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Tıpta Uzmanlık Öğrencilerinin COVID-19 Küresel Salgın Süreci Deneyimleri: Nitel Bir Araştırma

Year 2022, , 91 - 108, 31.08.2022
https://doi.org/10.25282/ted.1092139

Abstract

Amaç: COVID-19 salgını dünya genelinde sağlık hizmetleri ve profesyonelleri üzerine benzeri görülmemiş büyük bir etki yaratmıştır. Bu çalışmada COVID-19 salgının ilk aylarında Hacettepe Hastanelerinde dahili ve cerrahi alanlarda çalışan uzmanlık öğrencilerinin salgın sürecine ilişkin deneyimlerinin paylaşılması, salgın sürecinin uzmanlık öğrencilerinin yaşamları ve eğitim süreçleri üzerine etkisinin araştırılması amaçlanmıştır.
Yöntem: Araştırma niteliksel desene sahip olup, veriler Hacettepe Üniversitesi Tıp Fakültesi'nde uzmanlık eğitimine devam eden, küresel salgın sürecinde ön saflarda çalışan dokuz uzmanlık öğrencisinden derinlemesine görüşme ile elde edilmiştir. Verilerin analizinde içerik analizi kullanılmıştır.
Bulgular: Tıpta uzmanlık öğrencileri, COVID-19 salgınının mesleki, psikososyal ve eğitim yaşantıları üzerine etkilerini geniş bir bakış açısı ile ele almışlardır. Çalışma koşullarında, mesleki ve kurumsal yaklaşımlarda yaşanan değişiklikleri, salgın sürecinin beraberinde getirdiği mesleki çatışmaları, salgının hasta tedavi/bakımına etkilerini ve bu süreçten kazanımlarını COVID-19 salgının mesleki yaşamları üzerine etkileri olarak tanımlamışlardır. Aile ve arkadaş desteğininin yanı sıra özellikle öğretim üyelerinin desteğinin salgın sürecinde önemli rolü olduğu görülmüştür. Salgının yönetiminde toplumun desteğinin önemine vurgu yapılmış, karar vericilerden ve kurumlarından beklentilerinin yeterince karşılanmadığı görüşü paylaşılmıştır. Aile bireyleri ve yakın çevreye hastalığı bulaştırma korkusu ile yaşanan kaygı/endişe, sosyal uyum ve toplumsal damgalanma salgının başlıca psikososyal etkileri arasında yer almıştır. Salgının eğitim süreçlerinde aksaklıklara ve değişikliklere yol açtığı, tıp eğitiminin sağlık profesyonellerini olağanüstü durumlara hazırlamada yetersiz olduğu ifade edilmiştir. Uzmanlık öğrencilerinin tıp eğitimine yönelik önerileri; salgın, afet gibi beklenmedik durumların yönetimine ilişkin eğitimlerin tıp eğitiminin bütün süreçlerinde yer almasına yönelik olmuştur.
Sonuç: COVID-19 uzmanlık öğrencilerinin yaşamlarını birçok yönüyle etkilemiştir. Salgın deneyimi getirdiği bazı kazanımların yanısıra tıp eğitiminin, üniversitenin, hastane yönetiminin, devletin zayıf kaldığı alanları öne çıkarmıştır. Salgın, mesleki yaşamda değişikliklere, çalışma ortamlarında gerginliklere ve psikososyal zorluklara neden olmuştur. Mezuniyet öncesi tıp eğitimi programlarının sağlık profesyonellerini sağlık sisteminde oluşabilecek krizlere hazırlamada yetersiz olduğuna ilişkin görüşler düşündürücüdür. Salgın, mezuniyet sonrası eğitim faaliyetlerinde aksaklıklara neden olurken öğretim üyelerinin akademik, mesleki ve psikolojik desteğinin uzmanlık öğrencisinin motivasyonunu sağlamada kilit unsur olduğu görülmüştür. İlgili tarafların, uzmanlık öğrencilerinin önerilerini ve gereksinimlerini dikkate alması, eğitim kurumlarının tıp eğitimi programlarını afet/kriz yönetimine ilişkin yeterlikleri kazandırma bağlamında gözden geçirmesi, tarihin en özel dönemine tanıklık eden genç hekimlere ve sağlık hizmet sunumunun öznesi olan topluma karşı sorumluluğudur.

