Venditti Sarah A, Sazegar Payam, Fuchs Lance C, Snarskis Carolyn E
Kaiser Permanente San Diego Family Medicine Residency Program, San Diego, CA.
Kaiser Permanente San Diego Family Medicine Residency Program, San Diego, CA | Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.
PRiMER. 2022 Apr 11;6:9. doi: 10.22454/PRiMER.2022.665996. eCollection 2022.
Telemedicine has become a highly-utilized form of primary care, requiring medical schools and residency programs to develop standardized telemedicine training to meet learners' educational needs. This study highlights specific areas of clinical teaching and faculty development regarded as highly valuable in a family medicine (FM) residency program.
We developed a needs assessment survey instrument based on Accreditation Council for Graduate Medical Education (ACGME) milestones and circulated it to faculty and residents at a suburban FM residency program in August 2020. We mapped each survey question to ACGME core competencies to identify common themes. We performed two-sample tests to compare perceived self-confidence in faculty assessment and resident performance of key telemedicine clinical skills.
A total of 29 respondents (15 faculty, 14 residents) completed the survey. Both residents and faculty expressed comfort with obtaining a focused history, ruling out red flag symptoms, formulating a differential diagnosis, and planning follow-up care. Faculty reported confidence in their ability to provide feedback about medical knowledge and clinical decision making, but also identified a need for better feedback tools. Both faculty and residents identified a need for better teaching of physical exam skills during video visits. There were no statistically significant differences for perceived self-confidence in evaluating and performing key telemedicine skills between faculty and residents, respectively.
Development of effective telemedicine educational experiences should emphasize teaching virtual communication and physical exam skills, and developing new approaches to learner evaluation.
远程医疗已成为初级医疗中一种广泛应用的形式，这就要求医学院校和住院医师培训项目制定标准化的远程医疗培训，以满足学习者的教育需求。本研究突出了在家庭医学住院医师培训项目中被视为极具价值的临床教学和教师发展的特定领域。
我们基于毕业后医学教育认证委员会（ACGME）的里程碑制定了一份需求评估调查问卷，并于2020年8月分发给一个郊区家庭医学住院医师培训项目的教师和住院医师。我们将每个调查问题映射到ACGME核心能力，以确定共同主题。我们进行了双样本检验，以比较教师评估中的自我认知信心和关键远程医疗临床技能的住院医师表现。
共有29名受访者（15名教师、14名住院医师）完成了调查。住院医师和教师都表示在获取重点病史、排除警示症状、制定鉴别诊断以及规划后续护理方面感到轻松。教师报告称对自己提供有关医学知识和临床决策反馈的能力有信心，但也指出需要更好的反馈工具。教师和住院医师都认为在视频问诊期间需要更好地教授体格检查技能。在评估和执行关键远程医疗技能方面，教师和住院医师的自我认知信心分别没有统计学上的显著差异。
有效的远程医疗教育体验的发展应强调教授虚拟沟通和体格检查技能，以及开发新的学习者评估方法。
