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      Medizinstudierende als Helfende in der Pandemie : Innovatives Konzept zu Rekrutierung, Schulung und Einsatzplanung von Medizinstudierenden als medizinisches Personal während der COVID-19-Pandemie Translated title: Medical students as helpers in the pandemic : Innovative concept for recruitment, training and assignment planning of medical students as medical personnel during the COVID-19 pandemic

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          Abstract

          Hintergrund

          Die COVID-19-Pandemie hat das deutsche Gesundheitssystem vor enorme Herausforderungen gestellt und den Bedarf an Strategien zu Rekrutierung, Schulung und Einsatzplanung von medizinischem Personal verdeutlicht. Bislang existierte kein ganzheitliches Konzept, welches Medizinstudierende als Unterstützung der Fachkräfte auf Intensivstationen (ICU) einsetzt, um Personalengpässe in der medizinischen Versorgung zu vermeiden.

          Methode

          In einem groß angelegten Pilotprojekt wurden 265 Medizinstudierende für den Einsatz auf ICU trainiert. Begleitet wurde das innovative Schulungsmodul mit einem Prä-post-Fragebogen zur Selbsteinschätzung über die erlernten Fertigkeiten. 22 Wochen nach dem Schulungsmodul und noch während des Pandemieeinsatzes wurden mit einem weiteren Fragebogen Erfahrungen im Einsatz und Effizienz des Trainingsmoduls in Bezug auf die Vorbereitung für den ICU-Einsatz evaluiert.

          Ergebnisse

          Die Analyse ergab signifikante Mittelwertdifferenzen für alle COVID-19-spezifischen Variablen ( Sicherheitsdimension) zugunsten des Schulungsmoduls ( n = 168). Die Einsatzevaluation zeigte für n = 69 von insgesamt 89 eingesetzten Studierenden eine uneinheitliche Bewertung des Schulungskonzeptes als Vorbereitung auf den Arbeitseinsatz (53 % Zustimmung/47 % Ablehnung).

          Schlussfolgerung

          Die Ergebnisse zeigen eine gute Realisierbarkeit des innovativen Trainingskonzeptes für Medizinstudierende in Bezug auf einen Pandemieeinsatz als Helfende auf Intensivstationen. Das Konzept ist geeignet, um zusätzliche Hilfskräfte während einer Pandemie auf den Intensivstationen zur Verfügung zu stellen. Die uneinheitliche Bewertung deutet jedoch auf Anpassungsbedarf des Konzeptes hin.

          Zusatzmaterial online

          Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00101-021-01009-3) enthalten.

          Translated abstract

          Background

          The COVID-19 pandemic posed enormous challenges to the German healthcare system and highlighted the need for strategies to recruit, train, and deploy medical personnel. Until now, no holistic concept existed to use medical students as support for professionals in intensive care units (ICU) to avoid staff shortages in medical care.

          Method

          In a large-scale pilot project 265 medical students were trained for an ICU assignment. The innovative training module was accompanied by a pre-post questionnaire for self-assessment of the skills learned. 22 weeks after the training module and still during the pandemic deployment, another questionnaire was used to evaluate experiences in deployment and the efficiency of the training module with respect to preparation for ICU deployment.

          Results

          The analysis revealed significant mean differences for all COVID-19-specific variables (safety dimension) in favor of the training module ( n = 168). The deployment evaluation showed that the training concept was inconsistently assessed as preparation for the work deployment for 69 of the 89 deployed students in total (53% agreement/47% disagreement).

          Conclusion

          The results show a good feasibility of an innovative training concept for medical students with respect to a pandemic deployment as assistants in intensive care units. The concept is suitable for providing additional helpers in intensive care units during a pandemic; however, the inconsistent evaluation indicates that the concept can be expanded and needs to be adapted.

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          Most cited references7

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          Critical Supply Shortages — The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic

          New England Journal of Medicine
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            Beware of the second wave of COVID-19

