Operations and Implementation

Ignite Sessions

O-04 - Standardizing Telemedicine Training: Development, Implementation and Evaluation of a Blended Curriculum

Sunday, April 29
3:00 PM - 3:09 PM
Location: Innovation Zone, Booth 434

Background:
The implementation of telemedicine programs across the country is increasing due to healthcare needs and consumer demand. While there is literature on the benefits of telemedicine, there is little information on how to train providers in using telemedicine effectively and safely. As with any other skill, learning to integrate telemedicine into clinical workflows and patient care requires dedicated time, resources and training to create a standardized operation. Few programs have formal, standardized training in providing telemedicine. We have developed, implemented and evaluated a comprehensive simulation-based blended-learning training curriculum for emergency medicine physicians.

Methods:
This study was a prospective, single-site, intervention at an academic children's hospital, which was preparing to implement an Emergency Department (ED) telemedicine program, Emergency Care Connect (ECC). The ECC program was implemented over the period of three months and consisted of three phases. The first two are mandatory to obtain privileges as a telemedicine provider: (a) round table session (b) individual session. A third optional step consisted of (c) open office hours with program leaders, as an opportunity to reinforce new skills learned. Prior to participation in the sessions, trainees were provided with an introductory video recording of a simulated ECC encounter.
30 faculty members were divided into groups of 5-8 participants for the round table sessions, which were designed to: provide a program overview, demonstrate simulated patient care encounters, and allow for hands-on practice. Topics covered included program standards, workflows, virtual presence training, technical equipment, and an introduction to the ECC Virtual Handbook, an easily accessible online resource developed for provider reference and decision support.

Individual sessions enabled the prospective ECC provider an opportunity for hands-on practice of the new skill and allowed for assessment of program readiness and proficiency. These sessions consisted of three simulated consultations, ranging from simple medical questions to sensitive subjects and complex situations (e.g., dealing with an angry parent, disclosure of sensitive information). Proficiency was assessed using a dichotomous checklist; employing the technique of deliberate practice to ensure that mastery was achieved on critical items. The checklists were developed according to a review of existing literature and expert feedback.

Data collection
To assess the effectiveness of this intervention, we distributed web-based, anonymous pre/post surveys. Data was analyzed using paired t-tests for the paired data and descriptive statistics for the additional, free-text, question on the post-survey.

Results:
Response rate for the pre and post session surveys were 100% and 76% respectively. There was a significant difference in knowledge and attitudes after our intervention, specifically regarding technology and medico-legal/risk issues (p < 0.05). Additional qualitative comments were abstracted and will be reported.

Conclusions:
We describe the development, implementation, and evaluation of a blended model curriculum for training ED providers in telemedicine. Our curriculum demonstrated evidence for knowledge improvement in our pilot study population. This intervention has been subsequently adopted hospital-wide, given its easy reproducibility as well as customizable nature. Future work includes continual improvements and evaluations to better assess generalizability and adaptability across the various healthcare specialties.

Learning Objectives:

Dana Aronson. Schinasi

Attending Physician, Pediatric Emergency Medicine
Northwestern University

Dr Schinasi is a physician in Pediatric Emergency Medicine, and the Medical Director of Emergency Care Connect, Ann & Robert H. Lurie Children's Hospital of Chicago's ED-based telemedicine program that provides virtual support to partnering EDs. She has a background in medical education and simulation, with a strong interest in quality improvement and research.

Presentation(s):

Send Email for Dana Schinasi


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