557 - Impact of COVID-19 Pandemic on Pediatric Medical Student Education

Poster Number: 557
Publication Number: 557.115

Alyssa S. Fujiwara, University of Hawaii, John A. Burns School of Medicine, Aiea, HI, United States; Jennifer R. Di Rocco, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, United States; Chieko Kimata, Hawaii Pacific Health, HONOLULU, HI, United States; Marissa H. Fakaosita, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, United States; Gina French, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, United States; Kyra Len, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, United States

Background:
The COVID-19 pandemic has had many effects on medical student education, ranging from curtailed clerkships and safety measures limiting patient exposure to changes in patient diagnoses for medical students in their clerkship experience. Quantitative information about the changes in patients seen by students may help identify gaps that will need to be filled by changes in the pediatric curriculum.

Objective:
To identify the effect of the COVID-19 pandemic on the inpatient experiences of 3rd and 4th year medical students by assessing patient volumes and diagnoses of patients seen by students.

Design/Methods: Site: Kapi’olani Medical Center for Women and ChildrenIRB exemption and HIPAA waiver were obtained. All admission histories and physicals, progress notes, and discharge summaries written by medical students on hospital-based pediatric rotations were tallied from the electronic health record for two time periods: Pre-Pandemic (June 2018 - February 2020) and Pandemic (March 2020 - September 2021), with identification of patient age and primary diagnosis. Chi-square test/Fisher’s exact test was used for comparing categorical variables, and the Mann-Whitney test was used for comparing non-normal continuous variables between these two time periods.

Results:
Notes from 251 medical students and 4566 patients were included. Students saw 83 patients/month during the Pandemic period versus 112 patients/month during the Pre-Pandemic period (p=0.016). The proportion of bronchiolitis and pneumonia diagnoses were significantly reduced in the Pandemic period (p < 0.0001). Bronchiolitis was diagnosed for 23 of 1835 (1.25%) patients during the Pandemic period compared with 149 of 2731 (5.46%) patients Pre-Pandemic.  Pneumonia made up 0.93% (17/1835 patients) of diagnoses in the Pandemic period compared with 4.1% (112/2731 patients) Pre-Pandemic. There was no significant difference in the number of medical students or the patient age between the two groups (p=1.00 and p=0.085 respectively).
Conclusion(s): During the first 18 months of the ongoing COVID-19 pandemic, medical students in our institution had a remarkably different inpatient experience from that of their predecessors. They saw fewer patients, and those patients had fewer common pediatric respiratory diseases.  These marked decreases suggest that these students may require supplemental education to compensate for these gaps in direct pediatric clinical experience.