Health worker education during the COVID-19 pandemic: global disruption, responses and lessons for the future—a systematic review and meta-analysis

Human Resources for Health

Review

Michail Sideris¹  Aikaterini Dedeilia²  Andreas N. Papadopoulos³  Christos Konstantinidis⁴  Melina Nikolakea⁵  Nina-Rafailia Karela⁵  Dimitra Mitsopoulou⁵  Anastasia Androutsou⁵  Michail Papapanou⁶  Manthia Papageorgakopoulou⁷  Marinos G. Sotiropoulos⁸  Siobhan Fitzpatrick⁹  Jim Campbell⁹  Giorgio Cometto⁹  Elizabeth O. Johnson^1,10 

[1] Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom;Department of Surgery, Massachusetts General Hospital, Boston, MA, USA;Harvard Medical School, Boston, MA, USA;HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece;HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece;Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece;HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece;School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece;HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece;School of Medicine, National and Kapodistrian University of Athens, Athens, Greece;HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece;School of Medicine, National and Kapodistrian University of Athens, Athens, Greece;Society of Junior Doctors (SJD), Athens, Greece;HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece;School of Medicine, University of Patras, Patras, Greece;Harvard Medical School, Boston, MA, USA;HEALth Workforce Education (HEAL-Edu) Study Group, Athens, Greece;Department of Neurology, Brigham and Women’s Hospital & Massachusetts General Hospital, 55 Fruit Street, WACC721, 02114, Boston, MA, USA;Health Workforce Department, World Health Organization, Geneva, Switzerland;School of Medicine, European University Cyprus, Nicosia, Cyprus;

关键词: Health worker;    Healthcare worker;    Education;    Training;    COVID-19;    Pandemic;    Online learning;    Assessment;    Disruption;    Mental health;    Volunteering;   

DOI  :  10.1186/s12960-023-00799-4

 received in 2022-03-22, accepted in 2023-02-01,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThis systematic review and meta-analysis identified early evidence quantifying the disruption to the education of health workers by the COVID-19 pandemic, ensuing policy responses and their outcomes.MethodsFollowing a pre-registered protocol and PRISMA/AMSTAR-2 guidelines, we systematically screened MEDLINE, EMBASE, Web of Science, CENTRAL, clinicaltrials.gov and Google Scholar from January 2020 to July 2022. We pooled proportion estimates via random-effects meta-analyses and explored subgroup differences by gender, occupational group, training stage, WHO regions/continents, and study end-year. We assessed risk of bias (Newcastle–Ottawa scale for observational studies, RοB2 for randomized controlled trials [RCT]) and rated evidence certainty using GRADE.ResultsOf the 171 489 publications screened, 2 249 were eligible, incorporating 2 212 observational studies and 37 RCTs, representing feedback from 1 109 818 learners and 22 204 faculty. The sample mostly consisted of undergraduates, medical doctors, and studies from institutions in Asia. Perceived training disruption was estimated at 71.1% (95% confidence interval 67.9–74.2) and learner redeployment at 29.2% (25.3–33.2). About one in three learners screened positive for anxiety (32.3%, 28.5–36.2), depression (32.0%, 27.9–36.2), burnout (38.8%, 33.4–44.3) or insomnia (30.9%, 20.8–41.9). Policy responses included shifting to online learning, innovations in assessment, COVID-19-specific courses, volunteerism, and measures for learner safety. For outcomes of policy responses, most of the literature related to perceptions and preferences. More than two-thirds of learners (75.9%, 74.2–77.7) were satisfied with online learning (postgraduates more than undergraduates), while faculty satisfaction rate was slightly lower (71.8%, 66.7–76.7). Learners preferred an in-person component: blended learning 56.0% (51.2–60.7), face-to-face 48.8% (45.4–52.1), and online-only 32.0% (29.3–34.8). They supported continuation of the virtual format as part of a blended system (68.1%, 64.6–71.5). Subgroup differences provided valuable insights despite not resolving the considerable heterogeneity. All outcomes were assessed as very-low-certainty evidence.ConclusionThe COVID-19 pandemic has severely disrupted health worker education, inflicting a substantial mental health burden on learners. Its impacts on career choices, volunteerism, pedagogical approaches and mental health of learners have implications for educational design, measures to protect and support learners, faculty and health workers, and workforce planning. Online learning may achieve learner satisfaction as part of a short-term solution or integrated into a blended model in the post-pandemic future.

【 授权许可】

CC BY   
© The Author(s) 2023

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