Paediatric anaesthetic training during COVID-19. The UK national paediatric anaesthesia trainee research network (PATRN) swift survey

ABSTRACT

Introduction: The re-deployment of anaesthetic trainees to support COVID-19 patients in intensive care, reduced elective surgery and pauses to trainee rotations1 have affected access to training. The 2020 PATRN swift survey examined the impact on UK paediatric anaesthetic training following the first wave of the pandemic. Method: Sixteen questions, designed by the PATRN committee, focussed on trainee experience of paediatric anaesthesia from March-August 2020. Paediatric anaesthesia experience in the UK occurs at all stages with the option for an 'advanced' module. The survey was reviewed by members of the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) Scientific Committee before distribution. Distribution was via email to UK traineesy College Tutors through The Royal College of Anaesthetists (RCOA) and APAGBI trainee members from December 2020March 2021. Results: 90/170 (53%) of respondents were due to complete a paediatric training module, representing all stages of training. Only 23% (n=21) remained working in paediatric anaesthesia, mainly trainees completing 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%). Most trainees felt they had insufficient paediatric experience for progression of training (37/69;54%) and did not have enough cases to achieve module completion (32/66;48%). This was due to re-deployment or a lack of elective training lists. Conclusion: Paediatric anaesthesia is a 'hands-on' specialty and requires experience for confidence. New annual competency progression outcomes2 have been created to identify missed training due to COVID-19. There will be an impact in the short-term for covering on-call cases and longer term on workforce if training extensions result in delays to completion. Access to training needs to be prioritised, especially for junior trainees most affected by re-deployment. There should be ongoing discussions nationally on how to address these issues.