A Qualitative Study on Using Telemedicine for Precepting and Teaching in the Academic Setting

Area of Science:

• Medical Education
• Health Services Research
• Digital Health

Background:

• The COVID-19 pandemic accelerated the adoption of telemedicine in healthcare settings.
• Telemedicine presents unique challenges and opportunities for medical education, particularly in clinical training and supervision.
• Understanding the experiences of both preceptors and patients is vital for effective telemedicine integration in teaching.

Purpose of the Study:

• To investigate the effects of telemedicine on the processes of teaching and precepting during the COVID-19 pandemic.
• To identify challenges and benefits associated with telemedicine-based clinical education from provider and patient perspectives.
• To inform strategies for optimizing telemedicine in undergraduate and graduate medical education.

Main Methods:

• Secondary analysis of a qualitative study involving 86 interviews with 65 patients and 21 providers across 4 academic health centers.
• Thematic analysis of interview data focusing on experiences and attitudes toward telemedicine in teaching and precepting.
• Mapping identified themes to the 2009 Consolidated Framework for Implementation Research (CFIR) domains.

Main Results:

• Lack of prior telemedicine experience and inadequate processes hindered effective teaching and precepting, impacting the learning environment and perceived care quality.
• Telemedicine use exacerbated challenges in maintaining resident continuity and altered communication dynamics between preceptors and trainees.
• Providers identified both challenges (e.g., mask-wearing, camera proximity) and benefits (e.g., observing trainees with camera off) in telemedicine supervision.
• A significant majority of identified themes (6 out of 8) fell within the CFIR domains of individual characteristics, processes, and intervention characteristics.

Conclusions:

• Enhancing telemedicine skills among healthcare professionals is essential for effective clinical teaching.
• Optimizing processes for telemedicine implementation in academic health centers is critical for successful integration into medical curricula.
• Telemedicine is recognized as a permanent fixture in medical education, necessitating structured approaches for its utilization.