C.E. Jonas is associate professor of family medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. S.J. Durning is professor of medicine and pathology and director, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland. C. Zebrowski is senior analyst for telehealth and metrics and analysis, Connected Health, Defense Health Agency, Silver Spring, Maryland. F. Cimino is assistant professor of family medicine, Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Acad Med. 2019 Jun;94(6):833-837. doi: 10.1097/ACM.0000000000002701.
The American Medical Association has called for telehealth to become a core competency of medical students. Studies indicate that a principal reason physicians do not practice telehealth is lack of training, yet patient interest in and satisfaction with telehealth are high. No comprehensive U.S. undergraduate medical education curriculum teaching telehealth principles has been published.
In February 2018, the Uniformed Services University of the Health Sciences (USU) provided an innovative telehealth training experience for third-year medical students. USU led an interinstitutional, interprofessional learner-centered course including six segments: (1) multiple-choice pretest; (2) asynchronous lectures covering telehealth history, applications, ethics, safety, military uses, etiquette, and patient considerations; (3) in-person interactive telehealth instruction including patient selection, current uses, and risk management; (4) faculty-supervised mock patient telehealth encounters; (5) hands-on diagnosis and advanced surgical procedures using telehealth equipment; and (6) multiple-choice posttest.
This course was piloted with 149 third-year medical students. Students' improvement in telehealth knowledge was demonstrated through (1) 10.1% average improvement between pre- and posttest scores, (2) completion of competency-based checklists, and (3) postcourse preceptor and student feedback. Faculty feedback indicated that technology use was novel and effective based on student input. Faculty noted that students enjoyed engaging via videoconference. Of participating medical students, 119 (80%) indicated future plans to practice telehealth; several requested to be part of future telehealth courses.
Telehealth will be integrated into clinical rotations in collaboration with other institutions. As the telehealth curriculum is taught at other institutions, lessons learned will inform enhancements at USU.
美国医学协会呼吁将远程医疗作为医学生的核心能力。研究表明,医生不进行远程医疗的主要原因是缺乏培训,而患者对远程医疗的兴趣和满意度很高。目前还没有发布涵盖远程医疗原则的美国综合性本科医学教育课程。
2018 年 2 月,美国卫生科学统一服务大学(USU)为三年级医学生提供了创新的远程医疗培训体验。USU 领导了一个跨机构、跨专业的以学习者为中心的课程,包括六个部分:(1)多项选择题前测;(2)涵盖远程医疗历史、应用、伦理、安全、军事用途、礼仪和患者注意事项的异步讲座;(3)面对面的互动远程医疗指导,包括患者选择、当前用途和风险管理;(4)教师监督的模拟患者远程医疗访问;(5)使用远程医疗设备进行实际诊断和高级手术;(6)多项选择题后测。
该课程对 149 名三年级医学生进行了试点。学生远程医疗知识的提高体现在:(1)前测和后测分数之间平均提高了 10.1%;(2)完成基于能力的检查表;(3)课程结束后导师和学生的反馈。教师反馈表明,根据学生的反馈,技术的使用是新颖和有效的。教师注意到学生喜欢通过视频会议进行互动。在参与的医学生中,119 人(80%)表示未来计划进行远程医疗实践;一些人要求参与未来的远程医疗课程。
将与其他机构合作,将远程医疗纳入临床轮转。随着远程医疗课程在其他机构的教授,在 USU 的教学中吸取的经验教训将为课程的改进提供信息。