What is the impact of the COVID-19 pandemic on emergency medicine residency training: an observational study

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has engendered difficulties for health systems globally; however, the effect of the pandemic on emergency medicine (EM) residency training programs is unknown. The pandemic has caused reduced volumes of emergency department (ED) patients, except for those with COVID-19 infections, and this may reduce the case exposure of EM residents. The primary objective of this study was to compare the clinical exposure of EM residents between the prepandemic and pandemic periods. Methods This was a retrospective study of EM resident physicians’ training in a tertiary teaching hospital with two branch regional hospitals in Taiwan. We retrieved data regarding patients seen by EM residents in the ED between September 1, 2019, and April 30, 2020. The first confirmed COVID-19 case in Taiwan was reported on January 11, so the pandemic period in our study was defined as spanning from February 1, 2020, to April 30, 2020. The number and characteristics of patients seen by residents were recorded. We compared the data between the prepandemic and pandemic periods. Results The mean number of patients per hour (PPH) seen by EM residents in the adult ED decreased in all three hospitals during the pandemic. The average PPH of critical area of medical ED was 1.68 in the pre-epidemic period and decreased to 1.33 in the epidemic period (p value < 0.001). The average number of patients managed by residents decreased from 1.24 to 0.82 in the trauma ED (p value = 0.01) and 1.56 to 0.51 in the pediatric ED (p value = 0.003) during the pandemic, respectively. The severity of patient illness did not change significantly between the periods. Conclusions The COVID-19 pandemic engendered a reduced ED volume and decreased EM residents’ clinical exposure. All portion of EM residency training were affected by the pandemic, with pediatric EM being the most affected. The patient volume reduction may persist and in turn reduce patients’ case exposure until the pandemic subsides. Adjustment of the training programs may be necessary and ancillary methods of learning should be used to ensure adequate EM residency training.

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What is the impact of the COVID-19 Pandemic on Emergency Medicine Residency Training: An observational study

10.21203/rs.3.rs-42333/v2 ◽

2020 ◽

Author(s):

Hsiang-Yun Lo ◽

Shen-Che Lin ◽

Chung-Hsien Chaou ◽

Yu-Che Chang ◽

Chip-Jin Ng ◽

...

Keyword(s):

Emergency Medicine ◽

Residency Training ◽

Training Programs ◽

Primary Objective ◽

Clinical Exposure ◽

Number Of Patients ◽

Tertiary Teaching ◽

Epidemic Period ◽

Methods Of Learning ◽

The Impact

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has engendered difficulties for health systems globally; however, the effect of the pandemic on emergency medicine (EM) residency training programs is unknown. The pandemic has caused reduced volumes of emergency department (ED) patients, except for those with COVID-19 infections, and this may reduce the case exposure of EM residents. The primary objective of this study was to compare the clinical exposure of EM residents between the prepandemic and pandemic periods. Methods This was a retrospective study of EM resident physicians’ training in a tertiary teaching hospital with two branch regional hospitals in Taiwan. We retrieved data regarding patients seen by EM residents in the ED between September 1, 2019, and April 30, 2020. The first confirmed COVID-19 case in Taiwan was reported on January 11, so the pandemic period in our study was defined as spanning from February 1, 2020, to April 30, 2020. The number and characteristics of patients seen by residents were recorded. We compared the data between the prepandemic and pandemic periods.Results The mean number of patients per hour (PPH) seen by EM residents in the adult ED decreased in all three hospitals during the pandemic. The average PPH of critical area of medical ED was 1.68 in the pre-epidemic period and decreased to 1.33 in the epidemic period (p value < 0.001). The average number of patients managed by residents decreased from 1.24 to 0.82 in the trauma ED (p value= 0.01) and 1.56 to 0.51 in the pediatric ED (p value=0.003) during the pandemic, respectively. The severity of patient illness did not change significantly between the periods. Conclusions The COVID-19 pandemic engendered a reduced ED volume and decreased EM residents’ clinical exposure. All portion of EM residency training were affected by the pandemic, with pediatric EM being the most affected. The patient volume reduction may persist and in turn reduce patients’ case exposure until the pandemic subsides. Adjustment of the training programs may be necessary and ancillary methods of learning should be used to ensure adequate EM residency training.

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What is the Impact of the COVID-19 Pandemic on Emergency Medicine Residency Training: An Observation Study

10.21203/rs.3.rs-42333/v1 ◽

2020 ◽

Author(s):

Hsiang-Yun Lo ◽

Shen-Che Lin ◽

Chung-Hsien Chaou ◽

Yu-Che Chang ◽

Chip-Jin Ng ◽

...

