Advanced Communication and Examination Skills in Telemedicine: A Structured Simulation-Based Course for Medical Students

Abstract

Introduction Telemedicine has become part of mainstream medical practice. High quality virtual care is a skill that will be required of many physicians. Skills required for effective evaluation and communication during a video encounter differ from skills required at bedside, yet few rubrics for educational content and student performance evaluation in telemedicine training have been developed. Our objective was to develop, implement, and assess a training module designed to teach medical providers techniques to deliver professional, effective, and compassionate care during a telemedicine encounter. Methods We created a simulation-based, 8-hour modular curriculum using the PEARLS debriefing framework with video-based encounters focused on “web-side manner” as a critical corollary to traditional bedside manner. We recorded simulated cases for each student with standardized patients, guided debriefs, and incorporated small-group exercises to teach advanced communication and examination skills. Results Of medical students, 98 in their major clinical year participated in 2019. Of participants, 97% were enthusiastic about the course; 100% felt simulation was an effective mechanism for delivery of the educational material. After participation, 71% believed that telemedicine had the potential to become part of their future practice; 92% perceived an improvement in their comfort and ability to conduct video-based patient encounters. Discussion Teaching telemedicine using this methodology was well received by students, providing early exposure to this evolving aspect of medical practice. Qualitative comments were used for targeted improvements of the content and delivery for curriculum development. Objective assessment tools of students completing telemedicine encounters need to be created.

A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

“…145 To overcome these limitations, a new curriculum is being developed to train providers in "web-side manner." 147 In general, telemedicine does not facilitate high-quality communication between patients and providers. Nonverbal cues can be missed, including facial expressions hidden by masks.…”

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