New paradigm for faculty and resident clinical care roles
Continuing resident involvement in clinical activities is considered a
critical aspect of ongoing resident education. This priority has been
previously described by the head and neck surgery department in
Lombardy, Italy 5. The traditional hierarchy of junior
residents performing primary assessment of patients guided by a senior
resident is disrupted for two reasons. First the cohort system requires
more manpower for daily assignments. Second, in order to reduce the
number of at risk exposures, involvement of an experienced clinician is
critical at the earliest phase of clinical interactions. In the new
paradigm, detailed management of urgent otolaryngologic issues could be
discussed as they arose through one-on-one discussion, in small groups,
and in group video conferences, with special attention paid to the
unique impact of the ongoing pandemic on clinical decision-making.
Certain activities once considered routine for a head and neck surgeon,
such as bedside endoscopy or tracheotomy change, now pose potential risk
to the surgeon and trainee. Consideration is given to which patients
require such procedures and who should be present. There were also
opportunities to discuss evolving appropriate use and re-use guidelines
as well as proper donning and doffing of personal protective equipment.