Expanding Telehealth Competencies in Primary Care: A Longitudinal Interdisciplinary Simulation to Train Internal Medicine Residents in Complex Patient Care

Wong, Rachel; Ng, Patricia; Spinnato, Tracey; Taub, Erin; Kaushal, Alka; Lerman, Mark; Fernan, Alice; Dainer, Erin; Noel, Kimberly

doi:10.4300/jgme-d-20-00030.1

Cited by 19 publications

(18 citation statements)

References 18 publications

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“…This is intuitive specially for physicians who frequently use telemedicine, including those involved in internal medicine and family medicine [52]. Our findings are consistent with those of previous studies [53][54][55]. Ha et al reported that physicians who had a structured educational program in telemedicine had greater confidence in addressing clinical problems than those who did not receive an educational program [56].…”

Section: Principal Findingssupporting

confidence: 91%

Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study

Alhajri¹,

Simsekler²,

Alfalasi³

et al. 2021

JMIR Med Inform

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Background To mitigate the effect of the COVID-19 pandemic, health care systems worldwide have implemented telemedicine technologies to respond to the growing need for health care services during these unprecedented times. In the United Arab Emirates, video and audio consultations have been implemented to deliver health services during the pandemic. Objective This study aimed to evaluate whether differences exist in physicians’ attitudes and perceptions of video and audio consultations when delivering telemedicine services during the COVID-19 pandemic. Methods This survey was conducted on a cohort of 880 physicians from outpatient facilities in Abu Dhabi, which delivered telemedicine services during the COVID-19 pandemic between November and December 2020. In total, 623 physicians responded (response rate=70.8%). The survey included a 5-point Likert scale to measure physician’s attitudes and perceptions of video and audio consultations with reference to the quality of the clinical consultation and the professional productivity. Descriptive statistics were used to describe physicians’ sociodemographic characteristics (age, sex, designation, clinical specialty, duration of practice, and previous experience with telemedicine) and telemedicine modality (video vs audio consultations). Regression models were used to assess the association between telemedicine modality and physicians’ characteristics with the perceived outcomes of the web-based consultation. Results Compared to audio consultations, video consultations were significantly associated with physicians’ confidence toward managing acute consultations (odds ratio [OR] 1.62, 95% CI 1.2-2.21; P=.002) and an increased ability to provide patient education during the web-based consultation (OR 2.21, 95% CI 1.04-4.33; P=.04). There was no significant difference in physicians’ confidence toward managing long-term and follow-up consultations through video or audio consultations (OR 1.35, 95% CI 0.88-2.08; P=.17). Video consultations were less likely to be associated with a reduced overall consultation time (OR 0.69, 95% CI 0.51-0.93; P=.02) and reduced time for patient note-taking compared to face-to-face visits (OR 0.48, 95% CI 0.36-0.65; P<.001). Previous experience with telemedicine was significantly associated with a lower perceived risk of misdiagnosis (OR 0.46, 95% CI 0.3-0.71; P<.001) and an enhanced physician-patient rapport (OR 2.49, 95% CI 1.26-4.9; P=.008). Conclusions These results indicate that video consultations should be adopted frequently in the new remote clinical consultations. Previous experience with telemedicine was associated with a 2-fold confidence in treating acute conditions, less than a half of the perceived risk of misdiagnosis, and an increased ability to provide patients with health education and enhance the physician-patient rapport. Additionally, these results show that audio consultations are equivalent to video consultations in providing remote follow-up care to patients with chronic conditions. These findings may be beneficial to policymakers of e-health programs in low- and middle-income countries, where audio consultations may significantly increase access to geographically remote health services.

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Section: Principal Findingssupporting

confidence: 91%

Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study

Alhajri¹,

Simsekler²,

Alfalasi³

et al. 2021

JMIR Med Inform

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show abstract

“…Along with the creation of new telehealth sites and services, telehealth education will also highlight the concepts of interprofessional clinical support as a way of bolstering the provision of care and improving the ongoing care coordination activities that benefit from a team-based approach. 49 These approaches will be essential in services such as remote patient monitoring, where tiered teams will evaluate and adjust patients’ care plans to ensure improved health outcomes and reduced expenditures.…”

Section: Digital Disruption For Health Care Providers and Patientsmentioning

confidence: 99%

The Role of Technology in Health Professions Education During the COVID-19 Pandemic

et al. 2022

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The COVID-19 pandemic has sparked radical shifts in the ways that both health care and health professions education are delivered. Before the pandemic, some degree programs were offered fully online or in a hybrid format, but in-person learning was considered essential to the education and training of health professionals. Similarly, even as the use of telehealth was slowly expanding, most health care visits were conducted in-person. The need to maintain a safe physical distance during the pandemic rapidly increased the online provision of health care and health professions education, accelerating technology adoption in both academic and professional health care settings. Many health care professionals, educators, and patients have had to adapt to new communication modalities, often with little or no preparation. Before the pandemic, the need for cost-effective, robust methodologies to enable teaching across distances electronically was recognized. During the pandemic, online learning and simulation became essential and were often the only means available for continuity of education and clinical training. This paper reviews the transition to online health professions education and delivery during the COVID-19 pandemic and provides recommendations for moving forward.

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“…Evaluation metrics should align with the core competencies of the field of practice and include telemedicine‐specific behaviours that promote a more effective encounter 11‐14 12‐14 …”

Section: Utilising Telemedicine For Feedback and Evaluationmentioning

confidence: 99%

Can you hear me now? A toolkit for telemedicine training

Roth

Costich

Moerdler

et al. 2021

The Clinical Teacher

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Expanding Telehealth Competencies in Primary Care: A Longitudinal Interdisciplinary Simulation to Train Internal Medicine Residents in Complex Patient Care

Cited by 19 publications

References 18 publications

Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study

Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study

The Role of Technology in Health Professions Education During the COVID-19 Pandemic

Can you hear me now? A toolkit for telemedicine training

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