COVID-19 impact on junior doctor education and training: a scoping review

Educational impact of COVID-19 on foundation doctors and the decision to take a break from structured approved training programmes in the United Kingdom

INTRODUCTION

The COVID-19 pandemic impacted the Foundation Programme for doctors in the United Kingdom. Foundation doctors were working under increased pressure and significant changes were made to their training.

AIMS

The aim of this study is to explore the educational impact the COVID-19 pandemic had on foundation doctors and to understand how this resulted in doctors choosing to take time away from structured training programmes within the United Kingdom to make up for lost educational opportunities.

METHODS

In this phenomenological research, semi-structured interviews were carried out with post-foundation doctors who had completed their training during the pandemic. The data collected from these interviews were coded to carry out a thematic analysis.

RESULTS

All 12 participants reported that their formalised teaching had been cancelled, and due to the pandemic, many doctors felt that service provision was prioritised over their postgraduate education. Some doctors had positive experiences of informal teaching; however, many felt they missed out on educational opportunities. Doctors acknowledged that this was a contributing factor when deciding to take time out of training. This also resulted in doctors seeking educational opportunities outside of training.

DISCUSSION

The pandemic created many educational challenges for foundation doctors; this has contributed to doctors deciding to take time away from training. In some cases, due to a focus on service provision and their 'lost education', doctors are using time away from training to address their own specific educational needs. The impact of this 'lost education' requires further research and needs to be considered when doctors do apply to speciality training.

Junior doctors' workplace well-being and the determinants based on ability-motivation-opportunity (AMO) theory: Educational and managerial implications from a three-year longitudinal observation after graduation

PURPOSE

Junior doctors function as trainees from an educational perspective and as employees from a human resource management perspective. Employing the ability-motivation-opportunity (AMO) theory as a conceptual framework, this study longitudinally investigated the factors affecting the workplace well-being and career progression of junior doctors over a 3-year period following their graduation from medical schools.

MATERIALS AND METHODS

This 3-year prospective cohort study enrolled junior doctors who graduated from 2 medical schools in June 2019 in Taiwan. This study collected data by implementing web-based, self-administered structured questionnaires at 3-month intervals between September 2019 and July 2022. The collected data encompassed ability indicators (i.e. academic performance and perceived preparedness for clinical practice), motivation indicators (i.e. educational and clinical supervision), opportunity indicators (i.e. clinical unit cultures), and workplace well-being indicators (i.e. burnout, compassion satisfaction, and job performance). A total of 107 junior doctors participated, providing 926 total responses. The data were analysed using univariate analyses and structural equation modelling with path analysis.

RESULTS

Over the 3-year period following graduation, the junior doctors' confidence in their preparedness for clinical practice and the educational and clinical supervision had varying degrees of influence on the junior doctors' workplace well-being. The influence of clinical unit cultures, which can provide opportunities for junior doctors, became evident starting from the second year postgraduation; notably, unit cultures that emphasised flexibility and discretion played positive and critical roles in enhancing the junior doctors' workplace well-being lasted to the third year.

CONCLUSIONS

Our findings provide insights into the distinct critical factors that affect the socialisation of junior doctors within workplace environments over 3 consecutive years. These findings can provide guidance for medical educators and healthcare managers, helping them understand and support the progressive integration of junior doctors into their work environments.

Investigating the impact of innovative AI chatbot on post-pandemic medical education and clinical assistance: a comprehensive analysis

BACKGROUND

The COVID-19 pandemic has significantly disrupted clinical experience and exposure of medical students and junior doctors. Artificial Intelligence (AI) integration in medical education has the potential to enhance learning and improve patient care. This study aimed to evaluate the effectiveness of three popular large language models (LLMs) in serving as clinical decision-making support tools for junior doctors.

