Front-line Care Research Articles

Health workers' experience of a digital health intervention implemented in peri-urban communities in Karachi, Pakistan.

ObjectiveDigital health interventions (DHIs) have the potential to improve access and quality of care in low-middle-income countries. The aim of this study was to assess the acceptability, usability and aesthetics of a DHI by frontline workers in peri-urban community settings in Karachi, Pakistan.MethodsA mixed-methods study was carried out in peri-urban field sites in Karachi, Pakistan, where maternal and childcare services are provided through front-line care providers using a DHI. These workers include community health workers, midwives, and physicians who were using the DHI for at least six months. For quantitative data, a questionnaire regarding the module design and interface, technical difficulty, and appropriate utilisation was assessed using a 5-point Likert scale. For qualitative data, focus group discussions (FGDs) based on experiences regarding operability, design, its effect on work efficiency and the provision of beneficial health services were conducted.ResultsThere were 93 respondents for the quantitative questionnaire who reported high satisfaction (>85%) with the DHI in many themes including content quality, aesthetics and ease of use. Participants were least satisfied with service quality (45% satisfaction only) due to issues related to data sync and network connections in these areas. During the FGDs, the workers stated that the DHI helped them with accessing previous data and providing quality health care services to the community.ConclusionAlthough frontline workers reported a few technical difficulties while using the DHI, the majority reported that it was acceptable, had user-friendly features and was beneficial in their work processes.

Nurses as Warriors: Challenges and Impacts among Kerala Nurses during Coronavirus Disease-2019 Pandemic.

Introduction:In December 2019, the global outbreak of coronavirus disease-2019 (COVID-19) was announced. The pandemic has cast a spotlight like never before on health-care professionals in general, and nurses in particular. Nurses have been dubbed “warriors” by the general public for their determination to provide frontline care to patients with the disease, despite the risk of exposure and a lack of professional resources. The goal of the study was to assess the obstacles and consequences faced by Kerala nurses during the COVID-19 pandemic.Materials and Methods:A cross-sectional study was conducted from January to June 2021 among Kerala nurses. A total of 1630 nurses were chosen using a randomized sampling technique. The data were gathered using a semi-structured self-reported questionnaire. The information was entered into a database and analyzed using SPSS program version 16.0.Results:After analyzing the data, seven themes emerged: (a) love for the profession; (b) frustration for being labeled as “COVID Nurses”; (c) fear of infection and transmission; (d) personal protective equipment uncertainty; (e) workplace safety especially against hospital violence; (f) burnout in nurses; and (g) job stress.Conclusion:Nurses undertook a hazardous rescue mission and played an essential contribution in COVID-19 pandemic. Over the course of intensive work, they underwent significant psychological changes. Nurses burnout and occupational stress must be addressed with effective interventions. In order to mitigate the pandemic, the administration should also promote a healthy workplace and have a positive attitude and harmonious connection with the frontline personnel.

Pathology trainees rarely report safety incidents: A review of 13,722 safety reports and a call to action

Reporting and understanding patient safety incidents is a cornerstone of improving patient care quality and safety. The Accreditation Council for Graduate Medical Education specifically mandates that physician trainee education include participation in the recognition, reporting, and root cause analysis of patient safety incidents. Studies on safety event reporting, however, have consistently shown that attending physicians submit few safety reports, and trainees submit even fewer. We undertook a study to assess the rate at which pathology trainees report patient safety events relative to the rates at which trainees in other medical specialties do. We performed a retrospective analysis of 13,722 safety reports submitted to our medium-sized Academic Medical Center’s incident reporting system. We then analyzed those reported by trainees (residents and fellows), and then further drilled down on the subset of trainee-reported safety events reported by pathology trainees. Despite accounting for over 5% of all types of trainees at the enterprise level, pathology trainees accounted for only 0.5% of all trainee safety reports. Our findings represent a call to action for pathology training programs to engage their residents and fellows in quality and safety initiatives, to understand and remove barriers to safety event reporting for vulnerable populations such as trainees, and to empower trainees to confidently report safety risks as valued frontline care providers.

