The immediate impact of the COVID-19 pandemic on burn-out, work-engagement and surgical training in the Netherlands

Poelmann, F.B.; Koëter, T.; Steinkamp, P.J.; Vriens, M.R.; Verhoeven, B.; Kruijff, S.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic led to major changes in health care and education options for all health care employees. The aim of this study is to achieve insight into COVID-care participation of surgical residents in the Netherlands, the impact of COVID-19 on the experienced quality of surgical training and the influence on Burn-out and Work Engagement compared to the non-COVID-19 period in January 2020. METHODS: In this study, we have conducted two digital surveys immediately prior to and two months after the start of the COVID-19 pandemic. We surveyed a validated Dutch questionnaire ‘Utrecht Burn-out Scale’, derived from the Maslach Burn-out Inventory, and also collected the ‘Utrecht Work Engagement Scale’ measuring work engagement. Additionally we describe the COVID-care participation of surgical residents, the impact on how they experienced the quality of their surgical training and the influence on ‘Burn-out and Work Engagement’ compared to the pre-COVID-19 period for surgical residents in the Netherlands. RESULTS: In January 2020, a total 317 residents completed the online survey and in April 2020 a total of 313 residents completed the online survey. 48.6% of the responders in April participated in COVID-care in both the COVID ward as well as the COVID ICU. Residents experienced that COVID-19 influenced their surgical training in 85.2%. In only 5% of the residents the pandemic did not affect the exposure to surgical training in the operating theater. More burn-out symptoms were noted amongst COVID ward deployed residents vs. no COVID ward deployment, (16.0% vs. 7.6%, p = 0.06). The Work-Engagement questionnaire showed a significantly lower work engagement score of 4.2 for residents who were deployed in COVID-care ICU versus a 4.6 of residents scheduled in COVID ward (p = 0.02). CONCLUSION: This study shows a significant impact of the first months of the COVID-19 pandemic on the Dutch surgical trainee program, with a major redistribution of residents with a decrease of surgical exposure and education. We emphasize the need for adequate guidance of all surgical residents and potentially lengthening the surgical training program.