METHODS

A series of increasingly complex clinical scenarios were presented to ChatGPT, Google's Bard and Bing's AI. Their responses were evaluated against standard guidelines, and for reliability by the Flesch Reading Ease Score, Flesch-Kincaid Grade Level, the Coleman-Liau Index, and the modified DISCERN score for assessing suitability. Lastly, the LLMs outputs were assessed by using the Likert scale for accuracy, informativeness, and accessibility by three experienced specialists.

RESULTS

In terms of readability and reliability, ChatGPT stood out among the three LLMs, recording the highest scores in Flesch Reading Ease (31.2 ± 3.5), Flesch-Kincaid Grade Level (13.5 ± 0.7), Coleman-Lau Index (13) and DISCERN (62 ± 4.4). These results suggest statistically significant superior comprehensibility and alignment with clinical guidelines in the medical advice given by ChatGPT. Bard followed closely behind, with BingAI trailing in all categories. The only non-significant statistical differences (P > 0.05) were found between ChatGPT and Bard's readability indices, and between the Flesch Reading Ease scores of ChatGPT/Bard and BingAI.

CONCLUSION

This study demonstrates the potential utility of LLMs in fostering self-directed and personalized learning, as well as bolstering clinical decision-making support for junior doctors. However further development is needed for its integration into education.

Simulation-based education in neurology: lessons from the COVID-19 pandemic

OBJECTIVES

The COVID-19 pandemic has led to the disruption of all sectors of the economy including education. According to UNESCO over 1.37 million young people including medical students, were affected by the lockdowns in response to COVID-19 and the subsequent closure of the education system. The primary challenge for medical education was to provide clerkships in a biosafety environment. This study aimed to determine the impact of a simulated hospital in a neurology clerkship of 5-year medical students during the coronavirus pandemic and compare their results with a non-pandemic group in Bogotá, Colombia.

RESULTS

The students in the pandemic group answered a Likert scale survey regarding their satisfaction with the simulated hospital. Both groups were required to perform an oral, mid-term and final examination. From the results, it is clear that students perceived that exposure to a simulated hospital facilitated their learning process (93.1%) and allowed greater interaction with the teacher compared to a face-to-face environment (77.3%). There were no clinically significant differences in test results. This experience indicates that a simulated hospital is a valuable method to acquire clinical skills in trainees, that could be integrated into the curricular milestones of medical education programs regardless of the pandemic.

Simulated virtual on-call training programme for improving non-specialised junior doctors' confidence in out-of-hours psychiatry: quantitative assessment

AIMS AND METHOD

To investigate whether a psychiatry-specific virtual on-call training programme improved confidence of junior trainees in key areas of psychiatry practice. The programme comprised one 90 min lecture and a 2 h simulated on-call shift where participants were bleeped to complete a series of common on-call tasks, delivered via Microsoft Teams.

RESULTS

Thirty-eight trainees attended the lecture, with a significant improvement in confidence in performing seclusion reviews (P = 0.001), prescribing psychiatric medications for acute presentations (P < 0.001), working in section 136 suites (places of safety) (P = 0.001) and feeling prepared for psychiatric on-call shifts (P = 0.002). Respondents reported that a virtual on-call practical session would be useful for their training (median score of 7, interquartile range 5-7.75). Eighteen participants completed the virtual on-call session, with significant improvement in 9 out of the 10 tested domains (P < 0.001).

CLINICAL IMPLICATIONS

The programme can be conducted virtually, with low resource requirements. We believe it can improve trainee well-being, patient safety, the delivery of training and induction of rotating junior doctors during the COVID-19 pandemic and it supports the development and delivery of practical training in psychiatry.

Assessment of YouTube as an educational tool in teaching flexible nasendoscopy and peritonsillar abscess drainage

BACKGROUND

Partly as a result of coronavirus disease 2019, YouTube has become a more frequent educational source for otolaryngology trainees. This study sought to assess the quality of flexible nasendoscopy and peritonsillar abscess drainage videos.

