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Paediatric Anaesthetic Training During COVID-19:
The UK National Paediatric Anaesthesia Trainee Research Network (PATRN) Swift Survey
The Paediatric Anaesthesia Trainee Research Network (PATRN) Committee read with great interest the findings of the national survey of paediatric trainee experiences during the Covid-19 pandemic from Harmer et al. The re-deployment of anaesthetic trainees to support the surge in demand from adult intensive care, postponement of elective surgery and pauses to trainee rotations1 all affected access to sub-specialty training in anaesthesia. Thus, PATRN conducted an equivalent national survey evaluating the impact of the pandemic on training in paediatric anaesthesia from March to August 2020.
A survey questionnaire consisting of Sixteen questions focussed on trainee experience of paediatric anaesthesia during the first wave of Covid-19 infections, from March to August 2020. Paediatric anaesthesia experience in the UK occurs at all stages of training, with the option for an additional ‘advanced’ module. The survey was reviewed by members of the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) Scientific Committee. Distribution was via email to all UK-based trainees by College Tutors and the Anaesthetists in Training Representative Group (ATRG) through The Royal College of Anaesthetists (RCoA) and APAGBI trainee members from December 2020 to March 2021.
The findings were reflective of thos...
The findings were reflective of those identified by Harmer et al, with changes to work schedule being commonplace. 90/170 (53%) of respondents, representing all stages of training, were due to complete a paediatric training module during the specified timeframe. Only 23% remained working in paediatric anaesthesia, almost all of whom were undertaking ‘higher’ or ‘advanced’ modules (n=19). The majority of trainees who experienced disruption with re-deployment was to support adult intensive care (33/69; 48%). Many trainees did not have sufficient paediatric cases to achieve module sign off (32/66; 48%), due to re-deployment or a lack of elective training lists. Most trainees felt they had insufficient paediatric experience for progression of training (37/69; 54%).
In addition, teaching sessions were reduced; 52% (90/170) of respondents reported fewer sessions compared to pre-COVID, despite delivery of virtual sessions. 84/170 (49%) of respondents were able to undertake extracurricular activities for personal development, including training other staff, writing COVID protocols, quality improvement projects and COVID research.
Training in paediatric anaesthesia relies upon ‘hands-on’ experience to develop confidence. Our findings reflect the RCoA’s efforts to minimise disruption to trainees at a critical stage of progression, however, the qualitative impact of COVID-19 is difficult to assess and relates to individual confidence. New ARCP outcomes2 have been created to identify the impact of COVID-19 on training and allow remediation. Following the acute phase of the pandemic, the authors feel access to training should be prioritised. This is of particular importance for junior trainees who have been unable to achieve sign-off or gain experience to feel well-equipped for progression. The survey findings support the requirement for ongoing open discussions at a national level on how to address these issues.
Rimmer A. COVID-19: trainees will not move jobs in April. BMJ 2020;368:m1088
RCOA. Anaesthetics ARCP decision guidance COVID – 19. RCOA. Anaesthetics ARCP decision guidance COVID – 19. https://www.rcoa.ac.uk/sites/default/files/documents/2020-05/Anaesthetic... (last accessed 29th March 2021).