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01-09-2020 | SARS-CoV-2 | Original Paper

Impact of the COVID-19 pandemic on orthopaedic and trauma surgery training in Europe

Authors: Panayiotis D. Megaloikonomos, Martin Thaler, Vasilios G. Igoumenou, Tommaso Bonanzinga, Marko Ostojic, André Faria Couto, Jasmin Diallo, Ismail Khosravi

Published in: International Orthopaedics | Issue 9/2020

Abstract

Purpose

This study aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on orthopaedic and trauma surgery training in Europe by conducting an online survey among orthopaedic trainees.

Methods

The survey was conducted among members of the Federation of Orthopaedic and Trauma Trainees in Europe (FORTE). It consisted of 24 questions (single-answer, multiple-answer, Likert scales). Orthopaedic trainees’ demographic data (six questions), clinical role changes (four questions), institutional changes due to the COVID-19 pandemic (nine questions), and personal considerations (five questions) were examined.

Results

Three hundred and twenty-seven trainees from 23 European countries completed the survey. Most trainees retained their customary clinical role (59.8%), but a significant number was redeployed to COVID-19 units (20.9%). A drastic workload decrease during the pandemic was reported at most institutions. Only essential activities were performed at 57.1% of institutions and drastic disruptions were reported at 36.0%. Of the respondents, 52.1% stated that faculty-led education was restricted and 46.3% pursued self-guided learning, while 58.6% stated that surgical training was significantly impaired. Concerns about the achievement of annual training goals were expressed by 58.2% of the participants, while 25.0% anticipated the need for an additional year of training.

Conclusions

The SARS-CoV-2 pandemic significantly affected orthopaedic and trauma training in Europe. Most trainees felt the decrease in clinical, surgical, and educational activities would have a detrimental effect on their training. Many of them consulted remote learning options to compensate training impairment, stating that after the COVID-19 pandemic electronic educational approaches may become more relevant in future.

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Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W, China Novel Coronavirus I, Research T (2020) A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 382(8):727–733. https://doi.org/10.1056/NEJMoa2001017CrossRefPubMedPubMedCentral

WHO (2020) Coronavirus disease (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed 21/06/2020

Vannabouathong C, Devji T, Ekhtiari S, Chang Y, Phillips SA, Zhu M, Chagla Z, Main C, Bhandari M (2020) Novel coronavirus COVID-19: current evidence and evolving strategies. J Bone Joint Surg Am 102(9):734–744. https://doi.org/10.2106/JBJS.20.00396CrossRefPubMed

Steffens I (2020) A hundred days into the coronavirus disease (COVID-19) pandemic. Euro Surveill 25(14). https://doi.org/10.2807/1560-7917.ES.2020.25.14.2000550

Seah KM (2020) Redeployment in COVID-19: old dogs and new tricks. Emerg Med J: EMJ. https://doi.org/10.1136/emermed-2020-210052

Mavrogenis AF, Quaile A, Scarlat MM (2020) The virus crisis affects orthopaedic surgery and scientific activities worldwide. Int Orthop 44(5):813–817. https://doi.org/10.1007/s00264-020-04557-2CrossRefPubMed

Liebensteiner MC, Khosravi I, Hirschmann MT, Heuberer PR, Board of the AGASoA, Joint S, Thaler M (2020) Massive cutback in orthopaedic healthcare services due to the COVID-19 pandemic. Knee Surg Sports Traumatol Arthrosc 28(6):1705–1711. https://doi.org/10.1007/s00167-020-06032-2CrossRefPubMedPubMedCentral

Thaler M, Khosravi I, Hirschmann MT, Kort NP, Zagra L, Epinette JA, Liebensteiner MC (2020) Disruption of joint arthroplasty services in Europe during the COVID-19 pandemic: an online survey within the European Hip Society (EHS) and the European Knee Associates (EKA). Knee Surg Sports Traumatol Arthrosc 28(6):1712–1719. https://doi.org/10.1007/s00167-020-06033-1CrossRefPubMedPubMedCentral

Hernigou J, Morel X, Callewier A, Bath O, Hernigou P (2020) Staying home during “COVID-19” decreased fractures, but trauma did not quarantine in one hundred and twelve adults and twenty eight children and the “tsunami of recommendations” could not lockdown twelve elective operations. Int Orthop. https://doi.org/10.1007/s00264-020-04619-5

10.

