is Research Data Associate, New York University Grossman School of Medicine.
is Program Manager, New York Harbor Veterans Health Affairs, and New York University Grossman School of Medicine.
J Grad Med Educ. 2023 Aug;15(4):456-462. doi: 10.4300/JGME-D-22-00868.1.
The transition to telehealth during the COVID-19 pandemic revealed a lack of preexisting telehealth training for clinicians. As a workplace-based simulation methodology designed to improve virtual clinical skills, announced standardized patients (ASPs) may help meet evolving educational needs to sustain quality telehealth care.
We describe the development and implementation of an ASP program to assess and provide feedback to resident and faculty clinicians in virtual practice, and report on performance, feasibility, and acceptability.
From June 2021 to April 2022, resident and faculty clinicians at a VA primary care clinic participated in a video visit in which an ASP portrayed either a 70-year-old man with hearing loss and hypertension or a 60-year-old man with hypertension and financial stress. Following the visit, ASPs provided verbal feedback and completed a behaviorally anchored checklist to rate telehealth and communication skills, chronic disease management, and use of resources. Domain summary scores were calculated as the mean percentage of "well done" items. Participants completed a feedback survey on their experience.
Seventy-six televisits (60 primary care residents [postgraduate year 1-3], 16 internal medicine faculty) were conducted from August 2021 to April 2022. Clinicians performed well in communication skills: information gathering (79%, 60 of 76, well done), relationship development (67%, 51 of 76), education and counseling (71%, 54 of 76), and patient satisfaction (86%, 65 of 76). They performed less well in telemedicine skills (38%, 29 of 76). Participants agreed that the experience was a good use of their time (88%, 67 of 76).
An ASP-facilitated training for resident and faculty clinicians assessed telehealth skills and clinical practice and identified areas for intervention. Clinicians responded well to the training and feedback.
在 COVID-19 大流行期间向远程医疗的转变凸显了临床医生缺乏预先存在的远程医疗培训。作为一种旨在提高虚拟临床技能的基于工作场所的模拟方法，宣布标准化患者（ASPs）可能有助于满足不断发展的教育需求，以维持高质量的远程医疗服务。
我们描述了一个 ASP 计划的开发和实施，该计划旨在评估和为虚拟实践中的住院医师和教师临床医生提供反馈，并报告绩效、可行性和可接受性。
从 2021 年 6 月到 2022 年 4 月，退伍军人事务部初级保健诊所的住院医师和教师临床医生参加了视频访问，其中一名 ASP 扮演了一名 70 岁听力受损和高血压的男性或一名 60 岁患有高血压和经济压力的男性。访问结束后，ASPs 提供口头反馈并完成行为锚定清单，以评估远程医疗和沟通技巧、慢性病管理以及资源使用情况。计算域总结分数作为“做得好”项目的平均百分比。参与者完成了一份关于他们体验的反馈调查。
从 2021 年 8 月到 2022 年 4 月，进行了 76 次电视访问（60 名初级保健住院医师[研究生第 1-3 年]，16 名内科教师）。临床医生在沟通技巧方面表现出色：信息收集（79%，76 人中的 60 人，做得好）、关系发展（67%，76 人中的 51 人）、教育和咨询（71%，76 人中的 54 人）和患者满意度（86%，76 人中的 65 人）。他们在远程医疗技能方面表现较差（38%，76 人中的 29 人）。参与者认为这次经历很好地利用了他们的时间（88%，76 人中的 67 人）。
一项针对住院医师和教师临床医生的 ASP 辅助培训评估了远程医疗技能和临床实践，并确定了干预领域。临床医生对培训和反馈反应良好。
