Paediatric training during the COVID-19 pandemic: the voice of 638 trainees

ABSTRACT

BackgroundHigh quality paediatric training is essential to the provision of excellent child health care both now and in the future. To ensure a high standard of training is maintained within The London School of Paediatrics, an annual trainee survey has taken place since 2012. The COVID-19 pandemic brought new challenges to paediatric training (and meant that many of the usual metrics to assess training across the region became obsolete) and in September 2020, The School conducted an abbreviated, tailored survey to capture experiences of trainees, and challenges faced in training during a pandemic.ObjectivesTo ascertain the ways in which London paediatric trainees were impacted by the emergency operational response to the first wave of the COVID-19 pandemic.To provide rapid feedback to training centres to inform the response to any subsequent surges.Methods950 (769 in programme) London Paediatric trainees were surveyed about their March-September 2020 training placement. Online survey was emailed directly, with reminders, and promoted via social media. Five closed questions addressed overall placement satisfaction (excellent to poor), performance areas (morale, educational supervision, teaching and rest/catering facilities), and specific impact of covid-19. Three free text questions addressed the impact of covid-19, positive practices and initiatives, and areas of improvement.ResultsThere were 638 responses, with 566 from in-programme trainees (74% of in-programme trainees). 83.4% trainees rated their placement excellent/good (2019, 84%) and 5.8% rated it poor/below average (2019, 4%). There was inter-sector variability, with higher number of poor/below average ratings in the sector with most disruption to service.147 (23%) trainees were seconded from their placement, 102 (16%) to another paediatric department and 45 (7%) to an adult department. 102 (16%) trainees worked additional antisocial hours to cover for seconded colleagues, and 165 (26%) worked additional antisocial hours for other reasons. 38 (6%) trainees had no direct patient contact. Only 125 trainees (20%) reported that their work was not impacted by COVID. Other ways in which work was impacted included cancelled OOP (11), PICU taken over for adult patients (13), department closed without redeployment (5).The performance area most impacted by the pandemic was the provision of educational supervision. There was improvement in provisions for rest, food and drink.Thematic analysis of the free text identified that good team relationships, senior support and a supportive work environment were key to a positive training experience. Challenges faced were around teaching, lack of learning opportunities and poor communication. 8% of trainees highlighted that lack of communication worsened their training experience.ConclusionsThe survey shows that overall, the excellent standards of training were maintained during the first wave, despite evidence of significant disruption to services. The highlighted challenges can be used to guide training provision during the ongoing pandemic, and ensure that trainees continue to receive the highest standard of training.