Alignment of Pediatric Nurse Practitioner Licensure, Accreditation, Certification, and Education for Employers

Advanced practice registered nurses (APRNs) are a critical member of the health care team, providing essential frontline care to patients and families. Given the evolution of the use of pediatric-focused APRNs in more acute and critical care settings, it is essential to understand the APRN consensus model. Understanding the APRN consensus document and its relationship to selecting the pediatric nurse practitioner who is appropriately qualified for the population of interest is crucial. Compliance with regulatory guidelines during the credentialing and privileging processes, along with organized clinical onboarding after hire, can optimize outcomes for employers and providers alike.

'Teenagers are into perfect-looking things': Dating, sexual attitudes and experiences of adolescents with severe obesity.

BackgroundThis qualitative study explored the dating and sexual health attitudes and behaviours among adolescents with severe obesity (body mass index [BMI] > 99th%) attending a multidisciplinary weight‐management programme.MethodsSemi‐structured interviews were conducted with 19 participants (12 females, 7 males; M age = 16.8) and analysed through reflective thematic analysis.ResultsParticipants described polarized dating behaviours in which dating and sexual relationships were either avoided due to this not being a priority, lack of time, feared rejection, and/or body size as perceived barrier or in contrast, when approached, involved greater sexual risk.ConclusionsThese findings have numerous implications including the need for increased education on the romantic developmental challenges faced by adolescents with severe obesity, the importance of ongoing screening of high‐risk sexual behaviours and body dissatisfaction from frontline care providers, and the ability to support referrals to psychosocial services when appropriate.

The Psychological Impact of COVID-19 on Front Line Nurses: A Synthesis of Qualitative Evidence

Caring for people with COVID-19 on the front line has psychological impacts for healthcare professionals. Despite the important psychological impacts of the pandemic on nurses, the qualitative evidence on this topic has not been synthesized. Our objective: To analyze and synthesize qualitative studies that investigate the perceptions of nurses about the psychological impacts of treating hospitalized people with COVID-19 on the front line. A systematic review of qualitative studies published in English or Spanish up to March 2021 was carried out in the following databases: The Cochrane Library, Medline (Pubmed), PsycINFO, Web of Science (WOS), Scopus, and CINHAL. The PRISMA statement and the Cochrane recommendations for qualitative evidence synthesis were followed. Results: The main psychological impacts of caring for people with COVID-19 perceived by nurses working on the front line were fear, anxiety, stress, social isolation, depressive symptoms, uncertainty, and frustration. The fear of infecting family members or being infected was the main repercussion perceived by the nurses. Other negative impacts that this review added and that nurses suffer as the COVID-19 pandemic progress were anger, obsessive thoughts, compulsivity, introversion, apprehension, impotence, alteration of space-time perception, somatization, and feeling of betrayal. Resilience was a coping tool used by nurses. Conclusions: Front line care for people with COVID-19 causes fear, anxiety, stress, social isolation, depressive symptoms, uncertainty, frustration, anger, obsessive thoughts, compulsivity, introversion, apprehension, impotence, alteration of space-time perception, somatization, and feeling of betrayal in nurses. It is necessary to provide front line nurses with the necessary support to reduce the psychological impact derived from caring for people with COVID-19, improve training programs for future pandemics, and analyze the long-term impacts.

Technological Change and Frontline Care Delivery Work: Toward the Quadruple Aim.

The COVID-19 pandemic stressed the health care sector's longstanding pain points, including the poor quality of frontline work and the staffing challenges that result from it. This has renewed interest in technology-centered approaches to achieving not only the "Triple Aim" of reducing costs while raising access and quality but also the "Quadruple Aim" of doing so without further squeezing wages and abrading job quality for frontline workers. How can we leverage technology toward the achievement of the Quadruple Aim? I view this as a "grand challenge" for health care managers and policymakers. Those looking for guidance will find that most analyses of the workforce impact of technological change consider broad classes of technology such as computers or robots outside of any particular industry context. Further, they typically predict changes in work or labor market outcomes will come about at some ill-defined point in the medium to long run. This decontextualization and detemporization proves markedly problematic in the health care sector: the nonmarket, institutional factors driving technology adoption and implementation loom especially large in frontline care delivery, and managers and policymakers understandably must consider a well-defined, near-term, i.e., 5-10-year, time horizon. This study is predicated on interviews with hospital and home health agency administrators, union representatives, health care information technology (IT) experts and consultants, and technology developers. I detail the near-term drivers and anticipated workforce impact of technological changes in frontline care delivery. With my emergent prescriptions for managers and policymakers, I hope to guide sectoral actors in using technology to address the "grand challenge" inherent to achieving the Quadruple Aim.

