AUTHOR=Bajra Rika , Srinivasan Malathi , Torres Elise Cheng , Rydel Tracy , Schillinger Erika 

TITLE=Training future clinicians in telehealth competencies: outcomes of a telehealth curriculum and teleOSCEs at an academic medical center

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1222181

DOI=10.3389/fmed.2023.1222181

ISSN=2296-858X

ABSTRACT=Background: This report describes program and learner outcomes of a telehealth skills curriculum based on the Association of American Medical Colleges (AAMC) telehealth competencies for clerkship-level medical students.Methods:133 third-and fourth-year medical students in a required Family Medicine clerkship at Stanford University School of Medicine participated in a telehealth curriculum, including a telehealth workshop, site-specific telehealth clinical encounters, and teleOSCEs between July 2020 and August 2021. Workshop communication and physical examination competencies were assessed in two teleOSCEs utilizing a novel telehealth assessment tool. Students' attitudes, skills, and self-efficacy were assessed through voluntary pre-clerkship, post-workshop, and post-OSCE surveys.Discussion: Most learners reported low confidence in their telehealth physical examinations (n=79, mean=1.6 [scale 0-5, 5= very confident,SD=1.0]), which improved post-workshop (n=69, 3.3 [0.9], p<0.001); almost all (97%, 70/72) felt the workshop prepared them to see patients in clinic. In formative OSCEs, learners demonstrated appropriate "webside manner" (communication scores 94% to 99%, 4 items), but did not confirm confidentiality (21%) or review limitations of the visit (35%). In a low back pain OSCE, most learners assessed pain location (90%) and range of motion (87%), nearly half (48%) omitted strength testing.Conclusion: Our telehealth curriculum demonstrated that telehealth competencies can be taught and assessed in medical student education. Improvement in self-efficacy scores suggest that an 80-minute workshop can prepare students to see patients in the clinical setting. Assessment of OSCE data informs opportunities for growth for further development in the curriculum including addressing visit limitations and confidentiality in telehealth visits.