Challenges and Difficulties Related to the Professional Performance and Training of Peruvian Medical Residents during a Pandemic

Round 1

Reviewer 1 Report

This paper aimed to evaluate the influence of academic and personal factors on professional development and growth of first-year medical residents during the pandemic. The methodology design is rigorous and appropriately implemented within the study, results and discussion are well organized and presented, with consistent and explicative tables. As regards the conclusions, they are well written and present an adequate balance between the description of previous findings and the original results by the authors.

 Regarding the topic, this paper has important implications providing new insight on medical education and training in emergency situations. Residency training has probably been the most affected aspect of medical education during the pandemic, and research on this topic is crucial for educators and clinical teachers. So, this paper may represent a considerable contribute to the ongoing educational research since there is little evidence on this topic.

 In my opinion, the manuscript would benefit from an expansion of discussion section, so I have few suggestions just to make the article more appealing and to increase its impact.

 One aspect that should be introduced (lines 375-378) is that the difficulties revealed during the training may impact the fulfilment of professional skills (see Bianchi S., Gatto R., Fabiani L. Effects of the SARS-CoV-2 pandemic on medical education in Italy: Considerations and tips. EuroMediterranean Biomed. J. 2020;15:100–101. doi: 10.3269/1970-5492.2020.15.24).

 Another missing topic (Lines 390-395) is the risk of burnout among trainees (see Alsaywid B, Housawi A, Lytras M, Halabi H, Abuzenada M, Alhaidar SA, Abuznadah W. Residents’ Training in COVID-19 Pandemic Times: An Integrated Survey of Educational Process, Institutional Support, Anxiety and Depression by the Saudi Commission for Health Specialties (SCFHS). Sustainability. 2020; 12(24):10530)

 The introduction of these arguments would offer plenty of food for thought and it may open new scenarios for further research.

 In conclusion, this manuscript is well organized. The authors were lucid in their style of writing, making it easy to read and understand the message portrayed in the manuscript. Moreover, this research has great importance and could be useful for future research.

 Well done to the authors.

Author Response

Dear Reviewer, we send you our manuscript with the corrections we have made, we have incorporated the suggestions of the reviewers:
1. We have expanded the description of participants; We have explained regarding the size of the sample, and the population and the specialties of its origin.
2. We have expanded the description of the characteristics of the medical residency programs and the characteristics of the hospitals where they provide their services and specialized training.
3. We have included the two references suggested by the reviewers to further the discussion.
4. We have included in the discussion what refers to simulation as part of the training of medical residents.
5. We have added three references. We've also improved in-text citation.

Reviewer 2 Report

Dear Authors, I have reviewed the manuscript entitled "Challenges and difficulties related to the professional performance and training of Peruvian medical residents during a pandemic". The study gives a clear and detailed picture how COVID-19 affected the residency training programmes in Peru. However, the sample size is relativetly small (142 residents), the study is well designed, the used methods are adequate and it expands the already existing knowledge in the field. The literature review is overall good, it contains the most relevant information.  The quality of the paper meets the high standards of the journal. The findings has a significant contribution to the field. I recommend it for a minor revision, with the following questions: 

1.) Are there any information about the study population, in terms of specilaization in their residency programme? (.e.g surgery, ER, internal medicine etc.)

2.) Can the authors describe the structure of the residence programme in Peru (generally how many years - threshold only - depending on the specilaization?)? I think this would further add interesting and important information to the manuscript.

3) In the discussion, it would be interesting to write a short paragraph how medical simulation education have been used in the training of residents in Peru, during the pandemic.

Thank you very much, respectfully yours, 

Reviewer

Author Response

Dear Reviewer, we send you our manuscript with the corrections we have made, we have incorporated the suggestions of the reviewers:
1. We have expanded the description of participants; We have explained regarding the size of the sample, and the population and the specialties of its origin.
2. We have expanded the description of the characteristics of the medical residency programs and the characteristics of the hospitals where they provide their services and specialized training.
3. We have included the two references suggested by the reviewers to further the discussion.
4. We have included in the discussion what refers to simulation as part of the training of medical residents.
5. We have added three references. We've also improved in-text citation.