Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, PA, USA.
Adult Multidisciplinary Critical Care, Geisinger Medical Center, Danville, PA, USA.
Int J Med Inform. 2021 Sep;153:104526. doi: 10.1016/j.ijmedinf.2021.104526. Epub 2021 Jun 10.
Restrictions to direct patient contact resulting from the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic left some medical students near graduation in need of a required critical care medicine (CCM) sub-internship. A group of educators deployed a virtual curriculum utilizing telemedicine and electronic health record (EHR) technologies.
Nine students participated in a formal curriculum of high-value critical care medicine topics designed to meet the learning objectives of the in-person experience. Students obtained patient histories and directed physical examinations virtually via telemedicine. They followed assigned patients, submitted clinical documentation, and practiced electronic order entry using a non-production EHR copy. At conclusion these students completed the same evaluation used for "in-person" CCM rotations earlier in the year.
Students rated the virtual rotation comparably to the traditional rotation in most evaluated criteria. Lower rated areas included "perform minor procedures", "patient counseling", and "interprofessional experiences". Students' narrative responses specifically noted strengths of the "student focus" and the ability to practice in an EHR copy.
Students and preceptors generally found that the virtual curriculum provided adequate educational opportunities. Certain areas were clearly lacking, as expected. Students felt the dedication of the faculty to the students' educational needs was the most important factor contributing to the success of the program. The results suggest several ways telemedicine and EHR technologies might enhance clinical medical education in the future.
This methodology was successful in providing elements of a CCM rotation experience. This technology could prove efficacious for primary care rotations where in-person training is not feasible due to the SARS-CoV-2 pandemic.
由于严重急性呼吸系统综合症冠状病毒 2（SARS-CoV-2）大流行，限制了直接与患者接触，使得一些即将毕业的医学生需要完成必修的重症监护医学（CCM）实习。一组教育工作者利用远程医疗和电子健康记录（EHR）技术部署了一个虚拟课程。
9 名学生参加了一项高价值重症监护医学主题的正式课程，旨在满足亲身实践的学习目标。学生通过远程医疗获得患者病史并进行虚拟体格检查。他们通过电子病历副本进行分配患者的随访、提交临床文档和练习电子医嘱录入。在课程结束时，这些学生完成了与当年早些时候“亲身”CCM 轮转相同的评估。
学生在大多数评估标准上对虚拟轮转的评价与传统轮转相当。评价较低的领域包括“进行小手术”、“患者咨询”和“跨专业经验”。学生的叙述性回复特别提到了“以学生为中心”和在 EHR 副本中进行实践的能力的优势。
学生和导师普遍认为，虚拟课程提供了足够的教育机会。由于预期的原因，某些领域明显缺乏。学生们认为教师对学生教育需求的奉献精神是该计划成功的最重要因素。结果表明，远程医疗和 EHR 技术在未来可能会增强临床医学教育。
这种方法在提供 CCM 轮转体验的元素方面是成功的。由于 SARS-CoV-2 大流行，这种技术可能在亲身培训不可行的初级保健轮转中证明是有效的。
