Incorporating Telemedicine Education in the Medical School Curriculum
There are unique barriers to incorporating telemedicine competencies to the existing curriculum: a busy schedule, limited institutional and financial resources, lack of experienced faculty and lack of available telemedicine curriculum
This article highlights 3 ways to incorporate telemedicine into the curriculum
December 10, 2019 — As I’ve mentioned before, the diffusion and impressive growth of telemedicine has exposed the lack of telemedicine training in medical schools. Telemedicine has been adopted by payers, employers and hospitals. More recently states have adopted telemedicine-friendly policy to drive further expansion of telemedicine. In addition, many federal agencies such as the Office for the Advancement of Telehealth (HRSA), Dept of Agriculture, VA Health System and CMS are supporting telehealth and telemedicine initiatives.
Makes sense that telemedicine should be included in medical schools’ curriculum. It’s a “no-brainer”, Right? Not so quick. Medical education and the practice of medicine has been gradually evolving for centuries. However, over the last 20 years the practice of medicine has changed rapidly — driven by consumer demand and digital technology — while medical educators are trying to find unique and innovative ways to prepare students for the future of health care delivery.
Adding Topics to a Curriculum is Difficult
The academic calendar and curriculum schedule are too “busy”, not to mention the limited institutional and financial resources most schools face. Other barriers that apply specifically to telemedicine education include lack of experienced faculty to teach and lack of available telemedicine curriculum.
Do not be discouraged though. In this article I want to highlight a few ways to incorporate telemedicine into a medical school curriculum without much disruption. Here are 3 ways to incorporate telemedicine education into the curriculum.
Interprofessional Education Competencies
The goal of inter-professional education (IPE) is to prepare all health profession students for working together with the goal of providing quality care in a patient-centered manner. The following are core competencies of IPE:
Values/Ethics for Inter-professional Collaboration (IPC)
Roles/Responsibilities
Inter-professional communication
Teams/Teamwork
Telemedicine and IPE/IPC go hand-in-hand. This modality facilitates a team-based approach by removing geographic and distance barriers. Incorporating telemedicine into IPE competencies would certainly allow students learn about telemedicine in a meaningful way. Here are a few telemedicine skills that could be incorporated in IPE:
Ability to discuss the clinical limitations of telemedicine among the team
Ability to build trust and rapport in a virtual environment
Knowledge of how technology can be used in sharing information with colleagues and patients
Supports IPE/IPC and communicate readiness to work together as a team
Ability to help the team feel at ease when insecurity about using technology ensues
Ability to troubleshoot communication difficulties in a virtual environment
Approaches virtual consultations from the perspective of the referring team member’s needs
Uses virtual consultation as an opportunity to build ongoing professional relationships
Rural Health Competencies
Telemedicine is a great way to increase access to quality care in rural communities. It achieves this by removing geographic and distance barriers. Rural health competencies focus on addressing the social determinants of health such as economic stability, education, food insecurity, neighborhood and environment, and access to health care. Telemedicine addresses another important issue in rural health: the physician geographic maldistribution. This refers to the fact that most medical specialties tend to concentrate in tertiary care centers — usually located in urban areas — creating a disadvantage for rural communities. Here are some telemedicine skills that can be incorporated in the rural health course:
Understands how telemedicine can be used to increase access to care in rural communities
Knows how social determinants influence access to in-person care
Adjusts interview to patient’s technological preferences
Knows how to tailor recommendations to available resources, cultural specificity and patient preferences
Provider is sensitive of impact of disclosures on patient confidentiality and relationships in small communities
Humanities and Ethics Competencies
Telemedicine is reshaping the physician-patient relationship. While telemedicine is embraced as a new way to deliver care, patients need to be able to trust that physicians will place patient welfare above other interests. Within the medical curriculum there are competencies related to professionalism, ethics, cultural competency and the physician-patient relationship. Telemedicine skills can easily be incorporated into these subjects. Here are a few examples:
Knowledge of how to establish a physician-patient relationship via telemedicine
Ability to trouble-shoot informed consent problems and telemedicine appropriateness
Understands the importance of privacy, security and integrity of patient’s information in the virtual environment
Understands the importance of keeping an ethically-correct attitude during a telemedicine visit — confidentiality, personal and professional integrity
Assure proficiency in the use of telemedicine technologies
Consider diversity of patient, family and communities during the virtual interaction
Considers and adjusts to patient’s culture, values and preferences during the virtual interaction
These simple interventions are effective in exposing students to the basics of telemedicine without disrupting the curriculum schedule. However, these could serve as “seed” for further diffusion of telemedicine in the curriculum. We should keep in mind that faculty development is necessary when adding telemedicine into the curriculum (this would be discussed separately in the future).
As usual, if you have any questions this article, feel free to contact me.
