Finding Focus in Crisis: Resident-Driven Graduate Medical Education at a Military Training Facility during the COVID-19 Pandemic

Reed, Donovan; Hill, Marshall D; Justin, Grant A.; Giles, Gregory B; Santamaria, Joseph; Hobbs, Samuel D.; Davies, Brett W.; Legault, Gary L

doi:10.1093/milmed/usaa193

Cited by 5 publications

(6 citation statements)

References 6 publications

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“…Developing and implementing competency-based assessment to help adequately gauge resident preparation, as well as alternative training strategies (e.g. virtual reality simulators) [4][5][6] to provide residents with sufficient experience in a time with decreased surgical volume was a key task of residency program directors with the 2020 graduating classes [8].…”

Section: Discussionmentioning

confidence: 99%

“…Following guidance urging provision of only urgent or emergent care from March to July 2020 in the United States (U.S.), total encounters in ophthalmology fell nearly 80% [1][2][3]. Residency programs had to consider methods to supplement resident learning during this time, especially considering that these shutdowns occurred in the months prior to residency graduation in June 2020 [4][5][6]. Residency is a crucial time for residents to gain surgical skills in preparation for fellowship and/or career as a practicing ophthalmologist, primarily through guided exposure to diverse cases performed in the operating room.…”

Section: Introductionmentioning

confidence: 99%

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The impact of COVID-19 on ophthalmology resident surgical experience: a retrospective cross-sectional analysis

et al. 2022

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Background The coronavirus disease 2019 (COVID-19) pandemic caused significant disruption to in-office and surgical procedures in the field of ophthalmology. The magnitude of the impact of the pandemic on surgical training among ophthalmology residents is not known. This study aims to quantify changes in average case logs among United States (U.S.) ophthalmology residency graduates prior to and during the COVID-19 pandemic. Methods Retrospective, cross-sectional analysis of aggregate, national data on case logs of U.S. ophthalmology residency graduates from 2012 to 2020. The yearly percent change in the average number of procedures performed in the Accreditation Council for Graduate Medical Education (ACGME) ophthalmology resident case logs were analyzed using linear regression on log-transformed dependent variables. The average percent change from 2019 to 2020 was compared to the average yearly percent change from 2012 to 2019 for procedures performed as the primary surgeon, and primary surgeon and surgical assistant (S + A), as well as procedures for which there are ACGME minimum graduating numbers. Results Across all procedures and roles, average case logs in 2020 were lower than the averages in 2019. While average total cases logged as primary surgeon increased yearly by 3.2% (95% CI: 2.7, 3.8%, p < 0.001) from 2012 to 2019, total primary surgeon case logs decreased by 11.2% from 2019 to 2020. Cataract (-22.0%) and keratorefractive (-21.1%) surgery experienced the greatest percent decrease in average primary surgeon cases logged from 2019 to 2020. Average total cases logged as S + A experienced an average yearly increase by 1.2% (95% CI: 0.9,1.6%, p < 0.001) prior to 2020, but decreased by 9.6% from 2019 to 2020. For ACGME minimum requirements, similar changes were observed. Specifically, the average case logs in YAG, SLT, filtering (glaucoma), and intravitreal injections had been increasing significantly prior to 2020 (p < 0.05 for all) but decreased in 2020. Conclusions These findings demonstrate the vulnerability of ophthalmology residency programs to a significant interruption in surgical volume. There is a critical need for development of competency-based, rather than volume-based, requirements to evaluate readiness for independent practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of COVID-19 on ophthalmology resident surgical experience: a retrospective cross-sectional analysis

et al. 2022

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“…Didactic lectures remain the primary means of disseminating information to learners, with many educators using synchronous tools such as Zoom to deliver content due to the COVID-19 pandemic. 18 Recent research has indicated that residents may be less engaged and distracted by non-conference activities during synchronous virtual didactic learning. 19 Escape rooms have a theoretical basis to motivate learners as described by self-determination theory.…”

Section: How Does This Improve Population Health?mentioning

confidence: 99%

A Virtual Escape Room versus Lecture on Infectious Disease Content: Effect on Resident Knowledge and Motivation

