Slowdown of urology residents’ learning curve during the COVID‐19 emergency

Porpiglia, Francesco; Checcucci, Enrico; Amparore, Daniele; Verri, Paolo; Campi, Riccardo; Claps, Francesco; Esperto, Francesco; Fiori, Cristian; Carrieri, Giuseppe; Ficarra, Vincenzo; Scarpa, Roberto; Dasgupta, Prokar

doi:10.1111/bju.15076

Cited by 124 publications

(151 citation statements)

References 5 publications

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“…The COVID-19 pandemic represents a global emergency with a major impact on healthcare systems worldwide. In this context, Urology has been significantly involved 1 , with a dramatic reorganization of elective surgical activity 1 , 2 , 3 , 4 and a slowdown of Urology residents’ learning curve 5 , 6 , 7 , 8 . Several cross-sectional surveys, investigating the impact of COVID-19 on urological services worldwide, confirmed that the pandemic has imposed great challenges to urology health care providers.…”

Section: Introductionmentioning

confidence: 99%

Deferring Elective Urologic Surgery During the COVID-19 Pandemic: The Patients’ Perspective

Campi

Tellini

Grosso

et al. 2021

Urology

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Objectives To explore the perspective of urological patients on the possibility to defer elective surgery due to the fear of contracting COVID-19. Methods All patients scheduled for elective urological procedures for malignant or benign diseases at two high-volume Centres were administered a questionnaire, through structured telephone interviews, between 24 th and 27 th April 2020. The questionnaire included three questions: 1) In light of the COVID-19 pandemic, would you defer the planned surgical intervention? 2) If yes, when would you be willing to undergo surgery? 3) What do you consider potentially more harmful for your health: the risk of contracting COVID-19 during hospitalization or the potential consequences of delaying surgical treatment? Results Overall, 332 patients were included (51.5% and 48.5% in the oncology and benign groups, respectively). Of these, 47.9% patients would have deferred the planned intervention (33.3% vs 63.4%; p<0.001), while the proportion of patients who would have preferred to delay surgery for more than six months was comparable between the groups (87% vs 80%). These answers were influenced by patient age and ASA score (in the Oncology group) and by the underlying urological condition (in the benign group). Finally, 182 (54.8%) patients considered the risk of COVID-19 potentially more harmful than the risk of delaying surgery (37% vs 73%; p<0.001). This answer was driven by patient age and the underlying disease in both groups. Conclusions Our findings reinforce the importance of shared decision-making before urological surgery, leveraging patients’ values and expectations to refine the paradigm of evidence-based medicine during the COVID-19 pandemic and beyond.

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Section: Introductionmentioning

confidence: 99%

Deferring Elective Urologic Surgery During the COVID-19 Pandemic: The Patients’ Perspective

Campi

Tellini

Grosso

et al. 2021

Urology

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“…Studies have reported the effect of the COVID-19 pandemic on residency training programs in urology, surgery, and ophthalmology. (6)(7)(8)(9) The rapid decrease in clinical and surgical activities has posed challenges to residency training programs in several specialties. The pandemic has also affected the mental health of residents, which may further interfere with their clinical learning.…”

Section: Introductionmentioning

confidence: 99%

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

Lin

Chaou

et al. 2020

Preprint

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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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“…Returning to the subject of students, in particular in Italy, the paper by Porpiglia et al [4] explains that residents are unable to practise as the areas in which they usually work have been suspended (benign pathologies, lower urinary tract surgery and andrology), as have case meetings and outpatient clinics, and major surgery is being carried out mainly by senior colleagues. Alternative teaching methods, via video link, are being introduced, such as surgeryinmotion-school.org, a well established website showing recorded and live surgeries.…”

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confidence: 99%