METHOD

YouTube was systematically searched using 13 terms related to flexible nasendoscopy and peritonsillar abscess drainage. Two independent reviewers assessed the quality of each video using the Laparoscopic Video Educational Guidelines.

RESULTS

Twenty-seven videos were deemed suitable. The mean total Laparoscopic Video Educational Guidelines scores for videos on flexible nasendoscopy (18 videos) and peritonsillar abscess drainage (9 videos) were 10.3 (standard deviation = 3.1) and 11.7 (standard deviation = 4.6), respectively. Most of the videos were deemed of medium quality. The Laparoscopic Video Educational Guidelines score correlated positively with flexible nasendoscopy video length and how recently a peritonsillar abscess drainage video had been uploaded.

CONCLUSION

The limited high-quality videos on YouTube are difficult to identify from the search metrics available. Trainees and ENT induction programmes would benefit greatly from an online platform that contains a catalogue of high-quality surgical videos.

ChatGPT-4: Transforming Medical Education and Addressing Clinical Exposure Challenges in the Post-pandemic Era

Background

The COVID-19 pandemic has affected medical education, constraining clinical exposure and posing unprecedented challenges for students and junior doctors. This research explores the potential of artificial intelligence (AI), specifically the ChatGPT-4 language model, to transform medical education and address the deficiencies in clinical exposure during the post-pandemic era.

Research Questions/Purpose

What is the potential of AI large language models in delivering safe and coherent medical advice to junior doctors for clinical orthopaedic scenarios?

Patients and Methods

A series of diverse orthopaedic questions was presented to ChatGPT-4, from general medicine to highly specialised fields. The questions were based on a variety of common orthopaedic presentations including neck of femur fracture, compartment syndrome, pulmonary embolism, and a motor vehicle accident. A validated questionnaire (Likert Scale) was implemented to evaluate the answers produced by ChatGPT-4.

Results

Our results indicate that ChatGPT-4 exhibits exceptional proficiency in delivering accurate and coherent medical advice. Its intuitive interface, accessibility, and sophisticated algorithm render it an ideal supplementary tool for medical students and junior doctors. Despite certain limitations, such as its inability to fully address highly specialised areas, this study highlights the potential of AI and ChatGPT-4 to revolutionise medical education and fill the clinical exposure void generated by the pandemic. Future research should concentrate on the practical application of ChatGPT-4 in real-world medical environments and its integration with other emerging technologies to optimise its influence on the education and training of healthcare professionals.

Conclusions

ChatGPT-4's integration into orthopaedic education and practice can mitigate pandemic-related experience gaps, promoting self-directed, personalised learning and decision-making support for interns and residents. Future advancements may address limitations to enhance healthcare professionals' learning and expertise.

Level of Evidence

Level III evidence-observational study.

The Effectiveness of Online Learning in Improving the Electrocardiogram Interpretation Skills of Junior Medical Trainees: A Mixed Methods Observational Study

