American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Practical Resources

Resources in this section include those focused on direct responses to the pandemic as well as information about pivoting to virtual platforms.

COVID-19 Response

Blueprint for Restructuring a Department of Surgery in Concert with the Health Care System During a Pandemic: The University of Wisconsin experience

Ben L. Zarzaur, MD, MPH; Christopher C. Stahl, MD; Jacob A. Greenberg, MD, EdM; Stephanie A. Savage, MD, MS; Rebecca M. Minter, MD

Keywords: academia, administrative restructuring, framework, crisis management

The authors share lessons learned during the COVID-19 pandemic by the Department of Surgery at the University of Wisconsin School of Medicine and Public Health and University of Wisconsin Health, based on past experience with incident command structures in military combat operations and Federal Emergency Management Agency responses.

Early Report from the Greater New York Chapter of the American College of Surgeons Committee on Trauma on the COVID-19 Crisis

Matthew Bank, MD, FACS; Patricia O’Neill, MD, FACS; Jose Prince, MD, FACS; Ronald Simon, MD, FACS; Sheldon Teperman, MD, FACS; Robert Winchell, MD, FACS

Keywords: administrative restructuring, framework, crisis management

This article provides a summary of the COVID-19 crisis in the Greater New York City area on how it was exacerbated by an early “bottleneck” in limited ICU capacity, which prevented the flow of critically ill patients out of the emergency department, left critically ill patients at lower than ideal levels of care within the hospital, prevented full functionality of operating rooms, and degraded the health system’s ability to handle other non-COVID-19 medical and surgical emergencies such as trauma, stroke, and myocardial infarction.

Rapid Development of Resident-led Procedural Response Teams to Support Patient Care During the Coronavirus Disease 2019 Epidemic: A surgical workforce activation team

Barbara E. Coons, MD; Sophia F. Tam, MD; Shunpei Okochi, MD

Keywords: administrative restructuring, framework, crisis management, checklist for triage kit

This organization’s SWAT (Surgical Workforce Activation Team) has become an integral part of their hospital’s response to the COVID-19 epidemic. Strategic appropriation of resources will be key to a community’s success in treating the virus. They describe their technique of using surgical staff as a rapidly deployed access team as an efficient use of staffing, personal protective equipment, and supplies that aid in the treatment of all patients.

Stepping Outside Your Typical Scope of Work? Resources from the University of Wisconsin May Help

Various authors

Keywords: guidelines, administrative restructuring, working outside of scope

The University of Wisconsin-Madison (UW) has developed guidance for surgeons and other health care professionals who do not routinely provide trauma/burn or intensivist care, as many providers have been asked to step out of their typical scope of work because of COVID-19. UW is making the resources widely available via the ACS.

Lessons in Flexibility from a General Surgery Program at the Epicenter of the Pandemic in New York City

Tamar Nobel, MD; Michael L. Marin, MD, FACS; Celeste M. Divino, MD, FACS

Keywords: academia, administrative restructuring, framework, crisis management

This resource shares a residency restructuring plan that describes the different types and composition of resident teams during a surge of patients such as in a pandemic.

Resident/Fellow/Student Deployment/Education During COVID-19 Crisis and Beyond: University of Buffalo perspective

Steven Schwaitzberg, MD, FACS

Keywords: academia, administrative restructuring, framework, crisis management

This resource describes a residency deployment plan based on the stage of the pandemic.

Resident/Fellow/Student Deployment/Education During COVID-19 Crisis and Beyond: University of Pennsylvania, Department of Orthopedics Perspective

L. Scott Levin, MD, FACS

Keywords: academia, administrative restructuring, framework, crisis management

This resource provides points for sub-specialty programs to consider in their response to a pandemic-type event.

Addressing General Surgery Residents’ Concerns in the Early Phase of the COVID-19 Pandemic

Katherine He, MD; Allan Stolarski, MD; Edward Whang, MD; Gentian Kristo, MD

Keywords: resident concerns, mental health, workforce adaptation

The purpose of this study was to determine the concerns of General Surgery residents as they prepare to be in the frontlines of the response against coronavirus disease 2019 (COVID-19).

