key: cord-313140-8043wvpa
authors: Cain, Robert; Shafer Klink, Dane; Yunus, Samina
title: Telemedicine implementation in family medicine: Undergraduate clerkship during COVID‐19 pandemic
date: 2020-09-22
journal: Med Educ
DOI: 10.1111/medu.14313
sha: 
doc_id: 313140
cord_uid: 8043wvpa

nan

The COVID-19 pandemic forced cancellation of student clinical activities abruptly in March 2020. Clinical patient contact was needed to supplement the online curriculum that was implemented, whereas students were barred from clinical settings.

Introducing medical students to virtual visits with patients as an alternative to real-time patient contact during the COVID-19 crisis.

Shortly before the onset of the pandemic, our organisation had prioritised the implementation of 'virtual visits' using a proprietary video platform as a method of patient population management. With the onset of the pandemic in our region, these types of visit quickly became the standard format for out-patient visits. We developed a pilot programme to see whether students in their family medicine clerkship would benefit from patient interactions in these visits.

Telemedicine has become an increasingly adopted part of undergraduate medical training in the United States, 1 but had only been available on an elective basis at our school before this.

Student volunteers were recruited from the cohort scheduled to begin their clerkship in early April. They worked with clinical faculty conducting virtual visits individually or jointly with the faculty.

Students worked remotely to ensure their safety. Patients were selected in advance and screened for their consent to participate and to ensure they had the appropriate virtual interfaces. Students were able to review charts in advance via their remote access to our EHR platform (Epic). Ongoing feedback was provided by text messages or by the chat function of the EHR. At the conclusion of the visit, students were able to document the visit in the chart, and this was reviewed and attested by the attending.

Students readily adapted to this type of patient visit. A postparticipation survey (1 = strongly disagree and 5 = strongly agree) of the students revealed: Connecting was easy and intuitive (3.80/5), meaningful connection with the patient was established (4.20), format was sufficient to demonstrate clinical skill to preceptor (3.60), student felt confident in ability to thoroughly assess patient's complaints in virtual setting (3.80), and preceptor was able to teach sufficiently using virtual format (4.40).

Student participants felt that the experience was a meaningful introduction to telemedicine, provided an excellent opportunity to work on interviewing skills and provided a chance to work on a virtual team for the first time. Technical obstacles were very minor.

They expressed the importance of communication with the attending physician before the clinic, and a post-clinic phone session for feedback and additional learning suggestions. Physical examination options were limited in this format.

Students and faculty alike felt the programme was a valid format for clinical experiences during clerkships and endorsed expanding it to all students training in family medicine at our institution.

https://orcid.org/0000-0002-2553-563X

Telemedicine training in undergraduate medical education: mixed-methods review