From the Baylor Scott & White, University Medical Center, Dallas, TX (Dr. Oguayo, Dr. Chu, and Dr. Jones); and Orthopedic Associates of Dallas, Dallas, TX (Dr. Oguayo, Dr. Chu, and Dr. Jones).
J Am Acad Orthop Surg Glob Res Rev. 2021 Jan 12;5(1):e20.00107. doi: 10.5435/JAAOSGlobal-D-20-00107.
The COVID-19 pandemic has rapidly affected all facets of everyday life including the practice of medicine. Hospital systems and medical practices have evolved to protect patients, physicians, and staff and conserve personal protective equipment and resources. Orthopaedic practices have been specifically affected by social distancing and stay at home guidelines, limiting in-office practice and elective surgery restrictions. This, in turn, has had an effect on resident education. Previous literature has been published regarding how academic programs have adjusted to these changes. However, the effects on smaller orthopaedic residencies with nonacademic faculty has not been discussed. The orthopaedic residency at Baylor University Medical Center of Dallas is a fifteen-resident program with a combination of hospital employed and private practice faculty. We adjusted our resident education in mid-March 2020 to keep residents safe while trying to maximize surgical and clinical education and outside research.
Our goals were to come up with a plan allowed for continuing high-level patient care and resident education while protecting residents and limiting burnout.
We devised a four-team system with five-day call periods. Interactions between teams were strictly minimized. We also moved to a web-based academic curriculum and devised a system for safe resident participation in surgical cases. The model has been adjusted based on attending and resident feedback.
Until we develop effective treatments or vaccination for COVID-19, there is a possibility that it will be an ongoing threat. Resident education must also adapt to the changing environment while continuing to provide residents safe opportunities for patient care, didactic education, and research. We believe we have come up with a sustainable, adaptable model for resident education during this challenging time.
COVID-19 大流行迅速影响了日常生活的方方面面，包括医学实践。医院系统和医疗实践已经发展到保护患者、医生和员工，并节约个人防护设备和资源的地步。由于社交距离和居家隔离指南的限制，骨科实践受到了特别影响，限制了门诊实践和择期手术。这反过来又对住院医师教育产生了影响。之前已经发表了一些关于学术项目如何适应这些变化的文献。然而，关于没有学术背景的小型骨科住院医师的影响尚未讨论。达拉斯贝勒大学医学中心的骨科住院医师培训计划是一个有 15 名住院医师的项目，由医院雇佣的和私人执业的教员组成。我们在 2020 年 3 月中旬调整了住院医师教育计划，以确保住院医师的安全，同时尽量增加手术和临床教育以及外部研究。
我们的目标是制定一个计划，在保护住院医师和限制职业倦怠的同时，允许继续进行高水平的患者护理和住院医师教育。
我们设计了一个由四支队伍组成的系统，每支队伍的轮班时间为五天。团队之间的互动严格减少。我们还转向基于网络的学术课程，并设计了一个安全的住院医师参与手术的系统。该模式根据主治医生和住院医师的反馈进行了调整。
在我们开发出有效的 COVID-19 治疗方法或疫苗之前，它可能会持续存在威胁。住院医师教育也必须适应不断变化的环境，同时继续为住院医师提供安全的患者护理、理论教育和研究机会。我们相信，我们已经为在这个充满挑战的时期为住院医师教育制定了一个可持续、适应性强的模式。
