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TitleNational survey of telemedicine education and training in medical schools in France.
AuthorsYaghobian, S; Ohannessian, R; Mathieu-Fritz, A; Moulin, T
JournalJournal of telemedicine and telecare
Publication Date1 Jun 2020
Date Added to PubMed4 Jan 2019
AbstractTelemedicine is a remote medical practice using information communication technology (ICT), and has been increasing in France since 2009. With all new forms of medical practice, education and training (ET) is required for quality and safety. To date, implementation of telemedicine ET has not been assessed in France. The objective of this study was to describe the implementation of telemedicine ET and evaluate the knowledge, attitudes and practices (KAP) of deans and associate deans from all medical schools in France. A cross-sectional non-mandatory, descriptive online survey with a self-administered questionnaire was performed from 15 November to 6 December, 2017. Respondents were accessed through the 'Conférence des doyens des Facultés de médecine'. There were 48 respondents with a 47.4% response rate among deans. Telemedicine ET was limited in France; 10.4% in 1st year medicine (PACES); 4% in the final 3 years of medical school (D.F.A.S.M.) and 18.8% in medical residency. Emergency medicine, dermatology, radiology, neurology and geriatrics were specialties with implemented telemedicine training during residency. Of all respondents, 90% expressed a need to increase telemedicine ET, among which 75% accepted external support. A highly positive attitude towards telemedicine practice was reflected by 60.4% of respondents, and 56.2% practiced telemedicine at least once. This study was the first to assess national telemedicine ET implementation in France. Telemedicine was integrated into initial medical education; however, telemedicine ET remains limited despite the positive attitudes of deans and associate deans. Further research would need to be conducted on telemedicine ET implementation and KAP of medical students and residents.
TitleAddressing the Covid-19 Burden on Medical Education and Training: The Role of Telemedicine and Tele-Education During and Beyond the Pandemic.
AuthorsSharma, D; Bhaskar, S
JournalFrontiers in public health
Publication Date1 Dec
Date Added to PubMed18 Dec 2020
AbstractMedical students are the future of sustainable health systems that are severely under pressure during COVID-19. The disruption in medical education and training has adversely impacted traditional medical education and medical students and is likely to have long-term implications beyond COVID-19. In this article, we present a comprehensive analysis of the existing structural and systemic challenges applicable to medical students and teaching/training programs and the impact of COVID-19 on medical students and education. Use of technologies such as telemedicine or remote education platforms can minimize increased mental health risks to this population. An overview of challenges during and beyond the COVID-19 pandemic are also discussed, and targeted recommendations to address acute and systemic issues in medical education and training are presented. During the transition from conventional in-person or classroom teaching to tele-delivery of educational programs, medical students have to navigate various social, economic and cultural factors which interfere with their personal and academic lives. This is especially relevant for those from vulnerable, underprivileged or minority backgrounds. Students from vulnerable backgrounds are influenced by environmental factors such as unemployment of themselves and family members, lack of or inequity in provision and access to educational technologies and remote delivery-platforms, and increased levels of mental health stressors due to prolonged isolation and self-quarantine measures. Technologies for remote education and training delivery as well as sustenance and increased delivery of general well-being and mental health services to medical students, especially to those at high-risk, are pivotal to our response to COVID-19 and beyond.
TitleBuilding Telemedicine Capacity for Trainees During the Novel Coronavirus Outbreak: a Case Study and Lessons Learned.
