647 - Improving Competency and Equitable Care through a Novel Residency Telemedicine Curriculum

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 647
Publication Number: 647.456

Andrew J. Carlson, Connecticut Children's Medical Center, Milford, CT, United States; Carla M. Pruden, Connecticut Children's Medical Center, Hartford, CT, United States; Matthew Nardozza, Connecticut Children’s, Hartford, CT, United States; Richelle deMayo, University of Connecticut, Westport, CT, United States; Sharon Smith, UConn/CT Children's, Canton, CT, United States; Natalie S. Bezler, University of Connecticut School of Medicine, Hartford, CT, United States; Cem S.. Demirci, University of Connecticut, Farmington, CT, United States; Barbara Edelheit, Connecticut Children's Medical Center, Hartford, CT, United States; Kelly Smith, Connecticut Children's Medical Center, Hartford, CT, United States; Nancy Presnick, University of CT Pediatrics Residency, Connecticut Childrens, Hartford, CT, United States; Lauren Weaver, Connecticut Children's Medical Center, Hartford, CT, United States; Emily Colpas, University of Connecticut School of Medicine/Connecticut Children’s, Glastonbury, CT, United States

Presenting Author(s)

Andrew J. Carlson, MD (he/him/his)

Medical Director, Division of Primary Care
Connecticut Children's Medical Center
Milford, Connecticut, United States

Background:

Background: The move to telemedicine in 2020 dictated the development of a formal telemedicine curriculum (TMC) for residents. Designed to address the AAMC telehealth competencies, an AAMC Equity Catalyst grant funded this project.

Objective:

Objectives:

Develop the necessary knowledge and skills to deliver telemedicine-based patient care

Introduce broad applications of telehealth

Improve the quality and safety of telemedicine care

Improve access to telemedicine for all patients

Design/Methods:

Methods: Pediatric residents from all graduate levels collaborated with interprofessional content experts in simulation (SIM), education, and information systems to develop content and evaluation tools for a 3-year longitudinal telemedicine curriculum (TMC).

Goals: Address technological instruction needs, confront health equity issues, design scalable but “personalized” learning modalities, and create content and processes applicable to multiple roles.

Activities: Experiential learning sessions designed to practice essential telemedicine skills and expose participants to potential disparities, included:

Hopkins PEAC Telehealth module

Written curriculum with literature citations and supporting video

Twice yearly SIM sessions

Case-Based Branching Scenario Learning (CBB)

The small group SIM sessions utilized peer facilitation and content expert debriefing. Software hosted on a local server supported CBB activities. The CBB sessions provided opportunities to elicit and evaluate implicit biases from responses to paired case presentations. Residents provide TM care with faculty in primary care and subspecialty settings with yearly Structured Clinical Observations.

Results:

Results: All interns completed a needs assessment and orientation SIM. Most were comfortable with telehealth functionality yet identified challenges with physical exams and legal requirements. All residents completed PEAC modules with improved pre vs post-knowledge scores similar to national averages.

SIM 1 - 11 small groups; taught basics of video visits

SIM 2 -14 small groups; included implicit biases

Both SIMs assessed ten basic skills (table 1). Resident SIM surveys: 100% strongly agree/agree that time well spent, low-stress environment, CBB technology conducive to learning, and 95% small group debriefing was beneficial.

Conclusion(s):

Conclusion: This novel TMC combined online modules, written and video content, simulation, and CBB scenario learning to complement real-world use in clinical settings. Simulation and branched scenario learning also allowed the exploration of implicit biases in telemedicine in a safe environment for learners.