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老年人视频远程医疗的能力。

Competencies for video telemedicine with older adult patients.

机构信息

Division of Geriatrics Gerontology and Palliative Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA.

South Texas Veterans Health Care System Geriatric Research Education and Clinical Center, San Antonio, Texas, USA.

出版信息

J Am Geriatr Soc. 2023 Apr;71(4):1283-1290. doi: 10.1111/jgs.18246. Epub 2023 Mar 23.

Abstract

BACKGROUND

Telemedicine has recently become a part of mainstream clinical practice. Many curricula have been developed to teach general and specialty-specific video telemedicine skills; however, a lack of defined best practices for translating comprehensive interprofessional geriatric care to the virtual setting presents a unique challenge to educators and clinicians. This manuscript introduces and describes the development of competencies for video telemedicine with older adults for all health professionals who treat them.

METHODS

A modified Delphi process was used in competency development. In 2019, interprofessional clinicians and educators who had expertise in telemedicine formed a competency development workgroup. The aim was to draft competencies for interprofessional video telemedicine with older adults while not duplicating existing competencies in geriatrics, interprofessional care, or general telemedicine. Draft competencies were circulated among experts in geriatric telemedicine and geriatric education for two rounds of comments. The competencies incorporated comments from 41 clinicians representing 7 professions.

RESULTS

Twenty-three competencies were created spanning six domains. A temporal organization by domain was used: (1) Overarching considerations, (2) Pre-visit preparation, (3) Beginning of the visit, (4) History taking and communication during the visit, (5) Exam during the visit (organized by the 5Ms: Mind, Mobility, Medication, Multicomplexity, and Matters Most), and (6) Post-visit coordination.

CONCLUSIONS

These newly developed competencies fill a gap left by those developed for specific disciplines or that do not address considerations for older adults. They lay the groundwork for curriculum development and the development of virtual Age-Friendly care.

摘要

背景

远程医疗最近已成为主流临床实践的一部分。许多课程已经开发出来,以教授一般和专业特定的视频远程医疗技能;然而,将全面的跨专业老年护理转化为虚拟环境的最佳实践缺乏定义,这对教育者和临床医生提出了独特的挑战。本文介绍并描述了为所有治疗老年人的医疗保健专业人员开发针对老年人的视频远程医疗技能的能力。

方法

使用改良 Delphi 法进行能力发展。2019 年,具有远程医疗专业知识的跨专业临床医生和教育工作者组成了一个能力发展工作组。目的是为跨专业与老年人进行视频远程医疗制定能力,同时不重复老年医学、跨专业护理或一般远程医疗中的现有能力。草案能力在老年远程医学和老年教育方面的专家中进行了两轮评论。这些能力吸收了来自代表 7 个专业的 41 名临床医生的意见。

结果

创建了 23 项能力,涵盖 6 个领域。按域进行时间组织:(1)总体考虑,(2)访问前准备,(3)访问开始,(4)访问期间的病史和沟通,(5)访问期间的检查(按 5M 组织:思维、移动性、药物、多复杂性和最重要的事情),和(6)访问后协调。

结论

这些新开发的能力填补了为特定学科开发的能力或不解决老年人问题的能力所留下的空白。它们为课程开发和虚拟友好型老年护理的发展奠定了基础。

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