We have increased throughout the fellowship the use of video Telehealth, especially for autism evaluations

-Developmental behavioral fellow at Madigan Army Medical Center

AGP fellow @ UC Davis medical center, my clinical role is as an attending in the newborn nursery, no change in my role yet however I am on “backup” for potential COVID surge

I'm in DBP at UW. We are voluntarily participating in redeployment but will be kept within pediatrics. Clinical experiences are decreased as our attendings become more familiar with telehealth platforms. However, my co-fellows and I are taking on more academic work and also voluntarily working more with residents and their COVID curriculum, which as been meaningful.

for Peds Critical Care: we’ve seen a drop in census and thus change in clinical experience for now

Uni of Washington*

I'm a PHM fellow. I was on an elective that I created myself where I worked with nurses, respiratory therapists, enteral access teams, wound care, etc. I had to halt the rotation half way through due to COVID and just do research from home. I am going on service next week but no trainees are allowed to see patients requiring PPE. So it will definitely be a new experience! Definitely less clinical experience but I'm hopeful to make the most of the teaching opportunities I will have with the residents.

I'm from Children's Mercy Kansas City.

I am a third year fellow at University of Florida. I am doing tele health visits (video and phone) by myself as a lead with staff supervision. Billing is being done by my attendings.

Allergy and Immunology Fellow, A.I./duPont & Jefferson in Philadelphia - We are performing all of the telehealth encounters as fellows regardless of year for both adult and pediatrics. Initial drop in census as we converted from in-person, but quickly picked up and now back to full panels. We are also on backup for inpatient/ICU/ED backup at both pediatric and adult hospitals.

I would add volume wise, ironically in PEM we are also seeing very decreased volume. In a ridiculous piece of timing, I’m scheduled for my adult EM month now so still busy… (1st yr PEM @ Hasbro)

Im a Pediatric radiology fellow at Nemours AIDHC, DE. My program has arranged a home work station to do radiology reporting from home.

Third year Neonatal fellow at University of Louisville. We have seen an increase in our census due to early deliveries of mothers in respiratory failure and are already running short on PPE, which has been very stressful as we have many older attendings who do not feel safe and trainees feel pressured to put themselves in a high-risk scenario.

Hi, PEM fellow year 2 here in Detroit, formerly with Wayne State now Central Michigan program, we are also seeing a decrease in volume in the Peds ED side. however, i will say acuity levels have definitely been higher. seeing more bone fractures non-accidental traumas, and facial traumas

2nd year fellow in child abuse/emergency med (4 yr fellowship). ED volumes are down significantly, and fellows are expected to manage the department with attendings present. no restrictions on which patients or procedures we cannot do. For child abuse, almost no outpatient appointments or consults, attendings are doing some foster care appointments.

Zoom / BlueJeans / Webex. no break out groups yet.

we are doing all zoom, although topics are slightly changed. I’m teaching myself about breakout groups, polls and whiteboard for a formerly quite interactive session I now have to give over zoom

We are hosting our regularly scheduled lectures virtually, 2-3x weekly. Our fellowship section is hosting national lectures 3x a week, which has been awesome to have access to other institutions and national experts.

using gotomeeting for conferences and lectures weekly. However, missing out on hands-on procedure workshops

we are continuing weekly didactics online via webex

child abuse has used zoom for years even before COVID for weekly meetings and journal clubs for fellows across the country--I love this since there are not many fellows

I use nearpod.com to teach residents and medical students. For audio, we join via Microsoft Teams or Zoom. Learners login to the nearpod presentation with a login code and can see it on their personal devices. They can interact with it as well. Nearpod allows for multiple things to be embedded: polls, multiple choice or open answer questions, microsft sways, videos, etc.