Introduction The COVID-19 pandemic hindered medical education and limited access to clinical skills training for trainee medical doctors, including electrocardiogram (ECG) interpretation. These restrictions prompted a shift towards virtual training environments and online learning. In this study, we assessed the impact of the pandemic on trainees' confidence and their perceived difficulty in independently interpreting ECGs. Additionally, we examined the effectiveness of two online learning approaches, namely lectures and case-solving webinars, in improving their skills. Methods The study was a mixed methods observational study conducted in three phases. In the first phase, a cross-sectional study was conducted to subjectively assess the trainees' confidence levels and the perceived difficulty independently reading ECGs. The second phase involved a cohort study where an online learning module consisting of eight lecture-based sessions was implemented. This module covered all the topics recommended in the foundation doctor training curriculum. The third phase also involved a cohort study where an online case-based discussion learning module with two problem-solving webinars was introduced. We assessed the outcomes on a 1 to 10 Likert scale for confidence and perceived difficulty in independently reading ECGs. Results Sixty-five trainees participated in the initial cross-sectional study. Among them, 100% of the participants reported substantial difficulty in interpreting ECGs (scoring 6 or more on the Likert scale), and 76.5% of the participants did not feel enough confidence to read ECGs independently (scoring 6 or less). Ten trainees attended the second phase. Online lectures significantly increased the mean confidence score by 1.9 points (t(9) = 2.82, p = 0.02, 95% confidence interval (CI) [0.38-3.42]) and significantly reduced the mean of the perceived difficulty score by 2.7 points (t(9) = 5.71, p < 0.001, 95% CI [1.63-3.77]). Compared to the online lectures, the online problem-solving sessions significantly increased the mean of the composite score of confidence and perceived difficulty in reading ECGs (-0.8 vs. 4 points, 95% CI [1.49, 8.26], p = 0.011). Conclusion The COVID-19 pandemic negatively affected the ECG reading skills of junior medical trainees. However, the online teaching approach effectively improved their confidence and the level of difficulty they experienced in ECG interpretation. Applying online case problem-solving was found to be superior to the lecture-based approach in enhancing these parameters.

Risk of burnout and depression: A survey of veterinary anaesthesia specialists in-training during COVID-19

OBJECTIVE

To investigate risk, risk factors and effects on adherence to adequate clinical standards, of burnout and depression in veterinary anaesthesia residents.

STUDY DESIGN

Closed online cross-sectional survey study.

STUDY POPULATION

A sample of 89 residents registered to the European and/or the American Colleges of Veterinary An (ae)sthesia and Analgesia out of a total of 185.

METHODS

A link to access an online questionnaire, which included the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), the Harvard National Depression Screening Day Scale (HANDS) and 28 questions developed to assess adherence to adequate clinical standards, was sent by email to 185 residents. The three components of the MBI-HSS namely emotional exhaustion (EE), depersonalization and reduced personal accomplishment were analysed separately. Analysis of proportions and two-step regression statistical modelling were used for data analysis, and p values < 0.05 were considered statistically significant.

RESULTS

The response rate was 48%. Based on HANDS and MBI-HSS scores, 49% of the residents were at high risk of both depression and burnout. These residents expressed greater concern of delivering inadequate animal care (p < 0.001), of decreased quality of supervision during COVID-19 (p = 0.038) and of negative impact of the pandemic on their training programme (p = 0.002) than residents at low-to-moderate risk. Working in a clinical environment for ≥ 60 hours/week was a risk factor for both depression (p = 0.016) and EE (p = 0.022), while female sex was a risk factor for EE only (p = 0.018).

CONCLUSIONS AND CLINICAL RELEVANCE

A large proportion of residents is at high risk of depression and burnout, a scenario likely worsened by the pandemic. The findings of this study suggest that reducing the clinical workload and increasing the level of support and supervision may help to improve residents' mental health.

Palliative care teaching in the new internal medicine curriculum: Project ECHO-an innovative approach to postgraduate education

BACKGROUND

The Internal Medicine Training (IMT) Programme is an evolution of Core Medical Training introduced in 2019. The IMT curriculum places an increased emphasis on palliative care; however, access to palliative care training is variable. Project ECHO (Extension of Community Healthcare Outcomes) develops communities of practice and is a valuable tool for medical education. We report on an evaluation of Project ECHO to deliver palliative medicine training across a geographically large deanery in the North of England.

METHODS

The Project ECHO training programme involved multipoint video technology, telementoring, expert talks and case-based discussions over six sessions, and was fully mapped to the palliative care component of the IMT curriculum. We collected data particularly around attendance and self-reported confidence and knowledge.

RESULTS

By creating a community of practice, we provided virtual placements and over 9 hours of virtual direct contact with palliative medicine consultants; and in total, 921 individual attendances occurred, with 62% attending all six sessions. The course was associated with an increase in self-reported confidence and high satisfaction.

