Addressing the Rapidly Increasing Need for Telemedicine Education for Future Physicians

Abstract

Introduction: As the COVID-19 pandemic affected the ability to conduct in-person sessions to teach clinical skills, our medical school developed a curriculum to introduce first-year medical students to telemedicine visits, while also reinforcing their history-taking and clinical reasoning skills. Methods: All first-year medical students at Florida Atlantic University went through three sessions on telemedicine that began with a lecture, followed by a standardized patient interaction, then a small group meeting with clinical faculty. We assessed the sessions using survey questions on a 5-point Likert scale and additional narrative feedback. We also assessed students on a telemedicine objective structured clinical examination (OSCE) at the end of the semester and compared results to the previous year’s same case done in person. Results: Students overall found the sessions helpful for refining their history-taking skills and that the knowledge gained would be helpful in their future practices. They felt the online platform was a useful way to interact with patients, but had frustrations with technical difficulties. They also expressed a greater appreciation for the ability to perform an in-person physical examination. Students performed similarly on the OSCE station in person compared to virtual visits (mean score 93% vs 93.75%). Conclusion: Introducing telemedicine during a first-year medical school clinical skills course provides students with opportunities to refine their clinical skills while introducing a skill that will be commonplace in the postpandemic environment. This curriculum could be adopted not only during a time of necessary distance learning, but also continued as in-person education resumes.

Interns’ perspectives on impacts of the COVID-19 pandemic on the medical school to residency transition

“…Interestingly, a study by Patel et al, found that in addition to a desire to contribute, a motivating factor for UK medical students to volunteer clinically early on in the pandemic, was to develop skills and gain experience thereby likely leading to better preparedness [ 23 ]. Fortunately, medical schools are innovating rapidly and creatively to meet the needs of their students and better prepare them for their internship, including integrating students back into sub-internships, integrating students into telehealth activities [ 24 ], offering virtual preparatory experiences [ 25 ], and developing virtual objective structured clinical examinations [ 26 ]. However, residency programs may also need to provide additional training and support for new residents whose medical school experiences may result in them either being less prepared or perceiving themselves to be less prepared for internship, especially as they enter a residency landscape that is significantly different in the face of the pandemic.…”

A systematic review of online education initiatives to develop students remote caring skills and practices

“…The most noted impact on students was an increase in confidence in using digital technology [ 23 , 32 , 38 , 40 ]. Students reported increased comfort and confidence when working with telehealth technology and planning and providing telehealth to patients [ 25 , 26 , 33 , 41 , 42 ; 19 , 30 , 43 , 44 ]. Student teachers also demonstrated increased comfort creating online learning environments [ 17 , 18 , 37 , 45 ].…”

“…Researchers reported that several elements of virtual communications differed from in-person engagement including lighting, body positioning and movements, and the use of silence to communicate empathy and concern [ 41 ]. Students gained an appreciation for the differences between in-person and remote care and teaching [ 25 , 34 ] and recognized the need to increase connectivity and communication despite the distance factor [ 46 ]. Students also learned strategies for interacting in online environments in a respectful manner and practicing with integrity as a key concept [ 47 ; 19 ], with several studies noting improvements in students’ communication skills [ 21 , 29 , 32 , 48 ].…”

“…Students generally valued opportunities to apply and practice clinical skills with real-world technology outside of a high-stakes testing environment [ 25 , 49 ] and benefited from direct observation of skills and immediate faculty and peer feedback [ 33 , 41 ]. That said, researchers did note that some students found it challenging to learn remote skills in an online or simulated environment [ 31 , 36 , 44 , 49 ].…”

Role-Play Simulation of Telemedicine for Undergraduate Health Students

“…We need to move forward and use technological resources to our advantage, looking for innovative ways to improve patient care, starting with the way we teach undergraduate health students. Some studies have focused on the importance of students training on telemedicine (10,11,12) which plays an important role in healthcare delivery and management of patients in the Covid-19 pandemia since it allows communication with any available technological device, avoiding physical contact, and limiting exposure as reducing the risk of virus infection (9,11).…”