Abstract and Introduction
Abstract
Objective: The Association of American Medical Colleges (AAMC) has recommended that the provision of telemedicine services become an entrustable professional activity (EPA). Given its increased scope, medical student comfort with telemedicine was explored.
Methods: An institutional review board–approved 17-question, anonymous voluntary survey was created based on the AAMC's EPAs and administered to students at Northeast Ohio Medical University across 4 weeks. The primary outcome of this study was to assess medical students' self-reported telemedicine comfort levels.
Results: The response rate was 141 students (22%). At least 80% of students believed that they were able to gather essential and accurate patient information, counsel patients and families, and communicate effectively across a broad range of social, economic, and cultural backgrounds using telemedicine. In total, 57% and 53% of students, respectively, believed that they were able to gather information and diagnose patients using telemedicine as well as they did in person, 38% of respondents believed that their patient's health outcome was the same via telemedicine or in-person visits, and 74% of respondents wished that telemedicine was formally taught in school. Most of the students believed they could effectively gather essential information and counsel patients via telemedicine, but there was a notable decrease in confidence for medical students when comparing telemedicine and in-person care directly.
Conclusions: Despite the EPAs created by the AAMC, students did not self-report the same comfort level with telemedicine as they had with in-person patient visits. There are opportunities for improvement in the telemedicine medical school curriculum.
Introduction
An emerging trend in the ever-evolving field of medicine is the routine use of telemedicine. Catalyzed by the coronavirus disease 2019 (COVID-19) pandemic, this tool has improved patient access to medical care. The Centers for Disease Control and Prevention notes a 154% increase in the use of telemedicine between March 2019 and March 2020. By June 2020, 35.8% of healthcare visits were conducted by telemedicine.[1] Prepandemic, only 4% of health centers had the existing technological infrastructure to provide telemedicine care.[1] Through the pandemic, 95% of health centers reported using telemedicine to provide care.[1]
Government legislation has been passed to widen access to telemedicine and increase reimbursement rates to healthcare providers.[2] In addition to outpatient visits, telemedicine has grown to create virtually monitored intensive care units and improve monitoring for chronic patient conditions on medical floors.[3] In a recent American Medical Association survey of more than 1500 physicians, 80% of the respondents indicated that telemedicine improved the timeliness of care and 68% were highly motivated to increase telemedicine use in their practices.[3]
Telemedicine has changed how we can practice medicine. The format has increased access to care and ease of follow-up, especially when there are transportation difficulties. As a result, there are opportunities for telemedicine to be formally incorporated into the medical school curriculum. Although telemedicine has not yet been formally incorporated into the Liaison Committee on Medical Education accreditation standards, the Association of American Medical Colleges (AAMC) has taken action to discuss its importance.[4] The AAMC has made an entrustable professional activity (EPA) based on providing telemedicine services.[5] EPAs are defined as activities that an organization expects its participants to perform independently and competently.[6] Through these EPAs, the AAMC delineates multiple competencies, including the ability to effectively gather information, engender trust, communicate, and use epidemiological sciences to improve care provision.[5]
Given the prevalence of telemedicine today, we wanted to explore medical student comfort with the provision of medical care through telemedicine. We hypothesized that although medical students believe that diagnostic and counseling abilities do not differ between telemedicine and in-person appointments, the therapeutic alliance and overall quality of care would be perceived as lower when using telemedicine.
South Med J. 2023;116(5):400-404. © 2023 Lippincott Williams & Wilkins
