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      Avera eCARE: Medical Student Education in Telemedicine

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          Abstract

          The purpose of this research is to explore medical students’ knowledge of and interest in telemedicine services in urban and rural communities. In the past, medical students reported feeling unprepared to use telemedicine and uninformed about laws regarding telemedicine usage following graduation. However, they also reported that telemedicine training is relevant and important for their future work.

          Methods

          Study participants included medical students taking part in a 2-day telemedicine education program in 2018 and 2019. The first day included a faculty seminar where students were introduced to telemedicine by experts in telemedicine innovations. The second day was a simulation (SIM) day where medical students completed a rotation at the Avera eCARE virtual hospital hub. A survey was given prior to the faculty seminar and readministered following the SIM day. Questions were asked about telemedicine knowledge, curriculum, and willingness to practice via telemedicine.

          Results

          Chi-square analysis was used to look for associations pre/post by year. Both years showed an increase in favorable responses for questions to telemedicine training and education. For analyses by topic area, we created clusters of questions to build scores. T-tests were used to look for associations pre/post by year. The analysis resulted in three topic areas to build scores. Both years showed a significant increase in Rating of Overall Knowledge and Interest in Curriculum and Utilization. There was no significant difference in Willingness to Practice.

          Conclusions

          Results show notable differences in how students perceive and understand telemedicine after structured exposure to telemedicine services. Furthermore, this study demonstrates students’ need for and interest in more telemedicine training opportunities in their curriculum. There was no significant difference in the willingness to practice in rural settings. Future studies may focus on how telemedicine training is perceived by those more willing to work in rural communities.

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          Most cited references 6

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          Telemedicine Training in Undergraduate Medical Education: Mixed-Methods Review

          Background Telemedicine has grown exponentially in the United States over the past few decades, and contemporary trends in the health care environment are serving to fuel this growth into the future. Therefore, medical schools are learning to incorporate telemedicine competencies into the undergraduate medical education of future physicians so that they can more effectively leverage telemedicine technologies for improving the quality of care, increasing patient access, and reducing health care expense. This review articulates the efforts of allopathic-degree-granting medical schools in the United States to characterize and systematize the learnings that have been generated thus far in the domain of telemedicine training in undergraduate medical education. Objective The aim of this review was to collect and outline the current experiences and learnings that have been generated as medical schools have sought to implement telemedicine capacity-building into undergraduate medical education. Methods We performed a mixed-methods review, starting with a literature review via Scopus, tracking with Excel, and an email outreach effort utilizing telemedicine curriculum data gathered by the Liaison Committee on Medical Education. This outreach included 70 institutions and yielded 7 interviews, 4 peer-reviewed research papers, 6 online documents, and 3 completed survey responses. Results There is an emerging, rich international body of learning being generated in the field of telemedicine training in undergraduate medical education. The integration of telemedicine-based lessons, ethics case-studies, clinical rotations, and even teleassessments are being found to offer great value for medical schools and their students. Most medical students find such training to be a valuable component of their preclinical and clinical education for a variety of reasons, which include fostering greater familiarity with telemedicine and increased comfort with applying telemedical approaches in their future careers. Conclusions These competencies are increasingly important in tackling the challenges facing health care in the 21st century, and further implementation of telemedicine curricula into undergraduate medical education is highly merited.
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            Telemedical Education: Training Digital Natives in Telemedicine

            Telemedicine plays an important role in the delivery of medical care, and will become increasingly prominent going forward. Current medical students are among the first generation of “digital natives” who are well versed in the incorporation of technology into social interaction. These students are well positioned to apply advances in communications to patient care. Even so, providers require training to effectively leverage these opportunities. Therefore, we recommend introducing telemedicine training into medical school curricula and propose a model for incorporation.
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              The Use of Telemedicine to Address Access and Physician Workforce Shortages.

              The use of telemedicine technologies by primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists (henceforth referred to as "pediatric physicians") has the potential to transform the practice of pediatrics. The purpose of this policy statement is to describe the expected and potential impact that telemedicine will have on pediatric physicians' efforts to improve access and physician workforce shortages. The policy statement also describes how the American Academy of Pediatrics can advocate for its members and their patients to best use telemedicine technologies to improve access to care, provide more patient- and family-centered care, increase efficiencies in practice, enhance the quality of care, and address projected shortages in the clinical workforce. As the use of telemedicine increases, it is likely to impact health care access, quality, and education and costs of care. Telemedicine technologies, applied to the medical home and its collaborating providers, have the potential to improve current models of care by increasing communication among clinicians, resulting in more efficient, higher quality, and less expensive care. Such a model can serve as a platform for providing more continuous care, linking primary and specialty care to support management of the needs of complex patients. In addition, telemedicine technologies can be used to efficiently provide pediatric physicians working in remote locations with ongoing medical education, increasing their ability to care for more complex patients in their community, reducing the burdens of travel on patients and families, and supporting the medical home. On the other hand, telemedicine technologies used for episodic care by nonmedical home providers have the potential to disrupt continuity of care and to create redundancy and imprudent use of health care resources. Fragmentation should be avoided, and telemedicine, like all primary and specialty services, should be coordinated through the medical home.
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                Author and article information

                Journal
                TMT
                Telehealth and Medicine Today
                Partners in Digital Health
                2471-6960
                29 April 2020
                2020
                : 5
                Affiliations
                [1 ]Medical Director, Outreach and Innovation, Avera eCARE, Sioux Falls, South Dakota, and Assistant Professor, University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota
                [2 ]Graduate Research Assistant, Avera eCARE, Sioux Falls, South Dakota
                [3 ]Manager, Research and Quality, Avera eCARE, Sioux Falls, South Dakota
                [4 ]Biostatistician, Avera Research Institute, Sioux Falls, South Dakota; University of South Dakota, Sanford School of Medicine, Sioux Falls, South Dakota
                [5 ]Coordinator, Research Program, Avera eCARE, Sioux Falls, South Dakota
                [6 ]Dean, Rural Medicine, University of South Dakota, Sanford School of Medicine, Sioux Falls, South Dakota
                Author notes
                Corresponding Author: Kelly Rhone, MD FACEP, Avera eCARE 4500 N Lewis Ave Sioux Falls, South Dakota, USA, 57104, Email: kelly.rhone@ 123456avera.org
                Article
                179
                10.30953/tmt.v5.179
                © 2020 Kelly Rhone

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, adapt, enhance this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

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                Original Research

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