Sidney Kimmel Medical College , Philadelphia, PA, USA.
Department of Neurology, Neuroscience Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, USA.
Med Educ Online. 2020 Dec;25(1):1818439. doi: 10.1080/10872981.2020.1818439.
The COVID-19 crisis has had an unprecedented impact on resident education and well-being: social distancing guidelines have limited patient volumes and forced virtual learning, while personal protective equipment (PPE) shortages, school/daycare closures, and visa restrictions have served as additional stressors. Our study aimed to analyze the effects of COVID-19 crisis-related stressors on residents' professional and personal lives. In April 2020, we administered a survey to residents at a large academic hospital system in order to assess the impact of the pandemic on residency training after >6 weeks of a modified schedule. The primary outcome was to determine which factors or resident characteristics were related to stress during the pandemic. Our secondary goals were to examine which resident characteristics were related to survey responses. Data were analyzed with regression analyses. Ninety-six of 205 residents completed the survey (47% response rate). For our primary outcome, anxiety about PPE < 0.001), female gender ( = 0.03), and the interaction between female gender and anxiety about PPE = 0.04) were significantly related to increased stress during the COVID-19 pandemic. Secondary analyses suggested that medicine residents were more comfortable than surgical residents using telemedicine ( > 0.001). Additionally, compared to juniors, seniors believed that the pandemic was more disruptive, modified schedules were effective, and virtual were less effective while virtual were more effective (all ≤ 0.05) Furthermore, the pandemic experience has allowed seniors in particular to feel more confident to lead in future health crises ( ≤ 0.05). Medicine and surgery residency programs should be cognizant of and closely monitor the effects of COVID-19 crisis-related factors on residents' stress and anxiety levels. Transparent communication, telemedicine, online lectures/meetings, procedure simulations, advocacy groups, and wellness resources may help to mitigate some of the challenges posed by the pandemic.
社交距离准则限制了患者数量，并迫使采用虚拟学习，而个人防护设备（PPE）短缺、学校/日托关闭以及签证限制则成为了额外的压力源。我们的研究旨在分析与新冠疫情相关的压力源对住院医师专业和个人生活的影响。2020 年 4 月，我们向一家大型学术医院系统的住院医师发放了一项调查，以评估在修改后的时间表实施 6 周后，疫情对住院医师培训的影响。主要结果是确定哪些因素或住院医师特征与疫情期间的压力相关。我们的次要目标是检查哪些住院医师特征与调查结果相关。数据采用回归分析进行分析。在 205 名住院医师中，有 96 名完成了调查（47%的回复率）。对于我们的主要结果，对 PPE 的焦虑（<0.001）、女性性别（=0.03）以及女性性别与对 PPE 的焦虑之间的相互作用（=0.04）与新冠疫情期间压力增加显著相关。次要分析表明，与外科住院医师相比，内科住院医师更愿意使用远程医疗（<0.001）。此外，与初级住院医师相比，高级住院医师认为疫情更具破坏性，修改后的时间表有效，而虚拟教学效果较差，但虚拟教学更有效（均<0.05）。此外，疫情经历尤其使高级住院医师在未来的卫生危机中更有信心担任领导角色（<0.05）。内科和外科住院医师培训项目应意识到并密切监测与新冠疫情相关因素对住院医师压力和焦虑水平的影响。透明沟通、远程医疗、在线讲座/会议、程序模拟、倡导团体和健康资源可能有助于缓解疫情带来的一些挑战。
