scholarly journals What is the impact of the COVID-19 pandemic on residency training: a systematic review and analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shou-Yen Chen ◽  
Hsiang-Yun Lo ◽  
Shang-Kai Hung
Keyword(s):  
Systematic Review ◽  
Medical Education ◽  
Residency Training ◽  
The United States ◽  
Case Volume ◽  
Target Groups ◽  
Clinical Teachers ◽  
Aggregated Data ◽  
Crucial Information ◽  
The Impact

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has greatly affected medical education in addition to clinical systems. Residency training has probably been the most affected aspect of medical education during the pandemic, and research on this topic is crucial for educators and clinical teachers. The aim of this study was to understand the effect of the COVID-19 pandemic comprehensively through a systematic review and analysis of related published articles. Methods A systematic review was conducted based on a predesigned protocol. We searched MEDLINE and EMBASE databases until November 30, 2020, for eligible articles. Two independent reviewers extracted data by using a customized form to record crucial information, and any conflicts between the two reviewers were resolved through discussion with another independent reviewer. The aggregated data were summarized and analyzed. Results In total, 53 original articles that investigated the effect of the COVID-19 pandemic on residency training were included. Studies from various regions were included in the research, with the largest percentage from the United States (n = 25, 47.2%). Most of these original articles were questionnaire-based studies (n = 44, 83%), and the research target groups included residents (79.55%), program directors (13.64%), or both (6.82%). The majority of the articles (n = 37, 84.0%) were published in countries severely affected by the pandemic. Surgery (n = 36, 67.92%) was the most commonly studied field. Conclusions The COVID-19 pandemic has greatly affected residency training globally, particularly surgical and interventional medical fields. Decreased clinical experience, reduced case volume, and disrupted education activities are major concerns. Further studies should be conducted with a focus on the learning outcomes of residency training during the pandemic and the effectiveness of assisted teaching methods.

scholarly journals What is The Impact of The COVID-19 Pandemic on Residency Training: A Systematic Review and Analysis

2021 ◽  
Author(s):  
Shang-Kai Hung ◽  
Shou-Yen Chen ◽  
Hsiang-Yun Lo
Keyword(s):  
Systematic Review ◽  
Medical Education ◽  
Residency Training ◽  
The United States ◽  
Case Volume ◽  
Target Groups ◽  
Clinical Teachers ◽  
Aggregated Data ◽  
Crucial Information ◽  
The Impact

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has greatly affected medical education in addition to clinical systems. Residency training has probably been the most affected aspect of medical education during the pandemic, and research on this topic is crucial for educators and clinical teachers. The aim of this study was to understand the effect of the COVID-19 pandemic comprehensively through a systematic review and analysis of related published articles. Methods A systematic review was conducted based on a predesigned protocol. We searched MEDLINE and EMBASE databases until November 30, 2020, for eligible articles. Two independent reviewers extracted data by using a customized form to record crucial information, and any conflicts between the two reviewers were resolved through discussion with another independent reviewer. The aggregated data were summarized and analyzed. Results In total, 53 original articles that investigated the effect of the COVID-19 pandemic on residency training were included. Studies from various regions were included in the research, with the largest percentage from the United States (n = 25, 47.2%). Most of these original articles were questionnaire-based studies (n = 44, 83%), and the research target groups included residents (79.55%), program directors (13.64%), or both (6.82%). The majority of the articles (n = 37, 84.0%) were published in countries severely affected by the pandemic. Surgery (n = 36, 67.92%) was the most commonly studied field. Conclusions The COVID-19 pandemic has greatly affected residency training globally, particularly surgical and interventional medical fields. Decreased clinical experience, reduced case volume, and disrupted education activities are major concerns. Further studies should be conducted with a focus on the learning outcomes of residency training during the pandemic and the effectiveness of assisted teaching methods.

scholarly journals Efficacy of hydrofibre dressing following total joint arthroplasty: a meta-analysis of randomised controlled trials

