How Do Pediatric Urology Fellows Learn Outside of Direct Patient Care: A Qualitative Study
Campbell Grant, MD1, Alexandra Szabova, MD1, Lynne Smith, EdD2.
1Cincinnati Children's Hospital, Cincinnati, OH, USA, 2University of Cincinnati, Cincinnati, OH, USA.
BACKGROUND: Pediatric Urology fellows spend a large portion of their training time on skill development in the operating room, in combination with learning about disease processes by taking care of patients on their service. While all fellows begin their fellowship training with some baseline knowledge of pediatric urology from residency, they rely on didactics and self-directed learning to expand their knowledge base and explore concepts in-depth. A qualitative study was conducted to evaluate how pediatric urology fellows learn about their field outside of direct patient care experiences. Additionally, we were interested in how learning outside of direct patient care has changed since the beginning of the pandemic.
METHODS: First- and second-year pediatric urology fellows at ACGME-accredited programs were asked to participate in the study. I conducted and transcribed individual virtual interviews. Each transcript was coded shortly after transcription. Constructivist grounded theory was used in the data collection and analysis. As interviews progressed, a constant comparative analysis was used iteratively to generate themes.
RESULTS: A convenience sample of thirteen fellows from programs across the U.S. agreed to participate; eight were male and five were female. Twelve second year fellows and one first year fellow responded. The median time spent each week on didactics was 2.75 hours (Range: 1.5-5.25 hours). Five themes emerged from the interviews: Fellows engage in self-directed learning, fellows have little independent study time, fellows are not the target audience, and there is a lack of organization when it comes to didactics. The majority of teaching post-COVID is done via teleconference.
CONCLUSIONS: Fellows in pediatric urology programs are independent learners who understand the need for self-directed learning outside of the setting of formal didactics in fellowship. However, many lack appropriate time and guidance or mentorship when it comes to facilitating this self-directed learning. 
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