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Impact of COVID-19 on training: a single-centre survey of trainees
  1. Thomas Whitby1,
  2. Gavin Cleary2,
  3. Clare P Halfhide3
  1. 1General Paediatrics, Alder Hey Children's Hospital, Liverpool, UK
  2. 2Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  3. 3Respiratory Unit, Alder Hey Children's Hospital, Liverpool, UK
  1. Correspondence to Dr Thomas Whitby; thomas.whitby{at}


To review the impact of COVID-19 on postgraduate paediatric training, a 10-question online survey was designed to evaluate trainees’ training opportunities. 56 trainees working at a single centre, Alder Hey Children’s Hospital, completed the survey. The majority of trainees felt that COVID-19 had affected their training. Trainees wanted to become involved in Quality Improvement Programs. Face-to-face teaching was still favourable but web-based teaching methods were preferred. Novel online, Worked Based Assessment clinics were well received. COVID-19 has affected traditional learning opportunities but offered a new positive range of digital solutions to give and store educational material.

  • health services research
  • qualitative research
  • statistics

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Alder Hey Children’s Foundation Trust (AHH) is a standalone, tertiary, regional paediatric hospital. Prior to COVID-19, the education programme comprised of mandatory training, regional educational programme run out of AHH and self-directed learning supported by educational and clinical supervisors. During COVID-19, from 23 March, Alder Hey implemented new ways of clinical working, moving to weekend working 7 days a week and loss of typical placements of trainees within departments. Due to government recommendations of social distancing, regular face-to-face teaching and traditional teaching/training opportunities disappeared overnight.

An online survey using ‘monkey survey’ (table 1) was designed to ascertain how the trainees felt about their training and to identify what training opportunities they wanted. The survey was sent out 4 weeks into the start of changes to normal working pattern. The style of question was determined to be binary yes or no, or rank.

Table 1

Ten questions used on the survey monkey

Patient involvement

This research was done without patient or public involvement. Patients were not invited to comment on the study design, interpret the results or contribute to the writing of this document.

At AHH, after implementation of the new COVID-19 way of working (COVID-19 rota), there were: 8 Foundation/GP trainees, 15 ST1–3 and 33 ST4–8 paediatric trainees. The overall response rate was 53/56 (94.6%), comprising 6/8 (75%) Foundation/GP trainees, 15/15 (100%) ST1–3 and 32/33 (96.9%) ST4+.

The majority of trainees thought the COVID rota had affected their education and training opportunities. Most of the trainees wanted to become involved in Quality Improvement Program (QIP) (table 2). For paediatric trainees: guidelines (19/38), audits (15/38), standard operating procedure (3/38) and parent and family feedback (1/38) were listed as the preferred QIP for them to be involved with. For Foundation/GP trainees, guidelines (4/6) and audit (2/6) were ranked highest. Overall, 45/47 paediatric trainees wanted a Work Based Assessment (WBA) clinic (12 daily, 12 weekly, 20 two times per week, 1 monthly) and 5/6 Foundation/GP trainees wanted a WBA clinic (4 weekly, 1 monthly). Formal teaching programmes were still desired by trainees (table 2). The frequency most highly ranked was weekly for paediatric trainees and two times per week for Foundation/GP trainees (19/46 weekly for paediatric trainees and 4/6 two times per week for Foundation/GP trainees). All trainees still liked having face-to-face teaching (13/47 paediatric and 5/6 Foundation/GP trainees) but the paediatric trainees also indicated that their preferred method was live streamed and recorded material 21/47. Other options were live streamed with no recording 9/47 and only recorded 4/47. For all trainees, the best time for training was 13:30 (12/53) or 14:00 (16/53). The optimal length of a teaching session for all trainees was 30 min (19/53) or 45 min (23/53).

Table 2

Results of binary questions

The majority of trainees felt that the introduction of a new way of working due to COVID-19 had affected their training. There were no significant difference between the paediatric trainees and the Foundation doctors results. Trainees wanted to become involved in Quality Improvement Programs, particularly guidelines and audits. Formal and novel online teaching (WBA clinics) formats were well received. Face-to-face teaching was still favourable but using web-based teaching methods was the most preferred. With the introduction of social distancing, new digital solutions to learn and teach have become available, which appear to be well received by the trainees. Although service provision is vital during a pandemic, the educational needs of trainees’ should still be considered and are important to our future medical workforce. By seeking out the trainees’ views about their education, we hope that this will allow the development of the best-informed programme and engagement of the trainees in their adult learning.


  • Contributors TW and CPH contributed to the planning, conduct and reporting of the work described in the article. GC contributed to the editing of the manuscript. TW is responsible for the overall content as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.