Novice training during COVID-19: challenges and considerations
Dear Editor,
In the August issue of Anaesthesia News, Dr Lim highlighted the impact of COVID-19 on novice anaesthetists [1]. With a second wave predicted, we should again anticipate disruption for our novice trainees and be prepared to adapt our approach in order to maximise their experience.
Here are some of the main challenges faced by new novices, with some potential solutions.
- With reduced elective work, achieving the initial assessment of competencies (IAC) may prove to be difficult. Regular simulation teaching could help address this. Locally, we implemented a weekly simulation programme that was specifically tailored towards the IAC.
- PPE makes communication and face-to-face teaching difficult within theatres. Name and role badges can help with familiarising new staff. Reducing unnecessary ambient noise, and speaking loudly and clearly, have never been more important.
- Delays between cases for cleaning theatres are frustrating; however this provides opportunities to debrief on cases and address specific learning points.
- Use of videolaryngoscopes has been recommended for COVID-19 cases, and may provide a useful early learning resource for novice anaesthetists when intubating in full PPE [2].
- Our novices also found it useful to shadow the first on-call anaesthetist to maximise exposure to the emergency theatres and gain experience before going onto the on-call rota.
Despite these challenges, the pandemic has provided some unforeseen advantages to training. Supraglottic devices are now being removed in theatre rather than in recovery. This has provided more opportunities to witness the effects of drug choice and dose on anaesthetic duration and recovery, which will no doubt help our patients (and recovery nurses!).
We will be required to be more creative and flexible in our approach to teaching novices, a group whose training was particularly disrupted during the pandemic’s first wave, and who should not be forgotten in the aftermath.
Neil Choudhuri
Clinical Fellow in Anaesthetics, Southmead Hospital, Bristol
Johanna Slothouber Galbreath
CT2 ACCS Trainee in Anaesthetics, Royal United Hospital, Bath
Twitter: @neilchoudhuri
References
- Lim E. A CT1’s reflections on COVID-19. Anaesthesia News 2020. Issue 397: 11
- Aseri S, Ahmad H, Vallance H. Video laryngoscopy improves endotracheal intubation training for novices. British Journal of Anaesthesia 2015; 115: 133.