2021 ◽  
pp. 112070002110126
Author(s):  
Raman Mundi ◽  
Harman Chaudhry ◽  
Seper Ekhtiari ◽  
Prabjit Ajrawat ◽  
Daniel M Tushinski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Infection ◽  
The United States ◽  
Joint Arthroplasty ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Observable Effect ◽  
The Impact

Introduction: In the United States, over 1,000,000 total joint arthroplasty (TJA) surgeries are performed annually and has been forecasted that this number will exceed 4,000,000 by the year 2030. Many different types of dressing exist for use in TJA surgery, and it is unclear if any of the newer, hydrofibre dressings are superior to traditional dressings at reducing rates of infections or improving wound healing. Thus, the aim of this systematic review and meta-analysis was to assess the impact of hydrofiber dressings on reducing complications. Methods: A systematic review and meta-analysis was performed using the online databases MEDLINE and the Cochrane Library. Randomized controlled trials (RCTs) comparing hydrofibre dressings to a standard dressing were included. Summary measures are reported as odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Our primary outcome was prosthetic joint infection (PJI). Secondary outcomes included blisters, dressing changes and wound irritation. Results: 5 RCTs were included. Hydrofibre dressing had no observable effect on PJI or wound irritation (OR 0.53; 95% CI, 0.14–1.98; p = 0.35). Hydrofibre dressings reduced the rate of blisters (OR 0.36; 95% CI, 0.14–0.90; p = 0.03) and number of dressing changes (MD -1.89; 95% CI, -2.68 to -1.11). Conclusions: In conclusion, evidence suggests hydrofibre dressings have no observable effect on PJI and wound irritation. Evidence for reduction in blisters and number of dressings is modest given wide CIs and biased trial methodologies. Use of hydrofibre dressings should be considered inconclusive for mitigating major complications in light of current best evidence.

Focal Concerns and Police Decision Making in Sexual Assault Cases: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 152483802199128
Author(s):  
David S. Lapsey ◽  
Bradley A. Campbell ◽  
Bryant T. Plumlee
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Sexual Assault ◽  
Meta Analysis ◽  
The United States ◽  
Empirical Literature ◽  
Campbell Collaboration ◽  
Focal Concerns ◽  
Police Decision Making ◽  
The Impact

Sexual assault and case attrition at the arrest stage are serious problems in the United States. Focal concerns have increasingly been used to explain police decision making in sexual assault cases. Because of the popularity of the focal concerns perspective and potential to inform evidence-based training, a systematic review and meta-analysis are needed to condense the literature. In this study, we assess the overall strength of the relationship between focal concerns variables and police decisions to arrest in cases of sexual assault. Our assessment of the effects of focal concerns variables on arrest decision making in sexual assault cases followed the systematic review protocols provided by the Campbell Collaboration of Systematic Reviews. Specifically, we used the Campbell Collaboration recommendations to search empirical literature and used meta-analysis to evaluate the size, direction, and strength of the impact of focal concerns variables on arrest decisions. Our search strategy detected 14 eligible studies and 79 effect sizes. The meta-analysis found several robust and statistically significant correlates of arrest. In fact, each focal concerns concept produced at least one robust arrest correlate. Overall, focal concerns offers a strong approach for explaining police decisions in sexual assault cases. Although practical concerns and resource constraints produced the strongest arrest correlates, results show the importance of additional case characteristics in officers’ decision to arrest.

scholarly journals The health and relationship dynamics of late-life couples: a systematic review of the literature

2009 ◽  
Vol 29 (3) ◽  
pp. 455-480 ◽  
Author(s):  
RUTH B. WALKER ◽  
MARY A. LUSZCZ
Keyword(s):  
Systematic Review ◽  
Marital Quality ◽  
Late Life ◽  
The United States ◽  
Health It ◽  
Social Emotional ◽  
Marital Relations ◽  
The Impact ◽  
The Relationship ◽  
Adequate Communication

