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Effectiveness of Telehealth-Enabled Standardized Patient Encounters in Behavioral Health Training for PA Students
Shani Fleming1,2,3,4,5,6,7,8, Violet A Kulo1,2,3,4,5,6,7,8, Karen L Gordes1,2,3,4,5,6,7,8
1Shani Fleming, PhD, MPH, PA-C, is an associate professor and assistant dean of Values and Strategic Initiatives, School of Graduate Studies at University of Maryland Baltimore, Baltimore, Maryland.
Introduction:
With telehealth training now mandated in physician assistant (PA) education, little is known about the effectiveness of telehealth training modules in fostering the desired competencies. This study examined whether behavioral health competencies differ between telehealth and in-person standardized patient (SP) encounters.
Methods:
A nonrandomized educational intervention was conducted with first-year PA students. After completing an online asynchronous telehealth certificate, students engaged in a telehealth-enabled behavioral health SP encounter. Later in the semester, students completed a similar case in person. Performance was evaluated by faculty, SPs, and student self-assessments, focusing on SP performance, treatment planning, diagnostic accuracy, and communication skills.
Results:
Faculty SP evaluations were higher for in-person (M = 82.77, SD = 8.44) versus telehealth (M = 79.04, SD = 9.45), t (51) = 2.983, P = .004. Treatment planning also favored in-person training, t (54) = 2.263, P = .028, while diagnostic accuracy showed no significant difference ( P = .399). Standardized patient assessments of communication were significantly higher in person (M = 91.73, SD = 9.07) than telehealth (M = 85.56, SD = 13.04), t (54) = 3.089, P = .003. Students demonstrated core behavioral health competencies across both modalities, but telehealth encounters scored lower in rapport building, patient assessment, and treatment planning.
Discussion:
Telehealth training developed foundational behavioral health skills but was less robust in fostering communication and nuanced decision-making. Findings highlight the need for telehealth-specific strategies, including enhanced SP training and targeted communication development. Future research should explore best practices for integrating telehealth into clinical training to optimize both technical and interpersonal skills.
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