Nugroho Setyo Widi, Pradhana Ivan, Gunawan Kevin
Department of Neurosurgery, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Heliyon. 2021 Aug 12;7(8):e07757. doi: 10.1016/j.heliyon.2021.e07757. eCollection 2021 Aug.
Many institutions in numerous countries have made changes in their health care services during the COVID-19 pandemic. One change has been to reduce elective neurosurgery cases, which has impacted neurosurgery education. Published literature is lacking about the healthcare services, education, and residents' well-being during adaptation to the pandemic, especially in national referral hospitals in developing countries.
We conducted a cross-sectional study on current neurosurgical services during 2020. We evaluated 34 neurosurgery residents in Cipto Mangunkusumo National General Hospital using a self-made questionnaire to determine the effects of the COVID-19 pandemic on their surroundings, education process, and satisfaction with the currently adapted education program. We used the modified Maslach Burnout Inventory to assess burnout in the residents before and during the pandemic.
Neurosurgical residents spent more time studying neurosurgical theory (Mode 1-1.5h/day, p < 0.05) but spent less time learning neurosurgical skills (Mode 30 min-1 h/day, p < 0.05) compared to before the pandemic. The resident satisfaction mean score (scale 0-10) was 7.58 for live surgery and 8.53 for the microsurgical skills lab training program. On a scale of 1-10, the residents' stress level increased after the pandemic but the change was not statistically significant (6.61 ± 1.87, p > 0.05). The Modified Maslach Burnout inventory score was 3.02 ± 3.74 during the pandemic, and increased from before the pandemic (2.41 ± 3.18), but the difference was not statistically significant.
The COVID-19 pandemics have reduced the working hours and the clinical exposure of neurosurgical residents. Fortunately, this pandemic has led to a new opportunity to find many suitable learning methods which may decrease the risk of burnout. The psychological burden of residents is still worrisome, and planned management is necessary to sustain resident performance.
在新冠疫情期间，许多国家的众多机构都对其医疗服务进行了调整。其中一项调整是减少择期神经外科手术病例，这对神经外科教育产生了影响。关于在适应疫情期间的医疗服务、教育以及住院医师的福祉，尤其是在发展中国家的国家级转诊医院，目前缺乏相关的文献报道。
我们在2020年对当前的神经外科服务进行了一项横断面研究。我们使用自制问卷对西托·曼古库苏莫国家综合医院的34名神经外科住院医师进行了评估，以确定新冠疫情对他们周围环境、教育过程以及对当前所采用教育项目的满意度的影响。我们使用改良的马氏职业倦怠量表来评估疫情前和疫情期间住院医师的倦怠情况。
与疫情前相比，神经外科住院医师花费更多时间学习神经外科理论（模式为每天1 - 1.5小时，p < 0.05），但学习神经外科技能的时间减少（模式为每天30分钟 - 1小时，p < 0.05）。住院医师对现场手术的满意度平均得分（0 - 10分制）为7.58分，对显微外科技能实验室培训项目的满意度平均得分是8.53分。在1 - 10分的量表上，疫情后住院医师的压力水平有所上升，但变化无统计学意义（6.61 ± 1.87，p > 0.05）。疫情期间改良马氏职业倦怠量表得分是3.02 ± 3.74，较疫情前（2.41 ± 3.18）有所增加，但差异无统计学意义。
新冠疫情减少了神经外科住院医师的工作时间和临床接触机会。幸运的是，这场疫情带来了新的机遇，能找到许多合适的学习方法，这可能降低倦怠风险。住院医师的心理负担仍然令人担忧，需要进行有计划的管理以维持住院医师的表现。
