Department of Oral and Maxillofacial Surgery, Boston University Henry M. Goldman School of Dentistry, Boston, MA, USA.
Department of Oral and Maxillofacial Surgery, Boston University Henry M. Goldman School of Dentistry, Boston, MA, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Jan;131(1):27-42. doi: 10.1016/j.oooo.2020.08.012. Epub 2020 Aug 18.
The coronavirus disease 2019 (COVID-19) pandemic has specific implications for oral and maxillofacial surgeons because of an increased risk of exposure to the virus during surgical procedures involving the aerodigestive tract. The objective of this survey was to evaluate how the COVID-19 pandemic affected oral and maxillofacial surgery (OMFS) training programs during the early phase of the pandemic.
During the period April 3 to May 6, 2020, a cross-sectional survey was sent to the program directors of 95 of the 101 accredited OMFS training programs in the United States. The 35-question survey, designed by using Qualtrics software, aimed to elicit information about the impact of the COVID-19 pandemic on OMFS residency programs and the resulting specific modifications made to clinical care, PPE, and resident training/wellness.
The survey response rate from OMFS program directors was 35% (33 of 95), with most responses from the states with a high incidence of COVID-19. All OMFS programs (100%) implemented guidelines to suspend elective and nonurgent surgical procedures and limited ambulatory clinic visits by third week of March, with the average date being March 16, 2020 (date range March 8-23). The programs used telemedicine (40%) and modified in-person visit (51%) protocols for dental and maxillofacial emergency triage to minimize the risk of exposure of HCP to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Shortage of personal protective equipment (PPE) was experienced by 51% of the programs. Almost two-thirds (63%) of the respondents recommended the use of a filtered respirator (i.e., N95 respirator) with full-face shield and stated that it was their preferred PPE, whereas 21% recommended the use of powered air-purifying respirators (PAPRs) during OMFS procedures. Only (73%) of the programs had resources for resident wellness and stress reduction. Virtual didactic training sessions conducted on digital platforms, most commonly Zoom, formed a major part of education for all programs.
All programs promptly responded to the pandemic by making appropriate changes, including suspending elective surgery and limiting patient care to emergent and urgent services. OMFS training programs should give more consideration to providing residents with adequate stress reduction resources to maintain their well-being and training and to minimize exposure risk during an evolving global epidemic.
由于在涉及气消化道的手术中,外科医生接触病毒的风险增加,因此 2019 年冠状病毒病(COVID-19)大流行对口腔颌面外科医生具有特殊意义。本调查的目的是评估 COVID-19 大流行在大流行早期阶段如何影响口腔颌面外科(OMFS)培训计划。
在 2020 年 4 月 3 日至 5 月 6 日期间,对美国 101 个经认可的 OMFS 培训计划中的 95 个计划主任进行了横断面调查。该调查由 Qualtrics 软件设计,共有 35 个问题,旨在了解 COVID-19 大流行对 OMFS 住院医师培训计划的影响,以及对临床护理,个人防护设备(PPE)和住院医师培训/健康产生的具体修改。
OMFS 计划主任的调查答复率为 35%(95 名中的 33 名),大多数答复来自 COVID-19 发病率较高的州。所有 OMFS 计划(100%)均实施了指南,以暂停选择性和非紧急手术,并在 3 月的第三周限制门诊就诊,平均日期为 2020 年 3 月 16 日(日期范围为 3 月 8 日至 23 日)。该计划使用远程医疗(40%)和修改后的现场访问(51%)协议来对牙科和颌面急诊进行分诊,以最大程度地减少卫生保健人员接触严重急性呼吸系统综合症冠状病毒 2(SARS-CoV-2)的风险。有 51%的计划经历了个人防护设备(PPE)短缺。近三分之二(63%)的受访者建议使用带全脸盾牌的过滤式呼吸器(即 N95 呼吸器),并表示这是他们首选的 PPE,而 21%的人建议在 OMFS 手术中使用动力空气净化呼吸器(PAPR)。只有(73%)的计划有居民健康和减轻压力的资源。在数字平台(最常见的是 Zoom)上进行的虚拟教学课程构成了所有计划教育的主要部分。
所有计划都通过及时做出适当的改变来应对大流行,包括暂停选择性手术并将患者护理限制为紧急和紧急服务。OMFS 培训计划应更多地考虑为居民提供足够的减轻压力的资源,以维持其健康和培训,并在不断发展的全球流行中最大程度地降低接触风险。