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An Interdisciplinary, Multi-Institution Telehealth Course for Third-Year Medical Students
Christopher E Jonas1, Steven J Durning, Catherine Zebrowski
1C.E. Jonas is associate professor of family medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. S.J. Durning is professor of medicine and pathology and director, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland. C. Zebrowski is senior analyst for telehealth and metrics and analysis, Connected Health, Defense Health Agency, Silver Spring, Maryland. F. Cimino is assistant professor of family medicine, Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Problem:
The American Medical Association has called for telehealth to become a core competency of medical students. Studies indicate that a principal reason physicians do not practice telehealth is lack of training, yet patient interest in and satisfaction with telehealth are high. No comprehensive U.S. undergraduate medical education curriculum teaching telehealth principles has been published.
Approach:
In February 2018, the Uniformed Services University of the Health Sciences (USU) provided an innovative telehealth training experience for third-year medical students. USU led an interinstitutional, interprofessional learner-centered course including six segments: (1) multiple-choice pretest; (2) asynchronous lectures covering telehealth history, applications, ethics, safety, military uses, etiquette, and patient considerations; (3) in-person interactive telehealth instruction including patient selection, current uses, and risk management; (4) faculty-supervised mock patient telehealth encounters; (5) hands-on diagnosis and advanced surgical procedures using telehealth equipment; and (6) multiple-choice posttest.
Outcomes:
This course was piloted with 149 third-year medical students. Students' improvement in telehealth knowledge was demonstrated through (1) 10.1% average improvement between pre- and posttest scores, (2) completion of competency-based checklists, and (3) postcourse preceptor and student feedback. Faculty feedback indicated that technology use was novel and effective based on student input. Faculty noted that students enjoyed engaging via videoconference. Of participating medical students, 119 (80%) indicated future plans to practice telehealth; several requested to be part of future telehealth courses.
Next Steps:
Telehealth will be integrated into clinical rotations in collaboration with other institutions. As the telehealth curriculum is taught at other institutions, lessons learned will inform enhancements at USU.
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