EP.TU.53Mark of Cain: lessons from a field hospital Boot Camp under COVID’s Cloak

COVID-19 restrictions have cursed and canceled most academic training events. Because of fears related to social distancing, centres normally housing >100 delegates now accommodate only 12. Aim To assess the feasibility of a multidisciplinary Core Surgical Trainee (CST) Boot camp training event at a UK field hospital. Method All CST1s within a single UK Statutory Education Body were invited to participate in a three-day Boot camp at the Dragon’s Heart Hospital, Millennium Stadium, Cardiff, consisting of simulated, Operative and Non-Operative Technical Skills for Surgeons (NOTSS). Primary outcome measures were; satisfaction and perceived competence using Likert scale (1-5). Results Attendees numbered 44 (median age 29 yr. 21 female, 23 male). Median satisfaction scores by domain were: Overall course satisfaction 4 (range 2-5), simulation skills 5 (3-5), lecture-based learning 4 (2-5), academic skills 4 (2-5), and NOTSS 5 (1-5). Levels of perceived confidence in performing simulated index procedures improved markedly (before median 2 (1-5) vs. after 4 (2-5), (p < 0.001). Free text comments reflected and praised the quality of staff commitment, enthusiasm, and in particular interactive workshops related to NOTSS. In contrast, resource limitations inherent to the marquee character of the venue (ambient temperature, IT limitations) received criticism. Conclusion COVID’s curse can be broken by creativity, enthusiasm, and engagement of translational multidisciplinary team leadership.

EP.WE.83Surgeon’s Acute Stress Disorder During Covid-19: A Case Study with E-Mail Therapy

Aims A higher surgical trainee combatted patients’ deaths and disasters from COVID-19. The trainee treated daily COVID-19-positive patients. In May 2020, he recognized symptoms of COVID-19. Throat swab test confirmed the suspicion of contagion. We aimed to study the acute stress disorder (ASD) during the COVID-19 pandemic in the surgical trainee. Methods The case self-isolated for 2 weeks with an intensifying fear of health deterioration. The case’s isolation and feelings of being in poor health, opened for an e-mail therapy. Sixty open-ended questions were answered in Socratic-maieutic style. The finding of severe (ASD) was validated and confirmed by use of the National Stressful Events Survey Acute Stress Disorder Short Scale. The mail therapy continued until the case felt that the crisis had faded. After 10 weeks a follow up was completed A, B and C times for 7 issues: death anxiety, worries about family after own death, chest pressure, other physical symptoms, stress, depression, other psychological symptoms Results Our hypothesis was termed “acute stress reactions”. Our case’s ASD was categorized as “severe”. Friedman test was applied for the related groups A, B and C, indicating an overall symptom improvement (p < .001) which by Page’s L trend test disclosed a significant trend in symptom cutback from A to C (p < .001). Conclusion The surgeons’ awareness is required that in some cases, the psychological symptoms escalate during isolation and quarantine periods and may even override the physical awkwardness, urging us to address both types of discomfort simultaneously and intensely.

TP8.2.15 Higher General Surgical Trainee preferences for Annual Review of Competency Progression during COVID-19 Pandemic

Aims The COVID-19 pandemic has caused significant disruption in surgical training. We aim to explore the preferences of higher general surgical trainees for Annual Review of Competency Progression (ARCP) also compare the responses across different training grades. Methods All higher general surgical trainee in a single deanery were invited to participate in an online voluntary anonymous survey. The respondents were divided in two groups: junior (ST3-ST5) and senior higher surgical trainees (ST6-ST8) and responses compared. Results Sixty-four of 88 trainees responded. Thirty-three (51.6%) were ST3–ST5, 24 (37.5%) were ST6–ST8 and 7 (10.9%) were out-of-training. More trainees in ST3–ST5 group preferred to defer the next rotation for 12 months (18.2% vs 0%, p = 0.034), repeat current sub-specialty (33.3% vs 4.2%, p = 0.009), or add 12 months to training and delay predicted CCT date by 12 months (18.2% vs 0%, p = 0.034). Most trainees in both groups preferred the option of prolonging training should be offered to all trainees with an option to decline extension if ARCP competencies met (66.7% vs 50.0%, p = 0.276). Conclusions The preference for ARCP and length of training was different between two training groups, hence the need of trainees should be considered by training committees when addressing the impact of COVID-19.

SP4.1.16 V is for vicious: a COVID burnout vector perspective

Aims No employment sector has been more heavily pressed by COVID-19 than healthcare. This study aimed to characterise surgical trainee burnout related to the pandemic, following a previous observational cohort study reporting 59% burnout. Methods A 36-point survey, including the 22-point Maslach Burnout Inventory evaluated emotional exhaustion, depersonalisation, and personal accomplishment amongst all surgical trainees within a UK Statutory Education Body, with responses received from 121 (75 Core (CST), 46 Higher Surgical Trainees (HST)). Results High burnout levels were evident across one, two, or all three domains in 60.3% (n = 73), 32.2% (n = 39) and 13.2% (n = 16), respectively. Median emotional exhaustion, depersonalisation and personal accomplishment scores were 19 (range 0-48), 7 (0-25) and 36 (6-48), respectively. Median emotional exhaustion score was related to age (25-29yr 25 vs. >40yr 4; p = 0.016), trainee grade (CST 23 vs. HST 13; p = 0.001) and parenthood (parents 13 vs. not parents 21; p = 0.011), as was depersonalisation: 9 (25-29yr) vs. 1 (>40yr; p = 0.001), 8 (CST) vs. 6 (HST; p = 0.006) and 5 (parents) vs. 8 (not parents; p < 0.001), respectively. COVID-19 induced curriculum working pattern disruption was observed in 82.6% (n = 100), with 31.4% (n = 38) redeployed away from surgery. Barriers to training and career development were the commonest stressors (71.9%) and more prevalent among younger trainees (25-29yr. 76.8% vs. >40yr. 28.6%; p = 0.045) and CST (80.0% vs. HST 58.7%; p = 0.011). Clinical workload concerns were associated with emotional exhaustion (OR 3.12; p = 0.008). Conclusions Burnout endures, though unique adverse clinical work environments may have boosted resilience. Countermeasures including Enhanced Stress Resilience Training remain a priority.