AuthorsLawrence, K; Hanley, K; Adams, J; Sartori, DJ; Greene, R; Zabar, S
JournalJournal of general internal medicine
Publication Date1 Sep 2020
Date Added to PubMed10 Jul 2020
AbstractHospital and ambulatory care systems are rapidly building their virtual care capacity in response to the novel coronavirus (COVID-19) pandemic. The use of resident trainees in telemedicine is one area of potential development and expansion. To date, however, training opportunities in this field have been limited, and residents may not be adequately prepared to provide high-quality telemedicine care. This study evaluates the impact of an adapted telemedicine Objective Structured Clinical Examination (OSCE) on telemedicine-specific training competencies of residents. Primary Care Internal Medicine residents at a large urban academic hospital. In March 2020, the New York University Grossman School of Medicine Primary Care program adapted its annual comprehensive OSCE to a telemedicine-based platform, to comply with distance learning and social distancing policies during the COVID-19 pandemic. A previously deployed in-person OSCE on the subject of a medical error was adapted to a telemedicine environment and deployed to 23 primary care residents. Both case-specific and core learning competencies were assessed, and additional observations were conducted on the impact of the telemedicine context on the encounter. Three areas of telemedicine competency need were identified in the OSCE case: technical proficiency; virtual information gathering, including history, collateral information collection, and physical exam; and interpersonal communication skills, both verbal and nonverbal. Residents expressed enthusiasm for telemedicine training, but had concerns about their preparedness for telemedicine practice and the need for further competency and curricular development. Programs interested in building capacity among residents to perform telemedicine, particularly during the COVID-19 pandemic, can make significant impact in their trainees' comfort and preparedness by addressing key issues in technical proficiency, history and exam skills, and communication. Further research and curricular development in digital professionalism and digital empathy for trainees may also be beneficial.
TitleTelemedicine Training in Undergraduate Medical Education: Mixed-Methods Review.
AuthorsWaseh, S; Dicker, AP
JournalJMIR medical education
Publication Date8 Apr 2019
Date Added to PubMed9 Apr 2019
AbstractTelemedicine has grown exponentially in the United States over the past few decades, and contemporary trends in the health care environment are serving to fuel this growth into the future. Therefore, medical schools are learning to incorporate telemedicine competencies into the undergraduate medical education of future physicians so that they can more effectively leverage telemedicine technologies for improving the quality of care, increasing patient access, and reducing health care expense. This review articulates the efforts of allopathic-degree-granting medical schools in the United States to characterize and systematize the learnings that have been generated thus far in the domain of telemedicine training in undergraduate medical education. The aim of this review was to collect and outline the current experiences and learnings that have been generated as medical schools have sought to implement telemedicine capacity-building into undergraduate medical education. We performed a mixed-methods review, starting with a literature review via Scopus, tracking with Excel, and an email outreach effort utilizing telemedicine curriculum data gathered by the Liaison Committee on Medical Education. This outreach included 70 institutions and yielded 7 interviews, 4 peer-reviewed research papers, 6 online documents, and 3 completed survey responses. There is an emerging, rich international body of learning being generated in the field of telemedicine training in undergraduate medical education. The integration of telemedicine-based lessons, ethics case-studies, clinical rotations, and even teleassessments are being found to offer great value for medical schools and their students. Most medical students find such training to be a valuable component of their preclinical and clinical education for a variety of reasons, which include fostering greater familiarity with telemedicine and increased comfort with applying telemedical approaches in their future careers. These competencies are increasingly important in tackling the challenges facing health care in the 21st century, and further implementation of telemedicine curricula into undergraduate medical education is highly merited.
TitleBuilding Capacity and Training for Digital Health: Challenges and Opportunities in Latin America.
AuthorsCurioso, WH
JournalJournal of medical Internet research
Publication Date18 Dec 2019
Date Added to PubMed19 Dec 2019
AbstractTackling global health challenges demands the appropriate use of available technologies. Although digital health could significantly improve health care access, use, quality, and outcomes, realizing this possibility requires personnel trained in digital health. There is growing evidence of the benefits of digital health for improving the performance of health systems and outcomes in developed countries. However, significant gaps remain in resource-constrained settings. Technological and socio-cultural disparities between different regions or between provinces within the same country are prevalent. Rural areas, where the promise and need are highest, are particularly deprived. In Latin America, there is an unmet need for training and building the capacity of professionals in digital health. This viewpoint paper aims to present a selection of experiences in building digital health capacity in Latin America to illustrate a series of challenges and opportunities for strengthening digital health training programs in resource-constrained environments. These describe how a successful digital health ecosystem for Latin America requires culturally relevant and collaborative research and training programs in digital health. These programs should be responsive to the needs of all relevant regional stakeholders, including government agencies, non-governmental organizations, industry, academic or research entities, professional societies, and communities. This paper highlights the role that collaborative partnerships can play in sharing resources, experiences, and lessons learned between countries to optimize training and research opportunities in Latin America.
