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新冠疫情对巴基斯坦外科住院医师培训计划的影响;住院医师的观点。计划是否需要正式重组以适应“新常态”?一项横断面调查研究。

Impact of COVID-19 on surgical residency programs in Pakistan; A residents' perspective. Do programs need formal restructuring to adjust with the "new normal"? A cross-sectional survey study.

机构信息

Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Int J Surg. 2020 Jul;79:252-256. doi: 10.1016/j.ijsu.2020.06.004. Epub 2020 Jun 9.


DOI:10.1016/j.ijsu.2020.06.004
PMID:32526265
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7280820/
Abstract

BACKGROUND: Due to high-risk exposure of surgical residents to coronavirus, surgical residency programs have changed their training methods and working hours drastically. The purpose of this study is to find out the positive and negative impacts of the pandemic on surgical residency programs and on the lives of surgical residents. MATERIALS AND METHODS: A cross-sectional study was conducted on 112 surgical residents of a tertiary care hospital in Pakistan, with a mean age of 30.5 years from all the departments of surgery using a self-made, validated 40-point questionnaire comprising three sections. The last section also included modified Maslach Burnout inventory. RESULTS: Of all the residents, 97 (86.6%) stated that their surgical hands-on duration is adversely affected by the pandemic. As for clinical exposure, 92 (82.1%) trainees responded that their clinical exposure is affected too. Among all the subjects, 69 (61%) were concerned about transmitting it to their family members and 43 (38.4%) affirmed on being afraid of dying because of their direct exposure. On the brighter side, the average number of working hours per week for surgical residents were reduced from 81.10 ± 6.21 to 49.16 ± 6.25 (p < 0.001) due to the outbreak. Modified Maslach Burnout inventory score was 8.33 ± 2.34 after the outbreak, showing statistically significant reduction in burnout among the surgical residents (p < 0.001). CONCLUSION: The changes in the surgical residency programs amidst the pandemic has reduced the working hours, hands-on and clinical exposure of the surgical residents. Moreover, the situation has provided an opportunity to explore efficient methods of learning that can lead to lesser burnout. However, psychological burdens of surgical residents like fear of acquiring the infection should be appropriately addressed.

摘要

背景:由于外科住院医师面临冠状病毒的高风险暴露,外科住院医师培训计划已大幅改变其培训方式和工作时间。本研究的目的是了解大流行对外科住院医师培训计划以及外科住院医师生活的积极和消极影响。

材料与方法:对巴基斯坦一家三级护理医院的 112 名外科住院医师进行了横断面研究,这些住院医师来自外科的所有科室,平均年龄为 30.5 岁,使用自制的、经过验证的 40 分问卷进行了研究,问卷分为三个部分。最后一部分还包括修改后的 Maslach 倦怠量表。

结果:所有住院医师中,有 97 名(86.6%)表示他们的手术动手时间受到大流行的不利影响。至于临床暴露,92 名(82.1%)受训者表示他们的临床暴露也受到影响。在所有受试者中,有 69 名(61%)担心将其传染给家人,有 43 名(38.4%)则肯定因直接接触而害怕死亡。从好的方面来看,由于疫情爆发,外科住院医师每周的平均工作时间从 81.10±6.21 减少到 49.16±6.25(p<0.001)。疫情爆发后,修改后的 Maslach 倦怠量表评分为 8.33±2.34,显示外科住院医师的倦怠程度有统计学显著降低(p<0.001)。

结论:大流行期间外科住院医师培训计划的变化减少了外科住院医师的工作时间、动手操作和临床暴露。此外,这种情况为探索更有效的学习方法提供了机会,从而减少倦怠感。但是,应适当解决外科住院医师的心理负担,例如对感染的恐惧。

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本文引用的文献

[1]
Managing Resident Workforce and Education During the COVID-19 Pandemic: Evolving Strategies and Lessons Learned.

JB JS Open Access. 2020-4-15

[2]
Novel Coronavirus and Orthopaedic Surgery: Early Experiences from Singapore.

J Bone Joint Surg Am. 2020-5-6

[3]
Addressing General Surgery Residents' Concerns in the Early Phase of the COVID-19 Pandemic.

J Surg Educ. 2020

[4]
COVID-19 outbreak: current scenario of Pakistan.

New Microbes New Infect. 2020-4-14

[5]
Editorial. Impact of COVID-19 on neurosurgery resident training and education.

J Neurosurg. 2020-4-17

[6]
Joint International Collaboration to Combat Mental Health Challenges During the Coronavirus Disease 2019 Pandemic.

JAMA Psychiatry. 2020-10-1

[7]
Residency and Fellowship Program Accreditation: Effects of the Novel Coronavirus (COVID-19) Pandemic.

J Am Coll Surg. 2020-6

[8]
Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore.

Ann Intern Med. 2020-8-18

[9]
Emergency Restructuring of a General Surgery Residency Program During the Coronavirus Disease 2019 Pandemic: The University of Washington Experience.

JAMA Surg. 2020-7-1

[10]
Cleveland Clinic Akron General Urology Residency Program's COVID-19 Experience.

Urology. 2020-6

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