Trainee doctors’ experiences of learning and well-being while working in intensive care during the COVID-19 pandemic: a qualitative study using appreciative inquiry

Abstract

ObjectivesConcern about trainee work-related well-being has been raised in recent years and is the subject of several reviews, reports and research studies. This study aimed to understand the experiences of trainees working in a large intensive care unit during the first surge of the COVID-19 pandemic from an educational and operational perspective in order to highlight what worked and what could be improved.DesignA qualitative study using peer-to-peer semistructured interviews, developed using appreciative inquiry methodology, was conducted during July 2020. Responses were analysed using a thematic analysis technique.SettingA large, tertiary intensive care unit in the UK.ParticipantsAll trainees in anaesthesia and intensive care working on the intensive care unit during the first surge were invited to participate.ResultsForty interviews were conducted and four over-arching themes were identified. These were: feeling safe and supported; physical demands; the emotional burden of caring; and a sense of fulfilment, value and personal development. Positive aspects of the organisational response to the pandemic included communication, personal protective equipment supply, team working and well-being support. Suggestions for improvement focused on rest facilities, rota patterns and hierarchies, creating opportunities for reflection and ensuring continued educational and training opportunities despite operational demands.ConclusionsTrainees described opportunities for learning and fulfilment, as well as challenges, in working through a pandemic. Trainees described their needs and how well these were met during the pandemic. Ideas for improvement most frequently related to basic needs including safety and fatigue, but suggestions also related to supporting learning and development. The appreciative inquiry methodology of the project facilitated effective reflection on positive aspects of trainee experiences.

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

“…Warren et al [36] described residents' learning and well being experiences working in tertiary ICUs in the UK. Despite the logistical, structural, and clinical changes that forced the development of new policies and procedures, residents valued this period as academically positive.…”

Impacto da Pandemia COVID-19 na Formação Especializada do Internato Médico de Medicina Intensiva em Portugal

“…7,8 Em suma, serão necessários novos métodos para manter a formação, sem descurar a grande exigência clínica a que todos os profissionais de saúde estão sujeitos, por forma a garantir a aquisição de competências essenciais. [9][10][11] Apesar das dificuldades e desafios referidos, a clara inclinação da maioria dos inquiridos reside no não prolongamento do tempo de internato além do inicialmente definido, podendo indiciar que os impactos negativos não superarão os impactos positivos da primeira vaga da pandemia.…”

In their own words: Experiences of emergency health care workers during the COVID‐19 pandemic

“…16,18 Many qualitative studies have focused on hospital-based providers without specific focus on emergency medicine (EM) HCWs and have excluded emergency medical services (EMS) providers. [21][22][23] The purpose of this study was to describe the impact of COVID-19 on emergency physicians (EPs), emergency medicine (EM) nurses, and EMS providers' health and well-being using a qualitative approach that allowed us to document participants' reflections and experiences in their own words. We relied on semistructured interviews to identify important themes and patterns that emerged from the personal narratives of the emergency HCWs.…”

“…Most studies conducted to date relied on standardized surveys that include scales and questions with uniform response options that facilitate the quantification of outcomes and statistical comparison 16,18 . Many qualitative studies have focused on hospital‐based providers without specific focus on emergency medicine (EM) HCWs and have excluded emergency medical services (EMS) providers 21–23 …”