A Qualitative Study on Using Telemedicine for Precepting and Teaching in the Academic Setting

Author:

Raffa Brittany J.1ORCID,Muellers Kimberly A.2,Andreadis Katerina3,Ancker Jessica S.4,Flower Kori B.5,Horowitz Carol R.6,Kaushal Rainu7,Lin Jenny J.8

Affiliation:

1. B.J. Raffais clinical instructor and NRSA Primary Care Research Fellow, Department of Pediatrics, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

2. K.A. Muellersis a clinical research coordinator, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, and a PhD student, Department of Psychology, Pace University, New York, New York.

3. K. Andreadisis a PhD student, Department of Population Health, NYU Grossman School of Medicine, New York, New York.

4. J.S. Anckeris professor and vice chair for educational affairs, Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.

5. K.B. Floweris professor and division chief, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

6. C.R. Horowitzis founding director, Institute for Health Equity Research, and professor, Division of General Internal Medicine and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.

7. R. Kaushalis senior associate dean of clinical research, Nanette Laitman Distinguished Professor, and chair, Department of Population Health Sciences, Weill Cornell Medicine, and physician-in-chief, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.

8. J.J. Linis professor, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Abstract

Purpose To examine the impact of telemedicine use on precepting and teaching among preceptors and patients during the COVID-19 pandemic. Method The authors conducted a secondary analysis of a qualitative study focusing on providers’ and patients’ experiences with and attitudes toward telemedicine at 4 academic health centers. Teaching and precepting were emergent codes from the data and organized into themes. Themes were mapped to domains from the 2009 Consolidated Framework for Implementation Research (CFIR), a framework that assists with effective implementation and consists of 5 domains: intervention characteristics, outer settings, inner settings, characteristics of individuals, and process. Results In total, 86 interviews were conducted with 65 patients and 21 providers. Nine providers and 3 patients recounted descriptions related to teaching and precepting with telemedicine. Eight themes were identified, mapping across all 5 CFIR domains, with the majority of themes (n = 6) within the domains of characteristics of individuals, processes, and intervention characteristics. Providers and patients described how a lack of prepandemic telemedicine experience and inadequate processes in place to precept and teach with telemedicine affected the learning environment and perceived quality of care. They also discussed how telemedicine exacerbated existing difficulties in maintaining resident continuity. Providers described ways communication changed with telemedicine use during the pandemic, including having to wear masks while in the same room as the trainee and sitting closely to remain within range of the camera, as well as the benefit of observing trainees with the attending’s camera off. Providers expressed a lack of protected structure and time for teaching and supervising with telemedicine, and a general view that telemedicine is here to stay. Conclusions Efforts should focus on increasing knowledge of telemedicine skills and improving processes to implement telemedicine in the teaching setting in order to best integrate it into undergraduate and graduate medical education.

Funder

PCORI

NRSA Post-Doctoral Traineeship from the Health Resources and Services Administration

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Education,General Medicine

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Improving the Effectiveness of Telemedicine Services: A Conceptual Framework;2023 IEEE International Biomedical Instrumentation and Technology Conference (IBITeC);2023-11-09

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