In-person Attendance Research Articles

Measuring the effects of the COVID-19 pandemic on Diné and White Mountain Apache school personnel, families, and students: protocol for a prospective longitudinal cohort study

BackgroundThis paper describes the protocol for a longitudinal cohort study, “Project SafeSchools” (PSS), which focuses on measuring the effects of COVID-19 and the return to in-person learning on Diné (Navajo) and White Mountain Apache (Apache) youth, parents, and educators. The early surges of the COVID-19 pandemic led to the closure of most reservation and border town schools serving Diné and Apache communities. This study aims to: (1) understand the barriers and facilitators to school re-opening and in-person school attendance from the perspective of multiple stakeholders in Diné and Apache communities; and (2) evaluate the educational, social, emotional, physical, and mental health impacts of returning to in-person learning for caregivers and youth ages 4–16 who reside or work on the Diné Nation and the White Mountain Apache Tribal lands.MethodsWe aim to recruit up to N = 200 primary caregivers of Diné and Apache youth ages 4–16 and up to N = 120 school personnel. In addition, up to n = 120 of these primary caregivers and their children, ages 11–16, will be selected to participate in qualitative interviews to learn more about the effects of the pandemic on their health and wellbeing. Data from caregiver and school personnel participants will be collected in three waves via self-report surveys that measure COVID-19 related behaviors and attitudes, mental health, educational attitudes, and cultural practices and beliefs for both themselves and their child (caregiver participants only). We hypothesize that an individual’s engagement with a variety of cultural activities during school closures and as school re-opened will have a protective effect on adult and youth mental health as they return to in-person learning.DiscussionThe results of this study will inform the development or implementation of preventative interventions that may help Diné and Apache youth and their families recover from the negative impact of the COVID-19 pandemic, and positively impact their health and wellness.

Using the HyFlex model to deliver a capstone seminar course

IntroductionThe HyFlex course structure allows students to attend class in-person or via synchronous videoconferencing technology. This model has been described, but no data are available in pharmacy curricula. MethodsStudents enrolled in Grand Rounds (GR) were eligible. The GR Engagement Assessment Tool (GREAT) measured engagement three times during the semester. Eighteen statements across four domains were rated using a five-point Likert scale (1 = not true at all and 5 = completely true). Free-text responses were collected for qualitative analysis. The primary outcome was the difference in GR engagement between students attending in-person vs. remotely. Descriptive statistics were used for demographic information. Wilcoxon rank-sum tests compared Likert-scale responses between in-person and remote attendance. ResultsSurveys included 128 responses from 88 unique students. There were no differences between remote and in-person attendance for the boredom and elaboration domains. In-person students reported listening more intently (median 4, IQR [3,4]; P = .03). In-person students felt the material was more practical (median 4, IQR [4,5]) than remote students (median 4, IQR [3,4]; P = .002) and more applicable to other situations (median 3, IQR [3,5]) than remote students (median 3, IQR [2,4]; P = .04). Qualitative analysis of the entire cohort demonstrated five themes for satisfaction: safety, flexibility, convenience, technology, and professionalism. ConclusionsThere were subtle differences in student engagement or satisfaction using the HyFlex model. This study supports the expansion of this methodology to similar courses where remote instruction is needed.

Virtual, bilingual English-Spanish community nutrition and exercise classes: Barriers and opportunities

Objective: Regular exercise and healthy eating are important contributors to a person’s overall health and well-being. To enhance community health, Keck School of Medicine of the University of Southern California medical students have been leading in-person nutrition, cooking and exercise classes for community members at the Los Angeles County Wellness Center. In September 2020, due to the COVID-19 pandemic, students pivoted to teaching through a virtual platform. In this study, we evaluated community participants’ experiences attending virtual, bilingual nutrition, cooking and exercise classes; the efficacy of virtual classes in providing education; participants’ preference for virtual versus in-person classes; and potential advantages and disadvantages of the virtual versus in-person formats. Design: Cross-sectional study design. Setting: Following 22 virtual classes between September 2020 and April 2021, participants completed an online Qualtrics survey. Methods: Quantitative data were descriptively analysed within Qualtrics using the Sign test. Qualitative free response data were analysed by coding responses for common themes using an inductive approach. Results: There were 326 responses from 130 unique participants. Satisfaction was high for nutrition and exercise classes (99%), and 98% of participants reported they would make healthy nutrition and exercise behaviour changes. Participants preferred online classes compared to in-person classes ( p = .0008). Barriers to attending in-person classes included lack of childcare, transport issues and COVID-19 risk. Conclusion: Virtual classes were well-received and effective. Virtual classes circumvented some of the barriers to in-person class attendance, and many participants preferred virtual classes to in-person classes.