ABSTRACTLate-life husband and wife relationships are increasingly recognised as an important factor in promoting wellbeing, particularly in terms of the health, social, emotional, financial and practical needs of older people. Knowledge of marital dynamics and how they affect both members of a couple remains scarce. This systematic review aimed to identify and appraise research that has focused explicitly on the dynamics of the relationship, as evinced by data frombothspouses. Implementing rigorous identification strategies, 45 articles were identified and reviewed. These studies were grouped into three broad thematic areas: marital relations and satisfaction; concordance in emotional state or physical health; and the interplay between marital quality and wellbeing. The issues found to affect marital relations and satisfaction in late life included equality of roles, having adequate communication, and transitions to living apart. There is strong evidence for couple concordance in depression, that marital relationships affect ill-health, longevity and recovery from illness, and reciprocally that ill-health impacts on the marriage itself. The research also suggests important gender differences in the impact of marital dynamics on health. It has led to the conclusion that there is a need for more diverse studies of late-life marriages, particularly ones that examine the dynamics of non-traditional elderly couples and that extend beyond a predominant focus on the Caucasian population of the United States.

Neighborhood Socioeconomic Status and Stroke Incidence: A Systematic Review

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011892
Author(s):  
Yeonwoo Kim ◽  
Erica Twardzik ◽  
Suzanne E. Judd ◽  
Natalie Colabianchi
Keyword(s):  
United States ◽  
Systematic Review ◽  
Socioeconomic Status ◽  
Stroke Risk ◽  
Keyword Search ◽  
The United States ◽  
Stroke Incidence ◽  
Neighborhood Socioeconomic Status ◽  
Modifiable Factors ◽  
The Impact

ObjectiveTo summarize overall patterns of the impact of neighborhood socioeconomic status (nSES) on incidence stroke and uncover potential gaps in the literature, we conducted a systematic review of studies examining the association between nSES and incident stroke, independent of individual socioeconomic status (SES).MethodsFour electronic databases and reference lists of included articles were searched, and corresponding authors were contacted to locate additional studies. A keyword search strategy included the three broad domains of neighborhood, SES, and stroke. Eight studies met our inclusion criteria (e.g., nSES as an exposure, individual SES as a covariate, and incident stroke as an outcome). We coded study methodology and findings across the eight studies.ResultsThe results provide evidence for the overall nSES and incident stroke association in Sweden and Japan, but not within the United States. Findings were inconclusive when examining the nSES-incident stroke association stratified by race. We found evidence for the mediating role of biological factors in the nSES-incident stroke association.ConclusionsHigher neighborhood disadvantage was found to be associated with higher stroke risk, but it was not significant in all the studies. The relationship between nSES and stroke risk within different racial groups in the United States was inconclusive. Inconsistencies may be driven by differences in covariate adjustment (e.g., individual-level sociodemographic characteristics, neighborhood-level racial composition). Additional research is needed to investigate potential intermediate and modifiable factors of the nSES and incident stroke association, which could serve as intervention points.

The Impact of Race/Ethnicity on the Outcomes of Burn Patients: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Jasmine Peters ◽  
Mariel S Bello ◽  
Leigh Spera ◽  
T Justin Gillenwater ◽  
Haig A Yenikomshian
Keyword(s):  
Systematic Review ◽  
Native American ◽  
The United States ◽  
Current Status ◽  
Surgical Trauma ◽  
Insurance Status ◽  
Inclusion Criteria ◽  
Burn Care ◽  
Race Ethnicity ◽  
The Impact

Abstract Racial and ethnic disparities are endemic to the United States and are only beginning to attract the attention of researchers. With an increasingly diverse population, focused and tailored medicine to provide more equitable care is needed. For surgical trauma populations, this topic is a small but expanding field and still rarely mentioned in burn medicine. Disparities in prevention, treatment, and recovery outcomes between different racial and ethnic minorities who are burned are rarely discussed. The purpose of this study is to determine the current status of identified disparities of care in the burn population literature and areas of future research. A systematic review was conducted of literature utilizing PubMed for articles published between 2000-2020. Searches were used to identify articles that crossed the burn term (burn patient OR burn recovery OR burn survivor OR burn care) and a race/ethnicity and insurance status-related term (race/ethnicity OR African-American OR Black OR Asian OR Hispanic OR Latino OR Native American OR Indigenous OR Mixed race OR 2 or more races OR socioeconomic status OR insurance status). Inclusion criteria were English studies in the US that discussed disparities in burn injury outcomes or risk factors associated with race/ethnicity. 1,169 papers were populated, 55 were reviewed, and 36 articles met inclusion criteria. Most studies showed minorities had poorer inpatient and outpatient outcomes. While this is a concerning trend, there is a paucity of literature in this field and more research is needed to create culturally-tailored medical care and address the needs of disadvantaged burn survivors.

