Training Internal Medicine Residents to Perform Telemedicine Visits: A Novel Skill-Based Curriculum.

Abstract

Introduction: Since the COVID-19 pandemic, internal medicine (IM) residents have provided patient care via telemedicine in their continuity clinics but often without formal training in telemedicine skills. To address this education gap, we developed a two-part curriculum to improve IM residents' self-perceived competence with outpatient telemedicine skills.

Methods: From May to August 2020, IM residents participated in a 45-minute interactive case-based, small-group discussion focused on patient triage, virtual physical examination, and telemedicine communication skills. Faculty preceptors directly observed resident telemedicine visits and provided residents with formative feedback using a checklist. Residents completed pre- and postsession surveys assessing self-perceived competence with 15 telemedicine skills.

Results: A total of 119 residents participated in the case-based session, and most (61%) received direct observation. Among these residents, 51% (61/119) completed both pre- and postsession surveys. After completing the curriculum, residents' self-perceived competence increased for all skills, with the largest gains in triaging patients to visit types, physical exam adaptation, addressing preventative care, and arranging follow-up (mean 0.5 increase in participant ratings based on 5-point Likert scale; p < .001). Improvement in self-perceived competence was independent of resident level of training and video visit volume. Faculty performing direct observations expressed high levels of confidence in the care delivered.

Discussion: This easily implemented curriculum combining a case-based discussion with direct observation increased IM residents' self-perceived competence in telemedicine skills and could be readily adopted in IM residency programs and various specialties to provide trainees with telemedicine skills.