A chief concern over the first months of the coronavirus disease 2019 (COVID-19) pandemic was the capacity to provide care for acutely ill patients in hospitals and intensive care units (ICUs). The variability in outcomes of patients with COVID-19 internationally has been striking, with some reports describing ICU mortality in ranges between 40 and 90%. 1-3 Systematic reviews including Characteristics and outcomes of patients with COVID-19 admitted to hospital and intensive care in the first phase of the pandemic in Canada: a national cohort study

Objective To synthesize qualitative literature exploring the lived experience of healthcare workers (HCWs) who cared for patients during the following infectious disease outbreaks (IDOs): the 2003 SARS epidemic, 2009 H1N1 pandemic, 2012 MERS outbreak, and 2014 EVD epidemic. We aim to reveal the collective experience of HCWs during these four IDOs and to create a reference for comparison of current and future IDOs. Methods Three electronic databases were searched, yielding 823 results after duplicates were removed. Forty qualitative and mixed-methods studies met the criteria for full file review. Fourteen studies met the inclusion and exclusion criteria. The data from the Results or Findings sections were manually coded and themes were conceptualized using thematic analysis. Results Of the 14 studies, 28.6% focused on SARS, 21.4% on H1N1, 21.4% on MERS, and 28.6% on EVD. Studies occurred in six different countries and included physicians, nurses, paramedics, and emergency medical technicians as participants. Five themes were conceptualized: Uncertainty, Adapting to Change, Commitment, Sacrifice, and Resilience. Conclusion This review identified the collective experience of HCWs caring for patients during four 21st century IDOs. This qualitative systematic review offers a reference to compare similarities and differences of other IDOs, including the COVID-19 pandemic.

Implication Statement: Given the efficacy of simulations as a medical education tool, the inability to provide them during the COVID-19 pandemic may be detrimental to pre-clinical medical student learning. We developed hybrid simulations, where remote learner participants could direct an in-person assistant. This offered a learning opportunity that was more realistic than fully virtual simulations and abided by public health guidelines. Hybrid simulations provided an opportunity for medical students to practice real-time clinical decision making in a remote, high-fidelity, simulated environment. This approach could be adapted for rural healthcare students and professionals to participate in simulations without a local simulation centre.

Objectives In‐hospital cardiac arrests are common and associated with high mortality. Smartphone applications offer quick access to algorithms and timers but often lack real‐time guidance. This study assesses the impact of the Code Blue Leader application on the performance of providers leading cardiac arrest simulations. Methods This open‐label randomized controlled trial included Advanced Cardiac Life Support (ACLS)–trained medical doctors (MD) and registered nurses (RN). Participants were randomized to lead the same ACLS simulation with or without the app. The primary outcome, “performance score,” was assessed by a trained rater using a validated ACLS scoring system. Secondary outcomes included percentage of critical actions performed, number of incorrect actions, and chest compression fraction (percentage of time spent performing chest compressions). A sample size of 30 participants was calculated to detect a difference of 20% at the 0.05 alpha level with 90% power. Results Fifteen MDs and 15 RNs underwent stratified randomization. The median (interquartile range) performance score in the app group was 95.3% (93.0%–100.0%) compared to 81.4% (60.5%–88.4%) in the control group, demonstrating an effect size of r = 0.69 (Z = −3.78, r = 0.69, p = 0.0002). The percentage of critical actions performed in the app group was 100% (96.2%–100.0%) compared to 85.0% (74.1%–92.4%) in the control group. The number of incorrect actions performed in the app group was 1 (1) compared to 4 (3–5) in the control group. Chest compression fraction in the app group was 75.5% (73.0%–84.0%) compared to 75.0% (72.0%–85.0%) in the control group. Conclusions The Code Blue Leader smartphone app significantly improved the performance of ACLS‐trained providers in cardiac arrest simulations.

Background: Medical students are traditionally introduced to suturing in a simulated environment using animal products or synthetic materials. However, there is little evidence to support this pedagogy. Our study explored whether a modern suturing curriculum adequately prepares medical students and examined   student preference for learning suturing skills.   Methods: Suturing performance was recorded and assessed by expert raters. Students also completed a survey that inquired about self-perceived knowledge and confidence in suturing, and preferred pedagogical methods.   Results: The majority (79%) of students that completed our suturing curriculum demonstrated competence in basic suturing techniques. There was no correlation between objective abilities and self-perceived knowledge or confidence. Students reported being significantly more confident suturing anesthetized patients and in simulated environments. Students reported a desire for earlier introduction to suturing and more frequent simulation training.   Conclusion: A modern medical school suturing curriculum, comprising online modules and in-person simulation-based learning, adequately develops basic suturing techniques.