Dimeo

Astemborksi

Smart

et al. 2022

WestJEM

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Introduction: Medical educators are constantly seeking methods to increase engagement in the era of coronavirus disease 2019 (COVID-19) where virtual and blended learning formats are increasingly common. Educational escape rooms have previously been used to motivate learners, enhance communication skills, and cultivate teamwork. However, it is not known whether escape rooms increase learner knowledge as compared to a lecture format. Methods: This quasi-experimental study included 30 emergency medicine residents at two programs who participated in both a virtual escape room and a lecture on infectious disease content. Learners completed a pre- and post-quiz and a tool to gauge resident motivation for each activity (the Intrinsic Motivation Inventory [IMI]). The primary objective was to determine a change in knowledge as a result of the activities, and a secondary objective was to determine resident motivation for each format. Results: At both programs learners demonstrated a significant improvement in their pre- vs. post-quiz scores for the escape rooms (University of California Irvine [UCI]: 77.8% to 88.9%, p = 0.028, Prisma: 73.81% to 89.68%, p = 0.002), whereas the lectures did not impact a statistical improvement (UCI: 73.8% to 78.6%, p = 0.460, Prisma: 85.71% to 91.27%, p = 0.236). Learners at UCI noted equivalent results on the IMI for both formats, while residents at Prisma noted they were more motivated by the escape room. Conclusion: Emergency medicine residents at two programs participating in a virtual escape room demonstrated a statistical increase in knowledge on infectious disease content as compared to a lecture format and reported positive motivation ratings for both formats, with one program preferring the escape room.

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“…In the UK, medical colleges also provided virtual learning 9 , however, a survey of nal year UK medical students, reported 77.3 % medical elective placements being cancelled with only 1.6% being replaced by formative online modules 10 . Similarly, at a postgraduate level residency training programs in Canada 11 , ACGME accredited residency programs in the US 12 and speciality residency programs like neurology 13 started relying on e-learning tools for continuing didactic lectures and providing training in skills and procedures. Our study has also shown the same trend with QU CMED and HMC moving from a predominantly face-to-face delivery of education to online learning albeit after a short break.…”

Section: Models Of Education and Perceptionsmentioning

confidence: 99%

A Survey on the Impact of COVID 19 on Undergraduate and Postgraduate Medical Education in Qatar

Thomas

Suleiman

Allen

et al. 2021

Preprint

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BackgroundCOVID-19 pandemic has affected all dimensions of day to day life across the world and medical education was no exception. In Qatar, two institutions provide undergraduate medical education; Qatar University - College of medicine and Weill Cornell Medical College, Qatar and post graduate medical education is provided by tertiary care public hospitals under Hamad Medical Corporation (HMC) through Accreditation Council for Graduate Medical Education -International (ACGME-I) accredited residency and fellowship programs. With this study we aimed to understand the impact of nationwide restrictions on medical education in Qatar.MethodsWe conducted a cross sectional study utilising an online questionnaire between April and October 2020. Two questionnaires for the faculty and trainees each were designed to address the objectives. The questionnaires addressed barriers to delivery of medical education and perceptions on the models of education used.ResultsMajority of trainees (58.5%) responded that the pandemic has adversely affected medical education at both the undergraduate and postgraduate levels. Trainees (58.5%) and faculty (35.7%) reported an increased reliance on e-learning. Trainees preferred face to face education (33.5%) while the faculty (37.1%) preferred a combination of different models of education delivery. Although 52.5% of the faculty had no previous experience of delivering education using e-learning modalities, but 58.9% felt confident in using e-learning software.ConclusionsFaculty and trainees agree that the COVID-19 pandemic has had a significant impact on the provision of medical education and training in Qatar, with an increased dependence on e-learning. As trainee’s prefer face-to-face models of education, we may have to consider restructuring of medical curricula in order to ensure that optimum learning is achieved via e-learning, while at the same time enhancing our use, knowledge and understanding of the e -learning methods as they may be an essential way of delivering education in the future.

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Finding Focus in Crisis: Resident-Driven Graduate Medical Education at a Military Training Facility during the COVID-19 Pandemic

Cited by 5 publications

References 6 publications

The impact of COVID-19 on ophthalmology resident surgical experience: a retrospective cross-sectional analysis

The impact of COVID-19 on ophthalmology resident surgical experience: a retrospective cross-sectional analysis

A Virtual Escape Room versus Lecture on Infectious Disease Content: Effect on Resident Knowledge and Motivation

A Survey on the Impact of COVID 19 on Undergraduate and Postgraduate Medical Education in Qatar

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