The Telehealth Ten: A Guide for a Patient-Assisted Virtual Physical Examination

Benziger, Catherine P.; Huffman, Mark D.; Sweis, Ranya; Stone, Neil J.

doi:10.1016/j.amjmed.2020.06.015

Cited by 104 publications

(80 citation statements)

References 11 publications

(12 reference statements)

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“…Based on the available literature, telehealth curricula should include the following key content areas: technical skills needed to operate equipment and software, including troubleshooting difficulties; professionalism in telehealth, including review of informed consent and patient privacy; telehealth communication skills [25][26][27]; physical examination skills in the telehealth environment [28,29]; and affordances and limitations of telehealth visits, including the potential for telehealth to increase disparities in care [30]. It is important to specifically teach and coach students through sensitive aspects of patient history, which can include eliciting social and mental health histories and intimate partner violence screening [31] and which may be more challenging in the virtual environment.…”

Section: Provide Students With a Telehealth Curriculum That Is Aligned With Telehealth Competenciesmentioning

confidence: 99%

“…Plan in advance which specific examination maneuvers the student will perform and how to communicate the instructions for the exam to the patient. Consider with the student what can be gleaned from the encounter: how the patient tells their story; aspects of the history that help build the differential diagnosis; which data are available from wearable devices; or what findings can result from the "Telehealth Ten," a patient-assisted clinical examination to help guide providers in their physical examination and clinical reasoning over telemedicine [28]. Clerkship students have noted that they appreciate timely feedback during the telehealth encounter or right after the visit, and virtual exam skills observation allows for a focused discussion around behaviors the student can keep, start, or stop doing [14].…”

Section: Build In Opportunities To Teach and Observe The Virtual Physical Exammentioning

confidence: 99%

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Best Practices for Integrating Medical Students Into Telehealth Visits

Wamsley¹,

Cornejo²,

Kryzhanovskaya³

et al. 2021

JMIR Med Educ

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Telehealth has become an increasingly important part of health care delivery, with a dramatic rise in telehealth visits during the COVID-19 pandemic. Telehealth visits will continue to be a part of care delivery after the pandemic subsides, and it is important that medical students receive training in telehealth skills to meet emerging telehealth competencies. This paper describes strategies for successfully integrating medical students into telehealth visits in the ambulatory setting based on existing literature and the extensive experience of the authors teaching and learning in the telehealth environment.

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Section: Provide Students With a Telehealth Curriculum That Is Aligned With Telehealth Competenciesmentioning

confidence: 99%

Section: Build In Opportunities To Teach and Observe The Virtual Physical Exammentioning

confidence: 99%

Best Practices for Integrating Medical Students Into Telehealth Visits

Wamsley¹,

Cornejo²,

Kryzhanovskaya³

et al. 2021

JMIR Med Educ

View full text Add to dashboard Cite

show abstract

“…The National Institutes of Health defines telemedicine as the use of technology to provide and support health care at a distance [9]. The physical examination may be accomplished virtually, including listening to the patient and assembling a careful history to guide physical subtleties from a limited, but potentially impressionable, patient‐assisted physical examination [10].…”

Section: Introductionmentioning

confidence: 99%

Rapid Implementation of Telemedicine During the COVID-19 Pandemic: Perspectives and Preferences of Patients with Cancer