Doctors Dealing With COVID-19 in Pakistan: Experiences, Perceptions, Fear, and Responsibility.

This study aimed to describe the dealings of 20 biomedical doctors with coronavirus disease-19 (COVID-19) in the Sindh province of Pakistan. Focusing on physicians from three different hospitals, we describe their challenges, emotions, and views concerning the pandemic. Many regarded the virus from a biomedical standpoint. Yet some also perceived it as a “tool of a proxy war” and a “plot,” without giving agency to anyone for that “plot.” Furthermore, these care providers faced a great fear of infection and an even greater fear of transmitting the virus to their families and friends. A few also feared stigmatization as viral carriers. Whether they experienced fear or not, all of our physician interlocutors emphasized their sense of responsibility to “serve humanity,” yet some also expressed a strong belief in the inevitability of the will of Allah. Some were satisfied with the role of the government in containing the virus, while others expressed concerns and felt that the government should be doing much more. All expressed confidence in the use of personal protective equipment (PPE), viewing it as an effective buffer against viral contagion. We conclude with a call for further research especially ethnographic studies on dealings of physicians with COVID-19 across Pakistan as frontline care providers.

Nurse Practitioners and The Use of Antipsychotic Medications in Long Term Care in Ontario, Canada

Introduction: Antipsychotic use in Long-Term Care (LTC) in Ontario, Canada continues to pose a challenge in the care of older adult patients living in these institutions. The dangers and patterns of inappropriate prescribing have been documented frequently. Most of the current literature focuses on dementia and behavioral and psychological symptoms of dementia, the role of prescribers, or on interprofessional interventions with person-centered care to address the behavior. Very little discussion has focused on the role of nurse practitioners and other frontline long-term care staff in the assessment and interactions with residents that may result in prescriptions of antipsychotics.
 Objectives: The purpose of this population based retrospective study of data from all LTC facilities in Ontario, Canada in 2019-2020 was to determine the extent to which antipsychotic medications were used in and the factors associated with this use. Reflections about the NP role are discussed.
 Results: The results demonstrate that over thirty percent of residents in LTC continue to receive antipsychotics and those with the responsive behaviours are significantly more likely to be prescribed antipsychotics. 
 Conclusions: The findings identify a potential link between over-burdened front-line staff and increased antipsychotic prescriptions, as well as continued use of antipsychotics in attempts to prevent harm to residents and staff at long-term care homes. Recommendations are made that include changes to legislation that will ensure optimal front-line care and time for care, increased training for front line staff and, in particular, how the role of the nurse practitioner in LTC can be utilized to optimize the appropriate use of antipsychotics, and the support of discontinuing or decreasing the dose of antipsychotics when required.

Aligning policymaking in decentralized health systems: Evaluation of strategies to prevent and control non-communicable diseases in Nigeria.

Noncommunicable diseases (NCDs) are leading causes of death globally and in Nigeria they account for 29% of total deaths. Nigeria's health system is decentralized. Fragmentation in governance in federalised countries with decentralised health systems is a well-recognised challenge to coherent national health policymaking. The policy response to the rising NCD burden therefore requires strategic intent by national and sub-national governments. This study aimed to understand the implementation of NCD policies in Nigeria, the role of decentralisation of those policies, and to consider the implications for achieving national NCD targets. We conducted a policy analysis combined with key informant interviews to determine to what extent NCD policies and strategies align with Nigeria's decentralised health system; and the structure and process within which implementation occurs across the various tiers of government. Four inter-related findings emerged: NCD national policies are 'top down' in focus and lack attention to decentralisation to subnational and frontline care delivery levels of the health system; there are defective coordination mechanisms for NCD programmes which are underpinned by weak regional organisational structures; financing for NCDs are administratively burdensome and fragmented; and frontline NCD service delivery for NCDs are not effectively being integrated with other essential PHC services. Despite considerable progress being made with development of national NCD policies, greater attention on their implementation at subnational levels is needed to achieve more effective service delivery and progress against national NCD targets. We recommend strengthening subnational coordination mechanisms, greater accountability frameworks, increased and more efficient funding, and greater attention to integrated PHC service delivery models. The use of an effective bottom-up approach, with consideration for decentralization, should also be engaged at all stages of policy formulation.

