Measurement tools

An online-based questionnaire was designed using the collaborative web survey software Google Forms to investigate the impact of COVID-19 pandemic on Italian medical residents’ competencies, working load, training, occupational exposure, and quality of life. The authors EA and LNS (last-year residents experienced in research studies) and LMV (senior statistician with experience in the conduction of survey studies) developed the survey after literature review about medical education, residency training, occupational exposure, and mental health among HCWs, and with feedback from Chiefs and Program Directors of their hospitals to assess the content and face validity of the questionnaire. A combination of binary (yes-no), multiple choice, 5-point Likert-type scale and ranking questions were employed. The complete questionnaire can be found in Supplementary Material (Appendix 1). Briefly, the survey was composed by 95 questions, divided into seven sections:

The main outcome measures were variation in self-perceived clinical, surgical and research competencies and in specialistic training. These outcomes were assessed with a 5-point Likert-type scale assessing the level of self-perceived competence before and after the onset of the pandemic (21 February 2020). Secondary outcome measures included changes in working load and in satisfaction regarding clinical, surgical, research and didactic activities and variation in quality of life items before and after the onset of the pandemic; reported adoption of virtual education strategies; perception of increased risk of COVID-19 infection and availability of personal protective equipment (PPE) among residents compared to other HCWs.

The purpose and objectives of the study and the composition of the study group were described to all participants in the online survey homepage. The survey was pilot-tested with a convenience sample of 10 residents to ensure clarity and ease of administration.