将远程医疗培训纳入医学研究生教育课程

Nubaha Elahi, Keegan McNally, L. Ganti, D. Lebowitz, T. Macintosh, C. Plamoottil, William Gonzalez
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摘要

本研究的主要目的是检查目前急诊科住院医师对远程医疗的了解程度,让住院医师虚拟接触标准化远程医疗患者,并分析远程医疗培训对成功完成会诊的效果。急诊科住院医师首先使用 ZoomTM 电信应用程序进行虚拟标准化远程医疗会诊,但事先未接受远程医疗培训。然后,通过一份包含成功远程医疗会诊各个方面的调查表,询问标准化病人在这次未经培训的会诊中是否成功。接下来,由一名远程医疗医生进行讲座。干预结束后,住院医师再次进行虚拟会诊,由标准化病人回答与成功会诊基本方面相同的问题。住院医师还接受了关于培训体验的后期调查。在获得知情同意(0% vs. 61%,p = 0.00012)、询问患者环境中的隐私(6% vs. 87%,p <0.00001)、核实姓名和/或出生日期(29% vs. 94%,p =0.00014)、向患者解释远程医疗流程和期望(0% vs. 94%,p <0.00001)等方面,与以往的虚拟会诊相比,差异具有统计学意义。在以下方面没有统计学意义:住院医师自我介绍(94% vs. 100%,P =0.31732)、有针对性地询问病情(100% vs. 100%,P =1)、通过解释护理计划结束会面(94% vs. 94%,P =1)。总体而言,急诊科住院医师在接受了该领域专家的培训后,在与标准化病人会诊时,在远程医疗所特有的方面有了显著提高。全国各地的急诊医学住院医生都可以很容易地接受类似的培训。由于 COVID-19 大流行造成的全球健康危机,这种培训在未来可能会被证明是非常重要的,而且对于农村急诊病人护理和远程教育项目来说也是如此。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Integrating Telemedicine Training into the Graduate Medical Education Curriculum
The primary objective of this study was to examine current emergency medicine resident knowledge of telemedicine, expose residents to standardized telemedicine patients virtually, and analyze the effectiveness of telemedicine training on completing a successful encounter. emergency medicine residents first underwent a virtual standardized telemedicine encounter using the ZoomTM telecommunications application without prior training in telemedicine. Standardized patients were then queried on resident success during this untrained encounter using a survey with aspects of a successful telemedicine encounter. The following session involved a lecture by a telemedicine physician. After this intervention, the residents underwent a repeat virtual encounter, with standardized patients responding to the same questions on the fundamental aspects of a successful interview. Residents also underwent a post-survey on their experiences with the training. Statistically significant differences were noted on aspects of the encounter related to obtaining informed consent (0% vs. 61%, p = 0.00012), asking about privacy in the patient’s environment (6% vs. 87%, p <0.00001), verifying name and/or date of birth (29% vs. 94%, p =0.00014), explaining the telehealth process and expectations to the patient (0% vs. 94%, p <0.00001). No statistical significance was seen with: resident introducing themselves (94% vs. 100%, p =.31732), asking focused questions about medical condition (100% vs. 100% p = 1), closing the encounter by explaining care plan (94% vs. 94%, p = 1). Overall, emergency medicine residents had significant improvement on aspects of an encounter with a standardized patient that were unique to telemedicine after undergoing training from an expert in the field. Similar training could easily be utilized across the country in emergency medicine residencies. This training could prove to be essential in the future because of the global health crisis of the COVID-19 pandemic, but also for rural emergency patient care and remote educational programs.
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