Weygandt Paul L, Jordan Jaime, Caretta-Weyer Holly, Osborne Anwar, Grabow Moore Kristen
Department of Emergency Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA.
Department of Emergency Medicine David Geffen School of Medicine at UCLA Acute Care College Los Angeles California USA.
AEM Educ Train. 2021 May 16;5(3):e10603. doi: 10.1002/aet2.10603. eCollection 2021 Jul.
The COVID-19 pandemic continues to impact health systems across the United States and worldwide in an unprecedented way; however, its influence on frontline medical trainees' educational experiences is unknown. Our objective was to determine the effects of COVID-19 on emergency medicine (EM) training programs and residents.
We performed a mixed-methods cross-sectional survey study of faculty and residents at programs registered with Foundations of Emergency Medicine. Participants completed an online survey consisting of closed and open-ended response items. We reported descriptive statistics for discrete and continuous data. Free-response data were analyzed qualitatively using a thematic approach.
Ninety-two percent of faculty (119/129) and 47% (1,965/4,154) of residents responded to our survey. We identified three major themes related to effects on learning: 1) impact on clinical training, 2) impact on didactic education, and 3) impact on the trainee. Nearly all residencies (96%, 111/116) allowed residents to work with patients suspected of having COVID-19, although fewer (83%, 96/115) allowed residents to intubate them. We found that 99% (1918/1928) of residents experienced virtual didactics. Faculty and trainees noted multiple educational challenges and strategies for adaptation. Trainees also expressed concerns about stress and safety.
COVID-19 has impacted EM education in many ways including clinical training, didactic education, and trainee emotional state and concentration. Challenges and suggested solutions for learning in the virtual environment were also identified. While the pandemic continues to evolve and impact EM residents in various ways, our results may inform strategies to support medical educators and trainees during pandemics or other periods of significant disruption or crisis.
2019冠状病毒病（COVID-19）大流行继续以前所未有的方式影响着美国乃至全球的卫生系统；然而，其对一线医学实习生教育经历的影响尚不清楚。我们的目标是确定COVID-19对急诊医学（EM）培训项目及住院医师的影响。
我们对在急诊医学基金会注册项目的教员和住院医师进行了一项混合方法的横断面调查研究。参与者完成了一项包含封闭式和开放式回答项目的在线调查。我们报告了离散型和连续性数据的描述性统计结果。对自由回答数据采用主题分析法进行定性分析。
92%的教员（119/129）和47%的住院医师（1965/4154）回复了我们的调查。我们确定了与学习影响相关的三个主要主题：1）对临床培训的影响，2）对理论教学的影响，3）对实习生的影响。几乎所有住院医师培训项目（96%，111/116）都允许住院医师与疑似感染COVID-19的患者一起工作，不过允许住院医师为这些患者插管的项目较少（83%，96/115）。我们发现99%（1918/1928）的住院医师经历了虚拟理论教学。教员和学员指出了多种教育挑战及适应策略。学员们还表达了对压力和安全的担忧。
COVID-19在许多方面影响了急诊医学教育，包括临床培训、理论教学以及学员的情绪状态和注意力。同时也确定了虚拟环境下学习的挑战及建议解决方案。虽然疫情仍在持续演变并以各种方式影响急诊医学住院医师，但我们的结果可能为在疫情期间或其他重大干扰或危机时期支持医学教育工作者和学员的策略提供参考。
