PDF(Pubmed)
Abstract：
The COVID-19 pandemic has had many effects on medical student education, ranging from safety measures limiting patient exposure to changes in patient diagnoses encountered by medical students in their clerkship experience. This study aimed to identify the impact of the pandemic on the inpatient experiences of third- and fourth-year medical students by assessing patient volumes and diagnoses seen by students. Frequency and types of notes written by medical students on hospital-based pediatric rotations at Kapi\'olani Medical Center for Women and Children as well as patient diagnoses and ages were compared between 2 time periods: pre-pandemic (July 2018-February 2020) and pandemic (May 2020-September 2021). On average, the number of patients seen by medical students was significantly reduced in the pandemic period from 112 patients/month to 88 patients/month (P=.041). The proportion of patients with bronchiolitis or pneumonia were also significantly reduced in the pandemic period (P<.001). Bronchiolitis was diagnosed in 1.3% of patients seen by medical students during the pandemic period, compared with 5.9% of patients pre-pandemic. Pneumonia was diagnosed in 1.0% of patients seen by medical students in the pandemic period compared with 4.6% pre-pandemic. There was no significant difference in patient age between the 2 groups (P=.092). During the first 18 months of the COVID-19 pandemic, medical students in this 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 decreases suggest these students may require supplemental education to compensate for these gaps in direct pediatric clinical experience.
摘要：
COVID-19大流行对医学生的教育产生了许多影响，从限制患者暴露的安全措施到医学生在实习经历中遇到的患者诊断变化。这项研究旨在通过评估患者数量和学生的诊断来确定大流行对三年级和四年级医学生的住院经历的影响。在大流行前（2018年7月至2020年2月）和大流行（2020年5月至2021年9月）两个时间段之间，比较了医学生在Kapi'olani妇女和儿童医学中心以医院为基础的儿科轮换以及患者诊断和年龄撰写的记录的频率和类型。平均而言,在大流行期间,医学生就诊的患者数量从112例/月显著减少至88例/月(P=0.041).在大流行期间，毛细支气管炎或肺炎患者的比例也显著降低（P<.001）。在大流行期间，医学生看到的1.3%的患者被诊断出毛细支气管炎，与大流行前的5.9％的患者相比。在大流行期间，医学生看到的患者中有1.0％被诊断出肺炎，而在大流行前这一比例为4.6％。两组患者年龄差异无统计学意义（P=0.092）。在COVID-19大流行的前18个月，该机构的医学生的住院经历与他们的前辈截然不同。他们看到更少的病人，这些患者的常见儿科呼吸系统疾病较少。这些减少表明这些学生可能需要补充教育来弥补直接儿科临床经验中的这些差距。
