Abstract
BackgroundThe coronavirus disease 2019 pandemic led to major changes in health care and education options for all health care employees. The aim of this study is to achieve insight into coronavirus disease-care participation of surgical residents in the Netherlands, the impact of coronavirus disease 2019 on the experienced quality of surgical training, and the influence on Burn-out and Work Engagement compared with the non-coronavirus disease 2019 period in January 2020. MethodsIn this study, we have conducted 2 digital surveys immediately before and 2 months after the start of the coronavirus disease 2019 pandemic. We surveyed a validated Dutch questionnaire ‘Utrecht Burn-out Scale,’ derived from the Maslach Burn-out Inventory, and also collected the ‘Utrecht Work Engagement Scale’ measuring work engagement. Additionally, we describe the coronavirus disease-care participation of surgical residents, the impact on how they experienced the quality of their surgical training, and the influence on ‘Burn-out and Work Engagement’ compared with the pre-coronavirus disease 2019 period for surgical residents in the Netherlands. ResultsIn January 2020, a total of 317 residents completed the online survey, and in April 2020, a total of 313 residents completed the online survey. Of the responders, 48.6%, in April, participated in coronavirus disease-care in both the coronavirus disease ward as well as the coronavirus disease intensive care unit. Residents experienced that the coronavirus disease 2019 influenced their surgical training in 85.2% of responders. In only 5% of the residents did the pandemic not affect the exposure to surgical training in the operating theater. More burn-out symptoms were noted amongst coronavirus disease ward deployed residents versus no coronavirus disease ward deployment, (16.0% vs 7.6%, P = .06). The Work-Engagement questionnaire showed a significantly lower work engagement score of 4.2 for residents who were deployed in a coronavirus disease-care intensive care unit versus a score of 4.6 for residents scheduled in a coronavirus disease ward (P = .02). ConclusionThis study shows a significant impact of the first months of the coronavirus disease 2019 pandemic on the Dutch surgical trainee program, with a major redistribution of residents with a decrease of surgical exposure and education. We emphasize the need for adequate guidance of all surgical residents and potentially lengthening the surgical training program.
Highlights
Recent published articles from Italy concerning urology residency and general surgery residents showed an overall decrease in daily exposure to all training activities from both clinical and surgical perspectives.7e10 In the Netherlands, a Dutch nationwide survey showed that 41% of cardiology residents suspended their training and worked at COVID-19 cohort units for up to 3 months.[8]
It is interesting to look at the differences between the surgical residents who were deployed at the intensive care unit (ICU) versus the COVID-19 ward
This national study showed a significant decrease in experienced surgical training quality, with almost half of the Dutch surgical residents deployed at COVID departments and with a majority working at the ICU during the first two months of the COVID-19 pandemic
Summary
Recent published articles from Italy concerning urology residency and general surgery residents showed an overall decrease in daily exposure to all training activities from both clinical and surgical perspectives.7e10 In the Netherlands, a Dutch nationwide survey showed that 41% of cardiology residents suspended their training and worked at COVID-19 cohort units for up to 3 months.[8] In many training hospitals, surgical residents provided assistance in special dedicated COVID-19 wards and the ICU, making them undeployable in the surgical department. This led to a significant temporary decrease of teaching opportunities in their surgical environment. We emphasize the need for adequate guidance of all surgical residents and potentially lengthening the surgical training program
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