Keyword(s):

Emergency Medicine ◽

Residency Training ◽

Training Programs ◽

Working Hours ◽

Primary Objective ◽

Observation Study ◽

Clinical Exposure ◽

Number Of Patients ◽

Methods Of Learning ◽

The Impact

Abstract BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has engendered difficulties for health systems globally; however, the effect of the pandemic on emergency medicine (EM) residency training programs is unknown. The pandemic has engendered reduced volumes of emergency department (ED) patients, except for those with COVID-19 infections, and this may reduce the case exposure of EM residents. The primary objective of this study was to compare the clinical exposure of EM residents between the prepandemic and pandemic periods. MethodsThis was a retrospective study of EM resident physicians in Taiwan. We performed a medical record review and retrieved data regarding patients seen by EM residents in the ED between September 1, 2019, and April 30, 2020. The number and characteristics of patients seen by residents were recorded, and the training schedules, including clinical working hours, of EM residents were determined. We compared the data between the prepandemic and pandemic periods.ResultsA total of 51,337 patients were managed by 36 EM residents during the 8-month study period. The mean number of patients per hour (PPH) seen by EM residents decreased significantly during the pandemic period. The PPH seen by residents in the adult ED decreased in all three hospitals during the pandemic. The average number of patients managed by residents decreased by 50% and 70% in the trauma ED and pediatric ED during the pandemic, respectively. The severity of patient illness did not change significantly between the periods. ConclusionsThe COVID-19 pandemic engendered a reduced ED volume and decreased EM residents’ clinical exposure. All portion of EM residency training were affected by the pandemic, with pediatric EM being the most affected. The patient volume reduction may persist and in turn reduce patients’ case exposure until the pandemic subsides. Adjustment of the training programs may be necessary and ancillary methods of learning should be used to ensure adequate EM residency training.

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High Fidelity Simulation Is Associated With Good Discriminability In Emergency Medicine Residents’ In-Training Examinations

10.21203/rs.3.rs-80182/v1 ◽

2020 ◽

Author(s):

Shou-Yen Chen ◽

Chung-Hsien Chaou ◽

Shiuan-Ruey Yu ◽

Yu-Che Chang ◽

Chip-Jin Ng ◽

...

Keyword(s):

Emergency Medicine ◽

Residency Training ◽

Test Scores ◽

Training Programs ◽

Primary Objective ◽

High Fidelity ◽

High Fidelity Simulation ◽

Discriminative Ability ◽

Certification Examination ◽

Written Test

Abstract BackgroundIn-training examinations (ITEs), arranged during residency training, evaluate the residents' performances periodically. The ITE usually consists of written and oral forms. There is limited literature focusing on the effectiveness of emergency medicine (EM) resident ITEs in the format of simulation-based examinations, as compared to traditional oral or written tests. Our primary objective is to compare high fidelity simulation with written and oral tests in the evaluation of the residents with different seniority in EM training programs. MethodsDuring the 5-year study period, 8 ITEs were administered to 68 EM residents, and 253 ITE scores were collected. Different ITE scores were calculated and presented as mean and standard deviation. Discrimination of ITE scores between different training years of residency was examined using one-way ANOVA test. ResultsThe high fidelity simulation scores correlated to the EM training year, and residents in their fourth training year (R4) had the highest scores consistently, followed by R3, R2, and then R1. The oral test scores had similar results but not as consistent as the high fidelity simulation tests. The written test scores distribution failed to discriminate the residents' seniority. The high fidelity simulation test had the best discriminative ability and better correlation between different EM residency training years comparing to oral or written forms.ConclusionsHigh fidelity simulation tests had a good discriminative ability and were well correlated to the EM training year. We suggest high-fidelity simulation should be a part of ITE of EM training programs and maybe adopted in EM board certification examination in the future.

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The impact of COVID-19 pandemic on training and mental health of residents: a cross-sectional study

BMC Medical Education ◽

10.1186/s12909-021-02655-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eman Alshdaifat ◽

Amer Sindiani ◽

Wasim Khasawneh ◽

Omar Abu-Azzam ◽

Aref Qarqash ◽

...

