Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.
Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA.
Telemed J E Health. 2022 Feb;28(2):240-247. doi: 10.1089/tmj.2021.0005. Epub 2021 Jun 3.
Telehealth, especially the use of real-time video and phone visits in ambulatory care, is increasingly important in the wake of the COVID-19 pandemic. The current state of internal medicine (IM) interns' telehealth training at the start of residency is unknown. To characterize the attitudes, training, and preparedness of IM interns regarding the use of telehealth video and phone visits in ambulatory care. We conducted a cross-sectional survey of IM interns at four IM residency programs in the United States in 2020. One hundred fifty-six surveys were analyzed (response rate 82%). Seventy-five percent of interns rated training in the use of real-time video and phone visits for ambulatory care as important or very important. The vast majority received no training (74%) or clinical experience (90% no prior video visits, 81% no prior phone visits) during medical school. More interns believed that primary care may be effectively delivered via video visits compared with phone visits (77% vs. 35%). Most interns (69%) missed clinical time during medical school due to the COVID-19 pandemic; 41% felt that the pandemic negatively affected their ambulatory care preparation. Overall, the majority of interns (58%) felt prepared for primary care; only 12% felt prepared to deliver primary care using either video or phone visits. Although IM interns had favorable attitudes toward video and phone visits, few had training or clinical experience; most felt unprepared. Residency programs may need to close training gaps for current interns in conducting telehealth video and phone visits.
远程医疗,尤其是实时视频和电话门诊在大流行后的门诊护理中变得越来越重要。目前尚不清楚内科住院医师培训中远程医疗培训的现状。本研究旨在描述内科住院医师在开始住院医师生涯时对远程医疗视频和电话门诊在门诊护理中应用的态度、培训和准备情况。我们于 2020 年在美国的四个内科住院医师培训计划中对内科住院医师进行了横断面调查。分析了 156 份调查(应答率 82%)。75%的住院医师认为在门诊护理中使用实时视频和电话门诊的培训很重要或非常重要。绝大多数住院医师在医学院期间没有接受过培训(74%)或临床经验(90%无先前的视频就诊,81%无先前的电话就诊)。与电话就诊相比,大多数住院医师认为初级保健可以通过视频就诊有效提供(77%比 35%)。大多数住院医师(69%)由于 COVID-19 大流行而在医学院错过了临床时间;41%的人认为大流行对他们的门诊护理准备产生了负面影响。总体而言,大多数住院医师(58%)认为自己已为初级保健做好了准备;只有 12%的人认为自己已经准备好使用视频或电话就诊来提供初级保健。尽管内科住院医师对视频和电话就诊持积极态度,但很少有人接受过培训或临床经验;大多数人觉得自己准备不足。住院医师培训计划可能需要为当前的住院医师在进行远程医疗视频和电话门诊方面缩小培训差距。