A student‐led telephone‐based clinical learning program for outreach to older adults

Abstract

Background: Early clinical experiences expose students to patient-centered care. However, early incorporation of telehealth communication skills remains limited in health professions education. In this study, we aimed to design and evaluate a telephone-based clinical learning program for students to promote the development of patient-centered communication skills while addressing healthcare disparities experienced by older adults during the COVID-19 pandemic.Methods: We utilized workplace learning principles in designing a telephone-based clinical learning pilot program for health professions students at an academic geriatrics primary care clinic. Students conducted three types of telephone calls to patients that 1) assessed for unmet needs (e.g. food, medication, medical supplies, caregiving, social support, and/or access to medical care) (screening call), 2) addressed social isolation (social call), and 3) helped patients set up videoconferencing software to prepare for telehealth appointments (telehealth-training call). We tracked telephone call completion and outcomes via weekly student reports and the electronic health record. To evaluate program e cacy and learning outcomes, students completed an anonymous post-program survey that assessed pre-and postprogram knowledge and skills acquisition. Data was analyzed using descriptive statistics and Wilcoxon rank-sum tests. Results: Five medical student liaisons led 23 medical and nurse practitioner students in calling 335 patients over 13 weeks. Students successfully reached 247 patients (74%), assisted 25 patients in setting up videoconferencing software, and engaged 30 patients in weekly social calls. Of 21 students who completed the post-program survey, 18 (86%) believed this program provided meaningful clinical exposure. After participation, all students felt comfortable interacting with patients by telephone and 20 (95%) felt con dent in relationship-centered communication. Students reported increased knowledge about vulnerabilities in the geriatric population (p = 0.002). Conclusion: This telephone-based program allowed health professions students to support a vulnerable population and gain patient-centered communication skills. This program could be adapted for implementation in multiple contexts as an effective telehealth clinical learning experience, especially for pre-clerkship health professions students who could gain early exposure to telehealth and practice communication and health coaching skills with patients.

Training Service Users in the Use of Telehealth: Scoping Review

“…The database searches yielded 13,997 records. After removing duplicates and applying the eligibility criteria, 13 articles were included in the review [23][24][25][26][27][28][29][30][31][32][33][34][35](See Figure 1…”

“…All studies aimed to train service users on how to use telehealth, primarily to prepare them for upcoming video visits. Additional training-related aims were to reduce cognitive load demands of telehealth [23], develop health professions students' communication skills [25], and improve broader digital literacy of service users [31]. The content of the training activities primarily focused on helping patients set up for a video call.…”

“…Hawley et al [27] described categorizing patients into four phenotypes based on their interest and capability to complete a home telehealth visit, and subsequently creating training to overcome patient-perceived barriers. Pichan et al [32] described that medical students developed the training programme, and Gulati et al [25] reported that the geriatrics faculty lead provided guidance on the design of the programme.…”

Telehealth and virtual learning

“…Lastly, to improve both patient care and clinical education of learners, Gulati et al 4 designed a student‐led telephone‐based outreach to older adult patients. The programme enabled learners to engage in a structured programme to simultaneously acquire health communication and coaching skills while addressing social and technological barriers to patient care.…”

“…As noted by Shepherd et al, 1 there were certainly challenges in adapting to a new way of learning. However, by integrating simulation modules 2,3 and modifying clinical practice to assimilate learners in a structured outreach programme, 4 learners were able to develop communication skills vital to clinical practice. Overall, these curricular innovations further broadened the repertoire of clinical teachers by allowing for greater flexibility and creativity to meet the needs of their learners.…”