The TeleHealth OSCE: Preparing Trainees to Use Telemedicine as a Tool for Transitions of Care

Telemedicine holds promise to bridge the transition of care between inpatient and outpatient settings. Despite this, the unique communication and technical skills required for virtual encounters are not routinely taught or practiced in graduate medical education (GME) programs. To develop an objecti...

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Bibliographic Details
Published in:Journal of graduate medical education 2020-12, Vol.12 (6), p.764-768
Main Authors: Sartori, Daniel J, Hayes, Rachael W, Horlick, Margaret, Adams, Jennifer G, Zabar, Sondra R
Format: Article
Language:English
Subjects:
Aftercare
Brief Report
Clinical Competence
Educational Measurement
Humans
Internship and Residency
Patient Discharge
Physical Examination
Telemedicine
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Summary:Telemedicine holds promise to bridge the transition of care between inpatient and outpatient settings. Despite this, the unique communication and technical skills required for virtual encounters are not routinely taught or practiced in graduate medical education (GME) programs. To develop an objective structured clinical examination (OSCE) case to assess residents' telemedicine-specific skills and identify potential gaps in our residency program's curriculum. As part of a multi-station OSCE in 2019, we developed a case simulating a remote encounter between a resident and a recently discharged standardized patient. We developed an assessment tool comprising specific behaviors anchored to "not done," "partly done," and "well done" descriptors to evaluate core communication and telemedicine-specific skills. Seventy-eight NYU internal medicine residents participated in the case. Evaluations from 100% of participants were obtained. Residents performed well in Information Gathering and Relationship Development domains. A mean 95% (SD 3.3%) and 91% (SD 4.9%) of residents received "well done" evaluations across these domains. A mean 78% (SD 14%) received "well done" within Education/Counseling domain. However, only 46% (SD 45%) received "well done" evaluations within the Telemedicine domain; specific weak areas included performing a virtual physical examination (18% well done) and leveraging video to augment history gathering (17% well done). There were no differences in telemedicine-specific skill evaluations when stratified by training track or postgraduate year. We simulate a post-discharge virtual encounter and present a novel assessment tool that uncovers telemedicine-specific knowledge gaps in GME trainees.
ISSN:1949-8349
1949-8357
DOI:10.4300/JGME-D-20-00039.1