Bridging Learning in Medicine and Citizenship During the COVID-19 Pandemic: A Telehealth-Based Case Study

Abstract

Background COVID-19 presented great challenges for not only those in the field of health care but also those undergoing medical training. The burden on health care services worldwide has limited the educational opportunities available for medical students due to social distancing requirements. Objective In this paper, we describe a strategy that combines telehealth and medical training to mitigate the adverse effects of the COVID-19 pandemic. Methods A toll-free telescreening service, Telecoronavirus, began operations in March 2020. This service was operated remotely by supervised medical students and was offered across all 417 municipalities (14.8 million inhabitants) in the Brazilian state of Bahia. Students recorded clinical and sociodemographic data by using a web-based application that was simultaneously accessed by medical volunteers for supervision purposes, as well as by state health authorities who conducted epidemiological surveillance and health management efforts. In parallel, students received up-to-date scientific information about COVID-19 via short educational videos prepared by professors. A continuously updated triage algorithm was conceived to provide consistent service. Results The program operated for approximately 4 months, engaging 1396 medical students and 133 physicians. In total, 111,965 individuals residing in 343 municipalities used this service. Almost 70,000 individuals were advised to stay at home, and they received guidance to avoid disease transmission, potentially contributing to localized reductions in the spread of COVID-19. Additionally, the program promoted citizenship education for medical students, who were engaged in a real-life opportunity to fight the pandemic within their own communities. The objectives of the education, organization, and assistance domains of the Telecoronavirus program were successfully achieved according to the results of a web-based post-project survey that assessed physicians’ and students’ perceptions. Conclusions In a prolonged pandemic scenario, a combination of remote tools and medical supervision via telehealth services may constitute a useful strategy for maintaining social distancing measures while preserving some practical aspects of medical education. A low-cost tool such as the Telecoronavirus program could be especially valuable in resource-limited health care scenarios, in addition to offering support for epidemiological surveillance actions.

Telehealth utilization during the Covid-19 pandemic: A systematic review

“…Considering the continuous spread of the novel coronavirus infection in many countries, different governments have applied social distancing and lockdown rules to control disease spread. However, these rules have affected the in-person health care service for many non-infected patients who wish to receive proper medical care [ 37 , 46 , 53 ]. Given the disruption of medical care delivery, many surgical procedures were postponed [ 37 , 42 ], and many in-clinic patient care services struggled to maintain contact with their patients [ 87 ].…”

“…As mentioned in the literature, improving the safety of individuals, patients or health care professionals was the main motivation in most of the studies; the use of telehealth reduces face-to-face interactions [ 22 , 37 , 46 , 65 , 68 ]. Different studies were motivated to show the minimisation of health care settings during the pandemic [ 69 ].…”

“…Therefore, they provided invaluable information related to the impact of telehealth technologies on flattening the COVID-19 infection curve. A telehealth strategy was developed and provided by the authors of this study [ 46 ]. The strategy aimed to mitigate the adverse effects of COVID-19 by combining telehealth and medical training.…”

Implementations and strategies of telehealth during COVID-19 outbreak: a systematic review

“…One study highlighted the medical training [ 21 ]. In particular Cerqueira-Silva et al [ 21 ] described a strategy combing telehealth and medical training to mitigate the adverse effects of the COVID-19 pandemic. Patients staying at home received a guidance to avoid disease transmission and reduce the spread of pandemic.…”

Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint

“…This new fragility in health care networks was particularly straining for already underserved rural regions and ethnic populations [93,94]. Prolonged pandemic conditions further inhibited traditional pathways to hands-on health care experience and clinical supervision, which delayed professional development of the next generation of health care providers [95][96][97]. Governments, hospitals, and health care providers rallied to support public health during COVID-19, but extended pandemic conditions created a clear need for remote health solutions to sustain health care practice, improve access to health care, and provide quality health care education.…”