Bajra Rika, Frazier Winfred, Graves Lisa, Jacobson Katherine, Rodriguez Andres, Theobald Mary, Lin Steven
Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.
St. Margaret Family Medicine Residency Program, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
JMIR Med Educ. 2023 May 8;9:e43190. doi: 10.2196/43190.
Telemedicine use increased as a response to health care delivery changes necessitated by the COVID-19 pandemic. However, lack of standardized curricular content creates gaps and inconsistencies in effectively integrating telemedicine training at both the undergraduate medical education and graduate medical education levels.
This study evaluated the feasibility and acceptability of a web-based national telemedicine curriculum developed by the Society of Teachers of Family Medicine for medical students and family medicine (FM) residents. Based on the Association of American Medical Colleges telehealth competencies, the asynchronous curriculum featured 5 self-paced modules; covered topics include evidence-based telehealth uses, best practices in communication and remote physical examinations, technology requirements and documentation, access and equity in telehealth delivery, and the promise and potential perils of emerging technologies.
A total of 17 medical schools and 17 FM residency programs implemented the curriculum between September 1 and December 31, 2021. Participating sites represented 25 states in all 4 US census regions with balanced urban, suburban, and rural settings. A total of 1203 learners, including 844 (70%) medical students and 359 (30%) FM residents, participated. Outcomes were measured through self-reported 5-point Likert scale responses.
A total of 92% (1101/1203) of learners completed the entire curriculum. Across the modules, 78% (SD 3%) of participants agreed or strongly agreed that they gained new knowledge, skills, or attitudes that will help them in their training or career; 87% (SD 4%) reported that the information presented was at the right level for them; 80% (SD 2%) reported that the structure of the modules was effective; and 78% (SD 3%) agreed or strongly agreed that they were satisfied. Overall experience using the national telemedicine curriculum did not differ significantly between medical students and FM residents on binary analysis. No consistent statistically significant relationships were found between participants' responses and their institution's geographic region, setting, or previous experience with a telemedicine curriculum.
Both undergraduate medical education and graduate medical education learners, represented by diverse geographic regions and institutions, indicated that the curriculum was broadly acceptable and effective.
作为对新冠疫情导致的医疗服务提供方式变化的应对措施,远程医疗的使用有所增加。然而,缺乏标准化的课程内容导致在本科医学教育和研究生医学教育层面有效整合远程医疗培训方面存在差距和不一致性。
本研究评估了由家庭医学教师协会为医学生和家庭医学住院医师开发的基于网络的全国性远程医疗课程的可行性和可接受性。基于美国医学院协会的远程医疗能力要求,该异步课程包括5个自定进度的模块;涵盖的主题包括基于证据的远程医疗应用、沟通和远程体格检查的最佳实践、技术要求和文档记录、远程医疗服务的可及性和公平性,以及新兴技术的前景和潜在风险。
共有17所医学院校和17个家庭医学住院医师培训项目在2021年9月1日至12月31日期间实施了该课程。参与的机构代表了美国所有4个人口普查区域的25个州,城市、郊区和农村环境分布均衡。共有1203名学习者参与,其中包括844名(70%)医学生和359名(30%)家庭医学住院医师。通过自我报告的5级李克特量表回答来衡量结果。
共有92%(1101/1203)的学习者完成了整个课程。在各个模块中,78%(标准差3%)的参与者同意或强烈同意他们获得了有助于其培训或职业发展的新知识、技能或态度;87%(标准差4%)报告所呈现的信息对他们来说难度适中;80%(标准差2%)报告模块结构有效;78%(标准差3%)同意或强烈同意他们感到满意。在二元分析中,医学生和家庭医学住院医师使用全国性远程医疗课程的总体体验没有显著差异。在参与者的回答与其所在机构的地理区域、环境或之前的远程医疗课程经验之间,未发现一致的具有统计学意义的关系。
以不同地理区域和机构为代表的本科医学教育和研究生医学教育学习者均表示,该课程广泛可接受且有效。