TitleRemote Mentoring of Point-of-Care Ultrasound Skills to Inexperienced Operators Using Multiple Telemedicine Platforms: Is a Cell Phone Good Enough?
AuthorsSmith, A; Addison, R; Rogers, P; Stone-McLean, J; Boyd, S; Hoover, K; Pollard, M; Dubrowski, A; Parsons, M
JournalJournal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
Publication Date1 Nov 2018
Date Added to PubMed27 Mar 2018
AbstractTelemedicine technology contributes to the teaching of point-of-care ultrasound (US); however, expensive equipment can limit its deployment in resource-challenged settings. We assessed 3 low-cost telemedicine solutions capable of supporting remote US training to determine feasibility, acceptability, and effectiveness. We also explored the value of instructional videos immediately before telementoring. Thirty-six participants were randomly assigned to receive US mentoring in 1 of 3 telemedicine conditions: multiple fixed cameras, a smartphone, and traditional audio with a live US stream. Participants were then asked to perform a standardized US examination of the right upper quadrant under remote guidance. We measured observer's global ratings of performance along with the mentor's and student's rating of effort and satisfaction to determine which of the 3 approaches was most feasible, acceptable, and effective. During the second phase, students were randomized to watch an instructional video or not before receiving remote coaching on how to complete a subxiphoid cardiac examination. Effort, satisfaction, and performance from the independent observer's and student's perspective were surveyed. There was no significant difference between the different telemedicine setups from the observer's perspective; however, the mentor rated the smartphone significantly worse (P = .028-.04) than other technologies. Platforms were rated equivalent from the student's perspective. No benefit was detected for watching an instructional video before the mentored task. Remote US skills can be taught equally effectively by using a variety of telemedicine technologies. Smartphones represent a viable option for US training in resource-challenged settings.
TitleEvaluation of a telemedicine-based training for final-year medical students including simulated patient consultations, documentation, and case presentation.
AuthorsHarendza, S; Gärtner, J; Zelesniack, E; Prediger, S
JournalGMS journal for medical education
Publication Date1 Dec 2020
Date Added to PubMed29 Dec 2020
AbstractBackground: Focused history taking, knowledge-based clinical reasoning, and adequate case presentation during hand-offs represent important facets of competence of practicing physicians. Based on a validated 360-degree assessment simulating a first day of residency we developed a training for final-year medical students including patient consultation, patient management, and patient hand-off. Due to the COVID-19 pandemic the training was changed to a telemedicine format and evaluated. Methods: In 2019, 103 final-year students participated in a newly designed competence-based training including a consultation hour with simulated patients, a patient management phase with an electronic patient chart, and a case presentation in hand-off format. Due to social distancing regulations, the training was not allowed to take place in this way. Therefore, we changed the training to a telemedicine format. In May 2020, 32 students participated in the telemedicine training. A 5-point Likert scale (1: does not apply to 5: fully applies) was used for the evaluation items. The two formats were compared with t-tests. Results: The students were similarly satisfied with the content of the training independently of its format. Both groups found the patient cases interesting (presence: 4.68 ± 0.49, telemedicine: 4.66 ± 0.48). With respect to the telemedicine format, participants were glad that an option had been found that could be offered throughout the final year (4.94 ± 0.24) despite the COVID-19 pandemic and they regarded it as a very useful training for their final examination (4.94 ± 0.24). Conclusion: The telemedicine format of the competence-based training worked as well as the presence format. In its telemedicine format, the training can be offered to students independently of their location. Copyright © 2020 Harendza et al.HarendzaSigridSUniversitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany.GärtnerJuliaJUniversitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany.ZelesniackElenaEUniversitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany.PredigerSarahSUniversitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany.engJournal ArticleResearch