Impact of COVID-19 on Hematology-Oncology Trainees: A Quantitative and Qualitative Assessment

PURPOSE: Graduate medical and research training has drastically changed during the COVID-19 pandemic, with widespread implementation of virtual learning, redeployment from core rotations to the care of patients with COVID-19, and significant emotional and physical stressors. The specific experience of hematology-oncology (HO) fellows during the COVID-19 pandemic is not known. METHODS: We conducted a mixed-methods study using a survey of Likert-style and open-ended questions to assess the training experience and well-being of HO fellows, including both clinical and postdoctoral trainee members of the American Society of Hematology and ASCO. RESULTS: A total of 2,306 surveys were distributed by e-mail; 548 (23.8%) fellows completed the survey. Nearly 40% of fellows felt that they had not received adequate mental health support during the pandemic, and 22% reported new symptoms of burnout. Pre-existing burnout before the pandemic, COVID-19–related clinical work, and working in a primary research or nonclinical setting were associated with increased burnout on multivariable logistic regression. Qualitative thematic analysis of open-ended responses revealed significant concerns about employment after training completion, perceived variable quality of virtual education and board preparation, loss of clinical opportunities to prepare for independent clinical practice, inadequate grant funding opportunities in part because of shifting research priorities, variable productivity, and mental health or stress during the pandemic. CONCLUSION: HO fellows have been profoundly affected by the pandemic, and our data illustrate multiple avenues for fellowship programs and national organizations to support both clinical and postdoctoral trainees.

Assistive Technology to Help Students With Disabilities

This chapter reviews some of the low-tech as well as the high-tech devices available for a wide variety of students with special learning needs. A history of assistive technology devices is explored and defined. Assistive technology has increased in use in recent decades due to accessibility of computers and the digital age. Digital devices such as hand held scanners, online learning environments, and digital resources have changed the educational experiences for students with special needs and disabilities. In response, teacher in-service programs and ongoing professional development programs need to be involved to understand and develop appropriate 21st-century learning opportunities and curricula. Future trends, such as virtual reality (VR) environments, allow opportunities for safe, effective learning. To assist in understanding and choosing the appropriate devices, multiple resources, such as global and national organizations, and online resources are provided.

Cloud Computing and Information Systems Strategy in Multi-National Companies

This chapter explores how information systems (IS) strategy is developed and implemented in multi-subsidiary international groups, and how this has been influenced by the advent of cloud computing and the solutions offered by the major cloud providers. Using an inductive, qualitative research approach, the chapter assesses learnings to date from cloud adoption, reports on individual expert interviews, and discusses future challenges for those companies embarking upon cloud projects. Key issues distilled from the literature and the in-depth interviews with practitioners are identified and discussed. The chapter concludes that cloud has significantly impacted IS strategy within multi-national organizations, allowing flexibility in various scenarios like, for example, moving from monolithic enterprise resource planning applications to a micro-service based architecture. There are nevertheless a range of strategic and operational issues that must be carefully managed and planned for, including multiple aspects of compliance and security.

Brexit on Stage: Two Verbatim Projects in Progress

The article deals with two post-Referendum projects launched by British national organizations, the National Theatre and the Guardian with Headlong, whose task was to reflect more accurately on a broader range of current British experience. The projects were written in response to questions on whether national artistic institutions, the subsidized “complex culture,” have not been out of touch with the rest of the country, notably the post-Referendum crisis. Both projects set out to research the crisis with documentary and quasi-documentary methods, to involve in an exercise in “listening” and to focus on polarisation, voter fatigue and lack of trust. The article concentrates on the two projects as variants of political theatre and on the ways they use the verbatim method in their attempts to diagnose and understand the crisis arguing, further on, that the effects differ, leading either to populism or to empathetic understanding and reconciliation.

COVID-19 Prevention Measures Implemented by Tennis Coaches: The Role of Continent, Experience, and Type of Facility

The prevention strategies used by tennis coaches when delivering tennis lessons during the COVID-19 pandemic were analyzed in this study. An ad hoc questionnaire collected data from 655 Spanish and Portuguese speaking tennis coaches working in Latin America and Europe. Differences in the prevention measures were analyzed according to the continent, the coaches’ experience, and the type of facility they worked in. Results showed that coaches used information provided from local and national organizations more than from international ones. Hand hygiene, communication of preventive strategies, and changes in the coaching methodology were the most used prevention measures. Latin American coaches and those working in public facilities implemented the measures more often than their European colleagues or those working in private venues. Finally, more experienced coaches showed a greater awareness of the adoption of the measures than their less experienced counterparts. The data provided by this research may assist in developing new specific guidelines, protocols, and interventions to help better understand the daily delivery of tennis coaching in this challenging context.

Global Health Education and Best Practices for Neonatal-Perinatal Medicine Trainees

Neonatal-perinatal medicine (NPM) trainees are expressing an increased interest in global health. NPM fellowship programs are tasked with ensuring that interested fellows receive appropriate training and mentorship to participate in the global health arena. Global health engagement during fellowship varies based on a trainee’s experience level, career goals, and academic interests. Some trainees may seek active learning opportunities through clinical rotations abroad whereas others may desire engagement through research or quality improvement partnerships. To accommodate these varying interests, NPM fellows and training programs may choose to explore institutional partnerships, opportunities through national organizations with global collaborators, or domestic opportunities with high-risk populations. During any global health project, the NPM trainee needs robust mentorship from professionals at both their home institution and their partner international site. Trainees intending to use their global health project to fulfill the American Board of Pediatrics (ABP) scholarly activity requirement must also pay particular attention to selecting a project that is feasible during fellowship and also meets ABP criteria for board eligibility. Above all, NPM fellows and training programs should strive to ensure equitable, sustainable, and mutually beneficial collaborations.

