Virtual Care Training: A Competency-Based Telehealth Curriculum for Physician Trainees.

Abstract

Introduction: Although virtual care has rapidly expanded, standardized, competency-based training is lacking. We developed a feasible, interactive, virtual care training (VCT) curriculum for trainee physicians that is aligned with nationally recognized competency standards.

Methods: Utilizing a single-group pre-post quasi-experimental design, we implemented a three-hour, in-person, competency-based VCT program aligned with the Association of American Medical Colleges (AAMC) telehealth competencies. The program comprised a one-hour interactive didactic session followed by two one-hour activity rotations: (1) two experiential case-based activities and (2) two objective structured clinical examinations (OSCEs)-simulated encounters with standardized patients to perform a virtual physical examination and medication reconciliation. Standardized patients and faculty debriefers provided real-time feedback. Self-reported outcomes (comfort, difficulty, and likelihood to recommend) were evaluated using pre- and post-program surveys, while objective clinical performance was assessed by faculty debriefers during the OSCEs.

Results: One hundred twenty-six trainees participated in the VCT program: 119 (94.0%) completed the pre-program survey and 126 (100.0%) completed the post-program survey. Among the pre-program survey respondents, 64.0% reported having neither previous training in virtual care nor prior experience conducting a virtual care visit with a patient. Post-program, trainees reported significant improvements in being "very" or "quite" comfortable with virtual care visits (94.4% vs 36.9%), virtual physical examinations (78.5% vs 10.0%), and virtual medication reconciliation (96.0% vs 60.5%) (all p < 0.001). Perceived difficulty improved significantly after the training, with "difficult" rates dropping from 40.0% to 8.0% and "very easy" rates rising from 0.0% to 23.0%, although over half (55.0%) felt that providing virtual care was "easy" before completing the program. Lastly, trainees reported higher rates of being "extremely" or "quite" likely to recommend virtual care to patients after completing the VCT program (88.0% vs 50.4%; p < 0.001).

Conclusion: Our structured three-hour VCT program is a feasible model that leads to significant improvements in trainee confidence and the demonstrated performance of discrete telehealth tasks. This curriculum offers a scalable approach for integrating telehealth training into graduate medical education.