Impact of an Ultrasound Demonstration on Vascular Surgery Interest in Preclinical Medical Students

One strategy to address the impending shortage of vascular surgeons is to augment interest in the trainee pipeline. Endovascular procedures are unique to vascular surgery (VS) and endovascular simulations have proven effective at generating VS interest in the past. Like endovascular techniques, the use of ultrasound (US) testing in VS is unique among medical specialties. We hypothesized that an interactive US demonstration would increase VS interest in preclinical medical students. We created a 5-point Likert scale survey assessing interest in VS, understanding of VS, likelihood to further investigate VS, choosing VS as a rotational elective, and pursuing VS shadowing and research opportunities. This survey was administered 1day before and 1day after the demonstration. Results were compared via paired t-test. A VS attending assisted by a senior registered vascular technologist covered physics, B-mode, continuous, pulsed wave, and color Doppler in an interactive, hands-on experience. Our dedicated US simulation laboratory enabled simultaneous interactive virtual broadcast and in-person learning. All first-year and second-year students at our medical school were invited via e-mail. Five hundred twelve students were invited, 39 attended, and 19 students who completed surveys were included. Sixty eight percent were female. Attendance at the US demonstration resulted in a significant increase in students' interest in vascular surgery (P=0.012), understanding of vascular surgery (P<0.001), likelihood to further investigate vascular surgery (P<0.001), likelihood to choose a vascular surgery rotation (P<0.001), and likelihood to pursue vascular surgery shadowing and research opportunities (P<0.001). Although only 2 of 6 in-person attendees returned surveys, their increase in average response to all questions was higher than virtual attendees (+1.80 vs. +0.91, P=0.043). Attending an interactive US demonstration significantly increased preclinical medical students' interest in understanding of VS. In-person and virtual attendance both had a positive impact. Such a demonstration may be an effective tool to recruit students. It is imperative that we continue innovating to address the future shortage of vascular surgeons.

Determinants and Outcomes of In-person Lecture Attendance in Medical School.

IntroductionAttendance at in-person lectures in medical schools is declining with nearly 28.8% of all active, second-year medical students who reported “almost never” attending in-person lectures during their preclinical years. The objective of this study was to explore the relationship between medical student attendance and performance and investigate students’ goal orientation as factors influencing their decision to attend.MethodsParticipants completed a survey at the end of their second year that asked to self-report attendance during each of the three preclinical semesters, factors that influenced attendance, and measured their goal orientation (GO). Student performance outcomes included all courses in the preclinical curriculum and USMLE Step 1 scores.ResultsThere was a statistically significant reduction in frequency of attendance after each subsequent semester (p < .001). Third semester attendance, but not learning GO, was positively related to M2 course performance. Prove performance GO was positively related and third semester attendance was negatively related to Step 1 score after controlling for M2 course performance.ConclusionsThe pattern of declining lecture attendance in medical school with the rapid adoption of virtual learning triggered by the Covid-19 pandemic indicates students have taken more control over where and when they learn. Our results showed that students perceived in-person attendance at lectures was more valuable for balancing keeping up with coursework and maintaining social relationships and less valuable for efficient Step 1 preparation. Students’ goal orientation may help identify individuals who are less likely to attend in-person. The full impact of the COVID-19 on student learning is yet to be determined.

