236 - Through the Webcam: Impact of Telehealth on Developmental and Behavioral Pediatric Fellowship Training

Poster Number: 236
Publication Number: 236.332

Kimberly Hung, Akron Children's Hospital, akron, OH, United States; Jacqueline M. Branch, Akron Children's Hospital, Akron, OH, United States; Mark D. McManus, The University of Akron, Fairlawn, OH, United States; Miraides Brown, Akron Children's Hospital, Akron, OH, United States; Diane L. Langkamp, Akron Children's Hospital, Akron, OH, United States

Background: During the Covid-19 pandemic (PAN), telehealth (TH) became the cardinal means of didactics and clinical education for Developmental and Behavioral Pediatric (DBP) Fellows.

Objective: This study examines how fellowship program directors (PDs) and their fellows perceive the impact of TH on fellowship education in DBP during the PAN.

Design/Methods: We designed 2 surveys - one for DBP PDs and the other for current DBP fellows. PDs were sent an electronic survey of 34 closed and 5 open-ended questions about TH’s impact on didactics, clinical teaching, and clinical experience. Fellows were sent a similar electronic survey. We analyzed results using descriptive statistics, Fisher-exact test, and qualitative content analysis.

Results: From January to May 2021, 31 of 38 eligible PDs (82% response rate) and 62 of 121 eligible fellows responded (51% response rate). Pre-PAN, 96% of fellowships had in-person lectures 1-2x /week, but only 8% of fellowships had in-person lectures 1-2x /week during the PAN. While 86% of programs never had fellows conduct TH visits prior to the PAN, 84.6% of the programs had fellows conduct TH visits at least once/week during the PAN. Most fellows (80%) learned how to do TH patient encounters through hands-on experience, 62% received TH tips from their preceptors, and only 32% received a course on using TH. PDs and fellows had similar views on TH’s impact on fellow autonomy, teaching of behavioral observations, teaching of physical exam, teaching communication skills, and intensity of fellow observation. PDs and fellows found “real-time” feedback by private “chat” or text message, observing patients in their own homes, and allowing preceptors to observe fellow-run encounters unobtrusively to be advantages of learning through TH. PDs and fellows reported that the lack of physical exam and limited developmental testing were disadvantages of learning through TH. Fellows felt that overall time with their preceptors was diminished when learning through TH, whereas PDs felt that the lack of physical proximity to their fellow reduced the amount of spontaneous/informal teaching that otherwise occurs. In the future, 93% of fellows and 100% of fellowship directors believe that TH should be a formal part of DBP fellowship training even when in-clinic visits resume.Conclusion(s): TH enhances DBP fellow education by providing “real-time” observation of trainees and more immediate feedback, but it must be supplemented by in-person training to ensure adequate teaching of physical exam skills and developmental testing. Specific courses to teach TH skills may improve outcomes in DBP training.