Virtually Serving the Underserved: Resident Perceptions of Telemedicine Use While Training During Coronavirus Disease 2019

Abstract

Background: To adapt during the coronavirus disease 2019 (COVID-19) pandemic, a large safety-net hospital in Atlanta, Georgia and other hospitals across the United Sates, increased telemedicine (TM) for outpatient visits. The impact on resident physicians, including minority providers, had not yet been reported. We aimed to assess how primary care residents perceived increased TM in clinics during the pandemic, and assess resident burnout. Materials and Methods: An online survey was sent to 60 internal medicine (IM) and 18 family medicine (FM) residents who used TM to treat underserved patients, from March to May 2020, at the onset of the COVID-19 pandemic. The questionnaire included questions on resident demographics, satisfaction with TM, screening capability for COVID-19, effectiveness for patient education on COVID-19, impact on patient interactions and time management. Burnout was assessed with the Abbreviated Maslach Burnout Inventory. Results: A majority (62 of 78) eligible residents (79.5%) responded to the survey. Ninety-one percent of residents agreed that TM was a secure alternative to face-to-face encounters. Seventy-nine percent used it to screen for signs/symptoms of COVID-19 and 93% provided patient education on COVID-19. Average visit length decreased by 10-20 min with TM. Post-TM, scores for overall burnout were decreased (p = 0.0003) and less residents in total exhibited burnout (p = 0.0156). Discussion and Conclusions: IM and FM residents viewed TM as an efficient way to screen for and provide education on COVID-19, as well as a secure alternative to face-to-face encounters. With increased used of TM during COVID-19, there was decreased burnout among primary care residents.

Evaluating the impact of coronavirus disease on burnout among healthcare workers using maslach burnout inventory tool: A systematic review

“…Among the remaining three cohort studies, two studies 40,41 involved only doctors, while the last study 42 involved mixed professions. While all three studies assessed burnout before and during COVID-19 using MBI scores, Baro et al 40 and Mills et al 41 used an abbreviated MBI, which is not validated. The cohort study by Kok et al 42 collected pre-COVID-19 burnout data close to the start of COVID-19 (defined in this review as 1 December 2019).…”

“…Two of the remaining cohort studies used modified MBI 40,41 and hence were excluded for analysis. The last cohort study 42 examined burnout scores among HCWs before and during COVID-19.…”

“…Among the studies, only one study 43 had low risk of bias, 86 studies had moderate risk of bias (90.5%) and eight studies 40,41,52,61,79,84,100,122 had high risk of bias (8.4%).…”

“…Figure 2 shows the box-and-whisker plot of the weighted means for the prevalence of overall burnout, high EE, high DP, and low PA across all studies (n studies = 67), excluding those that used modified MBI (n studies = 28). 40,41,45,48,49,52,54,55,57,58,61,68,[77][78][79][93][94][95][96][97][98][99][100][101][102][103][104][105] Based on the authors' definitions of burnout and MBI cut-off scores across included studies, the mean burnout prevalence measured among HCWs during COVID-19 regardless of MBI variant was 39.95% (range: 6.00%-90.40%). The mean prevalence for high EE, high DP, and low PA were 35.92% (range: 5.61%-70.30%), 32.33% (range: 1.87%-77.01%) and 39.80% (range: 0.16%-89.09%), respectively.…”

Resident Perspectives on Using Telemedicine in Training

“…A survey from an internal medicine residency in Atlanta, GA, demonstrated decreased average visit length and a reduction in total exhibited burnout among residents in continuity clinics. 4 Overall, we support the integration of telemedicine within resident continuity clinics. However, we believe that it is absolutely crucial that formal telemedicine curricula accompany this integration.…”