Evaluating the Effectiveness of a Small Bowel Anastomosis Workshop during the COVID-19 Pandemic


Department of General Surgery, East Kent Hospitals University Foundation Trust, Kent, UK.



Background: Surgical education has traditionally been implemented through both theoretical and practical training. The practical teaching, in particular, has been significantly impacted during the coronavirus disease 2019 (COVID-19) pandemic due to limited theatre time and a paucity of simulated or cadaveric courses. This study aims to evaluate the self-reported confidence and also knowledge of trainees attending a bowel anastomosis workshop.
Materials and Methods: Fifteen trainees attended a bowel anastomosis workshop at a district general hospital in September 2020. To adhere to social distancing and infection control measures, the trainees were split into three groups. Each workshop was divided into three sections: (1) end-to-end hand-sewn bowel anastomosis; (2) stapled anastomosis; and (3) stoma formation. Feedback was gathered from each attendee before and after each session using a questionnaire designed by the author that assessed self-reported confidence on a 5-point Likert scale.
Results: A total of 86% of attendees were core surgical trainees (CT). There was a measured improvement in the confidence of trainees for all three of the techniques; bowel anastomosis (1.9 vs 4.2, p = 0.0052), stapled anastomosis (2.2 vs. 3.8, p = 0.0082), and stoma formation (2.2 vs. 4.3, p=0.0036). A paired-samples t-test was used to compare the overall ‘confidence’ with each technique which combined the individual ratings for the theoretical and practical aspects.
Conclusion: Medical education has undoubtedly been affected by the pandemic. It is necessary that deaneries and hospitals support doctors to ensure the continuation of remote and face-to-face education by organizing sessions planned quarterly despite the pandemic with strict safety measures and improve the confidence of the trainees.