Adamkiewicz Daniel, Atri Lavannya, Berman Lindsay, Broughton Robert, Jones Cara, Maslesa Ana, Lyon Matthew
Center for Ultrasound Education, Augusta University Medical College of Georgia, Augusta, Georgia, USA.
Department of Medicine and Augusta University Medical College of Georgia, Augusta, Georgia, USA.
Telemed J E Health. 2023 Mar;29(3):432-441. doi: 10.1089/tmj.2022.0127. Epub 2022 Jul 18.
As part of a curricular change, an academic medical center implemented a medical student telemedicine clinical experience for first-year medical students in October 2020. This research is a process evaluation of the implementation of a preclerkship medical student telemedicine clinical experience. Patients with two or more chronic diseases were recruited from affiliated primary care practices. We monitored the recruitment and retainment of patients throughout the curriculum. We used surveys to evaluate patient, student, and primary care overall experience with the program. We tracked referrals to higher levels of care and assessed skills students' felt they practice with each encounter. We followed progression of notes through chart review as the year progressed. Of the 408 patients contacted, 150 agreed to participate in this program (36%). Of 1,053 scheduled visits, 686 (65%) were successfully completed. Seventy-five percent of patients were seen two or more times. Nearly 70% of surveyed patients felt that the clinical experience enhanced their communication with their primary care provider, and nearly 90% stated that students were "somewhat" or "extremely" professional. The majority (97%) of students reported an "excellent" or "good" view of the medical student telemedicine clinical experience. Qualitative measures of student performance, such as note writing, showed improvement over the course of the curriculum. Our data suggest that patients, students, and primary care providers were widely accepting of the curriculum, patients were successfully recruited and retained, and students successfully practiced key clinical skills on a telemedicine platform.
作为课程改革的一部分,一所学术医疗中心于2020年10月为一年级医学生开展了远程医疗临床体验。本研究是对医学生实习前远程医疗临床体验实施情况的过程评估。从附属基层医疗诊所招募患有两种或更多种慢性病的患者。我们在整个课程中监测患者的招募和留存情况。我们通过调查评估患者、学生和基层医疗人员对该项目的总体体验。我们追踪向上级医疗机构的转诊情况,并评估学生在每次诊疗中感觉自己所练习的技能。随着时间推移,我们通过病历审查跟踪记录的进展情况。在联系的408名患者中,150名同意参与该项目(36%)。在安排的1053次就诊中,686次(65%)成功完成。75%的患者就诊两次或更多次。近70%的受访患者认为临床体验增强了他们与基层医疗服务提供者的沟通,近90%表示学生“有些”或“非常”专业。大多数(97%)学生对医学生远程医疗临床体验评价为“优秀”或“良好”。学生表现的定性指标,如病历书写,在课程过程中有所改善。我们的数据表明,患者、学生和基层医疗服务提供者广泛接受该课程,患者成功招募并留存,学生在远程医疗平台上成功练习了关键临床技能。