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设计和实施基于能力的交互式儿科远程医疗试点课程。

Design and implementation of an interactive, competency-based pilot pediatric telemedicine curriculum.

机构信息

Department of Pediatrics, Division of Child and Adolescent Health, Columbia University Irving Medical Center, USA.

出版信息

Med Educ Online. 2021 Dec;26(1):1911019. doi: 10.1080/10872981.2021.1911019.

Abstract

During the height of the COVID-19 pandemic, telemedicine visits surged to increase access and maintain continuity of care, while reducing transmission of disease. However, few curricula exist for training residents on how to care for patients via telemedicine, especially in pediatrics. We aimed to create and evaluate an interactive, competency-based pilot curriculum, to meet the urgent need to train residents in telemedicine. The curriculum was developed in 2020 and includes a didactic, cased-based discussions, and direct observation exercise. A model for precepting residents, adhering to new ACGME guidelines, was also created to further engage residents in telemedicine in the outpatient general pediatrics settings. To evaluate the curriculum, we assessed feasibility of a direct observation to provide feedback and we conducted pre and post surveys to assess for changes in residents' self-reported skills in performing telemedicine visits following implementation of the curriculum. 16 residents participated in the curriculum and 15 completed both the pre and post surveys (93%). Residents' self-reported efficacy in performing key components of telemedicine visits, including completion of telemedicine visit (p = 0.023), initiation of visits (p = 0.01), and documentation (p = 0.001) all improved significantly following implementation. Residents' perception of patient satisfaction with telemedicine and personal perception of ease of use of the telemedicine system increased, though neither were statistically significant. Uptake of the direct observation exercise was nearly universal, with all but one resident having a direct observation completed during their ambulatory month. This novel, interactive telemedicine pilot curriculum for residents addresses ACGME competencies and provides residents with a toolkit for engaging in telemedicine.

摘要

在 COVID-19 大流行期间,远程医疗就诊量激增,以增加获取医疗服务的机会并保持医疗服务的连续性,同时减少疾病传播。然而,针对如何通过远程医疗为患者提供护理,培训住院医师的课程却很少,尤其是在儿科领域。我们旨在创建并评估一个互动式、基于能力的试点课程,以满足培训住院医师远程医疗技能的迫切需求。该课程于 2020 年开发,包括理论教学、基于案例的讨论和直接观察练习。还创建了一个以新的 ACGME 指南为指导的住院医师指导模型,以进一步促使住院医师在门诊儿科常规环境中参与远程医疗。为了评估该课程,我们评估了直接观察的可行性,以提供反馈,并进行了课程实施前后的调查,以评估住院医师在实施课程后进行远程医疗就诊的自我报告技能的变化。16 名住院医师参加了该课程,其中 15 名(93%)完成了课程实施前后的调查。住院医师在进行远程医疗就诊的关键环节方面的自我效能感显著提高,包括完成远程医疗就诊(p=0.023)、开始就诊(p=0.01)和记录(p=0.001)。住院医师对患者对远程医疗的满意度和对远程医疗系统易用性的个人感知有所提高,但均无统计学意义。直接观察练习的采用率几乎是普遍的,除了一名住院医师外,所有住院医师在他们的门诊月期间都完成了直接观察。这个针对住院医师的新颖的、互动式远程医疗试点课程满足了 ACGME 的能力要求,并为住院医师提供了参与远程医疗的工具包。

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