Investigating the impact of the COVID-19 pandemic on postgraduate surgical technical skills training: a systematic review

Background Surgical training was significantly affected during the COVID-19 pandemic due to several factors, including the postponement of professional exams, fewer hands-on surgical training opportunities and redeployment. This systematic review aimed to explore the impact of the COVID-19 pandemic on post-graduate technical skills training in surgical specialities. Methods The systematic review was conducted following the guidelines set out by PRISMA with the inclusion of studies on surgical training from any of the 12 specialities. The studies were screened in duplicate. A thematic analysis was conducted on the extracted data. Results Fifty-three studies reported a significant impact on technical skills training due to the pandemic with statistically significant reduction in operating compared to before the pandemic. Only a few studies discussed the use of simulation, to which about 50% of the trainees had access, but was underutilised during the prolonged downtimes where trainees could not operate but could have practised in simulation. There was a lack of evidence regarding recovery planning, with only one study that discussed the use of the independent sector as a potential avenue to provide trainees with opportunities for technical skills training. Worries regarding progression, exam cancellations and loss of technical skills were reported by most of the studies in this review. Conclusion There is an opportunity for a paradigm shift in surgical training with technical skills simulation as an essential adjunct to learning in the operating theatre after the pandemic. These findings underscore the need for adaptable, equitable recovery measures to address training deficits.