Effect of 24/7 attending coverage in the Neonatal Intensive Care Unit on fellow education.

Abstract

Background There is a current change in type of attending coverage in the Neonatal Intensive Care Unit (NICU) from home calls to 24/7 in House. Effects of this increased attending physician presence on education of NICU fellows has not been studied. The objective of this study is to evaluate the fellows’ perception of in house attending coverage on their education and evaluate its effect on their perceived autonomy.Methods A secure, anonymous, web-based survey was designed using using RedCap. The web-based survey was sent via the section of Neonatal Perinatal Medicine of the American Academy of Pediatrics, to all members of Training & Early Career Neonatologists. Chi-square tests were used to compare groups on dichotomous outcomes, with Fisher Exact tests used when the expected cell frequencies were small.Results One hundred and twenty-three surveys were analyzed, that included responses from 82 fellows & 41 early career neonatologists. 52% reported having 24/7 attending in-house (IH) coverage. 30 of the 123 respondents experienced a change in model of attending coverage during their training. Among these 30, only 26.6% preferred the model of attending IH coverage. The respondents currently working in IH models, when compared to those in non-IH coverage models felt IH attending coverage was beneficial for fellow education (p <0.05) but was less likely to give fellows autonomy for decision making (p=0.02). Conclusion In our survey respondents with in house attending, had a more favorable view of its benefit on fellow education. Institutions practicing or considering IH attending coverage should consider use of adequate measures to balance fellow supervision and education.

Hedgehog-responsive PDGFRa(+) fibroblasts maintain a unique pool of alveolar epithelial progenitor cells during alveologenesis

“…BPD, which is characterized by alveolar hypoplasia, is a highly complex, variable, and poorly understood neonatal lung disease ( Sahni and Mowes, 2020 ). Two major etiologic factors are lung immaturity and injury.…”