Impact of COVID-19 on endoscopy trainees: an international survey.,Gastrointestinal Endoscopy

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Impact of COVID-19 on endoscopy trainees: an international survey.
Gastrointestinal Endoscopy ( IF 6.7 ) Pub Date : 2020-06-11 , DOI: 10.1016/j.gie.2020.06.010
Katarzyna M Pawlak ₁ , Jan Kral ₂ , Rishad Khan ₃ , Sunil Amin ₄ , Mohammad Bilal ₅ , Rashid N Lui ₆ , Dalbir S Sandhu ₇ , Almoutaz Hashim ₈ , Steven Bollipo ₉ , Aline Charabaty ₁₀ , Enrique de-Madaria ₁₁ , Andrés F Rodríguez-Parra ₁₂ , Sergio A Sánchez-Luna ₁₃ , Michał Żorniak ₁₄ , Catharine M Walsh ₁₅ , Samir C Grover ₁₆ , Keith Siau ₁₇

Affiliation

Department of Internal Medicine, Cardiology, Gastroenterology and Endocrinology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland.
Hepatogastroenterology Department, Institution for Clinical and Experimental Medicine, Prague, Czech Republic.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.
Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Division of Gastroenterology and Hepatology, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
Case Western Reserve University, Division of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio, USA.
The University Of Jeddah, Jeddah, Saudi Arabia.
Gastroenterology & Endoscopy, John Hunter Hospital, Newcastle, Australia; University of Newcastle, Australia.
Division of Gastroenterology, Johns Hopkins School of Medicine, Johns Hopkins-Sibley Memorial Hospital, Washington DC, USA.
Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.
General Hospital Dr. Manuel Gea González, National Autonomous University of Mexico, Mexico City, Mexico.
Division of Gastroenterology and Hepatology, The University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Department of Gastroenterology, Medical University of Silesia, Katowice, Poland and Department of Medicine II, Ludwig-Maximillian's Univeristy, Munich, Germany.
Division of Gastroenterology, Hepatology and Nutrition and the Research and Learning Institutes, Hospital for Sick Children, Department of Paediatrics and the Wilson Centre, University of Toronto, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada.
Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Liver Unit, University Hospitals Birmingham, Birmingham, UK.

Background and Aims

Although coronavirus disease 2019 (COVID-19) has affected endoscopy services globally, the impact on trainees has not been evaluated. We aimed to assess the impact of COVID-19 on procedural volumes and on the emotional well-being of endoscopy trainees worldwide.

Methods

An international survey was disseminated over a 3-week period in April 2020. The primary outcome was the percentage reduction in monthly procedure volume before and during COVID-19. Secondary outcomes included potential variation of COVID-19 impact between different continents and rates and predictors of anxiety and burnout among trainees.

Results

Across 770 trainees from 63 countries, 93.8% reported a reduction in endoscopy case volume. The median percentage reduction in total procedures was 99% (interquartile range, 85%-100%), which varied internationally (P < .001) and was greatest for colonoscopy procedures. Restrictions in case volume and trainee activity were common barriers. A total of 71.9% were concerned that the COVID-19 pandemic could prolonged training. Anxiety was reported in 52.4% of respondents and burnout in 18.8%. Anxiety was independently associated with female gender (odds ratio [OR], 2.15; P < .001), adequacy of personal protective equipment (OR, 1.75; P = .005), lack of institutional support for emotional health (OR, 1.67; P = .008), and concerns regarding prolongation of training (OR, 1.60; P = .013). Modifying existing national guidelines to support adequate endoscopy training during the pandemic was supported by 68.9%.

Conclusions

The COVID-19 pandemic has led to restrictions in endoscopic volumes and endoscopy training, with high rates of anxiety and burnout among endoscopy trainees worldwide. Targeted measures by training programs to address these key issues are warranted to improve trainee well-being and support trainee education.

中文翻译：

COVID-19 对内窥镜实习生的影响：一项国际调查。

背景和目标

尽管 2019 年冠状病毒病 (COVID-19) 影响了全球内窥镜检查服务，但对学员的影响尚未评估。我们的目的是评估 COVID-19 对全世界内窥镜学员的手术量和情绪健康的影响。

方法

2020 年 4 月发布了一项为期三周的国际调查。主要结果是在 COVID-19 之前和期间每月手术量减少的百分比。次要结果包括不同大陆之间 COVID-19 影响的潜在差异以及受训者焦虑和倦怠的比率和预测因素。

结果

来自 63 个国家的 770 名学员中，93.8% 的学员表示内窥镜检查病例数量有所减少。总手术减少的中位百分比为 99%（四分位数范围，85%-100%），该数字在国际上有所不同 ( P < .001)，其中结肠镜检查手术减少的百分比最大。案件数量和学员活动的限制是常见的障碍。共有 71.9% 的人担心 COVID-19 大流行可能会延长训练时间。52.4% 的受访者表示焦虑，18.8% 的受访者表示倦怠。焦虑与女性性别（比值比 [OR]，2.15；P < .001）、个人防护装备是否充足（OR，1.75；P = .005）、缺乏对情绪健康的机构支持（OR，1.67；P < .005）独立相关。P = .008），以及关于延长培训的担忧（OR，1.60；P = .013）。68.9% 的人支持修改现有的国家指南，以支持在大流行期间进行足够的内窥镜培训。