Reid Hadley W, Branford Kelly, Reynolds Tracey, Baldwin Melody, Dotters-Katz Sarah
Third-Year Medical Student, Duke University School of Medicine.
Director of Clinical Skills Program, Office of Curricular Affairs, Duke University School of Medicine.
MedEdPORTAL. 2021 Apr 28;17:11146. doi: 10.15766/mep_2374-8265.11146.
Although menopause is a common condition, trainees still express high levels of discomfort with managing climacteric symptoms. Trainees also receive little preparation for conducting telemedicine visits, which have become increasingly important in clinical care. We present a formative standardized patient (SP) encounter to introduce medical students to the diagnosis and treatment of menopausal symptoms and the process of conducting a telemedicine visit.
We designed a virtual telemedicine encounter with an SP for medical students. Students received feedback via a post-encounter note on history taking, differential diagnosis, and diagnostics/management and an SP debrief. We collected student input on the experience at the midpoint and end of clerkship and analyzed it for recurring themes. We calculated summary statistics from student post-encounter notes.
Thirty-two OB/GYN students completed the menopause telemedicine SP encounter between April and June 2020. Students scored a median of 20 out of 45 (interquartile range: 18, 22) on the post-encounter note. All students correctly provided a diagnosis of perimenopause/menopause; however, 50% did not offer any strategy for counseling or managing menopausal symptoms. Students expressed discomfort with using a telehealth format (78%) but found it a useful skill to practice (47%). A majority (66%) found the educational encounter to be of excellent or above-average educational value.
While medical students demonstrated discomfort with both managing menopause and utilizing a telemedicine format, this SP case provided an opportunity for them to practice both skills in a safe learning environment. The majority of participants rated the learning experience highly.
尽管更年期是一种常见情况，但实习生在处理更年期症状时仍表现出高度的不适感。实习生在进行远程医疗问诊方面也几乎没有接受过相关培训，而远程医疗问诊在临床护理中变得越来越重要。我们展示了一次形成性标准化患者（SP）问诊，以向医学生介绍更年期症状的诊断和治疗以及进行远程医疗问诊的过程。
我们为医学生设计了一次与标准化患者的虚拟远程医疗问诊。学生通过问诊后的记录获得关于病史采集、鉴别诊断以及诊断/管理方面的反馈，以及标准化患者的总结汇报。我们在实习中期和末期收集学生对该体验的反馈，并分析其中反复出现的主题。我们从学生问诊后的记录中计算汇总统计数据。
32名妇产科学生在2020年4月至6月期间完成了更年期远程医疗标准化患者问诊。学生在问诊后记录上的得分中位数为45分中的20分（四分位间距：18，22）。所有学生都正确诊断出围绝经期/更年期；然而，50%的学生没有提供任何咨询或管理更年期症状的策略。学生对使用远程医疗形式表示不适（78%），但认为这是一项值得练习的有用技能（47%）。大多数（66%）学生认为这次教育性问诊具有优秀或高于平均水平的教育价值。
虽然医学生在处理更年期问题和使用远程医疗形式方面都表现出不适，但这个标准化患者案例为他们提供了在安全的学习环境中练习这两项技能的机会。大多数参与者对学习体验给予了高度评价。
