Novel application of telemedicine and an alternate EHR environment for virtual clinical education: A new model for primary care education during the SARS-CoV-2 pandemic

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.