Sufficient personal protective equipment training can reduce COVID-19 related symptoms in healthcare workers: A prospective cohort study

BackgroundThe association between inadequate personal protective equipment during the COVID-19 pandemic and an increased risk of SARS-CoV-2 infection in frontline healthcare workers has been proven. However, frontline healthcare workers with an adequate supply of personal protective equipment still showed an increased risk of contracting COVID-19. Research on the use of personal protective equipment could provide insight into handling present and future pandemics. ObjectivesThis study aims to investigate the impact of the availability, training and correct selection of personal protective equipment on the incidence of SARS-CoV-2 infection or positive suspect cases in healthcare workers during the COVID-19 pandemic in Belgium. DesignThis was a prospective cohort study involving Belgian healthcare workers: nurses, nursing aides, and midwives working in hospitals, home care services, and residential care services. MethodsRespondents were invited from May to July 2020 (period 1) followed by a second time in October 2020 (period 2) to complete a digital survey on personal protective equipment availability, training, personal protective equipment selection, screening ability, COVID-19 testing and status, and symptoms corresponding with the COVID-19 suspect case definition. The main outcome was a composite of COVID-19 status change (from negative to positive) during the study or a positive suspect case definition in period 2. ResultsFull data were available for 617 participants. The majority of respondents were nurses (93%) employed in a hospital (83%). In total, 379 respondents provided frontline care for COVID-19 patients (61%) and were questioned on personal protective equipment availability and personal protective equipment selection. Nurses were more likely to select the correct personal protective equipment compared with nursing aides and midwives. Respondents working in residential care settings were least likely to choose personal protective equipment correctly. Of all healthcare workers, 10% tested positive for COVID-19 during the course of the study and a composite outcome was reached in 54% of all respondents. Working experience and sufficient personal protective equipment training showed an inverse relation with the composite outcome. The relationship between personal protective equipment availability and the composite outcome was fully mediated by personal protective equipment training (-0.105 [95% confidence interval -0.211 — -0.020]). ConclusionsProper training in personal protective equipment usage is critical to reduce the risk of COVID infection in healthcare workers. During a pandemic, rapid dissemination of video guidelines could improve personal protective equipment knowledge in practitioners.Tweetable abstract: Proper training in personal protective equipment usage is critical to reduce the risk of COVID infection in healthcare workers.

The Importance of Contextual Understanding in Solving the Last Mile Problem.

The COVID-19 pandemic has disrupted many global industries and shifted the digital health landscape by stimulating and accelerating the delivery of digital care. It has emphasized the need for a system level informatics implementation that supports the healthcare management of populations at a macro level while also providing the necessary support for front line care delivery at a micro level. From data dashboard to Telemedicine, this crisis has necessitated the need for health informatics transformation that can bridge time and space to provide timely care. However, heath transformation cannot solely rely on Health Information Technology (HIT) for progress, but rather success must be an outcome of system design focus on the contextual complexity of the health system where HIT is used. This conference highlights the important roles context plays for health informatics in global pandemics and aims to answer critical questions in four main areas: 1) health information management in the covid-19 context, 2) implementation of new practices and technologies in healthcare, 3) sociotechnical analysis of task performance and workload in healthcare, and 4) innovations in design and evaluation methods of health technologies. We deem this as a call to action to understand the importance of context while solving the last mile problem in delivering the informatics solutions that are needed to support our public health response.

Virtual Recruitment: Experiences and Perspectives of Internal Medicine Program Directors

Virtual Recruitment: Experiences and Perspectives of Internal Medicine Program Directors

The experience of the nurse during the COVID-19 pandemic: Aglobal meta-synthesis in the year of the nurse.

PurposeFrom its beginnings in China in December of 2019, the novel coronavirus COVID‐19 spread and quickly became the center of nursing care and conversation across the globe (WHO, 2020). This meta‐ethnographic study was conducted in order to provide the profession of nursing interpretative explanations of a common experience during the care of patients with COVID‐19.Design and methodA literature review focused on the experience of the nurse during the COVID‐19 pandemic revealed a total of 13 qualitative studies conducted in China, Spain, Turkey, Iran, Brazil, and the United States. A meta‐ethnographic review of these qualitative works, using the method of Noblit and Hare, was then conducted which revealed the experience of the nurse across the globe during the COVID‐19 pandemic.FindingsThe review revealed strong similarities between the experiences of the nurse across the 13 studies. Given this reciprocal relationship, translations were constructed and synthesized until four new themes emerged outlining the global experience of the nurse during the COVID‐19 pandemic.ConclusionsDespite the differences between the structures of healthcare and government of the six countries represented in this meta‐ethnography, the experience of the nurse emerged into a narrative shared by those represented in this study. As the profession of nursing continues to work through ongoing waves of COVID‐19, these results will help guide the resources and training provided to nurses on the frontline of care.Clinical relevanceDespite great personal risk, nurses across the globe stepped up to the challenge of upholding and improving the health of the world's people during the COVID‐19 pandemic. As health policy, education, and system leaders, we must listen to the common experience revealed in this meta‐synthesis and respond by providing the resources needed to improve nursing practice and care.

