574 - Safety before education: Coronavirus disease 2019 and pediatric residency program educational experiences

Poster Number: 574
Publication Number: 574.116

Juliann Reardon, Tufts Childrens Hospital, Boston, MA, United States; Rachel Johnson, Yale New Haven Hospital, New Haven, CT, United States; Amanda Quijano, Yale-New Haven Children's Hospital, Durham, CT, United States; Melissa L. Langhan, Yale University School of Medicine, New Haven, CT, United States

Background: The coronavirus disease 2019 (COVID-19) pandemic changed pediatric residency programs and impacted learning opportunities. Despite the pandemic’s longevity, little is known about its impact on pediatric graduate medical education training.

Objective: We aimed to describe pediatric program directors’ (PDs) experiences adapting residency programs during the COVID-19 pandemic.

Design/Methods: Semi-structured interviews were conducted with United States pediatric residency PDs or associate PDs. Purposive sampling ensured diversity in program locations and sizes. Transcripts were independently reviewed and analyzed for emergent codes, with a finalized codebook independently applied to interviews by the authors to ensure consistency. Common themes among interviews were identified using inductive analysis.

Results: Seventeen interviews were conducted. Themes mirrored Maslow’s hierarchy of needs: physiological (survival), safety, love/belonging, esteem (self-worth), self-actualization (realizing one’s potential). PDs were predominantly concerned about safety needs of their residents--maintaining a work and learning environment that limited COVID-19 exposure. They spoke of rapidly evolving guidelines and the need for transparency in communication. PDs discussed the effect safety protocols had on physiologic needs—resident ability to eat and take mask breaks—as well as the impact of isolation on distance learning and resident morale. They described methods adopted to encourage belonging and support mental health when residents were apart. To maintain resident esteem, PDs discussed the importance of maintaining an educational program that would produce competent pediatricians, despite the changes to in-person experiences. Changes made included adopting telehealth and supplementing rotations with lectures, case discussions, simulation, or review materials. Finally, PDs noted that the pandemic increased opportunities for residents to pursue self-directed learning, as well as research and quality improvement initiatives, leading to self-actualization. However, the pandemic also led to decreased opportunities for leadership and teaching development.Conclusion(s): PDs detailed changes implemented to ensure the safety and health of their trainees. They worried these changes created isolation and a sub-par learning experience that affected resident belonging and esteem. Despite PD concern about the learning experience, they described ways in which residents were able to fulfill their potential. Further evaluation is needed to understand the impact of the changes on resident experiences and preparedness for practice.
Safety and belonging needsThemes for the safety and belonging categories with representative quotes.
Esteem needsThemes for the esteem category with representative quotes.