Impact of <scp>COVID</scp>‐19 on emergency medicine resident procedure performance

Bruno, Tony W.; Janwadkar, Rohan; Clayton, Lisa M; Hughes, Patrick G.; Solano, Joshua J.; Shih, Richard D.; Bilello, Leslie A; Hughes, Mary J.; Alter, Scott M.

doi:10.1002/aet2.10832

Cited by 2 publications

(1 citation statement)

References 11 publications

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“… 21 As a result of the pandemic, EM residents’ critical procedural experiences also decreased. 22 Moreover there was a significant decline in all non-COVID-19 related patient presentations, with significantly less resident exposure to cardiac, psychiatric, surgical, and neurosurgical cases. 23 …”

Section: Introductionmentioning

confidence: 98%

COVID-lateral Damage: Impact of the Post-COVID-19 Era on Procedural Training in Emergency Medicine Residency

Frank,

Perera,

Weizberg

2023

WestJEM

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Introduction Hospitalizations during the coronavirus 2019 (COVID-19) pandemic peaked in New York in March–April 2020. In the months following, emergency department (ED) volumes declined. Our objective in this study was to examine the effect of this decline on the procedural experience of emergency medicine (EM) residents compared to the pre-pandemic period. Methods We conducted this multicenter, retrospective cohort study of patients seen and key procedures performed by EM residents at hospitals spanning three Accreditation Committee for Graduate Medical Education-approved EM residencies in New York City and Nassau County, NY. We obtained numbers of procedures performed during May–July 2020 and compared them to the same time period for 2019 and 2018. We a priori classified critical care procedures—cardioversion, central lines, chest tubes, procedural sedation, and endotracheal intubation. We also studied “fast-track” procedures—fracture/joint reduction, incision and drainage (I&D), laceration repairs, and splints. Results Total number of critical care procedures in the months following the COVID-19 peak decreased from 694 to 606 (−12.7%, 95% confidence interval [CI] 10.3–15.4%), compared to an increase from 642 to 694 (+8.1%, 95% CI 6.1–10.5%) the previous year (difference −9.3%). Total number of fast-track procedures decreased from 5,253 to 3,369 (−35.9%, 95% CI 34.6–37.2%), compared to a decrease from 5,333 to 5,253 (−1.5%, 95% CI 1.2–1.9%) the year before (difference −36.3%). Specific critical care procedures performed in 2020 compared to the mean of 2019 and 2018 as follows: cardioversion −33.3%; central lines +19.0%; chest tubes −27.9%; procedural sedation −30.8%; endotracheal intubation −13.8%. Specific fast-track procedures: reductions +33.3%; I&D −48.6%; laceration repair −17.3%; and splint application −49.8%. Conclusion Emergency medicine residents’ critical and fast-track procedural experience at five hospitals was reduced during the months following the COVID-19 peak in comparison to a similar period in the two years prior. Training programs may consider increasing simulation-lab and cadaver-lab experiences, as well as ED and critical care rotations for their residents to offset this trend.

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Section: Introductionmentioning

confidence: 98%

COVID-lateral Damage: Impact of the Post-COVID-19 Era on Procedural Training in Emergency Medicine Residency

Frank,

Perera,

Weizberg

2023

WestJEM

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Educational and personal impacts of the COVID-19 pandemic on emergency medicine resident physicians: a qualitative study

Fults,

Gerwin,

Boyce

et al. 2024

BMC Med Educ

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Background The COVID-19 pandemic had a significant impact on both the clinical practice and the psychological states of frontline physicians in the emergency department. Trainees, at the beginning of their careers and thus still developing their practice styles and identities as physicians, were uniquely affected. Objective In this qualitative study, we sought to explore how the pandemic environment shaped the experiences of emergency medicine resident physicians. Methods This was a qualitative study. We conducted in-depth interviews with emergency medicine faculty, resident physicians, and staff at a single emergency department based at an urban academic institution in the northeastern United States. Interviews were audio recorded and transcribed, and transcripts were then analyzed in an iterative process by our coding team for recurring themes related to the resident experience. Results We reached data saturation with 27 individuals. Of those who were interviewed, 10 were resident physicians [6 senior residents (PGY-3 or PGY-4) and 4 junior residents (PGY-1 or PGY-2)]. Three major recurring themes regarding resident physician experience emerged during our analysis of the interviews: (1) novel educational experiences dampened by negative structural forces from the pandemic, (2) fracturing of social interactions and mitigation through ad-hoc support systems and community of practice, and (3) development of negative emotions and psychological trauma including fear, resentment, and moral injury causing lasting harm. Conclusions Our results suggest that emergency medicine resident physicians training during the COVID-19 pandemic faced unique experiences concerning their education, social support systems, and emotional states. While the educational and social experiences were described as having both negative and positive impacts, the emotional experiences were largely negative. Residency program leadership may use these insights to improve resident preparation, wellness, and resilience in the face of future adverse events.

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Impact of COVID‐19 on emergency medicine resident procedure performance

Cited by 2 publications

References 11 publications

COVID-lateral Damage: Impact of the Post-COVID-19 Era on Procedural Training in Emergency Medicine Residency

COVID-lateral Damage: Impact of the Post-COVID-19 Era on Procedural Training in Emergency Medicine Residency

Educational and personal impacts of the COVID-19 pandemic on emergency medicine resident physicians: a qualitative study

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