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眼科住院医师培训项目中的远程医疗课程

Telemedicine Curriculum in an Ophthalmology Residency Program.

作者信息

Aziz Kanza, Sherif Noha A, Meshkin Ryan S, Lorch Alice C, Armstrong Grayson W

机构信息

Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.

The University of North Carolina School of Medicine, Chapel Hill, North Carolina.

出版信息

J Acad Ophthalmol (2017). 2022 Mar 10;14(1):e93-e102. doi: 10.1055/s-0042-1743580. eCollection 2022 Jan.

Abstract

The COVID-19 pandemic has accelerated the adoption of telemedicine in the field of ophthalmology. Despite the increasing utilization of telemedicine, there is a lack of formal training in ophthalmology residency programs to ensure ophthalmologists are prepared to conduct virtual eye exams.  This article aims to assess the impact of an ophthalmic telemedicine curriculum on ophthalmology residents' self-reported knowledge acquisition in conducting telemedicine eye exams, perceived ability to diagnose, manage, and triage common eye diseases, and evaluate their attitudes toward the current and future use of teleophthalmology.  This single-center study at Massachusetts Eye and Ear used a nonvalidated pre- and postcurriculum survey conducted during the 2020 to 2021 academic year among ophthalmology residents. Participants engaged in an ophthalmic telemedicine curriculum that consisted of interactive didactic lectures and electronic postdidactic assessments.  Twenty-four residents (100%) completed a precurriculum survey, while 23 of 24 (95.8%) residents completed both the telemedicine curriculum and a postcurriculum survey. On a five-point Likert scale, the median interquartile range (IQR) scores for confidence with setup/logistics, history taking, examination, documentation, and education increased from 2.5 (2.0-4.0) to 4.0 (3.5-4.5) (  = 0.001), 3.0 (3.0-4.0) to 5.0 (4.0-5.0) (  < 0.001), 2.0 (1.8-2.0) to 4.0 (3.5-4.0) (  < 0.001), 2.0 (1.0-2.0) to 4.0 (3.0-4.0) (  < 0.001), and 2.5 (2.0-3.0) to 4.0 (4.0-4.0) (  < 0.001), respectively. The median (IQR) scores for comfort with ethics/professionalism, disparities and conducting patient triage, diagnosis, and management increased from 2.0 (2.0-2.3) to 4.0 (3.0-4.0) (  < 0.001), 2.0 (2.0-2.0) to 3.0 (3.0-4.0) (  < 0.001) and 3.0 (2.0-3.0) to 4.0 (3.0-4.0) (  = 0.001), 2.0 (2.0-3.0) to 3.0 (3.0-4.0) (  < 0.001), and 3.0 (2.0-3.0) to 3.0 (3.0-4.0) (  = 0.008), respectively.  The implementation of an ophthalmic telemedicine curriculum increased resident confidence and self-reported knowledge across all logistical and clinical components of virtual ophthalmic care. Formal telehealth curricula can address an unmet educational need of resident trainees in an era of rapid uptake and utilization of telehealth services.

摘要

新冠疫情加速了远程医疗在眼科领域的应用。尽管远程医疗的使用日益增多,但眼科住院医师培训项目缺乏正规培训,以确保眼科医生有能力进行虚拟眼科检查。 本文旨在评估眼科远程医疗课程对眼科住院医师在进行远程医疗眼科检查时自我报告的知识获取、对常见眼病的诊断、管理和分诊的感知能力的影响,并评估他们对当前和未来远程眼科应用的态度。 这项在马萨诸塞州眼耳医院进行的单中心研究,在2020至2021学年期间,对眼科住院医师进行了一项未经验证的课程前后调查。参与者参与了一个眼科远程医疗课程,该课程包括互动式教学讲座和电子教学后评估。 24名住院医师(100%)完成了课程前调查,24名住院医师中的23名(95.8%)完成了远程医疗课程和课程后调查。在五分制李克特量表上,设置/后勤、病史采集、检查、记录和教育方面的信心中位数四分位间距(IQR)得分从2.5(2.0 - 4.0)提高到4.0(3.5 - 4.5)(P = 0.001),从3.0(3.0 - 4.0)提高到5.0(4.0 - 5.0)(P < 0.001),从2.0(1.8 - 2.0)提高到4.0(3.5 - 4.0)(P < 0.001),从2.0(1.0 - 2.0)提高到4.0(3.0 - 4.0)(P < 0.001),从2.5(2.0 - 3.0)提高到4.0(4.0 - 4.0)(P < 0.001)。伦理/专业精神、差异以及患者分诊、诊断和管理方面的舒适度中位数(IQR)得分分别从2.0(2.0 - 2.3)提高到4.0(3.0 - 4.0)(P < 0.001),从2.0(2.0 - 2.0)提高到3.0(3.0 - 4.0)(P < 0.001),从3.0(2.0 - 3.0)提高到4.0(3.0 - 4.0)(P = 0.001),从2.0(2.0 - 3.0)提高到3.0(3.0 - 4.0)(P < 0.001),从3.0(2.0 - 3.0)提高到3.0(3.0 - 4.0)(P = 0.008)。 眼科远程医疗课程的实施提高了住院医师在虚拟眼科护理所有后勤和临床环节的信心和自我报告的知识。正规的远程医疗课程可以满足在远程医疗服务迅速普及和应用的时代住院医师培训未得到满足的教育需求。

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