DISCUSSION

Project ECHO is an effective method of delivering teaching to trainees across a large geographical area. Course evaluation shows outstanding results in trainee satisfaction, confidence, knowledge, patient care, clinical skills and reduction in fear when managing death and dying.

The recovery of training and education post-COVID-19: the importance of supporting the consultant workforce

BACKGROUND/AIMS

Since the COVID-19 pandemic began, training and education have been significantly disrupted, causing an incalculable effect on trainees. However, the consultant workforce is crucial to the success of training recovery. The motivation of the consultant workforce to assist in training recovery, in a context of significant workload and increasing pressures on resources, is currently unknown.

METHODS

This survey gathered the consultant workforce's views on assisting training recovery at one site of a large NHS foundation trust.

RESULTS

There was reduced motivation to engage in training and education when compared to pre-pandemic levels, widespread indicators of burnout, and changes in attitude towards reducing their working hours and early retirement.

CONCLUSIONS

These findings demonstrate a worrying trend that is likely to be replicated nationwide, which highlights the need to support consultants to avoid further disruption to training recovery.

COVID-19 Pandemic and Its Effect on Resident Physicians' Mental Well-Being: A Cross-Sectional Study in Kuwait

OBJECTIVE

Concerns about COVID-19's long-term consequences on the mental health of frontline health professionals are mounting as the entire world strives anew to contain it. The primary objective of this research is to describe the impact of working during the COVID-19 pandemic on resident physicians' mental health.

SUBJECT AND METHODS

A cross-sectional online survey using the Google Forms platform was conducted from May 1 to May 30, 2021, on 311 residents currently enrolled in a residency program at the Kuwait Institutional of Medical Specialization (KIMS). Socio-demographic details of each resident physician were collected and the scores related to depression, anxiety, and stress were measured using the previously validated depression anxiety stress scale-21 (DASS-21).

RESULTS

Higher stress and depression scores were seen in those who were devoid of the option to work with COVID-19 patients, who reported that working during the pandemic affected their study schedule, and who lost off-service training time. Further, the anxiety scores were significantly higher in females.

CONCLUSION

The impact of the ongoing pandemic on residents' mental health is grave, necessitating psychological treatment and support. The study discovered various factors linked to depression, anxiety, and stress. As a result, these aspects must be regarded to protect the doctors' mental health.

Integrated clinical case discussions - a fully student-organized peer-teaching program on internal medicine

BACKGROUND

In response to students´ poor ratings of emergency remote lectures in internal medicine, a team of undergraduate medical students initiated a series of voluntary peer-moderated clinical case discussions. This study aims to describe the student-led effort to develop peer-moderated clinical case discussions focused on training cognitive clinical skill for first and second-year clinical students.

METHODS

Following the Kern Cycle a didactic concept is conceived by matching cognitive learning theory to the competence levels of the German Medical Training Framework. A 50-item survey is developed based on previous evaluation tools and administered after each tutorial. Educational environment, cognitive congruence, and learning outcomes are assessed using pre-post-self-reports in a single-institution study.

RESULTS

Over the course of two semesters 19 tutors conducted 48 tutorials. There were 794 attendances in total (273 in the first semester and 521 in the second). The response rate was 32%. The didactic concept proved successful in attaining all learning objectives. Students rated the educational environment, cognitive congruence, and tutorials overall as "very good" and significantly better than the corresponding lecture. Students reported a 70%-increase in positive feelings about being tutored by peers after the session.

CONCLUSION

Peer-assisted learning can improve students´ subjective satisfaction levels and successfully foster clinical reasoning skills. This highlights successful student contributions to the development of curricula.

