Yarahuan Julia Whitlow, Bass Lanessa, Hess Lauren M, Singhal Geeta, Lo Huay-Ying
Section of Pediatric Hospital Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
Section of Pediatric Hospital Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Hosp Pediatr. 2021 Nov 4. doi: 10.1542/hpeds.2021-006077.
We sought to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on the clinical exposure of pediatric interns to common pediatric inpatient diagnoses.
We analyzed electronic medical record data to compare intern clinical exposure during the COVID-19 pandemic from June 2020 through February 2021 with the same academic blocks from 2017 to 2020. We attributed patients to each pediatric intern on the basis of notes written during their pediatric hospital medicine rotation to compare intern exposures with common inpatient diagnoses before and during the pandemic. We compared the median number of notes written per intern per block overall, as well as for each common inpatient diagnosis.
Median counts of notes written per intern per block were significantly reduced in the COVID-19 group compared with the pre-COVID-19 group (96 [interquartile range (IQR): 81-119)] vs 129 [IQR: 110-160]; < .001). Median intern notes per block was lower in the COVID-19 group for all months except February 2021. Although the median number of notes for many common inpatient diagnoses was significantly reduced, they were higher for mental health (4 [IQR: 2-9] vs 2 [IQR: 1-6]; < .001) and suicidality (4.5 [IQR: 2-8] vs 0 [IQR: 0-2]; < .001). Median shifts worked per intern per block was also reduced in the COVID-19 group (22 [IQR: 21-23] vs 23 [IQR: 22-24]; < .001).
Our findings reveal a significant reduction in resident exposure to many common inpatient pediatric diagnoses during the COVID-19 pandemic. Residency programs and pediatric hospitalist educators should consider curricular interventions to ensure adequate clinical exposure for residents affected by the pandemic.
我们试图了解2019年冠状病毒病（COVID-19）大流行对儿科实习生常见儿科住院诊断临床接触的影响。
我们分析电子病历数据，以比较2020年6月至2021年2月COVID-19大流行期间实习生的临床接触情况与2017年至2020年相同学术阶段的情况。我们根据儿科住院医师轮转期间所写的记录将患者分配给每位儿科实习生，以比较大流行之前和期间实习生对常见住院诊断的接触情况。我们比较了每个实习生每个阶段总体所写记录的中位数，以及每种常见住院诊断的记录中位数。
与COVID-19之前的组相比，COVID-19组中每个实习生每个阶段所写记录的中位数显著减少（96[四分位间距（IQR）：81 - 119]对129[IQR：110 - 160]；P <.001）。除2021年2月外，COVID-19组每个月每个实习生每个阶段的记录中位数都较低。尽管许多常见住院诊断的记录中位数显著减少，但心理健康方面的记录中位数较高（4[IQR：2 - 9]对2[IQR：1 - 6]；P <.001），自杀倾向方面也是如此（4.5[IQR：2 - 8]对0[IQR：0 - 2]；P <.001）。COVID-19组中每个实习生每个阶段的轮班中位数也减少了（22[IQR：21 - 23]对23[IQR：22 - 24]；P <.001）。
我们的研究结果显示，在COVID-19大流行期间，住院医师对许多常见儿科住院诊断的接触显著减少。住院医师培训项目和儿科住院医师教育工作者应考虑课程干预措施，以确保受大流行影响的住院医师有足够的临床接触机会。
