Protective Equipment Preparedness and Accessibility: A Survey of Medical Trainees

After being removed from patient care due to equipment shortages, medical students and new residents around the United States are returning to clinical medicine/acute care settings as the SARS-CoV-2 (COVID-19) pandemic continues. We hypothesize that trainees returned with increased preparedness and had better access to and knowledge of personal protective equipment (PPE).

Anonymous online surveys were distributed via snowball sampling to medical students and residents performing clinical duties in the United States. Respondents completed self-assessments for preparedness regarding PPE use, access to PPE and COVID-19 testing, and access to COVID-19 positive patients. Group comparisons were conducted using chi-square analysis and the Kruskal Wallis rank sum test. Multivariate ordinary least squares regression analysis was used to estimate the relationship between feeling prepared and other variables.

A total of 194 trainees (63 year 3 [MS3] medical students, 95 year 4 [MS4] medical students, and 36 year 1 [PGY1] postgraduates]) completed the survey. Collectively, 27% provided their own PPE on ≥ 1 rotation, 27% did not know how/where to obtain PPE, 36% did not know how/where to get tested, and 57% were never asked to demonstrate proficiency with PPE. In-person training was reported at 31.3% prior to 2020, which decreased to 21% during 2020. Mask-fit testing decreased from 83.1% to 56.9%. Online video lectures on PPE training increased from 52% to 80%. The mean (±SD) preparedness for return to clinical duty for MS3 students was 3.4/5 (±1.0), for MS4 students was 3.8/5 (±.90), and for PGY1 residents was 4.1/5(± .89) (P = .002). PPE training in 2020 was not associated with feeling prepared (P = .81).

Survey respondents felt prepared by their institutions to return to clinical duties during the COVID-19 pandemic. There was some apprehension about knowledge of or access to PPE and COVID-19 testing. The confidence in the ability to don/doff PPE was the main factor associated with increased feelings of preparedness. While in-person training decreased from pre-2020 to during 2020, an increase of in-person training with supervised donning and doffing provides one potential avenue of further increasing the preparedness of trainees.