Keyword(s):

Mental Health ◽

Residency Training ◽

Training Programs ◽

Cross Sectional Study ◽

Protective Equipment ◽

Sectional Study ◽

Cross Sectional ◽

Surgical Residents ◽

Tertiary Center ◽

The Impact

Abstract Background Residency programs have been impacted by the Coronavirus disease 2019 (COVID-19) pandemic. In this study we aim to investigate and evaluate the impact of the pandemic on residents as well as residency training programs. Methods This was a cross-sectional study including a survey of 43 questions prepared on Google forms and electronically distributed among a convenience sample of residents training at a tertiary center in North Jordan during the COVID-19 pandemic. Data were collected in the period between October 30th and November 8th of 2020. The survey included questions that addressed the impact of the pandemic on residents’ health as well as training programs. The study participants included residents in training at KAUH in 2020 and were stratified according to the type of residency program (surgical residents (SRs) and non-surgical residents (NSRs)). Statistical methods included descriptive analysis, Chi-square or Fisher’s exact test, Mann Whitney U test, and Cramer’s V and r statistics as measures of effect sizes. Results Of all 430 residents, 255 (59%) responded to the survey. A total of 17 (7%) of residents reported being infected with COVID-19 and a significant difference was reported between SRs and NSRs (10% vs 4%, V = .124 “small effect” (95% CI; .017–.229), p = 0.048). Approximately, 106 (42%) reported a decrease in the number of staff working at the clinic and 164 (64%) reported limited access to personal protective equipment during the pandemic. On a 4-point Likert scale for the feeling of anxiety, the median was 2 (2–3 IQR) in the NSRs group, vs 2 (1–2 IQR) in the SRs groups, with the NSRs being more likely to feel anxious (r = 0.13 “small effect” (95% CI; 0.007–0.249), p = .044). Similarly, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; V = .201 “small effect” (95% CI; .078–.313), p = .001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; V = .158 “small effect” (95% CI; .032–.279), p = .012). Conclusion The burden of the ongoing pandemic on the mental health status of residents is very alarming and so providing residents with psychological counseling and support is needed. Also, critical implications on the flow of residency training programs have been noticed. This necessitates adapting and adopting smart educational techniques to compensate for such limitations.

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A Modified Delphi Study to Prioritize Content for a Simulation‐based Pediatric Curriculum for Emergency Medicine Residency Training Programs

AEM Education and Training ◽

10.1002/aet2.10412 ◽

2019 ◽

Vol 4 (4) ◽

pp. 369-378

Author(s):

Jennifer Mitzman ◽

Ilana Bank ◽

Rebekah A. Burns ◽

Michael C. Nguyen ◽

Pavan Zaveri ◽

...

Keyword(s):

Emergency Medicine ◽

Residency Training ◽

Delphi Study ◽

Training Programs ◽

Modified Delphi ◽

Simulation Based

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Strategies to Enhance Wellness in Emergency Medicine Residency Training Programs

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2017.07.007 ◽

2017 ◽

Vol 70 (6) ◽

pp. 891-897 ◽

Cited By ~ 14

Author(s):

Shana Ross ◽

E. Liang Liu ◽

Christian Rose ◽

Adaira Chou ◽

Nicole Battaglioli

Keyword(s):

Emergency Medicine ◽

Residency Training ◽

Training Programs

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Emergency medicine training demographics of physicians working in rural and regional southwestern Ontario emergency departments

CJEM ◽

10.1017/s1481803500015487 ◽

2007 ◽

Vol 9 (06) ◽

pp. 449-452 ◽

Cited By ~ 4

Author(s):

Munsif Bhimani ◽

Gordon Dickie ◽

Shelley McLeod ◽

Daniel Kim

Keyword(s):

Emergency Medicine ◽

Family Medicine ◽

Residency Training ◽

Emergency Departments ◽

Training Programs ◽

Family Physicians ◽

Demographic Information ◽

Trauma Resuscitation ◽

Curriculum Content

ABSTRACT Objectives: We sought to determine the emergency medicine training demographics of physicians working in rural and regional emergency departments (EDs) in southwestern Ontario. Methods: A confidential 8-item survey was mailed to ED chiefs in 32 community EDs in southwestern Ontario during the month of March 2005. This study was limited to nonacademic centres. Results: Responses were received from 25 (78.1%) of the surveyed EDs, and demographic information on 256 physicians working in those EDs was obtained. Of this total, 181 (70.1%) physicians had no formal emergency medicine (EM) training. Most were members of the College of Family Physicians of Canada (CCFPs). The minimum qualification to work in the surveyed EDs was a CCFP in 8 EDs (32.0%) and a CCFP with Advanced Cardiac and Trauma Resuscitation Courses (ACLS and ATLS) in 17 EDs (68.0%). None of the surveyed EDs required a CCFP(EM) or FRCP(EM) certification, even in population centres larger than 50 000. Conclusion: The majority of physicians working in southwestern Ontario community EDs graduated from family medicine residencies, and most have no formal EM training or certification. This information is of relevance to both family medicine and emergency medicine residency training programs. It should be considered in the determination of curriculum content and the appropriate number of residency positions.

