How to incorporate telemedicine into clinical training

During the COVID-19 pandemic, telemedicine has become a paramount part of clinical training. However, care needs to be taken to make sure that learners and faculty alike are set up to succeed in this new medium.

There is an AMA (American Medical Association) webinar available on how to make the transition, which features guidance from physician experts. The webinar is called “Engaging Learners in Telemedicine Visits: Workflows to Support Teaching, Feedback, and Billing” and it features speakers from the AMA’s senior medical staff along with other medical education leaders. Virtual learning can indeed be quite different from in-person learning, hence the webinar outlines the key steps to make sure that virtual learning is a positive learning experience.

Remove logistical hurdles. Learners and faculty can use guidance in downloading the required software and setting up video conferencing in their homes. No matter which video conferencing platform is chosen, training may be necessary. It is best not to assume that instructors and students will immediately understand it straight away. Moreover, it is helpful to have transparent preceptor expectations. This includes clear schedules for who’s available as you don’t always know who is physically in the clinic under these new learning situations. Last but not least, establishing a background communication channel, for example, private messaging on the video conferencing platform or texting, as well as getting used to pre-briefing and debriefing.

Focus on creating new skills. Teaching students how to perform clinical assessments over a video conference requires rethinking the fundamentals of patient-physician interaction. Some examples are how to undertake a physical exam. What is different about taking a patient’s history? How to communicate with a patient effectively.

Panel management will also be different. For example, how high-risk patients should be identified and encouraged to try video conferencing for their appointment? This type of learning can be thought of as experiential. Also, there is the possibility that faculty are not experienced in telemedicine either, so they too may not be able to capture the unknowns.

Make the most of the technology. Telemedicine can also present an opportunity to maximize learning: there are real-time background channels for learning, meaning that students can look something up on their own screens if they are unsure what faculty are talking about.

In addition to this, educational conferences are more accessible than ever with the use of videocall. Distance is no barrier and the costs of attending remote conferences are very low. Unlocking the platform is a question of mindset, and there is potential even to improve the in-person interactions using the telemedicine clinical experience.

When using EHRs as paper charts in electronic form, their potential is rarely realised. The same mistake should not be made with telehealth. Instead, we should enhance this encounter and not just replace the existing situations.

A resource center was developed by the AMA along with a physician’s guide to COVID-19. This is to give doctors a fully comprehensive area to find the latest updates and resources from the Centers for Disease Control and Prevention and the World Health Organization.

The AMA has also created many resources to help residents and medical students during the pandemic. These resources are made to help with the shifting timelines, cancellations and adjustments to testing, rotations and other events.