An TW, Henry JK, Igboechi O, Wang P, Yerrapragada A, Lin CA, Paiement GD (2020) How are orthopaedic surgery residencies responding to the COVID-19 pandemic? An assessment of resident experiences in cities of major virus outbreak. J Am Acad Orthop Surg. https://doi.org/10.5435/JAAOS-D-20-00397

11.

Pang KH, Carrion DM, Rivas JG, Mantica G, Mattigk A, Pradere B, Esperto F, European Society of Residents in U (2020) The impact of COVID-19 on European health care and urology trainees. Eur Urol. https://doi.org/10.1016/j.eururo.2020.04.042

12.

Zingaretti N, Contessi Negrini F, Tel A, Tresoldi MM, Bresadola V, Parodi PC (2020) The impact of COVID-19 on plastic surgery residency training. Aesthet Plast Surg. https://doi.org/10.1007/s00266-020-01789-w

13.

Madanat R, Makinen TJ, Ryan D, Huri G, Paschos N, Vide J committee Fw(2017) The current state of orthopaedic residency in 18 European countries. Int Orthop 41(4):681–687. https://doi.org/10.1007/s00264-017-3427-0CrossRefPubMed

14.

Culp BM, Frisch NB (2020) COVID-19 impact on young arthroplasty surgeons. J Arthroplast. https://doi.org/10.1016/j.arth.2020.04.058

15.

Dedeilia A, Sotiropoulos MG, Hanrahan JG, Janga D, Dedeilias P, Sideris M (2020) Medical and surgical education challenges and innovations in the COVID-19 era: a systematic review. In Vivo 34(3 Suppl):1603–1611. https://doi.org/10.21873/invivo.11950CrossRefPubMedPubMedCentral

16.

Ambrosio L, Vadala G, Russo F, Papalia R, Denaro V (2020) The role of the orthopaedic surgeon in the COVID-19 era: cautions and perspectives. J Exp Othop 7(1):35. https://doi.org/10.1186/s40634-020-00255-5CrossRef

17.

Guo X, Wang J, Hu D, Wu L, Gu L, Wang Y, Zhao J, Zeng L, Zhang J, Wu Y (2020) Survey of COVID-19 disease among orthopaedic surgeons in Wuhan, People’s Republic of China. J Bone Joint Surg Am 102(10):847–854. https://doi.org/10.2106/JBJS.20.00417CrossRefPubMed

18.

Jella TK, Acuna AJ, Samuel LT, Jella TK, Mroz TE, Kamath AF (2020) Geospatial mapping of orthopaedic surgeons age 60 and over and confirmed cases of COVID-19. J Bone Joint Surg Am Vol 102(12):1022–1028. https://doi.org/10.2106/JBJS.20.00577CrossRef

19.

Dunham AM, Rieder TN, Humbyrd CJ (2020) A bioethical perspective for navigating moral dilemmas amidst the COVID-19 pandemic. J Am Acad Orthop Surg 28(11):471–476. https://doi.org/10.5435/JAAOS-D-20-00371CrossRefPubMed

20.

Sarpong NO, Forrester LA, Levine WN (2020) What’s important: redeployment of the orthopaedic surgeon during the COVID-19 pandemic: perspectives from the trenches. J Bone Joint Surg Am 102(12):1019–1021. https://doi.org/10.2106/JBJS.20.00574CrossRefPubMed

21.

Haffer H, Schomig F, Rickert M, Randau T, Raschke M, Wirtz D, Pumberger M, Perka C (2020) Impact of the COVID-19 pandemic on orthopaedic and trauma surgery in university hospitals in Germany: results of a nationwide survey. J Bone Joint Surg Am. https://doi.org/10.2106/JBJS.20.00756

22.

