COMMENTARY

More Telehealth Training Needed in Medical Education

Nicholas W. Kieran, MS; Yash B. Shah

Disclosures

November 18, 2022

Yash B. Shah<

Before joining medical school, we frequently imagined our roles as future physicians: long hours rounding on hospital floors, dealing with high-stress situations in the emergency department, or sitting with a family to help them process a difficult diagnosis. All of these situations centered around working in-person with patients.

One of our first times shadowing as newfound medical students, the physician started her day seeing patients in the clinic. She displayed empathy, held eye contact, carefully performed physical exam maneuvers, and comforted her patients, all of which were clinical practices that we had envisioned ourselves performing. After lunch, however, we moved to the physician's office, where she mentioned that her remaining appointments were via telemedicine.

Over the next 2 hours, we watched this highly skilled clinician struggle to connect with patients. Seamless interactions became choppy and unnatural, conversations felt forced, symptom assessment became less effective, and empathy failed to shine through. She explained that COVID had abruptly forced her to move to this platform, where she felt unprepared.

Nicholas W. Kieran, MS

After this interaction, we aimed to learn more about the growing role of telemedicine. We attended a talk by Judd Hollander, MD, head of Thomas Jefferson University's industry-leading telemedicine program. Hollander demonstrated that with some creativity, telemedicine can be as effective as in-person visits for most encounters. Modified virtual physical exams can be performed, patient medications and home-environment can be better appreciated, and patient comfort can be enhanced. To reach this potential, however, clinicians need better training.

Given the sudden transition to telemedicine, clinicians and hospital systems were understandably unprepared. With telemedicine continuing to expand, it's imperative that future physicians be properly trained in this virtual setting.

Today, we are determined to be leaders in medical education to catalyze the adoption of telemedicine training for medical students. My shadowing experience juxtaposed a physician's masterful in-person care and their struggles via telemedicine, demonstrating the importance of proper training for telemedical practice. We must aim to use this technology to improve access and reduce inequalities, and we commit ourselves to continuously seeking training throughout our careers to be best prepared for real-world care.

Nicholas W. Kieran and Yash B. Shah are second-year medical students at Sidney Kimmel Medical College.

Kieran earned a Bachelor of Science in Interdepartmental Honors Immunology and a Master of Science in immunology from McGill University. His past research interests have included multiple sclerosis, stroke, and cardiology. He is actively involved in community outreach, expanding medical services via telemedicine, and scientific research projects that aim to better diagnose or treat patients with various illnesses.

Shah earned a Bachelor of Science in premedicine from Penn State University. Prior to attending medical school, Yash worked on clinical and translational research in hematology-oncology at the Children's Hospital of Philadelphia. He has long-standing interests in advancing medical education, improving healthcare policy and economics, and working with patients with cancer.

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