Neurosurgery at UT Southwestern Medical Center: 1956–2020

The history of neurosurgery at UT Southwestern Medical Center in Dallas, Texas, is reviewed. Kemp Clark, MD, started the academic neurosurgical practice at Parkland Hospital in 1956. Clark developed a robust training program that required the resident to operate early. In 1972, the Dallas Veterans Affairs Hospital was added to the training program. Duke Samson, MD, became chair in 1988. He emphasized technical excellence and honest reporting of surgical outcomes. In 1989, Zale Lipshy University Hospital opened and became a center for neurosurgical care, and Hunt Batjer, MD, became chair in 2012. The program expanded significantly. Along with principles established by his predecessors, Batjer emphasized the need for all neurosurgeons to engage the community and to be active in policy leadership through local and national organizations. During his tenure, the pediatric neurosurgery group at Children’s Medical Center Dallas was integrated with the department, and a multidisciplinary spine service was developed. In 2014, the Peter O’Donnell Jr. Brain Institute was established, and the William P. Clements Jr. University Hospital opened. For 64 years, UT Southwestern Medical Center has been fertile ground for academic neurosurgery, with a strong emphasis on excellence in patient care.

COVID-19 in Assisted Living: Evidence on Policies, Provider Experiences, and Resident Mortality

The devastating effects of Coronavirus disease 2019 (COVID-19) among older adults residing in long-term care settings has been well documented. Assisted living settings in the U.S. have 811,000 residents; most are 80 years or older, and many have one or more chronic illnesses, making them highly susceptible to poor outcomes if exposed to COVID-19. This symposium highlights five studies that focus on various levels of COVID-19 response in assisted living: national organizations, states, assisted living operators and healthcare providers, and residents. The first study compares the sometimes conflicting guidance provided by national long-term care industry-related organizations and recommends assisted living-specific actions for the future. The second study describes the state regulatory response to COVID-19 in assisted living, identifying the themes and implications for the function of the care networks of assisted living residents. The third study presents findings from interviews with key stakeholders, including policymakers and industry leaders, that reflect on the challenges responding to changing recommendations and policies. The fourth study reports results from a survey with administrators and medical and mental health care providers who treat their residents that illustrates the care practices that were implemented in response to COVID-19 in assisted living. The fifth presentation documents the national excess assisted living resident mortality that was attributable to COVID-19. This symposium culminates with a leading assisted living industry expert reflecting on providers’ experiences and posing areas to consider when preparing for and responding to future pandemic events in assisted living settings.

Efforts by the Coalition to End Social Isolation and Loneliness

Established in the Fall 2018 and based in Washington, D.C., the Coalition to End Social Isolation & Loneliness brings together dozens of national organizations including consumer groups, community-based organizations, health plans, mental and behavioral health organizations, health care innovators, and many others to lead a multi-stakeholder dialogue to address the crisis of social isolation and loneliness in America. The Coalition focuses on three major areas to achieve this goal: Disseminating research findings, developing and advocating for federal and state legislative and regulatory policy interventions, and leading public awareness events in Washington, D.C. and across the nation. The COVID-19 pandemic has greatly accelerated efforts to engage Congress and the Executive Branch on a range of federal policy priorities, including leveraging and advancing social services and supports, supporting health care delivery to support those who are socially isolated and/or lonely, and advancing federally-funded research initiatives.

Exploring how national educational organizations can promote educational research amongst members: a survey-based study

Background: Engagement of academic faculty in research remains low. While barriers to research have been explored, there are no data on how national organizations can help overcome these barriers. Our study explored faculty satisfaction and motivational drivers for engagement with research opportunities offered by the Council on Medical Student Education in Pediatrics (COMSEP), an organization of pediatric medical educators, and characterize strategies perceived by faculty to promote the use of these opportunities.Methods: In 2021, 5 survey questions were administered to faculty members of COMSEP to explore satisfaction with COMSEP’s research offerings, the perceived value of educational research, and the facilitators, barriers and potential opportunities for COMSEP to promote research. Clark’s Commitment and Necessary Effort model on motivation served as the theoretical framework for our study, which explores motivation, self-efficacy and contextual factors influencing individual’s pursuit of goals. Chi-square analysis and Wilcoxon Signed Ranks Test were used to compare categorical and scaled variables among groups who did and did not avail of COMSEP’s research offerings.Results: 90 (25%) of 360 recipients responded. Sixty-one percent expressed satisfaction with COMSEP’s research offerings. Sixty-eight percent indicated research was an expectation of their academic appointment, that education was their primary research focus (74%) and that they did not have other research opportunities that met their needs (58%). Of respondents, 75.7% of females had submitted a proposal versus 60% of females who had not. The comparison by gender was not statistically significant. Exploration by academic rank revealed that 35% of instructor/assistant professors had submitted a proposal compared to 65% of associate professors/professors (p=.05). Barriers leading to non-submission to any of the offerings included having too much other work, lack of enjoyment in writing and inability to find mentors. Respondents endorsed the importance of several strategies to promote engagement in research-skill building opportunities, personalized consultations and increased funding. Conclusions: Faculty educators value the importance of educational research and recognize that research opportunities offered by COMSEP address an unmet need, but express ambivalence in the enjoyment of writing (reflecting their mood), and endorse structural barriers, that are amenable to change, affecting their personal agency.