Supporting Institution

. Bu araştırma, kamu, ticari veya kâr amacı gütmeyen sektörlerdeki finansman kuruluşlarından herhangi bir özel destek almamıştır.

Thanks

Araştırmamıza katılan tıpta uzmanlık öğrencililerine teşekkür ederiz.

References

  • Vindrola-Padros C, Andrews L, Dowrick A, Djellouli N, Fillmore H, Gonzalez EB, Johnson G. Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK. BMJ open. 2020;10(11): e040503.
  • Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav. Immun. 2020; 88:901–907.
  • Kıroğlu F. COVID-19 pandemi ortamında çalışma koşulları ve genel sorunlar. MEYAD Akademi. 2020;1(1):79–90.
  • Murphy B. Residency in a pandemic: how COVID-19 is affecting trainees. American Medical Association. 2020 [Internet]
  • Gupta Y. Residents remaining flexible during COVID-19 pandemic. The American Board of Radiology.2020[Internet]
  • Rana T, Hackett C, Quezada T, Chaturvedi A, Bakalov V, Leonardo J, Rana S. Medicine and surgery residents’ perspectives on the impact of COVID-19 on graduate medical education. Medical education online. 2020;25(1): 1818439.
  • Karslıoğlu MZ, Öztürkmen C, Kesim C, Taş AY, Karadeniz PG, Şahin, A. COVID-19 Pandemisinin Ülkemiz Göz Hekimlerinin Klinik Pratiğine Etkisinin Araştırılması. Turk J Ophthalmol.2021; 51:269–281
  • Ives J, Greenfield S, Parry JM, et al. Healthcare workers' attitudes to working during pandemic influenza: a qualitative study. BMC Public Health. 2009; 9:56.
  • Yüce MÖ, Adalı E, Işık G, Şimşek B. Yeni Koronavirüs Pnömonisi Önleme ve Kontrol Döneminde Ağız, Diş ve Çene Cerrahisi Acil Hastalarını Yönetme Deneyimi: Retrospektif Çalışma. Eğe Üniversitesi Diş Hekimliği Dergisi. 2021;42(2):107–113
  • Topçu G, Özçivit İB, Erkılınç S. Effects of the COVID-19 pandemic on obstetrics and gynecology residency training in Turkey. Turkish Journal of Obstetrics and Gynecology.2021;18(4):304-3
  • Johnson WR, Blitzer D. Residents’ perspectives on graduate medical education during the COVID-19 pandemic and beyond. MedEdPublish. 2022; 9:77
  • Liu Q, Luo D, Haase JE, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. Lancet Glob Health. 2020;8: e790–8.
  • Schwartz AM, Wilson JM, Boden SD, Moore Jr, TJ, Bradbury Jr, TL, Fletcher ND. Managing resident workforce and education during the COVID-19 pandemic: evolving strategies and lessons learned. JBJS Open Access.2020;5(2): e0045
  • San Juan NV, Aceituno D, Djellouli N, Sumray K, Regenold N, Syversen A, Vindrola-Padros C. Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice. BJPsych Open.2020; 7(1):1–19. doi: 10.1192/bjo.2020.148
  • Bennett P, Noble S, Johnston S, Jones D,Hunter R. COVID-19 confessions: a qualitative exploration of healthcare workers experiences of working with COVID-19. BMJ open.2020; 10(12): e043949.
  • Ardebili ME, Naserbakht M, Bernstein, C., Alazmani-Noodeh, F, Hakimi H,Ranjbar H. Healthcare providers experience of working during the COVID-19 pandemic: a qualitative study. American journal of infection control.2021;49(5):547–554
  • Yılmaz Y, Erdoğan A, Hocaoglu C. COVID-19 ve Damgalanma. Kocaeli Tıp Dergisi.2021;10(Supp: 1):47-–55.
  • Yakut E, Kuru Ö, Güngör Y. Sağlık Personelinin Covid-19 Korkusu İle Tükenmişliği Arasındaki İlişkide Aşırı İş Yükü Ve Algılanan Sosyal Desteğin Etkisininyapısal Eşitlik Modeliyle Belirlenmesi. Ekev Akademi Dergisi.2020;(83):241–262
  • Yüncü V, Yılan Y. COVID-19 Pandemisinin Sağlık Çalışanlarına Etkilerinin İncelenmesi: Bir Durum Analizi. Igdir University Journal of Social Sciences. 2020; Ek sayı:373–401
  • Schwartz, J, Yen CCKM. Y. Protecting Health Care Workers during the COVID-19 Coronavirus Outbreak–Lessons from Taiwan's SARS response; Clinical Infectious Diseases, Oxford Academic. Clinical Infectious Diseases.2019 [Internet]
  • Wu PE, Styra R, Gold WL. Mitigating the psychological effects of COVID-19 on health care workers. CMAJ.2020;192: E459–60.
  • Word Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report 72. 2020 [Internet]
  • Kapila AK, Farid Y, Kapila V, Schettino M, Vanhoeij M,Hamdi M. The perspective of surgical residents on current and future training in light of the COVID-19 pandemic. Journal of British Surgery.2020;107(9): e305–e305
  • Accreditation Council for Graduate Medical Education.Three stages of GME during the COVID-19 pandemic.2020 [Internet]
  • Sherbino J, Atzema C. “SARS-Ed”: severe acute respiratory syndrome and the impact on medical education. Annals of emergency Medicine.2004; 44(3): 229–231.
  • Bernstein SL, Shayne P. Ebola, Physicians in Training, and the Duty to Treat. Academic Emergency Medicine.2015; 22(1), 88–90.
  • Yıldırım A, Şimşek H. Nitel Araştırma Yöntemleri. (10. bs.). İstanbul: Seçkin Yayınları.2016.
  • Miles MB, Huberman AM. An Expanded Sourcebook: Qualitative Data Analysis (Second edition). Thousand Oaks, CA: SAGE Publications.1994.
  • Tong A, Sainsbury P, Craig, J.Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International journal for quality in health care. 2007;19(6):349–357.
  • Yücesan B, Özkan Ö. Evaluation of the COVID-19 pandemic process in terms of health management. Eurasian Journal of Health Sciences. 2020; COVID-19 Özel Sayı:134–139
  • Pertile D, Gallo G, Barra F, Pasculli A, Batistotti P, Sparavigna M, Mazzarri A. The impact of COVID-19 pandemic on surgical residency programmes in Italy: a nationwide analysis on behalf of the Italian Polyspecialistic Young Surgeons Society (SPIGC). Updates in surgery. 2020; 72(2): 269–280.
  • Kogan M, Klein SE, Hannon CP, Nolte, M. T. Orthopaedic education during the COVID-19 pandemic. The Journal of the American Academy of Orthopaedic Surgeons.2020;28(11):456–464.
  • Tolu LB, Feyissa GT, Ezeh A, Gudu, W.Managing resident workforce and residency training during COVID-19 pandemic: scoping review of adaptive approaches. Advances in Medical Education and Practice. 2020; 11:527–535.

