Stress and the Surgical Resident in the COVID-19 Pandemic

Collins, Caitlin; Mahuron, Kelly; Bongiovanni, Tasce; Lancaster, Elizabeth; Sosa, Julie Ann; Wick, Elizabeth C.

doi:10.1016/j.jsurg.2020.07.031

Cited by 88 publications

(98 citation statements)

References 22 publications

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“…All of the 52 neurosurgery trainees participating in an international survey reported that their social life had been affected by the pandemic [ 36 ]. Two studies reported that trainees were concerned about the health of their loved ones or transmitting the virus to them [ 30 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

The impact of COVID-19 on surgical training: a systematic review

et al. 2021

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Background Coronavirus disease 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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Section: Resultsmentioning

confidence: 99%

The impact of COVID-19 on surgical training: a systematic review

et al. 2021

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“…The most common psychological symptoms measured with surveys or validated questionnaires reported included anxiety ( n = 103), depression ( n = 73), stress ( n = 68), fear ( n = 61), burnout ( n = 25), mental distress/health ( n = 21), and post-traumatic stress disorder (PTSD) ( n = 14) (Additional File 3 ). Most COVID-19 studies reported on physicians from USA ( n = 23) [ 41 , 52 , 66 , 70 , 77 , 90 – 107 ], China ( n = 22) [ 15 , 49 , 54 – 56 , 65 , 68 , 73 , 86 , 89 , 102 , 108 – 118 ] followed by India ( n = 21) [ 40 , 50 , 58 , 63 , 67 , 71 , 102 , 119 – 132 ] [ 41 , 52 , 66 , 70 , 77 ], Italy ( n = 10) [ 32 , 94 , 102 , 125 , 133 – 138 ], and Turkey ( n = 11) [ 35 , 44 , 94 , 139 – 146 ] [ 28 , 30 , 32 , 34 , 36 , 37 , 42 , 45 , 47 , 48 , 59 , 60 , 62 , 80 , 87 ]. .Sixtee...…”

Section: Resultsmentioning

confidence: 99%

Experiences and management of physician psychological symptoms during infectious disease outbreaks: a rapid review

et al. 2021

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Background Prior to the COVID-19 pandemic, physicians experienced unprecedented levels of burnout. The uncertainty of the ongoing COVID-19 pandemic along with increased workload and difficult medical triage decisions may lead to a further decline in physician psychological health. Methods We searched Medline, EMBASE, and PsycINFO for primary research from database inception (Medline [1946], EMBASE [1974], PsycINFO [1806]) to November 17, 2020. Titles and abstracts were screened by one of three reviewers and full-text article screening and data abstraction were conducted independently, and in duplicate, by three reviewers. Results From 6223 unique citations, 480 articles were reviewed in full-text, with 193 studies (of 90,499 physicians) included in the final review. Studies reported on physician psychological symptoms and management during seven infectious disease outbreaks (severe acute respiratory syndrome [SARS], three strains of Influenza A virus [H1N1, H5N1, H7N9], Ebola, Middle East respiratory syndrome [MERS], and COVID-19) in 57 countries. Psychological symptoms of anxiety (14.3–92.3%), stress (11.9–93.7%), depression (17–80.5%), post-traumatic stress disorder (13.2–75.2%) and burnout (14.7–76%) were commonly reported among physicians, regardless of infectious disease outbreak or country. Younger, female (vs. male), single (vs. married), early career physicians, and those providing direct care to infected patients were associated with worse psychological symptoms. Interpretation Physicians should be aware that psychological symptoms of anxiety, depression, fear and distress are common, manifest differently and self-management strategies to improve psychological well-being exist. Health systems should implement short and long-term psychological supports for physicians caring for patients with COVID-19.

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“…One of the greatest concerns of the respondents (n = 73; response rate-73.7%) was the decline in operative exposure. Another significant finding of this research is that residents are more worried and concerned about the health of their loved ones than about their own risk and exposure of contracting COVID-19 [9].…”

Section: Critical Literature Reviewmentioning

confidence: 85%

Residents’ Training in COVID-19 Pandemic Times: An Integrated Survey of Educational Process, Institutional Support, Anxiety and Depression by the Saudi Commission for Health Specialties (SCFHS)

et al. 2020

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In late December of 2019, the outbreak of coronavirus disease (COVID-19) was first reported in the city of Wuhan, the capital of Hubei province in China, and was declared a pandemic by the World Health Organization in March 2020. Globally, as of 8 July 2020, there have been 11,669,259 confirmed cases of COVID-19, including 539,906 deaths. In Saudi Arabia, the confirmed cases have already reached 223,327, with 161,096 patients confirmed to have recovered, and 2100 deaths. This study aims to determine the effect of the COVID-19 pandemic on the training programs of the Saudi Commission for Health Specialties (SCFHS) and assess trainees’ mental health status (i.e., anxiety and depression). Trainee evaluations on training programs were also sought in order to obtain insights for strategic planning necessary for curricular modifications or improvements to address the clinical learning needs of trainees during this pandemic. The main contribution of our work is an investigation of the incidence of depression and anxiety regarding COVID-19 within the community of residents and fellows. Furthermore, we elaborate on key responsive actions towards the enhancement of the mental health of trainees. Last but not least, we propose the Saudi Commission for Health Specialties (SCFHS) Model for Residents’ Mental Health Enhancement during the COVID-19 Pandemic, which consists of five integrative value layers for medical education and training, namely: the knowledge creation process and innovation; technological capabilities for personalized medicine and patient-centric healthcare with a social impact; innovative applications of technology-enhanced learning and web-based active learning approaches for medical training and education; residents’ wellbeing and the impact of COVID-19 in strategic layers. In our future work, we intend to enhance the proposed framework with studies on trainee satisfaction and the efficiency of different technology-enhanced learning platforms for medical education.

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Stress and the Surgical Resident in the COVID-19 Pandemic

Cited by 88 publications

References 22 publications

The impact of COVID-19 on surgical training: a systematic review

The impact of COVID-19 on surgical training: a systematic review

Experiences and management of physician psychological symptoms during infectious disease outbreaks: a rapid review

Residents’ Training in COVID-19 Pandemic Times: An Integrated Survey of Educational Process, Institutional Support, Anxiety and Depression by the Saudi Commission for Health Specialties (SCFHS)

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