It's Getting Hot in Here: Piloting a Telemedicine OSCE Addressing Menopausal Concerns for Obstetrics and Gynecology Clerkship Students

Abstract

Introduction Although menopause is a common condition, trainees still express high levels of discomfort with managing climacteric symptoms. Trainees also receive little preparation for conducting telemedicine visits, which have become increasingly important in clinical care. We present a formative standardized patient (SP) encounter to introduce medical students to the diagnosis and treatment of menopausal symptoms and the process of conducting a telemedicine visit. Methods We designed a virtual telemedicine encounter with an SP for medical students. Students received feedback via a post-encounter note on history taking, differential diagnosis, and diagnostics/management and an SP debrief. We collected student input on the experience at the midpoint and end of clerkship and analyzed it for recurring themes. We calculated summary statistics from student post-encounter notes. Results Thirty-two OB/GYN students completed the menopause telemedicine SP encounter between April and June 2020. Students scored a median of 20 out of 45 (interquartile range: 18, 22) on the post-encounter note. All students correctly provided a diagnosis of perimenopause/menopause; however, 50% did not offer any strategy for counseling or managing menopausal symptoms. Students expressed discomfort with using a telehealth format (78%) but found it a useful skill to practice (47%). A majority (66%) found the educational encounter to be of excellent or above-average educational value. Discussion While medical students demonstrated discomfort with both managing menopause and utilizing a telemedicine format, this SP case provided an opportunity for them to practice both skills in a safe learning environment. The majority of participants rated the learning experience highly.

Menopause and healthcare professional education: A scoping review

“…Nine articles were concerned with postgraduate training or continuing medical education [13][14][15][16][17][18][19][20][21] and 2 with undergraduate medical education [22,23]. One article concerned textbooks [24].…”

“…Data collection methods were varied; five used survey methods, one included self-reported assessments [13,15,17,18,21], 1 considered Foucauldian discourse analysis [24], one considered a cross sectional analysis of data from the ReCEnT cohort study [14] and one considered pre and post session knowledge tests [19]. The focus of two articles was evaluation of the educational strategy used to teach about menopause [20,23].…”

“…Menopause is portrayed as failure and the precursor to disease according to the Foucauldian discourse analysis of textbooks by Reid et al [23]. Women's bodies are represented as reproductive systems that then 'fail' are 'infantile' and 'easily damaged' therefore constructing the 'normal' female as young and reproductive.…”

“…Medical students demonstrated discomfort in managing menopause [23]. They were utilising a telemedicine format when engaged in remote learning about menopause with simulated patients.…”

“…Ng et al [19] utilised a jigsaw method to enhance medical residents' knowledge and attitudes in 'managing geriatric women's health' finding this was effective in increasing knowledge and confidence. Reid et al [23] focused on the utilisaton of a telemedicine format. There was a consensus by those participating that they appreciated the teaching but there was little or no evidence of effectiveness.…”