Carolinas Research Day 2021

Medical Student Confidence and Satisfaction in Using Telemedicine Improve after Conducting Patient Encounter Emily L. Unrue, OMS II, Grayson White, OMS II, Ning Cheng, PhD, Tom Lindsey, DO, FACOS. Edward Via College of Osteopathic Medicine, Center for Simulation and Technology, Spartanburg, SC.

SIM-1

Abstract

Results

Discussion

As the COVID-19 pandemic rapidly changes the landscape of clinical medicine, it is pertinent for medical students to practice interacting with patients over telemedicine platforms. Many medical school curricula are completely devoid of telemedicine education, leaving medical students and new residents at a loss when they get to clinic. Students are aware of these deficits and recognize the benefit and relevance of additional telemedicine training in their future practice. 5 The requisite addition of a standardized telemedicine encounter to the undergraduate medical education curriculum afforded students the opportunity to evaluate their own confidence and satisfaction with telemedicine. The addition of one standardized telemedicine patient improved first year medical students’ confidence and satisfaction with a telemedicine encounter (Figure 1 and 3). Medical students reported greater confidence and satisfaction in their ability to conduct encounters, connect with patients, and preparedness to use these skills into their future practice. (Figure 1, 2 and 3). Osteopathic physicians should be aware of these findings because providing excellent care despite current limitations and social distancing guidelines is paramount for the treatment and health maintenance of our patients. Telemedicine is a solution that keep patients, providers, and learners safe from unnecessary harm. Telemedicine is an invaluable resource whose use will remain even after the pandemic resolves. Patients and physicians are facing unprecedented times. As Osteopathic physicians, we understand the impact this may have on a person’s overall well-being. 6 Using telemedicine in a way that is effective for medical care and maintains the doctor-patient relationship depends on developing unique skills. 7 Incorporation of telemedicine into undergraduate medical curriculum should become a standard in the training of osteopathic medical students.

While telemedicine has slowly gained traction over the past few years, the COVID-19 global pandemic has rapidly promoted its importance to the forefront of healthcare delivery. 1 Telemedicine offers a safe alternative to office visits, however many physicians and physicians-to-be are struggling with how to use telemedicine to best meet healthcare demands. 2,8,9 Resident physicians report an increase in their ability to utilize telemedicine after participating in a three year long course. Prior the the course few resident physicians felt they were able to utilize telemedicine in their practice, indicating that telemedicine exposure may occur after medical school. 3 While most current medical students are comfortable with using technology, many still lack the additional training needed to be fully competent in using telemedicine in practice. 5 The current level of integration of telemedicine into medical school curricula varies widely among both allopathic and osteopathic schools. Incorporation ranges from use in patient encounters, didactic learning, or scholarly projects. 4 The goal of the present study is to quantitatively evaluate first year medical students’ confidence and satisfaction with using telemedicine for patient encounters. Objective : Evaluate the role of a standardized patient encounter on first year medical student confidence and satisfaction in using telemedicine. Methods : First-year medical students recruited from Edward Via College of Osteopathic Medicine- Carolinas Campus were surveyed on their confidence and satisfaction with using telemedicine platforms before and after conducting a patient encounter. Participant confidence and satisfaction were assessed with a 5-point Likert scale. Results : Medical student confidence and satisfaction with telemedicine improved after standardized patient experience. Before the experience, 55% of students were “a little confident” or less in their ability to conduct a patient interview over telemedicine. Following the encounter, 75% of students reported feeling “somewhat confident” to “confident” in their ability. Conclusion : Growth of telemedicine over the past year has changed the delivery of healthcare, medical students must receive adequate training to practice the unique skills required for telemedicine patient encounters. Medical schools should consider adding a telemedicine curriculum and standardized patient experiences in the undergraduate medical setting. Introduction

Figure 1. Confidence in ability to conduct telemedicine patient encounters. Before performing the telemedicine patient encounter most participants reported less confidence than after performing the encounter (p < 0.0)

References

Figure 2. Confidence in establishing a doctor-patient relationship over telemedicine. Participants reported greater confidence in their ability to create a doctor- patient relationship over telemedicine after the encounter (p < 0.0)

1. Mann DM, Chen J, Chunara R, Testa PA, Nov O. COVID-19 transforms health care through telemedicine: Evidence from the field. J Am Med Inform Assoc JAMIA . 2020;27(7):1132-1135. 2. Iancu AM, Kemp MT, Alam HB. Unmuting Medical Students’ Education: Utilizing Telemedicine During the COVID-19 Pandemic and Beyond. J Med Internet Res . 2020;22(7):e19667. 3. Sartori, Daniel J; Olsen, Sonja; Weinshel, Elizabeth; Zabar, Sondra R. Medical Education . 2019 May;53(5): 517-518.

4. Sartori, Daniel J., Zabar, Sondra R., Weinshel, Elizabeth, and Olsen, Sonja K.. Gastroenterology . 2018 May;154(6): 458.

5. Kirkland EB, DuBose-Morris R, Duckett A. Telehealth for the internal medicine resident: A 3-year longitudinal curriculum. J Telemed Telecare . 2019 6. Pathipati AS, Azad TD, Jethwani K. Telemedical Education: Training Digital Natives in Telemedicine. J Med Internet Res . 2016;18(7):e193. 7. Waseh S, Dicker AP. Telemedicine Training in Undergraduate Medical Education: Mixed-Methods Review. JMIR Med Educ . 2019;5(1):e12515. 8. Talevi D, Socci V, Carai M, et al. Mental health outcomes of the CoViD-19 pandemic. Riv Psichiatr . 2020;55(3):137-144

Table 1. Participant demographics. Participant demographics were recorded and a total of 103 participants were recruited for the study, 29 participants were lost to follow up.

9. Bokolo Anthony Jnr null. Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic. J Med Syst . 2020;44(7):132.

Acknowledgements

Figure 3. Satisfaction with telemedicine. Following the encounter participants reported feeling more satisfied with their preparedness for clinical practice (p = 0.02)

Special thanks to the members of the class of 2024 who voluntarily participated in this study.

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