P024 Adolescent Independent Eating Occasion Frequency and Dietary Intake by Personal and Household Characteristics

<h3>Background</h3> Independent eating occasions (iEOs) among adolescents were associated with poorer diet quality and overweight status in previous studies. Little is known about how iEOs (frequency and food groups/food types consumed) vary by personal (e.g., age, sex, race, ethnicity) and household (e.g., food security) characteristics and other factors (e.g., school learning format - online vs. remote). <h3>Objective</h3> To determine associations among iEOs (frequency and food groups/food types consumed) and key personal and household characteristics among low-income adolescents in the US. <h3>Study Design, Settings, Participants</h3> A US-based online cross-sectional survey was administered to a national sample of low-income adolescents who reported iEOs and their parents (n = 622 dyads) from Qualtrics survey panelists (November/December 2021). About half were 11-12 years (44%), boys (53%), non-Hispanic White (44%), and from food-insecure households (52%). About two-thirds (68%) reported attending school in person. An adapted 27-item FLASHE (Family Life, Activity, Sun, Health, Eating) Study food frequency questionnaire was used to quantify mean daily intake frequencies of food groups/types consumed overall and during iEOs. <h3>Measurable Outcome/Analysis</h3> Chi-square tests were used to compare iEO frequency by demographic characteristics. Linear regression analyses were used to determine associations among mean iEO and overall daily food group intake frequencies (dependent variables) and iEO frequency (independent variable) adjusting for demographic and household characteristics. <h3>Results</h3> Frequency of iEOs was ≤ 3-4 times/week (46%) and ≥ 5-6 times/week (54%), with no differences by age group, sex, or in-person school attendance. Frequency of IEOs was positively associated with intake frequencies for all food groups both during IEOs and overall. Higher daily iEO intake frequencies of sugar-sweetened beverages, fast food/convenience foods, and all detrimental foods were also associated with food insecurity and non-Hispanic White race. <h3>Conclusions</h3> More frequent iEOs were associated with greater daily intake frequency of less healthful and healthful foods during iEOs and overall. Nutrition education could focus on increasing intake of healthful foods during iEOs for food-insecure youth. <h3>Funding</h3> USDA

Viable SARS-CoV-2 Delta variant detected in aerosols in a residential setting with a self-isolating college student with COVID-19

The B.1.617.2 (Delta) variant of SARS-CoV-2 emerged in India in October of 2020 and spread widely to over 145 countries, comprising over 99% of genome sequence-confirmed virus in COVID-19 cases of the United States (US) by September 2021. The rise in COVID-19 cases due to the Delta variant coincided with a return to in-person school attendance, straining COVID-19 mitigation plans implemented by educational institutions. Some plans required sick students to self-isolate off-campus, resulting in an unintended consequence: exposure of co-inhabitants of dwellings used by the sick person during isolation. We assessed air and surface samples collected from the bedroom of a self-isolating university student with mild COVID-19 for the presence of SARS-CoV-2. That virus’ RNA was detected by real-time reverse-transcription quantitative polymerase chain reaction (rRT-qPCR) in air samples from both an isolation bedroom and a distal, non-isolation room of the same dwelling. SARS-CoV-2 was detected and viable virus was isolated in cell cultures from aerosol samples as well as from the surface of a mobile phone. Genomic sequencing revealed that the virus was a Delta variant SARS-CoV-2 strain. Taken together, the results of this work confirm the presence of viable SARS-CoV-2 within a residential living space of a person with COVID-19 and show potential for transportation of virus-laden aerosols beyond a designated isolation suite to other areas of a single-family home.

In-Person Education During the Early COVID-19 Pandemic at Wichita Collegiate School.

IntroductionThe COVID-19 pandemic forced most Kansas schools to adopt remote or hybrid learning in 2020–2021. Wichita Collegiate School proceeded with an in-person teaching model. The purpose of this study was to determine if in-person learning can be done safely during the COVID-19 pandemic prior to vaccine use.MethodsWichita Collegiate is a private school located in Sedgwick County, Kansas. The study population included 671 students (grades 1 – 12) and 130 staff. The procedures implemented during the school year (August 19, 2020 – May 21, 2021) included: mandatory face coverings, six feet physical distancing, and daily temperature checks. A registered nurse performed contact tracing and executed quarantine requirements per the U.S. Centers for Disease Control and Prevention guidelines.ResultsOver the study period, 487 students and staff were tested for COVID-19 and 18.5% (n = 90) were positive. Overall, students and staff rate of COVID-19 infection was lower than the expected rate when compared to the surrounding community of Sedgwick County. Thorough contract tracing of positive cases revealed that 2.2% (n = 2) individuals were likely exposed to COVID-19 at school.ConclusionsThis study suggested that transmission of COVID-19 was infrequent in a school setting with in-person attendance, even before widespread vaccine availability. By following public health guidelines and utilizing contact tracing, it was possible to limit the spread of COVID-19 during in-person learning. This has immediate implications for how schools safely returned to in-person learning in the post-vaccine era.

