The Virtual Visit: A Telehealth Curriculum for Internal Medicine Residents Featuring a Virtual Physical Examination

Abstract

Background During the COVID-19 pandemic, medical professionals were obligated to adapt to virtual care. Most resident physicians had no formal telehealth training. The virtual physical examination remained underutilized. Objective We describe a needs assessment leading to the creation of a telehealth curriculum for internal medicine (IM) and internal medicine pediatric (IM/P) residents, and report changes in residents’ confidence level as well as feasibility data. We hypothesized that residents’ confidence in delivering virtual care would significantly improve after implementing a telehealth curriculum. Methods A needs-based assessment for all University of California Los Angeles (UCLA) IM and IM/P residents was conducted in July 2020. Specific competencies were identified: (1) telehealth legal guidelines; (2) virtual physical examination; (3) health equity; and (4) telehealth chronic disease management. The curriculum was presented via 3 synchronous interactive online interventions between November 2020 and March 2021. Pre- and post-intervention learner assessments were conducted. Results Out of all 180 residents, 146 UCLA IM and IM/P residents completed pre- and post-Virtual Physical Examination curriculum surveys, which were not uniquely linked to individuals. Residents reported statistically significant increased confidence levels in performing a targeted virtual physical examination (P<.001; 95% CI 0.97-1.35), engaging patients or caregivers to assist in virtual examinations (P<.001; 95% CI 0.76-1.21), and using remote monitoring devices (P<.001; 95% CI 0.58-1.03). Conclusions Our results demonstrate that, within our IM and IM/P residency programs, a formalized telehealth curriculum significantly improved residents’ confidence in delivering virtual care.