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COVID-19 疫情对欧洲妇产科住院医师培训的影响:对培训和住院医师的影响调查。

The influence of the COVID-19 outbreak on European trainees in obstetrics and gynaecology: A survey of the impact on training and trainee.

机构信息

Haaglanden Medical Center, Lijnbaan 32, 2512VA, The Hague, The Netherlands.

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2021 Jun;261:52-58. doi: 10.1016/j.ejogrb.2021.04.005. Epub 2021 Apr 10.

Abstract

OBJECTIVE

The purpose of this study is to evaluate how the obstetrics and gynaecology residency program and trainees have been affected by the Corona Virus Disease-19 (COVID-19) pandemic in Europe.

STUDY DESIGN

This study is a cross-sectional explorative survey using an online questionnaire. The questionnaire comprised of 40 questions that were subdivided into 4 subjects; workload, specialist training aspects in obstetrics and gynaecology, health and safety of the trainee and women's health and maternal health issues. Inclusion criteria consisted of being a trainee in Obstetrics and Gynaecology (ObGyn) at the time of the COVID-19 pandemic in Europe or trainees who had recently finished their training during the time of the outbreak. Taking part in the survey was voluntary. The questionnaire was shared on the website of the European Network for Trainees in Obstetrics and Gynaecology (ENTOG), ENTOG social media, in the ENTOG-newsletter and through the national representatives of ENTOG.

RESULTS

110 ObGyn trainees from 25 different countries responded to the questionnaire. Almost all trainees (95 %, N = 105) reported an effect on their training due to COVID-19 pandemic. Training was interrupted in 21 % of cases (n = 23). Trainees observed a decrease in educational activities or lectures and a decrease in number of patients. The possibility of training surgical skills decreased, because 67 % (N = 74) trainees reported that surgeries were cancelled. Trainees expressed concerns about reaching the goals of their ObGyn specialist training in 60 % (n = 66) of cases. A decrease in workload was experienced during the first COVID-19 wave in Europe by 60 % (n = 66) of trainees. On average these trainees worked 33 % less hours compared to a normal workweek. Although 22 % (n = 24) were expected to be available continuously for 24 h a day and 7 days a week for unscheduled duties, 15 % (n = 16) were deployed to work on special COVID-units. Concerning preparation, 45 % of the trainees (n = 50) had not received any training for treating COVID-positive patients. Trainees claimed to have enough personal protective equipment (PPE), although problems were reported. Any form of psychosocial support was arranged for 65 % of trainees (n = 71) by the hospital or department. The results of the survey suggest that obstetric care was not affected much (92 % (n = 102) of the respondents said at least necessary care continued) while patients in need for reproductive medicine were affected the most; out of the 110 departments 58 % (n = 60) were closed and 35 % (n = 36) reduced their activities. Access to family planning and benign gynaecology were also significantly reduced; 77 % and 87 % respectively of the departments were less accessible or only open to emergency cases.

CONCLUSION

COVID-19 pandemic has had a tremendous effect on the ObGyn training in Europe. Exposure to learning opportunities, surgeries and teaching has been decreased during the outbreak and may result in a decrease in quality of care provided to women in the future if impairment of training is not recovered.

摘要

目的

本研究旨在评估欧洲的妇产科学住院医师培训计划和学员如何受到冠状病毒病-19(COVID-19)大流行的影响。

研究设计

这是一项使用在线问卷的横断面探索性调查。问卷由 40 个问题组成,分为 4 个主题;工作量、妇产科专科培训方面、学员的健康和安全以及妇女健康和产妇健康问题。纳入标准包括在欧洲 COVID-19 大流行期间为妇产科住院医师培训学员或在疫情期间刚完成培训的学员。参与调查是自愿的。问卷被分享在欧洲妇产科住院医师培训网络(ENTOG)的网站、ENTOG 社交媒体、ENTOG 新闻通讯以及通过 ETOG 的国家代表。

结果

来自 25 个不同国家的 110 名妇产科住院医师对问卷做出了回应。几乎所有学员(95%,N=105)报告 COVID-19 大流行对其培训产生了影响。21%的情况下(n=23)培训中断。学员观察到教育活动或讲座减少,患者数量减少。由于 67%(N=74)的学员报告手术被取消,因此手术技能培训的可能性降低。60%(n=66)的学员表示对达到妇产科专科培训目标表示担忧。欧洲 COVID-19 第一波疫情期间,60%(n=66)的学员经历了工作量减少。与正常的每周工作时间相比,这些学员平均每周工作时间减少了 33%。尽管 22%(n=24)预计每天 24 小时、每周 7 天不间断地为非计划任务提供服务,但 15%(n=16)被部署到专门的 COVID 病房工作。关于准备情况,45%的学员(n=50)没有接受过任何治疗 COVID 阳性患者的培训。学员声称有足够的个人防护设备(PPE),尽管报告了一些问题。65%(n=71)的学员由医院或科室提供任何形式的社会心理支持。调查结果表明,产科护理受影响不大(102 名受访者中有 92%(n=102)表示至少继续提供必要的护理),而需要生殖医学的患者受影响最大;110 个部门中有 58%(n=60)关闭,35%(n=36)减少了活动。计划生育和良性妇科的服务也显著减少;77%和 87%的部门分别减少或仅对急诊开放。

结论

COVID-19 大流行对欧洲的妇产科培训产生了巨大影响。在疫情爆发期间,学员接触学习机会、手术和教学的机会减少,如果不恢复培训方面的损失,未来可能会导致向妇女提供的护理质量下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2403/8035806/bca538cf1728/gr1_lrg.jpg

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