Looking beyond the COVID-19 Pandemic: Congregants’ Expectations of Future Online Religious Service Attendance

Many religious congregations in the United States have adapted to COVID-19 lockdowns by offering religious services online. This study aims to understand whether congregants from a diverse set of faith traditions expect to attend online or in-person religious services after the pandemic. First, it examines how members of different religious traditions vary in their expectations of future attendance. Second, it explores whether respondents’ habituation to online attendance during the pandemic might result in greater preference for future online attendance. This study draws on a non-representative sample of 1609 members of Christian, Jewish, and Hindu communities in four US states surveyed in late 2020 and employs logistic regression models. The findings first suggest a divergence between congregation types that require in-person attendance for certain rituals versus those that do not. Second, habituation of the practice of online attendance may cultivate the desire to sustain this practice into the future. Online religious services have been well received by most congregants, and online services will likely play a useful role across congregation types, albeit at differing levels and with different audiences. Our finding that marginal congregants were more likely to prefer online religious services, while more engaged members preferred in-person attendance, is of relevance to faith leaders.

Snapshot of a Child and Adolescent Psychiatric ER during Pandemic

IntroductionThe COVID-19 pandemic has disrupted numerous fundamental systems ranging from businesses to education system. The long-term consequences of the Pandemic, namely virtual learning and prolonged social isolation are coming to fruition in Child/Adolescent-Psychiatric Emergency-Rooms (CAP-ER). Discontinuity of in-person attendance of schools has poorly impacted the mental health of children and adolescents (C&amp;A) of low-socioeconomic areas, who often rely on schools for meals, physical activity, and mental-health support. An increase in agitation, suicidal ideation, and a declining school performance has been observed in such situations.ObjectivesThe primary objective of this study is to explore the increase in these symptoms as the presenting complaint in the psychiatric ER.MethodsBetween April to June 2021 a cross-sectional quality improvement (QI) study was done on children presenting to CAP-ER BronxCare-Hospital NY with psychiatric complaints. Concomitant substance use disorder was determined using CRAFT questionnaire.ResultsOur data comprised 209 patients (84 M/125 F) with 79 children and 130 adolescents. Ethnicity: 116 Hispanics (56%), 84 African Americans (40%), and 9 others. The most common presenting complaints were aggression (111, 53%), suicidal ideation/suicide attempt (50, 24%), acute exacerbation of chronic illness (7, 3.3%), accidental overdosage (5, 2.3%) and others (36, 17.4). Marijuana was the most used substance (34 patients).ConclusionsThere has been a surge in severity of presentation of psychiatric disorders among children and adolescents, aggression so far, the most prevalent. Further studies are needed to delineate the social links with this high emergent load and pandemic.DisclosureNo significant relationships.

Building Transformation for Precautionary Measures against COVID-19 Pandemic: Case of Off-Street Car Parking of Campuses

COVID-19 set off a problem for businesses due to an unbalanced utilization of buildings, services, and utilities. Thus, some countries reduced the length of the quarantine period and returned to natural life earlier than necessary to allow the economy and businesses to survive. This research aims to review the standards of off-street car parking (OSCP) for higher education institutes (HEIs) and examine the possibility of the transformation of the car parking buildings. Secondary and descriptive research approaches have been applied, and OSCP standards of different countries have been reviewed to identify the challenges facing the transformation design process in terms of standard dimensions, finishing materials, building envelope, illumination, ventilation, and technical installations. OSCP of Kingdom University (KU) in Bahrain has been analysed for proposing the rescheduling of space planning and accommodating a certain number of in-person attendance students as per the three situations of the COVID-19 pandemic. The author concluded that OSCP spaces of the HEIs are the most feasible building for design transformation in terms of rescheduling the space planning, but it is not very achievable in terms of affordability due to much adaptation being required and additional technical installations. At least 68% of the area of OSCP is used for circulation and services. Future studies seeking the feasibility of smart rotary car parking to save such a huge area of car circulation in the traditional OSCP building are recommended.

