{"id":19794,"date":"2019-08-06T10:19:18","date_gmt":"2019-08-06T15:19:18","guid":{"rendered":"https:\/\/feminem.org\/?p=19794"},"modified":"2019-08-06T10:19:20","modified_gmt":"2019-08-06T15:19:20","slug":"telehealth-education-and-the-resident","status":"publish","type":"post","link":"https:\/\/feminem.org\/2019\/08\/06\/telehealth-education-and-the-resident\/","title":{"rendered":"Telehealth Education and the Resident"},"content":{"rendered":"\n<p>In <a href=\"https:\/\/feminem.org\/2019\/05\/20\/telehealth-education-what-do-we-actually-need-for-our-clinical-practice\/\">my previous post<\/a>, I gave an overview of telehealth visit training basics, why it\u2019s important and how we framed it. While, the need for increasing and standardizing training for residents also applies to current providers, the needs are different. <\/p>\n\n\n\n<p>Our education has gone through several changes as we try to\nfigure out what is most relevant to the next generation of emergency physicians.\nIt\u2019s also a challenge to figure out how to implement a successful education\nprogram due to the following challenges inherent in our clinical practice:<\/p>\n\n\n\n<ul><li><em>Supervision:<\/em> Usually as residents progress, they become more independent with less and less need of direct supervision. Since there are few options to do this efficiently over Telehealth, it leads us back to directly supervising learners. The advantage, of course, is getting real time feedback both on clinical judgment as well as camera presence. It does, however, likely lead to a different behavior than may be present when not being supervised. <\/li><\/ul>\n\n\n\n<ul><li><em>Necessity:<\/em>\nTelehealth is a care modality, not a new branch of medicine so does it really\nneed specific education? Is it based on having a safe encounter, lack of tech\nissues, patient disposition, or whether there was a readmission within 72 hours?\nMost of these are standard QA clinical criteria and (mostly) irrelevant to\ntelehealth. <\/li><\/ul>\n\n\n\n<p>While that\u2019s true, telehealth is becoming more ubiquitous and necessary to expose our trainees. Currently since only used as care modality, the comfort has more to do with the provider\u2019s level and in person clinical experience. However, just as other parts of medicine have drastically changed, making telehealth visits an everyday part of graduate medical education may change that in the upcoming years. <\/p>\n\n\n\n<ul><li><em>Judging\ncompetency:<\/em> If the adage of 10k hours or patients is enough to be branded\nan expert, how do we extend that to telehealth. If you consider it only a care\nmodality, it likely means the components of webside manner including\nprofessional environment, patient interaction, eye contact and ability to\nresolve minor complaints without in person evaluation. &nbsp;Most of these are still not standardized. <\/li><\/ul>\n\n\n\n<ul><li><em>Unintended\nconsequences:<\/em> Most telehealth programs don\u2019t make use of students or\nresidents as the primary provider due to the above-mentioned need for\nefficiency. Because of this, education can be affected if attendings at\nteaching institutions are doing things that may be a necessary skill for\nresidents. For example, any program that uses their faculty to triage patients,\nwhether in person or over telehealth, leaves the initial evaluation, decision\nmaking and order placing to someone already experienced (we do it over\ntelehealth). There is less time to learn that skill in training. This is one\nreason it\u2019s important to note how changes to practice affect those you are\ntraining and try to predict the unintended consequences. Well, if not predict,\nat least account for them, be nimble and change the program. <\/li><\/ul>\n\n\n\n<p>Although not all of us are at teaching institutions, how we\nget trained in and use telehealth will affect everyone. It\u2019s not surprising\nthat we need ways to determine competency, how to do a quality visit and figure\nout what is important in EM. The future efforts at standardization will be\nessential so all future providers have access and feel comfortable with its\nuse. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>In my previous post, I gave an overview of telehealth visit training basics, why it\u2019s important and how we framed it. While, the need for increasing and standardizing training for residents also applies to current providers, the needs are different&#8230;.<\/p>\n","protected":false},"author":507,"featured_media":12929,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_mi_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":"","_jetpack_memberships_contains_paid_content":false,"jetpack_publicize_message":"@draditijoshi continues to #telehealth series, this time exploring the implications for resident training. @CORD_EM\n@JeffEMRes\n","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[1,5],"tags":[737,64,416],"coauthors":[795],"jetpack_publicize_connections":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Telehealth Education and the Resident - FemInEM<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/feminem.org\/2019\/08\/06\/telehealth-education-and-the-resident\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Telehealth Education and the Resident - FemInEM\" \/>\n<meta property=\"og:description\" content=\"In my previous post, I gave an overview of telehealth visit training basics, why it\u2019s important and how we framed it. 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