Introduction Telemedicine has become part of mainstream medical practice. High quality virtual care is a skill that will be required of many physicians. Skills required for effective evaluation and communication during a video encounter differ from skills required at bedside, yet few rubrics for educational content and student performance evaluation in telemedicine training have been developed. Our objective was to develop, implement, and assess a training module designed to teach medical providers techniques to deliver professional, effective, and compassionate care during a telemedicine encounter. Methods We created a simulation-based, 8-hour modular curriculum using the PEARLS debriefing framework with video-based encounters focused on “web-side manner” as a critical corollary to traditional bedside manner. We recorded simulated cases for each student with standardized patients, guided debriefs, and incorporated small-group exercises to teach advanced communication and examination skills. Results Of medical students, 98 in their major clinical year participated in 2019. Of participants, 97% were enthusiastic about the course; 100% felt simulation was an effective mechanism for delivery of the educational material. After participation, 71% believed that telemedicine had the potential to become part of their future practice; 92% perceived an improvement in their comfort and ability to conduct video-based patient encounters. Discussion Teaching telemedicine using this methodology was well received by students, providing early exposure to this evolving aspect of medical practice. Qualitative comments were used for targeted improvements of the content and delivery for curriculum development. Objective assessment tools of students completing telemedicine encounters need to be created.

Study objective: Elder abuse is common and has serious health consequences but is underrecognized by health care providers. An important reason for this is difficulty in distinguishing between elder abuse and unintentional trauma. Our goal was to identify injury patterns associated with physical elder abuse in comparison with those of patients presenting to the emergency department (ED) with unintentional falls.Methods: We partnered with a large, urban district attorney's office and examined medical, police, and legal records from successfully prosecuted cases of physical abuse of victims aged 60 years or older from 2001 to 2014.Results: We prospectively enrolled patients who presented to a large, urban, academic ED after an unintentional fall. We matched 78 cases of elder abuse with visible injuries to 78 unintentional falls. Physical abuse victims were significantly more likely than unintentional fallers to have bruising (78% versus 54%) and injuries on the maxillofacial, dental, and neck area (67% versus 28%). Abuse victims were less likely to have fractures (8% versus 22%) or lower extremity injuries (9% versus 41%). Abuse victims were more likely to have maxillofacial, dental, or neck injuries combined with no upper and lower extremity injuries (50% versus 8%). Examining precise injury locations yielded additional differences, with physical elder abuse victims more likely to have injuries to the left cheek or zygoma (22% versus 3%) or on the neck (15% versus 0%) or ear (6% versus 0%). Conclusion:Specific, clinically identifiable differences may exist between unintentional injuries and those from physical elder abuse. This includes specific injury patterns that infrequently occur unintentionally. [