Hanson Amy E, P'Pool April, Starr Michelle C, Byrne Bobbi J
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA.
Department of Pediatrics, Division of Pediatric Nephrology, Indiana University School of Medicine, Indianapolis, USA.
Cureus. 2021 Oct 3;13(10):e18453. doi: 10.7759/cureus.18453. eCollection 2021 Oct.
Background Medical student education has been impacted by the ongoing coronavirus 2019 (COVID-19) pandemic. Medical students were removed from clinical settings, and the censuses in pediatric hospitals decreased. While there have been studies starting to evaluate these effects on medical students training in surgical subspecialties, the literature in pediatrics is limited. Objective This study analyzed third-year medical students' National Board of Medical Examiners (NBME) Clinical Science Pediatrics Shelf Exam scores at the conclusion of their core pediatric clerkship. We compared the exam scores before COVID-19 pandemic to those during the pandemic. We hypothesized that the ongoing COVID-19 pandemic would have a negative impact on NBME shelf exam scores and that shelf exam failure rates would increase. Methods Institutional Review Board approval was obtained prior to initiation of this study. We conducted a retrospective review of medical student pediatric shelf exam scores from June 2017 to December 2020 from one large, single institution. We adjusted scores for block schedule timing and standardized them based on national norms published for the year prior. We compared two groups: those who completed their pediatric clerkship experiences before pandemic (predominantly in-person learning) vs. those who completed it during the pandemic (predominantly virtual learning). Groups were compared using chi-square and analysis-of-variance testing. Results We included 991 medical students, 772 before COVID-19 and 219 during COVID-19. Of these, 19 of 772 (2.5%) students failed the exam prior to COVID-19 compared to 19 of 219 (8.7%) during COVID-19 ( < 0.001). Students who completed their pediatric clerkship during COVID-19 were 3.77 times more likely to fail their end-of-clerkship NBME shelf exam ( < 0.001). Conclusions Students who completed their core pediatric clerkship in a predominantly virtual platform during the COVID-19 pandemic were significantly more likely to fail their end-of-clerkship NBME shelf exam. Increased failure rates may suggest issues with acquisition and retainment of pediatric medical knowledge throughout the clerkship, creating knowledge gaps in the foundation of their pediatric experience. Long-term effects of virtual learning platforms will need to be studied further.
背景 医学生教育受到持续的2019冠状病毒病（COVID-19）大流行的影响。医学生被撤离临床环境，儿科医院的普查人数减少。虽然已经有研究开始评估这些对医学生外科亚专业培训的影响，但儿科方面的文献有限。目的 本研究分析了三年级医学生在核心儿科实习结束时的美国医学考试委员会（NBME）临床科学儿科架上考试成绩。我们将COVID-19大流行前的考试成绩与大流行期间的成绩进行了比较。我们假设持续的COVID-19大流行会对NBME架上考试成绩产生负面影响，并且架上考试不及格率会增加。方法 在本研究开始前获得了机构审查委员会的批准。我们对来自一个大型单一机构的2017年6月至2020年12月医学生的儿科架上考试成绩进行了回顾性审查。我们根据课程表时间调整成绩，并根据前一年公布的全国标准进行标准化。我们比较了两组：在大流行前完成儿科实习的学生（主要是面对面学习）与在大流行期间完成实习的学生（主要是虚拟学习）。使用卡方检验和方差分析对两组进行比较。结果 我们纳入了991名医学生，772名在COVID-19之前，219名在COVID-19期间。其中，772名学生中有19名（2.5%）在COVID-19之前考试不及格，而在COVID-19期间219名学生中有19名（8.7%）不及格（<0.001）。在COVID-19期间完成儿科实习的学生在实习结束时的NBME架上考试不及格的可能性高出3.77倍（<0.001）。结论 在COVID-19大流行期间主要在虚拟平台上完成核心儿科实习的学生在实习结束时的NBME架上考试不及格的可能性显著更高。不及格率的增加可能表明在整个实习期间获取和保留儿科医学知识存在问题，在他们儿科经验的基础上造成了知识差距。虚拟学习平台的长期影响需要进一步研究。