Educational opportunities for postgraduate medical trainees during the COVID-19 pandemic: deriving value from old, new and emerging ways of learning

The COVID-19 pandemic has had a significant impact on postgraduate medical training across all specialties. Although some traditional learning opportunities have been curtailed, there have been numerous examples of highly valuable educational experiences that have arisen during this time. Here, from a trainee perspective, we consider the educational merits of the re-emergence of 'firm-based' teams, new online learning opportunities, use of digital technologies and the rise of telephone clinics and new COVID-19 clinical services. As health services continue to recover from surges in COVID-19 cases, it is important to reflect on and recognise the value of these educational experiences so that helpful elements can be retained and embedded into training programmes for the benefit of both trainees and patients.

Simulation in plastic and reconstructive surgery: a scoping review

Since the origins of surgery, simulation has played an important role in surgical education, particularly in plastic and reconstructive surgery. This has greater relevance in contemporary settings of reduced clinical exposure resulting in limited work-based learning opportunities. With changing surgical curricula, it is prescient to examine the role of simulation in plastic and reconstructive surgery.

A scoping review protocol was used to identify relevant studies, with an iterative process identifying, reviewing and charting the data to derive reported outcomes and themes.

Of the 554 studies identified, 52 studies were included in this review. The themes identified included simulator modalities, curriculum elements targeted and relevant surgical competencies. There was a predominance of synthetically based simulators, targeting technical skills largely associated with microsurgery, paediatric surgery and craniomaxillofacial surgery.

Existing simulators largely address high-complexity procedures. There are multiple under-represented areas, including low-complexity procedures and simulation activities addressing communication, collaboration, management and leadership. There are many opportunities for simulation in surgical education, which requires a contextual appreciation of educational theory. Simulation may be used both as a learning method and as an assessment tool.

This review describes the literature relating to simulation in plastic and reconstructive surgery and proposes opportunities for incorporating simulation in a broader sense, in the surgical curriculum.

COVID-19 Pandemic and Its Impact on Training Programs of Medical Residency in Romania

Background: The COVID-19 pandemic has had a negative impact on the training process for resident physicians. The objective of this study was to evaluate the impact of the COVID-19 pandemic on professional training, and also the subjective perception of the levels of stress, anxiety, and depression among resident doctors specializing in gastroenterology in Romania. Methods: We conducted an observational cross-sectional study, for a period of two months, among 180 resident doctors specializing in gastroenterology, working in university hospitals in Romania. A questionnaire consisting of 29 questions distributed through social media platforms was completed in Google Forms. Statistical analyses were performed using IBM SPSS software v.20. Results: A linear relationship was identified between the number of daily hospitalizations in the gastroenterology department and the rate of SARS-CoV-2 infection among resident physicians. In total, 80% of the participants reported an increase in the levels of stress, anxiety, and depression during the COVID-19 pandemic, and 88.3% stated that they were unsatisfied by online courses. Conclusions: The COVID-19 pandemic has had negative effects on both professional training and levesl of stress, anxiety and depression of resident doctors specializing in gastroenterology. In the specialty of gastroenterology there may be certain peculiarities, due to the interventional aspects that this medical specialty involves, for example, endoscopic procedures. Thus, the necessity to acquire practical skills in addition to theoretical knowledge increases the negative impact on gastroenterology internship.

Telemedicine and Telementoring in Urology: A Glimpse of the Past and a Leap Into the Future

Telemedicine is the process of utilizing telecommunications and digital relay to perform, teach, or share medical knowledge. The digital era eased the incorporation of telemedicine to different areas of medical care, including the surgical care of Urologic patient mainly through telementoring, telesurgery, and telerobotics. Over the years, Telemedicine has played an integral part in a physicians' ability to provide high quality medical care to remote patients, as well as serve as an educational tool for trainee physicians, in the form of telementoring. During the COVID-19 pandemic, telemedicine has played a vital role in combatting the health implications of confinements. Challenges of telemedicine implementation include cost, ethical considerations, security, bandwidth, latency, legal, and licensure difficulties. Nevertheless, the future of telemedicine, specifically telementoring, promises several improvements and innovative advancements that aim to bridge the gap in technological divides of urologic care. In this review, we build on what is already known about telemedicine focusing specifically on aspects related to telementoring, telestration, and telesurgery. Furthermore, we discuss its historical role in healthcare with a special emphasis on current and future use in urology.

