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Gerk A, Naus A, Carroll M, Ponte L, Salgado LS, Marrazzo E, Secanho M, Botelho F, Mooney D, Ferreira R, Ferreira JL. Perceived Impact of Coronavirus Disease 2019 on Surgical Training: A Brazilian Survey. J Surg Res 2024; 295:619-630. [PMID: 38101108 DOI: 10.1016/j.jss.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/22/2023] [Accepted: 10/27/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Recent studies revealed that coronavirus disease 2019 (COVID-19) negatively impacted residency programs worldwide, particularly procedure-based programs. However, most studies are from high-income countries, with scarce data from low- and middle-income countries. Pandemic effects on surgical training were likely worse in strictly apprenticeship models relying heavily on surgical volume as opposed to competency-based programs. Notably, training programs in Brazil and other low- and middle-income countries follow these strict apprenticeship style frameworks. In this study, we aimed to evaluate the trainees' perceptions of the impact of COVID-19 on their Brazilian surgical programs. METHODS A cross-sectional study was performed using an anonymous survey in Portuguese, distributed via social media platforms to surgical residents enrolled in Brazilian surgery programs. Data collection took place from August 2021 to May 2022. The survey contained 30 questions on the perception of the impact of COVID-19 on surgical training. RESULTS One-hundred sixty-two residents from 17 different surgical specialties and all five regions of Brazil responded to the survey. Of 162 residents, 145 (89%) believed the pandemic negatively impacted their surgical training. Furthermore, of 162 residents, 153 (94%) reported that elective surgical volume decreased during the pandemic and 91 (56%) were redeployed to assist with COVID-19 management. As a result, 102 of 162 (63%) residents believed their surgical skills were negatively impacted by COVID-19. Yet, 95 of 162 (59%) residents reported their residency programs did not offer resources to mitigate the pandemic's impact on training. Of 162 residents, 57 (35%) reported they did not feel on track for graduation, with no statistical difference between responses by year of residency (P = 0.083). Additionally, 124 of 162 (77%) residents reported that the pandemic negatively affected their mental health, most commonly related to stress at work, stress about transmitting COVID-19, and loss in surgical training. CONCLUSIONS Most of the surveyed Brazilian surgical residents felt the COVID-19 pandemic negatively impacted their training. This leads to believe that the detrimental impacts of the pandemic exposed preexisting weaknesses in the Brazilian surgical training model's dependence on a strict apprenticeship model. Our findings suggest a crucial need to redesign surgical education programs to make residency programs more prepared for changes in surgical volume, evolve the apprenticeship model to competency-based approaches, and unify surgical training standards in low- and middle-income countries.
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Affiliation(s)
- Ayla Gerk
- Universidad Católica Argentina, Buenos Aires, Argentina; Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts
| | - Abbie Naus
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts
| | - Madeleine Carroll
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts
| | - Lucas Ponte
- School of Medicine, University of Fortaleza, Fortaleza, Ceará, Brazil
| | | | - Enzzo Marrazzo
- Faculty of Medicine, Institute of Biological Sciences, Pontifícia Universidade Católica de Minas Gerais Poços de Caldas, Poços de Caldas, Minas Gerais, Brazil
| | - Murilo Secanho
- Faculty of Medical Sciences of Botucatu, UNESP Botucatu, Botucatu, São Paulo, Brazil
| | - Fabio Botelho
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Childrens' Hospital, McGill University, Montreal, Quebec, Canada
| | - David Mooney
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, Massachusetts; Boston Children's Hospital, Boston, Massachusetts
| | - Roseanne Ferreira
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Júlia Loyola Ferreira
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Childrens' Hospital, McGill University, Montreal, Quebec, Canada.
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