Support, Non-U.S. Gov't20201203GermanyGMS J Med Educ1016760862366-5017IMCOVID-19epidemiologyClinical CompetenceEducation, Distanceorganization & administrationEducation, Medicalorganization & administrationHumansPandemicsPatient Care ManagementstandardsPatient HandoffstandardsPatient SimulationSARS-CoV-2Students, MedicalpsychologyTelemedicineorganization & administrationHintergrund: Fokussierte Anamneseerhebung, wissensbasiertes klinisches Argumentieren und adäquate Fallpräsentationen in Übergabegesprächen stellen wichtige Kompetenzfacetten praktizierender Ärzt*innen dar. Basierend auf einer validierten 360-Grad Beurteilung eines simulierten ersten Arbeitstags in der ärztlichen Weiterbildung im Krankenhaus entwickelten wir ein Training für Studierende im Praktischen Jahr (PJ) mit einer Sprechstunde, einer Patient*innenbetreuungsphase und einem Übergabegespräch. Aufgrund der COVID-19 Pandemie wurde das Training in ein telemedizinisches Format umgewandelt und evaluiert.Methoden: Im Jahr 2019 nahmen 103 PJ-Studierende an einem neu entwickelten, kompetenzbasierten Training teil, das seine Sprechstunde mit Simulationspatient*innen, eine Patient*innenbetreuungsphase mit einer elektronischen Patient*innenakte und eine Patient*innenfallpräsentation im Übergabeformat beinhaltete. Aufgrund der Abstandsregeln gab es keine Genehmigung, das Training in dieser Weise durchzuführen. Daher wandelten wir das Training in ein Telemedizinformat um. Im Mai 2020 nahmen 32 Studierende an dem Telemedizintraining teil. Eine 5-Punkte Likert Skala (1: trifft nicht zu, bis 5: trifft voll zu) wurde für die Evaluationsitems eingesetzt. Die beiden Formate wurden mittels t-Test verglichen.Ergebnisse: Die Studierenden waren unabhängig vom Trainingsformat gleichermaßen mit den Inhalten des Trainings zufrieden. Beiden Gruppen fanden die Patient*innenfälle interessant (Präsenz: 4,68±0,49; Telemedizin: 4,66±0,48). In Bezug auf das Telemedizinformat waren die Teilnehmenden froh, dass eine Möglichkeit gefunden wurde, die trotz der COVID-19 Pandemie über das gesamte PJ hinweg durchgeführt werden kann (4,94±0,24) und sie erachteten das Format als sehr nützliches Training für ihre Abschlussprüfung (4,94±0,24).Schlussfolgerung: Das Telemedizinformat des kompetenzbasierten Trainings funktionierte genauso gut wie das Präsenzformat. Im Telemedizinformat kann das Training Studierenden unabhängig von deren Standort angeboten werden.
TitleSERIES: eHealth in primary care. Part 3: eHealth education in primary care.
AuthorsHouwink, EJF; Kasteleyn, MJ; Alpay, L; Pearce, C; Butler-Henderson, K; Meijer, E; van Kampen, S; Versluis, A; Bonten, TN; van Dalfsen, JH; van Peet, PG; Koster, Y; Hierck, BP; Jeeninga, I; van Luenen, S; van der Kleij, RMJJ; Chavannes, NH; Kramer, AWM
JournalThe European journal of general practice
Publication Date1 Dec 2020
Date Added to PubMed8 Aug 2020
AbstractEducation is essential to the integration of eHealth into primary care, but eHealth is not yet embedded in medical education. In this opinion article, we aim to support organisers of Continuing Professional Development (CPD) and teachers delivering medical vocational training by providing recommendations for eHealth education. First, we describe what is required to help primary care professionals and trainees learn about eHealth. Second, we elaborate on how eHealth education might be provided. We consider four essential topics. First, an understanding of existing evidence-based eHealth applications and conditions for successful development and implementation. Second, required digital competencies of providers and patients. Third, how eHealth changes patient-provider and provider-provider relationships and finally, understanding the handling of digital data. Educational activities to address these topics include eLearning, blended learning, courses, simulation exercises, real-life practice, supervision and reflection, role modelling and community of practice learning. More specifically, a CanMEDS framework aimed at defining curriculum learning goals can support eHealth education by describing roles and required competencies. Alternatively, Kern's conceptual model can be used to design eHealth training programmes that match the educational needs of the stakeholders using eHealth. Vocational and CPD training in General Practice needs to build on eHealth capabilities now. We strongly advise the incorporation of eHealth education into vocational training and CPD activities, rather than providing it as a separate single module. How learning goals and activities take shape and how competencies are evaluated clearly requires further practice, evaluation and study.