Resident physicians’ perceptions of COVID-19 risk

BACKGROUND: Resident physicians provide front-line care to coronavirus disease 2019 (COVID-19) patients, but little is known about how they perceive the risk to their own health or how this is affected by the increasing role of social media in disseminating information. This study aims to determine resident physicians’ perceptions of personal COVID-19 risk during the first COVID wave and compare risk perceptions between low–average and high social media users. METHODS: We conducted a cross-sectional survey at the University of Toronto in May 2020 among resident physicians in internal medicine, emergency medicine, critical care, and anaesthesia. Participants were considered high social media users if above the median for daily social media use and low-average users if at or below the median. The primary outcome was perceived risk of hospitalization with COVID-19 within 6 months. RESULTS: A total of 98 resident physicians reported a median of 1–2 hours daily on social media, and 55.7% endorsed social media as a very or the most common source of information on COVID-19. The median overall perceived risk of hospitalization was 10% (inter-quartile ratio [IQR] 5–25)—7.5% for low–average social media users and 17.5% for high social media users ( p = 0.10). CONCLUSIONS: Resident physicians have an elevated perception of COVID-19 risk, including a perceived risk of hospitalization 250 times greater than the local population risk. Although social media are an important source of information on COVID-19, risk perception did not significantly differ between high and low–average social media users.

Seismic resilience index evaluation for healthcare facilities: A case study of hospital in Tehran

Due to the fact that Iran is located in one of the most earthquake-prone areas throughout the world, it is of great importance to pay specific attention to the performance of healthcare facilities after the occurrence of an earthquake to identify how they would serve patients and potential victims during and after the seismic events. Health centers should play a pivotal role in rescue operations during severe accidents, especially the emergency department, which normally stands at the frontline of caring for the patients and injured individuals. In this research, the seismic resilience index of an emergency department located in Iran has been investigated as an indicator, representing the post-earthquake level of medical services to the patients. This study, also, identifies the recovery mechanism of the hospital to the normal conditions after the coming earthquake. When it comes to assessing the hospital's seismic resilience index, officials should meet the need of “patient satisfaction” and the best parameter satisfying this need is the waiting time of patients, as a good indicator for the capacity of the hospital in critical circumstances, which is considered in this study as the main measure for the depiction of functionality curve as well. The considered case study is modeled by discrete event simulation in Anylogic software. The results indicate an increase in patient waiting time due to changes in hospital admission rate after the event. Having examined the changes in waiting time and quality of treatment in normal and seismic scenario conditions, the results show that the peak waiting time in the emergency department is equal to 20 h during the seismic scenario. While plotting the functionality curve, it is determined that right after the occurrence of the earthquake, the loss reduction of the emergency department would reach 24% while the value of the seismic resilience index would be approximately 86%. As a final approach, a plan for the promotion of resiliency is proposed by which the waiting time can be reduced up to 35%, enabling decision-makers to have fruitful and proper crisis management when a calamity strikes.

What do end-users want to know about managing the performance of healthcare delivery systems? Co-designing a context-specific and practice-relevant research agenda