What challenges did junior doctors face while working during the COVID-19 pandemic? A qualitative study

OBJECTIVES

This paper reports findings exploring junior doctors' experiences of working during the COVID-19 pandemic in the UK.

DESIGN

Qualitative study using in-depth interviews with 15 junior doctors. Interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.12 to facilitate data management. Data were analysed using reflexive thematic analysis.

SETTING

National Health Service (NHS) England.

PARTICIPANTS

A purposive sample of 12 female and 3 male junior doctors who indicated severe depression and/or anxiety on the DASS-21 questionnaire or high suicidality on Paykel's measure were recruited. These doctors self-identified as having lived experience of distress due to their working conditions.

RESULTS

We report three major themes. First, the challenges of working during the COVID-19 pandemic, which were both personal and organisational. Personal challenges were characterised by helplessness and included the trauma of seeing many patients dying, fears about safety and being powerless to switch off. Work-related challenges revolved around change and uncertainty and included increasing workloads, decreasing staff numbers and negative impacts on relationships with colleagues and patients. The second theme was strategies for coping with the impact of COVID-19 on work, which were also both personal and organisational. Personal coping strategies, which appeared limited in their usefulness, were problem and emotion focused. Several participants appeared to have moved from coping towards learnt helplessness. Some organisations reacted to COVID-19 collaboratively and flexibly. Third, participants reported a positive impact of the COVID-19 pandemic on working practices, which included simplified new ways of working-such as consistent teams and longer rotations-as well as increased camaraderie and support.

CONCLUSIONS

The trauma that junior doctors experienced while working during COVID-19 led to powerlessness and a reduction in the benefit of individual coping strategies. This may have resulted in feelings of resignation. We recommend that, postpandemic, junior doctors are assigned to consistent teams and offered ongoing support.

"Concerns and Psychological Wellbeing of Health Care Workers During the COVID-19 Pandemic in a Tertiary Care Hospital in NSW"

Background

In early 2020, the impending COVID‐19 pandemic placed a once‐in‐a‐generation professional and personal challenge on healthcare workers. Publications on direct physical disease abound. The authors wanted to focus on doctors' psychological well‐being.

Aims

To assess the impact of the COVID‐19 pandemic on doctors' well‐being and evaluate their concerns as the pandemic progressed.

Methods

A mixed‐methods, hospital‐based survey was sent to doctors at the 650‐bed tertiary referral hospital in NSW at two different periods (late‐March and early May 2020). A validated mental well‐being tool (Short Warwick Edinburgh Mental Well‐being Scale (SWEMWBS)) was combined with COVID‐19‐specific questions.

Results

Two hundred and thirty‐five responses were obtained from 450 doctors, with a response rate of 32% in the first survey and 20% in the second. The majority (35%) of respondents were doctors‐in‐training, followed by staff‐specialists (23%). The highest response was from frontline workers in both surveys, including the intensive care unit (27%), anaesthesia (21%) and emergency department (13%). ‘Extreme concern’ regarding personal protective equipment (PPE) shortage dropped from 22.6% to 2.2% and ‘extreme concern’ of contracting COVID‐19 fell from 22.6% to 3.4% in the second survey. The proportion of respondents with a ‘low’ psychological well‐being score improved from 38% to 27% between the two surveys. The resulting mean improvement in the SWEMWBS was 3.49 (95% confidence interval = 3.06–3.91, P < 0.001).

Conclusion

Both COVID‐19 specific concerns and psychological well‐being improved greatly in the second survey. Possible explanations are the fall in COVID‐19 cases in the district, improvements in PPE supply and supportive measures communicated to doctors during this period.