The First Hybrid International Educational Comprehensive Cleft Care Workshop.

Describe the first hybrid global simulation-based comprehensive cleft care workshop, evaluate impact on participants, and compare experiences based on in-person versus virtual attendance. Cross-sectional survey-based evaluation. International comprehensive cleft care workshop. Total of 489 participants. Three-day simulation-based hybrid comprehensive cleft care workshop. Participant demographic data, perceived barriers and interventions needed for global comprehensive cleft care delivery, participant workshop satisfaction, and perceived short-term impact on practice stratified by in-person versus virtual attendance. The workshop included 489 participants from 5 continents. The response rate was 39.9%. Participants perceived financial factors (30.3%) the most significant barrier and improvement in training (39.8%) as the most important intervention to overcome barriers facing cleft care delivery in low to middle-income countries. All participants reported a high level of satisfaction with the workshop and a strong positive perceived short-term impact on their practice. Importantly, while this was true for both in-person and virtual attendees, in-person attendees reported a significantly higher satisfaction with the workshop (28.63 ± 3.08 vs 27.63 ± 3.93; P = .04) and perceived impact on their clinical practice (22.37 ± 3.42 vs 21.02 ± 3.45 P = .01). Hybrid simulation-based educational comprehensive cleft care workshops are overall well received by participants and have a positive perceived impact on their clinical practices. In-person attendance is associated with significantly higher satisfaction and perceived impact on practice. Considering that financial and health constraints may limit live meeting attendance, future efforts will focus on making in-person and virtual attendance more comparable.

COVID-19 Positivity Following an In-Person Surgical Society Meeting: A Cross-Sectional Survey Study

IntroductionMany surgical societies have recently resumed in-person meetings after canceling or adopting virtual formats during the COVID-19 pandemic. These meetings implemented safety measures to limit viral exposure and ensure participant safety. While there have been anecdotal reports of COVID-19 cases after attendance, no large-scale assessments have been undertaken. The objective of this study was to evaluate COVID-19 positivity following an in-person surgical society meeting. MethodsAn online survey was administered to participants of the Society for Asian Academic Surgeons annual meeting, which was held in Chicago, Illinois in September 2021. This survey assessed vaccination status, in-person versus virtual conference attendance, and COVID-19 testing and symptoms in the 7 d immediately following the meeting. ResultsAmong the 220 meeting participants, 173 attended in person (79%). There were 91 survey respondents (41% response rate): 67% attending physicians, 27% trainees, and 6% medical students. Nearly, all (99%) reported being fully vaccinated against COVID-19. COVID-19 testing was sought within 7 d of the meeting by 15% of in-person respondents, and all reported negative results. Among individuals who were not tested, no one reported development of symptoms (cough, shortness of breath, fever, new loss of taste/smell, etc.). ConclusionsAmong in-person attendees of a recent surgical society meeting, no one reported positive COVID-19 testing after the meeting, and individuals who were not tested denied developing symptoms. While these results are encouraging, societies hosting meetings should continue to proactively assess the safety of in-person meetings to promptly identify outbreaks and opportunities for improvement.

