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BACKGROUND: We sought to evaluate changes in In-Training Examination (ITE) scores and associations with clinical work during the COVID-19 pandemic. We hypothesized that residents saw a decrease in clinical encounters during the pandemic and that this would be associated with smaller gains in ITE scores. METHODS: We compared ITE score changes with data on patient notes for three classes of pediatric residents at four residency programs: one not exposed to the pandemic during their intern year who entered residency in 2018, one partially exposed to COVID-19 in March of their intern year (2019-2020), and one that was fully exposed to the pandemic, starting residency in June of 2020. RESULTS: ITE scores on average improved from the PGY1 to PGY2 year in the "no covid" and "partial COVID" cohorts. The "full COVID" cohort had little to no improvement, on average. The total number of patient encounters was not associated with a change in ITE scores from PGY1 to PGY2. There was a small but statistically significant association between change in ITE score and number of inpatient H+P notes. CONCLUSIONS: A drop in ITE scores occurred in pediatric residents who entered residency during the COVID-19 pandemic. This change was largely unrelated to clinical encounter number changes. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to enormous practical and emotional challenges for healthcare workers globally, including NHS staff. Psychological support provisions have been established by an NHS healthcare trust in the North of England, including 1:1 psychological support provided by the in-house psychology team. This study sought to understand how staff experienced the service, what worked well and what could be improved. Five participants who had accessed the staff support service took part in semi-structured interviews. Data were analysed using Interpretative Phenomenological Analysis (IPA). Three main themes emerged from the data: 'The need for a flexible, responsive approach', 'Individual and group benefits' and 'The future of staff support: "we need to invest in staff mentally"'. Accessing the service was seen as personally and professionally rewarding for the NHS staff interviewed. These findings are discussed in relation to the relevant literature. Clinical implications, methodological limitations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

• COVID-19 patients are at increased risk of thromboembolic complications. • Escalated-dose thromboprophylaxis may help reduce the rate of thromboembolic events. • The bleeding risk is highest for patients treated with therapeutic anticoagulation. [ABSTRACT FROM AUTHOR]