Universidade Federal da Bahia, Salvador, Brazil.
Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil.
JMIR Public Health Surveill. 2021 Mar 4;7(3):e24795. doi: 10.2196/24795.
COVID-19 presented great challenges for not only those in the field of health care but also those undergoing medical training. The burden on health care services worldwide has limited the educational opportunities available for medical students due to social distancing requirements.
In this paper, we describe a strategy that combines telehealth and medical training to mitigate the adverse effects of the COVID-19 pandemic.
A toll-free telescreening service, Telecoronavirus, began operations in March 2020. This service was operated remotely by supervised medical students and was offered across all 417 municipalities (14.8 million inhabitants) in the Brazilian state of Bahia. Students recorded clinical and sociodemographic data by using a web-based application that was simultaneously accessed by medical volunteers for supervision purposes, as well as by state health authorities who conducted epidemiological surveillance and health management efforts. In parallel, students received up-to-date scientific information about COVID-19 via short educational videos prepared by professors. A continuously updated triage algorithm was conceived to provide consistent service.
The program operated for approximately 4 months, engaging 1396 medical students and 133 physicians. In total, 111,965 individuals residing in 343 municipalities used this service. Almost 70,000 individuals were advised to stay at home, and they received guidance to avoid disease transmission, potentially contributing to localized reductions in the spread of COVID-19. Additionally, the program promoted citizenship education for medical students, who were engaged in a real-life opportunity to fight the pandemic within their own communities. The objectives of the education, organization, and assistance domains of the Telecoronavirus program were successfully achieved according to the results of a web-based post-project survey that assessed physicians' and students' perceptions.
In a prolonged pandemic scenario, a combination of remote tools and medical supervision via telehealth services may constitute a useful strategy for maintaining social distancing measures while preserving some practical aspects of medical education. A low-cost tool such as the Telecoronavirus program could be especially valuable in resource-limited health care scenarios, in addition to offering support for epidemiological surveillance actions.
COVID-19 不仅给医疗保健领域的人带来了巨大的挑战，也给正在接受医学培训的人带来了挑战。由于社交距离的要求，全球医疗服务的负担限制了医学生可获得的教育机会。
在本文中，我们描述了一种结合远程医疗和医学培训的策略，以减轻 COVID-19 大流行的不利影响。
2020 年 3 月，一个名为 Telecoronavirus 的免费电话筛查服务开始运营。该服务由经过监督的医学生远程操作，并在巴西巴伊亚州的 417 个城市（1480 万居民）提供。学生通过使用基于网络的应用程序记录临床和社会人口统计学数据，该应用程序同时供医疗志愿者监督以及州卫生当局用于进行流行病学监测和健康管理。同时，学生通过教授制作的关于 COVID-19 的最新科学信息短视频接收教育。为了提供一致的服务，我们设计了一个不断更新的分诊算法。
该项目运行了大约 4 个月，有 1396 名医学生和 133 名医生参与。共有 343 个城市的 111965 人使用了该服务。近 70000 人被建议留在家中，他们得到了避免疾病传播的指导，这可能有助于局部减少 COVID-19 的传播。此外，该计划还为医学生提供了公民教育，让他们有机会在自己的社区中参与抗击疫情的实际行动。根据一项基于网络的项目后调查，评估了医生和学生的看法，Telecoronavirus 项目的教育、组织和援助目标都成功实现。
在长期的大流行情况下，远程工具和通过远程医疗服务进行医疗监督的结合可能是维持社交距离措施的有用策略，同时保留医学教育的一些实际方面。像 Telecoronavirus 计划这样的低成本工具在资源有限的医疗保健环境中尤其有价值，除了为流行病学监测行动提供支持外。