The impact of the resumption of in-person school attendance on COVID-affected child abuse and neglect trends in Florida

BackgroundThe COVID-19 pandemic has led to fewer child abuse and neglect (CAN) hotline calls, CAN investigations, and foster care entries across the U.S. ObjectiveTo determine if there were decreases in CAN hotline calls, CAN investigations, foster care entries, and foster care exits in Florida (the largest among the few states that publishes monthly public data on the four areas) after the pandemic began, and to determine if there was any amelioration of these trends in Florida once schools had reopened for in-person learning. MethodsSecondary data analyses of administrative child welfare data from January 2010 to June 2021 from Florida were used. Spline regression equations were calculated for CAN hotline calls, CAN investigations, foster care entries, and foster care exits during three periods: 1) before the COVID-19 pandemic (January 2010 to February 2020); 2) after the pandemic, but before schools reopened (March 2020 to October 2020); and 3) after the pandemic and after schools reopened (November 2020 to June 2021). ResultsPrior to the pandemic, there was a non-statistically significant increase of 1.35 hotline calls per 100,000 children per month (p = .478), a statistically significant increase of 0.01 investigations per 100,000 children per month (p < .001), a non-statistically significant increase of 0.01 foster care entries per 100,000 children per month (p = .415), and a statistically significant increase of 0.03 foster care exits per 100,000 children per month (p < .05). Once the pandemic started in March 2020, there were statistically significant decreases of 136.02 hotline calls per 100,000 children per month (p < .001), 102.84 investigations per 100,000 children per month (p < .001), 6.32 foster care entries per 100,000 children per month (p < .001) and 5.75 foster care exits per 100,000 children per month (p < .01). Once all schools reopened for in-person learning in November 2020, there continued to be statistically significant decreases of 47.86 hotline calls per 100,000 children per month (p < .05), 6.38 foster care entries per 100,000 children per month (p < .001) and 6.53 foster care exits per 100,000 children per month (p < .001). This suggests that there were an estimated 34,374 fewer CAN hotline calls, 2338 children who did not enter foster care, and 2587 youth residing in foster care (YRFC) whose foster care exits were delayed. The delay in foster care exits suggests that YRFC in Florida had stayed a combined cumulative equivalent of 477.1 years longer in care. ConclusionWith the COVID-19 variants like Omicron continuing to wreak havoc in Florida, there will be a continued trend of decreasing CAN hotline calls, foster care entries and foster care exits even with in-person learning in all Florida schools. A real-time interoperable data system utilizing real-time predictive analytics must be developed in concert with the development of leaders and executives with advanced degrees in child welfare organizations who are able to maximize information from such systems.

Estimated Transmission Outcomes and Costs of SARS-CoV-2 Diagnostic Testing, Screening, and Surveillance Strategies Among a Simulated Population of Primary School Students

In addition to illness, the COVID-19 pandemic has led to historic educational disruptions. In March 2021, the federal government allocated $10 billion for COVID-19 testing in US schools. Costs and benefits of COVID-19 testing strategies were evaluated in the context of full-time, in-person kindergarten through eighth grade (K-8) education at different community incidence levels. An updated version of a previously published agent-based network model was used to simulate transmission in elementary and middle school communities in the United States. Assuming dominance of the delta SARS-CoV-2 variant, the model simulated an elementary school (638 students in grades K-5, 60 staff) and middle school (460 students grades 6-8, 51 staff). Multiple strategies for testing students and faculty/staff, including expanded diagnostic testing (test to stay) designed to avoid symptom-based isolation and contact quarantine, screening (routinely testing asymptomatic individuals to identify infections and contain transmission), and surveillance (testing a random sample of students to identify undetected transmission and trigger additional investigation or interventions). Projections included 30-day cumulative incidence of SARS-CoV-2 infection, proportion of cases detected, proportion of planned and unplanned days out of school, cost of testing programs, and childcare costs associated with different strategies. For screening policies, the cost per SARS-CoV-2 infection averted in students and staff was estimated, and for surveillance, the probability of correctly or falsely triggering an outbreak response was estimated at different incidence and attack rates. Compared with quarantine policies, test-to-stay policies are associated with similar model-projected transmission, with a mean of less than 0.25 student days per month of quarantine or isolation. Weekly universal screening is associated with approximately 50% less in-school transmission at one-seventh to one-half the societal cost of hybrid or remote schooling. The cost per infection averted in students and staff by weekly screening is lowest for schools with less vaccination, fewer other mitigation measures, and higher levels of community transmission. In settings where local student incidence is unknown or rapidly changing, surveillance testing may detect moderate to large in-school outbreaks with fewer resources compared with schoolwide screening. In this modeling study of a simulated population of primary school students and simulated transmission of COVID-19, test-to-stay policies and/or screening tests facilitated consistent in-person school attendance with low transmission risk across a range of community incidence. Surveillance was a useful reduced-cost option for detecting outbreaks and identifying school environments that would benefit from increased mitigation.

