Challenges in the Cardiothoracic and Vascular Anesthesia Fellowship Program Since the Coronavirus Disease 2019 (COVID-19) Pandemic: An Electronic Survey on Potential Solutions

Abstract

Objective We explored the current practice of fellowship training in cardiothoracic and vascular anesthesia and surveyed the acceptability of potential solutions to mitigate the interrupted fellowship training during the severe acute respiratory syndrome coronavirus disease (COVID-19) pandemic. Design A prospective electronic questionnaire-based survey. Setting The survey was initiated by the Education Committee of the European Association of Cardiothoracic Anesthesiology and Intensive Care (EACTAIC) Participants EACTAIC fellows, EACTAIC and non-EACTAIC subscribers to the EACTAIC newsletter and EACTAIC followers on different social media platforms. Interventions After obtaining the consent of participants, we assessed the peri-operative management of COVID-19 patients, infrastructural aspects of the workplace, local routines for preoperative testing, the perceived availability of personal protective equipment (PPE) and the impact of COVID-19 on fellowship training. In addition participants rated suggested solutions by the investigators to cope with the interruption of fellowship training using a traffic light signal scale. Measurements and Main Results We collected 193 responses from 54 countries. 82.4% of respondents reported cancelling or postponing elective cases during the first wave. Of the respondents, 89.7% had provided care for COVID-19 patients, 75.1% reported staff in their center being reassigned to work in the Intensive Care Unit (ICU), and 45% perceived a shortage of PPE at their centers. Most respondents reported the termination of local educational activities (79.6%) and fellowship assessments (51.5%) because of the pandemic (although 84% of them reported having time to participate in online teaching), and 83% reported a definitive psychological impact. More than 90% of the respondents chose green and/or yellow traffic lights to rate the importance of the suggested solutions to cope with the interrupted fellowship training during the pandemic. Conclusions The COVID-19 pandemic led to the cancellation of elective cases, deployment of anesthesiologists to intensive care units, involvement of anesthesiologists in perioperative care for COVID-19 patients, and interruption of educational activities and trainees’ assessments. There is some consensus on suggested solutions for mitigation of the interruption in fellowship training.

Retailoring training programmes in anaesthesia and intensive care after the coronavirus disease 2019 outbreak

“…In October 2021, EACTAIC developed a consensus on some suggested solutions to cope with challenges in training during the pandemic, including [49]:…”

Survey Says… The Effects of the COVID-19 Pandemic on Graduate Medical Education

“…7 Tahan et al also found that EACTA Cardiothoracic and Vascular Anaesthesia trainees also experienced personal protective equipment shortage. 3 Female respondents reported a greater amount of stress compared with their male counterparts. One theory behind this is the role strain that women face regarding childcare, though both male and female residents reported a heavy burden regarding childcare.…”

“…In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Tahan et al explored the impact of the COVID-19 pandemic on fellowship training in cardiothoracic and vascular anesthesiology across the globe. 3 Their survey results found 82.4% of respondents reported cancellation of elective surgeries; 79.6% of respondents reported termination of program-specific educational activities including clinical rounds, echocardiography rounds, morbidity and mortality conferences, and fellowship assessments; and 55.6% reported that fellowship pedagogy was "interrupted" at their training center. These findings mirror previously reported challenges in postgraduate anesthesiology education that described decreased caseload, altered subspecialty clinical rotations, and changes in supervision that alter learning and advanced provider skill development.…”

“…Many subspecialities reported a decrease or cancellation of elective procedures, reducing trainees' direct procedural learning opportunities. 3,5,6 Barberio et al discussed the decrease in endoscopic training for gastroenterology fellows. Even centers that continued with a portion of their elective outpatient schedule, eliminated fellow involvement from the procedures.…”