BackgroundDespite increasing interest in joint research priority-setting, few studies engage end-user groups in setting research priorities at the intersection of the healthcare and management disciplines. With health systems increasingly establishing performance management programmes to account for and incentivize performance, it is important to conduct research that is actionable by the end-users involved with or impacted by these programmes. The aim of this study was to co-design a research agenda on healthcare performance management with and for end-users in a specific jurisdictional and policy context.MethodsWe undertook a rapid review of the literature on healthcare performance management (n = 115) and conducted end-user interviews (n = 156) that included a quantitative ranking exercise to prioritize five directions for future research. The quantitative rankings were analysed using four methods: mean, median, frequency ranked first or second, and frequency ranked fifth. The interview transcripts were coded inductively and analysed thematically to identify common patterns across participant responses.ResultsSeventy-three individual and group interviews were conducted with 156 end-users representing diverse end-user groups, including administrators, clinicians and patients, among others. End-user groups prioritized different research directions based on their experiences and information needs. Despite this variation, the research direction on motivating performance improvement had the highest overall mean ranking and was most often ranked first or second and least often ranked fifth. The research direction was modified based on end-user feedback to include an explicit behaviour change lens and stronger consideration for the influence of context.ConclusionsJoint research priority-setting resulted in a practice-driven research agenda capable of generating results to inform policy and management practice in healthcare as well as contribute to the literature. The results suggest that end-users are keen to open the “black box” of performance management to explore more nuanced questions beyond “does performance management work?” End-users want to know how, when and why performance management contributes to behaviour change (or fails to) among front-line care providers.

Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey.

Since health professionals provide frontline care to COVID-19 patients, information on vaccine acceptance among healthcare workers is needed. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate. COVID-19 vaccine acceptance groups (acceptors, hesitant, refusers) were defined; an adapted version of the WHO vaccine hesitancy scale was included. The survey demonstrated good reliability (Cronbach’s alpha = 0.92 for vaccine hesitancy scale; 0.93 for determinants). General linear and logistic regression methods examined factors which were univariately associated with vaccine hesitancy and vaccine acceptance, respectively. Multivariable models were constructed with stepwise model-building procedures. Race/ethnicity, marital status, job classification, immunocompromised status, flu vaccination and childhood vaccination opinions independently predicted hesitancy scale scores. Gender, education, job classification and BMI independently predicted acceptance, hesitancy, and refusal groups. Among hesitant employees, uncertainty was reflected in reports of motivating factors influencing their indecision. Despite a strong employee-support environment and job protection, respondents reported physical and mental health effects. The appreciation of varied reasons for refusing vaccination should lead to culturally sensitive interventions to increase vaccination rates amongst healthcare workers.

Reflections from the “Forgotten Front Line”: A qualitative study of factors affecting wellbeing among long-term care workers in New York City during the COVID-19 pandemic

While long-term care (LTC)11LTC: long-term care facilities serving older adults have long struggled with low employee morale and high rates of staff turnover, the COVID-19 pandemic brought unprecedented challenges to these facilities and the frontline staff working in them. This study aimed to explore factors that influenced the personal and professional wellbeing of care providers working in LTC facilities across New York City (NYC) during the pandemic. Fourteen semi-structured qualitative interviews were conducted with frontline care providers working in LTC facilities across NYC. Interviews were audio-recorded, transcribed, and systematically coded according to both pre-existing and emergent topics. Four main themes emerged from the data: the toll of the virus; home and work-life balance stressors; workplace stressors; and participants’ recommendations for facility leadership. Findings from this study may inform strategies for supporting the wellbeing of frontline care providers in LTC environments, especially during future public health emergencies.

A Review of the Impact of COVID-19 Pandemic on Urology Residence Training

Abstract Introduction and Objective: Since March 11, 2020, when the World Health Organization declared COVID-19 as a pandemic, a significant strain was placed on the worldwide health-care system. Although urology does not stand at the frontline of care for patients with COVID-19, every practicing urologist has been affected by the global outbreak. The impact of the COVID-19 pandemic on urology residency training was evaluated taking into account the residents’ point of view regarding these unprecedented circumstances. Evidence Acquisition: We performed a literature review on the current evidence based on urology residency training during the COVID-19 pandemic. Relevant databases (MEDLINE, Scopus, and Cochrane Library) were searched (until June 2021), and the main inclusion criterion was the presence of residents’ or directors’ opinion on their residency training program during the COVID-19 pandemic. Evidence Synthesis: The search identified 72 articles. A total of 14 studies reporting on more than 2500 residents were eligible for inclusion. The articles were analyzed, and the results are presented in the current review. Conclusions: This unprecedented situation has critically affected urology residency training. A decrease in operation volume, especially those in which residents were directly involved as well as in the majority of academic activities, has been reported by many studies. Furthermore, the COVID-19 pandemic has generated a significant impact on trainees’ mental well-being and lifestyle. On the other hand, the lockdown stressed the opportunity to implement innovative training tools, such as smart training programs and surgical skill development activities monitored by expert urologists.