et al. 2021

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Introduction The use of telemedicine in oncology practice is rapidly expanding and is considered safe and cost effective. However, the implications of telemedicine on patient‐physician interaction, patient satisfaction, and absence of the personal touch have not been studied to date. Following the spread of COVID‐19, telemedicine services were rapidly incorporated at the Oncology Division of Tel Aviv Medical Center. We aimed to evaluate patients' perspectives and preferences regarding telemedicine and to assess whether this virtual communication platform affects the patient‐physician relationship. Methods Between March 2020 and May 2020, adult cancer patients who conducted at least one successful telemedicine meeting were interviewed by trained medical personnel. The interview was based on validated patient satisfaction questionnaires and focused on patient‐physician interaction in relation to the last in‐patient visit. Results Of 236 patients, 172 (74%) patients agreed to participate. The study population comprised mainly patients with gastrointestinal malignancies ( n = 79, 46%) with a median age of 63 years (range 21–88). The majority of patients were male ( n = 93, 54%). Eighty‐nine (51.7%) patients were receiving active oncologic treatment, and 58 (33.7%) were under routine surveillance following completion of active therapy. Almost all had a sense of secured privacy ( n = 171, 96%), the majority of patients affirmed that their concerns were met ( n = 166, 93%) and perceived that eye contact with the treating physician was perceived ( n = 156, 87%). Only a minority felt that the absence of physical clinic visits harmed their treatment ( n = 36, 20%). Most patients ( n = 146, 84.9%) wished to continue telemedicine services. A multivariate analysis revealed that higher satisfaction and visits for routine surveillance were both predictors of willingness to continue future telemedicine meetings over physical encounters (odds ratio [OR] = 2.41, p = .01; OR = 3.34, p = .03, respectively). Conclusion Telemedicine is perceived as safe and effective, and patients did not feel that it compromised medical care or the patient‐physician relationship. Integration of telemedicine is ideal for patients under surveillance after completion of active oncologic treatment. Physician communication skills workshops are warranted with implementing this platform. Implications for Practice During the COVID‐19 pandemic, telemedicine was rapidly implemented worldwide to facilitate continuity of quality care and treatment. Despite many potential setbacks, telemedicine has become a useful and safe tool for oncology practitioners to care for their pa...

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“…Our introductory course therefore focused on video communication skills, the virtual physical examination, documentation changes and technology troubleshooting to help build resident competency in this new framework. Many recent articles detail best practices for the virtual physical examination, 11 and the neurological 12 and musculoskeletal 13 14 examinations in particular. One study showed non-inferiority of the virtual shoulder examination compared with the traditional ‘in person’ examination.…”

Section: Discussionmentioning

confidence: 99%

Implementing a telemedicine curriculum for internal medicine residents during a pandemic: the Cleveland Clinic experience

Savage

Gutiérrez

Montanè

et al. 2021

Postgraduate Medical Journal

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Telemedicine training was not a substantial element of most residency programmes prior to the COVID-19 pandemic. Social distancing measures changed this. The Cleveland Clinic Internal Medicine Residency Programme (IMRP) is one of the largest programmes in the USA, which made the task of implementing a telemedicine curriculum more complex. Here we describe our experience implementing an effective, expedited telemedicine curriculum for our ambulatory resident clinics. This study was started in April 2020 when we implemented a resident-led curriculum and training programme for providing ambulatory telemedicine care. The curriculum was finalised in less than 5 weeks. It entailed introducing a formal training programme for residents, creating a resource guide for different video communication tools and training preceptors to safely supervise care in this new paradigm. Residents were surveyed before the curriculum to assess prior experience with telemedicine, and then afterward to assess the curriculum’s effectiveness. We also created a mini-CEX assessment for residents to solicit feedback on their performance during virtual appointments. Over 2000 virtual visits were performed by residents in a span of 10 weeks. Of 148 residents, 38% responded to the pre-participation survey. A majority had no prior telemedicine experience and expressed only slight comfort with the modality. Through collaboration with experienced residents and faculty, we expeditiously deployed an enhancement to our ambulatory care curriculum to teach residents how to provide virtual care and help faculty with supervision. We share our insights on this experience for other residency programmes to use.

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The Telehealth Ten: A Guide for a Patient-Assisted Virtual Physical Examination

Cited by 104 publications

References 11 publications

Best Practices for Integrating Medical Students Into Telehealth Visits

Best Practices for Integrating Medical Students Into Telehealth Visits

Rapid Implementation of Telemedicine During the COVID-19 Pandemic: Perspectives and Preferences of Patients with Cancer

Implementing a telemedicine curriculum for internal medicine residents during a pandemic: the Cleveland Clinic experience

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