Developing the eMedical Student (eMS)—A Pilot Project Integrating Medical Students into the Tele-ICU during the COVID-19 Pandemic and beyond

Abstract

The COVID-19 pandemic has accelerated the demand for virtual healthcare delivery and highlighted the scarcity of telehealth medical student curricula, particularly tele-critical care. In partnership with the Penn E-lert program and the Department of Anesthesiology and Critical Care, the Perelman School of Medicine (PSOM) established a tele-ICU rotation to support the care of patients diagnosed with COVID-19 in the Intensive Care Unit (ICU). The four-week course had seven elements: (1) 60 h of clinical engagement; (2) multiple-choice pretest; (3) faculty-supervised, student-led case and topic presentations; (4) faculty-led debriefing sessions; (5) evidence-based-medicine discussion forum; (6) multiple-choice post-test; and (7) final reflection. Five third- and fourth-year medical students completed 300 h of supervised clinical engagement, following 16 patients over three weeks and documenting 70 clinical interventions. Knowledge of critical care and telehealth was demonstrated through improvement between pre-test and post-test scores. Professional development was demonstrated through post-course preceptor and learner feedback. This tele-ICU rotation allowed students to gain telemedicine exposure and participate in the care of COVID patients in a safe environment.

A scoping review on adaptations of clinical education for medical students during COVID-19

“…Adding to previous reviews, we found reports using telemedicine to overcome the challenges in clinical education amidst the pandemic disruption ( Table 2 ). 17 papers [ 8 , 9 , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] ] described the use of telemedicine as an educational tool mostly for clerkship rotations but three also included pre-clinical year students. Whilst telemedicine was mainly implemented in university hospitals, six programs were also executed in the community.…”

“…5 ). Practice guidelines [ 11 , 12 , 20 , 22 ] and training for faculty and students were provided [ 10 , 14 , 16 , 18 , 20 , 22 , 24 ] prior to encountering patients over the telehealth platform. In-advance informed consent from the patients were obtained and screening took place to ensure patients had the appropriate virtual interfaces [ 18 , 19 , 21 ].…”

“…Students joined as observers or participation. 2,4,5,7 Univ MS US Iancu et al [ 13 ] Based on experience in applying telemedicine consultation as part of core and elective clerkships, 12 tips were suggested in setting stage, needs assessment, creating tools for student integration into telemedicine 1,2,4,5 Univ MS US Ho et al [ 14 ] 5hr student shifts on remote tele-ICU patient care, performing real interventions (medication, ventilator adjustment, lab recheck) as part of interdisciplinary care. 1,2,3,4,6,8,9 Univ Med US Lal et al [ 15 ] Flipped classroom over zoom, role-play with faculty assessing symptoms and disclosing prognosis.…”

“…Family medicine departments used telemedicine for communication skills education [ 16 ]; scripts and disease templates used in telemedicine were shared amongst students to widen their clinical knowledge [ 17 ]; and prior training in EMR (Electronic Medical Records) allowed students to contribute to telemedicine documentation of consented patients visits [ 18 ]. Ho et al [ 14 ] developed a pilot project integrating medical students into tele-ICU patient care using a 2-way video conferencing platform.…”

“…Iancu et al [ 13 ] highlighted telemedicine education as an important aspect of future medical student training, especially in augmenting traditional in-person clinical experiences. Telemedicine engaged students and patients in diverse clinical settings providing a platform to teach wide range of clinical skills including clinical reasoning, professionalism, and communication skills during a pandemic [ 14 , 19 ] with high satisfaction levels [ 14 , 33 ]. The publications reporting clinical teaching via telemedicine during the COVID-19 could serve as a scalable model for future educational programs to be incorporated into the medical student curricula [ 21 ] and expanded into outreach programs, especially in underserved rural communities [ 19 ].…”