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. 2021 Jul;11(7):e106-e110.
doi: 10.1542/hpeds.2021-005899. Epub 2021 Apr 16.

Pediatric Intern Clinical Exposure During the COVID-19 Pandemic

Alexandra T Geanacopoulos  1 , Kathryn M Sundheim  2 , Kimberly F Greco  3 , Kenneth A Michelson  2   4 , Chase R Parsons  5 , Jonathan D Hron  5 , Ariel S Winn  5
Affiliations

Pediatric Intern Clinical Exposure During the COVID-19 Pandemic

Alexandra T Geanacopoulos et al. Hosp Pediatr. 2021 Jul.

Abstract

Background and objectives: Pediatric health care encounters declined during the coronavirus disease 2019 (COVID-19) pandemic, and pediatric residency programs have adapted trainee schedules to meet the needs of this changing clinical environment. We sought to evaluate the impact of the pandemic on pediatric interns' clinical exposure.

Methods: In this retrospective cohort study, we quantified patient exposure among pediatric interns from a single large pediatric residency program at a freestanding children's hospital. Patient encounters and shifts per pediatric intern in the inpatient and emergency department settings were evaluated during the COVID-19 pandemic, from March to June 2020, as compared with these 3 months in 2019. Patient encounters by diagnosis were also evaluated.

Results: The median number of patient encounters per intern per 2-week block declined on the pediatric hospital medicine service (37.5 vs 27.0; P < .001) and intensive care step-down unit (29.0 vs 18.8; P = .004) during the pandemic. No significant difference in emergency department encounters was observed (63.0 vs 40.5; P = .06). The median number of shifts worked per intern per 2-week block also decreased on the pediatric hospital medicine service (10.5 vs 9.5, P < .001). Across all settings, there were more encounters for screening for infectious disease and fewer encounters for respiratory illnesses.

Conclusions: Pediatric interns at the onset of the COVID-19 pandemic were exposed to fewer patients and had reduced clinical schedules. Careful consideration is needed to track and supplement missed clinical experiences during the pandemic.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have no conflicts of interest relevant to this article to disclose.

Figures

Figure 1:
Figure 1:
Box and whisker plot of (A) patient encounters per intern per two-week block, (B) patient encounters per intern per shift, and (C) shifts worked per intern per two-week block in the emergency department (ED), pediatric hospital medicine (PHM), and intensive care unit (ICU) step-down settings before vs. during the COVID-19 pandemic.
Figure 2:
Figure 2:
Encounters associated with common CCSR codes before vs. during the COVID-19 pandemic for the (A) emergency department (ED), (B) pediatric hospital medicine (PHM), and (C) intensive care unit (ICU) step-down settings. Values reported as mean encounters by CCSR code per intern per two-week block. Common CCSR codes were identified by the top 10 CCSR codes by setting for both the pre-pandemic and pandemic cohorts. *Indicates statistically significant difference between the pre-pandemic and pandemic cohorts (p < 0.05).
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