scholarly journals Motivators and Incentives of Pediatric Medical Educators in an Academic Hospital Setting in the United States

2019 ◽  
Vol 2 (2) ◽  
pp. 25-28
Author(s):  
Jackie C. Fuller ◽  
Mary C. Ottolini
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Hospital Setting ◽  
The United States ◽  
Clinical Teachers ◽  
Graduate Medical ◽  
Creative Commons ◽  
Quality Patient Care ◽  
Academic Teaching Hospital ◽  
Medical Educators

Graduate medical education (GME) has undergone a phenomenal transformation aimed at aligning medical education and the learning environment with educational outcomes and quality patient care. The Accreditation Council for Graduate Medical Education (ACGME) has challenged faculty to adapt novel teaching methodologies. However, there are limited studies about motivational factors that impact pediatric graduate medical educators. This article brings an insight to these motivators from the perspectives of teaching and clinical pediatric educators at an academic teaching hospital. Key words: Graduate Medical Education • GME • Pediatrics • Medical Educators • Clinical Teachers • Motivators • Incentives • Hospital • Faculty   Copyright © 2018 Fuller et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals For Better or for Worse? A Systematic Review of the Evidence on Social Media Use and Depression Among Lesbian, Gay, and Bisexual Minorities (Preprint)

2018 ◽  
Author(s):  
César G Escobar-Viera ◽  
Darren L Whitfield ◽  
Charles B Wessel ◽  
Ariel Shensa ◽  
Jaime E Sidani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Media ◽  
Risk Factor ◽  
Media Use ◽  
The United States ◽  
Qualitative Studies ◽  
Social Media Use ◽  
Patterns Of Use ◽  
And Bisexual ◽  
The Impact

BACKGROUND Over 90% of adults in the United States have at least one social media account, and lesbian, gay, and bisexual (LGB) persons are more socially active on social media than heterosexuals. Rates of depression among LGB persons are between 1.5- and 2-fold higher than those among their heterosexual counterparts. Social media allows users to connect, interact, and express ideas, emotions, feelings, and thoughts. Thus, social media use might represent both a protective and a risk factor for depression among LGB persons. Studying the nature of the relationship between social media use and depression among LGB individuals is a necessary step to inform public health interventions for this population. OBJECTIVE The objective of this systematic review was to synthesize and critique the evidence on social media use and depression among LGB populations. METHODS We conducted a literature search for quantitative and qualitative studies published between January 2003 and June 2017 using 3 electronic databases. Articles were included if they were peer-reviewed, were in English, assessed social media use either quantitatively or qualitatively, measured depression, and focused on LGB populations. A minimum of two authors independently extracted data from each study using an a priori developed abstraction form. We assessed appropriate reporting of studies using the Strengthening the Reporting of Observational Studies in Epidemiology and the Consolidated Criteria for Reporting Qualitative Research for quantitative and qualitative studies, respectively. RESULTS We included 11 articles in the review; 9 studies were quantitative and cross-sectional and 2 were qualitative. Appropriate reporting of results varied greatly. Across quantitative studies, we found heterogeneity in how social media use was defined and measured. Cyberbullying was the most studied social media experience and was associated with depression and suicidality. Qualitative studies found that while social media provides a space to disclose minority experiences and share ways to cope and get support, constant surveillance of one’s social media profile can become a stressor, potentially leading to depression. In most studies, sexual minority participants were identified inconsistently. CONCLUSIONS This review supports the need for research on the role of social media use on depression outcomes among LBG persons. Using social media may be both a protective and a risk factor for depression among LGB individuals. Support gained via social media may buffer the impact of geographic isolation and loneliness. Negative experiences such as cyberbullying and other patterns of use may be associated with depression. Future research would benefit from more consistent definitions of both social media use and study populations. Moreover, use of larger samples and accounting for patterns of use and individuals’ experiences on social media may help better understand the factors that impact LGB mental health disparities.

