Redeployment of Surgical Trainees to Intensive Care During the COVID-19 Pandemic: Evaluation of the Impact on Training and Wellbeing

Abstract

OBJECTIVE The aim of this study was to evaluate the impact of redeployment of surgical trainees to intensive care units (ICUs) during the COVID-19 pandemic–in terms of transferrable technical and nontechnical skills and wellbeing. DESIGN This was a survey study consisting of a 23-point questionnaire. SETTING The study involved surgical trainees that had been redeployed to the (ICU) across all hospitals in London during the COVID-19 pandemic. PARTICIPANTS The survey was sent to 90 surgical trainees who were between postgraduate years 2 to 4. Trainees in specialty training programs (>5 years after graduation) were not included. Thirty-two trainees responded to the questionnaire and were included in the study results. RESULTS All respondents spent between 4 and 8 weeks working in ICU. Prior to redeployment, 78% of participants had previous experience of ICU or an affiliated specialty, and >90% had attended at least 1 educational course with relevance to ICU. There were statistically significant increases in confidence performing central venous cannulation and peripheral arterial catheterisation (p < 0.05). With regards to clinical skills, respondents reported feeling more confident managing ventilated patients, patients on noninvasive ventilation, dialysis, and circulatory failure patients after working in ICU. Respondents (97%) felt that the experience would be beneficial to their future careers but 53% felt the redeployment had a negative impact on their mental health. CONCLUSIONS Redeployment of surgical trainees to ICU led to increased confidence in a number of technical and nontechnical skills. However, proactive interventions are needed for training surgeons with regard to their psychological wellbeing in these extraordinary circumstances and to improve workforce planning for future pandemics.

Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systematic review

“…From the eleven research studies included in the review, sample sizes ranged from ten (Marks, Edwards, & Jerge, 2020) to 1269 (Camilleri et al, 2020). One study reported 59% (N=19) of participants were male, and 41% (N=13) female (Payne, Rahman, Bullingham, Vamadeva, & Alfa-Wali, 2020). Other participant demographic characteristics such as ethnicity were not provided.…”

“…These included prone and positioning, maintaining vascular catheters and dialysis circuits, sedation, and administering vasoactive medication (Camilleri et al, 2020; Doussot et al, 2020; NHS England & NHS Improvement, 2020b). Redeployed staff was also often asked to liaise with families and required training on communicating bad news (Payne et al, 2020).…”

ENT trainees’ experience of redeployment during the coronavirus disease 2019 pandemic: a qualitative study

“…In a recent review of surgical trainees redeployed to critical care, 53 per cent reported feeling that redeployment had had a negative impact on their mental health. 19 The feelings of inadequacy associated both with the roles that ENT trainees were being asked to fulfil and with leaving their established teams potentially compounded an already stressful situation. It is possible that better use of their existing skill sets would have helped to reduce this emotional impact.…”

Considerations for acute care staffing during a pandemic

“…Anesthesia providers can help with airway management, ventilation, and catheter access. Surgical teams can assist with procedures such as tracheotomy and thoracic tube insertion [ 64 ]. Perioperative nurses and operating room assistants can help with prone positioning and other forms of patient mobilization [ 21 ].…”