            The outbreak of coronavirus disease 2019 (COVID-19), which began in Wuhan, China, in late 2019, has spread to 203 countries as of March 30, 2020, and has been officially declared a global pandemic. 1 With unprecedented public health interventions, local transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appears now to have been contained in China. Multiple countries are now experiencing the first wave of the COVID-19 epidemic; thus, gaining an understanding of how these interventions prevented the transmission of SARS-CoV-2 in China is urgent. In The Lancet, Kathy Leung and colleagues 2 report their assessment of the transmissibility and severity of COVID-19 during the first wave in four cities and ten provinces in China outside Hubei. The study estimated the instantaneous reproduction number in the selected locations decreased substantially after non-pharmaceutical control measures were implemented on Jan 23, 2020, and has since remained lower than 1. The transmission of SARS-CoV-2 in these locations was mainly driven by imported cases from Hubei until late January, which is, to some extent, similar to the transmission in January in several countries. The epidemics in Chinese provinces outside Hubei were believed to be driven by local transmission dynamics after Jan 31; 3 therefore, the findings of Leung and colleagues' study highlight the fact that the package of non-pharmaceutical interventions in China has the ability to contain transmission—not only imported cases, but also local transmission. The epidemic is accelerating rapidly in multiple countries, indicating shortfalls in preparedness. Given that multiple countries imposed travel restrictions against China in late January, there is a need to model whether earlier implementation of interventions such as social distancing, population behavioural change, and contact tracing would have been able to contain or mitigate the epidemic. Leung and colleagues also modelled the potential adverse consequences of premature relaxation of interventions, and found that such a decision might lead to transmissibility exceeding 1 again—ie, a second wave of infections. The finding is critical to governments globally, because it warns against premature relaxation of strict interventions. However, the effect of each intervention, or which one was the most effective in containing the spread of the virus, was not addressed in the study. While interventions to control the spread of SARS-CoV-2 are in place, countries will need to work toward returning to normalcy; thus, knowledge of the effect of each intervention is urgently required. Air travel data were used to model the effect of travel restrictions on delaying overall epidemic progression, and were found to have a marked effect at the international scale, but only a 3–5 day delay within China. 4 A study 5 focused on the effects of extending or relaxing physical distancing control measures in Wuhan has suggested that if the measures are gradually relaxed in March, a second wave of cases might occur in the northern hemisphere mid-summer. Country-specific models of the effects of travel restrictions and social distancing, as well as the alternative strategies after the relaxation of these interventions, such as the use of face masks, temperature checks, and contact tracing, are now needed. Case fatality rate (CFR) is one of the important unknowns of COVID-19. Leung and colleagues estimated the confirmed CFR (cCFR) outside Hubei was 0·98% (95% CI 0·82–1·16), which was consistent with the report from the Chinese Center for Disease Control and Prevention. 6 Since the epidemics in the studied locations did not overwhelm the health-care capacities, the data on the number of confirmed cases are believed to be reliable. Leung and colleagues also found the cCFR was correlated with provincial per capita gross domestic product and the availability of hospital beds per 10 000. In Wuhan, the CFR was up to 5·08% by March 28, 2020. 7 The remarkable difference in the CFRa between these locations and Wuhan might be attributed to the difference in the degrees of health-care capacity. Therefore, consideration should be given to the variations in health-care capacity when implementing interventions. While the epidemic is growing exponentially, the health-care system will face severe burdens. Governments should act and prepare immediately to ensure that the health-care system has adequate labour, resources, and facilities to minimise the mortality risk of COVID-19. © 2020 Tingshu Wang/Reuters 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
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              COVID-19: Are We Ready for the Second Wave?

              Inayat Ali (2020)
              The coronavirus disease 2019 (COVID-19) pandemic has already exerted an enormous impact on the entire world. Everything is overwhelmed in the face of a rapid escalation of cases. The countries that have already reported the peak of transmission are easing their preventive measures yet fearing a second wave of infection. If the virus causes that next wave, are we sufficiently prepared to deal with it? I argue that the stakeholders concerned should simultaneously handle the ongoing pandemic while making effective preparations for its second wave. To relax the preventive measures, countries must thoroughly revisit their situations based on scientific evidence.
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                Author and article information

                Contributors
                lvogt@ukaachen.de
                Journal
                Anaesthesist
                Anaesthesist
                Der Anaesthesist
                Springer Medizin (Heidelberg )
                0003-2417
                1432-055X
                20 July 2021
                20 July 2021
                : 1-9
                Affiliations
                [1 ]GRID grid.1957.a, ISNI 0000 0001 0728 696X, Klinik für Anästhesiologie, Uniklinik RWTH Aachen, Medizinische Fakultät, , RWTH Aachen, ; Aachen, Deutschland
                [2 ]GRID grid.1957.a, ISNI 0000 0001 0728 696X, AIXTRA – Kompetenzzentrum für Training und Patientensicherheit, Medizinische Fakultät, , RWTH Aachen, ; Forckenbeckstraße 71, 52074 Aachen, Deutschland
                [3 ]GRID grid.1957.a, ISNI 0000 0001 0728 696X, Klinik für Operative Intensivmedizin und Intermediate Care, Uniklinik RWTH Aachen, Medizinische Fakultät, , RWTH Aachen, ; Aachen, Deutschland
                Article
                1009
                10.1007/s00101-021-01009-3
                8290386
                34283258
                4d34c426-fd3c-4967-97fa-0d8d4d980d9d
                © The Author(s) 2021

                Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden.

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                History
                : 11 February 2021
                : 14 June 2021
                : 16 June 2021
                Funding
                Funded by: RWTH Aachen University (3131)
                Categories
                Originalien

                patientensicherheit,intensivmedizin,pandemiemanagement,personalakquise,personalentwicklung,patient safety,intensive care medicine,pandemic management,personnel acquisition,personnel development

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