Adapting Urology Residency Training in the COVID-19 Era

Kwon, Young Suk; Tabakin, Alexandra L.; Patel, Hiren V.; Backstrand, Jeffrey R.; Jang, Thomas L.; Kim, Isaac Y.; Singer, Eric A.

doi:10.1016/j.urology.2020.04.065

Cited by 64 publications

(85 citation statements)

References 19 publications

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“…The COVID-19 pandemic has rapidly changed urology departments and training programs worldwide [26]. As the need to preserve resources and reduce transmission of COVID-19 increases, prioritizing only high priority surgical cases is paramount.…”

Section: Resultsmentioning

confidence: 99%

Urologic oncology surgery during COVID-19: a rapid review of current triage guidance documents

Shinder

Patel

Sterling

et al. 2020

Urologic Oncology: Seminars and Original Investigations

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The Coronavirus Disease 2019 pandemic placed urologic surgeons, and especially urologic oncologists, in an unprecedented situation. Providers and healthcare systems were forced to rapidly create triage schemas in order to preserve resources and reduce potential viral transmission while continuing to provide care for patients. We reviewed United States and international triage proposals from professional societies, peer-reviewed publications, and publicly available institutional guidelines to identify common themes and critical differences. To date, there are varying levels of agreement on the optimal triaging of urologic oncology cases. As the need to preserve resources and prevent viral transmission grows, prioritizing only high priority surgical cases is paramount. A similar approach to prioritization will also be needed as nonemergent cases are allowed to proceed in the coming weeks. While these decisions will often be made on a case-by-case basis, more nuanced surgeon-driven consensus guidelines are needed for the near future.

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Section: Resultsmentioning

confidence: 99%

Urologic oncology surgery during COVID-19: a rapid review of current triage guidance documents

Shinder

Patel

Sterling

et al. 2020

Urologic Oncology: Seminars and Original Investigations

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“…They also used surgical simulations models for training residents. [36] The most common digital platform used was “Zoom”. Some others used “Microsoft teams”, which has better security features and collaborative options.…”

Section: Discussionmentioning

confidence: 99%

A survey assessing the early effects of COVID-19 pandemic on oral and maxillofacial surgery training programs

Brar

Bayoumy

Salama

et al. 2021

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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The coronavirus disease 2019 (COVID-19) pandemic has specific implications for oral and maxillofacial surgeons due to an increased risk of exposure to the virus during surgical procedures of the aero-digestive tract. The objective of this survey was to evaluate how the COVID-19 pandemic affected oral and maxillofacial surgery (OMFS) training programs during the early phase of the pandemic. Methods A cross-sectional survey was sent to the program directors of 95 out of the 101 accredited OMFS training programs between April 3 rd and May 6 th , 2020. The 35- question survey designed using Qualtrics software, to elicit information about the impact of COVID-19 on OMFS residency programs and the specific modifications made to clinical care, PPE and resident training/wellness to meet the response to the COVID-19 pandemic. Results The survey response rate from OMFS program directors was 35% (33/95) with most responses from states with high incidence of COVID19. All OMFS programs (100%) implemented guidelines to suspend elective and non-urgent surgical procedures and limited ambulatory clinic visits by third week of March, with an average date of March 16 th , 2020 (Date range March 8 th -23 rd ). Programs used telemedicine (40%) and modified in-person visit (51%) protocols for dental and maxillofacial emergency triage to minimize exposure risk of HCP to SARS CoV2. PPE shortage was experienced by 51% of the programs. Almost two-thirds (63%) of the respondents recommended the use of a filtered respirator (i.e., N95 respirator) with full face shield as their preferred PPE, while 21% recommended Powered Air Purifying Respirators (PAPRs) during OMFS procedures. Only (73%) of the programs had resources for resident wellness and stress reduction. Virtual didactic training sessions conducted on digital platforms, most commonly “Zoom” formed a major part of education for all programs. Conclusion All programs promptly responded to the pandemic by making appropriate changes to suspend elective surgery and, to limit patient care to emergent and urgent services. OMFS training programs should give more consideration to provide residents with adequate stress reduction resources to maintain their wellbeing and training to minimize exposure risk during an evolving global epidemic.

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“…The COVID-19 pandemic represents a global emergency with a major impact on healthcare systems worldwide. In this context, Urology has been significantly involved 1 , with a dramatic reorganization of elective surgical activity 1 , 2 , 3 , 4 and a slowdown of Urology residents’ learning curve 5 , 6 , 7 , 8 . Several cross-sectional surveys, investigating the impact of COVID-19 on urological services worldwide, confirmed that the pandemic has imposed great challenges to urology health care providers.…”

Section: Introductionmentioning

confidence: 99%

Deferring Elective Urologic Surgery During the COVID-19 Pandemic: The Patients’ Perspective

Campi

Tellini

Grosso

et al. 2021

Urology

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Objectives To explore the perspective of urological patients on the possibility to defer elective surgery due to the fear of contracting COVID-19. Methods All patients scheduled for elective urological procedures for malignant or benign diseases at two high-volume Centres were administered a questionnaire, through structured telephone interviews, between 24 th and 27 th April 2020. The questionnaire included three questions: 1) In light of the COVID-19 pandemic, would you defer the planned surgical intervention? 2) If yes, when would you be willing to undergo surgery? 3) What do you consider potentially more harmful for your health: the risk of contracting COVID-19 during hospitalization or the potential consequences of delaying surgical treatment? Results Overall, 332 patients were included (51.5% and 48.5% in the oncology and benign groups, respectively). Of these, 47.9% patients would have deferred the planned intervention (33.3% vs 63.4%; p<0.001), while the proportion of patients who would have preferred to delay surgery for more than six months was comparable between the groups (87% vs 80%). These answers were influenced by patient age and ASA score (in the Oncology group) and by the underlying urological condition (in the benign group). Finally, 182 (54.8%) patients considered the risk of COVID-19 potentially more harmful than the risk of delaying surgery (37% vs 73%; p<0.001). This answer was driven by patient age and the underlying disease in both groups. Conclusions Our findings reinforce the importance of shared decision-making before urological surgery, leveraging patients’ values and expectations to refine the paradigm of evidence-based medicine during the COVID-19 pandemic and beyond.

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Adapting Urology Residency Training in the COVID-19 Era

Cited by 64 publications

References 19 publications

Urologic oncology surgery during COVID-19: a rapid review of current triage guidance documents

Urologic oncology surgery during COVID-19: a rapid review of current triage guidance documents

A survey assessing the early effects of COVID-19 pandemic on oral and maxillofacial surgery training programs

Deferring Elective Urologic Surgery During the COVID-19 Pandemic: The Patients’ Perspective

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