings and mandated in others. How often this advice is followed, how well, and whether it inadvertently leads to more disease transmission opportunities due to a combination of improper use and physical distancing lapses is unknown.DesignCross-sectional observational study performed in June–August 2020.SettingEleven outdoor and indoor public settings (some with mandated mask use, some without) each in Toronto, Ontario, and in Portland, Oregon.ParticipantsAll passers-by in the study settings.Outcome measuresMask use, incorrect mask use, and number of breaches (ie, coming within 2 m of someone else where both parties were not properly masked).ResultsWe observed 36 808 persons, the majority of whom were estimated to be aged 31–65 years (49%). Two-thirds (66.7%) were wearing a mask and 13.6% of mask-wearers wore them incorrectly. Mandatory mask-use settings were overwhelmingly associated with mask use (adjusted OR 79.2; 95% CI 47.4 to 135.1). Younger age, male sex, Torontonians, and public transit or airport settings (vs in a store) were associated with lower adjusted odds of wearing a mask. Mandatory mask-use settings were associated with lower adjusted odds of mask error (OR 0.30; 95% CI 0.14 to 0.73), along with female sex and Portland subjects. Subjects aged 81+ years (vs 31–65 years) and those on public transit and at the airport (vs stores) had higher odds of mask errors. Mask-wearers had a large reduction in adjusted mean number of breaches (rate ratio (RR) 0.19; 95% CI 0.17 to 0.20). The 81+ age group had the largest association with breaches (RR 7.77; 95% CI 5.32 to 11.34).ConclusionsMandatory mask use was associated with a large increase in mask-wearing. Despite 14% of them wearing their masks incorrectly, mask users had a large reduction in the mean number of breaches (disease transmission opportunities). The elderly and transit users may warrant public health interventions aimed at improving mask use.
Wearable technology and live video conferencing: The development of an affordable virtual teaching platform to enhance clinical skills education during the COVID-19 pandemic Technologie portable et vidéoconférence en direct : élaboration d'une plateforme d'enseignement virtuel abordable pour améliorer l'enseignement des habiletés cliniques pendant la pandémie de la COVID-19
Background: Trauma resuscitation skills are an essential part of medical training. Airway management skills are often learned via simulation-based training, but physical distancing restrictions have forced medical schools to transition their preclinical curricula to a virtual format. A wearable, point-of-view (POV), live streaming tool was piloted in a virtual airway management workshop to preclinical medical students to address limitations in the standard online curriculum. Methods: An anesthesiologist instructor donned a chest-mounted smartphone that captured POV video as it was connected to a Zoom video conference call. Simultaneously, a second camera view from a different angle was streamed from a laptop webcam. Preclinical medical student attendees watched the facilitator demonstrate airway management and resuscitation skills on a simulation mannequin. Student perceptions of the workshop were assessed via standardised course evaluations administered through the online student portal and a questionnaire distributed by the course representative. Results: Qualitative and quantitative course evaluation data showed that although this platform may not completely substitute in-person learning, students appreciated the alternative teaching style, particularly the use of POV video and multiple camera views. Generally, students believed that the learning objectives were achieved. Camera stability, camera positioning, and the distracting nature of the virtual student-instructor interactions were identified as areas for improvement. Conclusions: Moving forward, this innovative workshop format can act as a valuable framework for other institutions that wish to bridge gaps in current virtual education methods and enhance technical skills training in medical learners.
Implication Statement We piloted a virtual teaching tool comprised of a chest-mounted smartphone streaming point-of-view footage over videoconferencing software to deliver a physical exam skills session. Compared to medical students taught via third person view through pre-recorded video followed by preceptor-led discussion, a higher proportion of students taught via point-of-view wearable technology reported improved knowledge of demonstrated skills and feeling engaged, comfortable interacting with their tutor, and better able to visualize demonstrated exam maneuvers. This accessible, affordable, and easily replicable innovation can potentially enhance virtual clinical skills teaching and enable novel distant clinical learning opportunities for healthcare professions students and educators.
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