Background

Restrictions to direct patient contact resulting from the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic left some medical students near graduation in need of a required critical care medicine (CCM) sub-internship. A group of educators deployed a virtual curriculum utilizing telemedicine and electronic health record (EHR) technologies.

Methods

Nine students participated in a formal curriculum of high-value critical care medicine topics designed to meet the learning objectives of the in-person experience. Students obtained patient histories and directed physical examinations virtually via telemedicine. They followed assigned patients, submitted clinical documentation, and practiced electronic order entry using a non-production EHR copy. At conclusion these students completed the same evaluation used for “in-person” CCM rotations earlier in the year.

Results

Students rated the virtual rotation comparably to the traditional rotation in most evaluated criteria. Lower rated areas included “perform minor procedures”, “patient counseling”, and “interprofessional experiences”. Students’ narrative responses specifically noted strengths of the “student focus” and the ability to practice in an EHR copy.

Discussion

Students and preceptors generally found that the virtual curriculum provided adequate educational opportunities. Certain areas were clearly lacking, as expected. Students felt the dedication of the faculty to the students’ educational needs was the most important factor contributing to the success of the program. The results suggest several ways telemedicine and EHR technologies might enhance clinical medical education in the future.

Conclusion

This methodology was successful in providing elements of a CCM rotation experience. This technology could prove efficacious for primary care rotations where in-person training is not feasible due to the SARS-CoV-2 pandemic.

中文翻译：

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远程医疗的新应用和虚拟临床教育的替代 EHR 环境：SARS-CoV-2 大流行期间初级保健教育的新模式

背景

由于严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 大流行导致直接接触患者受到限制，一些即将毕业的医学生需要进行必要的重症监护医学 (CCM) 实习。一组教育工作者利用远程医疗和电子健康记录 (EHR) 技术部署了虚拟课程。

方法

九名学生参加了旨在满足亲身体验的学习目标的高价值重症监护医学主题的正式课程。学生几乎可以通过远程医疗获得病史并指导体检。他们跟踪指定的患者，提交临床文件，并使用非生产 EHR 副本练习电子订单输入。最后，这些学生完成了今年早些时候用于“面对面”CCM 轮换的相同评估。

结果

在大多数评估标准中，学生对虚拟轮换的评价与传统轮换相当。评分较低的领域包括“执行小手术”、“患者咨询”和“跨专业经验”。学生的叙述性反应特别指出了“以学生为中心”的优势和在 EHR 副本中练习的能力。

讨论

学生和导师普遍认为虚拟课程提供了足够的教育机会。正如预期的那样，某些领域显然缺乏。学生们认为教师对学生教育需求的奉献是促成该计划成功的最重要因素。结果表明，远程医疗和 EHR 技术可以通过多种方式加强未来的临床医学教育。

结论

这种方法成功地提供了 CCM 轮换经验的要素。由于 SARS-CoV-2 大流行，无法进行面对面培训的情况下，这项技术可能对初级保健轮换有效。