Use of Telemedicine in Surgical Education: A Seven-Year Experience

Marttos, Antonio; Moscardi, Mariana F. Jucá; Fiorelli, Rossano Kepler Alvim; Pust, Gerd Daniel; Ginzburg, Enrique; Schulman, Carl I.; Grant, April A.; Namias, Nicholas

doi:10.1177/000313481808400831

Cited by 10 publications

(4 citation statements)

References 24 publications

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“…This is intuitive specially for physicians who frequently use telemedicine, including those involved in internal medicine and family medicine [52]. Our findings are consistent with those of previous studies [53][54][55]. Ha et al reported that physicians who had a structured educational program in telemedicine had greater confidence in addressing clinical problems than those who did not receive an educational program [56].…”

Section: Principal Findingssupporting

confidence: 91%

Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study

Alhajri¹,

Simsekler²,

Alfalasi³

et al. 2021

JMIR Med Inform

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Background To mitigate the effect of the COVID-19 pandemic, health care systems worldwide have implemented telemedicine technologies to respond to the growing need for health care services during these unprecedented times. In the United Arab Emirates, video and audio consultations have been implemented to deliver health services during the pandemic. Objective This study aimed to evaluate whether differences exist in physicians’ attitudes and perceptions of video and audio consultations when delivering telemedicine services during the COVID-19 pandemic. Methods This survey was conducted on a cohort of 880 physicians from outpatient facilities in Abu Dhabi, which delivered telemedicine services during the COVID-19 pandemic between November and December 2020. In total, 623 physicians responded (response rate=70.8%). The survey included a 5-point Likert scale to measure physician’s attitudes and perceptions of video and audio consultations with reference to the quality of the clinical consultation and the professional productivity. Descriptive statistics were used to describe physicians’ sociodemographic characteristics (age, sex, designation, clinical specialty, duration of practice, and previous experience with telemedicine) and telemedicine modality (video vs audio consultations). Regression models were used to assess the association between telemedicine modality and physicians’ characteristics with the perceived outcomes of the web-based consultation. Results Compared to audio consultations, video consultations were significantly associated with physicians’ confidence toward managing acute consultations (odds ratio [OR] 1.62, 95% CI 1.2-2.21; P=.002) and an increased ability to provide patient education during the web-based consultation (OR 2.21, 95% CI 1.04-4.33; P=.04). There was no significant difference in physicians’ confidence toward managing long-term and follow-up consultations through video or audio consultations (OR 1.35, 95% CI 0.88-2.08; P=.17). Video consultations were less likely to be associated with a reduced overall consultation time (OR 0.69, 95% CI 0.51-0.93; P=.02) and reduced time for patient note-taking compared to face-to-face visits (OR 0.48, 95% CI 0.36-0.65; P<.001). Previous experience with telemedicine was significantly associated with a lower perceived risk of misdiagnosis (OR 0.46, 95% CI 0.3-0.71; P<.001) and an enhanced physician-patient rapport (OR 2.49, 95% CI 1.26-4.9; P=.008). Conclusions These results indicate that video consultations should be adopted frequently in the new remote clinical consultations. Previous experience with telemedicine was associated with a 2-fold confidence in treating acute conditions, less than a half of the perceived risk of misdiagnosis, and an increased ability to provide patients with health education and enhance the physician-patient rapport. Additionally, these results show that audio consultations are equivalent to video consultations in providing remote follow-up care to patients with chronic conditions. These findings may be beneficial to policymakers of e-health programs in low- and middle-income countries, where audio consultations may significantly increase access to geographically remote health services.

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Section: Principal Findingssupporting

confidence: 91%

Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study

Alhajri¹,

Simsekler²,

Alfalasi³

et al. 2021

JMIR Med Inform

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“…Some are clearly intended to improve clinical care by providing consultant telehealth services [ 6 7 8 9 10 11 12 ]. Others create online learning modules for trainees or educate clinicians on advanced topics and rare cases [ 13 14 15 16 ]. Our intervention hybridized these goals — we hoped that detailed case discussions would provide an educational opportunity for clinicians working in Malawi, allowing them to make more appropriate management decisions that could result in improved patient care and outcomes.…”

Section: Introductionmentioning

confidence: 99%

WhatsApp Linking Lilongwe, Malawi to Los Angeles: Impacting Medical Education and Clinical Management

Thorp

Pool

Tymchuk

et al. 2021

Annals of Global Health

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Background: Subspecialty expertise is often lacking in clinical environments in low-resource settings. As a result, medically complicated patients can receive suboptimal care, local clinicians can feel inadequately supported, and global health engagements can be difficult for medical trainees accustomed to more expert supervision at their home institutions. Objective: We created WhatsApp Messenger discussion groups to connect subspecialists at the University of California, Los Angeles (UCLA) David Geffen School of Medicine with clinicians and rotating global health residents at Partners in Hope (PIH) Medical Center in Lilongwe, Malawi. Methods: Case submitters and subspecialist respondents were surveyed about their experience in the discussion groups. Findings: Over a three-year period, 95 cases were discussed in ten subspecialty groups, with dermatology and radiology/pulmonology receiving the most submissions. Participants were surveyed and reported excellent educational outcomes; large majorities of both case submitters (89%) and experts (71%) agreed or strongly agreed that the case discussions improved their medical education. The surveys also suggested positive impact on medical management decisions and patient outcomes. The major challenge to our intervention was low utilization of this resource by Malawian clinicians in comparison to medical residents. We hope to further address the barriers to participation and adapt the intervention to better support our Malawian colleagues. Conclusion: Because the discussion groups are free to create and require very little maintenance, this intervention can be easily replicated at other institutions looking to augment their global health educational engagements and support their clinical partners abroad.

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“…All of our group educational activities were converted to videoconferencing. 8 , 9 Weekly grand rounds, morbidity and mortality conference, guest speakers, and journal club were held during the daytime. Core Curriculum and board exam preparation continued but were moved to evening and recorded, due to the demands of ongoing clinical duties.…”

mentioning

confidence: 99%

Lessons Learned at a COVID-19 designated hospital

Edwards

Breitman

Kovatch

et al. 2021

The American Journal of Surgery

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During early 2020, New York City became an epicenter for coronavirus disease 2019. The University Hospital of Brooklyn, which is the primary teaching hospital for the State University of New York Downstate Health Sciences University, became the only COVID-19 designated hospital in Brooklyn. The Department of Surgery implemented drastic changes to address the hospital’s needs while remaining committed to the education of surgical residents. They ensured resident safety, continued surgical education, participation and contribution to the care of COVID-19 patients. We were able to accomplish these goals using an access and procedure team and program-wide use of video-conferencing platforms. Here, we have shared our experiences and solutions to the challenges that our department faced during this pandemic.

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Use of Telemedicine in Surgical Education: A Seven-Year Experience

Cited by 10 publications

References 24 publications

Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study

Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study

WhatsApp Linking Lilongwe, Malawi to Los Angeles: Impacting Medical Education and Clinical Management

Lessons Learned at a COVID-19 designated hospital

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