Design and implementation of an interactive, competency-based pilot pediatric telemedicine curriculum

Abstract

During the height of the COVID-19 pandemic, telemedicine visits surged to increase access and maintain continuity of care, while reducing transmission of disease. However, few curricula exist for training residents on how to care for patients via telemedicine, especially in pediatrics. We aimed to create and evaluate an interactive, competency-based pilot curriculum, to meet the urgent need to train residents in telemedicine. The curriculum was developed in 2020 and includes a didactic, cased-based discussions, and direct observation exercise. A model for precepting residents, adhering to new ACGME guidelines, was also created to further engage residents in telemedicine in the outpatient general pediatrics settings. To evaluate the curriculum, we assessed feasibility of a direct observation to provide feedback and we conducted pre and post surveys to assess for changes in residents’ self-reported skills in performing telemedicine visits following implementation of the curriculum. 16 residents participated in the curriculum and 15 completed both the pre and post surveys (93%). Residents’ self-reported efficacy in performing key components of telemedicine visits, including completion of telemedicine visit (p = 0.023), initiation of visits (p = 0.01), and documentation (p = 0.001) all improved significantly following implementation. Residents’ perception of patient satisfaction with telemedicine and personal perception of ease of use of the telemedicine system increased, though neither were statistically significant. Uptake of the direct observation exercise was nearly universal, with all but one resident having a direct observation completed during their ambulatory month. This novel, interactive telemedicine pilot curriculum for residents addresses ACGME competencies and provides residents with a toolkit for engaging in telemedicine.

Pediatric Telemedicine

“…Education and training in telemedicine is important for improving pediatric providers’ acceptance of and comfort with virtual visits. 17 Telemedicine-specific training may also improve the quality of the visits and increase the experience of the encounters for providers, patients, and families. 3 In addition to training focused on delivering care over video, site-specific training around telemedicine workflows and processes is necessary for ensuring comprehensive and compliant documentation.…”

Can you hear me now? A toolkit for telemedicine training

“…The checklist we present in Table 3 is a compilation of multiple institutions’ checklists, originating from a single institution that studied its use in evaluating residents pre/post telemedicine training 15 …”

Digital Technology Application for Improved Responses to Health Care Challenges: Lessons Learned From COVID-19

“…Direct observation by attendees was also developed for evaluation purposes. 24 There was a significant increase in residents’ self-reported efficacy in performing key components of telemedicine visits. Another study demonstrated that undergraduate medical students taught using DH technologies were more familiar with them in their later clinical practice and more able to use such technologies in their career compared to peers who did not receive DH-based lessons during their training.…”