4.5 Article

One-Year Follow-Up of COVID-19 Impact on Surgical Education: Clinical Training Restored but Surgical Trainee Emotional Well-Being Still at Risk

Journal

JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
Volume 235, Issue 2, Pages 195-209

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/XCS.0000000000000243

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According to the results of a survey, the coronavirus disease 2019 pandemic had a severe disruption on surgical education and trainee well-being during the 2020 to 2021 academic year. However, compared to 2020, there was a decrease in severe disruption of education programs, reduction in nonemergency surgery, and improvement in surgical trainee autonomy. Although the physical safety and health of surgical trainees were less severely impacted in 2021, negative effects on isolation, burnout, and emotional well-being remained prevalent.
BACKGROUND: A previous survey documented the severe disruption of the coronavirus disease 2019 pandemic on surgical education and trainee well-being during the initial surge and systemic lock-downs. Herein, we report the results of a follow-up survey inclusive of the 2020 to 2021 academic year. STUDY DESIGN: A survey was distributed to education leaders across all surgical specialties in summer 2021. We compared the proportion of participants reporting severe disruption in key areas with those of the spring 2020 survey. Aggregated differences by year were assessed using chi-square analysis. RESULTS: In 2021, severe disruption of education programs was reported by 14% compared with 32% in 2020 (p < 0.0001). Severe reductions in nonemergency surgery were reported by 38% compared with 87% of respondents in 2020. Severe disruption of expected progression of surgical trainee autonomy by rank also significandy decreased to 5% to 8% in 2021 from 15% to 23% in 2020 among respondent programs (p < 0.001). In 2021 clinical remediation was reported for postgraduate year 1 to 2 and postgraduate year 3 to 4, typically through revised rotations (19% and 26%) and additional use of simulation (20% and 19%) maintaining trainee promotion and job placement. In 2021, surgical trainees' physical safety and health were reported as less severely impacted compared with 2020; however, negative effects of isolation (77%), burnout (75%), and the severe impact on emotional well-being (17%) were prevalent. CONCLUSIONS: One year after the initial coronavirus disease 2019 outbreak, clinical training and surgical trainee health were less negatively impacted. Disruption of emotional well-being remained high. Future needs include better objective measures of clinical competence beyond case numbers and the implementation of novel programs to promote surgical trainee health and well-being. (C) 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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