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在大流行期间为内科住院医师实施远程医疗课程:克利夫兰诊所的经验。

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

机构信息

Internal Medicine Residency Program, Cleveland Clinic, Cleveland, OH, USA

Department of Medicine, University of California, San Diego, La Jolla, CA, USA.

出版信息

Postgrad Med J. 2022 Jul;98(1161):487-491. doi: 10.1136/postgradmedj-2020-139228. Epub 2021 Mar 10.

Abstract

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.

摘要

远程医疗培训在 COVID-19 大流行之前并不是大多数住院医师培训计划的重要组成部分。社交距离措施改变了这一点。克利夫兰诊所内科住院医师培训计划(IMRP)是美国最大的计划之一,这使得实施远程医疗课程的任务更加复杂。在这里,我们描述了为我们的非住院居民诊所实施有效、快速的远程医疗课程的经验。这项研究始于 2020 年 4 月,当时我们为提供非住院远程医疗护理实施了一项由居民主导的课程和培训计划。课程在不到 5 周的时间内完成。它需要为居民引入一个正式的培训计划,为不同的视频通信工具创建一个资源指南,并培训指导医生在这个新的模式下安全地监督护理。在课程开始前,居民接受了调查,以评估他们以前的远程医疗经验,然后在课程结束后评估课程的效果。我们还为居民创建了一个迷你 CEX 评估,以征求他们对虚拟预约期间表现的反馈。在 10 周的时间里,居民进行了 2000 多次虚拟访问。在 148 名居民中,38%回答了参与前的调查。大多数人以前没有远程医疗经验,对这种模式只有轻微的舒适感。通过与有经验的居民和教师合作,我们迅速为我们的非住院医疗课程增加了一个内容,以教授居民如何提供虚拟护理,并帮助教师进行监督。我们分享我们在这方面的经验,以供其他住院医师培训计划使用。

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