Evaluating Resource Utilization for In-Person and Virtual Joint Classes in Total Joint Arthroplasty: An Analysis of Attendance Patterns at a Large Metropolitan Health System

BackgroundProvider-run “joint classes” educate total joint arthroplasty (TJA) patients on how to best prepare for surgery and maximize recovery. There is no research on potential healthcare inequities in the context of joint classes or on the impact of the recent shift toward telehealth due to coronavirus disease 2019 (COVID-19). Using data from a large metropolitan health system, we aimed to (1) identify demographic patterns in prepandemic joint class attendance and (2) understand the impact of telehealth on attendance. MethodsWe included data on 3,090 TJA patients from three centers, each with a separately operated joint class. Attendance patterns were assessed prepandemic and after the resumption of elective surgeries when classes transitioned to telehealth. Statistical testing included standardized differences (SD > 0.1 indicates significance) and a multivariate linear regression. ResultsThe in-person and telehealth attendance rates were 69.9% and 69.2%, respectively. Joint class attendance was significantly higher for non-White, Hispanic, non-English primary language, Medicaid, and Medicare patients (all SD > 0.1). Age was a determinant of attendance for telehealth (SD > 0.1) but not for in-person (SD = 0.04). Contrastingly, physical distance from hospital was significant for in-person (SD > 0.1) but not for telehealth (SD = 0.06). On a multivariate analysis, distance from hospital (P < .05) and telehealth (P < .0001) were predictors of failed class attendance. ConclusionThis work highlights the relative importance of joint classes in specific subgroups of patients. Although telehealth attendance was lower, telehealth alleviated barriers to access related to physical distance but increased barriers for older patients. These results can guide providers on preoperative education and the implementation of telehealth.

Healthcare Professional’s Perceptions of E-Learning during the COVID-19 Pandemic

Background: COVID-19 has a significant impact on lives worldwide. Owing to the adverse effect of this pandemic, there has been a major shift from in-person learning activities to virtual learning. Different methods of virtual learning or e-learning, such as online classes and webinars, have emerged rapidly. Objective: The aim of this study is to identify the perceptions of healthcare professionals regarding e-learning during the COVID-19 pandemic. Method: An online survey was conducted using Microsoft Forms sent via a text link to mobile phones and emails to healthcare professionals. The questionnaire had multiple-choice questions and five-point scaling to determine perceptions about virtual learning. Data in the form of responses were collected, analyzed, and summarized as mean ± standard deviation and percentage. Results: Responses were received from a total of 410 participants, out of which 240 (58.54%) were females, and 170 (41.46%) were males. Among all participants, 294 (71.71%) were doctors. A vast majority of participants (90%) attended online webinar/e-conferences since the pandemic. The mobile phone was the most commonly used device for e-learning. More than half of the participants opined that in-person meetings are more effective than virtual meetings. In terms of medical learning, 40.48% of participants believed that virtual conferences are more convenient compared to conventional in-person attendance. According to 42.2% of participants, lack of personal interaction in virtual meetings affected their ability to acquire knowledge and experience. Conclusion: Our survey demonstrated the acceptance of virtual learning by healthcare professionals as a new learning method. The majority of participants seem willing to adapt to this new medium.

