Department of Urology, SUNY Downstate College of Medicine, Brooklyn, NY, USA.
Department of Surgery, Rush University Medical Center, Chicago, IL, USA.
Int J Clin Pract. 2020 Sep;74(9):e13559. doi: 10.1111/ijcp.13559. Epub 2020 Jun 28.
The rapid spread of COVID-19 has placed tremendous strain on the American healthcare system. Few prior studies have evaluated the well-being of or changes to training for American resident physicians during the COVID-19 pandemic. We aim to study predictors of trainee well-being and changes to clinical practice using an anonymous survey of American urology residents.
An anonymous, voluntary, 47-question survey was sent to all ACGME-accredited urology programmes in the United States. We executed a cross-sectional analysis evaluating risk factors of perception of anxiety and depression both at work and home and educational outcomes. Multiple linear regressions models were used to estimate beta coefficients and 95% confidence intervals.
Among ~1800 urology residents in the USA, 356 (20%) responded. Among these respondents, 24 had missing data leaving a sample size of 332. Important risk factors of mental health outcomes included perception of access to PPE, local COVID-19 severity and perception of susceptible household members. Risk factors for declination of redeployment included current redeployment, having children and concerns regarding ability to reach case minimums. Risk factors for concern of achieving operative autonomy included cancellation of elective cases and higher level of training.
Several potential actions, which could be taken by urology residency programme directors and hospital administration, may optimise urology resident well-being, morale, and education. These include advocating for adequate access to PPE, providing support at both the residency programme and institutional levels, instituting telehealth education programmes, and fostering a sense of shared responsibility of COVID-19 patients.
COVID-19 的迅速传播给美国医疗保健系统带来了巨大压力。很少有研究评估过 COVID-19 大流行期间美国住院医师的健康状况或培训变化。我们旨在使用对美国泌尿科住院医师的匿名调查来研究学员健康状况的预测因素和临床实践的变化。
向美国所有 ACGME 认证的泌尿科计划发送了一份匿名、自愿、包含 47 个问题的调查。我们进行了横断面分析，评估了工作和家庭中焦虑和抑郁感知的风险因素以及教育结果。使用多元线性回归模型估计β系数和 95%置信区间。
在美国约 1800 名泌尿科住院医师中，有 356 人（20%）做出了回应。在这些回答者中，有 24 人数据缺失，留下了 332 人的样本量。心理健康结果的重要风险因素包括对个人防护设备的获取、当地 COVID-19 的严重程度和对易感家庭成员的感知。拒绝重新部署的风险因素包括当前的重新部署、有孩子以及对达到病例最低要求的能力的担忧。对实现手术自主权的担忧的风险因素包括取消选择性病例和更高水平的培训。
泌尿科住院医师项目主任和医院管理部门可以采取一些潜在的行动，优化泌尿科住院医师的健康、士气和教育。这些措施包括倡导获得足够的个人防护设备，在住院医师项目和机构层面提供支持，实施远程医疗教育计划，并培养对 COVID-19 患者的共同责任意识。
