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The impact of COVID-19 on surgical training: a systematic review
C Hope1, J-J Reilly2, G Griffiths3
1Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 3NE, UK. carlahope@nhs.net.
Insights
The COVID-19 pandemic significantly impacted surgical training worldwide, reducing operative experience and increasing trainee stress. New training models are needed to ensure competence and well-being for surgical residents.
Area of Science:
- Medical Education
- Surgical Training
- Public Health Crises
Background:
- The COVID-19 pandemic caused widespread disruption to healthcare systems globally.
- Surgical training faced significant challenges due to cancelled elective surgeries, reduced outpatient clinics, and fewer emergency presentations.
- These disruptions have profound implications for the educational opportunities available to surgical trainees.
Purpose of the Study:
- To systematically review and describe the global impact of the COVID-19 pandemic on surgical training.
- To identify the key challenges and changes experienced by surgical trainees during the pandemic.
Main Methods:
- A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Searches were performed across multiple databases including Medline, EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials.
- Data from 29 included articles, encompassing over 20 countries, 5260 trainees, and 339 program directors, were analyzed.
Main Results:
- Surgical trainee redeployment to non-surgical roles ranged from 6% to 35.1% across studies.
- All included studies reported a reduction in operative experience for trainees.
- Knowledge acquisition shifted to online platforms in 17 studies, while 7 noted increased time for educational activities; however, 54.9% to 91.6% of trainees reported negative mental health impacts, including increased stress.
Conclusions:
- The effects of COVID-19 on surgical training are global and affect all specialties.
- Negative impacts extend beyond clinical and operative experience to include trainee mental health and well-being.
- Future surgical training delivery must evolve beyond traditional models to ensure trainee competence and adequate support.
Background:
Coronavirus disease (COVID-19) has caused global disruption to health care. Non-urgent elective surgical cases have been cancelled, outpatient clinics have reduced and there has been a reduction in the number of patients presenting as an emergency. These factors will drastically affect the training opportunities of surgical trainees. The aim of this systematic review is to describe the impact of COVID-19 on surgical training globally.
Methods:
The review was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered with the Open Science Framework (OSF). Medline, EMBASE, PubMed and the Cochrane Central Register of Controlled Trials were searched.
Results:
The searches identified 499 articles, 29 of which were included in the review. This contained data from more than 20 countries with 5260 trainees and 339 programme directors. Redeployment to non-surgical roles varied across studies from 6% to 35.1%. According to all of the studies, operative experience has been reduced. Knowledge learning had been switched to online platforms across 17 of the studies and 7 reported trainees had increased time to devote to educational/academic activities. All of the studies reporting on mental health report negative associations with increased stress, ranging from 54.9% to 91.6% of trainees.
Conclusions:
The impact of COVID-19 on surgical trainees has been experienced globally and across all specialities. Negative effects are not limited to operative and clinical experience, but also the mental health and wellbeing of trainees. Delivery of surgical training will need to move away from traditional models of learning to ensure trainees are competent and well supported.
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