TitleExperiences of telehealth e-mentoring within postgraduate musculoskeletal physical therapy education in the UK and Canada: a protocol for parallel mixed-methods studies and cross-cultural comparison.
AuthorsHeneghan, NR; Nazareth, M; Johnson, WJ; Tyros, I; Sadi, J; Gillis, H; Rushton, AB
JournalBMJ open
Publication Date5 Feb 2021
Date Added to PubMed8 Feb 2021
AbstractMentored clinical practice is central to demonstrating achievement of International Educational Standards in advanced musculoskeletal physical therapy. While traditionally delivered face-to-face, telehealth e-mentoring is a novel alternative to offering this unique pedagogy to facilitate mentee critical reflection, deeper learning and enhanced knowledge translation to optimise patient care. With COVID-19 resulting in widespread adoption of telehealth and access to mentors often limited by geography or cost, the potential value of telehealth e-mentoring needs investigating. To investigate the experiences and outcomes of multiple stakeholders (student mentees, mentors and patients) engaged in musculoskeletal physical therapy telehealth e-mentoring across two universities (UK and Canada). Using case study design, we will use sequential mixed methods involving qualitative and quantitative components based on existing evidence. To examine the influence of telehealth e-mentoring on health outcomes in patients with musculoskeletal complaints, we will use patient-reported outcomes for satisfaction, patient empowerment and change in musculoskeletal health. We will conduct semistructured interviews to explore the development of critical thinking, clinical reasoning, communication skills and confidence of students engaged in telehealth e-mentoring. To explore the mentor acceptability and appropriateness of telehealth e-mentoring, we will conduct a focus group in each site. Finally, we will include a focus group of participants from each site to allow a cross-cultural comparison of findings to inform international stakeholders. Quantitative data will be analysed using descriptive statistics (median and IQR) to describe changes in outcome data and qualitative data will be analysed following the Framework Method. This study has ethical approval from both institutions: the University of Birmingham (ERN_20-0695) and Western University (2020-116233-47832). Findings will be published in a peer-reviewed journal and disseminated to key stakeholders in musculoskeletal physical therapy education and practice.
TitleUnmuting Medical Students' Education: Utilizing Telemedicine During the COVID-19 Pandemic and Beyond.
AuthorsIancu, AM; Kemp, MT; Alam, HB
JournalJournal of medical Internet research
Publication Date20 Jul 2020
Date Added to PubMed3 Jul 2020
AbstractDue to the coronavirus disease (COVID-19) pandemic, medical schools have paused traditional clerkships, eliminating direct patient encounters from medical students' education for the immediate future. Telemedicine offers opportunities in a variety of specialties that can augment student education during this time. The projected growth of telemedicine necessitates that students learn new skills to be effective providers. In this viewpoint, we delineate specific telehealth opportunities that teach core competencies for patient care, while also teaching telemedicine-specific skills. Schools can further augment student education through a variety of telemedicine initiatives across multiple medical fields. The explosion of telemedicine programs due to the pandemic can be a catalyst for schools to integrate telemedicine into their current curricula. The depth and variety of telemedicine opportunities allow schools to continue providing high-quality medical education while maintaining social distancing policies.
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