Non-clinical educational activities
A majority (62.3%) of participants reported an increase in didactic educational activities and 65.7% reported that their program had instituted a required educational curriculum (Table 2). Interestingly, a significantly higher proportion of participants in high COVID-19 regions reported an increase in didactic activities (p=0.011) and a required curriculum (p=0.035). Most participants (86.9%) felt their department utilized technology to good effect for educational activities, and again this was higher among participants from high COVID-19 regions (95.4% vs. 78.2%, p=0.011). Educational activities included participation in collaborative multi-institutional educational efforts (61.7%) as well as institution based education (62.3%). Tools utilized during social distancing included Zoom & WebEx for lectures including collaborative consortiums, resident lectures and journal clubs. Additional electronic resources used included OtoSim, AAO courses, COCLIA, Headmirror podcasts and online textbook reading.
With regard to conducting research, about one third of participants (29.1%) reported a reduction in research activities, a third reported no change, and a third reported an increase in research activity (34.9%). A greater proportion of participants reported a reduction in research activities if their research prior to the pandemic involved recruitment of clinical subjects (71.4%) or laboratory-based research (71.4%).
Most respondents felt that their education during the pandemic was either extremely or very important (57%) or somewhat important (30.3%), while 13% felt that their education was not so important during the pandemic. This did not differ by training level (p=0.10), but participants in high COVID-19 areas trended towards a stronger feeling that their education was either extremely or very important (65.9% high COVIDvs. 47.1% low COVID, p=0.072).
Despite acknowledging the importance of education, the majority (89.7%) of respondents felt that their education and training had been negatively impacted by the pandemic. In particular, two-thirds of participants were concerned about receiving adequate surgical training. Smaller proportions of participants expressed concern about receiving adequate training in clinical decision making (42.9%) and educational knowledge (34.3%). Concerns regarding adequate training did not significantly differ by trainee level, however, there was a trend towards fewer senior level trainees expressing concerns for adequate training (Table 2). Notably, 29.1% (n=51) of participants expressed concern in their ability to complete key indicator cases needed to graduate, and these concerns were acknowledged similarly by both junior (27.2%) and senior residents (39.2%, p=0.116, fellows excluded).
Participants in high COVID-19 regions reported less concern about receiving adequate educational knowledge (23.8% vs. 44.8%, p=0.025) and a trend towards less concern in receiving adequate training in clinical decision making (32.9% vs. 52.9%, p=0.062) compared to participants in low COVID-19 regions. These differences were not seen when examining concerns regarding adequate surgical training.
Concerns regarding adequate educational knowledge were decreased (29.6% vs. 65.2%) among participants who felt their program was able to utilize technology well (p=0.003), though not significantly correlated with whether a program had a required educational curriculum (p=0.250), or participation in collaborative education effort (p=0.403). Use of technology was not associated with concerns regarding adequate training in clinical decision-making (p=0.199) or surgical training (p=0.690).