Impact of COVID-19 on Away Rotations in Surgical Fields

Carter J. Boyd, BS; Dani C. Inglesby, BS; Britney Corey, MD; Benjamin J. Greene, MD; Michael A. Harrington, MD, MPH; Michael D. Johnson, MD; Timothy W. King, MD, PhD, MSBE; Soroush Rais-Bahrami, MD; M. Lance Tavana, MD

Keywords:  medical school; away rotations; student safety

The objective of this article is to assess the current COVID-19 pandemic situation in light of away rotations and to provide recommendations for surgical subspecialty programs and applicants in order to have the best outcome during this upcoming application cycle. In particular, we emphasize the importance of implementing universal processes within each individual subspecialty. This will provide equitable opportunities for all applicants minimizing potential biases or disadvantages based on geographic location or availability of a program at an applicant’s home institution.

Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic

Tait Shanafelt, MD; Jonathan Ripp, MD, MPH; Mickey Trockel, MD, PhD

Keywords: recommendations for leadership, anxiety, burnout

Maintaining an adequate health care workforce in this crisis requires not only an adequate number of physicians, nurses, advanced practice clinicians, pharmacists, respiratory therapists, and other clinicians, but also maximizing the ability of each clinician to care for a high volume of patients. This article summarizes considerations for supporting the health care workforce so health care professionals are equipped to provide care for their patients and communities.

Emergency Restructuring of a General Surgery Residency Program During the Coronavirus Disease 2019 Pandemic: The University of Washington Experience

Amer H. Nassar, MD; Nicole K. Zern, MD; Lisa K. McIntyre, MD; Dana Lynge, MD; Caitlin A. Smith, MD; Rebecca P. Petersen, MD; Karen D. Horvath, MD; Douglas E. Wood, MD

Keywords: restructuring, residency program, administrative, academia

This Special Communication describes how a surgical department in an epicenter of the coronavirus disease 2019 pandemic created a unique workflow of surgical resident physicians to accommodate team safety while optimizing patient care.

Restructuring the surgical service during the COVID‐19 pandemic: experience from a tertiary institution in Singapore

T. Y. Low; J. B. Y. So; K. K. Madhavan; M. Hartman

Keywords: restructure, administrator, workflow

This article provides insight into what it looked like to restructure surgical service in one of the first-hit countries of the pandemic.

Pivoting to Virtual

Virtual Interviews for Surgical Training Program Applicants during COVID-19: Lessons Learned and Recommendations

Ryan W. Day, MD; Brigitte M Taylor, CAP; Brian Bednarski, MD, FACS; Ching-Wei D. Tzeng, MD, FACS; Jeffrey E. Gershenwald, MD, FACS; Jeffrey E. Lee, MD, FACS; Elizabeth G. Grubbs, MD, FACS

Keywords: virtual interview, residency, workforce adaptation

This article provides recommendations for programs switching to virtual interviews, based on their experience during the COVID-19 pandemic.

Interactive Learning Methods You Can Use with Zoom

Compiled by Lynne Robins, PhD

Keywords: virtual learning, online platforms, e-learning strategies

This article includes the description of 12 interactive teaching methods that you can use with Zoom.

Interactive Lecturing

Geoff White

Keywords: virtual learning, e-learning strategies, teaching outline

This article provides, as an appendix, a hypothetical model of a 60-minute interactive lecture.  Faculty can adapt this model to their own virtual context.

Virtual Interviews in the Era of COVID-19: A Primer for Applicants

Ruth Ellen Jones, MD; Kareem R. Abdelfattah, MD

Keywords: virtual interviews, fellowship, advice for residents

This article provides advice for applicants preparing for virtual residency interviews.

Using Technology to Maintain the Education of Residents During the COVID-19 Pandemic

Robert Connor Chick, MD; Guy Travis Clifton, MD; Kaitlin M. Peace, MD; Brandon W. Propper, MD; Diane F. Hale, MD; Adnan A. Alseidi, MD; Timothy J. Vreeland, MD

Keywords: academia, distance learning, flipped classroom, surgical videos

In order to maintain rigorous surgical education during the indeterminate amount of time that social distancing will be in place, this group of authors proposes potential education solutions including the flipped classroom model, online practice questions, teleconferencing in place of in-person lectures, involving residents in telemedicine clinics, procedural simulation, and the facilitated use of surgical videos. Although there is no substitute for hands-on learning through operative experience and direct patient care, these may be ways to mitigate the loss of learning exposure during this time.