Wong JSH, Cheung KMC (2020) Impact of COVID-19 on orthopaedic and trauma service. J Bone Joint Surg 00-A(00):1–9. https://doi.org/10.2106/JBJS.20.00775CrossRef

23.

Marasco G, Nardone OM, Maida M, Boskoski I, Pastorelli L, Scaldaferri F, Italian Association of Young G, Endoscopist (2020) Impact of COVID-19 outbreak on clinical practice and training of young gastroenterologists: a European survey. Dig Liver Dis. https://doi.org/10.1016/j.dld.2020.05.023

24.

Bambakidis NC, Tomei KL (2020) Editorial. Impact of COVID-19 on neurosurgery resident training and education. J Neurosurg 1–2. https://doi.org/10.3171/2020.3.JNS20965

25.

Rosen GH, Murray KS, Greene KL, Pruthi RS, Richstone L, Mirza M (2020) Effect of COVID-19 on urology residency training: a nationwide survey of program directors by the Society of Academic Urologists. J Urolo 101097JU0000000000001155. https://doi.org/10.1097/JU.0000000000001155

26.

Pennington Z, Lubelski D, Khalafallah AM, Ehresman J, Sciubba DM, Witham TF, Huang J (2020) Letter to the editor “Changes to neurosurgery resident education since onset of the COVID-19 pandemic”. World Neurosurg. https://doi.org/10.1016/j.wneu.2020.05.139

27.

Ramos O, Mierke A, Eastin M, Morrison M, Wongworawat DM, Danisa O (2020) COVID-19 pandemic and the implications for orthopaedic and neurosurgery residents and fellows on spine rotations. N Am Spine Soc J (NASSJ). https://doi.org/10.1016/j.xnsj.2020.100006

28.

Kogan M, Klein SE, Hannon CP, Nolte MT (2020) Orthopaedic education during the COVID-19 pandemic. J Am Acad Orthop Surg 28(11):e456–e464. https://doi.org/10.5435/JAAOS-D-20-00292CrossRefPubMed

29.

Palan J, Roberts V, Bloch B, Kulkarni A, Bhowal B, Dias J (2012) The use of a virtual learning environment in promoting virtual journal clubs and case-based discussions in trauma and orthopaedic postgraduate medical education: the Leicester experience. J Bone Joint Surg Br Vol 94(9):1170–1175. https://doi.org/10.1302/0301-620X.94B9.28780CrossRef

30.

Stambough JB, Curtin BM, Gililland JM, Guild GN 3rd, Kain MS, Karas V, Keeney JA, Plancher KD, Moskal JT (2020) The past, present, and future of orthopedic education: lessons learned from the COVID-19 pandemic. J Arthroplast. https://doi.org/10.1016/j.arth.2020.04.032

31.

Pedowitz RA, Marsh JL (2012) Motor skills training in orthopaedic surgery: a paradigm shift toward a simulation-based educational curriculum. J Am Acad Orthop Surg 20(7):407–409. https://doi.org/10.5435/JAAOS-20-07-407CrossRefPubMed

32.

Scarlat MM, Quaile A, Waddell JP (2020) Conflicts, military medicine and war casualties in International Orthopaedics. Int Orthop 44(1):1–2. https://doi.org/10.1007/s00264-019-04466-zCrossRefPubMed

Title: Impact of the COVID-19 pandemic on orthopaedic and trauma surgery training in Europe
Authors: Panayiotis D. Megaloikonomos
Martin Thaler
Vasilios G. Igoumenou
Tommaso Bonanzinga
Marko Ostojic
André Faria Couto
Jasmin Diallo
Ismail Khosravi
Publication date: 01-09-2020
Publisher: Springer Berlin Heidelberg
Keywords: SARS-CoV-2
COVID-19
Published in: International Orthopaedics / Issue 9/2020
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04742-3

At a glance: The STEP trials

Springer Medicine

Impact of the COVID-19 pandemic on orthopaedic and trauma surgery training in Europe

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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