COVID-19 Pandemic Experiences of Residents: A Qualitative Study

Year 2022, , 91 - 108, 31.08.2022
https://doi.org/10.25282/ted.1092139

Abstract

Aim: The COVID-19 pandemic has had an unprecedented impact on the healthcare system and professionals worldwide. This study aims to explore the residents' experiences working in medical and surgical fields in Hacettepe University hospitals during the early months of the COVID-19 pandemic and investigate the effects of the pandemic on their lives and education.
Methods: The research is designed as a Qualitative research. We obtained the data through in-depth interviews with nine residents working at the forefront of the pandemic, maintaining their postgraduate education at Hacettepe University Faculty of Medicine. We used content analysis to analyze the data.
Results: Residents discussed the effects of the COVID-19 epidemic on their professional, psychosocial and educational lives with a broad perspective. They defined the modifications in working conditions, professional and institutional approaches, the professional conflicts caused by the pandemic, the effects of the pandemic on patient treatment/care, and the gains from experience as the effects of the COVID-19 epidemic on their professional lives. Besides family and friends' support, faculty members have an essential role in supporting residents. The residents stressed the importance of society's cooperation in managing the pandemic. They stated that the decision-makers and their institutions did not meet their expectations. They explained the pandemic's main psychosocial effect: the fear of infecting family members, social adaptation, and social stigma. The residents stated that the pandemic caused disruptions and changes in medical education. They indicated that undergraduate medical education was insufficient to prepare health professionals for extraordinary conditions. The residents suggested that the management of exceptional conditions topics such as epidemics, pandemics, and disasters should be included in medical education.
Conclusions: COVID-19 has affected many aspects of residents' lives. Although this experience provided some gains, the pandemic experience revealed the weaknesses of medical education, university, hospital management and government. The pandemic caused changes in professional life, tensions in work environments, and psychosocial difficulties. It is worrying that undergraduate medical education programs are insufficient to prepare health professionals for crises in the health system. The pandemic caused disruptions in residency education. Academic, professional, and psychological support of faculty members has been critical in ensuring the residents' motivation during the pandemic. Stakeholders should consider the suggestions and needs of residents, and medical education programs should be reviewed to achieve competencies related to disaster/crisis management. This effort is the responsibility of all partners to the young physicians who witnessed the most memorable period of history and society, which is the subject of health service delivery.

