Purpose
To report the degree to which post-graduate trainees in radiation oncology perceive their education has been impacted by COVID-19.
Methods
A cross-sectional online survey was administered in June 2020 to trainee members of Canadian Association of Radiation Oncology (CARO). The 82-item survey was adapted from a similar survey administered during SARS and included the Stanford Acute Stress Reaction and Ways of Coping Questionnaires. The survey was developed using best practices including expert review and cognitive pre-testing. Frequency statistics are reported.
Results
Thirty-four trainees (10 fellows, 24 residents) responded. Nearly half of participants indicated that the overall impact of COVID-19 on training was negative/very negative (n=15; 46%) or neutral (n=15; 46%) with a small number indicating a positive/very positive (n=3; 9%). Majority of trainees agreed/strongly agreed with the following statements: "I had difficulty concentrating on tasks because of concerns about COVID-19" (n=17; 52%), "I had fears about contracting COVID-19" (n=17; 52%), "I had fears of family/loved ones contracting COVID-19" (n= 29; 88%), "I felt socially isolated from friends and family because of COVID-19" (n=23; 70%), "I felt safe from COVID-19 in the hospital during my clinical duties" (n=15; 46%), and "I was concerned that my personal safety was at risk if/when I was redeployed from my planned clinical duties" (n=20; 61%). The changes that had a negative/very negative impact on learning included "the impact of limited patient contact" (n=19; 58%), "the impact of virtual patient contact" (n= 11; 33%), and "limitations to travel and networking" (n=31; 91%). Most reported reduced teaching from staff (n=22; 66%). Two-thirds of trainees (n=22, 67%) reported severe (>50%) reduction in ambulatory clinical activities, 16 (49%) reported a moderate (<50%) reduction in new patient consultations, while virtual follow-ups (n=25: 76%) and in-patient clinical care activities (n=12; 36%) increased. Nearly half of respondents reported no impact on contouring (n=16; 49%), on-treatment management (n=17; 52%) and tumor boards (n=14; 42%) with the majority of other respondents reporting a decrease in these activities. Electives were cancelled in province (n=10/20; 50%), out-of-province (n=16/20; 80%) and internationally (n=15/18; 83%).
Conclusions
Significant changes to radiation oncology training were wrought by the COVID-19 pandemic and roughly half of trainees perceive that these changes had a negative impact on their training. Safety concerns for self and family were significant and strategies to mitigate these concerns should be a priority.
Significance
We report specific areas of impact on training due to COVID-19 which might be addressed by adaptations in program design and delivery. We also identify the significant concerns of safety, for self and family, which must be addressed.
Keywords
COVID-19 curriculum learning
27