scholarly journals Patterns of Change in ACGME-Accredited Residency Programs and Positions: Implication for the Adequacy of GME Positions and Supply of Physicians in the United States

2014 ◽  
Vol 6 (2) ◽  
pp. 399-403 ◽  
Author(s):  
Kathleen D. Holt ◽  
Rebecca S. Miller ◽  
Ingrid Philibert ◽  
Thomas J. Nasca
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Graduate Medical Education ◽  
Primary Care Physicians ◽  
Population Data ◽  
The United States ◽  
Graduate Medical ◽  
The Past ◽  
Accredited Institutions ◽  
The Impact

Abstract Background Recent studies suggest that the supply of primary care physicians and generalist physicians in other specialties may be inadequate to meet the needs of the US population. Data on the numbers and types of physicians-in-training, such as those collected by the Accreditation Council for Graduate Medical Education (ACGME), can be used to help understand variables affecting this supply. Objective We assessed trends in the number and type of medical school graduates entering accredited residencies, and the impact those trends could have on the future physician workforce. Methods Since 2004, the ACGME has published annually its data on accredited institutions, programs, and residents to help the graduate medical education community understand major trends in residency education, and to help guide graduate medical education policy. We present key results and trends for the period between academic years 2003–2004 and 2012–2013. Results The data show that increases in trainees in accredited programs are not uniform across specialties, or the types of medical school from which trainees graduated. In the past 10 years, the growth in residents entering training that culminates in initial board certification (“pipeline” specialties) was 13.0%, the number of trainees entering subspecialty education increased 39.9%. In the past 5 years, there has been a 25.8% increase in the number of osteopathic physicians entering allopathic programs. Conclusions These trends portend challenges in absorbing the increasing numbers of allopathic and osteopathic graduates, and US international graduates in accredited programs. The increasing trend in subspecialization appears at odds with the current understanding of the need for generalist physicians.

scholarly journals Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Pediatric Myelomeningocele: Executive Summary

Neurosurgery ◽  
2019 ◽  
Vol 85 (3) ◽  
pp. 299-301 ◽  
Author(s):  
Catherine A Mazzola ◽  
Nadege Assassi ◽  
Lissa C Baird ◽  
David F Bauer ◽  
Alexandra D Beier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spina Bifida ◽  
Task Force ◽  
The United States ◽  
Folic Acid Deficiency ◽  
Evidence Based ◽  
Executive Summary ◽  
Full Text Review ◽  
Level I ◽  
The Impact

Abstract BACKGROUND The incidence of spina bifida (SB) in the developing world is higher than in the United States because of malnutrition and folic acid deficiency during pregnancy. Advances in technology have made prenatal repair of myelomeningocele (MM) possible. OBJECTIVE The objective of the guidelines are, (1) To create clinical recommendations for best practices, based on a systematic review and analysis of available literature, (2) to obtain multi-disciplinary endorsement of these guidelines from relevant organizations, and (3) to disseminate the educational content to physicians to improve the care of infants with MM. METHODS The Guidelines Task Force developed search terms and strategies used to search PubMed and Embase for literature published between 1966 and September 2016. Strict inclusion/exclusion criteria were used to screen abstracts and to develop a list of relevant articles for full-text review. RESULTS Guidelines authors aimed to systematically review the literature and make evidence based recommendations about the timing of closure after birth, hydrocephalus, the impact of prenatal closure, and the effect of prenatal closure on ambulation ability and tethered spinal cord. Evidence concerning persistent ventriculomegaly and cognitive impairment was also evaluated. Hundreds of abstracts were identified and reviewed for each of the 5 topics. A total of 14 studies met stringent inclusion criteria. CONCLUSION Based on a comprehensive systematic review, a total of 5 clinical practice recommendations were developed, with 1 Level I, 2 Level II and 2 Level III recommendations. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-1.

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