Mitigating the impact of COVID-19 on training

Dear Editor,

During the pandemic, elective surgery postponement, emergency rotas and the formation of intubation/ proning teams proved challenging for all members of our department, but in particular for trainees.

COVID-19 has created unique opportunities that will positively influence future practice - treating complex patients requiring intra-hospital transfers and proning has been invaluable. Working with PPE required trainees to develop communication skills, appreciation of human factors and situational awareness.

We sought to quantify the negative impact on training by surveying 2019 and 2020 trainees, and found a 65% reduction in perceived adequacy of training opportunities. Log-book data supported this, with a significant reduction in cases logged during the first three months of the pandemic. While trainees gained sufficient experience in ICU and obstetrics, there was a lack of exposure to emergency theatre cases, reduced case mix and limited departmental teaching. There was less variety on ICU, as the majority of patients with COVID-19 demonstrated similar patterns of presentation, disease progression and treatment. Novice trainees felt less prepared to participate in the on-call rota.

We were proactive in attempts to mitigate further detriment to training, developing ‘COVID-curriculum’ generic cases, with reference to relevant aspects highlighted, on which to base workplace-based assessments. Trainee learning needs were discussed at daily departmental meetings to ensure appropriate matching of trainees to cases. Early engagement with video-conferencing technology ensured continued ability to run teaching sessions, and allow presentation of cases and projects to the department.

Looking forward, it is imperative that we are prepared not only clinically, but also from an educational perspective. All departments should have plans in place to optimise available training opportunities, and allow satisfactory progression of trainee anaesthetists.

Sushil Pal
CT1 anaesthetist
Luke Winslow
ST6 anaesthetist
Beth Perritt
Consultant anaesthetist
Countess of Chester Hospital NHS Foundation Trust, Chester