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Insights on Otolaryngology Residency Training during the COVID-19 Pandemic

Otolaryngology ◽

10.1177/0194599820922502 ◽

2020 ◽

Vol 163 (1) ◽

pp. 38-41 ◽

Cited By ~ 14

Author(s):

Dana L. Crosby ◽

Arun Sharma

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Learning Strategies ◽

Residency Training ◽

Resident Education ◽

Training Programs ◽

Well Being ◽

Office Visits ◽

Key Indicator ◽

Medical Crisis ◽

The Impact

Otolaryngology residency training programs are facing a novel challenge due to severe acute respiratory syndrome coronavirus 2. The widespread impact and chronicity of this pandemic makes it unique from any crisis faced by our training programs to date. This international medical crisis has the potential to significantly alter the course of training for our current resident cohort. The decrease in clinical opportunities due to the limitations on elective surgical cases and office visits as well as potential resident redeployment could lead to a decline in overall experience as well as key indicator cases. It is important that we closely monitor the impact of this pandemic on resident education and ensure the implementation of alternative learning strategies while maintaining an emphasis on safety and well-being.

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A Comparison between Emergency Medicine Residency Training Programs in the United States and Saudi Arabia from the Residents’ Perception

Emergency Medicine International ◽

10.1155/2014/362624 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Khaled Alghamdi ◽

Abdulaziz Alburaih ◽

Mary Jo Wagner

Keyword(s):

United States ◽

Emergency Medicine ◽

Saudi Arabia ◽

Residency Training ◽

Training Programs ◽

The United States ◽

Training Techniques ◽

Academic Activities ◽

The Usa ◽

Strongly Agree

Objectives. This study was designed to compare the trainees’ perception of emergency medicine (EM) training in the United States (US) and Saudi Arabia (SA) and to identify residents’ levels of confidence and points of satisfaction in education, procedural skills, and work environment.Method. An IRB-exempt anonymous web-based survey was distributed to five EM residency training programs in the USA and three residency regions in SA.Results. 342 residents were polled with a 20% response rate (16.8% USA and 25.8% SA). The Saudi residents responded less positively to the questions about preparation for their boards’ examinations, access to multiple educational resources, and weekly academic activities. The Saudi trainees felt less competent in less common procedures than US trainees. American trainees also more strongly agree that they have more faculty interest in their education compared to the Saudi trainees. The Saudi residents see more patients per hour compared to their US peers.Conclusion. These findings may be due to the differences in training techniques including less formal didactics and simulation experience in SA and more duty hour regulations in the USA.

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Biomarkers-based Personalized Follow-up in Chronic Heart Failure Improves Patient’s Outcomes and Reduces Care Associate Cost

10.21203/rs.3.rs-117453/v1 ◽

2020 ◽

Author(s):

Antonio Leon Justel ◽

Jose Ignacio Morgado Garcia-Polavieja ◽

Ana Isabel Alvarez Rios ◽

Francisco Jose Caro Fernandez ◽

Pedro Agustin Pajaro Merino ◽

...

Keyword(s):

Incidence Rates ◽

Primary Objective ◽

Economic Problem ◽

Functional Class ◽

Post Intervention ◽

Number Of Patients ◽

Before And After ◽

Ed Visits ◽

The Impact

Abstract BACKGROUNDHeart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF.METHODSThis is a real-world, before-and after-intervention trial, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before and after an intervention. The primary objective was the rate of readmissions, due to a HF event, post-intervention compared to pre-intervention. Secondary outcomes compared the rate of ED visits and the number of patients who had reduced NYHA score pre and post-intervention. A cost- analysis was also performed on these data.RESULTSAdmission rates significantly decreased by 41% after the intervention (total length of stay was reduced by 55%). The rate of ED visits was reduced by 55%. Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was €139,717.65 for the whole group over 1 year.CONCLUSIONSA personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care- associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

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