Facilitating physician reentry to practice: perceived effects of deployments on US army pediatricians' clinical and procedural skills.

INTRODUCTION

US Army pediatricians regularly deploy for 6 to 12 months or longer and many are deployed multiple times during their career. Prolonged breaks in pediatric clinical practice may result in skill degradation, requiring a physician reentry process to prepare pediatricians to return to clinical practice. This study sought to identify which specific pediatric clinical skills were felt to be most affected by deployment.

METHODS

Army pediatricians on active duty between January 2012 and March 2012 were surveyed via e-mail to determine their comfort level and experience with clinical encounters and procedural skills prior to and after military deployment.

RESULTS

Eighty-three pediatricians were eligible, and 75 responded (90% response rate). Of those received, 65 surveys (78%) were complete and included in the statistical analysis. Over half (54%) of the respondents were deployed longer than 6 months, and 32% were deployed for 12 months or longer. The largest changes in reported comfort were seen in neonatal, pediatric, and adolescent acute care and neonatal routine care, including neonatal and pediatric procedures. There was a significant negative correlation (r = .64; p = .003) between provider's reported exposure to neonatal and pediatric clinical encounters during deployment and provider's comfort with those clinical encounters after deployment.

DISCUSSION

US Army pediatricians are required to deploy for extended periods of time and have limited opportunities to practice the full range of their pediatric skills. This break in clinical practice is associated with a significant decline in perceived comfort with both routine and acute pediatric care.