Layne Silver, MD,
MD
Cohen Children's Medical Center
New Hyde Park, NY
Disclosure information not submitted.
Aaron Kessel, MD
Assistant Professor
Cohen Children's Medical Center, United States
Disclosure information not submitted.
Cheryl Taurassi, MD, MS-HPPL
Asst. Professor of Pediatrics
Cohen Children's Medical Center of New York
New Hyde Park, NY
Disclosure information not submitted.
Matthew Taylor, MD
Pediatric Critical Care Attending Physician
Cohen Children's Medical Center
New Hyde Park, New York, United States
Disclosure information not submitted.
Title: The Effect of the COVID-19 Pandemic on Pediatric Critical Care Fellowship Training
Introduction: The COVID-19 pandemic has had a significant impact on medical education. Due to social distancing guidelines, many educational activities were canceled or moved to virtual classrooms. Additionally, in order to limit COVID-19 exposures and preserve personal protective equipment, in-hospital patient interactions were minimized and elective procedures were postponed. The objective of this study was to assess the impact of the COVID-19 pandemic on pediatric critical care medicine (PCCM) fellowship training.
Methods: A national cross-sectional internet-based survey of ACGME-accredited PCCM fellowship programs was performed. Responses were anonymous and collected in February 2021. Descriptive statistics and Fisher exact tests were used for analysis.
Results: A total of 34 PDs and 92 fellows responded to the survey (rate of 47% and 17% respectively). The majority (69%) of respondents agreed that medical education had been negatively impacted by the pandemic. When PDs were surveyed, 91% noted a decrease in patient census since March 2020, with 59% citing a >15% decrease. Further, 65% reported trainees had less procedural experience. All respondents reported that education was provided through virtual learning platforms, with nearly half having exclusive remote learning without in-person sessions. Fifty percent of PDs and 62% of fellows reported decreased learner engagement during virtual didactics. The majority of PDs reported decreases in simulation, procedural skills training, and ultrasound training. Few PDs and fellows (13-16%) reported redeployment to adult units, with northeastern programs having the highest rates. In univariate analyses, decreased PD confidence in trainee procedural skills was associated with reported decreases in number of procedures (p=0.0006) and procedural skills didactics (p=0.0245). Change in unit census was associated with less confidence in fellows’ medical knowledge (p=0.0004), management skills (p=0.0232), and procedural skills (p=0.0003), with larger decreases in patient census correlating with larger decreases in confidence.
Conclusions: The COVID-19 pandemic has significantly impacted the education and clinical training of PCCM fellows. More knowledge on this topic can assist PDs in curriculum changes for the future to address any gaps in learning that have occurred.