Integrating Medical and Physician Assistant Students Into Telemedicine: A Survey of Clinical Workflow and Platform...

There has been a steady increase in the adoption of telemedicine over time, with a dramatic surge in use during the COVID-19 pandemic. This rapid expansion highlighted telemedicine's importance in healthcare delivery but created uncertainty for medical educators regarding how best to integrate clinical learners into virtual visits. To address this gap, we conducted a multi-institutional, cross-sectional survey using snowball sampling to evaluate telemedicine workflows used to incorporate clinical students into patient encounters during the pandemic.

To describe how clinical students and educators perceived student participation models, educator workflows, and platform features that supported learner integration into telemedicine encounters during the COVID-19 pandemic.

We conducted an observational cross-sectional survey of third and fourth-year allopathic and osteopathic medical students, second-year physician assistant (PA) students, and clinical educators (resident and attending physicians, and advanced practice providers) in the United States between November 2020 and February 2021. We distributed the questionnaire electronically to educators at eligible institutions and used a snowball sampling; a response rate could not be calculated given this recruitment method. Survey items addressed participant demographics, telemedicine platforms used, availability of telemedicine curricula, workflows for integrating remotely located students into live patient encounters, and perceived educational utility of telemedicine.

In total, 95 students and 115 educators completed the survey. Among student respondents to the primary outcome item (n = 83), 75 students (90.4%) perceived telemedicine to be beneficial to their medical education. Of those who reported benefit, 57 students (76.0%) perceived that participation in telemedicine visits was helpful for future clinical practice. Both students and educators perceived several telemedicine platform features as supportive educational encounters, including the ability to add learners to patient encounters, the absence of time limits on visits, and functionality that allows post-encounter case debriefing between educators and learners. Many respondents reported that their telemedicine platforms lacked these features, which they perceived as limiting optimal educational integration.

Telemedicine represents a valuable and enduring modality for integrating clinical education into patient care workflows. Survey findings indicate that participants perceived telemedicine teaching workflows to be most effective when they mirrored traditional face-to-face clinical encounters. Though students perceived telemedicine participation as helpful preparation for future practice, inconsistent platform capabilities and lack of standardized workflows were identified as ongoing challenges. These findings are exploratory and reflect perceptions rather than objective outcomes. Developing standardized guidance and advocating for platforms that support multiple participants are essential to optimize learner integration and ensure high-quality clinical education in virtual care environments.