The impact of synchronous hybrid instruction on students’ engagement in a pharmacotherapy course

Background:Synchronous hybrid instruction offers flexible learning opportunities by allowing a portion of students to attend class sessions on campus while simultaneously allowing the remaining students to attend remotely. Although such flexibility may offer a number of advantages for pharmacy students, one area of concern is whether online participation options within synchronous hybrid courses can promote similar levels of engagement as courses that are designed entirely for face-to-face (FTF) participation.Objectives:The objective of this study was to evaluate the impact of synchronous hybrid instruction on pharmacy students’ engagement in a pharmacotherapy course. An evaluation was completed to determine if students were more likely to actively engage in class when they were participating remotely via teleconferencing technology or when FTF. Additionally, students’ perspectives were evaluated to determine their views of the benefits and challenges of the hybrid model for engagement in learning.Methods:The course utilizes team-based learning to apply critical thinking skills and develop a comprehensive care plan. A mixed methods approach was used to examine students’ engagement in the hybrid learning environment by quantitatively analyzing students’ responses to likert-scale survey items and qualitatively analyzing their responses to open-ended survey questions.Results:Students reported they were more likely to actively listen (p=0.004), avoid distractions (p=0.008), and react emotionally to a topic or instruction (p=0.045) when FTF. There were no significant differences found in student reported note taking, asking questions, responding to questions, or engaging in group work between the two modes of participation. Content analysis identified other benefits that supported student engagement, including perceived flexibility and enhanced ability to interact during class via the teleconferencing technology. For some students, challenges that negatively impacted engagement included difficulties with internet connectivity and a sense of dislocation or isolation in the course.Conclusion:This study demonstrated that when participating in a synchronous hybrid course, students participating remotely were less likely (compared to in-person attendance) to pay close attention and react emotionally, but were just as likely to take notes and communicate with teachers and groups. Key benefits of the hybrid approach were increased flexibility and the usefulness of online communication tools, while key challenges focused on technical and psychological isolation from others. The principles of flexible learning environments and self-regulated learning provide opportunities for pharmacy educators who are interested in improving hybrid instruction in the future.

Behavioral economics in neonatology-balancing provider wellness and departmental finances.

High work relative value units (wRVU) per clinical full-time-equivalent (cFTE) productivity by Neonatologists have played a key role in enhancing departmental revenue in Pediatrics. However, such high productivity is not sustainable due to recent changes in trainee schedules and global daily codes and is likely to impact physician morale and wellness. Incentives based on wRVU benchmarks have the capacity to promote desirable behavior such as better documentation and in-person attendance in delivery room resuscitation and consults but comes at a cost of physician time providing care. An alternate method of funding academic Pediatric departments using time- or point-based staffing models, a reduction in productivity benchmarks for academic neonatologists through more accurate reporting of effort and physician leadership that promotes transparency and mutual respect are warranted to improve neonatologist well-being and morale.

Prevalence and Factors of Anxiety During the Coronavirus-2019 Pandemic Among Teachers in Saudi Arabia.

BackgroundTeachers play a central role in successful education. Due to the COVID-19 pandemic, regular in-person attendance in classes at all levels of education has been disrupted for more than 1 year in many countries. These lockdowns, which include the discontinuation of in person learning at schools and universities has presented a significant challenge for teachers to adapt to online teaching. Given this rapid format change, occupational anxiety levels among educators has increased.ObjectiveThe primary objective of this study was to assess the prevalence of anxiety among teachers in Saudi Arabia. A secondary objective was to explore characteristics of teachers associated with the level of anxiety level during the period of lockdown.MethodsAn anonymous, online cross-sectional study was carried for 3 months (February 2021 through April 2021). The questionnaire consisted of four sections and included the Generalized Anxiety Disorder instrument (GAD-7). Chi-square tests were completed for categorical comparisons while binary logistic regressions were used for associative relationship exploration. The IRB at King Saudi University Medical City, Saudi Arabia approved this study.ResultsA total of 742 respondents completed the survey yielding an anxiety prevalence of 58.2 % among teachers. Medium degree of statistically significant differences identified as marital status (p = 0.046). women had higher anxiety (65.3%) than men (34.7%) but gender with anxiety was low degree of statistical significance compared with non-anxiety status (p = 0.697). The odds of anxiety among middle teachers was twice (OR = 2.01) as high as the odds of anxiety among other levels of teacher (p = 0.01, 95% CI 0.94–4.26).ConclusionsThis study identified that many teachers experienced anxiety during the lockdown, especially women and middle school teachers. Future studies should identify contributing factors to estimate the magnitude of the exposure to anxiety between different types of teachers to help establish better preventive measures based on the workplace environment.