The impact of COVID-19 pandemic on orthopaedic resident education: a nationwide survey study in South Korea

Abstract

Purpose There have not been well-designed survey studies investigating the impact of the coronavirus disease 2019 (COVID-19) pandemic on orthopaedic resident education. Methods A 58-question, web-based survey was administered to orthopaedic residents in South Korea. A total of 229 orthopaedic residents from 43 hospitals completed the survey questionnaire. Results The average working time of 72.7 hours/week before the pandemic was decreased to 65.6 hours/week during the pandemic ( p < 0.001). The time working in the operating room was significantly decreased during the pandemic, but not in the emergency centre and outpatient clinic. The education times for lecture and clinical case discussion were decreased during the pandemic (both, p < 0.001), respectively. While the use of traditional teaching methods was decreased, the use of online-based teaching methods was increased ( p < 0.001). However, satisfaction level with online-based teaching methods was significantly lower compared with that of traditional teaching methods. The average working time exposed to the patients with COVID-19 was 9.7 hours/week. About 47.6% of orthopaedic residents experienced isolation or quarantine. The average score for quality of life, which was 68.9 out of 100 scores before the pandemic, decreased to 61.7 during the pandemic ( p < 0.001). The most stressful factor for orthopaedic residents during the pandemic was family/relative health, followed by their own health and residency program. Conclusion The COVID-19 pandemic had a significant impact on orthopaedic resident education in South Korea. Therefore, flexible and sustainable strategies are necessary to prepare for the future as well as the current pandemic situation.

A look at the global impact of SARS CoV-2 on orthopedic services

“…Ten studies detailed the impact of the COVD-19 pandemic on residency training in their respective institutions. 1 , 3 , 4 , 7 , 13 , 14 , 18 , 22 , 31 , 33 Firstly, the decrease in elective surgeries performed and reduced outpatient clinic attendance resulted in diminished clinical exposure for residents. Studies by Foong et al.…”

“…stated that residents in their respective institutions saw a large overall decrease in time spent performing surgeries as well as seeing patients in clinic. 7 , 14 Additionally, the disproportionate decrease in elective surgeries compared to trauma surgeries meant that whilst junior residents were able to gain sufficient clinical exposure to trauma subspecialties, senior residents that had already completed their subspecialty rotations in trauma were unable to gain sufficient exposure to other subspecialties relevant to their training. 14 …”

“…The effects of the COVID-19 pandemic also saw a large restructuring of didactic teaching methodology for residency programs. Nine studies 1 , 3 , 4 , 7 , 13 , 14 , 18 , 31 , 33 described some form of shift in terms of teaching modalities for residents, due to the restrictions imposed by the pandemic situation. Required learning hours for residents were still maintained, for the most part, due to the shift of teaching sessions to online platforms, virtual reality (VR) based surgical simulators, 31 and other novel modalities of teaching.…”

“…Residents were able to receive adequate theory-based teaching through online lectures, journal clubs and various webinars and online symposiums. 3 , 7 , 13 , 14 , 18 , 33 Moreover, due to the decreased surgical exposure, some institutions made VR surgical simulators accessible to residents, allowing them to continue to develop their psychomotor skills required for surgery. 1 , 31 Other institutions offered their residents novel means of learning, such as a “virtual” bootcamp, 4 involving an online training program with accompanying take-home kits for residents to practice an array of surgical techniques from their homes.…”

“… 3 The increased frequency of calls, as well as greater exposure to COVID-19 patients proved to be stressors for some residents, with several self-reporting a decreased quality of life score as compared to pre-pandemic working conditions. 7 …”