We have also had “digital chalk talk” style presentations through bluejeans using a basic word document! It was really nice and interactive

We are using Microsoft Teams, which has also been a great platform to share lectures/grand rounds

Nationwide Children's has been using an online flipped classroom called MedEd On the Go - videos followed by case based questions. then we get on Zoom and talk through the cases. the last two weeks we had multiple other programs join in

and the benefit is comparing and contrasting differences in how we manage diseases

(I'm a first year NICU fellow)

@joy solano, nearpod sounds interesting, does your hospital pay for it?

I don't have audio on the device I'm using!

Go to nearpod.com and check it out!

My third grader is using NearPod and there's definitely a free version

I am a HUGE nearpod advocate, so please reach out to me personally if you'd like me to walk you through it. joy.chaput@gmail.com

It was developed for elementary school but I have found great use for it in higher education. :)

I have used it for attending level presentations as well. I gave a presentation on the development of goals and objectives for learning activities to all the program directors at my institution recently and it was well received.

re: wellness - for those of us still working clinically, and also trying to move projects forwards, and have kids now trapped at home climbing all over you - the *such fun* new challenges of finding “balance” (while surrounded by ongoing covid anxiety)

Don’t really have an answer here, haha sorry

trying to keep a regular schedule for work and relaxation helps partition the day and keeps me focused. having short daily goals also helps

I echo the work-life balance: trying to get ready to move/graduate, young kids/homeschooling, feeling anxiety about work. We have a daily schedule that alternates academic time, creative time, physical activity and snacks - it keeps us in a routine. I'm trying to enjoy this time with my kids that I didn't have before.

Actively limiting how much news/medical literature I read about COVID19 has been a good choice for my mental health...

second that

for PEM--we were told our vacation would likely not roll over due to the nature of the shiftwork based schedule, BUT we were told that if we needed time for something, the program would work with us and try to make that happen.

I am moving to a new city. House hunting virtually is definitely interesting, but doable. Our real estate agent has been a huge asset (like Debra said). I do know some fellows that have a contract have had their start dates pushed back, sometimes indefinitely.

my job search has definitely been impacted — had virtual interviews last week but this week i was notified that further interviews were postponed till further notice… hard to think about the possibility of not having a job after fellowship after all this training :(

I have had a lot of virtual interviews as well. It is hard imagining a place this way.

i missed the very beginning of this call so not sure if this has been discussed already but are any fellows experiencing “Telehealth” / other remote fellow participation for inpatient consults in an effort to conserve PPE/limit exposures/promote social distancing?

Not sure who is speaking now but please email me your question about DBP and I'll help - laura@degnon.org

Peds pulmonary in Seattle - our preceptors join on the web call and families have been generally very happy with these visits

I'm 3erd year peds endorcrinology fellow. I have been doing telephone visits by myself. Patients have not complained as I know of. It appears they were satisfy at the end of the call.

I’m at Stanford Children’s Health and we are using telehealth a lot more — for fellow visits, we use Zoom rather than the Epic-based videoconferencing platform since Zoom allows multiple people on the call, and that way the attending can come in and also see the patient

Our next session is on Telehealth, both in the inpatient and outpatient setting, with Fellowship Directors and Residency Directors.

I always tell them I will discuss with attending at the end of the call and get back to them if anything different is concluded and they are ok.

Any suggestions on who we could reach out to if we feel like we are not getting the support we need from our program leadership and GME? It sounds like there is quite a spectrum of support for mental health, work hours, graduation, etc.

Epic does allow for multidisciplinary visits at our institution. I’m not sure if there are different features?

People fellows can go to:

Associate Chairs of Education

Program Director (for residency, as an ombuds)

Clerkship Director (as an ombuds)

GME leadership

Other ombuds

Other faculty

This was outstanding! Yes, please do another! Would be great to reach even more fellows!

If any fellows are operating “remotely” for consults and want to share your experience - I would love to hear! kilbergm@email.chop.edu

Thank you for setting this up. Much appreciated.

Loved this, would definitely participate again!

Thank you!

Thank you