title: Facilitating physician reentry to practice: perceived effects of deployments on US army pediatricians' clinical and procedural skills.
abstract: BACKGROUND
  US Army pediatricians regularly deploy for 6 to 12 months or longer and many are deployed multiple times during their career. Prolonged breaks in pediatric clinical practice may result in skill degradation, requiring a physician reentry process to prepare pediatricians to return to clinical practice. This study sought to identify which specific pediatric clinical skills were felt to be most affected by deployment.
  
  
  METHODS
  Army pediatricians on active duty between January 2012 and March 2012 were surveyed via e-mail to determine their comfort level and experience with clinical encounters and procedural skills prior to and after military deployment.
  
  
  RESULTS
  Eighty-three pediatricians were eligible, and 75 responded (90% response rate). Of those received, 65 surveys (78%) were complete and included in the statistical analysis. Over half (54%) of the respondents were deployed longer than 6 months, and 32% were deployed for 12 months or longer. The largest changes in reported comfort were seen in neonatal, pediatric, and adolescent acute care and neonatal routine care, including neonatal and pediatric procedures. There was a significant negative correlation (r = .64; p = .003) between provider's reported exposure to neonatal and pediatric clinical encounters during deployment and provider's comfort with those clinical encounters after deployment.
  
  
  CONCLUSIONS
  US Army pediatricians are required to deploy for extended periods of time and have limited opportunities to practice the full range of their pediatric skills. This break in clinical practice is associated with a significant decline in perceived comfort with both routine and acute pediatric care.
authors.forename: LoRanée
authors.initials: L
authors.lastname: Braun
authors.forename: Taylor
authors.initials: T
authors.lastname: Sawyer
authors.forename: Laurie
authors.initials: L
authors.lastname: Kavanagh
authors.forename: Shad
authors.initials: S
authors.lastname: Deering
mesh_terms: D000293:Adolescent; D055826:Afghan Campaign 2001-; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004502:Education, Medical, Continuing / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D034742:Electronic Mail; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D054542:Iraq War, 2003-2011; D008889:Military Personnel / Q000193:education* / Q000523:psychology / Q000706:statistics & numerical data; D020380:Needs Assessment; D010372:Pediatrics / Q000193:education* / Q000379:methods / Q000706:statistics & numerical data; D020377:Self Efficacy; D013997:Time Factors
keywords: career transitions; clinical skills; deployment; medical/clinical speciality; pediatrics; physician reentry; procedural skills; refresher training