Adaptations to general surgery resident education in response to COVID-19

• Published in: Canadian journal of surgery Vol. 64; no. 5; p. E543
• Main Authors: Ma, Vivian, Scott, Tracy, Ott, Michael, Karimuddin, Ahmer
• Format: Journal Article
• Language: English
• Published: CMA Joule Inc 01.09.2021
• Subjects: Canada; College administrators; Educational aspects; Epidemics; Medical education; Surgery; Surveys; Canada
• ISSN: 0008-428X; 1488-2310
• DOI: 10.1503/cjs.017721

Background: The COVID-19 pandemic led to many new provincial public health measures to reallocate resources in response to an impending surge of cases. These necessary decisions had several downstream effects on general surgery training. We surveyed the actions taken by Canadian general surgery training programs in response to the COVID-19 pandemic. Method: A mixed-methods survey was sent to all general surgery program directors to assess various domains in surgical education and modifications made because of the pandemic. Responses were quantified as proportions or qualitative narratives describing those changes. Results: Most programs (13/15) recalled residents from planned rotations and redistributed them to rotations considered as core required services, including acute care surgery, trauma surgery and intensive care. Many programs also restructured their acute care surgery models to allow for a group of "reserve" residents to replace trainees who became infected with SARS-CoV-2. In terms of clinical experience, there was a reduction in both clinical and operative exposure among trainees. The reduction in clinical exposure disproportionately affected junior residents, whose involvement in COVID-19 cases was restricted. Formal educational sessions were maintained, but delivered virtually. Many programs instituted a program of increased frequency of communication with trainees. Conclusion: Many programs embraced using virtual platforms for teaching. The demonstrated utility of virtual teaching may lead to rethinking how training programs deliver didactic teaching and expand teaching opportunities. However, many programs also perceived a decrease in clinical and procedural exposure, primarily affecting junior residents. More information is needed to quantify the deficit in learning incurred as a result of the pandemic as well as its long-term effects on resident competency. Contexte : La pandemie de COVID-19 est a l'origine de plusieurs nouvelles mesures de sante publique a l'echelle des provinces qui ont permis de reassigner les ressources et de prendre en charge la hausse des cas anticipee. Ces decisions inevitables ont eu differentes repercussions en aval, sur la formation en chirurgie generale. Nous avons pris connaissance des initiatives prises par les programmes canadiens de formation en chirurgie generale en reponse a la pandemie de COVID-19. Methodes : Une enquete multimethode a ete menee aupres de tous les directeurs de programmes de chirurgie generale pour evaluer differents secteurs de la formation en chirurgie et les modifications qui y ont apportees en raison de la pandemie. Les reponses ont ete enregistrees sous forme de proportions ou de descriptions qualitatives de ces modifications. Resultats : La plupart des programmes (13/15) ont remplace les stages prevus de leurs residents par une reassignation vers les services dits essentiels, soit chirurgies d'urgence, traumatologie et soins intensifs. Plusieurs programmes ont aussi restructure leurs modeles de chirurgie d'urgence pour constituer un groupe de residents << reservistes >> capables de remplacer ceux qui contractaient le SRAS-CoV-2. Pour ce qui est de l'experience clinique, on a note une baisse de l'exposition des residents aux situations cliniques et chirurgicales. La reduction de l'exposition aux situations cliniques a penalise les residents juniors de facon disproportionnee car leur role aupres des cas de COVID-19 etait restreint. Les formation magistrales ont ete maintenues, mais offertes sous forme virtuelle. Plusieurs programmes ont instaure un systeme de communications plus frequentes avec leurs residents. Conclusion : De nombreux programmes ont adopte des plateformes d'enseignement virtuelles. L'utilite averee de l'enseignement a distance pourrait forcer la reflexion sur la facon d'offrir l'enseignement magistral et diversifier les facons de livrer la matiere. Par contre plusieurs programmes ont aussi percu une diminution de l'exposition aux situations cliniques et aux interventions affectant surtout les residents juniors. Il faudra recueillir plus de donnees pour quantifier le deficit d'apprentissage encouru en raison de la pandemie et ses effets a long terme sur la competence des residents.