References

  • Vindrola-Padros C, Andrews L, Dowrick A, Djellouli N, Fillmore H, Gonzalez EB, Johnson G. Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK. BMJ open. 2020;10(11): e040503.
  • Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav. Immun. 2020; 88:901–907.
  • Kıroğlu F. COVID-19 pandemi ortamında çalışma koşulları ve genel sorunlar. MEYAD Akademi. 2020;1(1):79–90.
  • Murphy B. Residency in a pandemic: how COVID-19 is affecting trainees. American Medical Association. 2020 [Internet]
  • Gupta Y. Residents remaining flexible during COVID-19 pandemic. The American Board of Radiology.2020[Internet]
  • Rana T, Hackett C, Quezada T, Chaturvedi A, Bakalov V, Leonardo J, Rana S. Medicine and surgery residents’ perspectives on the impact of COVID-19 on graduate medical education. Medical education online. 2020;25(1): 1818439.
  • Karslıoğlu MZ, Öztürkmen C, Kesim C, Taş AY, Karadeniz PG, Şahin, A. COVID-19 Pandemisinin Ülkemiz Göz Hekimlerinin Klinik Pratiğine Etkisinin Araştırılması. Turk J Ophthalmol.2021; 51:269–281
  • Ives J, Greenfield S, Parry JM, et al. Healthcare workers' attitudes to working during pandemic influenza: a qualitative study. BMC Public Health. 2009; 9:56.
  • Yüce MÖ, Adalı E, Işık G, Şimşek B. Yeni Koronavirüs Pnömonisi Önleme ve Kontrol Döneminde Ağız, Diş ve Çene Cerrahisi Acil Hastalarını Yönetme Deneyimi: Retrospektif Çalışma. Eğe Üniversitesi Diş Hekimliği Dergisi. 2021;42(2):107–113
  • Topçu G, Özçivit İB, Erkılınç S. Effects of the COVID-19 pandemic on obstetrics and gynecology residency training in Turkey. Turkish Journal of Obstetrics and Gynecology.2021;18(4):304-3
  • Johnson WR, Blitzer D. Residents’ perspectives on graduate medical education during the COVID-19 pandemic and beyond. MedEdPublish. 2022; 9:77
  • Liu Q, Luo D, Haase JE, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. Lancet Glob Health. 2020;8: e790–8.
  • Schwartz AM, Wilson JM, Boden SD, Moore Jr, TJ, Bradbury Jr, TL, Fletcher ND. Managing resident workforce and education during the COVID-19 pandemic: evolving strategies and lessons learned. JBJS Open Access.2020;5(2): e0045
  • San Juan NV, Aceituno D, Djellouli N, Sumray K, Regenold N, Syversen A, Vindrola-Padros C. Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice. BJPsych Open.2020; 7(1):1–19. doi: 10.1192/bjo.2020.148
  • Bennett P, Noble S, Johnston S, Jones D,Hunter R. COVID-19 confessions: a qualitative exploration of healthcare workers experiences of working with COVID-19. BMJ open.2020; 10(12): e043949.
  • Ardebili ME, Naserbakht M, Bernstein, C., Alazmani-Noodeh, F, Hakimi H,Ranjbar H. Healthcare providers experience of working during the COVID-19 pandemic: a qualitative study. American journal of infection control.2021;49(5):547–554
  • Yılmaz Y, Erdoğan A, Hocaoglu C. COVID-19 ve Damgalanma. Kocaeli Tıp Dergisi.2021;10(Supp: 1):47-–55.
  • Yakut E, Kuru Ö, Güngör Y. Sağlık Personelinin Covid-19 Korkusu İle Tükenmişliği Arasındaki İlişkide Aşırı İş Yükü Ve Algılanan Sosyal Desteğin Etkisininyapısal Eşitlik Modeliyle Belirlenmesi. Ekev Akademi Dergisi.2020;(83):241–262
