The Early Effects of the Coronavirus Disease-19 Pandemic on Pediatric Resident Education: A National Assessment

Monique M Naifeh; Michelle D Stevenson; Erika L Abramson; Christopher E Aston; Ryan M Combs; Hallie R Decker; Su-Ting T Li

doi:10.1016/j.acap.2022.11.003

The Early Effects of the Coronavirus Disease-19 Pandemic on Pediatric Resident Education: A National Assessment

Acad Pediatr. 2023 Jul;23(5):993-1000. doi: 10.1016/j.acap.2022.11.003. Epub 2022 Nov 11.

Authors

Monique M Naifeh¹, Michelle D Stevenson², Erika L Abramson³, Christopher E Aston⁴, Ryan M Combs⁵, Hallie R Decker⁵, Su-Ting T Li⁶

Affiliations

¹ Department of Pediatrics (MM Naifeh and CE Aston), University of Oklahoma Health Sciences Center, Oklahoma City, OK. Electronic address: Monique-naifeh@ouhsc.edu.
² Department of Pediatrics (MD Stevenson), Norton Children's Hospital and University of Louisville, Louisville, KY.
³ Department of Pediatrics and Department of Population Health Sciences (EL Abramson), Weill Cornell Medicine, New York, NY.
⁴ Department of Pediatrics (MM Naifeh and CE Aston), University of Oklahoma Health Sciences Center, Oklahoma City, OK.
⁵ Department of Health Promotion and Behavioral Sciences, School of Public Health & Information Sciences (RM Combs and HR Decker), University of Louisville, Louisville, KY.
⁶ Department of Pediatrics (S-TT Li), University of California Davis, Sacramento, CA.

Abstract

Purpose: Residency programs must ensure resident competence for independent practice. The coronavirus disease-19 (COVID-19) pandemic disrupted health care delivery, impacting pediatric residencies. This study examines the impact on pediatric resident education.

Methods: The authors conducted a mixed methods national survey of pediatric residency program directors (PDs) from May 2020 to July 2020. Data analysis included descriptive statistics, chi-square, and Wilcoxon rank sum tests. Multivariable modeling identified factors associated with resident preparation for more senior roles. Thematic analysis was performed on open-ended questions about PD COVID-19 pandemic recommendations to peers, Accreditation Council for Graduate Medical Education and American Board of Pediatrics.

Results: Response rate was 55% (110/199). PDs reported the COVID-19 pandemic negatively affected inpatient (n = 86, 78.2%), and outpatient education (n = 104, 94.5%), procedural competence (n = 64; 58.2%), and resident preparation for more senior roles (n = 50, 45.5%). In bivariate analyses, increasingly negative impacts on inpatient and outpatient education were associated with an increasingly negative impact on resident preparation for more senior roles (P = .03, P = .008), these relationships held true in multivariable analysis. Qualitative analysis identified 4 themes from PD recommendations: 1) Clear communication from governing bodies and other leaders; 2) Flexibility within programs and from governing bodies; 3) Clinical exposure is key for competency development; 4) Online platforms are important for education, communication, and support.

Conclusions: The COVID-19 pandemic negatively impacted inpatient and outpatient education. When these were more negatively impacted, resident preparation for more senior roles was worse, highlighting the importance of competency based medical education to tailor experiences ensuring each resident is competent for independent practice.

Keywords: Coronavirus disease-19; competency-based medical education; residency education.

MeSH terms

COVID-19*
Child
Competency-Based Education
Education, Medical, Graduate / methods
Humans
Internship and Residency*
Pandemics
Surveys and Questionnaires
United States