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PURPOSE: Medical trainees are likely at differential risk of exposure to COVID-19 per respective clinical activity. We sought to determine the seroprevalence of COVID-19 antibody (Ab) among resident and fellow physicians with varying degrees of exposure to COVID-19. METHODS: A cross-sectional study of Milwaukee-based resident and fellow physicians, encompassing December 2019-June 2020, was conducted. Relevant variables of interest were ascertained by survey and payroll data, and Abbott ARCHITECT Ab test (index cut-off of ≥1.4) was performed. Descriptive statistics were generated, with 95% CI calculated for the study's primary outcome of seroprevalence. RESULTS: Among survey respondents (92 of 148, 62%), 61% were male, 44% were non-White, mean age was 31 years, 94% had no underlying conditions, and 52% were either family or internal medicine residents. During the study period, ≥32% reported cough, headache, or sore throat and 62% traveled outside of Wisconsin. Overall, 83% thought they had a COVID-19 exposure at work and 33% outside of work; 100% expressed any exposure. Of those exposed at work, 56% received COVID-19 pay, variously receiving 69 mean hours (range: 0-452). Ultimately, 82% (75 of 92) had an Ab test completed; 1 individual (1.3%; 95% CI: 0.0-3.9) tested seropositive, was not previously diagnosed, and had received COVID-19 pay. CONCLUSIONS: The low Ab seroprevalence found in resident and fellow physicians was similar to the concurrently reported 3.7% Ab-positive rate among 2456 Milwaukee-based staff in the same integrated health system. Ultimately, COVID-19 seroconversion may be nominal in properly protected resident and fellow physicians despite known potential exposures.
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BACKGROUND: The clinical learning environment (CLE) is a priority focus in medical education. The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review's (CLER) recent addition of teaming and health care systems obligates educators to monitor these areas. Tools to evaluate the CLE would ideally be: (1) appropriate for all health care team members on a specific unit/project; (2) informed by contemporary learning environment frameworks; and (3) feasible/quick to complete. No existing CLE evaluation tool meets these criteria. OBJECTIVE: This report describes the creation and preliminary validity evidence for a Clinical Learning Environment Quick Survey (CLEQS). METHODS: Survey items were identified from the literature and other data sources, sorted into 1 of 4 learning environment domains (personal, social, organizational, material) and reviewed by multiple stakeholders and experts. Leaders from 6 interprofessional graduate medical education quality improvement/patient safety teams distributed this voluntary survey to their clinical team members (November 2019-mid-January 2021) using electronic or paper formats. Validity evidence for this instrument was based on the content, response process, internal structure, reliability, relations to other variables, and consequences. RESULTS: Two hundred one CLEQS responses were obtained, taking 1.5 minutes on average to complete with good reliability (Cronbach's α ≥ 0.83). The Cronbach alpha for each CE domain with the overall item ranged from 0.50 for personal to 0.79 for social. There were strong associations with other measures and clarity about improvement targets. CONCLUSIONS: CLEQS meets the 3 criteria for evaluating CLEs. Reliability data supports its internal consistency, and initial validity evidence is promising.