  • Yüncü V, Yılan Y. COVID-19 Pandemisinin Sağlık Çalışanlarına Etkilerinin İncelenmesi: Bir Durum Analizi. Igdir University Journal of Social Sciences. 2020; Ek sayı:373–401
  • Schwartz, J, Yen CCKM. Y. Protecting Health Care Workers during the COVID-19 Coronavirus Outbreak–Lessons from Taiwan's SARS response; Clinical Infectious Diseases, Oxford Academic. Clinical Infectious Diseases.2019 [Internet]
  • Wu PE, Styra R, Gold WL. Mitigating the psychological effects of COVID-19 on health care workers. CMAJ.2020;192: E459–60.
  • Word Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report 72. 2020 [Internet]
  • Kapila AK, Farid Y, Kapila V, Schettino M, Vanhoeij M,Hamdi M. The perspective of surgical residents on current and future training in light of the COVID-19 pandemic. Journal of British Surgery.2020;107(9): e305–e305
  • Accreditation Council for Graduate Medical Education.Three stages of GME during the COVID-19 pandemic.2020 [Internet]
  • Sherbino J, Atzema C. “SARS-Ed”: severe acute respiratory syndrome and the impact on medical education. Annals of emergency Medicine.2004; 44(3): 229–231.
  • Bernstein SL, Shayne P. Ebola, Physicians in Training, and the Duty to Treat. Academic Emergency Medicine.2015; 22(1), 88–90.
  • Yıldırım A, Şimşek H. Nitel Araştırma Yöntemleri. (10. bs.). İstanbul: Seçkin Yayınları.2016.
  • Miles MB, Huberman AM. An Expanded Sourcebook: Qualitative Data Analysis (Second edition). Thousand Oaks, CA: SAGE Publications.1994.
  • Tong A, Sainsbury P, Craig, J.Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International journal for quality in health care. 2007;19(6):349–357.
  • Yücesan B, Özkan Ö. Evaluation of the COVID-19 pandemic process in terms of health management. Eurasian Journal of Health Sciences. 2020; COVID-19 Özel Sayı:134–139
  • Pertile D, Gallo G, Barra F, Pasculli A, Batistotti P, Sparavigna M, Mazzarri A. The impact of COVID-19 pandemic on surgical residency programmes in Italy: a nationwide analysis on behalf of the Italian Polyspecialistic Young Surgeons Society (SPIGC). Updates in surgery. 2020; 72(2): 269–280.
  • Kogan M, Klein SE, Hannon CP, Nolte, M. T. Orthopaedic education during the COVID-19 pandemic. The Journal of the American Academy of Orthopaedic Surgeons.2020;28(11):456–464.
  • Tolu LB, Feyissa GT, Ezeh A, Gudu, W.Managing resident workforce and residency training during COVID-19 pandemic: scoping review of adaptive approaches. Advances in Medical Education and Practice. 2020; 11:527–535.
There are 33 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Bürge Atılgan 0000-0002-2800-4957

Nazmiye Celik 0000-0002-2800-4957

Melih Elçin 0000-0002-1652-906X

Sevgi Turan 0000-0001-9287-0641

Publication Date August 31, 2022
Submission Date March 23, 2022
Published in Issue Year 2022

Cite

Vancouver Atılgan B, Celik N, Elçin M, Turan S. COVID-19 Pandemic Experiences of Residents: A Qualitative Study. TED. 2022;21(64):91-108.